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Background: Echinococcosis is a uncommon condition in pediatric patients, and encompasses alveolar and cystic forms, predominantly affecting the lungs and liver. Transmission occurs primarily through zoonotic means, such as the contamination of water and food by infected dog and other canid feces. Diagnosis can be challenging due to nonspecific symptoms that often mimic pneumonia. The case: A 6-year-old female patient from a rural area in Ecuador who initially presented with nonspecific symptoms indicative of pneumonia. However, further investigation into socio-environmental factors led to a diagnosis of pulmonary and hepatic hydatid disease. Conclusion: The timely and accurate diagnosis of this infectious disease enabled the patient to receive appropriate treatment and surgical intervention, leading to her complete recovery.
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The aim of this paper is to better understand the dynamics of crystallogenic and starting activity in biological fluids of patients throughout surgery and the late postoperative phase in alveococcosis. Samples of saliva from 22 individuals with alveococcosis were included in the research. Biological fluid samples were taken at the time of admission and before the patient was discharged. Following that, slides were made utilizing the teziocrystalloscopy method, which incorporates the investigation of the crystal forming activity of mixed saliva with its starting characteristics using a 0.9 percent sodium chloride solution as the foundation ingredient. Using our own set of criteria, we evaluated the outcomes of crystalloscopic and tezigraphic experiments. Specrophotometric examination of tezigraphic and crystalloscopic facies was done using a PowerWave XS microplate spectrophotometer at wavelengths of 400, 350, and 300 nm to augment the results from ocular morphometry of dried saliva micro slides. Surgical therapy results in a partial normalization of physical and chemical parameters, as well as the composition of the patient's biological fluids after the patient is discharged from the hospital.
O objetivo deste trabalho foi compreender melhor a dinâmica da atividade cristalogênica e inicial nos fluidos biológicos dos pacientes durante a cirurgia e na fase pós-operatória tardia da alveococose. Amostras de saliva de 22 indivíduos com alveococose foram incluídas na pesquisa. Amostras de fluidos biológicos foram coletadas no momento da admissão e antes da alta do paciente. Em seguida, foram confeccionadas lâminas utilizando a técnica de teziocristaloscopia, que combina a investigação da atividade formadora de cristais da saliva mista com suas características iniciais, utilizando uma solução de cloreto de sódio a 0,9% como ingrediente-base. Usando nosso próprio conjunto de critérios, avaliamos os resultados de experimentos cristaloscópicos e tezigráficos. O exame espectrofotométrico da fácies tezigráfica e cristaloscópica foi feito usando um espectrofotômetro de microplaca PowerWave XS nos comprimentos de onda de 400, 350 e 300 nm para aumentar os resultados da morfometria ocular de microplacas de saliva seca. A terapia cirúrgica resulta na normalização parcial dos parâmetros físicos e químicos, bem como da composição dos fluidos biológicos do paciente, após a alta hospitalar.
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Humanos , Saliva/fisiologia , Saliva/química , Procedimentos Cirúrgicos Operatórios , EquinococoseRESUMO
Introducción: La hidatidosis, conocida también como equinococosis quística (EQ), es una zoonosis poco frecuente causada por el parásito Echinococcus, de la clase de los céstodos, del filio platelmintos. Se han descrito cuatro especies, los de importancia médica en humanos son: el Echinococcus multilocularis, Echinococcus vogeli y Echinococcus granulosus , este último responsable del 95% de los casos reportados de hidatidosis humana. Frecuentemente afectan la cavidad abdominal ubicándose en hígado, bazo, riñón, músculo y es poco común en retroperitoneo. Caso clínico : se trata de paciente masculino de 30 años, presentando dolor abdominal en hemiabdomen derecho, con limitación funcional de la marcha y estreñimiento, posterior a estudios de imágenes, se confirma patología compatible con hidatidosis abdominal en retroperitoneo derecho, se inicia tratamiento médico antiparasitario por un mes y luego se realiza resolución quirúrgica para resección de quiste retroperitoneal derecho, con buenos resultados. Conclusión : Este reporte debe su importancia a la escasa frecuencia con que se ha documentado esta patología en el país, sobre todo en la región oriental(AU)
Introduction: Hydatid disease, also knowns as echinococcosis, is an uncommon zoonosis frequently caused by the Echinococcus parasite, class cestodes, and phylum flatworms. Four species have been described, the ones with human medical relevance are multilocularis echuinococcus, vogeli echinococcus y granulosus echinococcus, last one being responsible for 95% of the human hydatidosis cases reported. They frequently affect the abdominal cavity, are located in the liver, spleen, kidney, and muscle, and rarely in the retroperitoneum.Clinical case : it is about a male patient, 30 years old, with symptoms for 3 years, feeling abdominal pain in right hemi-abdomen, ambulation disturbance, and constipation; after imaging tests is confirmed pathology compatible with Hydatid disease in right hemi-abdomen, Antiparasitic medical treatment was started for a month and then open surgical resolution was performed by resection of the right retroperitoneal cyst, with good results.Conclusion : This report owes its importance to the limited documented cases in the country, especially in the eastern region. It is also relevant because of the little-known special surgical technique used and the constant influx of foreigners in the country with unusual epidemiological pathologies that require treatment during their stay(AU)
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Humanos , Masculino , Adulto , Equinococose/diagnóstico , Cestoides , Cavidade AbdominalRESUMO
Abstract Hydatid cysts are rarely detected in the muscle tissue, even in endemic countries. Echinococcus granulosis is the most common causative agent, whereas Echinococcus alveolaris is rare. Three patients, two females and one male, with primary echinococcosis of the skeletal muscles are described in this report. Mean patient age was 33.3 ± 14.6 years. The disease occurred as soft tissue masses in all three patients, and no hydatid foci were detected elsewhere in the patients. Skeletal muscle echinococcosis should be considered in the differential diagnosis of limb masses, especially in endemic countries.
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Humanos , Animais , Masculino , Feminino , Adolescente , Adulto , Adulto Jovem , Equinococose/diagnóstico por imagem , Echinococcus , Extremidade Inferior , Diagnóstico Diferencial , Pessoa de Meia-IdadeRESUMO
INTRODUCTION: Hydatid cyst is a parasitic disease caused by Echinococcus granulosus, most commonly seen in the liver and lungs. The hydatid cyst is rarely seen in the heart and iliofemoral region, representing less than 2% of all cases. In this article, we report our cases of hydatid cysts in unusual loci. METHODS: Between 2015 and 2018, 6 rare cases of hydatid cysts were diagnosed at the Cardiovascular Surgery Department of Harran University. Four of these patients had cardiac localization and two patients had their cysts located in the iliofemoral region, extending to the pelvic zone. All patients were female. Three patients had no other organ involvement. One patient with cardiac hydatid cyst underwent normothermic cardiopulmonary bypass + total pericystectomy + Cooley-like aneurysmectomy. Total pericystectomy was performed in three other patients with intrathoracic locus by normothermic cardiopulmonary bypass. Two patients who were referred to our clinic with palpable iliofemoral mass were evaluated with appropriate imaging methods and diagnosed accordingly. Multiple iliofemoral cysts were managed with pericystectomy and drainage by a single incision made over the inguinal ligament. CONCLUSION: Hydatid cyst disease can develop in cardiac chambers and inguinal region with or without hepatic or pneumatic involvement. Normothermic cardiopulmonary bypass can be safely used in patients with cardiac hydatid cysts, and capitonnage similar to ventricular aneurysm repair in patients with a widely involved cystic lesion can be very useful for the protection of ventricular functions.
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Equinococose , Cardiopatias , Adolescente , Adulto , Criança , Equinococose/diagnóstico por imagem , Equinococose/cirurgia , Feminino , Coração , Cardiopatias/diagnóstico por imagem , Cardiopatias/cirurgia , Ventrículos do Coração , Humanos , Fígado , Adulto JovemRESUMO
Abstract Introduction: Hydatid cyst is a parasitic disease caused by Echinococcus granulosus, most commonly seen in the liver and lungs. The hydatid cyst is rarely seen in the heart and iliofemoral region, representing less than 2% of all cases. In this article, we report our cases of hydatid cysts in unusual loci. Methods: Between 2015 and 2018, 6 rare cases of hydatid cysts were diagnosed at the Cardiovascular Surgery Department of Harran University. Four of these patients had cardiac localization and two patients had their cysts located in the iliofemoral region, extending to the pelvic zone. All patients were female. Three patients had no other organ involvement. One patient with cardiac hydatid cyst underwent normothermic cardiopulmonary bypass + total pericystectomy + Cooley-like aneurysmectomy. Total pericystectomy was performed in three other patients with intrathoracic locus by normothermic cardiopulmonary bypass. Two patients who were referred to our clinic with palpable iliofemoral mass were evaluated with appropriate imaging methods and diagnosed accordingly. Multiple iliofemoral cysts were managed with pericystectomy and drainage by a single incision made over the inguinal ligament. Conclusion: Hydatid cyst disease can develop in cardiac chambers and inguinal region with or without hepatic or pneumatic involvement. Normothermic cardiopulmonary bypass can be safely used in patients with cardiac hydatid cysts, and capitonnage similar to ventricular aneurysm repair in patients with a widely involved cystic lesion can be very useful for the protection of ventricular functions.
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Humanos , Feminino , Criança , Adolescente , Adulto , Adulto Jovem , Equinococose/cirurgia , Equinococose/diagnóstico por imagem , Cardiopatias/cirurgia , Cardiopatias/diagnóstico por imagem , Coração , Ventrículos do Coração , FígadoRESUMO
Persistent extracellular tissue-dwelling pathogens face the challenge of antibody-dependent activation of the classical complement pathway (CCP). A prime example of this situation is the larva of the cestode Echinococcus granulosus sensu lato, causing cystic echinococcosis. This tissue-dwelling, bladder-like larva is bounded by a cellular layer protected by the outermost acellular "laminated layer" (LL), to which host antibodies bind. The LL is made up of a mucin meshwork and interspersed nano-deposits of calcium inositol hexakisphosphate (calcium InsP6). We previously reported that calcium InsP6 bound C1q, apparently initiating CCP activation. The present work dissects CCP activation on the LL. Most of the C1 binding activity in the LL corresponded to calcium InsP6, and this binding was enhanced by partial proteolysis of the mucin meshwork. The remaining C1 binding activity was attributable to host antibodies, which included CCP-activating IgG isotypes. Calcium InsP6 made only a weak contribution to early CCP activation on the LL, suggesting inefficient C1 complex activation as reported for other polyanions. CCP activation on calcium InsP6 gave rise to a dominant population of C3b deposited onto calcium InsP6 itself that appeared to be quickly inactivated. Apparently as a result of inefficient initiation plus C3b inactivation, calcium InsP6 made no net contribution to C5 activation. We propose that the LL protects the underlying parasite cells from CCP activation through the combined effects of inefficient permeation of C1 through the mucins and C1 retention on calcium InsP6. This mechanism does not result in C5 activation, which is known to drive parasite-damaging inflammation.
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Antígenos de Helmintos/imunologia , Via Clássica do Complemento , Proteínas do Sistema Complemento/imunologia , Echinococcus granulosus/imunologia , Ácido Fítico/imunologia , Animais , Antígenos de Helmintos/química , Ativação do Complemento , Proteínas do Sistema Complemento/metabolismo , Equinococose/imunologia , Equinococose/parasitologia , Interações Hospedeiro-Parasita/imunologia , Humanos , Imunoglobulina G/imunologia , Imunoglobulina M/imunologia , Ácido Fítico/química , Ligação ProteicaRESUMO
INTRODUCTION: Oxfendazole (methyl [5-(phenylsulphinyl)-1H benzimidazole-2-yl] carbamate) has a particularly long metabolic half-life in ruminants, and its metabolite fenbendazole also has anthelminthic action. A very limited number of drugs are available for the treatment of some zoonotic helminth infections, such as neurocysticercosis and echinococcosis. More recent work has expanded oxfendazole's nonclinical safety profile and demonstrated its safety and bioavailability in healthy human volunteers, thus advancing the possibility of a new and greatly needed option for antiparasitic treatment of geohelminths and tissue parasites. Areas covered: The present article reviews evidence supporting the safety and efficacy of oxfendazole against both gut and tissue dwelling helminths in animals, as well as more recent safety and pharmacokinetic data supporting its potential for use in human parasitoses. Expert commentary: The pharmacokinetics, safety, and wide spectrum of efficacy of oxfendazole are consistently demonstrated in intestinal helminth infections of animals as well as in tissue dwelling larval cestode and trematode infections in diverse animal species. Now supported by first-in-human safety and pharmacokinetic data, oxfendazole becomes a promising alternative to the limited portfolio of antiparasitic drugs available to treat helminthic diseases of humans.
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Anti-Helmínticos/uso terapêutico , Benzimidazóis/uso terapêutico , Helmintíase/tratamento farmacológico , Animais , Anti-Helmínticos/efeitos adversos , Anti-Helmínticos/farmacocinética , Benzimidazóis/efeitos adversos , Benzimidazóis/farmacocinética , Disponibilidade Biológica , Meia-Vida , Helmintíase/parasitologia , Helmintíase Animal/tratamento farmacológico , Helmintíase Animal/parasitologia , Humanos , Zoonoses/tratamento farmacológico , Zoonoses/parasitologiaRESUMO
Introducción: La cirugía es el tratamiento más efectivo para los pacientes portadores de quistes hidatídicos hepáticos (QHH). Actualmente no existe consenso si la cirugía abierta o laparoscópica es la mejor vía de tratamiento. El objetivo del presente estudio es describir la técnica quirúrgica y los resultados de la cirugía radical (periquistectomía) por vía laparoscópica. Materiales y métodos: Estudio de cohorte no concurrente. Se incluyeron a los pacientes portadores de QHH no complicados en los que se realizó periquistectomía radical laparoscópica entre los años 2007 y 2015 en el Hospital Clínico de la Pontificia Universidad Católica de Chile. Se consignaron variables demográficas, clínicas, características del QHH, morbimortalidad y recurrencia en el seguimiento. Resultados: Se operaron 24 pacientes. La mediana de edad fue de 35 años (3-79). La mediana de tamaño del QHH fue de 8 cm (3-15). Las complicaciones postoperatorias se presentaron en 4 casos (16%); un paciente presentó una fístula biliar (4,1%). No hubo mortalidad en este estudio y la estadía hospitalaria fue de 3 días (2-25). La mediana de seguimiento fue de 57,5 meses (9-106); se observó un caso de recurrencia a nivel hepático que requirió otra cirugía. Conclusiones: El tratamiento radical de los QHH no complicados por vía laparoscópica es factible y seguro; al compararlo con la literatura existente no se aprecian diferencias en la morbimortalidad ni recurrencia.
Introduction: Surgery is the most effective treatment for patients with hepatic hydatid cysts (HHC). Currently there is no consensus whether open or laparoscopic surgery is the best treatment. The aim of this study is to describe the surgical technique and the results of laparoscopic radical surgery (pericystectomy). Material and methods: Non-concurrent cohort study. We included patients with uncomplicated HHC in which it was performed a laparoscopic radical pericystectomy between 2007 and 2015 at the Clinical Hospital of the Pontificia Universidad Catolica de Chile. Demographic and clinical variables, HHC characteristics, morbi-mortality and recurrence at follow-up were recorded. Results: Twenty-four patients were operated. The median age was 35 years (3-79). The median HHC size was 8 centimeters (3-15). Postoperative complications occurred in 4 cases (16%); one patient had a biliary fistula (4.1%). There was no mortality in this study and the hospital stay was 3 days (2-25). Median follow-up was 57.5 months (9-106); a case of hepatic recurrence requiring another surgery was observed. Conclusions: The radical treatment of uncomplicated HHC by laparoscopic surgery is feasible and safe; when compared with existing literature there is no differences in morbi-mortality or recurrence.
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Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Laparoscopia/métodos , Equinococose Hepática/cirurgia , Seguimentos , Resultado do TratamentoRESUMO
Hydatid disease is a parasitic infection whose etiologic agent is Echinococcus granulosus. Human is an accidental intermediate host and the most common site is the liver. The brain involvement is unusual and up to 75% of cases are described in the pediatric population. We present six children with cerebral hydatid disease admitted to the Pediatric Hospital J.P. Garrahan. All had neurological involvement on admission. The images showed single cystic lesion in the brain. They did not present involvement in other organs. Serology was negative in all cases. Medical and surgical treatment in all cases. The clinical outcome was favorable without sequelae in five of them and one had a residual paresis right faciobrachiocrural. This infection should be considered in the differential diagnosis of cystic tumor lesions of the central nervous system.
La hidatidosis es una infección parasitaria causada por Echinococcus granulosus. El ser humano es un hospedero intermediario accidental. La localización más frecuente es la hepática. El compromiso cerebral es inusual, se describe que hasta 75% ocurre en población pediátrica. Se presenta una serie de seis niños con hidatidosis cerebral internados en el Hospital de Pediatría J. P. Garrahan. Todos presentaron compromiso neurológico al ingreso. Las imágenes mostraron lesiones quísticas únicas en el cerebro. No tuvieron compromiso de otros órganos. La serología fue negativa en todos los casos. El tratamiento fue médico-quirúrgico. La evolución clínica fue favorable sin secuelas en cinco de ellos y uno presentó una hemiparesia faciobraquiocrural derecha como secuela. Esta infección debe considerarse entre los diagnósticos diferenciales de lesiones tumorales quísticas del sistema nervioso central.
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Humanos , Masculino , Feminino , Pré-Escolar , Criança , Encefalopatias/diagnóstico , Helmintíase do Sistema Nervoso Central/diagnóstico , Equinococose/diagnóstico , Encefalopatias/cirurgia , Helmintíase do Sistema Nervoso Central/cirurgia , Equinococose/cirurgiaRESUMO
Cystic echinococcosis is a highly endemic parasitic zoonosis that is present in the Southern Cone countries of America. For several decades, various prevention and control programmes have been implemented in different countries and regions, with varying results. In Uruguay, a new control programme was implemented in 2006 that employed new strategies for canine diagnosis and treatment, dog population control, diagnosis in humans, epidemiological surveillance, and health education, including community participation. The control programme in Uruguay addresses the control and surveillance of the disease from a holistic perspective based on Primary Health Care, which has strengthened the community’s participation in developing and coordinating activities in an interdisciplinary manner. Similarly, the control programme that is currently implemented is based on a risk-focused approach. The surveillance and control measures were focused on small villages and extremely poor urban areas. In this study, the strategies used and the results obtained from 2008-2013 are analysed and discussed.
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Humanos , Animais , Cães , Doenças do Cão/prevenção & controle , Equinococose/prevenção & controle , Doenças do Cão/parasitologia , Equinococose/epidemiologia , Equinococose/veterinária , Programas Nacionais de Saúde , Uruguai/epidemiologiaRESUMO
Echinococcus granulosus is the causative agent of cystic hydatid disease, a neglected zoonosis responsible for high morbidity and mortality. Several molecular mechanisms underlying parasite biology remain poorly understood. Here, E. granulosus subcellular fractions were analyzed by top down and bottom up proteomics for protein identification and characterization of co-translational and post-translational modifications (CTMs and PTMs, respectively). Nuclear and cytosolic extracts of E. granulosus protoscoleces were fractionated by 10% GELFrEE and proteins under 30 kDa were analyzed by LC-MS/MS. By top down analysis, 186 proteins and 207 proteoforms were identified, of which 122 and 52 proteoforms were exclusively detected in nuclear and cytosolic fractions, respectively. CTMs were evident as 71% of the proteoforms had methionine excised and 47% were N-terminal acetylated. In addition, in silico internal acetylation prediction coupled with top down MS allowed the characterization of 9 proteins differentially acetylated, including histones. Bottom up analysis increased the overall number of identified proteins in nuclear and cytosolic fractions to 154 and 112, respectively. Overall, our results provided the first description of the low mass proteome of E. granulosus subcellular fractions and highlighted proteoforms with CTMs and PTMS whose characterization may lead to another level of understanding about molecular mechanisms controlling parasitic flatworm biology.
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Echinococcus granulosus/metabolismo , Proteínas de Helminto/isolamento & purificação , Histonas/isolamento & purificação , Processamento de Proteína Pós-Traducional , Proteoma/isolamento & purificação , Proteômica/métodos , Acetilação , Sequência de Aminoácidos , Animais , Bovinos , Núcleo Celular/química , Núcleo Celular/parasitologia , Cromatografia Líquida , Citosol/química , Citosol/parasitologia , Equinococose/parasitologia , Equinococose/patologia , Echinococcus granulosus/genética , Echinococcus granulosus/crescimento & desenvolvimento , Células Epiteliais/química , Células Epiteliais/parasitologia , Proteínas de Helminto/genética , Proteínas de Helminto/metabolismo , Histonas/genética , Histonas/metabolismo , Estágios do Ciclo de Vida/genética , Pulmão/química , Pulmão/parasitologia , Metionina/química , Metionina/metabolismo , Anotação de Sequência Molecular , Dados de Sequência Molecular , Proteoma/genética , Proteoma/metabolismo , Proteômica/instrumentação , Espectrometria de Massas em TandemRESUMO
Introducción: La hidatidosis hepática presenta una alta prevalencia en Uruguay y la región, pero la situación actual en el Departamento de Salto se desconoce. Se ha demostrado la utilidad de la ecografía abdominal como método de tamizado poblacional para conocer su prevalencia en personas asintomáticas. Material y métodos: Análisis de 4,478 ecografías abdominales, realizadas para la búsqueda de quistes hidáticos abdominales en personas asintomáticas, durante un periodo de cinco años (2007-2011), en el Departamento de Salto, Uruguay. Resultados: Se encontraron 17 casos con imágenes ecográficas compatibles con quiste hidático hepático. La prevalencia de imágenes compatibles con quiste hidático hepático fue de 0.38 o 3.8% (4 por 1,000 ecografías) de las ecografías abdominales realizadas. Conclusiones: Se concluye que, comparando con estudios anteriores realizados en el país y la región, existe un descenso de la prevalencia de hidatidosis hepática.
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Humanos , Masculino , Feminino , Equinococose Hepática/diagnóstico , Ultrassonografia , UruguaiRESUMO
Background: Acute fascioliasis (FA), cystic echinococcosis (CE) and neurocysticercosis (NCC) are three endemic parasitic diseases in Chile for whom there is scarce information about the economic impact they represent during management at the hospital. Aims: To quantify and compare hospital care expenses caused by these three endemic helminth infections in a Chilean hospital. Methods: Retrospective analysis of hospital costs at a referral hospital in Santiago between 2006 and 2010. Hospital databases were used to identify patients with the corresponding infections, and those with sufficient data on hospital costs were included. Results: A total of 16 patients representing 21 cases were identified and analyzed: four with AF, eleven with CE, and six with NCC. Median hospital expenses for cases with AF were US$ 1799 and mainly caused by bed-day costs. Median hospital costs for cases of CE were US$ 4707 and the most important costs components were medications, bed-day costs and consumables. NCC patients had median costs of US$ 1293, which were mainly due to bed-day costs. Non-parenchymatous or mixed forms of NCC showed a trend toward higher hospital costs compared with parenchymatous forms. Conclusions: Although helminth infections in Chile, an upper middle income country, are declining and considered rare in routine clinical practice, hospital care expenses caused by patients with AF, CE, and NCC are high and might still present an important economic burden to the Chilean healthcare system.
Antecedentes: La fascioliasis aguda (FA), la equinococosis o hidatidosis (H) y la neurocisticercosis (NCC) son tres enfermedades parasitarias endémicas en Chile de las cuales hay escasa información sobre el impacto económico que ellas generan por atención hospitalaria. Objetivos: Cuantificar y comparar los gastos hospitalarios causados por estas tres infecciones por helmintos en un hospital en Chile. Materiales y Métodos: Análisis retrospectivo de gastos hospitalarios en un hospital de referencia en Santiago entre los años 2006 y 2010. Se incluyeron aquellos casos identificados en las bases de datos de hospital y que contaran con datos económicos suficientes. Resultados: Un total de 16 pacientes con 21 ingresos fue identificado y analizado: 4 con FA, 11 con H y 6 con NCC. La mediana de gastos hospitalarios para los ingresos por FA fue de US$ 1.799, originados fundamentalmente por el costo del día cama. La mediana de los gastos en ingresos por H fue de US$ 4.707 y los componentes más importantes en el gasto fueron los medicamentos, estadía hospitalaria e insumos. Los pacientes con NCC tuvieron una mediana de gastos de US$ 1.293 explicado principalmente por la estadía hospitalaria. Los pacientes con formas no parenquimatosas o mixtas tuvieron una tendencia a presentar gastos más altos que aquellos con formas parenquimatosas de NCC. Conclusiones: Aunque las infecciones por helmintos están en declinación en Chile, un país de ingresos medios, y son consideradas raras en la práctica clínica, los gastos hospitalarios generados por la atención de pacientes con FA, H y NCC, son elevados y aún representan una importante carga económica para el sistema de salud chileno.
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Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Equinococose/economia , Fasciolíase/economia , Custos Hospitalares/estatística & dados numéricos , Hospitalização/economia , Neurocisticercose/economia , Doença Aguda , Chile , Tempo de Internação , Estudos RetrospectivosRESUMO
The lack of knowledge regarding polycystic hydatid disease results in delayed or even incorrect diagnosis. The lack of systematic information regarding treatment also makes it difficult to assess the results and prognosis in patients with peritoneal and hepatic lesions caused by Echinococcus vogeli. Here we describe the clinical features of patients, propose a radiological classification protocol and describe a therapeutic option for the treatment of hydatid disease that previously had only been used for cases of cystic echinococcosis (Echinococcus granulosus). A prospective cohort study was initiated in 1999 and by 2009 the study included 60 patients. These patients were classified according to the PNM classification (parasite lesion, neighbouring organ invasion and metastases) and placed in one of three therapeutic modalities: (i) chemotherapy with albendazole at a dose of 10 mg/kg/day, (ii) surgical removal of cysts or (iii) percutaneous puncture of the cysts via puncture, aspiration, injection and re-aspiration (PAIR). The results were stratified according to therapeutic outcome: "cure", "clinical improvement", "no improvement", "death" or "no information". The PNM classification was useful in indicating the appropriate therapy in cases of polycystic hydatid disease. In conclusion, surgical therapy produced the best clinical results of all the therapies studied based on "cure" and "clinical improvement" outcomes. The use of PAIR for treatment requires additional study.
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Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Cães , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Albendazol/uso terapêutico , Equinococose , Anticestoides/uso terapêutico , Brasil , Estudos de Coortes , Equinococose/tratamento farmacológico , Equinococose , Equinococose/cirurgia , Estudos Prospectivos , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios XRESUMO
Echinococcal disease remains a major problem within some endemic areas. We report a case of a single primary echinococcal cyst located in the retroperitoneal space. A 54-year-old woman, born in a rural area of southern Chile, was admitted with a 3-month history of right hip pain and painful swelling of the gluteal region. Hidatid disease was confirmed with serologic test, radiological examinations and histo-pathology. There were no cysts in any other location. A percutaneous drainage was performed and antihelminthics were administered for 12 weeks and is now being closely followed up, with good response to therapy. Especially in the endemic areas hydatid cyst should be considered when evaluating retroperitoneal cystic masses.
La hidatidosis sigue siendo un problema prevalente en áreas endémicas. Presentamos el caso de un quiste hidatídico primario ubicado en el espacio retro-peritoneal. Mujer de 54 años, procedente de área rural del sur de Chile, hospitalizada por cuadro de coxalgia derecha y aumento de volumen glúteo, con tres meses de evolución. Se realizó el diagnóstico de hidatidosis complicada por medio de exámenes de imágenes, tests serológicos y anatomía patológica. No se demostraron quistes hidatídicos en otras ubicaciones. Se realizó un drenaje percutáneo del quiste infectado y se administraron antihelmínticos durante 12 semanas y actualmente permanece en seguimiento cercano con buena respuesta al tratamiento. El quiste hidatídico debe ser considerado en el diagnóstico diferencial de masas quísticas retro-peritoneales, especialmente en áreas endémicas.
Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Equinococose/diagnóstico , Espaço Retroperitoneal/parasitologia , Anti-Helmínticos/uso terapêutico , Drenagem , Equinococose/terapia , Imageamento por Ressonância Magnética , Tomografia Computadorizada por Raios XRESUMO
Se reporta el caso de paciente femenina de 51 años, con antecedente de contacto con animales domésticos, a la cual se le realizó diagnóstico de quiste hidatídico hepático, en base a estudios de imagen y paraclínicos compatibles por patrón ecográfico, con gran Lesión de Ocupación de Espacio (LOE) quística, multivesicular, de aspecto septado, en lóbulo hepático derecho, eosinofilia moderada y discreta elevación del perfil bioquímico hepático, con Elisa (IgG) para hidatidosis positivo, que manifestó buena respuesta a terapia farmacológica única con benzimidazoles (Albendazol) vía oral, con disminución progresiva de la lesión hasta su total desaparición, sin requerir tratamiento quirúrgico, en seguimiento actual de 13 meses. Se revisa la literatura de la enfermedad y manejo terapéutico de la misma.
We report the case of a 51 years old female patient, with a history of contact with domestic animals, to whom we diagnosed a Hepatic Hydatid Cyst, on the grounds of image studies and laboratory tests compatible with a spaceoccupying lesion, multivesicular cysts, in the right hepatic lobe; moderate eosinophilia, and a discreet elevation of the hepatic biochemical profile, with Elisa (IgG) positive for Hydatid Cyst disease. She showed a good response to single therapy with benzimidazole (Albendazole), given orally, with a progressive diminution of the lesion until its total disappearance, without requiring surgical treatment, at follow up for 13 months. We review the literature relative to this disease and its therapeutic options.
RESUMO
Equine cerebral hydatid disease is described in a 7-year-old, crossbred, female horse. Clinical signs were characterized by circling gait, pressing of head against fences or objects and motor incoordination. On gross examination of the brain the hemispheres were swollen, mainly the left one. On transversal sections, a 5cm X 7cm fluid-filled cyst was observed within the lateral ventricle of the left hemisphere. The cyst extended from the parietal to the occipital lobe, and compressed the third ventricle. There was also marked mid line deviation. Histologically, the brain lesion adjacent to the cyst, was characterized by a piogranulomatous process and vacuolization of neuropil. A diagnosis of equine hydatidosis caused by Echinococcus granulosus was made on the basis of the morphometric features of protoscolices hooks.
Descreve-se um caso de hidatidose cerebral em um eqüino, cruza, fêmea, de 7 anos de idade, que apresentou sinais clínicos nervosos de torneio, pressão da cabeça contra cercas e objetos e incoordenação motora. Na abertura da caixa craniana observou-se aumento de volume do cérebro, mais acentuado no hemisfério esquerdo. Ao corte observou-se, no interior do ventrículo lateral esquerdo, um cisto de aproximadamente 5cm x 7cm, de parede branca opaca, com conteúdo líquido translúcido, que se estendia desde o lobo parietal até o lobo ocipital, comprimindo o tecido nervoso. No exame histológico do cérebro observou-se, na área contígua à parede do cisto a presença de um processo inflamatório piogranulomatoso e vacuolização da neurópila. Os dados morfométricos do cisto, dos protoescóleces e dos ganchos permitiram concluir que o cisto era de Echinococcus granulosus.
RESUMO
Equine cerebral hydatid disease is described in a 7-year-old, crossbred, female horse. Clinical signs were characterized by circling gait, pressing of head against fences or objects and motor incoordination. On gross examination of the brain the hemispheres were swollen, mainly the left one. On transversal sections, a 5cm X 7cm fluid-filled cyst was observed within the lateral ventricle of the left hemisphere. The cyst extended from the parietal to the occipital lobe, and compressed the third ventricle. There was also marked mid line deviation. Histologically, the brain lesion adjacent to the cyst, was characterized by a piogranulomatous process and vacuolization of neuropil. A diagnosis of equine hydatidosis caused by Echinococcus granulosus was made on the basis of the morphometric features of protoscolices hooks.
Descreve-se um caso de hidatidose cerebral em um eqüino, cruza, fêmea, de 7 anos de idade, que apresentou sinais clínicos nervosos de torneio, pressão da cabeça contra cercas e objetos e incoordenação motora. Na abertura da caixa craniana observou-se aumento de volume do cérebro, mais acentuado no hemisfério esquerdo. Ao corte observou-se, no interior do ventrículo lateral esquerdo, um cisto de aproximadamente 5cm x 7cm, de parede branca opaca, com conteúdo líquido translúcido, que se estendia desde o lobo parietal até o lobo ocipital, comprimindo o tecido nervoso. No exame histológico do cérebro observou-se, na área contígua à parede do cisto a presença de um processo inflamatório piogranulomatoso e vacuolização da neurópila. Os dados morfométricos do cisto, dos protoescóleces e dos ganchos permitiram concluir que o cisto era de Echinococcus granulosus.
RESUMO
Equine cerebral hydatid disease is described in a 7-year-old, crossbred, female horse. Clinical signs were characterized by circling gait, pressing of head against fences or objects and motor incoordination. On gross examination of the brain the hemispheres were swollen, mainly the left one. On transversal sections, a 5cm X 7cm fluid-filled cyst was observed within the lateral ventricle of the left hemisphere. The cyst extended from the parietal to the occipital lobe, and compressed the third ventricle. There was also marked mid line deviation. Histologically, the brain lesion adjacent to the cyst, was characterized by a piogranulomatous process and vacuolization of neuropil. A diagnosis of equine hydatidosis caused by Echinococcus granulosus was made on the basis of the morphometric features of protoscolices hooks.
Descreve-se um caso de hidatidose cerebral em um eqüino, cruza, fêmea, de 7 anos de idade, que apresentou sinais clínicos nervosos de torneio, pressão da cabeça contra cercas e objetos e incoordenação motora. Na abertura da caixa craniana observou-se aumento de volume do cérebro, mais acentuado no hemisfério esquerdo. Ao corte observou-se, no interior do ventrículo lateral esquerdo, um cisto de aproximadamente 5cm x 7cm, de parede branca opaca, com conteúdo líquido translúcido, que se estendia desde o lobo parietal até o lobo ocipital, comprimindo o tecido nervoso. No exame histológico do cérebro observou-se, na área contígua à parede do cisto a presença de um processo inflamatório piogranulomatoso e vacuolização da neurópila. Os dados morfométricos do cisto, dos protoescóleces e dos ganchos permitiram concluir que o cisto era de Echinococcus granulosus.