Introducción: La apendicitis aguda es la causa más común de dolor abdominal bajo agudo que lleva a los pacientes al servicio de urgencias. Este estudio tiene como objetivo encontrar la tasa de apendicectomía negativa en pacientes diagnosticados con apendicitis aguda de 2015 a 2019. Metodología: Este estudio fue de cohorte retrospectivo en pacientes diagnosticados preoperatoriamente con apendicitis aguda y sometidos a apendicectomía desde enero de 2015 hasta diciembre de 2019. La apendicectomía negativa se define como los resultados patológicos finales confirmados normales, congestión o periapendicitis. Resultados. La población de estudio fue de 492 pacientes de los cuales el 54,3% eran mujeres. La tasa de apendicectomía negativa a los cinco años fue del 8,6 % (n = 77) y del 70 % en mujeres (n = 54). Los factores asociados con el aumento de la tasa de apendicectomía negativa fueron sexo femenino (OR 2,23, P = 0,003), edad ≤ 40 años (OR 2,35, P = 0,003) y sin antecedentes de diarrea (OR 2,42, P = 0,017). Mientras que los factores relacionados con la disminución en la tasa de apendicectomía negativa fueron el recuento de glóbulos blancos (WBC) 10 000 (OR 0,39, P = 0,016), neutrófilos (N) 75 % (OR 0,28, P < 0,001) y apendicitis positiva por ultrasonografía de abdomen (OR 0,04, P < 0,001) o tomografía computarizada de abdomen (OR 0,07, P < 0,001). Conclusión. La tasa de apendicectomía negativa fue inferior al 10% en este estudio. Ser mujer, tener una edad ≤ 40 años y antecedentes de diarrea se relacionaron con aumento de apendicectomía negativa. Los factores que se relacionaron con la disminución de la apendicectomía negativa fueron la leucocitosis con células desplazadas hacia la izquierda, la apendicitis aguda positiva de la ecografía abdominal y la tomografía computarizada. Sin embargo, solicitar estudios de imagen adicionales para diagnosticar pacientes con sospecha de apendicitis aguda depende del riesgo y beneficio para cada paciente y la elección de la investigación.

Introduction: Adverse events following immunization for COVID-19 in some cases may be masked by probable active SARS CoV-2 infection. Objectives: The objective was to identify the frequency of post-vaccination clinical characteristics in times of pandemic as one of the protective measures in health personnel. Methodology: A database was created in Microsoft Excel 2016, processed with SPSS 25, frequencies and percentages of qualitative and quantitative variables were calculated.  Results: It was found that the mean age of the immunized people was 30 years, after the first and second administration of the vaccine the most frequent sign was fever and after the third joint pain.  Conclusions: It is important to identify and discriminate between the symptoms of infection versus the post-vaccination symptomatology, to avoid collapses in the emergency area of our hospitals.  General area of study: medicine. Specific study area: immunization.

Introduction: The Ecuadorian State seeks to ensure that the justice system adheres more and more to social reality, setting limits to its sanctioning power, justified by respect for due process as the regulatory axis of the procedural system. Meanwhile, criminal law seeks to regulate that punitive power, framed in the meticulous analysis of the infraction, the defendant and the social reproach. Objective: Analyze the minimum criminal intervention and its incidence in the development of the criminal process against the punitive power of the State. Methodology: In the applied methodology, critical, bibliographical-documentary scrutiny was used, the descriptive technique and the non-experimental design were applied, accompanied by the analytical-argumentative and inductive-deductive methods. For the collection of references, information platforms such as: Scopus, Google Scholar, Redalyc and Scielo were manipulated. Results: The power against crime must be based on a gear of requirements and justifications such as the minimum criminal intervention, considered as that scoop that limits the sanctioning power that conjectures a social necessity of the breach of the legal system. Conclusions: The category that founds the adequate and timely application of that procedural principle of meager criminal interference to regulate the rule of punishment of the state is instituted, concluding that it constitutes that appropriate response to regulate the advance or excessive abuse of the state's sanctioning power against the justiciable.

Introduction: Idiopathic hydrocephalus (IH) is a pathology that is related to age especially affects the elderly and the diagnosis is not clear to be able to adequately care for patients. General objective: to determine the management of normotensive hydrocephalus in adults. Description: 80-year-old female patient from Zhapacal-Azogues, widow, ORH+ blood type, with no instruction, housewife and also no allergies. Personal history was Hyperthyroidism with euthyrox 50mg treatment, Hypertension, Diabetes for 2 months with treatment that does not remember. The family history was that the daughter had diabetes. Evolution: The patient underwent on 10-08-2021 a surgical intervention placement of peritoneal ventricle shunt at the right frontoparietal level, (tunneling of peritoneal catheter from skull valve to abdomen) whose evolution was favorable before and after the surgical intervention and without any complication. His first postoperative day, with pale fascis, dry oral mucous membranes, soft abdomen on palpation, with the presence of a surgical wound on the right flank with dressing stained with blood fluid. Conclusion: Such was the clinical case exposed, thus ensuring the physical, mental, and social well-being of the individual.  Science Area: Cardiology.

Introduction: Stress is a main manifestation due to exhaustion, fatigue, regardless of age or profession, it influences causing different disorders. Objective: to examine the literature on the prevalence of work-related stress among nurses in the neonatal, and adult ICU area. Methodology: The research was carried out through a systematic review based on PRISMA. A search of updated scientific articles from five years ago was carried out using key words in databases such as: Scopus, PudMed, Redalyc, Scielo, and Medigraphic. Results: the prevalence of stress in nursing personnel in the Adult and Neonatal ICU area has a percentage of 67.50%, being the highest in the country of Nicaragua. On the other hand, in Ecuador the prevalence of stress in the Adult ICU area was 27%, being the lowest percentage of stress in the Adult ICU area. On the other hand, the prevalence of stress in the NICU area had a percentage of 34% being the highest, while 27.7% represents a lower percentage of stress, taking into account the different factors related to the work. Conclusion: the intensive care area is a place where qualified nursing personnel are required for the management of critical patients. Faced with this situation, health personnel are exposed to different stress situations. The risk factors that may cause stress are related to the degree of responsibility of the health professional, work overload, contact with death, suffering, conflict, and ambiguity of roles, problems of interrelation with the multidisciplinary team.

Introduction: measuring the result is a fundamental part of good medical practice, defining the quality of care and evaluating the effectiveness of interventions, the results act as endpoints in clinical trials to guide evidence-based practice, these being the protagonists of the individual performance of surgeons. As medical practice shifts from disease-focused to patient-focused care, patient-informed outcomes have taken precedence in health. The measures may not address what matters most to patients, although the holistic effects of the disease on multiple aspects of people's well-being are increasingly recognized, such as the usefulness of interventions focused on quality of life and patient symptoms, in addition to biological measures of disease. Methodology: A qualitative, descriptive, and reflective study will be conducted that aims to identify the factors that influence the quality of life after surgical procedures. Results: They will be measured by interviewing patients with a survey on the SERVQUAL model in person or by telephone to patients treated in the neurosurgery service who underwent various surgical procedures. Discussion: There is a need to perform a PROM in a protocol in neurosurgical patients to address the unmet needs of patients after undergoing neurosurgical procedures.

Introduction. The purpose of this research work is to identify and deepen the characteristics of the Electronically Controlled Hydraulically Operated Unit Injector. Objective. Analyze electrical elements, electronic devices, and their working logic together, as well as other technological developments for which this injection technology is the forefront in this area of work. Result. The importance of the injection system to reduce fuel consumption and therefore reduce the hot gases produced by commercial vehicles, as well as to study the efficiency of the injectors with the engine efficiency and engine power since it depends on several variables of study for specific systems work. Methodology. For this study, it was reviewed in an analytical and literary way based on a comprehensive review of scientific articles, student projects and related reports of academic impact that will make readers have a clear vision of this type of diesel injection system. Conclusions. The HEUI system places high demands on driving comfort and continues to influence the development of modern diesel engines.

Introduction. It is necessary that the people who make working life within the Provincial Governments, are participants in the fulfillment of the mission, vision, and institutional values to provide a quality service. Objective. Analyze the incidence of personnel selection in the adequate hiring of public servants in the Provincial Government of Manabí. Methodology. A non-experimental, descriptive, and quantitative design methodology was applied, applying a survey to 10 people that make up the sample. Results. It was evidenced that the selection of personnel directly affects the adequate hiring of public servants in the Provincial Government of Manabí, and that, by not applying adequate personnel selection processes, the administrative processes, as well as the functions of each worker, do not demonstrate the highest levels of efficiency. Conclusion. It is necessary that the Provincial Governments take into consideration that to achieve greater efficiency, in the development of their functions and their administrative processes it is necessary to have trained personnel, with skills and abilities according to the functions and responsibilities that are granted, it is also important Keep staff trained to keep information up-to-date and avoid executing inappropriate processes.

Introduction: The International Financial Information Standards were conceived as standards of general application for all types of companies; Consequently, its application began with the large organizations that traded on the stock market, since it was urgent to have internationally comparable information to support decision-making. Objectives: it is to determine the cost in the application of the IFRS regulation for SMEs specifically of deferred taxes since around 18 countries in the world have decided not to adopt this regulation. Methodology: Descriptive research was used for the development of this research, which allows presenting a point of view on a particular topic, providing arguments and evidence of the bibliographic review carried out. Results: When trying to implement the Accounting Regulations for SMEs, it turned out to be too complex because they did not have sufficient material, technological and human resources and even the benefit in the application of certain regulations was debatable. Conclusions: There are countries that refuse to implement the IFRS for SMEs because they consider them incomplete, however, according to the utility paradigm, only information that serves for decision making should be represented in the financial statement.

     Introduction: Online education has enabled the permanence of the teaching-learning process, emerging from the face-to-face modality to the online one, due to the emergence of the COVID-19 pandemic. Objective: The purpose of this study was to determine the incidence of online classes and its effect on the emotional exhaustion of the English language learning process. Methodology: The research was descriptive, with a quantitative approach, cross-sectional and non-experimental design. The study population comprised 103 students who were chosen through an intentional non-probabilistic sampling. The survey technique was used to measure acceptance of online classes; the "Emotional Exhaustion Scale" questionnaire for emotional exhaustion; and the “Placement Test” to establish the level of English. Results: The target reflected that 11.7% regardless of their gender was within the range required by the Ministry of Education (A2); women achieved better performance (13.3%); the skill that presented the greatest difficulty was Reading. Furthermore, 76.7% stated that the materials used are not didactic; 75.7% expressed their rejection of this modality. Likewise, 60% indicated that they do not get enough sleep due to studying; 83.5% presented fatigue and lack of energy. In the analysis of the statistical crossing showed that there is a low positive correlation. Conclusions: It was concluded that the majority of the students rejected the new virtual education system, identifying stress, tension, fatigue, among others., in the participants. Study area: Education.