La virtualización de la economía. La compra de comida por Internet : el consumo, el dinero y el trabajo como acontecimiento

Partiendo de un concepto de virtualización de la economía, donde las prácticas económicas se definen como procesos de desterritorialización y asumiendo que las TICs posibilitan nuevas formas de socialidad, en el presente trabajo se explora una práctica que nos habla de la economía como acontecimieto: La adquisición de comida, a través de Internet. La compra de comida es una práctica singularmente afectiva, que ha expresado a lo largo de la historia diversas formas de socialidad (la compra en el mercado tradicional difiere de la compra en el supermercado). En el presente trabajo exploramos una nueva forma de compra de alimentos, la compra por Internet y analizamos en ella el acontecer económico a partir de tres ejes: el consumo, el dinero y el trabajo.Starting from an economy virtualization concept, where economic practices are defined as de-territorialization processes, and assuming that ICTs (information and communication technologies) make possible new ways for sociality, this paper explores a practice that draws economy as a happening. The acquisition of food through the Internet. Food purchasing is a singularily affective practice, which through history has shown different forms of sociality (traditional market purchasing differs from supermarket purchasing). In this paper we explore a new way of buying food, Internet purchasing, analizing in it the economic happening through three axis: consumption, money and work

Costo-beneficio de la colangiopancreatografía retrograda endoscópica (CPRE) y exploración de vías biliares en pacientes con colédocolitiasis en el hospital nacional San Juan de Dios de San Miguel, enero del 2018 a diciembre del 2020

RESUMEN: La litiasis del conducto colédoco o coledocolitiasis es una de las patologías más comunes atendidas por los servicios de cirugía a nivel mundial, ya sea en su forma primaria o secundaria, el abordaje de las distintas formas de presentación clínica se realiza siguiendo protocolos ya estandarizados. El tratamiento ideal y de elección, en los centros hospitalarios donde se dispone tanto del personal capacitado como del instrumental endoscópico, es la Colangiopancreatografía retrograda endoscópica (CPRE), la cual permite el diagnóstico y tratamiento eficaz y con menor morbilidad para el paciente. Sin embargo, a pesar de sus beneficios ampliamente conocidos, sigue siendo una terapéutica no accesible a todos los hospitales del sistema de salud público de países como El Salvador, en donde aún predomina el abordaje por exploración abierta de la vía biliar. La CPRE se ha utilizado desde 1968 y se considera una excelente herramienta para el estudio de la vía biliar, aunque se conoce que en un 25 a un 60 % de las CPRE realizadas no se llega a confirmar el diagnóstico de coledocolitiasis. OBJETIVO GENERAL: Determinar el costo-beneficio de Colangiopancreatografía retrógrada endoscópica y la exploración de vías biliares en el manejo de los pacientes con coledocolitiasis en el Hospital Nacional San Juan de Dios de San Miguel, El Salvador. METODOLOGIA: Estudio descriptivo transversal, se realizará una descripción a detalle de los costos y beneficios de la realización de CPRE y exploración abierta de la vía biliar, así como las complicaciones más comunes de ambos procedimientos en pacientes diagnosticados con coledocolitiasis en sus distintas formas de presentación clínica, haciendo un corte en el tiempo sin modificar ni afectar su evolución clínica, diagnóstico y tratamiento. RESULTADOS ESPERADOS: Que las autoridades del MINSAL sepan que hay una gran demanda de pacientes con patología biliar que se verían beneficiado de que el servicio de CPRE sea descentralizado y disminuyendo los costos de estancia hospitalaria. ABSTRACT. Common bile duct lithiasis or choledocholithiasis is one of the most common pathologies treated by surgery services worldwide, either in its primary or secondary form, the approach to the different forms of clinical presentation is carried out following already standardized protocols. The ideal treatment of choice, in hospitals where both trained personnel and endoscopic instruments are available, is endoscopic retrograde cholangiopancreatography (ERCP), which allows effective diagnosis and treatment with less morbidity for the patient. However, despite its widely known benefits, it is still a therapy that is not accessible to all hospitals in the public health system in countries such as El Salvador, where the open bile duct exploration approach still predominates. ERCP has been used since 1968 and is considered an excellent tool for the study of the bile duct, although it is known that 25 to 60% of ERCPs performed fail to confirm the diagnosis of choledocholithiasis. GENERAL OBJECTIVE: To determine the cost-benefit of endoscopic retrograde cholangiopancreatography and bile duct exploration in the management of patients with choledocholithiasis at the San Juan de Dios National Hospital in San Miguel, El Salvador. METHODOLOGY: A descriptive cross-sectional study will be carried out, a detailed description of the costs and benefits of performing ERCP and open bile duct exploration will be carried out, as well as the most common complications of both procedures in patients diagnosed with choledocholithiasis in its different forms of presentation. clinic, making a cut in time without modifying or treatment affecting its clinical evolution, diagnosis and. EXPECTED RESULTS: The MINSAL authorities know that there is a great demand for patients with biliary pathology who would benefit from the ERCP service being decentralized and reducing the costs of hospital sta

Reorganización de los centros de capacitación de la Asociación Fe y Alegría tomo I Diagnóstico

La Asociación Fé y Alegria cuenta con centros de capacitación y cada uno de ellos tiene como objetivo primordial la reorganización de dichos centros, que consiste en el rediseño de los planes de estudios de los sistemas de control administrativo

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Build your own closed loop: Graph-based proof of concept in closed loop for autonomous networks

Next Generation Networks (NGNs) are expected to handle heterogeneous technologies, services, verticals and devices of increasing complexity. It is essential to fathom an innovative approach to automatically and efficiently manage NGNs to deliver an adequate end-to-end Quality of Experience (QoE) while reducing operational expenses. An Autonomous Network (AN) using a closed loop can self-monitor, self-evaluate and self-heal, making it a potential solution for managing the NGN dynamically. This study describes the major results of building a closed-loop Proof of Concept (PoC) for various AN use cases organized by the International Telecommunication Union Focus Group on Autonomous Networks (ITU FG-AN). The scope of this PoC includes the representation of closed-loop use cases in a graph format, the development of evolution/exploration mechanisms to create new closed loops based on the graph representations, and the implementation of a reference orchestrator to demonstrate the parsing and validation of the closed loops. The main conclusions and future directions are summarized here, including observations and limitations of the PoC

Evolving trends in the management of acute appendicitis during COVID-19 waves. The ACIE appy II study

Background: In 2020, ACIE Appy study showed that COVID-19 pandemic heavily affected the management of patients with acute appendicitis (AA) worldwide, with an increased rate of non-operative management (NOM) strategies and a trend toward open surgery due to concern of virus transmission by laparoscopy and controversial recommendations on this issue. The aim of this study was to survey again the same group of surgeons to assess if any difference in management attitudes of AA had occurred in the later stages of the outbreak. Methods: From August 15 to September 30, 2021, an online questionnaire was sent to all 709 participants of the ACIE Appy study. The questionnaire included questions on personal protective equipment (PPE), local policies and screening for SARS-CoV-2 infection, NOM, surgical approach and disease presentations in 2021. The results were compared with the results from the previous study. Results: A total of 476 answers were collected (response rate 67.1%). Screening policies were significatively improved with most patients screened regardless of symptoms (89.5% vs. 37.4%) with PCR and antigenic test as the preferred test (74.1% vs. 26.3%). More patients tested positive before surgery and commercial systems were the preferred ones to filter smoke plumes during laparoscopy. Laparoscopic appendicectomy was the first option in the treatment of AA, with a declined use of NOM. Conclusion: Management of AA has improved in the last waves of pandemic. Increased evidence regarding SARS-COV-2 infection along with a timely healthcare systems response has been translated into tailored attitudes and a better care for patients with AA worldwide