Home Care and the Effects of Hypericum tetrapterum Oil Extract in the Treatment of Chronic Wounds During the COVID-19 Pandemic.

The COVID-19 pandemic and the need for social distancing brought about sudden changes in the health system and treatment strategies. Patients with chronic wounds were affected by these changes and had limited access to professional treatment in hospitals. They were at a higher risk of infection with COVID-19 due to comorbidities and advanced age. The aim of the study was to develop an appropriate protocol for the in-home treatment of chronic wounds due to the COVID-19 pandemic when access to hospitals is limited and the risk of infection for these patients is high. In our case, Hypericum tetrapterum oil extract was applied for four months on a volunteer, a 78-year-old male patient with a chronic wound, additionally infected with Pseudomonas aeruginosa and comorbidities. His healing status was monitored by measuring the wound size and microbiological analysis at certain intervals. The scab of wound DPHR2 (right lower leg chronic wound 2), with its diameters of d1 (40 mm) and d2 (20 mm), fell off after 22 days of the first Hypericum tetrapterum oil extract application. The scab of wound DPHR1 (right lower leg chronic wound 1), with its diameters of d1 (74 mm) and d2 (35 mm), fell off after two and a half months of treatment with Hypericum tetrapterum oil extract. The results of our study indicated that Hypericum tetrapterum oil extract has a significant wound-healing potential and might be used as traditional medicine in the treatment of chronic wounds.

Sacrectomy with Ilio-Lumbar Stabilization Due to Low-Grade Chondrosarcoma of Sacrum and Iliac Wing. Case Report of the First Surgery Performed in the Republic of North Macedonia.

Low - grade chondrosarcomas are primary malignant bone tumors that are resistant to chemo- and radiotherapy and are treated surgically. Sacral localization makes surgical resection technically difficult due to position, anatomic structures involved, and large tumor size at detection. The risk of complications is high. We present the introduction of a novel surgical technique in our country, sacrectomy with ilio-lumbar stabilization. This was performed on a 67-year-old man with low-grade chondrosarcoma of the sacrum with sacroiliac joint involvement. The procedure was performed via an antero-posterior approach in two stages. Ilio-lumbar fixation with a mesh cage bridge was used to obtain spinopelvic continuity and stability. Sacrectomy is a technically demanding procedure that requires careful preoperative planning and a multidisciplinary approach, as well as high level of surgical experience.

Tricuspid insufficiency does not increase early after permanent implantation of pacemaker leads.

BACKGROUND: Interference between pacemaker (PM) lead and tricuspid apparatus may cause tricuspid regurgitation (TR). However, data regarding TR in patients with implanted PM are controversial. Our aim is to find out the degree of TR in a group of patients before and following PM implantation in a prospective manner. METHODS: The study group consisted of the patients referred for implantation of permanent PM or implantable cardioverter defibrillator (ICD). All patients underwent two-dimensional and Doppler echocardiographic evaluation before and after device implantation. The severity of TR was qualitatively classified into four groups as normal or trivial, mild, moderate, or severe. All studies were reviewed for accuracy by a second independent interpreter. RESULTS: Sixty-one patients (mean age 53 +/- 8 years, 44 male) referred for PM (n = 55) or ICD (n = 6) implantation consisted of the study population. Echocardiographic degree of TR was mild in 21 (70%), moderate in 7 (23%) and severe in 2 (7%) patients before PM implantation. Following device implantation, mild TR was noted in 23 (76%), moderate in 10 (33%), and severe in 2 (6%) cases. After the procedure, the TR severity was increased from normal/trivial to mild in 5 (16%) cases and from mild to moderate in 3 (10%). There was no worsening of the severity of TR in patients with moderate regurgitation following device implantation. The severity of TR did not change at a mean follow-up of 6 +/- 3 months. CONCLUSIONS: New or worsening TR is relatively rare after PM implantation. It is not associated with an acute worsening or clinical deterioration. But echocardiographic follow-up is recommended to monitor other complications in chronic phase.