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Background. The risk of herpes zoster reactivation is increased in immunocompromised patients, especially in those with immune-mediated inflammatory diseases (IMIDs) on Janus kinase inhibitor (JAKi) treatment. The recombinant subunit herpes zoster vaccine (RZV) is a non-live vaccine, recently approved for this subgroup of patients, which shows high rates of vaccine effectiveness, with few adverse effects reported in clinical trials. Purpose. The aim of this real-world study was to determine the immunogenicity and safety of RZV in IMID patients on JAKi treatment. Methods. The increase in the concentration of anti-gE antibody for varicella zoster virus post-vaccination, compared to the pre-vaccination concentration, was analyzed to test the humoral immune response. Adverse effects after the first and second vaccine doses were registered. Results. In total, 49 patients were analyzed, and a fourfold increase in antibody concentration was achieved in almost 40% of subjects, with only one serious local adverse effect. Discussion. The resulting immunogenicity was lower than that observed in clinical trials, probably due to the presence of immune disease and immunosuppressive treatment, and to the fact that this was a real-world study. No differences in response according to age, previous virus zoster reactivation, or concomitant treatments were found. Conclusions. RZV was well tolerated and reached the immune response objective in 40% of patients. These results reinforce the importance of including RZV vaccination for immunosuppressed patients. Real-world studies regarding vaccine effectiveness are still needed in order to gain a full understanding of the response to RZV in this group of patients.

Background: the teaching of the pulp and periapical diseases diagnosis is defined as an essential content of the teaching-learning process in the Clinical Operative subject, to fulfill the main functions declared in the professional profile of the general stomatologist training model in Cuba.Objective: to determine the current state of pulp and periapical disorders teaching diagnosis in the Stomatology career Clinical Operative subject.Methods: observational, descriptive and cross-sectional research carried out at the Cienfuegos University of Medical Sciences on a population of 8 teachers and 37 third-year students of the 2017-2018 academic year. A guide was used to directly observe how the teaching of the diagnosis of pulp and periapical diseases is carried out and a survey was applied to teachers and students with closed questions.Results:it was evidenced as a strength that education at work predominates as an organizational form and there are references to the clinical method teaching in the medical career. Limitations were found in the faculty with respect to the teaching and scientific categories and years of experience; limited use of the students characterization and their results as well as deficient application of the essential actions corresponding to the diagnostic stage of the clinical method and prevalence of the teacher authoritarian role. Conclusions: still limitations in the diagnosis of pulp and periapical diseases current teaching of the population under study.

Fundamento: las alteraciones de la marcha y el equilibrio en la tercera edad son la causa principal de caídas. Son necesarios métodos de valoración válidos y fiables para identificar el riesgo de caídas. Objetivo: determinar las relaciones de algunos indicadores del test escala de equilibrio avanzado de Fullerton y la edad, en adultos mayores. Métodos: se realizó un estudio exploratorio, descriptivo y transversal entre septiembre y diciembre de 2017 en los círculos de abuelos del combinado deportivo 5 del municipio Cienfuegos. Para ello se seleccionaron 115 adultos mayores. Fueron seleccionadas como variables generales: la edad y el sexo. Se tomaron cuatro de los diez incisos que conforman el test de Fullerton. Se aplicaron el coeficiente de correlación de Spearman y el coeficiente Gamma, se trabajó al 95 % de confianza. Los resultados se expusieron mediante el uso de tablas. Resultados: el grupo de edades más representado fue el de 71-75 años (40,9 %), con una prevalencia del sexo masculino (16 %). En la aplicación del test de Fullerton los adultos mayores lograron mantener el equilibrio en bipedestación, en más del 25 % de los casos; pudieron o bien tomar el objeto sin mover los pies o bien mediante un paso; en el control ortostático los valores más altos se concentran en el grupo de 71-75 años (40 %). Conclusiones: predominaron los adultos mayores que lograron mantener el equilibrio en bipedestación con los ojos cerrados, pudieron o bien tomar el objeto sin mover los pies o bien mediante un paso con supervisión, en el control ortostático los valores más altos se concentran en el grupo de 71-75 años.

Foundation: alterations in gait and balance in the elderly are the main cause of falls. Valid and reliable valuation methods are necessary to identify the risk of falls. Objective: to determine the relationships between some indicators of the Fullerton advanced equilibrium scale test and age in older adults. Methods: a descriptive cross sectional exploratory study was conducted between September and December 2017 in elder Day Care Centers of the Combined Sports Center N0 5 of the Cienfuegos Municipality. For this, 115 elderly adults were selected. The general variables were: age and sex. Four of the ten items that make up the Fullerton test were taken. The Spearman correlation coefficient and the Gamma coefficient were applied, with 95 % confidence. The results were exposed through the use of tables. Results: the most represented age group was 71-75 years (40.9 %), with a prevalence of males (16 %). In the application of the Fullerton test older adults managed to maintain balance in standing, in more than 25 % of cases, could take the object either without moving the feet or by a step, in the orthostatic control the highest values they are concentrated in the group of 71-75 years (40 %). Conclusions: older adults who managed to maintain balance in standing with their eyes closed, could either take the object without moving the feet or through a step with supervision, in the orthostatic control the highest values are concentrated in the group of 71-75 years.

Foundation: a questionnaire to characterize non-intentional lesions is important, it allows identifying the mechanism of action, the type of lesion and the most frequent place , thus contributing to its prevention. Objective: to validate a questionnaire to characterize non-intentional lesions in children from 1 to 4 years. Methods: a technological study development study was done which consisted on the validation of the content of a questionnaire by the Moriyama criteria. Its consistency was measured through the Alpha coefficient. A pilot test was done to 50 parents and/or tutors of children between 1 to 4 years old belonging to the Jose Luis Chaviano Polyclinic, Cienfuegos. Results: the questionnaire was validated; an item was eliminated due to having a score below 70%. Alpha coefficient had values of 0.88 as a sample of high internal consistency which qualified as feasible since surveyed parents referred a clear and comprehensible language. Conclusion: the results obtained by different ways aimed at validating our questionnaire were appropriate. It available a validated and reliable instrument which justifies the use and application in the research area for characterizing non intentional lesions in children from 1 to 4 years old.

Background: the Brunner’s glands are tubular structures located in the submucosa of the duodenum. Their excessive growth does not usually give symptoms or at least they are minimum. This is known as Brunner’s gland adenoma, Hamartoma or Brunneroma. Its most frequent localization is in the first portion of the duodenum, but it is extremely strange below the ampulla of Vater. Objective: to present the clinical case of a patient with the diagnosis of Brunneroma. Clinical case: white-skinned, 72 years-old, female patient with antecedents of a 20-years duodenal ulcer who is hospitalize with diffuse pain in superior abdomen accompanied by abundant depositions like coffee powder, profuse sweating and slight loss of weight in the last month. Conclusions: Brunneroma is a not very frequent benign lesion of the duodenum; it can be discovered accidentally and in some occasions it may cause digestive hemorrhage. DeCS: BRUNNER GLANDS; HAMARTOMA; DIGESTIVE SYSTEM DISEASES; AGED; CASE REPORTS.

Se estima que la prevalencia del trastorno por déficit de atención con hiperactividad (TDAH) en estudiantes universitarios es del 2 al 4.5% pero varía de una universidad a otra. Sin embargo, muchos estudiantes evitan acudir a tratamiento por ansiedad, temor al estigma, porque sienten que los problemas de los otros son mayores que los propios o bien desconocen la sintomatología del TDAH. En esta contribución se presenta el diseño e implementación de un chatbot para la aplicación del cuestionario Adult Self Report Scale-Versión 1.1 (EATDAH-A) así como los resultados de la aplicación del mismo y la opinión de los usuarios en cuanto a su utilidad y experiencia como usuario.

This paper focuses on prediction and prevention of seismic risk through a system for decision making. Data Warehousing and OLAP operations are applied, together with, data mining tools like association rules, decision trees and clustering to predict aspects such as location, time of year and/or earthquake magnitude, among others. The results of the data mining and data warehouse application help to confirm uncertainty about problems behavior in decision making, related to the prevention of seismic hazards.