Ingeniera social: Técnica de ataque Phishing y su impacto en las empresas colombianas.

Actualmente, el mundo de la tecnología se encuentra en constante cambio y actualización, ya que este avanza a pasos agigantados y todos en el mundo hacemos parte de él. En este documento se podrá evidenciar de forma clara los conceptos básicos de la ingeniería social y el Phishing, las técnicas utilizadas por los delincuentes para atacar sus víctimas y una guía para tener en cuenta y que las empresas y no sean blanco fácil para los delincuentes, un factor importante a tener en cuenta es que no existen fórmulas mágicas para contrarrestar este tipo de delitos, ya que el eslabón más débil de la cadena es el usuario y este es uno de los más difíciles de educar. El internet y las redes son las herramientas que posibilitan la interconexión de las empresas, lo que hace que estas mejoren su productividad y sus conexiones nacionales e internacionales, pero esto hace que también sean blanco de los ciberdelincuentes que se encuentran al asecho en las redes. Actualmente en centro cibernético policial de Colombia (CAI Virtual); lugar donde se realizan estudios acerca de los delitos informáticos, durante los últimos 4 años ha evidenciado un incremento significativo en las denuncias de las empresas sobre ataques informáticos, reporte que pone en alerta a los empresarios colombianos, puesto que su información es vital para el funcionamiento de estas. “En el año 2014, del total de incidentes atendidos, el 92% afectaban a los ciudadanos del común, para el año 2015 el 63% y en el 2016 el 57%, presentando una disminución del 35%. Mientras tanto, el sector empresarial pasó de un 5% a un incremento del 28% en los reportes atendidos”. Un factor importante a tener en cuenta es no contar con políticas de seguridad claras, lo que desencadena malas prácticas en el uso de los sistemas informáticos y de la red informáticas, el cual es uno de los puntos más importantes para que el departamento de seguridad de la información tenga en cuenta a la hora de protegerla. De acuerdo a diferentes investigaciones del centro cibernético, la ingeniería social, es uno de los métodos más utilizados por los atacantes para poder engañar a los usuarios informáticos, para que puedan realizar alguna acción que normalmente puede producir consecuencias negativas, como la descarga de un software malicioso (malware) o también la divulgación de información personal de la víctima. Un factor importante a tener en cuenta de acuerdo a un estudio realizado por BID, MINTIC y OEA , se observó que, de manera general, las organizaciones colombianas que contestaron que se sienten preparadas, de hecho, adoptan más medidas de seguridad que las demás organizaciones., como por ejemplo, las grandes empresas tienden a adoptar más medidas de seguridad que una microempresa, así como las entidades públicas nacionales tienen una preocupación más grande con la seguridad digital que las entidades de orden territorial. Se espera que esta monografía sirva de soporte para darle claridad a las falencias en las empresas colombianas en la parte de los ataques de Phishing, utilizados en la ingeniería social, para obtener las diferentes vulnerabilidades que hay y cómo generar una solución adecuada de acuerdo a los protocolos de seguridad establecidos., en el que se identificará ciertas características de este tipo de ataque “Phishing”, de cómo caer en la trampa de estos ciberdelicuentes, y de esta manera lograr una reevaluación en la parte de la seguridad informática en las diferentes empresas colombianas, en el que se debe tener en cuenta los diferentes casos sucedidos a nivel nacional. Además, también le puede suceder a una persona natural que lo puedan hackear, dependiendo del interés del atacante.Currently, the world of technology is constantly changing and updating, as it advances by leaps and bounds and everyone in the world is part of it. This document will clearly demonstrate the basic concepts of social engineering and phishing, the techniques used by criminals to attack their victims and a guide to take into account and that companies and are not easy targets for criminals, an important factor to keep in mind is that there are no magic formulas to counteract this type of crime, since the weakest link in the chain is the user and this is one of the most difficult to educate. The internet and networks are the tools that enable the interconnection of companies, which makes them improve their productivity and their national and international connections, but this also makes them the target of cybercriminals who are lurking in networks. Currently in the Colombian cyber police center (CAI Virtual); place where studies are carried out about computer crimes, during the last 4 years has shown a significant increase in the complaints of companies about computer attacks, a report that puts Colombian businessmen on alert, since their information is vital for the operation of this. "In 2014, of the total number of incidents attended, 92% affected ordinary citizens, for 2015 63% and in 2016 57%, presenting a 35% decrease. Meanwhile, the business sector went from 5% to an increase of 28% in the reports attended. " An important factor to take into account is not having clear security policies, which triggers bad practices in the use of computer systems and the computer network, which is one of the most important points for the security department of the information take into account when protecting it. According to different investigations of the cybernetic center, social engineering is one of the methods most used by attackers to deceive computer users, so they can perform some action that can normally produce negative consequences, such as downloading software malicious (malware) or also the disclosure of personal information of the victim. An important factor to be taken into account according to a study carried out by IDB, MINTIC and OAS, it was observed that, in general, It is expected that this monograph serves as a support to clarify the shortcomings in Colombian companies in the part of Phishing attacks, used in social engineering, to obtain the different vulnerabilities that exist and how to generate an adequate solution according to the established security protocols., which will identify certain characteristics of this type of attack "Phishing", how to fall into the trap of these cyberdelicuentes, and thus achieve a reassessment in the part of computer security in different companies Colombians, in which the different cases that have taken place at the national level must be taken into account. In addition, it can also happen to a natural person who can hack, depending on the interest of the attacker

Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care. We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially