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In the 21st century, we are facing the fact that the global population is ageing quite rapidly. The reason for this increasing trend lies in several factors. Firstly, the number of babies brought to this world declines and more and more couples face fertility issues. Second, more important factor includes better availability and quality of healthcare worldwide, which in return prolongs life expectancy. Western countries, and those with high quality of primary healthcare, are impacted the most with ageing phenomenon. According to some estimations provided by the World Health Organization (WHO), the total world’s population over 60 years of age will nearly double by the 2050. Shown in numbers, we can anticipate an increase from 900 million today, up to nearly 2 billion people of elderly people in thirty years. These, what appears to be dramatic data have multiple consequences, including social, economical, as well as healthcare issues.

Psychological and psychotherapy

Mental problems are well recognized health issue in the elderly. It is estimated that approximately one fifth of the global elderly population suffers from some form of psychological disorder which prevents them from independently performing everyday activities. As a society, we sometimes perceive intellectual and mental decline almost as a natural consequence of ageing. On the other hand, stigma that surrounds these conditions often prevents elderly people and their families from seeking professional help and assistance. Support and care are crucial when we discuss about how to overcome the challenges related to psychological problems in the old age.

What are the risk factors?

The spectrum of risk factors responsible for developing psychological problems in old age is quite extensive. Multiple chronic illnesses, especially those of cardiovascular and cerebrovascular origin (hypertension, stroke, coronary heart disease) may have direct consequences to the brain, thereby producing cognitive disturbances and mental issues. Chronic pain is a perfect trigger of psychological distress in the old age. Hospital admission and any change of the environment (moving to a care setting) can also have a negative impact for the overall psychological well-being in the elderly. Social isolation, reduced income during retirement and loss of close family members are significant stressors to cope with – these may produce severe psychological disturbances leading to anxiety or depression. In fact, any severe and long-term illness, such as cancer, tends to affect the behavioral and psychological status of an older person.

Sadly, people of older age are also recognized as a population group prone to abuse. There is evidence that one in six older people will experience some type of abuse. Loss of dignity and respect is, not surprisingly, tightly linked with severe psychological issues.

Are there any symptoms?

Close family members and caregivers should be aware of signs and symptoms related to mental disorders in the elderly in order to seek professional help in a timely manner. When we see our loved ones age, occasional forgetfulness is usually not something to especially worry about. However, persistent loss of memory is a clear indication of a severe health condition needing medical attention.

Significant changes in appearance including changes in clothing may implicate a psychological and behavioral problem. Confusion, disorientation, inability to concentrate or make decisions represent early signs of cognitive decline and dementia. If you experience that your loved ones persistently ask the same questions, forget important dates, frequently misplace their belongings, this is a clear sign to refer them to a medical professional.

It is advisable to especially keep an eye on the feelings of guilt, worthlessness, helplessness – such symptoms are linked with depression. Mood swings, ranging from e.g. being carefree to anxious are indicative of psychological issues. Inability to cope with everyday routine, problems in maintaining hygiene, home or garden should not be disregarded – they are often a sign of mental illness in older people.

Noticing any type of social withdrawal should be taken seriously. If your loved ones lose interest in social activities that they used to be excited about, or just avoid regular social engagements, you should consider seeking professional support for them.

Common psychological issues in old age

It is probably not that surprising that cognitive decline and dementia represent the most common mental health disorder in people older than 65 years. This severe and progressive disease affects approximately five million senior Americans or fifty million seniors worldwide. Concerning is the fact that this number will almost triple in the next twenty years. The disease by itself is estimated to take more lives than breast and prostate cancer combined. Any type of dementia can produce significant physical, emotional and economic pressure to patients and their caregivers. This is why an early diagnosis and appropriate care are essential for patients and their caregivers.

Depression and mood disorders are also quite frequent among seniors, however, the problem with this health condition is that it often goes undiagnosed and, therefore, untreated. Center for Disease Control (CDC) estimates that 5% of elderly individuals suffer from depressive disorder. It is worth mentioning that some medications such as those for the treatment of increased blood pressure may cause depression. Sadness is not the only symptom. Lack of motivation and energy are the usual complaints linked to depression. Prolonged suffering and impairment in performing daily activities are well recognized consequences of untreated depression. Timely diagnosis, accompanied with adequate treatment, care and support is crucial for increasing the quality of life of elderly individuals.

Anxiety is also quite prevalent and may encompass a wide range of mental issues including obsessive-compulsive disorder, post-traumatic stress disorder, panic disorder or phobias. Women are more prone to anxiety than men. Anxiety related disorders tend to occur after a stressful situation such as loss of a spouse or side by side to other chronic and prolonged disease. As in depression, anxiety disorders are usually overseen in elderly individuals, which may have severe implications to the overall well-being of seniors.

Sleep disorders including are common among seniors. Prolonged time needed to fall asleep (usually more than 45 minutes), trouble in maintaining sleep with frequent periods of being awake during night, as well as short overall duration of sleep represent clear signs of insomnia. Proper sleep is very important as it will reduce the probability of a severe psychological disorder. Maintaining a “sleep hygiene” reduces the need for sleep medications, which are sometimes responsible for memory impairment or poor daytime performance.

Is there a solution ( psychotherapy )?

It is important to mention that all of the above-mentioned disorders may coexist, and it is usually the case that seniors suffer from more then just one mental disorder. This is why they need all our support. WHO clearly recommends as a standard of care both psychological and medicinal treatment of seniors affected with mental disorders. This approach is essential for improving both physical and mental health and keeping an optimal quality of life of elderly individuals.

The demand for care and support of seniors with mental issues will increase as the elderly population grows. Providing a timely, high-quality professional help to older people directly reduces the number of complications that may arise as a consequence of mental disorders and prolongs the physical and emotional well-being of the elderly.

Solutions at CubaHeal

CubaHeal offers specialized programs for diagnosis and treatment of psychological problems in the elderly. An array of psychological therapies is available at CubaHeal facilities. Our team of health professionals can provide top-notch, evidence-based medical expertise. This includes diagnosis and treatment for our users, no matter the psychological condition and its stage.

You can find more info about our programs here. Long Term Elderly Care

If you need any additional info about our programs, feel free to Contact us.


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Is Coronavirus an impending doom? Videos of civilians dropping dead in Wuhan and footages of hospital personnel there dressed in something that looks like spacesuit are going viral, and it seems like humanity counts its last months on the planet. But is it that bad? Fortunately, no, the situation is not that bad. In just a few weeks, everything will go back to normal, and all this chaos triggered by the outbreak will be remembered by an impeccable feat of Chinese authorities- building a thousand beds fully equipped hospital in only seven days.

Coronavirus

That being said, let’s take a closer look at the Coronavirus, the disease it causes, treatments, precautionary measures, and what you can do to protect yourself against it.

The source of all the info in the article: World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC).

What is Coronavirus?

The virus responsible for the outbreak in Wuhan belongs to a large group of Coronaviruses. All viruses in the group share some characteristics- for example, the structure of their RNA, genome structure, set of replication enzymes, etc. Those „highly technical“ characteristics of Coronaviruses fall into the realm of microbiology, and we won’t further discuss them in this article- they’re not crucial for the talk.

The infections caused by Coronaviruses

Coronaviruses have been around for a long time, causing mild respiratory infections in humans and gastrointestinal diseases in animals. In nature, the reservoir of infection is animals, and people get infected by sharing the same environment with them. That’s how the Wuhan outbreak started. Between humans, the disease is spread by an airborne route.

In the past, Coronaviruses were to blame for a mild common cold- the outbreaks would pop here and there, causing nothing more than a runny nose or flu-like symptoms.

In 2003 the attention of the public was drawn to the unusually aggressive respiratory virus that caused severe lung damage in some patients (Severe Acute Respiratory Syndrome or SARS). The SARS virus belongs to the group of Coronaviruses. This was the first time a member of the group causes such severe respiratory infection in humans. What was the death rate of SARS? The rate varied a lot among different age groups, ranging from under 1% in persons 24 years of age or younger, to 15% in persons 44 to 64 years old. Altogether, the death rate of SARS was estimated at 10%.

The Coronavirus everybody is buzzing about these days seems to be substantially less lethal than the SARS virus. It’s too early to tell, but judging by the numbers available so far, it appears that the death rate is at about 2%. A more detailed epidemiological insight into the viruses „death profile“ is not available yet.

The symptoms of Coronavirus infection

As mentioned, Coronaviruses cause respiratory infections in humans. The symptoms are unspecific and include runny nose, sore throat, cough, breathing difficulties, shiver, fever, fatigue, or malaise. In other words, judging by the symptoms, one could not make a distinction between Coronavirus infection and common cold or flu.

Compared with other seasonal respiratory infections, the virus tends to cause complications such as pneumonia or kidney failure more often. People with chronic diseases such as diabetes or pulmonary diseases are at higher risk of complications.

The footages of people dropping dead on the streets of Wuhan are a hoax.

Treatments for the Coronavirus

Like for almost all viruses out there, the treatment is symptomatic. This means that it is focused on preventing complications, supporting the patient’s immune system as much as possible, and keeping an eye on those at higher risk of complications. In other words, Coronavirus infection is treated like a common cold or flu.

In patients with a severe form of the disease, doctors might reach out for antibiotics as a precaution of bacterial infection on a terrain of viral pneumonia, for example.

What can you do to protect yourself against Coronavirus?

Prevention is key.

Proper personal hygiene. Wash your hands frequently using soap and water or alcohol-based hand rub. This kills microorganisms on your hands and reduces the risk of infection.

Social distancing is another tactic. At public places, maintain at least 1 meter distance from other people. The infections are transmitted by small droplets when someone sneezes- being too close to the person increases chances of you breathing in the droplets containing the virus. Public transportation, shopping malls, train stations, and similar places should be avoided whenever possible.

Avoid touching eyes, nose, and mouth. The virus invades its host through the mucous membranes of the body. It is extremely sensitive to external conditions, but once it reaches its receptors on epithelial cells, it quickly replicates and continues to invade the host.

If you have symptoms of flu or a common cold, ask for medical help. Most people who get infected recover quickly and thoroughly. However, some get complications that are challenging to treat. This is why it is essential to seek medical help early- just so that doctors could timely diagnose a severe form of a disease and start appropriate treatment.

Masks- yes or no? A mask can help in preventing the spread of the infection. However, when it comes to Coronavirus (and other viral infections), its effectiveness is limited. The mask should be worn correctly and replaced with a new one every 2 hours. Earlier research mask effectiveness showed that they are not as nearly as important as the preventive measures listed above. While wearing a mask does reduce the risk of infection, the level of protection it provides is controversial.

What makes Coronavirus a threat to the world?

The importance of the infection lies in the fact that it has the potential to affect large percentage of population in short period (particularly working population) that way significantly slowing down the entire economy. While the death rate among those infected by the virus in Wuhan is not negligible, it is far below that of the SARS outbreak in 2003. Also, the situation is not new to public health experts- humanity faces the threat of pandemic viruses every ten years or so. From time to time, conditions for the perfect storm align, and the outbreak that has the potential to spread across the entire globe bursts. That’s the risk of living in a modern world in which one person may be in the far East and 24 hours later walking around Manhattan or Toronto.

 

Read also :

Women’s health: abnormal cervical cells symptoms
What is the main cause of eczema ?
Why Cuba Stands Tall in the Field of Orthopédies


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The abnormal cervical cells symptoms are considered unspecific. This means that neither a physician nor a patient can rely solely on the symptoms when concluding how severe the condition in the background may be. However, although unspecific, they help navigate the medical investigation in the right direction and make an accurate diagnosis.

abnormal cervical cells symptoms

We have to underline that regular checkups, no matter the symptoms, are the only way for a safe follow-up and timely detection of potentially malignant pathologies. Thus, the most important symptom for appointing a gynecologist examination is the fact that more than one year has passed since the last one.

That being said, let’s take a look at the common abnormal cervical cells symptoms some women experience and the conditions that might lie in the background.

Nabothian cysts 1, 2

Nabothian cysts are common and benign conditions on the cervix and are often seen as multiple cystic lesions. Their size varies, from only a few millimeters in diameter to a few centimeters (in literature, there have been reports of giant nabothian cysts with a diameter of 10 or even more centimeters, but those are quite unusual). Typically, they are asymptomatic, but they may present as a sense of fullness or pain (especially in case of larger cysts), although rarely. They usually occur after childbirth or minor trauma. Although benign, the Nabothian cysts sometimes may appear as malignant lesions, and in such cases further medical examination (MRI) is necessary to resolve the dilemma. If symptomatic, they can be surgically removed.

Cervical Ectropion 2, 3

The condition is also known as cervical ectopy or erosion, and it is actually a benign condition. It occurs when the epithelium of the cervix inside protrudes to its vaginal portion (normally, the epithelial cells of the inside differ from those in the vaginal portion in a sense that they are less resistant to mechanical trauma). The ectropion appears as a reddish patch on the cervix (seen during the pelvic examination). It is commonly seen in adolescents, pregnant women and among those who use oral contraceptive pills (as a means to prevent pregnancy or to treat polycystic ovaries syndrome). The typical symptom is clean to yellowish vaginal discharge without odor. Also, some patients experience spotting, postcoital bleeding or painful intercourse.

Cervical Polyps 2, 4

Cervical polyps are commonly seen in women after the age of 20 who have had at least one child. There are two main types of these polyps:

If they grow inside the cervical canal, they are called endocervical (more common than the other type, usually seen in premenopausal women).

If they grow from the outer surface of the cervix, they are called ectocervical (more common in postmenopausal women)

Cervical polyps do not usually appear in the period of preadolescence. They look like greyish-white, reddish-purple, or cherry-red and manifest themselves as round buds on thin stems, 1-2 centimeters in diameter.

The polyps are typically asymptomatic, but in some patients can cause heavier blood loss during the menstrual bleeding, bleeding or spotting after intercourse/ between the periods or vaginal discharge (which may be foul-smelling, giving that polyps in some patients develop on a terrain of chronic infection). They are usually diagnosed on routine pelvic examination.

It is still unclear why do they occur, but the research evidence suggests that chronic infection plays certain role in their pathogenesis.

Although the lesions are benign, they certainly need a follow-up. In some cases but rarely they are mistaken to be rare forms of malignancies or become malignant themselves (the chances for malignant alteration are estimated at 1:1000).

Cervicitis 1, 2, 5

Cervicitis relates to inflammation of the cervix, no matter its cause. It can be acute or chronic, infectious, or non-infectious. Chlamydia, gonococcus, trichomonas vaginalis, HPV, and Herpes are the most frequent infective agents that cause it. Different pathological entities act differently and carry various long term health risks. It is essential to point out that chronic inflammatory conditions can lead to several irreversible health issues, including cancer, in the long term (this “rule” applies not only to the area of the cervix but to the entire body as well). The typical symptom of cervicitis is a vaginal discharge (patients often report odor), pain (or painful coitus) or spotting (or postcoital bleeding). Quite often, the inflammation is asymptomatic and is discovered during a routine pelvic examination. Some infective agents can cause infertility, and some can cause miscarriage or severe congenital malformations. Giving the fact that the health risk connected to infective cervicitis is high and it is often asymptomatic, the Center for Disease Control and Prevention recommends screening of all sexually active women.

Cervical Intraepithelial Neoplasia (CIN) and cervical cancer 6

The condition occurs as a consequence of human papillomavirus (HPV) infection (not necessarily). But what exactly is the cervical intraepithelial neoplasia? This term is used to describe subtle changes seen in cells of cervix as they transform from healthy cells to cancerous ones. The process is slow and takes 10 to 20 years to go from CIN 1 to cervical cancer. There are three different shades of CIN 1, 2, and 3. The grading system concerns the depth to which the changed cells have reached, so CIN 1 means less than one-third of the cervical epithelium is changed, CIN 2 one to two thirds and CIN 3 more than two thirds. When it comes to grading CIN, its thickness is not the only parameter in decision making. The microscopic appearance of the cells and some biochemical markers plays a role as well.

There are more than 100 strains of HPV, and not all are equally cancerous. Types 16 and 18 are responsible for 75-80% of all cases of cervical cancer worldwide.

The symptoms of CIN are unspecific. Some patients are asymptomatic; others present with abnormal vaginal discharge or pelvic pain.

Takeaway notes

The abnormal cervical cells symptoms are unspecific. Without a routine pelvic exam in combination with other diagnostic tools (pap-smear, ultrasound, etc.), it is impossible to establish an accurate diagnosis. Also, abnormal cervical cells may be asymptomatic. This is why it is so important to do the annual checkups and follow screening guidelines (health professionals are regularly updated with these guidelines).

Generally speaking, the abnormal cervical cells symptoms include changes in the appearance or volume of the vaginal discharge, pain in the pelvic area (that may be in relation to intercourse, or occur without obvious explanation) and bleeding (abnormal bleeding of any intensity and volume).

 


 

Reference list

  1. El-Agwany A. S. (2018). Large Multilocular Cystic Lesions in the Uterine Cervix: Differential Diagnosis and Significance. Journal of medical ultrasound, 26(3), 153–156.
  2. Casey, P. M., Long, M. E., &Marnach, M. L. (2011). Abnormal cervical appearance: what to do, when to worry?. Mayo Clinic proceedings, 86(2), 147–151.
  3. Mitchell, L., King, M., Brillhart, H., & Goldstein, A. (2017). Cervical Ectropion May Be a Cause of Desquamative Inflammatory Vaginitis. Sexual medicine, 5(3), e212–e214.
  4. Cervical polyps in postmenopausal women: is there a difference in risk? Schnatz PF, Ricci S, O’Sullivan DM Menopause. 2009 May-Jun; 16(3):524-8.
  5. Young C, Argáez C. Management and Treatment of Cervicitis: A Review of Clinical Effectiveness and Guidelines [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2017 Sep 21.
  6. Mello V, Sundstrom RK. Cancer, Cervical Intraepithelial Neoplasia (CIN) [Updated 2019 Jun 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-.

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What is the main cause of eczemaEczema is the most common form of chronic dermatitis, a non-infectious skin condition characterized by an itchy rash. Commonly, across the literature, it is referred to as atopic dermatitis (AD) as well. Typically, it affects children and the situation gets better as time goes by, but adults can suffer from it as well. However, when it comes to the causes, there is no straightforward answer to explain these. By what we know about it so far, the most accurate answer would be – it is caused by a combination of genetic and environmental factors (basically, this means it is caused by something that’s written in the patient’s genetic code and something in his or her environment). However, giving that this answer can hardly satisfy the curiosity of people interested in the condition, we will discuss it in more detail and provide a broader perspective on the perplexity of eczema origin.

The roots are deep within the DNA 13

Although the pathophysiological mechanisms that cause eczema are pretty well described, their exact background remains to be a subject for academic debate. There are two widely accepted hypotheses – the first one concerns the imbalance in the immune system, and the second one concerns a defect in the skin barrier. The definitive answer to why eczema happens is still not found, but the two hypotheses offer a reasonable explanation. Also, they shouldn’t be taken as mutually exclusive but rather as points of view that complement each other.

The imbalance in the immune system hypothesis

The theory argues that the eczema results from an imbalance in the T cells production – in particular, in people with eczema, there are more T-helper 1 and T-regulatory cells (subtypes of T cells) than there should be. As a result, the amount of interleukins (substances that promote inflammatory response) is increased, so is the intensity of inflammation in the affected areas of the body.

The skin barrier hypotheses

The theory is a newer one and argues that individuals with mutations in the filaggrin gene more often develop eczema than those without the mutation. The filaggrin (filament aggregating protein) binds cells in the upper layer of the skin (referred to as epidermis) together and seals the tiny cracks between them. Filaggrin minimizes the water loss through the skin and penetration of the allergens from the environment (the size of the allergens varies – from small inorganic to large organic molecules or even microorganisms). In some people with the mutation, the production of filaggrin drops critically low, so the skin barrier doesn’t function as it should. The skin becomes more permeable for water (increased water loss), allergens and microorganisms.

The toll on health goes beyond the skin surface

Let’s take a pause from eczema causes here and briefly discuss the phenomenon known as “The Atopic March.” Our immune system works as a whole – defects in the execution of its functions reflect themselves on the whole body more often than not. Eczema is a skin condition, but the same genetic factors that lie in its background also affect other regions of the body. “The Atopic March” describes a temporal sequence of conditions that develop on the terrain of inadequate immune response seen in patients with eczema. The flaw mentioned above in the T-helper

lymphocyte function also can cause food allergies, asthma or allergic rhinitis. The eczema kicks in first and, in the early years of life, is often followed by the rest of the atopic cascade. The importance of this phenomenon lies in the fact that a timely treatment of eczema can reduce the severity of or prevent in temporary conditions that follow it.

Environmental factors

As mentioned earlier, the leading cause of eczema is a combination of genetic and environmental factors. Not all people with the “right genetic code” develop the condition. Eczema happens only if all or the majority of contributing factors align, creating a perfect storm. In this section, we’ll take a look at contributing environmental factors. The prevalence (the number of cases of a disease present in a particular population in a given time) of eczema has increased in the past few decades at a pace that changes in gene pool cannot explain. So, the increase in prevalence is explained by changes in environmental factors. At this moment, we can’t tell for sure what those factors are. Still, the growing body of scientific evidence suggests that exposure to dust mites, various allergens, infections, irritants and antibiotics increases the prevalence of eczema 1.

Hygiene Hypothesis 

The theory was introduced to the public back in 1989, and it suggests that the main cause of increased eczema prevalence may be the development and “sanitization” of society. The theory argues that the lack of adequate stimulation of the immune system in early life (children that are “too clean”) and failure of maintaining balanced gut flora in adulthood (antibiotics in food) are triggering factors in the pathogenesis of eczema. Furthermore, the hygiene hypothesis explains the rapid rise in prevalence among smaller, wealthier and more educated families in comparison with larger families and those attending a nursery.

The bottom line is that exposure to some pathogens in early life, as well as the timing of exposure, play an essential role in the pathogenesis of eczema. However, some pathogens may trigger the condition; for example, measles infection increases the risk of the disease.

References : 2,3,4,5

Irritants 6,7,8,9,10,11,12

Soap acts as an irritant. It causes skin dryness, increases its pH, and transepidermal water loss. Several studies have shown that exposure to soap is in relation to increased eczema prevalence and that removal or avoidance of such chemicals reduces its prevalence.
Some studies have shown that eczema prevalence is increased in areas with harder water, but in recent years this hypothesis has been rejected. Namely, the increased hardness of water requires increased use of soap, so the scientific community accepted the use of irritants as the cause of eczema rather than the water harness.
The avoidance of irritants early in life is vital as a preventive measure – once the condition establishes, exclusion of those chemicals do not affect further development of the disease (eczema, followed by atopic march).

So, what is the main cause of eczema?

After this discussion, it is essential to underline that eczema is a multifactorial disease. Its causes are not yet fully understood, and some claims about it are still wrapped in a veil of controversy. However, here are some important takeaway notes:
– The condition is a multifactorial disease caused by a combination of genetic and environmental factors.
– The genetic mutations in people with eczema affect not only the skin but potentially other organ systems, primarily respiratory organs. Eczema is often only the first in a cascade of health issues that arise from altered genes.
– Restriction from exposure to the microbes in the environment is in association with the increased prevalence of eczema, but some infective agents may increase the chance of disease establishment.
– Once the condition establishes, it is impossible to reverse the process, but it tends to milden or completely disappear during puberty.
– Exposure to skin irritants, soap in the first place, plays an important role in the pathogenesis of the disease.

Reference list

1. McPherson T. (2016). Current Understanding in Pathogenesis of Atopic Dermatitis. Indian journal of dermatology, 61(6), 649–655
2. Strachan DP. Hay fever, hygiene, and household size. BMJ. 1989;299:1259–60.
3. Williams HC. Atopic eczema – Why we should look to the environment. Br Med J. 1995;311:1241–2.
4. Flohr C, Yeo L. Atopic dermatitis and the hygiene hypothesis revisited. CurrProblDermatol. 2011;41:1–34.
5. Hesselmar B, Sjöberg F, Saalman R, Aberg N, Adlerberth I, Wold AE. Pacifier cleaning practices and risk of allergy development. Pediatrics. 2013;131:e1829–37.
6. MJ Cork. The importance of skin barrier function. Taylor & Francis J Dermatological Treatment. 1997.
7. McNally NJ, Williams HC, Phillips DR, Smallman-Raynor M, Lewis S, Venn A, et al. Atopic eczema and domestic water hardness. Lancet. 1998;352:527–31.
8. McNally NJ, Williams HC, Phillips DR. Atopic eczema and the home environment. Br J Dermatol. 2001;145:730–6.
9. Font-Ribera L, Gracia-Lavedan E, Esplugues A, Ballester F, Jiménez Zabala A, Santa Marina L, et al. Water hardness and eczema at 1 and 4 y of age in the INMA birth cohort. Environ Res. 2015;142:579–85.
10. Thomas KS, Dean T, O’Leary C, Sach TH, Koller K, Frost A, et al. A randomised controlled trial of ion- exchange water softeners for the treatment of eczema in children. PLoS Med. 2011;8:e1000395.

11. Simpson EL, Chalmers JR, Hanifin JM, Thomas KS, Cork MJ, McLean WH, et al. Emollient enhancement of the skin barrier from birth offers effective atopic dermatitis prevention. J Allergy ClinImmunol. 2014;134:818–23.
12. Harris JM, Williams HC, White C, Moffat S, Mills P, Newman Taylor AJ, et al. Early allergen exposure and atopic eczema. Br J Dermatol. 2007;156:698–704.
13. Thomsen S. F. (2014). Atopic dermatitis: natural history, diagnosis, and treatment. ISRN allergy, 2014, 354250.

Vitiligo Treatment Program
Treatment of Psoriasis

Treatment of Alopecia Areata Universalis


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The field of Orthopedics surgery is related to the complications and treatment of the musculoskeletal system in a human body. This field focuses on the complications arising in bones, muscles, joints, and ligaments in a human body. Surgeons adopt both surgical and non-surgical methods in treating fractures, injuries and spine problems.

You can go to an Orthopedist to diagnose any problem related to joints, muscles or bones. They can advise you on how to prevent the same and can provide treatment if it’s the best course to take. Athletes, bodybuilders and sports person also tend to develop complications related to muscles and spine which can be treated by orthopedic surgery.

Orthopedists surgery

The Growing Need of More Orthopedists

It is true that orthopedists are few in numbers. This increases the misery of patients around the globe to find qualified orthopedists for their treatment. There is a huge waiting list for patients as it’s pretty hard to get a consultation with an orthopedist. This is for a simple reason that demand exceeds supply. There are countless patients but a limited number of doctors. So there is a need to promote this field of medical science with students to pick this as their career.

Orthopedic Advancements in Cuba

This is worth mentioning that Cuba has a countless number of Orthopedists who are keen on treating patients. So, this can be your next possible destination to cure your musculoskeletal disease. Most of Americans and Canadians go to Cuba to treat their problems as Cuba has become very popular in the field of Orthopedics.

The use of latest technology and medical equipment has also played a major role in the advancement of orthopedics in Cuba. Technology advancements have made it easier to handle patients without performing large incisions in their body. Orthopedic patients can be treated with much less intrusion which will help them to heal relatively faster. This resulted in very low pain infliction patients and less amount of blood loss. Orthopedists can now have a 3D (before 2D) look of the spine which increases the chances of a successful surgery.

In Addition, Cuba Offers the Following Surgical and Treatment Procedures

  • Hand surgery
  • Shoulder and elbow surgery
  • Total joint reconstruction (arthroplasty)
  • Pediatric orthopedics
  • Foot and ankle surgery
  • Spine surgery
  • Musculoskeletal oncology
  • Surgical sports medicine
  • Orthopedic trauma

The Orthopedic Programs Include the Following

HOSPITALIZATION WILL INCLUDE

  • Accommodation in a private room
  • Three-course meals
  • 24/7 nursing care
  • Medical assistance
  • Evaluation and preparation of medical history
  • Pre-operative screening
  • Comprehensive laboratory tests
  • Imaging
  • Surgical specimen biopsy when indicated
  • Right to the operating room
  • Anaesthesia (TIVA basic)
  • surgical procedure
  • Monitoring and evaluation
  • Stitches removal (if required)
  • Recovery accommodation

CubaHeal’s Role

CubaHeal is adamant in providing the patient with all the logistical support such processing treatment requests, gaining treatment approval, and booking and visa granting support. Furthermore, our Cuban field team carries translation and personal support services and tasks for the patient and to eliminate all social boundaries and to ensure proper treatment can be availed by anyone at anytime in Cuba.


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CubaHeal Research Department:

head and neck cancer90 % of head and neck cancers are mostly squamous cell carcinomas. These carcinomas include nasopharyngeal cancer, nasal cavity, paranasal sinus cancer, oral and oro pharyngeal cancer, laryngeal cancer, hypo pharyngeal cancer and salivary gland cancer. As carcinomas their name indicates they are malignant tumors.

Oral and oro pharyngeal, laryngeal, hypo pharyngeal and salivary gland cancers are included in oral cavity cancers which are all squamous cell carcinomas and salivary gland carcinomas are adenocarcinomas. 95% of oral cavity cancers are squamous cell carcinomas. This aggressive epithelial malignancy is the sixth most common neoplasm in the world today .The overall long term survival rate has been less than 50% for the most past years. Multiple primary tumours will be present in initial diagnosis .These multiple primary tumours develop independently as a result of years of chronic mucosal epithelium exposure to carcinogens such as alcohol or tobaccos .Oropharynx cancer is due to mutations in TP53 gene and genes that regulate the differentiation of squamous cells such as p63 and notch1. Squampous cell carcinoma can arise anywhere in the oral cavity .The most common locations are the ventral surfaces of the tongue floor of the mouth lower lip soft palate and gingiva. These tumors
appear as raised firm pearly plaques. Republic of CUBA has succeeded in combating these cancers.

Salivary gland adenocarcinomas include pleomorphic adenoma and muco epidermis carcinoma. Pleomorphic adenomas are painless slowly growing mobile discrete masses. They represent about 60% in parotid and are less common in submandibular glands. While muco epidermoid carcinoma are composed of variable mixture of squamous cells, mucus secreting cells and intermediate cells.

Nasal cavity and paranasal sinus cancers. Squamous epithelial cells of the normal nasal cavity or sinuses can become squamous cell carcinomas. This is the most common type of cancer in the nasal cavity and Paranasal sinuses. Apillomas are warts that can grow inside the nasal cavity or paranasal sinuses and destroy healthy tissue. They usually have a bumpy surface. Papillomas are not cancer, but sometimes a squamous cell carcinoma will start in a papilloma .Republic of CUBA is trying to cure these carcinomas. Different drugs are given in CUBA and 24 hour observation of a patient is done.

Treatment by Cuba health centre.

The Republic of Cuba is in the forefront in battling these cancers. Cuba is taking measures to stop these carcinomas. Available Treatments are surgery radiations and chemotherapy in combination with immunotherapy. The treatment is based on the stage of cancer and on the health of the patient.

The program is carried by guiding the patient properly and thoroughly. If the cancer has not metastasized and its size is small, we can do surgery and also can treat him through radiations. Some drugs will also be given .Chemotherapeutic agents will be given according to their effects and by keeping in mind the condition of individual because chemotherapeutic agents also destroy the normal cells. Treatment procedure is mostly same in all the cancerous patients. But it depends upon the severity and stage of cancer In CUBA by the following method we treat cancer

  • First of all a proper medical check-up is done .or we can say pre-application medical
    check-up is applied.
  • Anti-cancerous drugs are given.

These drugs include cyclophosphamide 200mg. This is a nitrogen mustard agent.it inhibits DNA function and its synthesis. It is given for breast cancer, ovarian cancer and chronic lymphocytic lymphoma. In republic of CUBA this drug is given with proper dosage and according to the condition, otherwise every drug has some adverse effects. This drug is given for 15 days and when further treatment starts.

Another drug which is given in republic of CUBA is NIMOTUZUMAB it is also called CIMAher EGF. It is given for head and neck cancers in combination with radiotherapy and chemotherapy. 24 Vials are given for 6 weeks treatment. It should be given with precautions otherwise nausea tremors and chills can develop.It is given in IV form.

The induction phase last six weeks corresponding to the 24 vials of the drug. The first dose will be given in republic of Cuba , and next dose he can take himself in CUBA or any other country.

There are many drugs available for the chemotherapy. These drugs are bortizomib imatinib, antimetabolites, vincristine, and etoposide. Each drug first dose is given in CUBA. Patient is monitored. If this drug found successful then second dose of the drug he can take himself.

Surgery

Surgeries are also performed. That involves dissecting of the whole infected part. If less part is infected then a small part is dissected but mostly if small part is infected we took out large part even the whole part is not infected as a precaution.

These surgeries involve Total glossectomy semi glossectomy semi glossectomy partial glossectomy, trans maxillary glossectomy with neck dissection.

Total glassectomy : It is performed for the tongue .if whole tongue is affected whole tongue we be cut down so that the tumour does not metastasize. This is done in republic of CUBA with proper care.

Semi-glossectomy : It is the removal of half the tongue. This can also be done in republic of CUBA with proper care. If half tongue is not infected and other half is infected so we can perform partial dissection with proper care. We will cut half tongue if there is no chance of spreading this tumour to the other half.

Trans maxillary glassectomy with neck dissection. When cancer in the oral cavity is spread to the lymph nodes in the neck so removal of these lymph nodes is necessary because there are many lymph nodes are present in different sites of body. So cancer can spread to the different organs through lymph nodes which will be worst condition. Neck surgery is also performed in republic of CUBA. These include partial and modified neck dissections. Radical neck dissections are also performed.in which few or all lymph nodes are removed. There are also some maxillary and larynx medical programs in republic of CUBA in which partial or full dissection of the affected region is performed.

So CUBA is making a great progress in the treatment of cancer.


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 AUTISM SPECTRUM DISORDER

Cuba had the honor to host the first international conference regarding autism and inclusion in 2013. Island’s extraordinary efforts to understand, recognize and manage the condition in it’s early stages highlight the prestige and excellence of Cuba’s autism management. Cuban physicians represent global subject-matter-experts in the field of autism spectrum disorder (ASD). Cuba strives to find the best possible solutions for individuals suffering from ASD through the development of specialized ASD centers that focus on ASD treatment and inclusion of families within the society – of course, absolutely cost-free.

ASD represents a complex condition requiring multidisciplinary approach – a burden for profit- based healthcare systems. The fact that the management of ASD has been assessed as costly best illustrates the difficulties of western systems to properly address the issue of growing incidence of ASD. Waiting lists, inefficiency, high prices are the characteristics of profit-based healthcare systems that often result in inadequate management of those requiring prompt and intensive treatment. Cuba has developed a sustainable program for the management of individuals suffering from ASD focused on meeting the needs of each child.

Cuba offers a carefully tailored program for individuals suffering from autism spectrum disorder (ASD). The main goal of this program is to improve the child’s learning capabilities and reduce the symptoms of ASD. Overall, the program aims to boost the development capacity of each child with ASD. As a result, a visible improvement is seen in the child’s physical and mental abilities, due to the specific nature of the program design that is specifically tailored to meet the needs of each child individually. The program offers a peaceful and comfortable treatment environment and expert medical attention, which is very relevant for achieving the favorable treatment outcome. The facility is equipped with services and amenities such as cable TV, internet, pool, sauna, gym, pharmacy, and laundry services.

Program description

The program duration is 38 days. During this period, a set of activities is performed that may be divided into two main stages – evaluation and treatment. A detailed description of each phase is given below.

Stage 1 – Evaluation

During the evaluation phase, the information regarding the ASD nature of each child is obtained through consultation with specialists, laboratory and clinical investigations, as well as specific assessments necessary for evaluation and staging of the disease.

The initial steps in the evaluation phase include consultations with the team of experienced specialists in order to plan and tailor the comprehensive treatment and rehabilitation program for each child. This includes assessments performed by pediatricians, neuro-pediatricians, child psychologists, genetics specialists, logophobia specialists as well as otorhinolaryngologists. Furthermore, detailed laboratory investigations are required for disease evaluation and assessments. Biochemistry panel includes measurements of urea, creatinine, serology investigations, urine metabolic testing, complete blood count, sedimentation rate, blood glucose level, including but not limited to liver function tests.

Following initial testing, complex assessments are performed in order to get the clear picture regarding disease nature and severity. The assessments are performed by highly experienced subject-matter-experts and include logopedic evaluation, neuropsychologic assessment, Brunet-Lezine scale evaluation, as well as psychotherapy assessment and evaluation. Additionally, during the assessment period imaging studies may be performed such as brain MRI, evoked potential studies, EEG etc.

Once all the information has been gathered and a treatment plan has been tailored, the findings and possible management options are discussed with the family. The duration of this phase is dependable on the nature of the underlying disease as well as the child’s abilities to adapt to the new environment. Approximately, it takes no longer than 10 days in order to complete the evaluation and tailor the specific treatment.

Stage 2 – ASD Management

ASD represents a complex disorder requiring multidisciplinary and individual treatment approach for each child. This program offers multiple treatment modalities including equine therapy, sensorial stimulation techniques, occupational therapy, language therapy, ozone treatment as well as trans-cranial electric stimulation, which has been proven useful in hyperkinetic patients. Treatment is conducted by highly experienced experts with the constant involvement of parents.
The focus is on speech therapy that lasts for 20 days and involves both therapists and parents. This treatment modality lasts approximately 20 days and is conducted each day excluding Sundays and public holidays. Depending on the child’s ability to accept the treatment approach, initial sessions may last from 20 minutes to one hour. Protocol for conducting the therapy is tailored based on the individual characteristics of each child. It is strongly advised for the child to continue this treatment approach at home, once the language therapy is finished since this will ensure the long-
lasting results in the future.

Occupational therapy will last approximately 30 days where the intensive treatment will aim to reduce neurological, mental and physical barriers of each child with ASD. This program allows a child to develop and maintain self-care activities, increases the overall productivity and enables a child to participate in leisure activities. The intensive treatment protocol is comprised of two treatment sessions during the day (in the morning and in the afternoon) approximately lasting for an hour or longer. The responsiveness of a child is stimulated by various methods including images projection, object identification, interactive and didactic games, palpation exercises as well as equine therapy.

At the end of each treatment, a detailed report is issued to parents with all of the activities performed at the site including detailed expert recommendations for further treatment and rehabilitation.


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CubaHeal Research Department:

Professor Ricardo A. Gonzales MD Ph.D. DSc founded back in 1976 Cuba’s first health facility for substance abuse treatment at the Eduardo B. Ordaz Psychiatric Hospital in Havana. During his carrier of 40 years, he founded 17 similar facilities throughout Cuba making the hospital in Havana a national reference center for substance abuse treatment.  The Cuban approach to drug abuse is open for international patients as well. The legendary soccer player, Diego Maradona is certainly, the most well-known patient of Cuban program.

What’s a Cuban approach?

substance abuse

The program lasts for 97 days (14 weeks) and during that time, the patient goes through the process of detoxification and rehabilitation. All the details are worked out- the therapy is carried out in a natural environment, overseen by a team of highly trained professionals (multidisciplinary approach to the treatment is must!). Upon the conclusion, the re-evaluation and follow up visit are scheduled.

The facilities that accommodate patients are secured and reserved only for patients on a drug abuse treatment. The treatment principle applied relies on “therapeutic communities” where patients get a chance to talk and encourage each other, share their hopes, dreams, and frustrations, which altogether contributes to the recovery.

During the first week, the team of specialists decides if the patient should stay in the program or not. In case of excessive aggression, if the patient changes his mind (patients are admitted under their own free will) or because of other medical or non-medical reasons, the team releases the patient with a recommendation about further treatment. The patients who get admitted (a vast majority of them), undergo a series of lab tests, X-ray, ECG, and other necessary medical examination procedures. After the initial assessment, a personalized therapeutic plan is made.

During the three months period, the patient is undergoing individualized physical and psychological rehabilitation program to achieve behavioral changes that will allow him a healthy (long-term sustainable) rehabilitation. Specifically, the patient learns about how to control withdrawal symptoms, how to cope with cravings, new healthy lifestyle, how to eliminate harmful behaviors and accept responsibilities and develop his or her intellectual and labor potential to its maximum.

Multidisciplinary approach

The problem of drug abuse is complex and requires a team of many specialists- experienced internal medicine specialists, neurologists, psychologists, psychiatrists, nurses- all to be trained specifically for the treatment of drug abuse.

Drug abuse in some cases leads to a vicious, never-ending cycle of psychiatric problems- the drug abuse damages the brain which leads to psychiatric conditions (paranoid psychosis or schizophrenia for example), which deepens the problem of drug abuse and makes it even harder to quit. The art of treatment is to recognize and put under control the “layers of the problem” that developed into autonomous psychiatric conditions over time and target the treatment specifically towards addiction (once the problem of addiction is solved, other aspects of patient’s psychological condition are resolved much easier).

A number of neurological conditions due to brain damage develops in abusers over time. Recognizing and putting those under control is also very important.

To put it in simple words- drug abuse treatment is like a walk through the minefield. To get on the other side of it you need a trained and experienced team behind, otherwise, it’s just a guessing game (with low chances for success).

What happens after the patient has been admitted to the program?

After admission, each patient gets introduced with the program (the first week, personalized treatment, methods, goals, and other relevant info). After introduction procedure, the patient signs a therapeutic contract. Also, the patient writes his or her personal history, with self-assessment- this document helps the team of specialists to design a treatment plan and later on, after the rehabilitation is over, will help the patient understand the extent of treatment intervention he went through.

Most often, on the day of admission, the patient is introduced to the community and attends all activities with others. In case of severe withdrawal symptoms, the patient may be under intense medical attention until his or her condition stabilizes. After stabilization, the patient is integrated into the community.

Long-term goals of rehabilitation

The goal is lifelong abstinence from drugs and rehabilitation of consciousness, personality, and behavior. The program helps the patient make lifestyle changes that will incur the risk of relapse- patients are encouraged to avoid places, activities, and people that are cues to drug use, to identify, understand and resolve inside conflicts that may be misinterpreted as cravings (or have lead to drug abuse earlier).

Drug addictiveness is a complex problem that affects not only one’s health, but his or her social relations, family, and all other aspects of everyday life. The Cuban program is optimized to cope with all of these aspects and prepare a patient for a new drug-free life.

Besides drugs, the Cuban program deals with other addictions as well

Drug abuse is just one of the problems when it comes to addictive behaviors and substance abuse. Alcohol, tobacco use, marijuana and opiates abuse are also problems the Cuban program successfully deals with. Of course, the approach is optimized for each of these programs.

Readers take away

The Cuban substance abuse treatment programs are developing since 1976. Professor Ricardo A. Gonzales, founding the father of substance abuse treatment on Cuba and internationally recognized expert is active even today as a consultant, but what’s even more important is his legacy to Cuba- a National Reference Center for Substance Abuse in Havana and 17 more facilities throughout Cuba that deal with the issue. Besides Cubans, these programs are available to international clients as well.

The rehabilitation process takes 3 months (sometimes more), and a rough price of the entire process with all expenses included is $26.000 (the price may differ at the point you read this article, for more info, contact the National Reference Center for Substance Abuse in Havana. During those three months, the patient is under constant attention of a team of experts.


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Current Challenges in the Treatment of Retinitis Pigmentosa

CubaHeal Research Department

Retinitis pigmentosa (RP) represents a rare and severely debilitating group of disorders affecting vision that have a genetic background and are slowly progressive by nature (1). Despite the continuing efforts of the scientific community directed towards the understanding and treatment of the disease, RP still remains incurable. Management of RP was investigated in various preclinical models, as well as in numerous clinical trials on humans in the United States, however, the effective and safe solution to this problem was not yet found.

Retinitis pigmentosa causes a progressive and irreversible vision damage caused by deterioration of photosensitive cells (especially rods) in the retina (2). Early symptoms usually represent the loss of the peripheral visual field, followed by further vision narrowing, which may eventually result in complete blindness. Treatment options in the United States are currently quite limited. The management of RP mostly includes vitamin supplementation, aiming to hold off the progression of the degenerative process. However, even vitamin supplementation, besides its’ limited effectiveness, has its safety concerns. Vitamin A supplementation is not recommended in certain individuals since it may cause fertility issues and severe osteoporosis (3). Preventative measures, such as avoiding light exposure in the early phases of the disease did not prove to be highly effective.

When reviewing the current treatment options, it seems that RP still represents a challenging task. In order to improve the quality of life of patients suffering from this degenerative and progressive disorder, Cuban experts have developed a sophisticated and effective method for the management of RP.

Solution Offered by Cuban Experts

The main treatment objective is to limit the disease progression by improving the vascularization of the
retina. The management of RP in Cuba practiced now, that is focused on eye vascularization, has been
developed and improved for more than two decades. The milestone of therapy is to bring as much blood,
oxygen, and nutrients as possible to the eye. This is being performed by encouraging the development of blood vessels.
There have been some attempts in Russia to transplant the stem cells that would develop into the healthy retinal tissue, however, scientists were mostly frustrated by failure since the stem cells could not successfully engraft due to the lack of the healthy vascular supply (4). Cells remodeling was also attempted; however, this study was suspended due to the lack of efficacy. Cuba offers a sustainable treatment option that focuses on limiting or completely inhibiting the progression of degenerative vascular changes in the retina. There are several treatment approaches that are being applied to the overall management plan. They include eye surgery, ozone therapy, electrostimulation and drugs (5).

Micro-surgery

A very sophisticated and unique surgical technique is used to increase the blood flow within the part of the eye responsible for providing blood supply to the retina. When this technique is performed, retina remains adequately nourished and oxygenated. This allows normal retinal function and prevents further deterioration of vision. By stimulating the blood flow within the retina, visual acuity increases, and retina is encouraged to grow, and not deteriorate. The final result is stabilization of the disease and rapid improvement in both central and peripheral vision (6). Ophthalmologists from all over the world refer their patients to Cuba, for this surgery to be performed due to its’ efficacy and safety.

Ozonotherapy

It has been recognized that ozone improves cell metabolism, boosts the cell energy levels and exhibits antioxidant properties (7). The ozone is either administered rectally or being injected into the bloodstream.
Ozone provides detoxification effects by blocking the harmful lipid peroxidation that occurs in retinal cells affected with retinitis pigmentosa. The ozonotherapy also promotes the blood flow surrounding retina, thereby directly improving the retinal function. In order to ensure the best possible results, the patient should receive 14 cycles of treatment during the course of the whole therapy.

Electro-stimulation

Electrical stimulation produces a micro-massage effect that stimulates micro-circulation and lymphatic drainage. These effects promote electro-ionic balance and provide an additive effect to the ozonotherapy (8).
This method has demonstrated a high efficacy. Another benefit of this treatment modality includes reinforcing the process of the perception of visual stimuli within the brain. The electro-stimulation includes the application of pleasant therapeutic electrical currents on the head, neck, soles of the feet, and palms of the hands. For the complete and best possible effect, 10-15 treatment sessions are needed to be performed. During the full treatment course, drugs including immune-modulators, oxide-reductive substances, minerals, and vitamins are administered to boost the treatment effects.

Clinical Trials

Cuban scientists investigated the effects of ozone treatment on the visual field in participants that had retinitis pigmentosa. This was a controlled, randomized and double-blind study, with the study design that ensures a high level of evidence. 68 participants were enrolled in the trial. Half of the subjects received ozone treatment, while the other half received placebo. The study demonstrated that three times more subjects in the ozone group experienced a significant improvement in the visual field, compared to those who received placebo. Subjects with early stages of the disease experienced greater improvement with more long-lasting effects, which underlines the importance of early intervention. Subjects at early phases of the disease also experienced more stable and sustainable treatment effects. In conclusion, this study showed that ozone treatment had beneficial effects on patients with RP.

Another double-blind, placebo-controlled study also evaluated the effects of ozone treatment in patients with retinitis pigmentosa. This study had an even greater number of participants (168). This study also
demonstrated the significant improvement in patients treated with ozone therapy compared to patients that received placebo. Interestingly, approximately a half of the patients that had treatment response also succeeded to maintain the response for the longer period of time (9).

A study that investigated the redox-balance in patients with RP receiving ozone treatment concluded that ozone therapy represents a safe therapeutic modality since no side effects related to treatment were observed during the course of the trial. Therefore, ozone therapy can be safely administered to patients with RP without any risk of side effects (10).

Conclusion

Treatment of RP still represents a challenging task in the western countries. Vitamin supplements and avoiding excessive light are just not sufficient enough to provide any benefit to patients suffering from this severely debilitating illness. Various treatment approaches including stem cells transplantation and remodeling of the retinal cells have failed to demonstrate effectiveness. Stem cells failed to engraft, and retinal cell remodeling was not possible both because of the vascularization impairment that occurs in this serious illness. Cuban researchers and medical experts decided to target exactly this disease characteristic by improving the blood flow in the eye, which allows retina to properly function. Improvement of eye circulation ensures the adequate oxygenation of retinal tissue and postpones or completely stops the degenerative processes within the retina. Clinical trials and plenty of satisfied patients worldwide guarantee treatment success. Thousands of international patients referred to Cuba for the treatment of RP have experienced benefits following treatment. Clinics in Cuba still represent the only hope for people suffering from this genetic disorder. Cuban experts have found a solution to postpone or completely stop the development of the negative effects on the quality of life of patients suffering from RP.


References:


Baumgartner, W. (2000). Etiology, pathogenesis, and experimental treatment of retinitis pigmentosa.
Medical Hypotheses, 54(5), 814-824.
Medline Plus Encyclopedia. Retrieved on July 1st, 2018, from
http://www.nlm.nih.gov/medlineplus/ency/article/001029.htm
Jayashree N Sahni et al. (2011). Therapeutic Challenges to Retinitis Pigmentosa: From Neuroprotection to Gene Therapy. Curr Genomics. 12(4): 276–284.
Health Services International (Servimed) Inc. Retrieved on July 1st 2018, from http://www.healthservicecuba.com/retinitis-pigmentosa/ Centro Internacional de Retinosis Pigmentaria Camilio Cienfuegos de Cuba. Tratamiento cubano para la Retinosis Pigmentaria. Retrieved on July 1st, 2018, from http://www.infomed.sld.cu/instituciones/retinosis/quienesomos/quienesomos.html
Garcia Layana, A. (2003). La cirugía de la retinosis pigmentaria en Cuba. Communication presented at
Archivos de la Sociedad Española de Oftalmología, Madrid.
Copello, M., Eguía, F., Menéndez, S., & Menéndez, N. (2003). Ozone Therapy in Patients with Retinitis Pigmentosa. Ozone: Science & Engineering, 25(3), 223-232.
Berson, E., Remulla, J., Rosner, B., Sandberg, M., & Weigel-DiFranco, C. (1996). Evaluation of patients with retinitis pigmentosa receiving electric stimulation, ozonated blood, and ocular surgery in Cuba. Arch Ophthalmol, 114(5), 560-563.
Pérez, L. J. (2004). Ozone therapy in retinitis pigmentosa. Communication presented at 4th International Symposia on Ozone Applications, Cuba.
Menéndez, S., Hernández, F., & Copello, M. (2004). Ozone therapy and redox balance in patients with Retinitis Pigmentosa. Communication presented at 4th International Symposia on Ozone Applications.



CubaHeal Research department

The Rain Men

Autism treatmentIt has been estimated according to the data published by the World Health Organization that 1 in 160 children worldwide suffers from autism. The exact number is quite challenging to estimate for various reasons. It is presumed that Cuba has a lower rate of children with autism spectrum disorder when compared with the United States. Yet, Cuba has taken autism quite seriously and constantly develops and improves strategies aimed to increase the quality of life of children with this serious medical disorder and their families. The country has established specialized centers focused both on the treatment of children and inclusion of the families in the society, which is of course absolutely costs free.
In 2013, Cuba was the country to host the First International Forum on Autism and Inclusion. This conference gathered the globally recognized experts in the field of autism spectrum disorder (ASD). The focus of the conference was to establish methods and discuss the significance of an early diagnosis of ASD and effective inclusion of such families in the society. The conference alone mirrors the country’s efforts to seek for the best possible ways to make the lives
better for children with ASD and their families.

It has been estimated according to the data published by the World Health Organization that 1 in 160 children worldwide suffers from autism.  The exact number is quite challenging to estimate for various reasons.  It is presumed that Cuba has a lower rate of children with autism spectrum disorder when compared with the United States.  Yet, Cuba has taken autism quite seriously and constantly develops and improves strategies aimed to increase the quality of life of children with this serious medical disorder and their families.  The country has established specialized centers focused both on the treatment of children and inclusion of the families in the society, which is of course absolutely costs free.

In 2013, Cuba was the country to host the First International Forum on Autism and Inclusion.  This conference gathered the globally recognized experts in the field of autism spectrum disorder (ASD).  The focus of the conference was to establish methods and discuss the significance of an early diagnosis of ASD and effective inclusion of such families in the society.  The conference alone mirrors the country’s efforts to seek for the best possible ways to make the lives better for children with ASD and their families.

Treatment of Autism in Cuba

The program aimed to increase the quality of life of persons living with ASD is coordinated by the Cuban Ministry of Public Health and Ministry of Education.  Other public sectors including culture, media, and sports institutions are also involved in the program for helping ASD individuals to reach the best of their abilities.  The program consists of individualized, multi-disciplinary training aimed at developing and empowering skills.  The ASD individuals also receive specialized education and advocacy support.  The individualized treatment is tailored by the specialized Diagnostic Commission when the type and severity of the disease are taken into consideration.  Treatment is focused on early intervention.

The treatment for ASD is conducted in the peaceful and comfortable environment in order to ensure the best possible effects of the treatment plan and to allow the improvement the patient’s mental and physical abilities.  The objective of each individualized treatment plan is to ameliorate the symptoms of the disease and improve the child’s learning capacity.  As already mentioned, the treatment is tailored according to the individual needs of each child.

Accommodation

Each medical facility that deals will the treatment of autism is equipped with rooms that resemble those in a hotel (cable TV, phone, dry cleaning services).  The facility contains sauna, pool, gym, internet access, shops, and pharmacies.

Treatment Stage 1: Assessment

The first stage of treatment consists of detailed assessments and evaluations that include laboratory and imaging analyses, and consultations with different specialists.  The child is examined and evaluated by a pediatrician, neurologist, psychologist, speech therapist, and psychiatrist.  The laboratory panel consists of hemogram, serology testing, serum glucose, sedimentation, urine analyses, creatinine and liver functions tests.  Additionally, specific testing consists of magnetic resonance brain imaging, evoked potentials, and electroencephalography.  Each patient undergoes logopedic assessment, neuropsychological evaluation, Brunet-Lezine scale evaluation as well as psychotherapeutic treatment assessment.  Within the first stage, parents are also introduced to the team of experts and the treatment plan is referred to the parents once completed.  The phase duration is approximately one week, depending on the patient’s characteristics.

Treatment Stage 2: Therapy and Rehabilitation

The duration of actual treatment is approximately 30 days, but this may vary depending on the patient’s characteristics.  The tools that are used in the treatment of autism include equine therapy, occupational treatment, language therapy, sensorial stimulation, ozone treatment and trans-cranial electric stimulation if needed (in hyperkinetic patients).  Language treatment is carried out each day.  In the beginning, the language rehabilitation sessions last one hour during the day, but this is extended later to two sessions each day. 

Language rehabilitation usually lasts 20 days.  During this treatment, the child is being constables evaluated by the experts and the progress is being monitored.  Based on the effects of treatment, the language rehabilitation process is further re-tailored based on the response of each child.  Therefore, each treatment protocol is being adjusted by the characteristics of each child.  Language rehabilitation is broad and intensive.  During each treatment, specialist conducts sensorial stimulation techniques such as facial massage.  Specialized teams also work with family members or companions in order to ensure the best possible communication results.  Family members or companions are taught to conduct language exercises and sensorial stimulation as continuing the language training after the child leaves the facility is essential for obtaining good treatment results.

Occupational treatment is also a very important feature of the overall rehabilitation program.  This treatment aims to help the patients overcome the obstacles of physical and mental barriers present within the ASD, which restrict the everyday activities such as self-care, productivity, and participation in leisure activities.  The treatment is conducted each day in two sessions.  Specialists work with object identification, images projection and touching through interactive and didactic games.

As a part of occupational treatment, the children are engaged in outdoor activities.  Engaging and stimulative games and exercises are being tailored for each child in order to learn about the surroundings.  This treatment is also tailored based on the child’s preferences.  Children are stimulated with colors, various physical activities including swimming in the pool, soccer, horseback riding etc.  The specialists carefully monitor the children and adjust the program based on the child’s response to each stimulation.  The length and duration of occupational therapy are also assessed based on the child’s characteristics and the progress being made with this treatment approach.  This treatment has a goal to improve the patient’s productivity, physical performance, and sensorial activity.

Final Report and Recommendations

Once the treatment is considered completed, the experts will tailor the final report consisted of the diagnosis, severity, and prognosis of the ASD.  Based on the vigilant monitoring of the child during each stage of treatment, the experts will issue the comprehensive recommendations for each child regarding further treatments and ASD management approaches.

Readers Takeaway

Cuba is investing a lot of effort in advancing the management of children suffering from ASD.  Prestigious medical centers in Cuba have programs based on the extensive international experience in autism management.  Treatment protocols for ASD are in line with the globally accepted international medical standards.  Cuba invests in the training of staff that deals with kids suffering from ASD.  There is still a lot to be learned about ASD in order to provide the best possible treatments for ASD patient and their families.  Cuba has proven to take this issue seriously and professionally.




In short words


CubaHeal Medical is a global organization specialized in facilitating medical treatments, medical education, in addition to patient and student care in the Republic of Cuba. CubaHeal is a loyal supporter of the Republic of Cuba, the Cuban people, the Cuban revolution, and the Cuban revolutionary leadership.




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