Uncomplicated and small lesions (under 5cm) CE1,2 and 3 can be treated with oral albendazole (10- 15mg/kg/day) and close monitoring. However, large CE1 and CE3 cysts need treatment with both albendazole and PAIR (percutaneous aspiration, introduction of scolicide and reaspiration), performed after initiation of albendazole. Primary surgical treatment has been replaced with less invasive methods since the relapse rate can reach 20%. In patients with complicated cysts, surgery is the treatment of choice. CE4 and 5 only need to be monitored [1][3].
Catalina Diaconu,
Florentina Ioniţă Radu,
Mariana Jinga,
Petrut Nuta,
Sandica Bucurica,
Bogdan Macadon,
Mihaita Patrasescu,
Andrada Popescu,
Vasile Balaban,
Laura Voicu,
Daniel O. Costache View full articleChronic liver disease is a late stage of progressive hepatic fibrosis. It consists of functional and structural disruptions in most chronic liver diseases. An accurate diagnosis allows us to establish the degree of fibrosis and the stage of the disease, the prognosis of the patient and to predict a treatment response. Despite the fact that liver biopsy is considered a gold standard, non- invasive methods for diagnosing liver fibrosis have gained more and more importance. Whether we talk about serum biomarkers or imagistic methods from transient elastography to 3-D magnetic resonance elastography, the question remains: are these useful or useless? Serum biomarkers represent blood components that can reflect liver histological changes, thus they can monitor the continuous process of fibrosis. These can be subcategorized in direct (that show extracellular matrix turnover) and indirect markers (that reflect disturbances in the hepatic function). However these markers alone are not as accurate in the staging of fibrosis, only help differentiate patients without or with low grade of fibrosis from those with significant fibrosis and cannot be considered alone in the diagnosis of liver fibrosis. Imagistic methods include: ultrasound-based transient elastography, magnetic resonance elastography (MRE), 2D-shear wave elastography, acoustic radiation impulse imaging (ARFI) and cross sectional imaging, the first being the most used. Using a combination of non-invasive tools allows us to diminish the number of patients in need of liver biopsy. However, the patient must always be informed of the advantages and disadvantages of each method and its limitations.
As the medical sciences advances, so does the volume of information which becomes more and more consistent. The health care system is one of the most complex systems encountered in our society. Today, knowledge management practices have been adopted in many Romanian business sectors. However, Romanian health care system is slowly adopting such principles and concepts. This fact is created mainly because of the organizational culture. In the sanitary industry, this barrier is composed both from an organizational perspective and also, from an individual perspective. Through the knowledge management practices, doctors could benefit from the amount of data spread in different geographical regions.
