A Case of Scurvy Associated With Intracerebral Hemorrhage in a Patient With Alcohol Use Disorder.

Vitamin C deficiency, also known as scurvy, causes abnormalities in connective tissues and varied symptoms. We describe a patient with putaminal hemorrhage, a very rare presentation of scurvy. A 39-year-old man presented with weakness in the left arm and left leg. Right putaminal hemorrhage was initially diagnosed, and he underwent evacuation of the intracerebral hemorrhage. Scurvy was suspected when repeated physical examinations revealed a bleeding tendency and multiple untreated dental caries, missing teeth, and gingivitis. A diagnosis of scurvy was further supported by the patient's history of smoking, alcohol use disorder, poor diet, and low plasma vitamin C concentration. After receiving oral nutritional supplementation including vitamin C, the bleeding tendency quickly improved. This case highlights the importance of including scurvy in a differential diagnosis for patients with bleeding tendencies, especially those with a poor diet or unknown dietary history. Empirical administration of vitamin C is a reasonable treatment.

Metabolomics identifies and validates serum androstenedione as novel biomarker for diagnosing primary angle closure glaucoma and predicting the visual field progression.

Background: Primary angle closure glaucoma (PACG) is the leading cause of irreversible blindness in Asia, and no reliable, effective diagnostic, and predictive biomarkers are used in clinical routines. A growing body of evidence shows metabolic alterations in patients with glaucoma. We aimed to develop and validate potential metabolite biomarkers to diagnose and predict the visual field progression of PACG. Methods: Here, we used a five-phase (discovery phase, validation phase 1, validation phase 2, supplementary phase, and cohort phase) multicenter (EENT hospital, Shanghai Xuhui Central Hospital), cross-sectional, prospective cohort study designed to perform widely targeted metabolomics and chemiluminescence immunoassay to determine candidate biomarkers. Five machine learning (random forest, support vector machine, lasso, K-nearest neighbor, and GaussianNaive Bayes [NB]) approaches were used to identify an optimal algorithm. The discrimination ability was evaluated using the area under the receiver operating characteristic curve (AUC). Calibration was assessed by Hosmer-Lemeshow tests and calibration plots. Results: Studied serum samples were collected from 616 participants, and 1464 metabolites were identified. Machine learning algorithm determines that androstenedione exhibited excellent discrimination and acceptable calibration in discriminating PACG across the discovery phase (discovery set 1, AUCs=1.0 [95% CI, 1.00-1.00]; discovery set 2, AUCs = 0.85 [95% CI, 0.80-0.90]) and validation phases (internal validation, AUCs = 0.86 [95% CI, 0.81-0.91]; external validation, AUCs = 0.87 [95% CI, 0.80-0.95]). Androstenedione also exhibited a higher AUC (0.92-0.98) to discriminate the severity of PACG. In the supplemental phase, serum androstenedione levels were consistent with those in aqueous humor (r=0.82, p=0.038) and significantly (p=0.021) decreased after treatment. Further, cohort phase demonstrates that higher baseline androstenedione levels (hazard ratio = 2.71 [95% CI: 1.199-6.104], p=0.017) were associated with faster visual field progression. Conclusions: Our study identifies serum androstenedione as a potential biomarker for diagnosing PACG and indicating visual field progression. Funding: This work was supported by Youth Medical Talents - Clinical Laboratory Practitioner Program (2022-65), the National Natural Science Foundation of China (82302582), Shanghai Municipal Health Commission Project (20224Y0317), and Higher Education Industry-Academic-Research Innovation Fund of China (2023JQ006).

[Functional Neurological Disorders - A Common but Often Unrecognized Diagnosis]. / Funktionelle neurologische Störungen ­ eine häufige, aber häufig nicht erkannte Diagnose.

Functional Neurological Disorders - A Common but Often Unrecognized Diagnosis Abstract: Functional neurological disorders are frequent and diverse in the clinical presentation. Psychological factors are part of the development and perpetuation of symptoms; psychiatric comorbidities may be present, but are not an obligatory diagnostic criterion. The diagnosis is primarily made on the basis of anamnesis and positive clinical signs. The commonness and reversibility of the symptoms should be emphasised in the clinical consultation, and the positive clinical signs should be demonstrated. Science-based explanations as well as the bio-psycho-social model can help patients to understand their diagnosis, which is relevant for a successful therapeutic outcome. It is recommended to use the neutral and descriptive term "functional neurological disorder". Treatment of the potentially reversible disease will be interdisciplinary and multimodal.

Accuracy of reverse-transcription polymerase chain reaction and loop-mediated isothermal amplification in diagnosing severe fever with thrombocytopenia syndrome: A systematic review and meta-analysis.

Nucleic acid molecular diagnostic technology plays an important role in the detection of severe fever with thrombocytopenia syndrome (SFTS). However, no relevant reports have been published on the accuracy of reverse-transcription polymerase chain reaction (RT-PCR) and reverse-transcription loop-mediated isothermal amplification (RT-LAMP) in the diagnosis of SFTS. Thus, we conducted a meta-analysis and systematic review to evaluate the accuracy of the two methods. On June 19, 2022, we comprehensively searched the PubMed, Embase, Cochrane Library, Web of Science, Scoups, Ovid, Proquest, China National Knowledge Infrastructure Database, Wan Fang Data, Traditional Chinese Medicine Database (Sinomed), VIP Database, and Reading Showing Database for articles on nucleic acid diagnostic techniques, such as RT-PCR and RT-LAMP, used to diagnose SFTS. Statistical analysis was performed using STATA 14.0 and Meta-Disc 1.4. Sixteen articles involving 2942 clinical blood samples were included in the analysis. RT-PCR and RT-LAMP were used as index tests, whereas RT-PCR or other detection methods were used as reference standards. The pooled values for the sensitivity, specificity, positive and negative likelihood ratios of the RT-PCR test were 0.97 (95% confidence interval [CI]: 0.92-0.99), 1.00 (95% CI: 0.98-1.00), 483.87 (95% CI: 58.04-4033.76), and 0.03 (95% CI:0.01-0.08), respectively. Those for the RT-LAMP test were 0.95 (95% CI: 0.91-0.97), 0.99 (95% CI: 0.93-1.00), 111.18 (95% CI: 13.96-885.27), and 0.05 (95% CI: 0.03-0.09), respectively. Both RT-PCR and RT-LAMP have high diagnostic value in SFTS and can be applied in different scenarios for laboratory confirmation or on-site screening.

[Full-information Force Sensor for Pulse Condition Diagnose].

According to the collection principles and characteristics of the pulse physiological signals of traditional Chinese medicine, combined with the international standard requirements of the pulse graph force transducer (ISO 19614:2017-05), a special force sensor component that can be used for a complete and objective collection of pulse signals has been developed, this sensor meets the requirements of industrialization. The sensor can measure the pulse amplitude and width signals of the cunpart of the human body. In addition, three sensors can be placed at the cun, guan, chi part at the same time, so that the "three body parts and nine pulse-taking sites" can be realized synchronously. After the sensor has been verified, the results meet the relevant requirements of international standard. The consistency of the result can be reached to 92.3% compared with the diagnosis result of clinical TCM experts.

Full-information Force Sensor for Pulse Condition Diagnose / 中国医疗器械杂志

According to the collection principles and characteristics of the pulse physiological signals of traditional Chinese medicine, combined with the international standard requirements of the pulse graph force transducer (ISO 19614:2017-05), a special force sensor component that can be used for a complete and objective collection of pulse signals has been developed, this sensor meets the requirements of industrialization. The sensor can measure the pulse amplitude and width signals of the cunpart of the human body. In addition, three sensors can be placed at the cun, guan, chi part at the same time, so that the "three body parts and nine pulse-taking sites" can be realized synchronously. After the sensor has been verified, the results meet the relevant requirements of international standard. The consistency of the result can be reached to 92.3% compared with the diagnosis result of clinical TCM experts.

Noninvasive Swansea criteria are valuable alternatives for diagnosing acute fatty liver of pregnancy in a Chinese population.

BACKGROUND: This study aims to assess the diagnostic and prognostic value of Swansea criteria in diagnosing acute fatty liver of pregnancy (AFLP) in a Chinese population. METHODS: A retrospective study was conducted on 52 Chinese women diagnosed with AFLP. All selected cases were reassessed using the Swansea criteria with special focus on the noninvasive criteria, since performing a liver biopsy for this indication is rare in a Chinese population. RESULTS: Ninety point four percent of patients fulfilled five or more of the Swansea criteria. Thirty-one cases were positive for six or more Swansea criteria, but there were no significance differences between patients when using a cutoff criteria <6 or >6. When patients were positive for less than seven criteria, frequency of stillbirth, continuous blood purification (CBP) treatment, hysterectomy, and postpartum hemorrhage were not increased. However, patients who were positive for seven or more criteria had a significantly higher risk of stillbirth and a higher rate of CBP treatment (p < 0.05). Areas under the receiver operating characteristic (ROC) curve of postpartum hemorrhage was 0.670, which reached a statistical significance (p = 0.040). We observed a significantly elevated postpartum hemorrhage along with positivity of the Swansea criteria (p = 0.040). CONCLUSIONS: Swansea criteria without liver biopsy are good screening tools for AFLP diagnosis, and may be useful for assessing disease severity.

Research progress of the diagnosis and treatment of diabetic cardiomyopathy / 中国基层医药

Objective Diabetic cardiomyopathy is a heart disease that excludes coronary heart disease,hypertensive heart disease and other heart diseases,and patients with diabetes mellitus prone to cardiac structural and functional changes.Echocardiography is often the first choice of examination methods,and nuclear magnetic resonance and nuclear magnetic resonance imaging is a new method to observe the changes of myocardial fibrosis and myocardial metabolism.In the treatment,need to a variety of methods to intervene,such as blood glucose control,using statin lipid -lowering drugs,angiotensin converting enzyme inhibitor,angiotensin receptor blocking agent,beta blockers,antioxidants,and traditional Chinese medicine etc.

Diagnósticos de enfermagem de pacientes com insuficiência cardíaca: revisão integrativa / Diagnósticos de enfermería de pacientes con insuficiencia cardíaca: revisión integral / Nursing diagnoses of patients with heart failure: an integrative review

Aim: To identify the information produced and published in the Brazilian and international literature regarding the diagnoses of nurses in the case of hospitalized patients with heart failure. Method: This is an integrative review without a defined time frame, performed with regard to the consultation of the following databanks: CINAHL, MEDLINE, SCOPUS, LILACS, Web of Science, CAPES Thesis Bank, USP Thesis Bank and BIREME. Results: 24 studies were selected and analyzed. Decreased cardiac output, excessive fluid volume, activity intolerance, impaired skin integrity, impaired gas exchange, efficient knowledge, risk of falls and impaired physical mobility were the most frequently mentioned diagnoses in the studies that were analyzed. Discussion: The results match the progression of heart failure, which limits the tolerance of the individual to physical exercise and causes water retention. Conclusion: This evidence will contribute to guiding nursing care and to the development of caring protocols...

Objetivo: Identificar o conhecimento produzido e publicado na literatura nacional e internacional sobre diagnósticos de enfermagem em pacientes hospitalizados com insuficiência cardíaca. Método: Revisão integrativa sem corte temporal definido, realizada nas bases de dados CINAHL, MEDLINE, SCOPUS, LILACS, Web of science, Banco de teses da CAPES, Banco de Teses da USP e BIREME. Resultados: Foram selecionadas e analisadas 24 produções. Débito cardíaco diminuído, volume excessivo de líquidos, intolerância à atividade, integridade da pele prejudicada, troca de gases prejudicada, conhecimento deficiente, risco de quedas e mobilidade física prejudicada foram os diagnósticos mais citados nos estudos. Discussão: Os resultados vão de encontro com a progressão da insuficiência cardíaca, que limita a tolerância do indivíduo ao exercício e causa retenção hídrica. Conclusão: Estas evidências contribuirão para o direcionamento do cuidado de enfermagem e elaboração de protocolos de assistência...

Objetivo: Identificar los conocimientos producidos y publicados en la literatura nacional e internacional sobre los diagnósticos de enfermería dados a pacientes hospitalizados con insuficiencia cardíaca. Método: Revisión integral sin corte temporal definido, realizada en las bases de datos CINAHL, MEDLINE, SCOPUS, LILACS, Web of science, Banco de tesis de la CAPES, Banco de Tesis de la USP y BIREME. Resultados: Fueron seleccionadas y analizadas 24 producciones. Débito cardíaco disminuido, volumen excesivo de líquidos, intolerancia a la actividad, integridad de la piel perjudicada, intercambio de gases perjudicado, conocimiento deficiente, riesgo de caídas y movilidad física perjudicada fueron los diagnósticos más citados en los estudios. Discusión: Los resultados están de acuerdo con la progresión de la insuficiencia cardíaca, que limita la tolerancia del individuo al ejercicio y causa retención hídrica. Conclusión: Estas evidencias contribuirán para direccionar el cuidado de la enfermería y la elaboración de protocolos de asistencia...

La prevención de la enfermedad renal, un nuevo reto para la enfermera / Kidney disease prevention, a new challenge for nurses

En Colombia y en el mundo la transición demográfica ha traído cambios en el estado de salud. Es así como la enfermedad renal se ha ido incrementando debido al aumento de edad en la población, y a la presencia de hipertensión arterial y diabetes mellitus como enfermedades precursoras; en estas dos enfermedades la falta de detección temprana y de un tratamiento adecuado y oportuno conllevan a la aparición de la enfermedad renal, que sin un control adecuado, progresa llevando al usuario a terapias de soporte renal y su consecuente efecto negativo en la calidad de vida del usuario y su familia. Por lo anterior, las enfermeras tienen un gran reto desde la atención primaria en salud, reforzando el cuidado de enfermeria desde el empoderamiento de la salud, pasando por la promoción de la salud, la prevención de la enfermedad y la prevención de las complicaciones, y en unión con el equipo de salud, trabajar conjuntamente con el usuario y su familia, ya que de lo contrario, el cuidado de la salud será en vano.

In Colombia and the rest of the world demographic transitions have caused changes to the health of the population. Among these changes is an increase in kidney disease due to increased life expectancy; hypertension and diabetes are precursors of the disease and late or inadequate treatment of this conditions leads to kidney disease, which without proper control creates the need for renal support therapy that has a negative effect on patients and their families lifestyles.\r\nFor this reason, nurses have a great challenge in primary health care, reinforcing care with health empowerment, health promotion, disease prevention and prevention of complications. Nurses need to work together with the health care provider and the patient and family, otherwise health care services will be in vain.

Características de deficiência nutricional do amendoinzeiro submetido à omissão de N, P, K / Characteristics of nutritional deficiency in groundnut submitted to the absence of N, P, and K

O amendoim é uma excelente alternativa agrícola para a região Nordeste do Brasil, porém, poucos estudos têm sido realizados para esta cultura, no tocante à sua adubação. Sendo assim, foi realizado um estudo com o objetivo de avaliar o rendimento e as características visuais de deficiência nutricional do amendoinzeiro (Arachis hypogaea L.) submetido à omissão de N, P e K. O experimento foi realizado em casa de vegetação da Universidade Federal do Recôncavo da Bahia, no Centro de Ciências Agrárias, Ambientais e Biológicas, situada em Cruz das Almas ­ BA, no período de Agosto a Outubro de 2010. O delineamento experimental foi em blocos casualizados, constando de sete tratamentos e quatro repetições. Os tratamentos estudados foram: T1- Solução Completa; T2- Omissão de N; T3- Omissão de P; T4 - Omissão K; T5- Omissão de NP; T6- Omissão PK e T7- Omissão de NPK. Durante todo o ciclo da cultura avaliou-se os possíveis aspectos visuais de deficiência. Ao final do experimento foram avaliados dados de altura e teor de clorofila. Aos 60 dias após a emergência, as plantas foram coletadas e particionadas em folhas, hastes e raízes, e secadas a 65ºC em estufa com circulação forçada de ar até atingir peso constante para quantificar a massa seca da parte aérea e da raiz. Nestas condições experimentais a omissão de K não se mostrou um fator limitante para o acúmulo de massa seca de folhas e haste nas plantas de amendoim. O fósforo se mostrou bastante requerido para o crescimento em altura e acúmulo de massa seca das folhas e hastes. O teor de clorofila da planta foi menor nos tratamento onde houve a omissão de N. Dos tratamentos aplicados, o que se mostrou mais limitante foi o tratamento com omissão de NPK, confirmando a importância da aplicação destes nutrientes às plantas de amendoim.

The groundnut is a great agricultural alternative for the Northeast region of Brazil, but few studies have been carried out for this crop in relation to its fertilization. Thus, a study was conducted to evaluate the performance and visual characteristics of nutritional deficiency in groundnut (Arachis hypogaea L.) submitted to the absence of N, P, and K. The experiment was conducted in a greenhouse at the Federal University of Bahia Recôncavo, at the Center for Agricultural, Environmental and Biological Sciences, located in Cruz das Almas, BA, from August to October 2010. The experimental design was in randomized blocks, consisting of seven treatments and four replications. The treatments were: T1 - Complete Solution; T2 - Omission of N; T3 - Omission of P; T4 - Omission of K; T5 - Omission of NP; T6 ­ Omission of PK; and T7 - Omission of NPK. Throughout the crop cycle possible visual aspects of deficiency were assessed. At the end of the experiment, the data were evaluated in height and chlorophyll content. At sixty days after emergence (DAE) plants were collected and partitioned into leaves, stem and root for drying in air forced oven at 65°C until constant weight was obtained to measure the dry mass of shoot and root. Under these experimental conditions the omission of K was not a limiting factor for dry mass of leaves and stem in peanut plants. Phosphorus is an element that proved to be enough for the required growth in height and accumulation of dry mass of leaves and stem. The chlorophyll content of the plant was lower in the treatment in which there was the omission of N. The treatment with omission of NPK was the most limiting, demonstrating the importance of applying these nutrients to the groundnut plants.

Caracterização anatômica da folha de Aniba firmula (Nees & C. Mart.) Mez (Lauraceae) / Anatomical characters of Aniba firmula (Nees & C. Mart.) Mez (Lauraceae) leaves

A partir de um estudo sobre a anatomia foliar de Aniba firmula (Nees & C. Mart.) Mez (Lauraceae), objetivou-se identificar caracteres anatômicos que possam auxiliar, de forma efetiva, sua morfodiagnose, tendo em vista que as espécies pertencentes a esse gênero são consideradas de difícil identificação devido à semelhança entre elas. Para realização do trabalho, foram utilizados métodos usuais em Anatomia Vegetal. Os resultados revelaram caracteres que podem ser considerados diagnósticos para a espécie, tais como: presença de tricomas tectores; estômatos paracíticos classificados como sendo do tipo "graminoide"; cristais prismáticos em células parênquimáticas no pecíolo; tricoesclereídes e braquiesclereides na lâmina foliar; sistema vascular em arco, com extremidades voltadas para o centro nas porções proximal e mediana do pecíolo e em arco com extremidades eretas na porção distal; sistema vascular na forma de arco com extremidades eretas, "V" aberto ou traço contínuo na nervura mediana; células oleíferas no mesofilo; padrão de venação camptódromo-broquidódromo, com venação marginal do tipo fimbrial. A análise de indivíduos ocorrentes em diferentes localidades foi determinante para a escolha de caracteres que não variam em decorrência das condições ambientais distintas.

The study about the leaf anatomy of Aniba firmula (Nees & C. Mart.) Mez (Lauraceae), aimed to identify anatomical characters that assists in its diagnosis, in view of the difficulty to identificate the Aniba species by being considered very similars. To realizate this research, usual methods in Plant Anatomy were applied. The obtained results considered like diagnostic characters were the presence of non glandular trichomes; paracitic stomata like "graminoid type"; prismatic crystals in parenchymatic cells, trichosclereids and brachisclereids; vascular system in arc form, with borders revolved to the center in the basal and middle region and "U" shaped in distal region of the petiole, midrib in "U" or "V" shaped or simple trace form; oil cells in the mesophyll and camptodromous-broquidodromous venation pattern with fimbrial margin. The analysis of specimens occuring in different towns was crucial to choose the characters that´s not change because of the different environmental conditions.