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Zerem E, Puljiz Ž, Zdilar B, Kunosic S, Kurtcehajic A, Zerem O. Is endoscopic ultrasound a promising technique in the diagnosis and treatment of liver diseases? World J Gastroenterol 2024; 30:2920-2922. [PMID: 38947285 PMCID: PMC11212719 DOI: 10.3748/wjg.v30.i22.2920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/30/2024] [Accepted: 05/20/2024] [Indexed: 06/05/2024] Open
Abstract
Percutaneous ultrasound has been a longstanding method in the diagnostics and interventional procedures of liver diseases. In some countries, its use is restricted to radiologists, limiting access for other clinicians, such as gastroenterologists. Endoscopic ultrasound, as a novel technique, plays a crucial role in diagnosis and treatment of digestive diseases. However, its use is sometimes recommended for conditions where no clear advantage over percutaneous ultrasound exists, leaving the impression that clinicians sometimes resort to an endoscopic approach due to the unavailability of percutaneous options.
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Affiliation(s)
- Enver Zerem
- Department of Medical Sciences, The Academy of Sciences and Arts of Bosnia and Herzegovina, Sarajevo 71000, Sarajevo Canton, Bosnia and Herzegovina
| | - Željko Puljiz
- Department of Gastroenterology and Hepatology, University Clinical Center Split, Split 21000, Croatia
| | - Boris Zdilar
- Department of Medicine, Croatian Military Academy, Zagreb 10000, Croatia
| | - Suad Kunosic
- Department of Physics, Faculty of Natural Sciences and Mathematics, University of Tuzla, Tuzla 75000, Tuzla Kanton, Bosnia and Herzegovina
| | - Admir Kurtcehajic
- Department of Gastroenterology and Hepatology, Blue Medical Group, Tuzla 75000, Tuzla Kanton, Bosnia and Herzegovina
| | - Omar Zerem
- Department of Internal Medicine, Cantonal Hospital “Safet Mujić” Mostar, Mostar 88000, Bosnia and Herzegovina
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Casulli A, Abela-Ridder B, Petrone D, Fabiani M, Bobić B, Carmena D, Šoba B, Zerem E, Gargaté MJ, Kuzmanovska G, Calomfirescu C, Rainova I, Sotiraki S, Lungu V, Dezsényi B, Herrador Z, Karamon J, Maksimov P, Oksanen A, Millon L, Sviben M, Shkjezi R, Gjoni V, Akshija I, Saarma U, Torgerson P, Šnábel V, Antolová D, Muhovic D, Besim H, Chereau F, Belhassen García M, Chappuis F, Gloor S, Stoeckle M, Müllhaupt B, Manno V, Santoro A, Santolamazza F. Unveiling the incidences and trends of the neglected zoonosis cystic echinococcosis in Europe: a systematic review from the MEmE project. THE LANCET. INFECTIOUS DISEASES 2023; 23:e95-e107. [PMID: 36427513 DOI: 10.1016/s1473-3099(22)00638-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 09/02/2022] [Accepted: 09/05/2022] [Indexed: 11/24/2022]
Abstract
The neglected zoonosis cystic echinococcosis affects mainly pastoral and rural communities in both low-income and upper-middle-income countries. In Europe, it should be regarded as an orphan and rare disease. Although human cystic echinococcosis is a notifiable parasitic infectious disease in most European countries, in practice it is largely under-reported by national health systems. To fill this gap, we extracted data on the number, incidence, and trend of human cases in Europe through a systematic review approach, using both the scientific and grey literature and accounting for the period of publication from 1997 to 2021. The highest number of possible human cases at the national level was calculated from various data sources to generate a descriptive model of human cystic echinococcosis in Europe. We identified 64 745 human cystic echinococcosis cases from 40 European countries. The mean annual incidence from 1997 to 2020 throughout Europe was 0·64 cases per 100 000 people and in EU member states was 0·50 cases per 100 000 people. Based on incidence rates and trends detected in this study, the current epicentre of cystic echinococcosis in Europe is in the southeastern European countries, whereas historical endemic European Mediterranean countries have recorded a decrease in the number of cases over the time.
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Affiliation(s)
- Adriano Casulli
- WHO Collaborating Centre for the Epidemiology, Detection and Control of Cystic and Alveolar Echinococcosis, Istituto Superiore di Sanità, Rome, Italy; European Union Reference Laboratory for Parasites, Istituto Superiore di Sanità, Rome, Italy; Foodborne and Neglected Parasites Unit, Department of infectious Diseases, Istituto Superiore di Sanità, Rome, Italy.
| | - Bernadette Abela-Ridder
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Daniele Petrone
- Unit of Epidemiology, Biostatistics and Mathematical Modelling, Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy; Department of Statistics, Sapienza University of Rome, Rome, Italy
| | - Massimo Fabiani
- Unit of Epidemiology, Biostatistics and Mathematical Modelling, Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Branko Bobić
- Institute for Medical Research University of Belgrade, National Institute of Republic of Serbia, Belgrade, Serbia
| | - David Carmena
- Parasitology Reference and Research Laboratory, Spanish National Centre for Microbiology, Health Institute Carlos III, Majadahonda, Spain
| | - Barbara Šoba
- Laboratory of Parasitology, Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Enver Zerem
- Department of Medical Sciences, The Academy of Sciences and Arts of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina
| | - Maria João Gargaté
- National Reference Laboratory of Parasitic and Fungal Infections, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge, Lisboa, Portugal
| | - Gordana Kuzmanovska
- Department of Communicable Diseases Epidemiology, Institute of Public Health of Republic of North Macedonia, Skopje, North Macedonia
| | - Cristian Calomfirescu
- National Center for Statistics in Public Health, National Institute of Public Health, Bucharest, Romania
| | - Iskra Rainova
- National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Smaragda Sotiraki
- Veterinary Research Institute, Hellenic Agricultural Organisation/ELGO-DIMITRA, Thessaloniki, Greece
| | - Vera Lungu
- Department for Epidemiological Surveillance of Highly Contagious Diseases, Zoonoses and Parasitosis, National Public Health Agency of the Republic of Moldova, Chisinau, Moldova
| | - Balázs Dezsényi
- Department of Anatomy, Histology and Embryology, Semmelweis University, Budapest, Hungary
| | - Zaida Herrador
- National Centre of Epidemiology, Health Institute Carlos III, Madrid, Spain
| | - Jacek Karamon
- Department of Parasitology and Invasive Diseases, National Veterinary Research Institute, Pulawy, Poland
| | - Pavlo Maksimov
- National Reference Library for Echinococcosis, Institute of Epidemiology, Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Greifswald-Insel Riems, Germany
| | | | - Laurence Millon
- National Reference Center for Echinococcosis, University Hospital of Besançon, UMR 6249 CNRS Chrono-environnement, University of Bourgogne Franche Comté, Besançon, France
| | - Mario Sviben
- Croatian National Institute for Public Health, National Reference Laboratory for Parasites of Humans, Department of Microbiology, Zagreb, Croatia; Department of Microbiology and Parasitology, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Renata Shkjezi
- Mother Cabrini-ONLUS Foundation, Sant'Angelo Lodigiano, Italy
| | - Valbona Gjoni
- Department of National Reference Laboratories, Institute of Public Health, Tirana, Albania
| | - Ilir Akshija
- Statistics Department, University Hospital Center "Mother Teresa", Tirana, Albania
| | - Urmas Saarma
- Department of Zoology, Institute of Ecology and Earth Sciences, University of Tartu, Tartu, Estonia
| | - Paul Torgerson
- Section of Veterinary Epidemiology, Vetsuisse Faculty, University of Zürich, Zürich, Switzerland
| | - Viliam Šnábel
- Laboratory of Human Parasitology, Institute of Parasitology, Slovak Academy of Sciences, Košice, Slovakia
| | - Daniela Antolová
- Laboratory of Human Parasitology, Institute of Parasitology, Slovak Academy of Sciences, Košice, Slovakia
| | - Damir Muhovic
- Department of Gastroenterohepatology, Internal Clinic, Clinical Center of Montenegro, Faculty of Medicine, University of Montenegro, Podgorica, Montenegro
| | - Hasan Besim
- Department of General Surgery, Near East University Hospital, Nicosia, Cyprus
| | - Fanny Chereau
- Infectious Diseases Division, Santé publique France, Saint-Maurice, France
| | - Moncef Belhassen García
- Internal Medicine Service, Infectious Unit, University Hospital of Salamanca, Institute of Biomedical Research of Salamanca, Research Center for Tropical Diseases of the University of Salamanca, University of Salamanca, Salamanca, Spain
| | - François Chappuis
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Severin Gloor
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Marcel Stoeckle
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University Basel, Basel, Switzerland
| | - Beat Müllhaupt
- Gastroenterology and Hepatology, University Hospital Zürich, Zürich, Switzerland
| | - Valerio Manno
- Statistical Service, Istituto Superiore di Sanità, Rome, Italy
| | - Azzurra Santoro
- WHO Collaborating Centre for the Epidemiology, Detection and Control of Cystic and Alveolar Echinococcosis, Istituto Superiore di Sanità, Rome, Italy; European Union Reference Laboratory for Parasites, Istituto Superiore di Sanità, Rome, Italy; Foodborne and Neglected Parasites Unit, Department of infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
| | - Federica Santolamazza
- WHO Collaborating Centre for the Epidemiology, Detection and Control of Cystic and Alveolar Echinococcosis, Istituto Superiore di Sanità, Rome, Italy; European Union Reference Laboratory for Parasites, Istituto Superiore di Sanità, Rome, Italy; Foodborne and Neglected Parasites Unit, Department of infectious Diseases, Istituto Superiore di Sanità, Rome, Italy
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Sokouti M, Sadeghi R, Pashazadeh S, Abadi SEH, Sokouti M, Ghojazadeh M, Sokouti B. A systematic review and meta-analysis on the treatment of liver hydatid cyst using meta-MUMS tool: comparing PAIR and laparoscopic procedures. Arch Med Sci 2019; 15:284-308. [PMID: 30899281 PMCID: PMC6425195 DOI: 10.5114/aoms.2018.73344] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 03/20/2017] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION There is an academic debate over surgical treatments of liver hydatid cyst disease. In this study, a systematic review and meta-analysis were carried out in order to evaluate the pros and cons of both PAIR (Puncture, Aspiration, Injection, Respiration) and laparoscopic techniques by considering the outcomes of liver hydatid cysts. MATERIAL AND METHODS We designed descriptive Boolean queries to search two databases, PubMed and Scopus, to derive the articles published in the period of January 2000 to December 2016 in order to evaluate the outcomes of these research articles. The outcomes of laparoscopic and PAIR procedures include the rates of cure, postoperative complications, recurrences, and mortality, which were extracted, assessed, and used as their corresponding effect sizes. RESULTS Fifty-seven studies including a total of 2832 patients (PAIR group n = 1650 and laparoscopic group = 1182) were analyzed. In this meta-analysis study, a random effect model of correlations of outcomes (postoperative complications, mortalities, recurrences, and cure rates) of PAIR and laparoscopy procedures was used. The meta-analysis and the forest plots of the two procedures show that the PAIR approach is superior in terms of cure, complication, and mortality rates compared with the laparoscopy technique. However, the recurrence rate is low in laparoscopic approaches. Moreover, Egger's tests for determining publication bias and heterogeneity tests were also performed. CONCLUSIONS This study shows promising trends toward an advantage of PAIR procedures in treatment of liver hydatid cyst in comparison with laparoscopic procedures. The PAIR procedure is superior to laparoscopy due to having a higher cure rate and lower complication and mortality rates; however, the latter has a lower recurrence rate.
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Affiliation(s)
- Massoud Sokouti
- Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ramin Sadeghi
- Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saeid Pashazadeh
- Department of Computer and Electrical Engineering, University of Tabriz, Tabriz, Iran
| | - Saeed Eslami Hasan Abadi
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohsen Sokouti
- Department of Cardiothoracic Surgery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Morteza Ghojazadeh
- Research Center for Evidence-Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Babak Sokouti
- Biotechnology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Jahic D, Kapur E, Begic E, Zerem E. Splenic Localization of Primary Hydatid Cyst in a 27-Year-Old Sportsman Treated by PAIR Technique: Imaging Anatomy Assessment. Acta Inform Med 2017; 25:277-279. [PMID: 29284921 PMCID: PMC5723196 DOI: 10.5455/aim.2017.25.277-279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Accepted: 10/29/2017] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION In this paper, we report our experience with a case of primary hydatid cyst involving only the spleen in a 27-year-old sportsman treated by PAIR technique. CASE REPORT Five years before, a 27-year-old handball player being admitted to our hospital, it was detected the cyst in his spleen which size was 35 x 30 mm in diameter, by abdominal ultrasound during a systematic examination. There was no pain or any other symptoms at that time. Tests on the presence of echinococcus cysts were negative. After a period of 5 years, and regular check-ups, the patient began to feel a dull pain in the left upper quadrant area. The Echinococcus test was again negative. Puncture and aspiration of content was performed and sent to cytological analysis that confirmed the presence of Echinococcus. The CT finding showed the spleen in a normal position, shape, enlarged, 185 mm in longitudinal diameter (splenomegaly), with inhomogeneous parenchyma on the expense of rounded area with hyperdense halo, which did not opacify after contrast, located in the dorsal area of the spleen, 100x98 mm in diameter and which corresponded to the echinococcal cyst in differential diagnosis-clean dense contents (protein / haemorrhagic). CONCLUSION The reported case is very specific, considering that handball is contact sport, where it is almost impossible to avoid the physical contact between players, which is sometimes even rough. Due to rough contacts, spleen trauma is something we should be very aware about, especially in cases of splenomegaly with hydatid cyst, where the spleen rupture might lead to fatal outcome. According to all this, careful follow up of this patient is necessary.
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Affiliation(s)
- Dzenan Jahic
- Orthopaedics and Traumatology Clinic, University Clinical Center Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Eldan Kapur
- Department of Anatomy, Faculty of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Edin Begic
- Faculty of Medicine, Sarajevo School of Science and Technology, Sarajevo, Bosnia and Herzegovina
| | - Enver Zerem
- Department of Gastroenterology and Hepatology, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
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