Rare Case of Chagas Disease

Chagas is a multisystem disease transmitted from Trypanosoma cruiz, not uncommon in Latin America. This disease causes parasympathetic failure resulting in cardiac failure, arrhythmogenic, cardiomyopathy, sudden death, mega esophagus and mega colon. In this article, we present a case of chronic Chagas disease who had extensive investigation prior to reaching a correct diagnosis. We will highlight the symptomatology and treatment.

Digital restoration of maxillary central incisors after trauma using an intraoral scanner and a CAD/CAM system in an 11-year-old

Background: Most dental trauma in children and adolescents involve anterior tooth fractures. Advancements in ceramics technology and in computer-aided design/computer-aided manufacturing (CAD/CAM) systems, have led to the technological abilities to produce single all-ceramic crowns with high biocompatibility, esthetics, and optimal mechanical properties. However, there is no information regarding the use of this technique in children. Case report:Treatment of extensive crown fractures on an 11 years old patient using a chairside CAD/CAM technology. The teeth were scanned and the restorations were fabricated using the manufacturing unit of the CAD/CAM system and glazed to the appropriate tooth color. At a follow up visits the restorations kept their strength and esthetic appearance (one year follow up). Conclusion: The digital restoration treatment is especially suitable for treating children with dental trauma. It has the advantage of better esthetic, functional and durable results compering to conventional restorations, and it often requires only a single session.

Soft tissue necrosis after radiotherapy for head and neck cancer

A 60-year-old man with cT2N0M0 hypopharyngeal squamous cell carcinoma received definitive chemoradiotherapy. FDG PETCT at 4 weeks showed complete metabolic response at primary site (Figure 1). At 6 months, contrasted CT showed no evidence of disease with soft tissue air indicating radiation necrosis and ulceration (Figure 2). The patient had symptom of dysphagia. Laryngoscopy and esophagogastroduodenoscopy showed inflammation without other severe findings. He had conservative care as a treatment option. At 12 months, contrasted CT showed improved nonenhancing ulceration without disease progression (Figure 3).

Eosinophilic, polymorphic and pruritic eruption associated with radiotherapy (EPPER) in patient with tongue cancer

Eosinophilic polymorphic and pruritic eruption associated with radiotherapy (EPPER) is a rare disease entity that appears in cancer patients after radiotherapy. We describe patient with tonsil cancer who presented with EPPER in an area that had been irradiated. The patient responded to the application of topical corticosteroids and systemic antihistamines.

Reasons for increased tolerance and validation of psychoactive substance dependence

The article shows that the current level of physiology does not disclose the biological mechanisms of the organism transition from one range to adapt to a higher with an increase in the regular forces of the stimulus above sub-extreme. A new trend in the physiology of adaptation - proqredient adaptation, explains the mechanism of increasing the tolerance of the organism, with dependence on psychoactive substances (PAS). It is scientifically proved, that dependences of the organism on PAS are the states of progredient adaptation.

Surgical treatment of dropped head syndrome secondary to fascioscapulohumeral muscle dystrophy: a case report

Fascioscapulohumeral muscular dystrophy is an uncommon hereditary myopathy which affects mainly the muscle of the face and upper limb girdle. We present a rare case with dropped head syndrome as the prominent manifestation of that disease and successfully treated by surgical management. It was a 25-year-old male patient with the chief complaint of neck pain and inability to maintain his horizontal gaze for long periods and as a result he had to quit his job as a shipper. His mother also had signs and symptoms of fascioscapulohumeral muscle dystrophy. Conservative treatment consisting of physical therapy and hard collar was the first attempt in order to reduce the neck pain and had limited result. We then performed a posterior cervical surgery including C2 to T2 instrumentation and kyphotic correction for the patient. The ten-month postop clinical and radiological results were satisfactory and the patient could return to his previous job. Dropped head syndrome with failed conservative treatment can be surgically treated after considering all clinical and radiographic factors.

Deuterium-depleted water delayed hormone therapy of prostate cancer

The anticancer effect of deuterium depletion in combination with conventional therapies has been confirmed in phase II double-blind clinical trial with prostate cancer patients. In this study, we describe the case of a patient who was diagnosed with prostate cancer in 2009. He denied the hormone therapy offered, providing an opportunity for following the effect of deuterium depletion as a single intervention. The patient started consuming deuterium-depleted water (DDW) one month after the diagnosis. Already after one month of DDW consumption, his PSA level dropped from 8.7 ng/mL to 6.3 ng/mL and 1.5 years later, an MRI scan could not confirm the presence of the tumor 1 cm in diameter. The 11 years follow-up of the changes in PSA value proved that deuterium depletion controls the growth of prostate cancer. The data also revealed that increasing the length of the break in DDW consumption from 5-6 months to 11 months promoted the progression of the disease as confirmed by an MRI scan. The patient had 13 courses of DDW treatment in 11 years. This study confirms that deuterium depletion is an effective early-stage treatment as a single therapy and delays conventional therapy. Based on previous studies we also conclude that DDW in proper combination with hormone therapy assists in prolonging the development of hormone resistance.

Mental health challenges of the older adults during the covid-19 pandemic

The Coronavirus disease 2019 (COVID-19) pandemic that began in early 2020 has challenged all aspects of human life. Older adults have been affected most adversely by this virus. The difficulties this group is facing are contributing to negative mental health outcomes. The present article explored some pertinent areas of research regarding older adults and COVID-19. These areas included age discrimination, social isolation, and death anxiety.

Counseling protocol for the older adults during the covid-19 pandemic and similar future situations

COVID-19 has presented many unique challenges for the older adults since early 2020. The difficulties this group is facing, especially due to social isolation, are contributing negatively to their mental health outcomes. To date, a comprehensive treatment plan for older adults that deals with their special issues during the pandemic has not been developed. An integrated review of existing counseling techniques for the older adults during the COVID-19 pandemic was conducted and a research-based treatment plan was developed. This protocol can be used during the COVID-19 pandemic as well as during the other similar situations.

Nonspecific low back pain and associated factors in the professions of health care workers especially the physiotherapist

Introduction: Low back pain (LBP) is relatively a major cause of disability among the working population and has a significant socioeconomic impact. The study aims were to determine the prevalence and associated factors of low back pain among professions of health care workers especially the physiotherapist. Methods: A total of 225 participants (78,7%female, 21.3% male) among students of Professional and Scientific Master degree in University of Medicine, Faculty of Technical Medical Science and healthcare workers that working in the University and in the tertiary University Medical Center of Tirana "Mother Teresa" were involved to evaluate LBP for a period for more than two years (from Mars 2017 until to November 2019). A standardized Nordic questionnaire for the analysis of LBP symptoms and epidemiological risk factor data was used to collect information from our study participants. Results: Prevalence of LBP in healthcare workers was determined to be 87.5%. Female resulted to be 4.9 times in risk to have LBP compared to male for CI 95% (2.16-11.2) p value<0.001. The average age resulted to be 37 ± 5.9, where the minimum and maximum age were 21 and 55 years old respectively. The participants ≥51 years old were 14 times in high risk for LBP compared to other age groups for CI 95% (5.9-21.6) p value=0.001. It was observed that low back pain was most common among nurses (44.1%) p value<0.0001. Also risk factors such as job position, working condition, long standing and long sitting at desk, health status and also the physical activity demonstrated an association and increasing low back pain risk, p value in all these factors resulted less than 0.05. Conclusion:Our study demonstrated that the prevalence of LBP were higher and healthcare workers especially the nurses are among group with high risk of low back pain.