Resumen En el mundo del presente prevalece una gran incertidumbre a causa tanto de la zoonosis como de la geoeconomía. La importancia de esta contribución deriva del hecho que aclara los escenarios donde estamos forzados a tomar decisiones inciertas pero ajustadas a la realidad. Su justificación, es que distinta será la reconstrucción en las economías resilientes (adaptativamente eficientes), de la reorganización en las vulnerables (adaptativamente ineficientes). En las primeras, sus economías y sus sociedades fueron resilientes instrumentando al postfordismo en la producción (innovación empresarial), y el Estado Benefactor en la política social (innovación social). Tal dependencia de la trayectoria en los centros del mundo occidental permite prever que su reconversión productiva llevará a la economía numérica con tanta eficiencia comparativa como la lograda antes de la pandemia. Las economías rezagadas, por el contrario, reciclarán a la vulnerabilidad particularmente porque adolecen del pecado original de procrear estructuras artefactuales cuya oferta es rígida ante las variaciones del ingreso, y por esto propulsora del déficit estructural de financiamiento externo que las obliga a endeudarse en divisas extranjeras para financiar la procedente secuencia improductiva. Este es un artículo de investigación que aplica la metodología institucional para arribar al resultado que identifica cómo la reconstrucción de las economías resilientes será diversa de la de las vulnerables. Se concluye recalcando la importancia estratégica de la acción social racional a fin de transformar la vulnerabilidad en resiliencia económica.

Abstract Great uncertainty prevails in the world today because of both zoo noses and geo economics. The importance of this contribution derives from the fact that it clarifies the scenarios where we are forced to make uncertain decisions but adjusted to reality. Its justification is that reconstruction in resilient economies (adaptively efficient) will be different from reorganization in vulnerable ones (adaptively inefficient). In the former, their economies and societies were resilient, implementing post-Fordism in production (business innovation), and the Welfare State in social policy (social innovation). Such dependence on the trajectory in the centers of the Western World allows us to foresee that their productive reconversion will lead to the numerical economy with as much comparative efficiency as that achieved before the pandemic. Lagging economies, on the contrary, will recycle to vulnerability particularly because they suffer from the original sin of procreating artifactual structures whose offer is rigid in the face of variations in income, and therefore propellant of the structural deficit of external financing that forces them to borrow in foreign currencies. to finance the proceeding unproductive sequence. This is a research article that applies the institutional methodology to arrive at the result that identifies how the reconstruction of resilient economies will be different from that of vulnerable ones. We conclude by emphasizing the strategic importance of social action to transform vulnerability into economic resilience.

Abstract Background In transanalminimally-invasive surgery (TAMIS), the closure of the rectal defect is controversial, and endoluminal suture is one of the most challenging aspects. The goal of the present study is to evaluate the short- andmedium-term complications of a consecutive series of patients with extraperitoneal rectal injuries who underwent TAMIS without closure of the rectal defect. Materials and Methods A prospective, longitudinal, descriptive study conducted between August 2013 and July 2019 in which all patients with extraperitoneal rectal lesions, who were operated on using the TAMIS technique, were consecutively included. The lesions were: benign lesions ≥ 3 cm; neuroendocrine tumors ≤ 2 cm; adenocarcinomas in stage T1N0; and adenocarcinomas in stage T2N0, with high surgical risk, or with the patients reluctant to undergo radical surgery, and others with doubts about complete remission after the neoadjuvant therapy. Bleeding, infectious complications, rectal stenosis, perforations, and death were evaluated. Results A total of 35 patients were treated using TAMIS without closure of the defect. The average size of the lesionswas of 3.68±2.1 cm(95% confidence interval [95%CI]: 0.7cmto 9 cm), their average distance from the anal margin was of 5.7±1.48cm, and the average operative time was of 39.2±20.5 minutes, with a minimum postoperative follow-up of 1 year. As for the pathologies, they were: 15 adenomas; 3 carcinoid tumors; and 17 adenocarcinomas. In all cases, the rectal defect was left open. The overall morbidity was of 14.2%. Two patients (grade II in the Clavien-Dindo classification) were readmitted for pain treatment, and three patients (grade III in the Clavien-Dindo classification) were assisted due to postoperative bleeding, one of whom required reoperation. Conclusion The TAMIS technique without closure of the rectal defect yields good results, and present a high feasibility and low complication rate.

RESUMO A técnica com pasta CTZ (cloranfenicol, tetraciclina e óxido de zinco-eugenol) no tratamento endodôntico de dentes decíduos é de fácil execução e requer sessão única, o que é uma vantagem em pacientes infantis. A inexistência de protocolos clínicos com o uso do CTZ e do processo de reparo endodôntico em dentes decíduos evidencia a necessidade de pesquisas sobre o assunto. Este estudo teve como objetivo sugerir um modelo de protocolo clínico para a sistematização e padronização do tratamento endodôntico de dentes decíduos com a pasta CTZ. No relato de caso apresentado, após a terapia pulpar, o acompanhamento clínico-radiográfico foi realizado após 30, 60, 90 e 180 dias. Concluiu-se que o uso da pasta CTZ é uma alternativa simples, viável e satisfatória. Futuros estudos clínicos são necessários a respeito do uso de CTZ em clínica infantil com fortes evidências científicas.

ABSTRACT The technique using CTZ paste (chloramphenicol, tetracycline, and zinc oxide-eugenol) in the endodontic treatment of deciduous teeth is easy to perform and requires a single session, which is an advantage with child patients. The inexistence of clinical protocols with the use of CTZ and the multifactorial endodontic repair process in deciduous teeth evidence the need for research on the subject. This study aimed to suggest a clinical protocol model for the systematization and standardization of the endodontic treatment of deciduous teeth using CTZ paste. In the case report presented, after pulp therapy, clinical-radiographical follow-up was conducted after 30, 60, 90 and 180 days. It was concluded that using CTZ paste is a simple, viable, and satisfactory alternative. Future clinical studies are needed regarding CTZ use in child clinic with strong scientific evidence.

ABSTRACT Background: From a patient's point of view, an ‘ideal’ doctor could be defined as one having personal qualities for interpersonal relationships, technical skills and good intentions. However, doctors' opinions about what it means to be a ‘good’ patient have not been systematically investigated. Aim: To explore how patients define the characteristics of a ‘good’ and a ‘bad’ doctor, and how doctors define a ‘good’ and a ‘bad’ patient. Material and Methods: We surveyed a cohort of 107 consecutive patients attending a community teaching hospital in February 2019, who were asked to define the desirable characteristics of a good/bad doctor. Additionally, a cohort of 115 physicians working at the same hospital was asked to define the desirable characteristics of a good/bad patient. Responses were subjected to content analysis. Simultaneously, an algorithm in Python was used to automatically categorize responses throughout text-mining. Results: The predominant patients' perspective alluded to desirable personal qualities more importantly than proficiency in knowledge and technical skills. Doctors would be satisfied if patients manifested positive personality characteristics, were prone to avoid decisional and personal conflicts, had a high adherence to treatment, and trusted the doctor. The text-mining algorithm was accurate to classify individuals' opinions. Conclusions: Ideally, fusing the skills of the scientist to the reflective capabilities of the medical humanist will fulfill the archetype of what patients consider to be a ‘good’ doctor. Doctors' preferences reveal a “paternalistic” style, and his/her opinions should be managed carefully to avoid stigmatizing certain patients' behaviors.

Antecedentes: Desde la perspectiva del paciente, un médico “ideal” podría definirse como aquel que tiene cualidades para las relaciones interpersonales, habilidades técnicas y buenas intenciones. Sin embargo, las opiniones de los médicos sobre lo que significa ser un “buen” paciente no se han investigado sistemáticamente. Objetivo: Explorar cómo los pacientes definen las características de un “buen” y “mal” médico, y cómo los médicos definen un “buen” y “mal” paciente. Material y Métodos: Encuestamos a una cohorte de 107 pacientes consecutivos que asistieron a un hospital comunitario en febrero de 2019, a quienes se les pidió que definieran las características deseables de un médico bueno/malo. Además, se pidió a una cohorte de 115 médicos que trabajaban en el mismo hospital que definieran las características deseables de un paciente bueno/malo. Las respuestas se sometieron a un análisis de contenido. Simultáneamente, se utilizó un algoritmo en Python para clasificar automáticamente las respuestas mediante minería de texto. Resultados: Los pacientes aludieron que las cualidades personales del médico eran más importantes que la competencia en conocimiento y las habilidades técnicas. Los médicos estarían satisfechos si los pacientes mostraran características positivas de personalidad, fueran propensos a evitar conflictos, tuvieran una alta adherencia al tratamiento y confiaran en el médico. El algoritmo de minería de texto clasificó las opiniones de los encuestados en forma precisa. Conclusiones: Idealmente, fusionar las habilidades del científico con las capacidades reflexivas del médico humanista cumplirá con el arquetipo de lo que los pacientes consideran un “buen” médico. Las preferencias de los médicos revelan un estilo “paternalista”, y sus opiniones deben manejarse con cuidado para evitar estigmatizar los comportamientos de ciertos pacientes.