Inversi?n en inmuebles integrantes del patrimonio cultural de la naci?n: an?lisis de la regulaci?n aplicable al Centro de Lima

La presente investigaci?n tiene como objetivo analizar el marco legal aplicable a los bienes inmuebles integrantes del Patrimonio Cultural de la Naci?n ubicados en el Centro Hist?rico de Lima declarado por UNESCO, espec?ficamente, aquellos ubicados en Cercado de Lima con el fin de presentar mejoras para promover la inversi?n privada en dichos inmuebles. Se pudo identificar que: (i) la normativa vigente no contempla los beneficios o incentivos necesarios para promover la participaci?n de capitales privados en la conservaci?n de bienes inmuebles integrantes del Patrimonio Cultural de la Naci?n y del Centro Hist?rico de Lima; (ii) debido a las caracter?sticas especiales de los inmuebles materia de estudio, se requiere un nivel m?s alto de tecnicismo en los trabajos; haciendo necesario el apoyo de profesionales especializados y (iii) falta de promoci?n y reglamentaci?n de normativa que promueva la obtenci?n de financiamientos para ejecuci?n de trabajos de mantenimiento y conservaci?n de bienes inmuebles integrantes del Patrimonio Cultural de la Naci?n

Postoperative outcomes in oesophagectomy with trainee involvement

BACKGROUND: The complexity of oesophageal surgery and the significant risk of morbidity necessitates that oesophagectomy is predominantly performed by a consultant surgeon, or a senior trainee under their supervision. The aim of this study was to determine the impact of trainee involvement in oesophagectomy on postoperative outcomes in an international multicentre setting. METHODS: Data from the multicentre Oesophago-Gastric Anastomosis Study Group (OGAA) cohort study were analysed, which comprised prospectively collected data from patients undergoing oesophagectomy for oesophageal cancer between April 2018 and December 2018. Procedures were grouped by the level of trainee involvement, and univariable and multivariable analyses were performed to compare patient outcomes across groups. RESULTS: Of 2232 oesophagectomies from 137 centres in 41 countries, trainees were involved in 29.1 per cent of them (n = 650), performing only the abdominal phase in 230, only the chest and/or neck phases in 130, and all phases in 315 procedures. For procedures with a chest anastomosis, those with trainee involvement had similar 90-day mortality, complication and reoperation rates to consultant-performed oesophagectomies (P = 0.451, P = 0.318, and P = 0.382, respectively), while anastomotic leak rates were significantly lower in the trainee groups (P = 0.030). Procedures with a neck anastomosis had equivalent complication, anastomotic leak, and reoperation rates (P = 0.150, P = 0.430, and P = 0.632, respectively) in trainee-involved versus consultant-performed oesophagectomies, with significantly lower 90-day mortality in the trainee groups (P = 0.005). CONCLUSION: Trainee involvement was not found to be associated with significantly inferior postoperative outcomes for selected patients undergoing oesophagectomy. The results support continued supervised trainee involvement in oesophageal cancer surgery

Proyecto de pr?ctica profesional apegado al D-35

PregradoLicenciado(a) en Sistemas y Programaci?