Parasitologic findings in percutaneous drainage of human hydatid liver cysts

Article Abstract:

Cystic hydatid disease (CHD) is caused by the larval stage of the tapeworm Echinococcus granulosus. The disease presents an important health issue in the countries in which it is endemic. It is widely distributed in Italy and has its highest incidence in Sardinia. Dogs and related animals are definitive hosts, and in Italy, the intermediate hosts are sheep. Humans become infected by hand to mouth contact, particularly in the course of playful and intimate contact between persons and dogs. Infected dogs may harbor thousands of worms and each worm sheds hundreds of eggs weekly. Infective eggs adhere to muzzles, paws and hair. During the period between 1980 and 1984, 430 cases of CHD were officially reported, but the real incidence may be higher, since many cases are undiagnosed or asymptomatic and are not counted. Abdominal surgery and chemotherapy have been the principal interventions in use. In the past, cyst drainage was not recommended because of the potential for leakage of cysts and of the potential for allergic reactions. An alternate therapy was attempted on 13 patients using percutaneous (through the skin) aspiration and drainage under ultrasonographic direction. Viable worms and scolices (the part of the worm that attaches to the host) were observed in cystic aspirates obtained. This procedure confirmed diagnoses even when blood tests were negative. Alcohol was introduced into the cystic cavity after aspiration to detect leakage of potentially reinfective scolices. The procedure, although tested on a very small cohort, appears to be therapeutically safe. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Italy, Diagnosis, Disease transmission, Worms, Intestinal and parasitic, Helminths, Echinococcosis

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Desirable attributes of the ambulance technician, paramedic and clinical supervisor: findings from a Delphi study

Article Abstract:

The Delphi technique was used to identify those attributes that experts regard as desirable qualities in three groups of ambulance personnel predominantly engaged in operational activity. The results showed high levels of agreement among technician group rather than paramedical and clinical supervisor group.

Physiological aspects, Comparative analysis, Personality, Emergency medical personnel, Personality traits, Paramedics

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Ovarian cysts: what's normal, what's not

Article Abstract:

Women form functional ovarian cysts as a part of ovulation, and these cysts are normal and disappear without medical treatment. However, a minority of women develop nonfunctional cysts that grow large, cause acute pain, and are associated with infertility and sometimes cancer.

Ovaries, Ovarian cysts

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