AMA-positive hepatitis induced by the SARS-CoV-2 vaccine.

We present the case of a 56-year-old female admitted to our centre for hepatitis. She had recieved the first dose of the BNT162b2 vaccine against SARS-CoV-2 10 days before the admission. Etiologic study was negative. The patient was diagnosed with vaccine-induced hepatitis.

Diagnóstico de la higiene bucal en pacientes con aparatos de ortodoncia / Diagnosis of oral hygiene in patients with orthodontic appliances

Fundamento: una adecuada higiene bucal es necesaria en los pacientes que portan aparatos de ortodoncia. Objetivo: identificar conocimientos, actitudes, prácticas e higiene bucal en pacientes con aparatos de ortodoncia. Métodos: se realizó un estudio con diseño no experimental, descriptivo y transversal en la Clínica Estomatológica Docente Provincial de Sancti Spíritus en el período entre septiembre de 2018 y julio de 2019. Se utilizaron métodos del nivel teórico, empírico (encuesta, entrevista, observación y estadístico). La población estuvo constituida por 30 pacientes de esta institución con tratamiento de ortodoncia. Se midieron las variables: edad y sexo del paciente, tipo de aparato de ortodoncia, nivel de conocimiento sobre salud bucodental, actitud y prácticas del paciente de higiene bucal, frecuencia, forma y eficiencia del cepillado dental, así como el cepillado o no después de la ingestión de alimentos azucarados. Resultados: el 100 porciento de los pacientes presentó conocimientos deficientes sobre salud bucal y prácticas desfavorables, aunque se constató actitudes favorables en el 63,3 porciento de los pacientes. Predominó una higiene bucal regular en la población estudiada antes de iniciar el tratamiento y después de instalar los aparatos, de manera similar en los grupos con aparatos removibles, funcionales y fijos. Conclusiones: los pacientes de la población estudiada necesitan educación para apropiarse de conocimientos suficientes para mantener actitudes, prácticas e higiene bucal saludables (AU)

Background: adequate oral hygiene is necessary in patients who wear orthodontic appliances. Objective:to identify knowledge, attitudes, practices and oral hygiene in patients with orthodontic appliances. Methods: a study with a non-experimental, descriptive and cross-sectional design was carried out in the Provincial Teaching Dentistry Clinic of Sancti Spíritus in the period between September 2018 and July 2019. Methods from the theoretical, empirical (survey, interview and observation) and statistical level were used. The population consisted of 30 patients from this institution with orthodontic treatment. The measured variables were: age and sex of the patient, type of orthodontic appliance, level of knowledge about oral health, attitude and oral hygiene practices of the patient, frequency, form and efficiency of tooth brushing, as well as brushing or not after the ingestion of sugary foods. Results: 100 percent of the patients presented poor knowledge about oral health and unfavorable practices, although favorable attitudes were found in 63.3 percent of the patients. Regular oral hygiene predominated in the population studied before starting treatment and after installing the appliances, similarly in the groups with removable, functional and fixed appliances. Conclusions:the studied population patients need education to acquire sufficient knowledge to maintain healthy attitudes, practices and oral hygiene (AU)

Diagnóstico de la higiene bucal en pacientes con aparatos de ortodoncia / Diagnosis of oral hygiene in patients with orthodontic appliances

RESUMEN Fundamento: una adecuada higiene bucal es necesaria en los pacientes que portan aparatos de ortodoncia. Objetivo: identificar conocimientos, actitudes, prácticas e higiene bucal en pacientes con aparatos de ortodoncia. Métodos: se realizó un estudio con diseño no experimental, descriptivo y transversal en la Clínica Estomatológica Docente Provincial de Sancti Spíritus en el período entre septiembre de 2018 y julio de 2019. Se utilizaron métodos del nivel teórico, empírico (encuesta, entrevista, observación y estadístico). La población estuvo constituida por 30 pacientes de esta institución con tratamiento de ortodoncia. Se midieron las variables: edad y sexo del paciente, tipo de aparato de ortodoncia, nivel de conocimiento sobre salud bucodental, actitud y prácticas del paciente de higiene bucal, frecuencia, forma y eficiencia del cepillado dental, así como el cepillado o no después de la ingestión de alimentos azucarados. Resultados: el 100 % de los pacientes presentó conocimientos deficientes sobre salud bucal y prácticas desfavorables, aunque se constató actitudes favorables en el 63,3 % de los pacientes. Predominó una higiene bucal regular en la población estudiada antes de iniciar el tratamiento y después de instalar los aparatos, de manera similar en los grupos con aparatos removibles, funcionales y fijos. Conclusiones: los pacientes de la población estudiada necesitan educación para apropiarse de conocimientos suficientes para mantener actitudes, prácticas e higiene bucal saludables.

ABSTRACT Background: adequate oral hygiene is necessary in patients who wear orthodontic appliances. Objective: to identify knowledge, attitudes, practices and oral hygiene in patients with orthodontic appliances. Methods: a study with a non-experimental, descriptive and cross-sectional design was carried out in the Provincial Teaching Dentistry Clinic of Sancti Spíritus in the period between September 2018 and July 2019. Methods from the theoretical, empirical (survey, interview and observation) and statistical level were used. The population consisted of 30 patients from this institution with orthodontic treatment. The measured variables were: age and sex of the patient, type of orthodontic appliance, level of knowledge about oral health, attitude and oral hygiene practices of the patient, frequency, form and efficiency of tooth brushing, as well as brushing or not after the ingestion of sugary foods. Results: 100% of the patients presented poor knowledge about oral health and unfavorable practices, although favorable attitudes were found in 63.3% of the patients. Regular oral hygiene predominated in the population studied before starting treatment and after installing the appliances, similarly in the groups with removable, functional and fixed appliances. Conclusions: the studied population patients need education to acquire sufficient knowledge to maintain healthy attitudes, practices and oral hygiene.

Hepatitis colestásica por candesartán: descripción de un caso / No disponible

No disponible

Candesartan-induced cholestatic hepatitis: a case report.

We present the case of a 55-year-old male that was admitted to our hospital for cholestatic hepatitis. Other causes of hepatitis were excluded with imaging, laboratory and serologic tests. A liver biopsy was performed, which was compatible with toxicity-induced hepatitis. Re-assessing the patient, he mentioned the start of treatment with candesartan cilexetil 3 weeks prior to the onset of the symptoms. Candesartan was withdrawn, with a progressive improvement in cholestasis and complete normalization of liver biochemistry at 6 months. The patient was diagnosed with candesartan-induced cholestatic hepatitis, probable according to CIOMS/RUCAM scale.

Hepatitis aguda por virus de la hepatitis A durante la expansión epidémica de 2017 en Asturias / Acute hepatitis due to hepatitis A virus during the 2017 epidemic expansion in Asturias. Spain

Introducción: Desde junio de 2016 se ha producido un incremento de casos de hepatitis aguda A (HAA) en diversos países europeos, afectando principalmente a hombres que tienen sexo con hombres (HSH). El objetivo fue conocer las características de las HAA diagnosticadas en los últimos meses, comparándolas con una serie precedente. Pacientes y métodos: Se recogieron prospectivamente todos los casos de HAA diagnosticados en adultos entre noviembre de 2016 y diciembre de 2017 (G-I; n=108) y se compararon con una serie recogida también de forma prospectiva entre enero de 2004 y septiembre de 2016 (G-II; n=49), analizando las características clínico-epidemiológicas. Resultados: Con respecto al grupo II, en el I se observó una mayor proporción de varones (95,4 vs. 81,6%; p=0,005), de HSH (63,9 vs. 22,4%; p<0,001), de casos con serología positiva de lúes (20,4 vs. 2%; p=0,001) y de hepatitis aguda grave (15 vs. 4%; p=0,043). Conclusiones: Las HAA diagnosticadas en los últimos meses en nuestro medio afectan fundamentalmente a HSH y tienen con mayor frecuencia un carácter grave respecto a lo observado en una serie histórica, poniendo de manifiesto la necesidad de incrementar la tasa de vacunación frente al virus de la hepatitis A

Introduction: Since June 2016, there has been an increase in cases of acute hepatitis A (AHA) in several European countries, mainly affecting men who have sex with men (MSM). The aim was to know the characteristics of AHA diagnosed in recent months, comparing them with a previous series. Patients and methods: All cases of AHA diagnosed in adults between November 2016 and December 2017 (G-I; n=108) were prospectively collected and compared with a series also prospectively collected between January 2004 and September 2016 (G-II; n=49), analysing clinical and epidemiological characteristics. Results: Compared with group II, in group I there was a greater proportion of males (95.4 vs. 81.6%; p=0.005), of MSM (63.9 vs. 22.4%; p<0.001), of cases with positive luetic serology (20.4 vs 2%; p=0.001) and of severe acute hepatitis (15 vs. 4%; p=0.043). Conclusions: AHA diagnosed in recent months in our environment mainly affect MSM and have a more serious presentation with respect to what was observed in a historical series, highlighting the need to increase the vaccination rate against the hepatitis A virus

Acute hepatitis due to hepatitis A virus during the 2017 epidemic expansion in Asturias. Spain. / Hepatitis aguda por virus de la hepatitis A durante la expansión epidémica de 2017 en Asturias.

INTRODUCTION: Since June 2016, there has been an increase in cases of acute hepatitis A (AHA) in several European countries, mainly affecting men who have sex with men (MSM). The aim was to know the characteristics of AHA diagnosed in recent months, comparing them with a previous series. PATIENTS AND METHODS: All cases of AHA diagnosed in adults between November 2016 and December 2017 (G-I; n=108) were prospectively collected and compared with a series also prospectively collected between January 2004 and September 2016 (G-II; n=49), analysing clinical and epidemiological characteristics. RESULTS: Compared with group II, in group I there was a greater proportion of males (95.4 vs. 81.6%; p=0.005), of MSM (63.9 vs. 22.4%; p<0.001), of cases with positive luetic serology (20.4 vs 2%; p=0.001) and of severe acute hepatitis (15 vs. 4%; p=0.043). CONCLUSIONS: AHA diagnosed in recent months in our environment mainly affect MSM and have a more serious presentation with respect to what was observed in a historical series, highlighting the need to increase the vaccination rate against the hepatitis A virus.

Social Networks, Engagement and Resilience in University Students.

Analysis of social networks may be a useful tool for understanding the relationship between resilience and engagement, and this could be applied to educational methodologies, not only to improve academic performance, but also to create emotionally sustainable networks. This descriptive study was carried out on 134 university students. We collected the network structural variables, degree of resilience (CD-RISC 10), and engagement (UWES-S). The computer programs used were excel, UCINET for network analysis, and SPSS for statistical analysis. The analysis revealed results of means of 28.61 for resilience, 2.98 for absorption, 4.82 for dedication, and 3.13 for vigour. The students had two preferred places for sharing information: the classroom and WhatsApp. The greater the value for engagement, the greater the degree of centrality in the friendship network among students who are beginning their university studies. This relationship becomes reversed as the students move to later academic years. In terms of resilience, the highest values correspond to greater centrality in the friendship networks. The variables of engagement and resilience influenced the university students' support networks.

Reingresos por pancreatitis aguda biliar edematosa en pacientes sin colecistectomía / Readmissions due to acute biliary edematous pancreatitis in patients without cholecystectomy

Objetivos: analizar los reingresos de pacientes con pancreatitis aguda biliar edematosa (PABE) sin colecistectomía a pesar de un episodio previo de pancreatitis aguda biliar leve o colecistitis litiásica. Calcular el coste sanitario asociado a la no realización de colecistectomía. Material y métodos: estudio observacional prospectivo realizado en el Hospital de Cabueñes, entre julio y noviembre de 2014. Se incluyeron consecutivamente los pacientes ingresados en el Servicio de Digestivo con PABE que: a) habían presentado un episodio previo de pancreatitis aguda biliar leve o colecistitis al menos dos semanas antes del reingreso; y b) no se les había realizado colecistectomía pese a ausencia de contraindicaciones. Resultados: durante el periodo de estudio reingresaron 9 pacientes, 7 mujeres y 2 varones, con una edad media de 65,3 años (desviación estándar [DE] = 19,2). La mediana de días transcurridos desde el episodio previo de PABE o colecistitis hasta su reingreso fue de 114 días (recorrido intercuartílico [RIC] = 111,0). La estancia global mediana de los pacientes fue de 10 días (RIC = 2,0). Los pacientes realizaron una media de 2,8 (DE = 1,2) ecografías, 1,3 (DE = 0,9) TC abdómino-pélvicos, 0,8 (DE = 1,0) RM y 0,2 (DE = 0,4) CPRE. El coste medio de cada reingreso por paciente, incluyendo la estancia hospitalaria (143,0 €/día), en el servicio de Urgencias (332,31 €) y las pruebas realizadas, fue de 2.381,70 €/paciente. Conclusiones: la no realización de colecistectomía en las 2 semanas posteriores a un primer episodio de PABE leve o colecistitis contribuye a los reingresos por pancreatitis recurrentes con los consecuentes gastos evitables asociados

Aims: Analyzing the readmission of patients with acute biliary edematous pancreatitis (ABEP) without cholecystectomy despite a previous episode of mild acute gallstone pancreatitis or lithiasic cholecystitis. Calculating the health costs associated with the non-performance of cholecystectomy. Material and methods: Prospective observational study conducted at a tertiary hospital from July to November 2014. The study has consecutively included inpatients suffering from ABEP who: a) had suffered a previous episode of mild acute gallstone pancreatitis or cholecystitis at least 2 weeks before readmission; and b) had not undergone cholecystectomy despite the lack of contraindications. Results: During the research period, 9 patients (7 females and 2 males) with a mean age of 65.3 years (standard deviation [SD] 19.2) were readmitted. The median number of days between the previous episode of ABEP or cholecystitis and the readmission was 114 days (interquartile range [IQR] 111.0). Reported median overall length of hospital stay was 10 days (IQR = 2.0). Patients underwent a mean of 2.8 (SD = 1.2) ultrasound scans, 1.3 (SD = 0.9) abdominal and pelvic CT, 0.8 (SD = 1.0) MRCP and 0.2 (SD = 0.4) ERCP. The mean cost per patient for each readmission, including hospital stay (143.0 €/day), Emergency Service (332.31 €) and tests performed was 2,381.70 €/patient. Conclusions: Not performing a cholecystectomy within two weeks after a first episode of mild ABEP or cholecystitis contributes to patient readmission due to recurrent pancreatitis, resulting in avoidable treatment costs

Readmissions due to acute biliary edematous pancreatitis in patients without cholecystectomy.

AIMS: Analyzing the readmission of patients with acute biliary edematous pancreatitis (ABEP) without cholecystectomy despite a previous episode of mild acute gallstone pancreatitis or lithiasic cholecystitis. Calculating the health costs associated with the non-performance of cholecystectomy. MATERIAL AND METHODS: Prospective observational study conducted at a tertiary hospital from July to November 2014. The study has consecutively included inpatients suffering from ABEP who: a) had suffered a previous episode of mild acute gallstone pancreatitis or cholecystitis at least 2 weeks before readmission; and b) had not undergone cholecystectomy despite the lack of contraindications. RESULTS: During the research period, 9 patients (7 females and 2 males) with a mean age of 65.3 years (standard deviation [SD] 19.2) were readmitted. The median number of days between the previous episode of ABEP or cholecystitis and the readmission was 114 days (interquartile range [IQR] 111.0). Reported median overall length of hospital stay was 10 days (IQR = 2.0). Patients underwent a mean of 2.8 (SD = 1.2) ultrasound scans, 1.3 (SD = 0.9) abdominal and pelvic CT, 0.8 (SD = 1.0) MRCP and 0.2 (SD = 0.4) ERCP. The mean cost per patient for each readmission, including hospital stay (143.0 €/day), Emergency Service (332.31 €) and tests performed was 2,381.70 €/patient. CONCLUSIONS: Not performing a cholecystectomy within two weeks after a first episode of mild ABEP or cholecystitis contributes to patient readmission due to recurrent pancreatitis, resulting in avoidable treatment costs.

La red social del adolescente: la influencia de la amistad en el desarrollo de hábitos obesogénicos / The social network of adolescents: The influence of friendship in the development of obesogenic habits

El presente artículo pretende justificar la relevancia de las relaciones sociales en el entorno del adolescente obeso. La motivación por este enfoque surgió debido al vacío que se ha encontrado en estudios que expliquen si los adolescentes comen mejor o peor y/o realizan más o menos ejercicio físico dependiendo de su red de amigos. Se realizó una búsqueda bibliográfica centrada en la obesidad y el análisis de las redes sociales de los jóvenes a través de la Biblioteca de la Universidad de León, en diferentes bases de datos tales como Web of Knowledge (WOK), Scielo, Scopus, entre otras. Se obtuvieron artículos y otros documentos de interés utilizando revistas pertenecientes a las disciplinas de la Sociología y de las Ciencias de la Salud. Tras realizar la lectura de los textos más relevantes se pudo obtener los siguientes resultados: (1) las relaciones influyen en los hábitos de los adolescentes, (2) la calidad y la cantidad de comida puede depender del tipo de red que le rodea, y (3) el nivel de ejercicio físico que tiene un individuo se puede ver influenciado por sus mejores amigos, por el grupo en general que le rodea e incluso por los amigos de sus amigos. De todo ello se deriva, que el estudio de la red social del individuo puede ser una herramienta útil a la hora de visualizar los patrones de comportamiento, y por tanto, aplicable a los programas de salud y salud pública contribuyendo, de esta forma, a la sostenibilidad del sistema (AU)

This aim of this article is to demonstrate the importance of social networks in the obese adolescent's environment. This study emerged in response to the paucity of information encountered in the literature as regards whether adolescents eat better or worse and/or performs more or less physical exercise depending on their friendship networks. We performed literature search at the University of León library which focused on obesity and an analysis of young people's social networks, exploring databases such as the Web of Knowledge (WOK), SciELO and Scopus, among others. Articles and other documents of interest were identified using journals from the disciplines of Sociology and the Health Sciences. After the most relevant texts had been read in full, the following results were obtained: (1) relationships influence adolescents' habits, (2) the quality and quantity of food they consume can depend on the type of network to which they belong, and (3) the amount of physical exercise that adolescents do can be influenced by their best friends, by the wider group to which they belong and even by friends of friends. The foregoing suggests that the study of adolescents' social networks could be a useful tool for identifying behaviour patterns; it is therefore applicable to health and public health programmes and would contribute to the sustainability of the system (AU)

Formación de valores en los estudiantes en la municipalización de la enseñanza en la Atención Primaria de Salud / Formation of values in students in the municipal university teaching coverage in Primary Health Care

En la historia del pensamiento ético, la moral ha sido definida como un sistema de principios, normas, valores, cualidades e ideales morales que poseen finalidad de regular el comportamiento moral de los hombres en la sociedad, para asegurar así cierta coherencia social. Ha sido comprendida además, como la esfera de la actividad que se caracteriza por la contraposición del bien y el mal, y junto a ello por el sistema de normas de conducta humana. La profundización en el estudio de estos aspectos ético-filosóficos indicaque tienen gran relación con las transformaciones que se han producido en el sector de la salud pública(AU)

In the history of ethical thought, morale has been defined as a system of principles, norms, values, qualities and moral ideals that have the purpose of regulating the moral behavior of people in society, to assure in this way a certain social coherence. It has also been understood, as the field of activity that is characterized by the opposition of good and evil, and along with it by the system of norms of human behavior. The deepening into the study of these ethical-philosophical aspects indicates that they have a close relationship with the transformations that have taken place in the sector of public health(AU)

A density functional theory study on the electrocyclization of 1,2,4,6-heptatetraene analogues: converting a pericyclic to a pseudopericyclic reaction.

A comprehensive B3LYP/6-31+G* study on the electrocyclization of 1,2,4,6-heptatetraene analogues was conducted. Starting from the cyclization of (2Z)-2,4,5-hexatrienal, a pericyclic disrotatory process favored by the assistance of a electron lone pair, we incorporated small modifications in its molecular structure to obtain a truly pseudopericyclic process. To this purpose electronegative atoms (fluorine and nitrogen) were added to give a more electrophilic character on the carbon atom which is attacked by the electron lone pair of the oxygen atom. The complete pathway for each reaction was determined, and changes in magnetic properties were monitored with a view to estimating the aromatization associated with each process. This information, together with the energetic and structural results, allowed us to classify the reactions as pseudopericyclic or pericyclic. Among all studied reactions only one was a truly pseudopericyclic process and another was a borderline case. The features of this unequivocally pseudopericyclic case were analyzed in depth.