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The predictive roles of symptom combination traditionally evaluated in traditional Chinese medicine (TCM) in the treatment of rheumatoid arthritis (RA) were explored. Three hundred and ninety six patients were randomly divided into 197 subjects receiving Western medicine therapy (WM) and 199 subjects receiving TCM therapy (TCM). A complete physical examination and 18 clinical manifestations typically assessed in TCM were recorded before the randomization. The ACR responses were used for efficacy evaluation. ACR20 and 50 responses with WM treatment were higher than in the TCM group. The 18 symptoms in RA could be clustered into 4 symptom combinations with factor analysis, which represent joint symptoms, cold pattern, deficiency pattern and hot pattern in TCM respectively. TCM would be more effective in patients with weak-symptom combination 3 (deficiency pattern in TCM), and WM would be more effective in patients with symptom combination 2 (cold pattern in TCM). Symptom combinations judged with TCM may have influence on the efficacy of therapy in the treatment of RA.

This paper extends the theory of fuzzy diseases predictions in order to detect the causes of business failure. This extension is justified through the advantages of the reference model and its originality. Moreover, the fuzzy model is completed by this proposal and some parts of it have been published in isolated articles. For this purpose, the fuzzy theory is combined with the OWA operators to identify the factors that generate problems in firms. Also, a goodness index to validate its functionality and prediction capacity is introduced. The model estimates a matrix of economic- financial knowledge based on matrices of causes and symptoms. Knowing the symptoms makes it possible to estimate the causes, and managing them properly, allows monitoring and improving the company’s financial situation and forecasting its future. Also with this extension, the model can be useful to develop suitable computer systems for monitoring companies’ problems, warning of failures and facilitating decision-making.

In this paper, we describe the clinical symptoms, diagnosis, and surgical treatment of painful lumbar discs with the vacuum phenomenon (VP). The sole indication for anterior arthrodesis was painful discs with VP. Sixteen patients were included and retrospectively reviewed; of these, 10 patients had back and thigh claudication pain, and 5 patients had acute onset of excruciating back or thigh pain. Unilateral thigh pain tended to be on the concave side of lumbar scoliosis. Dynamic myelography and reformatted computed tomography (CT) were useful imaging tools to detect VP. Bone scan was useful in detecting painful discs in degenerative scoliosis, and selective nerve block was useful in differentiating compressive root pain. Mechanical and chemical factors were postulated for the pathogenesis of VP discs in patients with chronic and acute pain. Satisfactory outcomes were achieved in 94% (n = 15) of patients by anterior arthrodesis with cage. VP is a useful pain and fusion indicator in painful spine with or without deformities. The term "discogenic claudication" is proposed to describe clinical pictures of the vacuum sign.

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The paper aims at establishing the output-to-input relationship of the real-life adult depression data using a neural network (NN) model. The said model has been developed to diagnose and detect the associated severity (grade) of the illness. An intelligent NN-based reverse model has been trained through batch mode and put to test on another set of real-life data. Reverse mapping of this model has been developed to isolate significantly contributing input components (factors) for any given case to expedite the preventive procedure for further deterioration as well as the start of treatment.

The symptoms of cancer or its recurrence must be distinguished from the early and late side effects of anti-cancer treatment, other drugs, or unrelated concomitant illnesses. Symptoms of cancer may be directly due to the effects of the primary tumour or its metastases on surrounding tissue, or the manifestations of paraneoplastic syndromes, which are distant effects often mediated by hormones or cytokines, but not directly due to the local effect of tumour. Systemic symptoms of cancer include weight loss, fatigue, pruritus and fever and sweats, which must be distinguished from unrelated illnesses. Organ-specific cancers cause symptoms either due to the mass effect, such as tumour blockage of hollow passages like the airways, gastrointestinal tract or urogenital tract, or cause organ dysfunction, as may occur in the liver or lungs. Pain may occur with nerve compression, blockage of hollow organs, or the stretching of organ capsules, as occurs in the liver.

The side effects of chemotherapy are part of the differential diagnosis of symptoms which could mimic those of conditions unrelated to the cancer. Examples include emesis, infection, anaemia, or cumulative organ toxicities. Some toxicities manifest themselves very late after the treatment, such as second cancers and sterility.

Much has been learnt about severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) since the beginning of the Coronavirus disease 2019 (COVID-19) pandemic, including its clinical manifestations, diagnosis, and management. Unlike its zoonotic predecessor SARS-CoV which was largely a symptomatic disease where fever was a hallmark, a significant proportion of SARS-CoV-2 infections can be asymptomatic (40%), while severe disease (requiring oxygen supplementation or ventilatory support) occurs in approximately 20%, and mortality in about 2% of infected patients. Extra-pulmonary COVID-19 manifestations are also more protean, compared to SARS. Supportive care is the mainstay of treatment for most patients, but for those who progress to severe COVID-19, antivirals such as remdesivir and immunomodulatory treatment (such as corticosteroids or the JAK-inhibitor, baricitinib) may improve outcomes. While further advances in the management of COVID-19 are anticipated (including novel therapies), prevention of infection through public health measures (including vaccination), will remain as vital facets in confronting this pandemic.

The aim of this paper was to search for alternative hosts to green bean for Erwinia persicina. This enterobacteria, detected for the first time in southeastern Spain at the end of 2003, causes chlorotic and necrotic spots on leaves and pod deformation in green bean. Results showed that E. persicina caused disease in tomato, pepper, melon and cucumber. The most characteristic symptoms observed were: leaf necrosis, adventitious roots, brown colouring along the stem, internerval chlorosis, and curled and blistered leaves. In the case of cucurbits, a noticeable lesion in some areas of the stem was also observed. The presence of the bacteria in each plant was detected by microbiological and immunological analyses (ELISA).

A 50-year-old woman complains of hot flushes and excessive perspiration.

• What is menopause?
• What is menopausal transition?
• What are the major health issues related to menopause?

More than 95% of women experience at least one symptom during menopausal transition. The prevalence of symptoms reaches a peak at 47-years and declines in the ensuing five years for breast tenderness, palpitations, dizziness, irritability, anxiety or depression, tearfulness, and frequent severe headaches. In contrast, the prevalence of insomnia, musculoskeletal aches and joint pain, hot flushes, vaginal dryness, and difficulties with sexual intercourse increases between the age of 48 and 54 years. Of all the symptoms, insomnia, irritability/anxiety, severe hot flushes and sweating, and vaginal dryness carry the highest negative impact on the quality of life.