El oro azul (H2O)

Human health is seriously threatened by air pollution, water pollution, the presence of chemical and toxic substances as well as the deterioration of natural resources and the current environment. The rational use of water resources is reached alarming levels, as apart from not used according to the quantity produced, and he wasted little is used, directly to indirectly defiles him. The mathematical model is expressed as a function of a user utility, subject to restrictions such as clean water, unit cost, disposable income, quality of treated wastewater, among others. At present, the evidence indicates that various socio economic actors who have applied the reuse of waste, such as municipalities, the National University of Engineering, and several private companies under different water technologies. The economic sectors that consume more water (population and setting) are also those that show less efficiency when using the element.La salud humana se ve seriamente amenazada por la contaminación atmosférica, contaminación del agua, por la presencia de sustancias químicas y tóxicas así como por el deterioro de los recursos naturales y medio ambiente. La utilización racional actual del recurso hídrico está alcanzado niveles alarmantes, pues aparte de no usarse de acuerdo a la cantidad generada, se le desperdicia y a lo poco que se usa, se le contamina directa a indirectamente. El modelo matemático se expresa como una función de Utilidad de un usuario, sujeta a restricciones como agua limpia, costo unitario, ingreso disponible, calidad de agua residual tratada, entre otras. En la actualidad, las evidencias indican que existen diversos actores socio económicos que vienen aplicando el reúso de las aguas residuales, tales como los municipios, la Universidad Nacional de Ingeniería, y diferentes empresas privadas, bajo diferentes tecnologías. Los sectores económicos que más consumen agua (población y agrícola) son también los que menos eficiencia demuestran al momento de utilizar dicho elemento

Management of acute diverticulitis with pericolic free gas (ADIFAS). an international multicenter observational study

Background: There are no specific recommendations regarding the optimal management of this group of patients. The World Society of Emergency Surgery suggested a nonoperative strategy with antibiotic therapy, but this was a weak recommendation. This study aims to identify the optimal management of patients with acute diverticulitis (AD) presenting with pericolic free air with or without pericolic fluid. Methods: A multicenter, prospective, international study of patients diagnosed with AD and pericolic-free air with or without pericolic free fluid at a computed tomography (CT) scan between May 2020 and June 2021 was included. Patients were excluded if they had intra-abdominal distant free air, an abscess, generalized peritonitis, or less than a 1-year follow-up. The primary outcome was the rate of failure of nonoperative management within the index admission. Secondary outcomes included the rate of failure of nonoperative management within the first year and risk factors for failure. Results: A total of 810 patients were recruited across 69 European and South American centers; 744 patients (92%) were treated nonoperatively, and 66 (8%) underwent immediate surgery. Baseline characteristics were similar between groups. Hinchey II-IV on diagnostic imaging was the only independent risk factor for surgical intervention during index admission (odds ratios: 12.5, 95% CI: 2.4-64, P =0.003). Among patients treated nonoperatively, at index admission, 697 (94%) patients were discharged without any complications, 35 (4.7%) required emergency surgery, and 12 (1.6%) percutaneous drainage. Free pericolic fluid on CT scan was associated with a higher risk of failure of nonoperative management (odds ratios: 4.9, 95% CI: 1.2-19.9, P =0.023), with 88% of success compared to 96% without free fluid ( P <0.001). The rate of treatment failure with nonoperative management during the first year of follow-up was 16.5%. Conclusion: Patients with AD presenting with pericolic free gas can be successfully managed nonoperatively in the vast majority of cases. Patients with both free pericolic gas and free pericolic fluid on a CT scan are at a higher risk of failing nonoperative management and require closer observation