Cooperativas de ahorro y crédito, liderazgo y desempeño: Caso Loja

http://doi.org/10.5281/zenodo.5866609 This research work seeks to show the importance of the leadership styles that predominate in organizations and how these affect financial performance; The savings and credit cooperatives of the city of Loja are taken as a case study. A multifactorial tool was used to identify the predominant leadership in the managers of the savings and credit cooperatives in the city of Loja. Likewise, the relationship between leadership and financial performance was analyzed. The results showed that transformational leadership is the predominant one in cooperatives, dominating in 4 of 5 studied segments.http://doi.org/10.5281/zenodo.5866609 El presente trabajo de investigación busca mostrar la importancia de los estilos de liderazgo que predominan en las organizaciones y como estos afectan al desempeño financiero; se toma como caso de estudio las cooperativas de ahorro y crédito de la ciudad de Loja. Se utilizó una herramienta multifactorial que permitió identificar el liderazgo predominante en los gerentes de las cooperativas de ahorro y crédito de la ciudad de Loja. Así mismo, se analizó la relación existente entre liderazgo y desempeño financiero. Los resultaron arrojaron que el liderazgo transformacional es el predominante en las cooperativas, dominando en 4 de 5 segmentos estudiados

Drainage of the hepatic cyst by laparoscopy - clinical case

Liver cysts are formations of serous content surrounded by normal liver parenchyma, without communication with the bile duct. The cyst wall is generally lined with cuboidal epithelium surrounded by layers of connective tissue. They are rare entities in adult patients, generally, they are asymptomatic in 3%, and between 10-15% of all patients will generate symptoms that lead them to consult. A 38-year-old man with an external abdominal tomography study that reported a giant hepatic cyst. Laboratory blood tests: hemoglobin 7.9 g/dl; leukocytosis 11,000/ul; serum electrolytes, liver transaminases, and bilirubin were normal, alkaline phosphatase, and gamma glutamyl-transpeptidase 94 U/l and 241 U/l, respectively. Non-reactive anti-human immuno-deficiency virus (HIV 1) and two antibodies, venereal disease research laboratory (VDRL), cancer antigen (CA) 19-9 antigen, hepatitis B-C surface antigen, and carcinoembryonic antigen were negative. He underwent surgery by laparoscopic drainage of the liver cyst, through a median infraumbilical incision with the Hasson technique and placement of three 12 mm trocars, hepatomegaly was observed without finding an exit site for purulent material, it was punctured through liver segment V, and 2000 ml of citrine fluid was extracted. The hepatic wound is addressed with a 1-0 caliber chromic catgut thread, placing a Penrose-type drain. At 48 hours postoperatively, it evolves favorably, so it is decided to discharge. Hepatic cysts are fluid-filled cavities lined by a single-layered cuboidal or columnar biliary epithelium in the liver. A majority of hepatic cysts are found incidentally on liver imaging, such as abdominal ultrasonography, computed tomography, or magnetic resonance imaging

Global attitudes in the management of acute appendicitis during COVID-19 pandemic: ACIE Appy Study

Background: Surgical strategies are being adapted to face the COVID-19 pandemic. Recommendations on the management of acute appendicitis have been based on expert opinion, but very little evidence is available. This study addressed that dearth with a snapshot of worldwide approaches to appendicitis. Methods: The Association of Italian Surgeons in Europe designed an online survey to assess the current attitude of surgeons globally regarding the management of patients with acute appendicitis during the pandemic. Questions were divided into baseline information, hospital organization and screening, personal protective equipment, management and surgical approach, and patient presentation before versus during the pandemic. Results: Of 744 answers, 709 (from 66 countries) were complete and were included in the analysis. Most hospitals were treating both patients with and those without COVID. There was variation in screening indications and modality used, with chest X-ray plus molecular testing (PCR) being the commonest (19\ub78 per cent). Conservative management of complicated and uncomplicated appendicitis was used by 6\ub76 and 2\ub74 per cent respectively before, but 23\ub77 and 5\ub73 per cent, during the pandemic (both P < 0\ub7001). One-third changed their approach from laparoscopic to open surgery owing to the popular (but evidence-lacking) advice from expert groups during the initial phase of the pandemic. No agreement on how to filter surgical smoke plume during laparoscopy was identified. There was an overall reduction in the number of patients admitted with appendicitis and one-third felt that patients who did present had more severe appendicitis than they usually observe. Conclusion: Conservative management of mild appendicitis has been possible during the pandemic. The fact that some surgeons switched to open appendicectomy may reflect the poor guidelines that emanated in the early phase of SARS-CoV-2