A man in his 60s with multiple vascular comorbidities presented with sudden, painless vision loss in one eye. Although he had a high risk for atherosclerotic events, initial evaluation for stroke was negative for acute ischemia, but found to have markedly elevated inflammatory markers. Accordingly, giant cell arteritis was investigated and Ophthalmologic findings and fulfillment of the 2022 American College of Rheumatology/European Alliance of Associations for Rheumatology classification criteria supported the diagnosis of giant cell arteritis, despite a negative temporal artery biopsy. Management included high-dose glucocorticoids and delayed tocilizumab initiation due to the need for multiple vascular surgeries. Vision loss was irreversible, but systemic symptoms resolved and vascular interventions were successful. This case highlights the diagnostic and management complexities of biopsy-negative giant cell arteritis in patients with severe atherosclerotic vascular disease, emphasizing the importance of clinical judgment and established classification criteria when imaging and biopsy results are inconclusive.

A diagnosis of the current state of the crops is made regarding the control of weeds, use of pesticides, fungicides; with an assessment of the state of the plant covers in the crop, and its control by different types of herbicides, and we detected a high loss of biological diversity; and some of these compounds are mentioned due to their high toxicity. Similarly, the use of pesticides and fungicides is discussed due to their repercussions on health. In order to avoid the unhealthiness caused by the applications of these products, phytosanitary and educational control strategies are proposed; promoting the inspection of fruit and vegetable markets, and modifying the contents in higher professional and university education. To this end, we propose an active teaching methodology, through which the student acquires skills and responsibility for the use of chemical agents in agriculture, which serves to prevent the entry of these contaminants into the food chain. Of the different polluting chemical agents, in the case of herbicides we highlight Oxyfluorfen and Glyphosate with high toxicity and whose consumption is very high. In the case of pesticides and fungicides, among others are Organochlorine compounds, which have been detected in blood, and Carbon Tetrachloride and Chloroform, considered potent hepatotoxic and neurotoxic. The basic objective of this study is the awareness and acquisition of knowledge by future teachers about polluting agents, which will subsequently have an impact on society.

This article focuses on primary liver cancer and tries to present a possible CBT-Cognitive Behavioral Therapy group intervention of 6 sessions and a follow up based on a scientific review. We present an international national data analyze of the problem and characterize it in terms of symptoms, diagnosis and treatment. From the psychological point of view our goal is to show and reflect on the connection between theory and practice in research mental health and the quality of life of people suffering from liver cancer. CBT interventions programme have shown efficacy and effectiveness on improving quality of life of patients. The expected outcomes of CBT intervention are mainly a better adaptation to cancer and a better perception on quality of live.

We present a case of a critically ill patient with severe Legionella pneumonia complicated by morbid obesity (BMI ≥ 40 kg/m²) who was successfully treated with early initiation of veno-venous ECMO (V-V-ECMO) without any sequelae. The patient, a 48-year-old male, initially presented with symptoms of a sore throat, fever, significant fatigue, and decreased appetite. Upon diagnosis of severe pneumonia complicated by morbid obesity, he was transferred to our hospital for further management. Upon admission, he was promptly intubated and placed on mechanical ventilation. Due to a positive urinary Legionella antigen test indicating a risk of deterioration, V-V ECMO was initiated immediately after intubation. During ECMO support, the patient received Levofloxacin Hydrate at 500 mg/day and Prednisolone Sodium Succinate at 100 mg/day. He was successfully weaned off ECMO after 12 days and transferred back to the referring hospital on day 20. While ECMO therapy for morbidly obese patients was traditionally considered relatively contraindicated, this case suggest that obesity alone is not a contraindication to initiating ECMO.

The spiny xeromorphic shrublands on serpentine (cuabales) constitute outstanding plant formations for the conservation of Cuban biodiversity, due to their floristic richness, high number of endemic species and local endemism, as well as their economic, social, cultural value and functions environmental. In the Callejón de Los Patos of Santa Clara, there are relicts of cuabal, although they show a high level of deterioration due to human activity. This article presents the main results of an investigation, which focused on implementing actions for the development of Community Environmental Education, with emphasis on the conservation of cuabal, in Callejón de Los Patos. For the intervention process, the Community Self-Development Methodology was used, which is qualitative par excellence, and the investigative methods: document analysis, participant observation, in-depth, group and structured interviews, drawing directed, the reflective group, techniques group and triangulation of data. The main results of the research are: the diagnosis and implementation of actions, designed from the process of Community Environmental Education, which was developed at the Carlos Manuel de Céspedes National Rural School, of said settlement. During the intervention process, the development of cognitive, procedural and attitudinal knowledge for the conservation of cuabal was verified in the schoolchildren, contributing to the strengthening of the school as the most important cultural center of the community, as aspired in the Cuban National Education System.

The accurate estimation of Individual Wave Components (IWC) is crucial for automated diagnosis of the human digestive system in a clinical setting. However, this process can be challenging due to signal contamination by other signal sources in the body, such as the lungs and heart, as well as environmental noise. To address this issue, various denoising techniques are commonly employed in bowel sound signal processing. While denoising is important, it can increase computational complexity, making it challenging for portable devices. Therefore, signal processing algorithms often require a trade-off between fidelity and computational complexity. This study aims to evaluate an IWC parameter extraction algorithm that was previously developed and reconstruct the IWC without denoising using synthetic and clinical data. To that end, the role of a reliable model in creating synthetic data is paramount. The rigorous testing of the algorithm is limited by the availability of quality and quantity recorded data. To overcome this challenge, a mathematical model has been proposed to generate synthetic bowel sound data that can be used to test new algorithms. The proposed algorithm’s robust performance is evaluated using both synthetic and clinically recorded data. We perform time-frequency analysis of original and reconstructed bowel sound signals in various digestive system states and characterize the performance using Monte Carlo simulation when denoising is not applied. Overall, our study presents a promising algorithm for accurate IWC estimation that can be useful for predicting anomalies in the digestive system.

Background: The World Health Organization (WHO) has declared COVID-19 a public health emergency of international concern. In this context, effective and affordable diagnostic procedures are essential for identifying and managing cases. Complete blood counts (CBC) are among the most common and readily available diagnostic tests. The current study aimed to evaluate the efficacy of CBC in diagnosing COVID-19 and identifying cases. Patients and Methods: A case-control study was conducted on 173 patients at Ain Shams University Hospitals over a period of three months. Patients were allocated into two groups according to COVID-19 PCR results: Group 1 included patients with COVID-19 positive PCR, and Group 2 included patients with COVID-19 negative PCR. Results: The study found that differential CBC had significant value in diagnosing COVID-19 disease. Many COVID-19 patients had lymphopenia and leucopenia compared to non-COVID-19 suspected patients. The low values of leukocytes, neutrophils, lymphocytes, and eosinophils with a CBC test were found to be valuable in the initial diagnosis of COVID-19. Conclusion: The definitive diagnosis of COVID-19 requires RT-PCR analysis, which is time-consuming and less accessible. Thus, the initial diagnosis and treatment of patients may be delayed. This study suggests that CBC, which is easily available and affordable, can be valuable in the early identification of COVID-19 cases, allowing for prompt treatment and management.

Background: Oncology nurse navigators (ONNs) are becoming even more vital as healthcare continues to develop into a more complicated, confusing maze for patients. When many specialists on the treatment team have divergent points of view due to the nature of their respective professions or other factors, the patient may experience feelings of confusion. In the end, this can cause delays in treatment, pose a threat to the established standard of care, and lead to a decrease in patient satisfaction. Aim: To enumerate various ways in which ONNs may help improve the quality of life of cancer patients. Design: An integrative review. Results: A total of 19 studies related to the topic are evaluated. Four main themes namely: provider of psychological support, facilitator of timely care, oncology nurse navigators perception of their role and patient’s perception of oncology nurse navigators and 3 sub themes which are: information giver, source of emotional support and coordinator, were identified to be the roles of the ONNs. The findings showed that oncology nurse navigators help reduce patients anxiety and distress, increase patient satisfaction, shorten the time from diagnosis to treatment, provide necessary information, support them emotionally and coordinate their care with the different members of the healthcare team and resources. Conclusion: The main function of the ONNs is to address any barrier that may hinder the patient’s cancer treatment, survivorship and even palliative care. ONNs make sure that each patient has individualized nursing care according to the patients and their families' needs. Implications for Practice: ONNs have the potential to significantly contribute not only to the quality of life of cancer patients but also to the process of achieving better service integration. The result of this integrative review contributes to the growth of the healthcare system by improving accessibility, fairness, efficiency, effectiveness, and the ability to maintain health services throughout time brought about by ONNs.

Neurodegeneration and aging are pressing issues with significant personal, economic, ethical, and social consequences. However, the underlying biological mechanisms of these conditions remain largely unknown, making the development of effective treatments challenging. The difficulty in early detection and diagnosis of neurodegenerative diseases further compounds the issue. Recent advancements in genetics, genomics, and brain imaging technology hold great promise for improving our understanding of neurodegeneration and aging, as well as the development of personalized medicine and new drugs and therapies. Addressing these challenges will require a multi-disciplinary and collaborative approach from researchers in various fields. This Special Issue offers valuable insights and perspectives on this critical area of research, which can help advance our understanding and improve the health and well-being of our aging population.