Diagnosis and treatment experience of atypical hepatic cystic echinococcosis type 1 at a tertiary center in China

BACKGROUND Some hydatid cysts of cystic echinococcosis type 1(CE1)lack well-defined cyst walls or distinctive endocysts,making them difficult to differentiate from simple hepatic cysts.AIM To investigate the diagnostic methods for atypical hepatic CE1 and the clinical efficacy of laparoscopic surgeries.METHODS The clinical data of 93 patients who had a history of visiting endemic areas of CE and were diagnosed with cystic liver lesions for the first time at the People's Hospital of Xinjiang Uygur Autonomous Region(China)from January 2018 to September 2023 were retrospectively analyzed.Clinical diagnoses were made based on findings from serum immunoglobulin tests for echinococcosis,routine abdominal ultrasound,high-frequency ultrasound,abdominal computed tomography(CT)scan,and laparoscopy.Subsequent to the treatments,these patients underwent reexaminations at the outpatient clinic until October 2023.The evaluations included the diagnostic precision of diverse examinations,the efficacy of surgical approaches,and the incidence of CE recurrence.RESULTS All 93 patients were diagnosed with simple hepatic cysts by conventional abdominal ultrasound and abdominal CT scan.Among them,16 patients were preoperatively diagnosed with atypical CE1,and 77 were diagnosed with simple hepatic cysts by high-frequency ultrasound.All the 16 patients preoperatively diagnosed with atypical CE1 underwent laparoscopy,of whom 14 patients were intraoperatively confirmed to have CE1,which was consistent with the postoperative pathological diagnosis,one patient was diagnosed with a mesothelial cyst of the liver,and the other was diagnosed with a hepatic cyst combined with local infection.Among the 77 patients who were preoperatively diagnosed with simple hepatic cysts,4 received aspiration sclerotherapy of hepatic cysts,and 19 received laparoscopic fenestration.These patients were intraoperatively diagnosed with simple hepatic cysts.During the followup period,none of the 14 patients with CE1 experienced recurrence or implantation of hydatid scolices.One of the 77 patients was finally confirmed to have CE complicated with implantation to the right intercostal space.CONCLUSION Abdominal high-frequency ultrasound can detect CE1 hydatid cysts.The laparoscopic technique serves as a more effective diagnostic and therapeutic tool for CE.

Fifty-five cases of hepatic alveolar echinococcosis combined with lymph node metastasis:A retrospective study

BACKGROUND Lymph node metastasis is a specific type of metastasis in hepatic alveolar echinococcosis(AE).Currently,there is a scarcity of describing the clinical characteristics and lymph node metastasis rules of patients with hepatic AE combined with lymph node metastasis and its mechanism and management are still controversial.Radical hepatectomy combined with regional lymph node dissection is a better treatment.AIM To analyse the clinical features of hepatic AE combined with lymph node metastasis to explore its treatment and efficacy.METHODS A total of 623 patients with hepatic AE admitted to the First Affiliated Hospital of Xinjiang Medical University from 1 January 2012 to 1 January 2022 were retrospectively analysed.Fifty-five patients with combined lymph node metastasis were analysed for their clinical data,diagnosis and treatment methods,follow-up efficacy,and characteristics of lymph node metastasis.Finally,we comparatively analysed the lymph node metastasis rates at different sites.Categorical variables are expressed as frequencies and percentages,and the analysis of difference was performed using theχ2 test.The Bonferroni method was used for pairwise comparisons when statistical differences existed between multiple categorical variables.RESULTS A lymph node metastasis rate of 8.8%(55/623)was reported in patients with hepatic AE,with a female predilection(69.1%)and a statistically significant sex difference(χ2=8.018,P=0.005).Of the 55 patients with lymph node metastasis,72.7%had a parasite lesion,neighbouring organ invasion,and metastasis stage of P3N1M0 and above,of which 67.3%,78.2%,and 34.5%of hepatic AE lesions invaded the bile ducts,blood vessels,and distant metastases,respectively.Detection rates of lymph node metastasis of 16.4%,21.7%,and 34.2%were reported for a preoperative abdominal ultrasound,magnetic resonance imaging,and computed tomography examinations.All patients were intraoperatively suspected with enlarged lymph nodes and underwent radical hepatectomy combined with regional lymph node dissection.After surgery,a routine pathological examination was conducted on the resected lymph nodes.A total of 106 positive lymph nodes were detected in six groups at various sites,including 51 single-group metastasis cases and four multi-group metastasis cases.When the metastasis rates at different sites were statistically analysed,we observed that the metastasis rate in the para-hepatoduodenal ligament lymph nodes was significantly higher than that of the other sites(χ^(2)=128.089,P=0.000<0.05).No statistical difference was observed in the metastasis rate between the five other groups.Clavien-Dindo grade IIIa complication occurred in 14 cases,which improved after administering symptomatic treatment.Additionally,lymph node dissection-related complications were not observed.Recurrence after 2 years was observed in one patient.CONCLUSION Lymph node metastasis is a rare form of metastasis in hepatic AE,which is more frequent in women.Parahepatoduodenal ligament lymph nodes are commonly observed.Radical hepatectomy combined with regional lymph node dissection is a safe,effective,and feasible treatment for liver AE combined with lymph node metastasis.

Coinfection with hepatic cystic and alveolar echinococcosis with abdominal wall abscess and sinus tract formation:A case report

BACKGROUND Hepatic cystic and alveolar echinococcosis coinfections,particularly with concurrent abscesses and sinus tract formation,are extremely rare.This article presents a case of a patient diagnosed with this unique presentation,discussing the typical imaging manifestations of both echinococcosis types and detailing the diagnosis and surgical treatment experience thereof.CASE SUMMARY A 39-year-old Tibetan woman presented with concurrent hepatic cystic and alveolar echinococcosis,accompanied by abdominal wall abscesses and sinus tract formation.Initial conventional imaging examinations suggested only hepatic cystic echinococcosis,but intraoperative and postoperative pathological examination revealed the coinfection.Following radical resection of the lesions,the patient’s condition improved,and she was discharged soon thereafter.Subsequent outpatient follow-ups confirmed no recurrence of the hydatid lesion and normal surgical wound healing.Though mixed hepatic cystic and alveolar echinococcosis with abdominal wall abscesses and sinus tract formations are rare,the general treatment approach remains consistent with that of simpler infections of alveolar echinococcosis.CONCLUSION Lesions involving the abdominal wall and sinus tract formation,may require radical resection.Long-term prognosis includes albendazole and follow-up examinations.

How to use the Surveillance,Epidemiology,and End Results(SEER)data:research design and methodology

In the United States(US),the Surveillance,Epidemiology,and End Results(SEER)program is the only comprehensive source of population-based information that includes stage of cancer at the time of diagnosis and patient survival data.This program aims to provide a database about cancer incidence and survival for studies of surveillance and the development of analytical and methodological tools in the cancer field.Currently,the SEER program covers approximately half of the total cancer patients in the US.A growing number of clinical studies have applied the SEER database in various aspects.However,the intrinsic features of the SEER database,such as the huge data volume and complexity of data types,have hindered its application.In this review,we provided a systematic overview of the commonly used methodologies and study designs for retrospective epidemiological research in order to illustrate the application of the SEER database.Therefore,the goal of this review is to assist researchers in the selection of appropriate methods and study designs for enhancing the robustness and reliability of clinical studies by mining the SEER database.

Epidemiological survey of cystic echinococcosis in southwest China:From the Qinghai-Tibet plateau to the area of Yunnan

BACKGROUND Echinococcosis is prevalent in 9 provinces in Western and Northern China.An epidemiological survey of echinococcosis in 2012 and 2016 showed cases of echinococcosis in Yunnan Province.AIM To understand the spatial distribution and epidemiological characteristics of echinococcosis in Yunnan for the prevention and control of echinococcosis and to reduce the risk of infection in Yunnan Province.METHODS Based on the China Information System for Disease Control and Prevention(CISDCP),echinococcosis cases reported from 36 hospitals and 34 Centers for Disease Control were investigated and epidemiologically analyzed from 2021 to 2022.The exclusion criteria included suspected cases,same case only counted once and cases not from Yunnan.A total of 705 cases were investigated,of which 397 cases were suitable for statistical analysis.In these 397 cases,epidemiological investigation was tracked in 187 cases.All data were inputted using double entry in the Excel database,with error correction by double-entry comparison.The data on echinococcosis cases in Yunnan Province were analyzed by ArcGIS 10.1 software to generate a density map of echinococcosis distribution.All statistical analyses were conducted using SPSS 17.0,including the chi-square test,linear regression test and logistic univariate and multivariate regression analyses.RESULTS A total of 397 cases were found in 89 counties in Yunnan Province.The number of cases in the top three prefectures were Dali(38.1%),Diqing(10.1%),and Kunming(8.3%),and the top five counties were Jianchuan(9.1%),Shangri La(8.3%),Eryuan(7.6%),Heqing(6.9%),and Dali Districts(5.0%).There were significant differences between the different areas.The case reporting rate by CISDCP(33.8%)was low;the first case was reported by CISDCP in 2002,and the highest number of cases was 50(2017).Confirmed and clinical cases accounted for 62.5%and 37.5%,respectively.However,90.9%of the cases of hydatid disease were reported by the hospital system,and only 9.1%of the cases of hydatid disease were found in the community through active screening.The difference between the two methods of case detection was statistically significant.Most of the cases of echinococcosis were found in farmers/herdsmen(75.1%)and students(9.1%).In addition,Han(43.6%)and Bai(26.2%)had a higher incidence of infection than other nationalities,and the liver(87.7%)and lung(6.8%)were the most common sites of cyst formation.Among the analyzed cases,187 were epidemiologically analyzed and the clinical symptoms were not obvious in the early stage in 47.1%of cases.The results of logistic regression analysis showed that the age group,education level,presence of dogs in the family(either previously or currently),and handwashing(occasionally or not)were factors related to echinococcosis infection.55.6%of cases were in endemic areas,and 44.4%of cases were in non-endemic areas.Among 83 cases in non-endemic areas,only 4 cases had been to endemic areas and had a history of living,working,travelling,or hunting in echinococcosis epidemic areas.CONCLUSION Cases of echinococcosis were reported throughout the entire Yunnan province,with the majority distributed in Western Yunnan,suggesting that echinococcosis control should be strengthened in this area.We suggest that an epidemiological investigation should be carried out in the future,based on the clues from newly discovered cases in hospitals or from the CISDCP.The newly discovered cases in the hospital provided clues to comprehensively determine the location of cases and where epidemic spot investigation should be conducted.

Portal vein embolization combined with ex vivo liver resection and autotransplantation: A novel treatment strategy for end-stage and metastatic hepatic alveolar echinococcosis

Alveolar echinococcosis(AE)is a lethal parasitic disease caused by Echinococcus multilocularis larvae,and more than 90%of pri-mary AE lesions occur in the liver.Most of the affected individ-uals remain asymptomatic and the disease is often diagnosed at an advanced stage.The infection may spread to organs adjacent to the liver or distant locations,eventually causing end-stage multi-ple organ AE.Brain metastasis of AE is the most fatal with an inci-dence rate of 0.2%[1].

Pictorial review of hepatic echinococcosis:Ultrasound imaging and differential diagnosis

Echinococcosis is a zoonotic disease caused by parasites belonging to the genus Echinococcus that primarily affect the liver.The western plateau and pastoral areas of China are high-risk regions for hepatic cystic echinococcosis and hepatic alveolar echinococcosis(HAE).The high late mortality rate associated with HAE underscores the critical need for early diagnosis to improve cure rates and mitigate the disease burden in endemic areas.Currently,the World Health Orga-nization recommends ultrasonography as the preferred initial screening method for hepatic echinococcosis.However,distinguishing between specific types of lesions,such as those of hepatic cystic echinococcosis and HAE,and other focal liver lesions is challenging.To address this issue,contrast-enhanced ultrasound is recommended as a tool to differentiate solid and cysto-solid hepatic echino-coccosis from other focal liver lesions,significantly enhancing diagnostic accuracy.In this comprehensive review,we discuss the progression of hepatic echinococcosis and detail the imaging features of various types of echinococcosis using conventional,contrast-enhanced,and intraoperative ultrasound techniques.Our objective is to provide robust imaging evidence and guidance for early diagnosis,clinical decision making,and postoperative follow-up in regions with high disease prevalence.

Epidemiology of Mpox Outbreaks and Implications for Surveillance in Imo State, Nigeria

Mpox disease is caused by a double-stranded DNA virus, genus Orthopoxvirus of the family Poxviridae. The incubation period is usually 6 to 13 days but can range from 5 to 21 days while symptoms and signs may persist for 2 to 5 weeks. Although, the clinical features are usually less severe when compared to the deadly smallpox, the disease can be fatal with case fatality rate between 1% and 10%. In Imo State, Nigeria, there has been a changing epidemiology of the disease in the last 6 years and the frequency and geographic distribution of cases have progressively increased. This study aims to conduct a review of the disease epidemiology between 2017 and 2023 and implications for surveillance in Imo State. Surveillance data from the Surveillance Outbreak Response and Management System (SORMAS) was extracted between January 2017 and December 2023 across the 27 Local Government Areas (LGAs) of Imo State. A line list of 231 suspected cases was downloaded into an excel template and analyzed using SPSS® version 20 software. Analysis was done using descriptive statistics and associations were tested using Fischer’s exact at 0.05 level of significance. Of the 231 suspected cases, 57.1% (132) were males, 42.9% (99) were females and the modal age group was between the ages of 0 - 4 (32.5%). Eight (8) LGAs (districts) accounted for 71% (n = 164) of all the suspected cases. 21.2% (49) were confirmed positive, 27 males (55.1%) and 22 females (44.9%) (p > 0.05). Modal age group was 20 - 24 (22.4%, n = 11), 18% (9) were children under 14 years, p > 0.05. Case fatality rate was 8% (n = 4). There was no significant association between mortality and age group. Five (5) LGAs accounted for about 60% (29) of all confirmed cases. These LGAs contribute only 20% to the total population in the State. Only 5.6% and 4% of suspected and confirmed cases, respectively, had knowledge of contact with an infectious source. The study described the epidemiology of Mpox outbreaks between 2017 and 2023 and the findings have significant implications on detection and outbreak response activities.

Molecular Epidemiology and Clinical Characteristics of Hand, Foot and Mouth Disease in North Sichuan Region, China, 2018-2023: A Descriptive Study

Background: Hand, foot and mouth disease (HFMD) remains an important public health problem in China. Many studies on the epidemiological characteristics of HFMD have been reported, but studies in North Sichuan region have been neglected. Methods: HFMD-related enterovirus infected cases were clinically confirmed and underwent real-time RT-PCR (rRT-PCR) from May 2018 to October 2023 in Guangyuan Central Hospital. Results: During 2018-2023, other EV (437 cases, 81.08%) was the most predominant serotype followed by CV-A16 (94 cases, 17.44%), EV-A71 (8 cases, 1.48%) was the least predominant serotype. Peak infections occurred in July and October. There were no significant differences in gender, age and serotypes. HFMD was concentrated in children under 47 months of age, with the highest incidence in children aged 12 - 23 months and the highest proportion of other EV infections in the whole age group. COVID-19 did not cause significant changes in gender, age and serotype. Overall, there was a significant increase in the proportion of children aged 12 - 23 months infected with CV-A16, and an increase in the proportion of children aged over 36 months infected with other EVs. Conclusions: The incidence of HFMD caused by EV-A71 has decreased significantly, and other EVs have become the main pathogens of HFMD in North Sichuan region in recent years. In the prevention and control of CV-A16, more attention should be paid to children aged 12 - 23 months and the dominant serotype should be closely monitored. Our study highlights the importance of developing of new diagnostic reagents and vaccines for the prevention and control of enterovirus infection. This study for the first time provides insights into district interventions to local conditions.

Measurement,associations,patterns,and promotion:Unveiling vital areas in physical activity epidemiology

Physical activity(PA)epidemiology first emerged as a new field of study around the 1950s with publication of seminal investigations on London civil servants1 and has continued to evolve as a scientific discipline to present time.This subdiscipline of epidemiology studies the frequencies,distributions,and dynamics of PA and its impact on human health,morbidity,and mortality.Research over the past 75 years has demonstrated numerous health benefits of PA.Based on these research findings,the World Health Organization recommends adults aged 18-64 years engage in at least 150-300 min of moderate-intensity aerobic PA per week,or at least 75-150 min of vigorous-intensity aerobic PA per week,or a combination of both intensities.

Epidemiology and current management of cerebrovascular disease in China

The Annual Report on Cardiovascular Health and Diseases in China(2022)intricate landscape of cardiovascular health in China.In connection with the previous section,this fifth section of the report continues the dissection on the manage-ment of cardiovascular diseases(CVD).Cerebrovascular disease is the leading cause of death and loss of healthy life among Chinese residents.Based on the results of GBD 2019,from 1990 to 2019,the years of life lost due to premature death caused by stroke showed a decreasing trend,while the years lived with disability still increased continuously.At present,national mortal-ity surveillance system can provide national and provincial representative annual death data on cerebrovascular disease,but the national representative data on some other important epidemiological indicators(such as incidence,prevalence,disability rate,and case fatality rate)are scarce in China.With the construction of large cohort population and extension of follow-up time,re-search on stroke-related risk factors is increasing,providing a basis for the prevention and control of risk factors.Due to limited large-scale population-based intervention studies,there is a lack of epidemiological evidence to transform into feasible interven-tion strategies and measures.In recent years,great progress in endovascular treatment for basilar-artery occlusion has been achieved in China,but there is still much room for improvement of guideline-based anticoagulant treatment and lipid-lowering treatment,as well as standardized diagnosis and treatment among patients with ischemic stroke.

Valvular heart disease and cardiomyopathy in China:epidemiology and current treatments

The Annual Report on Cardiovascular Health and Diseases in China(2022)intricate landscape of cardiovascular health in China.In connection with the previous section,this ninth section of the report offers a comprehensive analysis of valvular heart disease and cardiomyopathy.Although rheumatic valve disease is still the main cause of valvular heart disease in China,with the aging of the population and the improvement of living standards,the prevalence of degenerative valvular heart disease is on the rise.Because many patients with valvular heart disease have only mild to moderate valve stenosis or insufficiency,and no symptoms,the detection rate in the population is low and late,resulting in many patients been in the severe late stage of disease at visit,increasing the difficulty of treatment and affecting effectiveness and prognosis.Therefore,we should strengthen the examination and screening of valvular heart disease in order to find and prevent it as early as possible.In addition,compared with other diseases,the treatment of valvular heart disease needs more and higher technical support(surgery,intervention,etc).However,not all hospitals can provide relevant technologies.At present,the treatment of valvular heart disease is still mainly concentrated in the provincial hospitals.It is necessary to carry out more professional training so that more doctors and hospitals can participate in the treatment of valvular heart disease.Cardiomyopathy is a group of myocardial diseases with abnormal myocardial structure and/or function,but couldn't be explained by hypertension,coronary atherosclerosis,valvular heart disease and congenital heart disease.It includes hypertrophic cardiomyopathy(HCM),dilated cardiomyopathy(DCM),arrhythmogenic cardiomyopathy(also known as arrhythmogenic right ventricular cardiomyopathy),restrictive cardiomyopathy(RCM)and undifferentiated cardiomyopathy.

Heart failure in China:epidemiology and current management

The Annual Report on Cardiovascular Health and Diseases in China(2022)intricate landscape of cardiovascularhealth in China.In connection with the previous section,this sixth section of the report offers a comprehensive analysis of heart failure(HF)in China.HF is one of the most important cardiovascular disease in the 21st century.Its mortality is equivalent to that of cancer.It is an important public health problem that seriously affects the health of Chinese residents.In recent years,with the deepeningof understanding,the change of treatment principles,the innovation of treatment methods and the update of treatment guidelines,the in-hospital mortality of HF patients has declined,and the long-term prognosis is also improving.However,there are stilldifferences in the management level of HF among different hospitals in China.How to improve the standardized diagnosis andtreatment level of HF in China remains an important challenge.

Epidemiology and current management of cardiovascular disease in China

The Annual Report on Cardiovascular Health and Diseases in China(2022) intricate landscape of cardiovascular health in China. This is the fourth section of the report with a specific focus on epidemiology and current management of cardiovascular disease(CVD) in China. This section of the report highlights the epidemiological trends of CVD in China. It reveal a concerning rise in prevalence, with approximately 330 million affected individuals, including significant numbers with stroke, coronary artery disease(CAD), heart failure, and other conditions. CVD stands as the primary cause of mortality among both urban and rural populations, accounting for nearly half of all deaths in 2020. Mortality rates are notably higher in rural areas compared to urban centers since 2009. While age-standardized mortality rates have decreased, the absolute number of CVD deaths has increased, primarily due to population aging. Ischemic heart disease, hemorrhagic and ischemic strokes are the leading causes of CVD-related deaths. Notably, the burden of atherosclerotic cardiovascular disease has risen substantially, with atherosclerotic cardiovascular disease-related deaths increasing from 1990 to 2016. The incidence of ischemic stroke and ischemic heart disease has shown similar increasing trends over the past three decades. CAD mortality, particularly acute myocardial infarction, has been on the rise, with higher mortality rates observed in rural areas since 2016. The prevalence of CAD has increased significantly, with over 11 million patients identified in 2013. Studies assessing hospital performance in managing acute coronary syndrome reveal gaps in adherence to guideline-recommended strategies, with disparities in care quality across hospitals. However, initiatives like the China Patient-centered Evaluative Assessment of Cardiac Events(PEACE)-Retrospective AMI Study and the Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome(CCC-ACS) project aim to improve patient outcomes through enhanced care protocols. Moreover, advancements in medical technology, such as quantitative flow ratio-guided lesion selection during percutaneous coronary intervention, show promise in improving clinical outcomes for patients undergoing intervention.

Coexistence of liver abscess, hepatic cystic echinococcosis and hepatocellular carcinoma: A case report

BACKGROUND Human cystic echinococcosis(CE)is a life-threatening zoonosis caused by the Echinococcus granulosus(sensu lato).Hepatocellular carcinoma(HCC)is a leading cause of cancer-related mortality in the world.The coexistence of CE and HCC is exceedingly rare,and only several well-documented cases have been reported.In addition to this coexistence,there is no report of the coexistence of CE,HCC,and liver abscess to date.Herein,we aimed to report a case of coexistence of liver abscess,hepatic CE,and HCC.CASE SUMMARY A 65-year-old herdsman presented to the department of interventional therapy with jaundice,right upper abdominal distension and pain for 10 d.Laboratory test showed that he had positive results for HBsAg,HBeAb,HBcAb,and echino-coccosis IgG antibody.The test also showed an increased level of alpha fetopro-tein of 3400 ng/mL.An abdominal computed tomography(CT)scan revealed an uneven enhanced lesion of the liver at the arterial phase with enhancement and was located S4/8 segment of the liver.In addition,CT scan also revealed a mass in the S6 segment of the liver with a thick calcified wall and according to current guideline and medical images,the diagnoses of hepatic CE(CE4 subtype)and HCC were established.Initially,transarterial chemoembolization was performed for HCC.In the follow-up,liver abscess occurred in addition to CE and HCC;thus,percutaneous liver puncture drainage was performed.In the next follow-up,CE and HCC were stable.The liver abscess was completely resolved,and the patient was discharged with no evidence of recurrence.CONCLUSION This is the first reported case on the coexistence of liver abscess,hepatic CE,and HCC.Individualized treatment and multidisciplinary discussions should be performed in this setting.Therefore,treatment and diagnosis should be based on the characteristics of liver abscess,hepatic CE,and HCC,and in future clinical work,it is necessary to be aware of the possibility of this complex composition of liver diseases.

Epidemiology of EGFR Mutation in Adenocarcinoma NSCLC Patients in India: A Systematic Review and Meta-Analysis

Studies reporting the Indian prevalence of Epidermal Growth Factor Receptor (EGFR) mutation are mostly single centers with small sample sizes. This systematic review and meta-analysis summarized the available evidence of EGFR mutation epidemiology in Indian patients with adenocarcinoma (ADC) Non-Small Cell Lung Cancer (NSCLC). We conducted a structured literature search in PubMed, and EMBASE databases from January 2004 through October 2019. The primary outcome of interest was prevalence of EGFR mutation by gender, smoking status, and mutation subtype. The review included 34 studies. EGFR mutation prevalence was 39.5% in patients with ADC, and significantly higher in females, non-smokers, and patients with exon 19 deletions. The EGFR mutation frequency in Indian patients with ADC was higher than reported in Caucasians but at a lower range of that reported in East Asians. These findings support the use of EGFR mutation testing to guide choice of treatment.

Current status of drug therapy for alveolar echinococcosis

Alveolar echinococcosis(AE)is a chronic zoonotic parasitic disease caused by infection with Echinococcus multilocularis.AE is associated with a high mortality rate and poses a significant threat to human health.The primary treatment for AE is surgical resection of the lesions;however,owing to its long incubation period and insidious disease progression,many patients are diagnosed only after the onset of complications such as liver cirrhosis,jaundice,and portal hypertension,which preclude curative surgical intervention.For patients who are unwilling or unable to undergo surgery,lifelong administration of anti-AE medications is necessary.Benzimidazole compounds,such as albendazole and mebendazole,are the current mainstays of treatment,offering good efficacy.Nevertheless,these medications primarily inhibit parasite proliferation rather than eradicate the infection,and their long-term use can lead to significant drug-related toxic effects.Consequently,there is an urgent need to develop new therapeutic strategies that convey better efficacy and reduce the adverse effects associated with current treatments.Recent advancements in AE therapy include novel synthetic compounds such as antiviral agents,antibiotics,antineoplastic agents,immunosuppressants,and antiangiogenic agents,as well as natural compounds derived from traditional Chinese and Tibetan medicine.These new drugs show promising clinical potential because they interfere with parasitic metabolic pathways and cellular structures.This review aims to discuss recent research on AE drug therapy,including mechanisms of action,dosing regimens,signalling pathways,and therapeutic outcomes,with a goal of providing new insights and directions for the development of anti-AE drugs and summarizing current advancements in AE pharmacotherapy.

Effectiveness of Wastewater-Based Epidemiology as an Early Warning Tool to Detect SARS-CoV-2 (COVID-19)

Medical diagnostic tests to detect Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) for individuals in the United States were initially limited to people who were traveling or symptomatic to track disease incidence due to the cost of providing testing for all people in a community on a routine basis. As an alternative to randomly sampling large groups of people to track disease incidence at significant cost, wastewater-based epidemiology (WBE) is a well-established and cost-effective technique to passively measure the prevalence of disease in communities without requiring invasive testing. WBE can also be used as a forecasting tool since the virus is shed in individuals prior to developing symptoms that might otherwise prompt testing. This study applied the WBE approach to understand its effectiveness as a possible forecasting tool by monitoring the SARS-CoV-2 levels in raw wastewater sampled from sewer lift stations at a large public university campus setting including dormitories, academic buildings, and athletic facilities. The WBE analysis was conducted by sampling from building-specific lift stations and enumerating target viral copies using RT-qPCR analysis. The WBE results were compared with the 7-day rolling averages of confirmed infected individuals for the following week after the wastewater sample analysis. In most cases, changes in the WBE outcomes were followed by similar trends in the clinical data. The positive predictive value of the applied WBE approach was 86% for the following week of the sample collection. In contrast, positive correlations between the two data with Spearmen correlation (rs) ranged from 0.16 to 0.36. A stronger correlation (rs = 0.18 to 0.51) was observed when WBE results were compared with COVID-19 cases identified on the next day of the sampling events. The P value of 0.007 for Dorm A suggests high significance, while moderate significance was observed for the other dormitories (B, C, and D). The outcomes of this investigation demonstrate that WBE can be a valuable tool to track the progression of diseases like COVID-19 seven days before diagnostic cases are confirmed, allowing authorities to take necessary measures in advance and also enable authorities to decide to reopen a facility after a quarantine.

Profiling of the Retrospective Epidemiology of the Human Papillomavirus and Related Cancers in the United Arab Emirates Population

The human papillomavirus (HPV) is a leading cause of infectious cancers, leading to a growing global interest on the profiling of HPV-related cancers. Therefore, the aim of the study was to determine the retrospective epidemiological profile of HPV-related cancer in the United Arab Emirates (UAE). The incidence profiling of HPV-related cancers in males and females of UAE of all ages ranged from a minimum of 0.6% to a maximum of 4.5% for testes cancer and colon cancer respectively in males;whilst in females it ranged from a minimum of 1.0% and a maximum of 34% for Hodgkin lymphoma, kidney, bladder, liver and pancreas cancer and breast cancer, respectively. The incidence profiling of HPV-related cancers in males and females of ages 15 - 44 years old ranged from a minimum of 0.1% to a maximum of 11.2% for pancreas cancer, and colon and rectum cancer respectively in males, whilst in females it ranged from a minimum of 0.1% and a maximum of 18% for pancreas and breast cancer, respectively. The mortality profiling of HPV-related cancers in males and females of all ages in the UAE ranged from a minimum of 0.1% for Hodgkin lymphoma and testicular cancer to a maximum of 4.5% for colon and rectum cancer respectively in males, whilst in females it ranged from a minimum of 0.2% and a maximum of 4.5% for pancreas and breast cancer, respectively. The mortality profiling of HPV-related cancers mortality in males and females of ages 15 - 44 years old in the UAE ranged from a minimum of 0.2% to a maximum of 4.3% for testicular cancer and colon cancer respectively in males, whilst in females it ranged from a minimum of 0.2% and a maximum of 7.2% for bladder and breast cancer respectively. In conclusion, the profiling of HPV-related cancers in UAE for both males and females of all ages is similar to that reported for other parts of the world.

Uncovering the epidemiology of bladder cancer in the Arab world: A review of risk factors, molecular mechanisms, and clinical features

Objective:Bladder cancer(BC)is a significant public health concern in the Middle East and North Africa,but the epidemiology and clinicopathology of the disease and contributors to high mortality in this region remain poorly understood.The aim of this systematic review was to investigate the epidemiological features of BC in the Arab world and compare them to those in Western countries in order to improve the management of this disease.Methods:An extensive electronic search of the PubMed/PMC and Cochrane Library databases was conducted to identify all articles published until May 2022,following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines.A total of 95 articles were included in the final analysis after title,abstract,and full-text screening,with additional data obtained from the GLOBOCAN and WHO 2020 databases.