Central nervous system cystic echinococcosis: a systematic review.

Central nervous system (CNS) cystic echinococcosis (CE) is a rare disease caused by Echinococcus which especially exists in agricultural endemic areas. This condition is more frequent in the pediatric and adolescent population and it can be associated with hydatid cyst in other localizations. A literature search was conducted up to April 28, 2021 by two independent reviewers. This study focused on clinical, imaging, therapeutic features as well as on complications of CNS CE among children and adults. Fifteen studies from seven different countries were included. A significant prevalence in males (ranging from 51% to 100%) was observed with an average rate of 60%. CNS CE was mainly single and located in the parietal region. The predominant symptoms were those of increased intracranial pressure. All patients were treated surgically, and the most common post-surgical complication was cyst rupture (prevalence: [3.3-37.5%], average: 12.9%). Furthermore, the outcomes were worse amongst patients with cyst ruptures and multiple recurrences. The average proportion of deaths due to CNS CE was 5.6% (range: 2.5-14.8%). This review highlights the necessity of including CNS CE in the differential diagnosis of patients with cystic lesions, especially in those residing in endemic areas. Early gross total cyst removal is the mainstay of treatment yielding the best outcomes.

Development and Validation of a Multidimensional Expectation Questionnaire for Thalassaemia Major Patients.

Nowadays, thalassaemia major (TM) patients are surviving into mature young adulthood; however, no published instrument exists to measure the expectations' dimensionality among older TM patients in their thirties. This study seeks to validate a novel multidimensional expectation questionnaire suitable for TM patients (MEQ-TMP) reaching their fourth decade of life. In order to establish the psychometric properties of the instrument, data analysis was carried out. The principal component analysis revealed four components ('Supportive social network'; 'Raising one's own family'; 'Career advancement'; 'Ability of daily activities'). Their cumulative contribution rate was 66.32%. Cronbach's alpha for the total scale was 0.87. Each subscale had an alpha value above 0.70; three subscales were in the 0.80 range. MEQ-TMP reliability was proved to be good. The known-group method served as a strategy in examining the operationalisation of the questionnaire's constructs. The present MEQ-TMP, developed for the aged group of TM patients, would be a useful tool for clinical personnel providing care to TM patients in understanding their outlook on life as they are growing up, to have better psychosocial adjustment to illness chronicity, live life as normally as possible, and fulfill their ambitions; thus enhancing their life satisfaction and quality of life.

Differences in clinical significance and morphologic features of Blastocystis sp subtype 3.

Blastocystis is a polymorphic intestinal parasite that is common in humans. A total of 51 asymptomatic and symptomatic patients positive for Blastocystis only were included in the study. Symptoms were mainly nonspecific gastrointestinal symptoms. Blastocystis isolates were xenically cultured and subtyped. Blastocystis species subtype 3 was the predominant subtype. Intrasubtype differences (vacuolar/amoeboid presence) in subtype 3 morphotypes were observed in 32 asymptomatic and symptomatic subtype 3 cases and could possibly be related to Blastocystis pathogenic potential. Diverse morphologic features (vacuolar transiting to amoeboid), probably reflecting the progression from an asymptomatic to a symptomatic state, were observed in an asymptomatic subtype 3 carrier who later had symptoms. Searching for amoeboid forms might be helpful to presumptively screen symptomatic patients with subtype 3 or to follow up an asymptomatic subtype 3 carrier in case symptoms become evident before antiprotozoal treatment was attempted. Further studies on the roles of morphologic features and variation within Blastocystis species subtypes as predictors of symptoms are encouraged.

Blastocystosis: an emerging or re-emerging potential zoonosis?

Blastocystis sp. is an intestinal protozoa that was formerly recognised as a yeast. However, it has since been classified in the Stramenopile Kingdom. In addition to being observed in humans, the disease has been diagnosed in a wide range of animals (mammals, amphibians, birds, reptiles and arthropods). Extensive genetic heterogeneity has been demonstrated. Blastocystis sp. subtypes 1 to 9 were recently considered to be of zoonotic origin. While some suggested that Blastocystis might play a pathogenic role in intestinal disorders in humans, others reported that there was no correlation. Furthermore, amoeboid forms of Blastocystis might be implicated in pathogenesis. In spite of recent reports, earlier data on the prevalence of the parasite suggest that blastocystosis could have occurred sporadically or continuously in the past. It might be speculated that in cases of zoonotic genotypes producing amoeboid forms, Blastocystis sp. infection might rather be considered a potential re-emerging zoonosis.

Direct detection of Blastocystis sp. in human faecal samples and subtype assignment using single strand conformational polymorphism and sequencing.

Blastocystis is an anaerobic parasitic microorganism, which has been found in the intestinal tract of many vertebrates including humans. Recently, members of Blastocystis sp. were classified into nine subtypes, based on phylogenetic trees derived from sequence analysis of the small subunit ribosomal RNA (SSU rRNA) gene. The role of Blastocystis in human disease remains uncertain and the existence of pathogenic and non-pathogenic subtypes is under investigation. We report the development of a polymerase chain reaction (PCR)-based assay that is able to detect Blastocystis directly from human faeces. Furthermore, combined with single strand conformational polymorphism (SSCP) analysis and/or sequencing of the respective PCR product, the protocol can classify Blastocystis among the nine established subtypes. The method was applied to 45-positive and 30-negative faecal samples and proved to be highly sensitive and specific. Genotyping using SSCP analysis and sequencing revealed that subtype 3 is the most frequent in Greece, while subtypes 1, 2, 4, 6 and 7 are also present but in lower frequencies. Hopefully, the simplicity of the proposed method will contribute toward large-scale epidemiological studies for prompt clarification of the role of the parasite.