The document discusses the importance of diversity and inclusion in the workplace. It notes that a diverse workforce leads to better problem solving and decision making as people from different backgrounds bring unique perspectives. The document recommends that companies implement diversity training for all employees and promote a culture of acceptance and respect for all.
Liver Tumors and Hepatocellular carcinoma supported by Hepatoblastoma. Most of the text are from Robbins Pathological basis of disease 9E, Goljan Review of pathology.
SHORT TALK ABOUT DIFFERENTIAL DIAGNOSIS ABOUT SOLID RENAL MASS , COMMON AND LESS COMMON CAUSES WITH CLUES TO DIAGNOSIS AND SOME EXAMPLES
HOPPING YOU LIKE IT
DR HISHAM ALKHATIB
CONSULTANT RADIOLOGIST
Liver Tumors and Hepatocellular carcinoma supported by Hepatoblastoma. Most of the text are from Robbins Pathological basis of disease 9E, Goljan Review of pathology.
SHORT TALK ABOUT DIFFERENTIAL DIAGNOSIS ABOUT SOLID RENAL MASS , COMMON AND LESS COMMON CAUSES WITH CLUES TO DIAGNOSIS AND SOME EXAMPLES
HOPPING YOU LIKE IT
DR HISHAM ALKHATIB
CONSULTANT RADIOLOGIST
La toxoplasmosis se encuentra en los seres humanos a nivel mundial y en muchas especies de animales y de aves. El parásito vive en los gatos.
La infección en humanos puede provenir de:
Transfusiones de sangre o trasplante de órganos sólidos.
Manejo de los excrementos de gato.
Ingerir tierra contaminada.
Comer carne cruda o mal cocida (de cordero, cerdo o res).
La toxoplasmosis también afecta a las personas que tienen sistemas inmunitarios debilitados.
La infección también se puede pasar de una madre infectada a su bebé a través de la placenta. Esto ocasiona toxoplasmosis congénita.
Síntomas
Puede no haber síntomas. Si los hay, suelen aparecer alrededor de 1 a 2 semanas después de entrar en contacto con el parásito. La enfermedad puede afectar el cerebro, el pulmón, el corazón, los ojos o el hígado.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
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Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
30. Review of Viral Hepatitis A B C E genome RNA DNA RNA RNA age young all all adults onset abrupt insidious insidious abrupt incubation 15-50 28-160 14-160 15-45 rash no yes no yes fever yes no no yes jaundice yes possible no yes Pregnancy mild mod mild severe
31. Review of Viral Hepatitis A B C E chronic no yes yes no liver cancer no yes yes no Transmission oral yes unlikely no yes IV rare yes yes no sexual uncommon yes yes no perinatal no yes low no
32. Markers of viral hepatitis Marker Significance HAV IgM acute hepatitis A infection HAV IgG prior hepatitis A infection, immunity HBVsurface antigen acute or chronic hepatitis B HBV core IgM acute hepatitis B HBV core IgG prior hepatitis B infection HBV surface antibody immunity to hepatitis B HBV e antigen infectious hepatitis B HCV Ig G antibody infection with hepatitis C HBVDNA viral titer of HBV HCVRNA viral titer of HCV
33.
34. High Moderate blood semen urine serum vaginal fluid feces wound exudates saliva sweat tears breastmilk Concentration of Hep B virus in Body Fluids Low/Not Detectable
Although the viral hepatitides have a very similar presentation, the subtypes can sometimes be differentiated by the time course, suspected source, host differences, environment and characteristic clinical syndromes. A diligent history best narrows the diagnosis. 5 different hepatitis virus agents have been recognized: A, B, C, D and E/an additional 4% of acute cases may be due to a viral agent not yet identified and are currently classified as “G” or “X” Other viral agents such as CMV, EBV, HSV, HIV, can produce similar clinical syndrome but these are rarely seen in the immunocompetent patients. Yellow fever: due to a flavivirus which causes hepatocellular and tubular(renal) necrosis. Hepatic manifestations include: jaundice, albuminuria, coagulopathy which produces the characteristic black vomit, epistaxis, gum bleeding, petechial & purpuric hemorrhages. Present in South America & Sub-Saharan Africa
to a polycyclic waxing and waning of sx to the abrupt onset of fulminant hepatitis In a “classic” presentation, 4 phases of infection can be characterized Asymptomatic phase of viral replication where serologic & enzyme markers can be measured Prodromal phase occurs next. One interesting symptom is aversion to cigarette smoke even in smokers. Patients who present during this phase are often diagnosed with “Viral Syndrome”, “URI” or “Viral Gastroenteritis” Icteric phase: that’s the phase when most patients present, GI symptoms and malaise predominate and the patient may complain of RUQ pain with corresponding hepatomegaly on exam. Before becoming jaundiced the patient may c/o darkening of the urine and then lightening of the stool, a historic finding that should always be sought. Final phase is a convalescent phase, where sx subside, icterus abates and LFT’s normalize, unless the infection becomes chronic. In chronic viral infection, the acute phases of infection are not frequently recalled and the patient seeks care for abnormal liver tests found on routine testing or for gradual onset of chronic fatigue.
abdo pain: especially in RUQ Rash can be macular, papular, urticarial or a serum sickness syndrome Magnitude of transaminases elevation is not a good indicator of severity of disease Imaging: rarely indicated unless there are atypical signs such as high fevers, rigors, colicky pain, high alk phosph, high amylase
Early signs of encephalopathy: changes in sleep/wake cycle Anxiety/agitation Personality change Altered mental status
The virus is also present in saliva & serum but only serum has been implicated in the rare transmission of HAV via transfusion. You cant get it by kissing, sneezing, coughing or needlestick!
Infection with hep B virus results in a broad spectrum of liver disease ranging from subclinical infection, to acute self-limited hepatitis to fulminant hepatic failure. Exposure to HBV especially in infancy may result in an asymptomatic carrier state that progresses to chronic active hepatitis, cirrhosis of the liver and eventually hepatocellular CA. Complex viral and host factors determine the variable clinical outcome More than 1 million HBV related deaths worldwide secondary to hepatocellular CA or cirrhosis 90% of children become carriers that is why it is so crucial to vaccinate babies at birth.
36
The hepatitis Be antigen is a more sensitive gauge of ongoing viral replication than HBSAg and is indicative of high infectivity. Detection of HBeAg for >10 weeks suggest chronic infection. IgM anti HBc is usually not detected in patients with chronic HBV infection and can therefore be used to differentiate a chronic from an acute infection in the HBsAg + patient
31
Prognosis: 6% risk of dying from hepatocellular CA
Hep B Vaccine: EngerixB/ RecombivaxHB TwinRix: hep A + hep B vaccine >18 years age
Interferon blocks the production or release of virus from infected cells.
Hep C discovered on 1989 (HIV 1983) Rates of infection in some prisons > 80%
- Most patients asymptomatic and discovered to have high LFT’s on routine labs
Risk from percutaneous injury: HCW have a prevalence of HBV infection 10X higher than the general population Because it can survive at room temp >1 week, infections can occur in HCW with no hx of percutaneous injury, but could have resulted from direct or indirect blood or body fluid exposures that inoculated HBV into scratches, abrasions, burns, other lesions or mucosal surfaces HCV: not transmitted efficiently thru occupational exposures to blood with one study indicating that transmission occurred only from hollow-bore needles compared with other sharps.
1 1 1
But Hep C is more virulent with 50% chance of developing significant liver disease
Hygiene and hand washing
Flush with 2-3 L/ no vigorous scrubbing Human bites: possible exposure of both the person bitten and the person who inflicted the bite must be considered. If a bite results in blood exposure to either person involved, PEP should be provided SE of vaccine: pain at injection site Anaphylaxis: none died HBIG: screened and prepared by cold ethanol extraction eliminating HIV from the final product. Other methods inactivate HCV and other viruses.
Available data suggest that an established infection might need to be present before Interferon can be an effective treatment Data from studies outside the US suggest that a short course of Interferon started early in the course of acute Hep C is associated with a higher rate of resolved infection than if begun after chronic Hep C has been well established In the absence of PEP for HCV, recommendations are intended to achieve early identification of chronic disease
1 million deaths a year/10-30 million new cases a year
Age: when seen in children & adolescents, underlying immune deficiency and trauma frequently exist
Pathophysiology: Appendicitis was the leading source of PLA in the preantibiotic era, but has been eliminated in recent times. Biliary Tract disease accounts for 60% of case. Obstruction of bile flow allows for bacterial proliferation. Biliary obstruction need not be from stone disease: patients with Caroli’s disease have a particularly high rate of pyogenic liver abscess formation (rare congenital cystic dilatation of intrahepatic bile ducts) Pylephlebitis: suppurative pylephlebitis usually arises from infection in the female genital tract but may result from infection elsewhere in the peritoneal cavity such as diverticulitis, pancreatitis, IBD. This occurs via septic thrombophlebitis of any tributary of the portal venous system. Septic emboli are released in the portal circulation, trapped by the hepatic sinusoids and become the nidus for microabscess formation. Initially, abscesses are multiple but usually they coalesce into a solitary lesion. Contiguous spread from empyema of the Gallbladder, subphrenic or perinephric abscess. About 4% develop in this manner. Cryptogenic cause: we don’t know Trauma: Penetrating via direct inoculation or Blunt Secondary infection can also be a complication of liver transplantation
Fever: especially in the elderly, FUO may be the presenting complaint Chills: the only patient I saw with this was having severe RIGORS Abdo pain can be localized to the RUQ or you can have referred pain to the right shoulder Cough due to diaphragmatic irritation may be present Exam: General: Patients are generally systemically unwell especially if they have multiple abscesses with signs of systemic toxicity but individuals with solitary lesions have a more insidious course with weight loss and anemia. 30% have a pleural effusion
Ultrasound: allows for close eval. of biliary tree and simultaneous aspiration of cavity/benefits include portability and diagnostic utility in patients too critical/operator dependent CT scan: peripheral enhancement is seen when IV contrast is given, gas can be seen in as many as 20% of lesions, Ct scan is superior in its ability to detect lesions less than 1 cm, also enables the eval. Of concurrent pathology throughout abdomen and pelvis
usually is the rule When the biliary tree is the source of infection, enteric gram – bacilli and enterococci are common isolates. Abscesses involving Klebsiella pneumonia has been associated with multiple cases of Endophthalmitis Antibiotics: 2 nd or 3 rd generation ceph, beta-lactam or beta-lactamase inhibitor + anaerobic coverage: flagyl or clinda. Carbapenems for PCN allergies. Duration: Multiple abscesses are more problematic and can require up to 12 weeks of therapy. Both the clinical and radiographic progress of the patient should guide the length of therapy Drainage introduced in the 70’s as an alternative to surgery, overall success rate equal or superior to surgery, taken out when output < 10 cc/ day or cavity collapse is documented by serial CT scanning/ Good even for multiple abscesses.
GI: after successful drainage to evaluate any underlying gastointestinal disease using colonoscopy or ERCP ID: in complicated case or unusual pathogens
- Starry sky seen on sono can be seen in disseminated mycobacterial disease, disseminated pneumocystis carinii or CMV infection
Fascioliasis Schistosomiasis (blood fluke) Ascariasis: round worm that causes the most common helminthic infection in the world/can cause biliary obstruction & cholangitis
Source: the infective cysts reach humans thru water and vegetables contaminated with feces, thru food contaminated by night soil fertilizers or by hands of infected food handlers or by direct transmission of the cyst
Pain is constant dull aching CXR: abnomal in 50% of patients, elevation of the right hemidiaphragm, pleural effusion, atelectasis, Sono: rounded or oval lesion that is hypoechoic and homogeneous in appearance with an absence of wall echoes; lesion near or contiguous with the liver capsule CT: Is highly sensitive but not specific. It reveals detailed margins of the lesion and info re: blood supply that help differentiate an amebic abscess from a hepatic cyst, solid tumor or hemangioma. MRI of the liver is considered the most sensitive imaging technique but not specific Tc Nuclear Scan is useful in differentiating an amebic abscess from a pyogenic abscess. Because amebic abscesses do not contain leukocytes, they appear as “cold” lesions
Flagyl is efficacious against both the systemic and intestinal manifestations of amebiasis. Luminal agent: iodoquinol, paromomycin, diloxanide/failure to use luminal agents can lead to relapse of infection in 10% of patients Aspiration should be considered in patients with a high risk of abscess rupture as defined by a cavity size >5cm, left lobe liver abscess which is associated with higher mortality and higher frequency of leak or rupture into the pericardium Pus is odorless and sterile on routine culture
Pleural cavity rupture can cause a large pleural effusion, empyema, severe dyspnea or pleuritic pain IVC obstruction can occur secondary to mechanical compression from the abscess ARDS + sepsis can also develop in severe cases of extraintestinal amebiasis
Liver is the commonest organ involved but lung, brain and bone can also be infected
Clinical: symptoms are generally non-specific, may be asymptomatic Aspiration: previously contraindicated in patients with Echinococcal disease because it is associated with risk of dissemination or anaphylaxis, nowadays it is gaining acceptance. Percutaneous Rx entails drainage & instillation of a sclerosing scolicidal agent. Pretreatment with mebendazole preferred. Precautions to prevent allergic & anaphylactic reactions are necessary. Surgery: liver is packed off with hypertonic saline soaked swabs, cysts are then decompressed with trocar and cannula, Scolicidal agent (hypertonic saline or 0.5% silver nitrate) can be injected into cyst cavity to kill residual daughter cysts in the germinal membrane before unroofing and pericystectomy