Abstract: The use of e-commerce to enhance consumer relationships is becoming increasingly important in the information society. The constant development of technologies allows existing platforms to benefit from their characteristics; however, these advancements also bring various legal issues that must be addressed to protect users' interests and rights. Blockchain technology is revolutionizing B2C electronic relations due to its transnational nature, decentralization, guarantee of trust, immutability, and one of its most distinctive functionalities: smart contracts. These agreements are characterized by their automation and self-execution, features that can conflict with existing consumer and user legislation. Additionally, the opportunities provided by Blockchain, such as allowing users to act anonymously, may contradict regulations concerning the determination of international judicial jurisdiction and the applicable law for B2C consumer legal relationships. This work aims to analyze the applicability of smart contracts in e-commerce, particularly for B2C companies, and to study the potential issues they pose for current regulations, in order to determine whether these regulations need to be adapted for these technologies

Resumen: El uso del comercio electrónico para celebrar relaciones de consumo cada vez toma más protagonismo en la sociedad de la información. El constante desarrollo de las tecnologías hace que las plataformas existentes puedan beneficiarse de sus características; sin embargo, también traen consigo diferentes cuestiones jurídicas que deben mitigarse a fin de proteger los intereses y derechos de los usuarios. La tecnología blockchain es una de las tecnologías que viene a revolucionar el ámbito de las relaciones electrónicas B2C gracias a su carácter transnacional, descentralización, garantía de confianza, inmutabilidad y a una de sus funcionalidades más características: los smart contracts. Este tipo de acuerdos se distinguen por su automatización y autoejecución, caracteres que a priori pueden poner en riesgo la legislación existente sobre consumidores y usuarios. Asimismo, las oportunidades que brinda blockchain de cara a que los usuarios puedan actuar de forma irreconocible puede poner en jaque la normativa encargada de determinar la competencia judicial internacional y la ley aplicable a las relaciones jurídicas de consumo B2C. Este trabajo analiza la aplicabilidad de los smart contracts en el ámbito del comercio electrónico, en especial en el de empresas con consumidores (B2C) y estudiar los posibles inconvenientes que generan sobre la normativa existente a fin de analizar si es necesario adaptar la legislación a estas tecnologías

Resumo: A utilização do comércio eletrônico para efetivar relações de consumo assume cada vez mais um papel central na sociedade da informação. O constante desenvolvimento das tecnologias faz com que as plataformas existentes possam beneficiar-se das suas características, no entanto, também trazem consigo diversas questões jurídicas que devem ser mitigadas de forma a proteger os interesses e direitos dos usuários. A tecnologia blockchain é uma das tecnologias que veio revolucionar o campo das relações eletrônicas B2C graças ao seu carácter transnacional, descentralização, garantia de confiança, imutabilidade e uma das suas funcionalidades mais características, os smart contracts. Estes tipos de acordos distinguem-se pela sua automatização e auto-execução, características que, a priori, podem colocar em risco a legislação existente sobre consumidores e usuários. Da mesma forma, as oportunidades que o Blockchain oferece para que os usuários possam agir de forma irreconhecível podem colocar em xeque os regulamentos encarregados de determinar a competência judicial internacional e a lei aplicável às relações jurídicas de consumo B2C. O objetivo deste trabalho é analisar a aplicabilidade dos smart contracts no campo do comércio eletrônico, especialmente o de empresas com consumidores (B2C) e estudar os possíveis inconvenientes que eles geram sobre a regulamentação existente, a fim de analisar se é necessário adaptar a legislação a estas tecnologias

Resumen: El artículo aborda la importancia de los ámbitos público y privado en el análisis feminista, destacando la presencia de la dicotomía entre estas esferas en las teorías del patriarcado y la interseccionalidad. La separación entre lo público y lo privado tiene raíces históricas y está relacionada con la opresión de las mujeres en la esfera privada y su exclusión de la esfera pública. Se critica la exclusión de las mujeres de la teoría política tradicional y la invisibilidad de sus identidades de género, señalando la importancia de reconocerla influencia del género en la esfera pública y la economía. La oposición entre lo público y lo privado se explora en los estudios feministas e impregna las teorías del patriarcado y la interseccionalidad, expresadas aquí por los escritos de Pateman, Okin, Fraser, Walby, Hill Collins, Crenshaw, Davis y Bilge; destacando el potencial de complementariedad entre ambas corrientes teóricas. Resumen feminista interseccionalidad economía Pateman Okin Fraser Walby Collins Crenshaw Bilge teóricas

Resumo: O artigo discute a importância dos domínios público e privado na análise feminista, destacando a presença da dicotomia entre essas esferas nas teorias do patriarcado e na interseccionalidade. A separação entre o público e o privado tem raízes históricas e está relacionada à opressão das mulheres na esfera privada e sua exclusão da esfera pública. A exclusão das mulheres da teoria política tradicional e a invisibilidade de suas identidades de gênero são criticadas, apontando a importância de reconhecer a influência do gênero na esfera pública e na economia. A oposição entre público e privado é explorada nos estudos feministas e permeia as teorias do patriarcado e da interseccionalidade, aqui expressas pelos escritos de Pateman, Okin, Fraser, Walby, Hill Colins, Crenshaw, Davis e Bilge, evidenciando o potencial de complementaridade entre ambas as correntes teóricas. Resumo feminista interseccionalidade criticadas economia Pateman Okin Fraser Walby Colins Crenshaw Bilge teóricas

Abstract: The paper discusses the importance of the public and private domains in feminist analysis, highlighting the presence of the dichotomy between these spheres in theories of patriarchy and intersectionality. The separation between the public and the private has historical roots and is related to the oppression of women in the private sphere and their exclusion from the public sphere. The exclusion of women from traditional political theory and the invisibility of their gender identities are critiqued, pointing to the importance of recognizing the influence of gender in the public sphere and the economy. The opposition between public and private is explored in feminist studies and permeates the theories of patriarchy and intersectionality, expressed here by the writings of Pateman, Okin, Fraser, Walby, Hill Collins, Crenshaw, Davis and Bilge; highlighting the potential for complementarity between both theoretical currents. Abstract analysis intersectionality critiqued economy Pateman Okin Fraser Walby Collins Crenshaw Bilge currents

RESUMEN Se valora críticamente las insuficiencias desde los fundamentos de la economía política reflejadas en la Conceptualización del modelo económico cubano en los documentos aprobados por el VIII Congreso del PCC. Se expone la necesidad de una institucionalidad socialista transparente y democrática que garantice la implementación de las decisiones económicas y pueda neutralizar las deformaciones burocráticas del aparato estatal en todos sus niveles. Se precisa la esencia de la propiedad social de todo el pueblo, sus dimensiones principales; así como el rol de la planificación a través de macroprogramas, programas y proyectos. Se determinan los rasgos principales del socialismo con mercado y se caracterizan las principales relaciones con el sector privado en condiciones de transición socialista.

ABSTRAC The insufficiencies from the foundations of Political Economy reflected in the Conceptualization of the Cuban economic model in the documents approved by the 8th Congress of the PCC are critically assessed. The need for a transparent and democratic socialist institutionality is exposed that guarantees the implementation of economic decisions and can neutralize the bureaucratic deformations of the state apparatus at all levels. The essence of the Social Property of the entire people is specified, its main dimensions; as well as the role of Planning through Macroprograms, Programs and Projects. The main features of Socialism with Market are determined and the main relationships with the private sector are characterized in conditions of socialist transition.

Abstract: Environmental pollution from transportation has been a fundamental challenge for humanity throughout history, with conventional fuels contributing significantly to environmental degradation. This project seeks to suppress pollution and reduce noise generated by motorcycle taxis, whether for personal and/or private use. The main objective of the research work was to implement an electrolyzer in the combustion system of a motorcycle taxi to suppress environmental pollution and reduce noise. Methods included vehicle preparation, electrolyzer installation, battery adjustment, hydrogen generation, emissions measurement, safety, and data collection. As a result, the electrolyzer was implemented in the single-cylinder motorcycle taxi; The noise limit allowed at work in Peru is 85 dB, which is equivalent to 100 % noise at most; When using gasoline, a value of 76.4 dB was obtained, equivalent to 89.88 % noise, and when using hydrogen, a value of 71.7 dB was obtained, equivalent to 84.35 % noise, therefore, the total noise reduction was 4.70 dB (5.53 %) than established. The discussion highlighted that hydrogen is a clean fuel, with zero emissions and only emitting water vapor instead of polluting gases (5). The conclusion highlights the critical importance of the research, supported by the total reduction of 5.53 % of noise with this new technology and in turn external sources support that using hydrogen produced a smoother and quieter combustion; Regarding the useful life of the engine, due to the cleaner and more efficient combustion, the accumulation of waste was reduced, which benefits reducing the wear of internal components and the need for costly maintenance.

Resumen: La contaminación ambiental derivada del transporte ha sido un desafío fundamental para la humanidad a lo largo de la historia, con los combustibles convencionales contribuyendo significativamente a la degradación ambiental. Este proyecto busca suprimir la contaminación y reducir el ruido generada por mototaxis, ya sean de uso personal y/o privado. El trabajo de investigación tuvo como objetivo principal implementar un electrolizador en el sistema de combustión de un mototaxi para suprimir la contaminación ambiental y reducir el ruido. Los métodos incluyeron la preparación del vehículo, instalación del electrolizador, ajuste de la batería, generación de hidrógeno, medición de emisiones, seguridad y recolección de datos. Como resultado, se logró implementar el electrolizador en el mototaxi monocilíndrico; el límite de ruido permitido en el trabajo en el Perú es de 85 dB, que equivalen el 100 % de ruido como máximo; al utilizar gasolina se obtuvo un valor de 76.4 dB equivalentes a 89.88 % de ruido y al usar hidrógeno se obtuvo un valor de 71.7 dB siendo el 84.35 % de ruido, por lo tanto, la reducción total de ruido fue de 4.70 dB (5.53%) de lo establecido. La discusión destacó que el hidrógeno es un combustible limpio, con nulas emisiones y solo emitiendo vapor de agua en vez de gases contaminantes (5). La conclusión subraya la importancia crítica de la investigación, respaldada por la reducción total del 5.53 % de ruido con esta nueva tecnología y a su vez fuentes externas apoyan, que el utilizar hidrógeno produjo una combustión más suave y silenciosa. En cuanto a la vida útil del motor, la combustión más limpia y eficiente reduce la acumulación de residuos, lo que disminuye el desgaste de los componentes internos y la necesidad de mantenimientos costosos.

Resumen Esta investigación planteó como objetivo identificar recomendaciones para reducir la contaminación visual en entornos urbanos mediante la comparación de la "Ley Ciudad Limpia" de Londrina, Brasil y la "Ordenanza que Regula la Instalación de Medios Publicitarios y Propaganda Electoral en el Espacio Público y Privado" de Portoviejo, Ecuador. Se llevó a cabo un análisis detallado y comparativo, destacando similitudes y diferencias entre ambas regulaciones, subrayando la necesidad de una adecuada gestión para proteger el paisaje urbano y a los ciudadanos que lo habitan. Se sugirió la implementación de medidas derivadas de la "Ley Ciudad Limpia" en Portoviejo para lograr un mejor manejo y control sobre aspectos técnicos de la rotulación comercial y de igual manera reducir el impacto ambiental causado en los espacios públicos de la urbe.

Abstract This research aimed to identify recommendations to reduce visual pollution in urban environments by comparing the "Clean City Law" of Londrina, Brazil and the "Ordinance Regulating the Installation of Advertising Media and Electoral Propaganda in Public and Private Space" from Portoviejo, Ecuador. A detailed and comparative analysis was carried out, highlighting similarities and differences between both regulations, underlining the need for adequate management to protect the urban landscape and the citizens who inhabit it. The implementation of measures derived from the "Clean City Law" in Portoviejo was suggested to achieve better management and control over technical aspects of commercial signage and likewise reduce the environmental impact caused in the city's public spaces.

Resumen: El pasado curso escolar 2019-2020 vivió una situación de confinamiento que obligó a la observancia de una educación online. Esto tuvo varias repercusiones como afectación del alumnado que venía arrastrando alguna dificultad previa (Organización de Estados Iberoamericanos, 2020); imposibilidad de acceso a herramientas tecnológicas para el desempeño educativo diario; incertidumbre sobre cuándo y cómo debía llevarse a cabo la vuelta a la normalidad; regreso a la presencialidad, entre otros. Esto provocó que los docentes manifestaran no sólo la incertidumbre en el ejercicio de su docencia, sino también se viesen hastiados por cambios que no han servido para mejorar su situación profesional, requiriendo sacrificios a nivel personal. Un estudio encaminado a analizar la particular situación educativa en la Comunidad Autónoma de Galicia (España), puso de manifiesto el hartazgo de la clase docente. Esto, con total independencia de la tipología del centro escolar al que pertenecían: público, privado o concertado. La necesidad de realizar varios procesos de muestreo-participación, para obtener la muestra requerida por el estudio, dada su relevancia, fue lo que motivó el análisis sobre las razones que llevan al colectivo de docentes a no participar determinando, a través de un indicador, el grado de hastío de estos.

Abstract: The past school year 2019-2020 has experienced a situation of school confinement, which forced the observance of an online education, with certain repercussions: affectation on students who had been dragging some previous difficulty (OEI), impossibility of access to technological tools for daily educational performance, uncertainty about when and how the return to normality should take place, i.e., return to face-to-face. This caused teachers to express not only uncertainty in the exercise of their teaching, but also to see themselves jaded by changes that have not served to improve their professional situation, requiring sacrifices on a personal level. A study carried out aimed at analyzing the particular educational situation in the Autonomous Community of Galicia (Spain), has revealed the weariness of the teaching class, with complete independence of the type of school to which they are attached: public, private or concerted. The need to carry out various sampling-participation processes, to obtain the sample required by the study, given its relevance, was what motivated the analysis of what leads the group of teachers not to participate, determining, through an indicator, the degree of boredom with them.

Resumen La transición de lo rural a lo semiurbano en Yucatán ocurre principalmente en las cabeceras municipales, y trae consigo problemas de gestión de los residuos. Las autoridades municipales son las encargadas del Manejo Integral de los Residuos Sólidos Urbanos (MIRSU); pero en últimos años, la asociación entre el sector público y el privado para la gestión de los residuos resulta una estrategia eficaz. Existen pocos estudios sobre el MIRSU en zonas rurales o semiurbanas y la disposición a pagar de los usuarios, información que ayudaría a los creadores de política pública a diseñar planes y programas adecuados para su gestión. Por lo tanto, el objetivo de este estudio es determinar los factores socioeconómicos asociados a la disposición a pagar por el MIRSU de los usuarios de municipios semiurbanos de Yucatán. Se realizaron 1,144 encuestas en 6 localidades semiurbanas de Yucatán, los datos se analizaron mediante estadística descriptiva e inferencial con un modelo econométrico de regresión Tobit. El 69,75% de los usuarios encuestados declararon estar dispuestos a pagar por el manejo integral de los residuos sólidos un monto promedio de 17,65 pesos mexicanos (0,85 dólares estadounidenses). La disposición a pagar disminuye cuando predomina el idioma maya, y mientras menos activos físicos y habitaciones tenga el hogar. Existen elementos culturales y sociales arraigados en la recolección de residuos sólidos, este sistema integral puede ir acompañado de otro tipo de incentivos económicos para modificar el comportamiento de los consumidores hacia algo más beneficioso para el medio ambiente, tal como el ingreso familiar.

Abstract In Yucatan, the transition from rural to semi-urban communities has occurred mainly in the municipality seats; this transition comes with the problems of waste management. The municipalities oversee the Integral Urban Solid Waste Management (IUSWM); but in recent years, the public-private partnership for waste management has proved to be an effective strategy. There are few studies on the IUSWM in rural or semi-urban areas and the users’ willingness to pay, information that would help public policymakers to design adequate plans and programs for its management. Therefore, the purpose of this study is to determine the socioeconomic factors associated with the willingness to pay for the IUSWM of users in semi-urban municipalities of Yucatan. A total of 1,144 interviews were conducted in 6 semi-urban localities in Yucatan, and the data were analyzed using descriptive and inferential statistics with a Tobit regression econometric model. 69.75% of the surveyed users declared that they were willing to pay an average of 17.65 Mexican pesos (0.85 U.S. dollars) for the integral urban solid waste management. The willingness to pay decreases when the Mayan language predominates among the member of the household, and when they have fewer tangible assets and rooms. There are cultural and social factors rooted in solid waste collection, this integrated system may be accompanied by other types of economic incentives to modify consumers’ behavior towards something more beneficial for the environment, such as the homes’ income.

ABSTRACT This article investigates regional specificities of coronelism in the First Republic based on the historical experience of Goiás. A significant part of Brazilian legal and political historiography adhered to Victor Nunes Leal’s thesis, according to which the republican coronelism, more than an expression of the private power of the coronels, would signify their weakness in a context of increasing state institutionality. The coronels would fight, with all means, to take over the public machine, starting to distribute its benefits to friends and its rigors to enemies. However, investigating the case of Goiás, based on the novel O tronco, by Bernardo Élis, with other documents from the period, Leal’s thesis cannot explain the hypertrophy of the private power of the coronels in northern Goiás, that ignored or forcibly subjugated state power, with its laws, judges, police, etc. In conclusion, coronelism had different expressions in Brazil, which requires the differentiation of its specificities. Goiás Leals Leal s institutionality fight means machine enemies However tronco Élis period laws judges police etc conclusion Brazil

RESUMO Este artigo investiga especificidades regionais do coronelismo da Primeira República a partir da experiência histórica de Goiás. Parte significativa da historiografia jurídica e política brasileira aderiu à tese de Victor Nunes Leal, para a qual o coronelismo republicano, mais do que expressão do poder privado dos coronéis, significaria a fraqueza deles em um contexto de incremento do aparato estatal. Os coronéis lutariam para se empossarem da máquina pública, passando a distribuir os seus benefícios aos amigos e os seus rigores aos inimigos. Porém, investigando o caso goiano a partir do romance O tronco, de Bernardo Élis, junto com outros documentos da época, a tese de Leal não consegue explicar a hipertrofia do poder privado dos coronéis do norte de Goiás, que ignorava ou subjugava à força o poder estatal, com suas leis, juízes, polícia etc. Conclui-se que o coronelismo teve expressões diferentes no Brasil, o que exige a diferenciação de suas especificidades. Goiás republicano estatal pública inimigos Porém tronco Élis época leis juízes etc Concluise Conclui Brasil

Resumen Estudio de tipo cualitativo que explora las perspectivas y experiencias de un grupo de mujeres mexicanas que vivieron la atención institucionalizada del parto en la primera y segunda ola de la pandemia por COVID-19. A través de un guión semiestructurado se entrevistó a nueve mujeres que vivieron la experiencia de la atención del parto entre marzo y octubre de 2020, en hospitales públicos y privados de la ciudad de San Luis Potosí, en México. Bajo la propuesta de análisis de la teoría fundamentada, se identificó que las estrategias sanitarias implementadas en el marco de la pandemia, trajeron consigo un retroceso en la garantía del parto humanizado, las mujeres se narraron desconfiadas en los protocolos que siguió el personal para la atención de sus partos en los hospitales del sector público y muy confiadas en los que se implementaron en el sector privado. La realización de cesáreas sin una justificación clara emergió como una constante, igual que la separación temprana de los binomios. Continúa frágil la disposición y el convencimiento del personal sanitario y las instituciones para garantizar, proteger y defender el derecho de las mujeres a vivir el parto libre de violencia. Persisten resistencias para repensar la atención del parto desde un paradigma no biomédicalizante. COVID19. COVID19 COVID 19. 19 COVID-19 2020 Potosí México fundamentada humanizado privado constante binomios garantizar violencia biomédicalizante COVID1 1 COVID-1 202 COVID- 20 2

Abstract This is a qualitative study that explores the perspectives and experiences of a group of Mexican women who experienced institutionalized childbirth care in the first and second waves of the COVID-19 pandemic. Through a semi-structured script, nine women who experienced childbirth care were interviewed between March and October 2020 in public and private hospitals in the city of San Luis Potosí, Mexico. Under the Grounded Theory analysis proposal, it was identified that the health strategies implemented during the pandemic brought with them a setback in the guarantee of humanized childbirth. Women described themselves as distrustful of the protocols that personnel followed to attend to their births in public sector hospitals and very confident in those implemented in the private sector. The intervention of cesarean sections without a clear justification emerged as a constant, as did early dyad separation. Healthcare personnel’s and institutions’ willingness and conviction to guarantee, protect and defend the right of women to experience childbirth free of violence remain fragile. Resistance persists to rethink childbirth care from a non-biomedicalizing paradigm. COVID19 COVID 19 COVID-1 semistructured semi structured script 202 Potosí Mexico proposal constant separation personnels s institutions fragile nonbiomedicalizing non biomedicalizing paradigm COVID1 1 COVID- 20 2

Abstract When a building is demolished, its cohesive and planned structure fractures into countless fragments. These heterogeneous and disorganised fragments blur the boundaries between what was once private - the domestic space - and what is now public - the formerly occupied land. In 2019, I stumbled upon a family photograph amidst the rubble left by the demolition of the last towers of the Bairro do Aleixo in Porto. Constructed in the 1970s, this was a public housing estate designed to accommodate families from Ribeira-Barredo who had been displaced due to urban redevelopment. Throughout the years, the five towers have hosted a sizable and fluctuating population that has adapted and made use of this previously unconventional housing model. From 2011 to 2019, Aleixo underwent three demolition operations, politically supported by arguments citing its structural and social deterioration as justification. The first two were striking implosions broadcasted on television, whereas the final demolition, which I witnessed, unfolded as a slow deconstruction spanning several months. In the photograph, the woman dressed in white poses on a balcony of Tower 1 within the old Bairro do Aleixo. In the background stands the phallic skeleton of Tower 4, which would be imploded decades later. Upon its unearthing, the photograph, weathered by time and circumstance, hinted at a conceptual connection with the debris surrounding it. In this article, my focus centres on this found photograph, aiming to unveil the processes and tensions encapsulated within this fragment. I draw on the ontological connections between photography and death, as well as between photography and ruin, to analyse the spectral image of this obliterated site. I delve into what the encounter with this image might reveal about the memory of the neighbourhood, its public image, and the extensive and violent process of displacing its residents. I reach the concept of a "rubble-image" as pivotal in interpreting this nearly vanished imprint that stubbornly affirms the persistence of a dissenting and complex place, supposedly erased from public space and suppressed from urban memory by dominant sensibilities.

Resumo Quando uma edificação é demolida, a sua estrutura, unitária e planeada, é desintegrada em incontáveis fragmentos. Heterogéneos e desordenados, estes fragmentos borram os limites entre o que era privado - o espaço doméstico - e o que é público - o terreno antes ocupado. Em 2019, encontrei uma fotografia familiar entre os escombros da demolição das últimas torres do Bairro do Aleixo, no Porto. Este foi um conjunto de habitação pública construído na década de 1970 para realojar famílias da Ribeira-Barredo, deslocadas por uma reabilitação urbana. Ao longo do tempo, as cinco torres abrigaram uma população numerosa e mutável que se apropriou desse modelo de habitação até então incomum. Entre 2011 e 2019, o Aleixo foi alvo de três operações de demolição, politicamente justificadas por sua degradação estrutural e social. As duas primeiras foram implosões espetaculares e televisionadas, enquanto a última, que presenciei, foi uma lenta desconstrução que durou meses. Na fotografia, uma mulher vestida de branco posa numa varanda da Torre 1 do antigo Bairro do Aleixo. Ao fundo, paira o esqueleto fálico da Torre 4, implodida décadas depois. Quando encontrada, a fotografia, arruinada pelo tempo e pelas circunstâncias, sugeria uma afinidade conceptual com os escombros que a cercavam. Neste artigo, detenho-me sobre essa fotografia encontrada, objetivando desvelar os processos e as tensões armazenadas nesse fragmento. Recorro às relações ontológicas entre fotografia e morte, também entre fotografia e ruína, para analisar a imagem espectral desse sítio obliterado. Desenvolvo o que o encontro com ela pode indicar sobre a memória do bairro, a sua imagem pública, assim como o longo e violento processo de remoção dos seus moradores. Chego à noção de “imagem-escombro” como chave de leitura para esse vestígio quase desaparecido que afirma teimosamente a persistência de um lugar dissidente e complexo, pretensamente apagado do espaço público e suprimido da memória urbana pelas sensibilidades dominantes.

Abstract Introduction : Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant vascular dysplasia that might affect 1/5000-10 000 individuals worldwide. It is a rare and underdiagnosed condition. Population-based epidemiological studies are crucial for comprehending and quantifying the impact of this disease. We aim to estimate the prevalence in a Prepaid Health Care System of Buenos Aires, Argentina. Methods : A descriptive cross-sectional study was de signed, which included all patients over 18 years of age affiliated with the Hospital Italiano Medical Care Program (IHMCP), a prepaid health maintenance organization (HMO) of Buenos Aires. For case inclusion, individuals were required to have a clinical diagnosis of HHT. Case detection included the search in our Institutional Registry. The prevalence was calculated by dividing the number of cases of HHT by the total number of all active affiliates at January 2023. Age and gender specific prevalence rates were estimated. Results : 48 cases were reported. The prevalence was 3.2 in 10 000 (IC 95% 2.4-4.2). Specific prevalence in women was 3.9 in 10 000 (IC 95% 2.8-5.5) and in men 2.1 in 10 000 (IC 95% 1.2-3.6). The average age was 54.8 (19), 35 patients were women (72.9%) with an aver age age of 55 (19.9), and 55 (17.2) for men. The most common referrals were physicians (60.4%) followed by family history (18.7%). The 48 patients corresponded to 39 families. Discussion : The prevalence identified in our study is higher than the one documented in other studies.

Resumen Introducción : La telangiectasia hemorrágica heredita ria (HHT) es una displasia vascular que puede afectar a 1 de 5000 a 10 000 personas en el mundo. Es una afección rara y subdiagnosticada. Los estudios epidemiológicos son fundamentales para comprender y cuantificar el im pacto de esta enfermedad. Nuestro objetivo fue estimar la prevalencia en un Sistema Prepago de Atención de la Salud, en Buenos Aires, Argentina. Métodos : Estudio descriptivo transversal en pacientes mayores de 18 años afiliados al Programa de Atención Médica del Hospital Italiano en Buenos Aires (Plan de Sa lud). Para la inclusión de casos, se requería el diagnóstico de HHT. La detección de casos incluyó su búsqueda en nuestro Registro Institucional. La prevalencia se calculó dividiendo el número de casos por el número total de afiliados activos en enero de 2023. Se estimaron tasas específicas por edad y género. Resultados : Se reportaron 48 casos. La prevalencia fue de 3.2 por 10 000 personas (IC 95% 2.4-4.2). La específica en mujeres fue de 3.9 (IC 95% 2.8-5.5) y en hombres de 2.1 por 10 000 (IC 95% 1.2-3.6). La edad promedio fue de 55 años (19), con 35 pacientes mujeres (72.9%) con una edad promedio de 55 años (19.9) y 55 (17.2) para hom bres. La derivación más común fue de médicos (60.4%), seguidas por antecedentes familiares (18.7%). Los 48 pacientes correspondían a 39 familias. Discusión : La prevalencia identificada en nuestro es tudio es más alta que la documentada en otros estudios.

ABSTRACT Background: Liver surgery has evolved over time. There are no prior publications on the experience of liver surgery in the province of Corrientes. Our work group operates in both the public and private sectors. Objective: The aim of this study was to describe the initial results of a consecutive series of patients undergoing different types of liver resections, performed by the same surgical team. Material and methods: We conducted a retrospective, observational, and descriptive study based on data from the medical records and operating room records of patients undergoing liver resection at public and private institutions from September 2019 to January 2023. Results: A total of 27 patients were operated on; mean age was 53 years (25-72) and 16 were women. We used the conventional approach in 25 cases and laparoscopy in 2. Four procedures were major liver resections and 23 were minor liver resections, The diagnoses were cancer in 22 cases and benign conditions in 5. Survival at 90 days was 96.2% One patient died (3.7%). The complications included postoperative liver abscesses in 2 patients (7.4%) and re-operation due to bleeding in 2 patients (7.4%), who had a subsequent favorable course and were discharged from the hospital. Conclusion: The morbidity and mortality in the described series were similar to those reported by other authors.

RESUMEN Antecedentes: la cirugía hepática ha evolucionado con el correr del tiempo. No existe bibliografía publicada sobre experiencia previa de hepatectomía en Corrientes. Nuestro grupo de trabajo se desenvuelve en el ámbito público y privado. Objetivo: describir los resultados iniciales de una serie consecutiva de pacientes con hepatectomías de distinta extensión, por el mismo equipo quirúrgico. Material y métodos: trabajo retrospectivo, observacional, descriptivo, sobre datos de las historias clínicas y libros de quirófano de pacientes con hepatectomías realizadas entre septiembre de 2019 y enero de 2023, en la práctica pública y privada. Resultados: fueron intervenidos 27 pacientes, con media de edad 53 años (25-72); 16 eran mujeres. El abordaje fue convencional en 25 casos y laparoscópico en 2. Se realizaron 4 hepatectomías mayores y 23 menores. Los diagnósticos fueron de patología maligna en 22 oportunidades y benigna en 5. La sobrevida a los 90 días fue de 96,2%. La mortalidad fue de 1 paciente (3,7%). Con respecto a las complicaciones, 2 pacientes (7,4%) presentaron abscesos hepáticos en el posoperatorio, 2 pacientes (7,4%) requirieron reintervención quirúrgica por sangrado, con buena evolución posterior y alta hospitalaria. Conclusión: la morbimortalidad en la serie descripta estuvo en relación con lo comunicado por otros autores.

ABSTRACT Background: Major abdominal surgeries may present serious postoperative complications that require early diagnosis. Objective: The aim of this study was to determine the usefulness of computed tomography (CT) for the early diagnosis of major abdominal surgery complications. Material and methods: We conducted a retrospective, observational and descriptive study using data obtained from the medical records of patients undergoing major abdominal surgery in a private hospital. Patients were divided into two groups according to the presence or absence of symptoms suggesting a postoperative complication. Patients with symptoms were classified into 3 groups: without CT, with CT with positive findings and with CT without abnormal findings. Results: A total of 154 patients were analyzed; mean age was 61.3 ± 12.5 years and 83 (54%) were male. Of 48 patients (31%) with symptoms suggestive of complications, 6 had very evident symptoms and were re-operated without CT, 7 had positive findings on CT and CT was negative in 14/41. All the patients had findings that supported the decision to re-operate. There were 27 cases (17.5%) with grade 3b complications of the Clavien-Dindo classification and 3 patients (2%) died. Conclusion: Computed tomography was useful to confirm a complication, but not to rule it out. Clinical parameters remain of utmost importance in patients with symptoms and absence of abnormal findings in post-operative CT.

RESUMEN Antecedentes: las cirugías abdominales mayores pueden presentar complicaciones posoperatorias graves cuya detección temprana resulta importante para su tratamiento. Objetivo: determinar la utilidad del uso de la tomografía computarizada (TC) para el diagnóstico temprano de las complicaciones de cirugía abdominal mayor. Materiales y métodos: estudio retrospectivo observacional descriptivo, mediante revisión de historias clínicas de pacientes operados de cirugía abdominal mayor en un Hospital Privado. Se agruparon los pacientes según presentaban o no síntomas sospechosos de complicación posoperatoria. Los primeros se clasificaron en 3 grupos: sin TC, con TC con hallazgos positivos y con TC sin hallazgos patológicos. Resultados: se analizaron 154 pacientes, con un promedio de edad de 61,3 ± 12,5 años; 83 (54%) fueron varones. Sobre 48 pacientes (31%) con síntomas sospechosos de complicaciones, fueron reoperados 6 sin TC, pero con síntomas muy evidentes, 7 con signos tomográficos positivos y 14/41 del grupo con TC negativa. Todos tuvieron hallazgos que justificaron la intervención. Hubo 27 casos (17,5%) con complicaciones IIIb según Clavien-Dindo y 3 pacientes (2%) fallecieron. Conclusión: la tomografía computarizada tuvo valor para confirmar una complicación, pero no para descartarla. Los parámetros clínicos cobran especial importancia en los pacientes sintomáticos sin hallazgos patológicos en la TC posoperatoria.

Objective: To describe the early outcomes of resective colorectal surgery for Deep Infiltrating Endometriosis (DIE) in women treated at private center over the past 6 years. Materials and Methods: This cross-sectional study presents the clinical evolution of surgically treated patients with colorectal resections for DIE diagnosis between 2016 and 2022 at Clínica INDISA. They were grouped into discoid resections (Group I) and segmental resections (Group II). Results: Of patients operated for DIE between 2016 and 2022, 160 underwent colorectal resections, with 56 in Group I and 104 in Group II. The demographic characteristics of both groups were similar, except for smoking habits, which showed a predominance in Group II. The analysis of surgical variables (approach type, conversion rate, anastomotic height, and protective ostomy) showed a similar distribution in both groups. Regarding postoperative outcomes, Group I showed a significant decrease in solid food resumption time, 2 vs 3 days (p = 0.001). The initiation of intestinal transit, hospitalization days, and presence of Clavien-Dindo complications >= 3 did not present significant differences between both groups. Discussion: Endometriosis significantly affects women worldwide, with limited evidence reporting colorectal surgery outcomes comparing both techniques, demonstrating that management in specialized centers yields better results. Conclusion: When comparing these two techniques of colorectal resection in DIE, we conclude that patients undergoing discoid resection have an earlier resumption of solid food intake without significant differences in the remaining studied variables.

Resumen Objetivo: Describir los resultados tempranos de la cirugía resectiva colorrectal por Endometriosis Infiltrante Profunda (EIP) en mujeres intervenidas en centro clínico privado, durante los últimos 6 años. Material y Método Estudio transversal que muestra la evolución clínica de pacientes intervenidas quirúrgicamente con resecciones colorrectales por diagnóstico de (EIP), entre los años 2016-2022 en Clínica Indisa. Se agruparon en resecciones discoidales (Grupo I) y segmentarias (Grupo II) Resultados: De los pacientes operados por (EIP) entre los años 2016 al 2022, 160 pacientes fueron sometidas a resecciones colorrectales, 56 en el Grupo I y 104 en el grupo II. Las características demográficas de ambos grupos fueron similares, con excepción del hábito tabáquico que mostró un predominio en el Grupo II. El análisis de las variables quirúrgicas (tipo de abordaje, tasa de conversión, altura de la anastomosis y ostomía de protección) mostró una distribución similar en ambos grupos. En relación a la evolución postoperatoria, el Grupo I presentó una disminución significativa en el tiempo de realimentación con sólidos de 2 vs 3 días (p = 0,001). El inicio del tránsito intestinal, días de hospitalización y presencia de complicaciones Clavien-Dindo > = 3, no presentó diferencias significativas entre ambos grupos. Discusión: La endometriosis afecta, significativamente, a mujeres en todo el mundo, existiendo escasa evidencia que reporte los resultados de las cirugías colorrectales que comparen ambas técnicas, demostrando que el manejo en centros especializados tiene mejores resultados. Conclusión: Al comparar estas dos técnicas de resección colorrectal en DIE, concluimos que los pacientes operados por resección discoidal tienen una realimentación más temprana sin diferencias significativas en el resto de las variables estudiadas.