Influenza vaccine effectiveness in Europe: Results from the 2022-2023 VEBIS (Vaccine Effectiveness, Burden and Impact Studies) primary care multicentre study.

Background: Influenza A(H3N2) viruses dominated early in the 2022-2023 influenza season in Europe, followed by higher circulation of influenza A(H1N1)pdm09 and B viruses. The VEBIS primary care network estimated the influenza vaccine effectiveness (VE) using a multicentre test-negative study. Materials and Methods: Primary care practitioners collected information and specimens from patients consulting with acute respiratory infection. We measured VE against any influenza, influenza (sub)type and clade, by age group, by influenza vaccine target group and by time since vaccination, using logistic regression. Results: We included 38 058 patients, of which 3786 were influenza A(H3N2), 1548 influenza A(H1N1)pdm09 and 3275 influenza B cases. Against influenza A(H3N2), VE was 36% (95% CI: 25-45) among all ages and ranged between 30% and 52% by age group and target group. VE against influenza A(H3N2) clade 2b was 38% (95% CI: 25-49). Overall, VE against influenza A(H1N1)pdm09 was 46% (95% CI: 35-56) and ranged between 29% and 59% by age group and target group. VE against influenza A(H1N1)pdm09 clade 5a.2a was 56% (95% CI: 46-65) and 79% (95% CI: 64-88) against clade 5a.2a.1. VE against influenza B was 76% (95% CI: 70-81); overall, 84%, 72% and 71% were among 0-14-year-olds, 15-64-year-olds and those in the influenza vaccination target group, respectively. VE against influenza B with a position 197 mutation of the hemagglutinin (HA) gene was 79% (95% CI: 73-85) and 90% (95% CI: 85-94) without this mutation. Conclusion: The 2022-2023 end-of-season results from the VEBIS network at primary care level showed high VE among children and against influenza B, with lower VE against influenza A(H1N1)pdm09 and A(H3N2).

"Eritadenine as a regulator of anxiety Disorders: An experimental and docking Approach".

Uncertainty persists regarding the specific chemical causal factors and their corresponding behavioral effects in anxiety disorders. Commonly employed first-line treatments for anxiety target G protein-coupled receptors (GPCRs), including inhibitors of monoaminergic systems. Alternatively, emerging natural bioactive strategies offer potential for mitigating adverse effects. Recent investigations have implicated adenosine in anxiety-triggering mechanisms, while eritadenine, an adenosine analog derived from Shiitake mushroom, has displayed promising attributes. This study explores eritadenine's potential as a bioactive substance for anxiety disorders in mice, employing behavioral tests, pentobarbital-sleep induction, and molecular docking. Behavioral test results reveal a pronounced anxiolytic and sedative-hypnotic pharmacological effect of eritadenine. Our findings suggest that eritadenine may modulate locomotor functions mediated by adenosine receptors, with a stronger affinity for binding to A2AAR over A1AR, thus eliciting these effects.

A hybrid machine learning-mathematical programming optimization approach for municipal solid waste management during the pandemic.

This paper provides a mathematical optimization strategy for optimal municipal solid waste management in the context of the COVID-19 epidemic. This strategy integrates two approaches: optimization and machine learning models. First, the optimization model determines the optimal supply chain for the municipal waste management system. Then, machine learning prediction models estimate the required parameters over time, which helps generate future projections for the proposed strategy. The optimization model was coded in the General Algebraic Modeling System, while the prediction model was coded in the Python programming environment. A case study of New York City was addressed to evaluate the proposed strategy, which includes extensive socioeconomic data sets to train the machine learning model. We found the predicted waste collection over time based on the socioeconomic data. The results show trade-offs between the economic (profit) and environmental (waste sent to landfill) objectives for future scenarios, which can be helpful for possible pandemic scenarios in the following years. Supplementary Information: The online version contains supplementary material available at 10.1007/s10668-023-03354-2.

Strategic planning for the optimal distribution of COVID-19 vaccines.

This work presents a multi-objective optimization strategy for fair vaccine allocation through different fairness schemes. The proposed approach considers a diverse series of parameters related to different public health data and social behaviors that influence the correct distribution of vaccines, such as corruption and crime. Simultaneously, the formulation includes prioritizing those groups with the highest risk based on the epidemiological traffic light. Furthermore, the presented strategy involves different budget constraints that allow identifying trade-off solutions through Pareto fronts. Therefore, vaccine allocations are obtained by combining fairness concepts with multi-objective optimization. The applicability of the model is illustrated using the case study of Mexico. The solution to the proposed scenarios was carried out using different justice schemes and an economic objective function. The results show the compromises between a satisfaction index and costs, which are shown through Pareto optimal solutions that allow selecting the solutions that balance the objectives. The solutions provided by the social welfare scheme suggest a greater allocation of vaccines to those states with higher epidemiological risk, which may be helpful in the first stage of vaccination. On the other hand, the Rawlsian scheme provides more balanced solutions that can be useful in situations with lower rates of infection. Finally, the Nash scheme is the one that provides the most balanced solutions, favoring to a lesser extent the areas with the highest epidemiological risk, which may be useful in the later stages of vaccination.

Epidemiological and clinical characteristics of SARS-CoV-2 reinfections in a Spanish region.

Objective: We aimed to assess the prevalence and clinical characteristics of SARS-CoV-2 reinfections in a Spanish region. Methods: This is a retrospective observational study in all patients with SARS-CoV-2 infections in the Lleida health region from 1 March to 30 November 2020. Reinfections were classified as patients with positive SARS-CoV-2 PCR tests separated by at least 90 days plus a negative test result between both infection episodes. Primary and secondary outcomes: The primary outcome was the percentage of SARS-CoV-2 reinfections among all SARS-CoV-2 infections detected during our study period. Secondary outcomes were the clinical and sociodemographic characteristics of patients with SARS-CoV-2 reinfections. Results: Of the 27,758 patients diagnosed with SARS-CoV-2 infection in the study period, 14 were identified as coronavirus reinfection (0.050%). Of the reinfected sample, 12 patients (85.7%) were women. The median age was 41.5 years. Two patients died in the second coronavirus episode. Conclusion: The reinfection rate of SARS-CoV-2 in the Spanish region Lleida was relatively low during the observational period in 2020 (less than 1%). These data are in line with the notion that previous SARS-CoV-2 infections may offer a significant protection by so called natural immunity.

Biomarkers of Venous Thromboembolism Recurrence after Discontinuation of Low Molecular Weight Heparin Treatment for Cancer-Associated Thrombosis (HISPALIS-Study).

The most appropriate duration of anticoagulant treatment for cancer-associated venous thromboembolism (CAT) remains unclear. We have conducted a prospective multicenter study in CAT patients with more than 6 months of anticoagulant treatment to predict the risk of venous thromboembolism (VTE) recurrence after anticoagulation discontinuation. Blood samples were obtained when patients stopped the anticoagulation, at 21 days and at 90 days. In each sample we assessed different coagulation-related biomarkers: D-dimer (DD), high-sensitivity C-reactive protein (hs-CRP), P-selectin (PS), phospholipids, soluble tissue factor, factor VIII and the thrombin generation test. It was evaluated 325 CAT patients and 166 patients were included in the study, mean age 64 ± 17 years. VTE recurrence until 6 months after stopping anticoagulation treatment was 9.87% [95% confidence interval (CI): 6−15]. The biomarkers sub-distribution hazard ratios were 6.32 for ratio DD basal/DD 21 days > 2 (95% CI: 1.82−21.90), 6.36 for hs-CRP > 4.5 (95% CI: 1.73−23.40) and 5.58 for PS > 40 (95% CI: 1.46−21.30) after 21 days of stopping anticoagulation. This is the first study that has identified the DD ratio, hs-CRP and PS as potential biomarkers of VTE recurrence in cancer patients after the discontinuation of anticoagulation treatment. A risk-adapted strategy may allow the identification of the optimal time to withdraw the anticoagulation in each CAT patient.

Optimal waste management during the COVID-19 pandemic.

There have been many problems generated by the COVID-19 pandemic. One of them is the worrying increase in the generation of medical waste due to the great risk they represent for health. Therefore, this work proposes a mathematical model for optimal solid waste management, proposing a circular value chain where all types of waste are treated in an intensified industrial park. The model selects the processing technologies and their production capacity. The problem was formulated as a mixed-integer linear programming problem to maximize profits and the waste processed, minimizing environmental impact. The proposed strategy is applied to the case study of the city of New York, where the increase in the generation of medical waste has been very significant. To promote recycling, different tax rates are proposed, depending on the amount of waste sent to the landfill. The results are presented on a Pareto curve showing the trade-off between profits and processed waste. We observed that the taxes promote recycling, even of those wastes that are not very convenient to recycle (from an economic point of view), favoring profits, reducing the environmental impact, and the risk to health inherent to the medical waste.

Situation of Neuromarketing Consulting in Spain.

The latest research in Spain indicates that the most advanced neuromarketing consulting companies in the sector are those that have been able to innovate in the development of their own technologies and methodologies. Despite their reduced volume of business compared to total investment in marketing and market research in our country, there are signs that suggest these companies have great potential to improve this sector, which is still to be explored. For this reason, this research straddling the ethnographic method and the theoretical-descriptive method aims to help us better understand the characteristic features of this sector by actively listening to the professional voices that lead it. Its epistemological value lies in its contribution to understanding the business culture related to the professional development of neuromarketing in our country today. The study shows that the main human resources strategy of neuromarketing consulting companies is based on the creation of multidisciplinary work teams. In addition, most of them develop data analysis software, which they can safeguard under various types of copyright, and on other occasions they manage to patent them, to later apply them to the objectives and purposes of their company. This would also explain the widespread use of certain procedures and resources by the vast majority of the consulting companies investigated. Thus, the trend in the market is the implementation of different synchronization software to the available technological and methodological resources. Others have even gone so far as to create a new technological support to incorporate methodologies already in use. Therefore, this gives them exclusivity in their services and the necessary competitive advantage over their competitors. Among other factors, these inferences about how this sector really works are very likely to be very useful in the academic field, which will constitute a further step in generating critical thinking and in expanding the frontiers of knowledge around this discipline.

Actualización acerca del riesgo de pérdida auditiva inducida por ruido en el personal odontológico / Upgrade about the risk of hearing loss in the dental personal

La relación entre la exposición a los ruidos y la pérdida auditiva se considera desde hace muchos años. La comunidad odontológica no está exenta de este problema, ya que los profesionales trabajan a diario, y durante tiempos prolongados, con instrumentos ruidosos. Esta revisión bibliográfica tiene como propósito realizar una actualización acerca del riesgo de pérdida auditiva inducida por ruido en el personal que trabaja en la clínica odontológica. En la actualidad, se afirma que los odontólogos y el personal en la clínica dental corren el riesgo de contraer diversas patologías auditivas ­como es el caso de la hipoacusia­ debido al ruido que producen los equipos de alta velocidad. Las enfermedades profesionales del tipo auditivas que se abordan en este trabajo constituyen factores que comprometen no solo el buen estado de salud de los odontólogos y demás profesionales, sino su calidad de vida (AU)

The relationship between noise exposure and hearing loss has been known for many years. The dental community is not exempt from this problem, because they work every day and for long periods of time with noisy instruments. This literature review aims to update the risk of noise-induced hearing loss in personnel working in the dental clinic. The risk to which dentists and staff in the dental clinic are subjected to the high-speed and other noisy equipment is well known, and that can cause various auditory problems such as hearing loss. The occupational diseases of the auditory type that were addressed in this article constitute factors that compromise not only the good state of health of dentists and other professionals who work in similar conditions, but also in their quality of life (AU)

Optimization of municipal solid waste management using a coordinated framework.

Municipal solid waste (MSW) management is an important but complex logistical problem. The deployment of MSW management systems is hindered by the ever-growing generation of waste and the often insufficient infrastructure to manage, process, and dispose of waste. This paper presents a coordinated framework for complex MSW management systems. The framework accommodates multiple key stakeholders in MSW systems, such as suppliers of waste, consumers of waste and derived products, and providers of transportation and processing services. Here, the stakeholders submit bids to a coordinator that solves an optimization problem to determine allocations and clearing prices that maximize the collective profit for all stakeholders and that balance supply and demand for waste and products. Furthermore, the clearing process guarantees that the individual profits are non-negative (no stakeholder loses money). Notably, the framework operates as a competitive market that accelerates transactions between stakeholders and that handles complex logistical constraints that would be difficult to handle in peer-to-peer transactions. The framework also facilitates the integration of policy incentives and the monetization of environmental impacts. In this regard, we evaluate a tax applied to open dump disposal. To illustrate the applicability, an MSW system in Mexico was analyzed as a case study. Results reveal that taxation can be used to incentivize the provision of services for all stakeholders. Specifically, we found that an appropriate tax can completely avoid disposal in open dumps. A tax of 5.1 USD/tonne was identified as the minimum penalization that avoids diverting waste to open dumps.

Night Shift Work and Risk of Breast Cancer in Women.

BACKGROUND: Night shift work involving circadian disruption has been associated with increased breast cancer rates in some epidemiological studies, but the evidence is still on debate. AIM OF THE STUDY: The objective of this study is to assess the association between night shift work and breast cancer in Mexican women. METHODS: A Case-control study was conducted with incident cases of breast cancer at the Instituto de Seguridad Social del Estado de México y Municipios. Cases were interviewed about past exposures prior to the final diagnosis. Controls were women without breast cancer matched on multiple sociodemographic characteristics. RESULTS: 101 cases and 101 matched controls were interviewed; this small sample size provided consistent, but wide estimates of the assessed associations. The multivariate conditional logistic regression showed that breast-feeding was associated with reduced risk for breast cancer (OR 0.12; 95% CI: 0.02-0.60); women who experienced early menarche (12 years) were more likely to develop breast cancer (OR 18.58; 95% CI 18: 2.19-148). Women who worked at night were more likely to develop breast cancer compared to women who never did (OR = 8.58; 95% CI: 2.19-33.8). CONCLUSIONS: Our results are consistent with studies from other countries, which positively associated night shift work with breast cancer.

D-dimer and high-sensitivity C-reactive protein levels to predict venous thromboembolism recurrence after discontinuation of anticoagulation for cancer-associated thrombosis.

BACKGROUND: Optimal duration of anticoagulation for cancer-associated thrombosis (CAT) remains unclear. This study assessed D-dimer (DD) and high-sensitivity C-reactive protein (hs-CRP) levels after the withdrawal of anticoagulation treatment to predict the risk of venous thromboembolism (VTE) recurrence among patients with CAT. METHODS: Prospective, multicentre study to evaluate CAT with ≥3 months of anticoagulation that was subsequently discontinued. Blood samples were taken when patients stopped the anticoagulation and 21 days later to determine the DD and hs-CRP levels. All patients were followed up for 6 months to detect VTE recurrence. RESULTS: Between 2013 and 2015, 325 patients were evaluated and 114 patients were ultimately enrolled in the study. The mean age was 62 ± 14 years and nearly 40% had metastasis. Ten patients developed VTE recurrence within 6 months (8.8%, 95% confidence interval [CI]: 4.3-15.5%). The DD and hs-CRP levels after 21 days were associated with VTE recurrence. The subdistribution hazard ratios were 9.82 for hs-CRP (95% CI: 19-52) and 5.81 for DD (95% CI: 1.1-31.7). CONCLUSIONS: This study identified that hs-CRP and DD were potential biomarkers of VTE recurrence after discontinuation of anticoagulation in CAT. A risk-adapted strategy could identify low-risk patients who may benefit from discontinuation of anticoagulation.

Copper-Catalyzed Enantioselective Synthesis of ß-Boron ß-Amino Esters.

In this report, the enantioselective, copper-catalyzed borylation of ß-amidoacrylates is disclosed. A broad variety of biologically important α-aminoboronates has been prepared with consistently high levels of enantiocontrol using an inexpensive copper catalyst and a commercially available chiral ligand. The method can be applied to the synthesis of novel boron-containing dipeptides and hemiboronates.

Percepción de estomatólogos sobre atención estomatológica a pacientes sordos. La Habana, 2016 / Dentists´ perception of dental care of deaf patients. Havana, 2016

Introducción: La sordera es una discapacidad neurosensorial que provoca un problema de salud pública que afecta no solo al individuo que la padece sino también a su entorno familiar y social. Objetivo: Identificar la percepción de los estomatólogos sobre la atención estomatológica a los pacientes sordos. Material y Método: Se realizó un estudio descriptivo de corte transversal, con una muestra de 42 estomatólogos, entre 29 y 69 años de edad, de ambos sexos, pertenecientes a las Clínicas Estomatológicas de los Policlínicos Docentes del Municipio Marianao en La Habana, en los meses de junio y julio de 2016. Se realizó encuesta. Las variables estudiadas fueron: edad, sexo, conocimientos sobre las reglas de comunicación con el paciente sordo, conocimiento de las posibles causas de insatisfacción de los pacientes sordos durante la atención estomatológica, reconocimiento de los elementos a considerar durante la atención estomatológica al paciente sordo y conocimiento de factores capaces de generar estímulos negativos durante la atención estomatológica al paciente sordo.Resultados: El sexo femenino fue el de mayor predominio con 73.8 por ciento. El 66.7 por ciento de los Estomatólogos no conoce las reglas de comunicación de los pacientes sordos y 78.6 por ciento no conoce los aspectos a tener en cuenta durante la atención al paciente sordo. El 100 por ciento de los encuestados no reconoce los estímulos negativos ni las posibles causas que provocan insatisfacción en dicha población. Conclusiones: La mayoría de los estomatólogos encuestados son del sexo femenino, no reconocen las reglas de comunicación ni los aspectos a tener en cuenta durante la atención al paciente sordo; mientras que la totalidad de ellos desconoce los factores capaces de generar estímulos negativos o las posibles causas que provocan insatisfacción en la atención a estos pacientes(AU)

Introduction: Deafness is a neurosensorial disability which causes a public health problem that affects not only the individual who suffers from it, but also his social and family environment. Objective:To identify the dentists´ perception of dental care they deliver to deaf patients. Material and methods:A descriptive cross-sectional study was conducted, which comprised a sample of 42 dentists aged from 29 to 69 years, of both sexes, who work in the Dental Clinics of the Teaching Polyclinics located in Marianao Municipality, Havana, in June-July, 2016. A survey was made. The variables studied were: age, sex, knowledge about the rules for communication with the deaf patient, knowledge of the possible causes of dissatisfaction of the deaf patients with dental care, recognition of the elements to consider during dental care of the deaf patient, and knowledge of the factors which are capable to generate negative stimuli during the dental care of the deaf patient. Results:The highest predominance was observed in females (73.8 percent). The 66.7 percent of dentists do not know the rules for communication with deaf patients, and the 78.6 percent of them are unaware of the aspects to keep in mind during the care of the deaf patient. The 100 percent of the surveyed dentists do not recognize neither the negative stimuli nor the possible causes that lead to dissatisfaction in this population. Conclusions: Most of the surveyed dentists are female, they do not know neither the communication rules nor the aspects to keep in mind during the care of the deaf patient; whereas the totality of them are unaware of the factors that are capable to generate negative stimuli or the possible causes which lead to dissatisfaction in the attention to these patients(AU)

Tinzaparin in cancer associated thrombosis beyond 6months: TiCAT study.

INTRODUCTION: The safety and efficacy of low-molecular-weight heparin (LMWH) treatment in patients with cancer-associated thrombosis (CAT) beyond 6months are unknown. Our aim was to determine the safety of long-term tinzaparin use in patients with CAT. METHODS: We performed a prospective, open, single arm, multicentre study in patients with CAT receiving treatment with tinzaparin. We evaluated the rate of clinically relevant bleeding events (major and non-major clinically relevant bleeding) and venous thromboembolism (VTE) recurrence. RESULTS: A total of 247 patients were recruited, with a crude incidence of major bleeding of 4.9% (12/247). The rate of clinically relevant bleeding during months 1-6 and 7-12, was 0.9% [95% confidence interval (95% CI) 0.5 to 1.6%] and 0.6% (95% CI 0.2 to 1.4%) (p=0.5) per patient and month, respectively. Male gender showed greater risk for clinically relevant bleeding with a hazard ratio (HR) of 2.97 (95% CI 1.01 to 8.1; p=0.02). The incidence of VTE recurrence at months 1-6 and 7-12 was 4.5% (95% CI 2.2 to 7.8%) and 1.1% (95% CI 0.1 to 3.9%), respectively. One patient died due to VTE recurrence and two because of severe bleeding. CONCLUSIONS: Treatment with tinzaparin beyond 6months is safe in patients with CAT.

Valoraciones de futuros estomatólogos sobre su formación para la atención al paciente sordo, La Habana, 2016 / Future odonatologists' educational evaluation for the attention to the deaf patient, Havana, 2016

Introducción: La sordera es una disminución única y el interés que muestran los futuros estomatólogos por conocer la comunidad sorda es para brindar un tratamiento estomatológico más integral. Objetivo: Identificar las valoraciones de los futuros estomatólogos sobre su formación para la atención al paciente sordo. Material y Métodos: Se realizó un estudio descriptivo de corte transversal. Se estudió una población de 35 estudiantes de quinto año de Estomatología, con edad promedio de 22 años, de ambos sexos, pertenecientes al Instituto de Ciencias Básicas y Preclínicas Victoria de Girón del Municipio Playa en La Habana, en marzo de 2016. Estos recibieron el curso optativo Manejo odontológico del paciente sordo y posteriormente se les realizó una encuesta. Las variables estudiadas fueron: sexo, temas más interesantes del curso optativo recibido, satisfacción de las necesidades de aprendizaje específicas para la atención estomatológica al paciente sordo, necesidad de recibir el curso optativo como complemento del Plan de Estudios de la Carrera. Resultados: El sexo femenino fue el de mayor predominio con 74.3 por ciento. El tema más interesante fue la Lengua de Señas Cubana para 62.9 por ciento. El 65.7 por ciento de los estudiantes encuestados creen que lo impartido en el plan de estudios de la carrera no satisface las necesidades especiales de atención estomatológica del paciente sordo. En correspondencia, 91.4 por ciento considera que necesita recibir el curso optativo para complementar el plan de estudios. Conclusiones: La mayoría de los estudiantes de estomatología encuestados es del sexo femenino, se interesa por la Lengua de Señas Cubana y considera que necesita del curso optativo Manejo odontológico del paciente sordo ,para complementar el plan de estudios de la carrera(AU)

Introduction: Deafness is a unique decline and the interest shown by future stomatologists to know the deaf community is related with their interest to provide a more comprehensive stomatological treatment. Objective: To identify future stomatologists' assessments of their training in the care of deaf patients. Material and Method: In March 2016, a cross-sectional descriptive study was carried out in a population of 35 students in the fifth year of stomatology's career from the Institute of Basic and Preclinical Sciences Victoria de Girón Playa Municipality in Havana, with an average age of 22 years, of both sexes. They received the optional training course Dental management of the deaf patient and then was performed a survey. The variables studied were: sex, more interesting subjects of the elective course received, satisfaction of the specific learning needs for the deaf patient's stomatological attention, the need of receiving an optional course as a complement to their Career Curriculum. Results: The female sex was the most prevalent with 74.3 percent. The most interesting topic was the Cuban Signs' Language for a 62.9 percent. 65.7percent of the students surveyed believe that what it is taught in the career does not meet the special dental care needs of the deaf patient. Correspondingly, 91.4 percent consider that they need to receive an elective course as a complement of the curriculum. Conclusions: The majority of stomatology students surveyed were female, they shown an interest in the Cuban Signs' Language and consider that they need the optional course Deaf patient dental management, to complement the curriculum of the course(AU)

Eritema nudoso asociado a parasitismo por Ascaris lumbricoides. Presentación de caso / Nudose erythema associated to Ascaris lumbricoides parasitism: Cases presentation

Introducción: El Eritema nudoso es una paniculitis, de relativa frecuencia, que se expresa como manifestación de trastornos internos de gran envergadura, como las enfermedades del tejido conectivo, las enfermedades infecciosas y el cáncer. Es por ello, que los pacientes que lo presenten, deben ser estudiados cuidadosamente en busca de la causa. Objetivo: Presentar un caso clínico de Eritema nudoso resaltando el diagnóstico de la causa parasitaria y su tratamiento. Presentación de Caso: Se muestra el caso de una paciente femenina de 29 años, de raza blanca, residente en un municipio rural (Jatibonico), profesora de escuela primaria, sin antecedentes patológicos, quien acude a consulta por eritema elevado muy doloroso en la superficie anterior de ambos miembros inferiores, malestar general y artralgias. Se le diagnosticó clínicamente un eritema nudoso, y durante varios meses se realizaron complementarios para establecer la posible causa; se encontró solo un parasitismo intestinal por Ascaris lumbricoides. Recibió tratamiento médico con antiparasitarios, y desapareció el eritema. Conclusiones: El diagnóstico clínico certero, más la búsqueda constante de la causa del eritema nudoso y el tratamiento del parasitismo encontrado, llevaron a la solución del problema de la paciente. El eritema nudoso siempre debe ser estudiado por la posibilidad de ser un síndrome reactivo a procesos grave(AU)

Introduction: Nudose erythema is a panniculitis, of relative frequency, that it is expressed like a manifestation of internal disorders of great significance, like the illnesses of the connective tissue, the infectious diseases and the cancer. So the patients that show it, must be studied carefully in search of the cause. Objective: To Present a nudose erythema clinic case highlighting the diagnose of parasitical cause. Cases presentation: Is show the case of a white female patient, 29 years old, resident at rural municipality (Jatibonico), elementary school teacher, without pathological past health history, that assist at the consult for nodular due to a high very painful erythema on the anticus surface of both inferior members, general discomfort and arthralgia. Was clinically diagnosed a nudose erythema, and during several months were performed complementary to establish the possible cause, finding only an intestinal parasitism for Ascaris lumbricoides. He received medical treatment with antiparasitcs, disappearing the erythema. Conclusions: The accurate diagnostic, furthermore, a constantly cause searching of the cause of the nudose erythema plus the treatment of parasitism found, solve the patients problem. Nudose erythema always must be studied due to the possibility to be a reactive syndrome of seriously ill process(AU)