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Clinical Management of Cystic Echinococcosis: State of the Art, Problems, and Perspectives
Thomas Junghanss
Thomas Junghanss
Section of Clinical Tropical Medicine, University Hospital Heidelberg, Heidelberg, Germany; Serviço de Cirugia Geral e Digestiva, Hospital de Pulido Valente, Lisbon, Portugal; Tropical Projects, Hitchin, United Kingdom; Department of Clinical Parasitology, Hospital for Tropical Diseases, London, United Kingdom; Division of Infectious and Tropical Diseases, University of Pavia, IRCCS S. Matteo Hospital Foundation, Pavia, Italy
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Antonio Menezes da Silva
Antonio Menezes da Silva
Section of Clinical Tropical Medicine, University Hospital Heidelberg, Heidelberg, Germany; Serviço de Cirugia Geral e Digestiva, Hospital de Pulido Valente, Lisbon, Portugal; Tropical Projects, Hitchin, United Kingdom; Department of Clinical Parasitology, Hospital for Tropical Diseases, London, United Kingdom; Division of Infectious and Tropical Diseases, University of Pavia, IRCCS S. Matteo Hospital Foundation, Pavia, Italy
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John Horton
John Horton
Section of Clinical Tropical Medicine, University Hospital Heidelberg, Heidelberg, Germany; Serviço de Cirugia Geral e Digestiva, Hospital de Pulido Valente, Lisbon, Portugal; Tropical Projects, Hitchin, United Kingdom; Department of Clinical Parasitology, Hospital for Tropical Diseases, London, United Kingdom; Division of Infectious and Tropical Diseases, University of Pavia, IRCCS S. Matteo Hospital Foundation, Pavia, Italy
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Peter L. Chiodini
Peter L. Chiodini
Section of Clinical Tropical Medicine, University Hospital Heidelberg, Heidelberg, Germany; Serviço de Cirugia Geral e Digestiva, Hospital de Pulido Valente, Lisbon, Portugal; Tropical Projects, Hitchin, United Kingdom; Department of Clinical Parasitology, Hospital for Tropical Diseases, London, United Kingdom; Division of Infectious and Tropical Diseases, University of Pavia, IRCCS S. Matteo Hospital Foundation, Pavia, Italy
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Enrico Brunetti
Enrico Brunetti
Section of Clinical Tropical Medicine, University Hospital Heidelberg, Heidelberg, Germany; Serviço de Cirugia Geral e Digestiva, Hospital de Pulido Valente, Lisbon, Portugal; Tropical Projects, Hitchin, United Kingdom; Department of Clinical Parasitology, Hospital for Tropical Diseases, London, United Kingdom; Division of Infectious and Tropical Diseases, University of Pavia, IRCCS S. Matteo Hospital Foundation, Pavia, Italy
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Clinical management of cystic echinococcosis (CE) has evolved over decades without adequate evaluation of important features such as efficacy, effectiveness, rate of adverse reactions, relapse rate, and cost. CE occurs in health care environments as different as Europe/North America and resource-poor countries of the South and the East. This creates setting-specific problems in the management of patients. Furthermore, studies carried out in either of the two fundamentally different environments lack external validity, i.e., results obtained in one setting may be different from those in the other and practices that can work in one may not be applicable to the other. In this paper, we review the current management procedures of CE with particular emphasis on the evidence base and setting-specific problems.
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