Efectividad de la ketamina con instilación intraperitoneal en analgesia post operatoria de pacientes con colecistectomía laparoscópica electiva del hospital Víctor Lazarte Echegaray

El presente estudio de tipo experimental, longitudinal, analítico prospectivo tiene como objetivo demostrar que la Ketamina con instilación intraperitoneal a dosis bajas es más efectiva que el tratamiento convencional en la analgesia post operatoria de las colecistectomías laparoscópicas electivas. Se dividirán aleatoriamente a los pacientes en dos grupos a uno de los cuales se le administrará ketamina intraperitoneal más el tratamiento analgésico convencional y al otro grupo únicamente el tratamiento analgésico convencional. Las variables a medir serán la Escala visual análoga para el dolor abdominal y para el dolor referido de hombro a las 3, 6, 12 y 24 horas postoperatorias, también se medirá el tiempo para el requerimiento de analgesia de rescate y la presencia de náuseas y vómitos. Los datos serán analizados en el programa SPSS versión 25. Se utilizará la prueba de comparación de grupos mediante la prueba t de student, con un nivel de significancia del 5% (p < 0.05).Trabajo de investigació

Vascular Pathology and Blood-Brain Barrier Disruption in Cognitive and Psychiatric Complications of Type 2 Diabetes Mellitus

Vascular pathology is recognized as a principle insult in type 2 diabetes mellitus (T2DM). Co-morbidities such as structural brain abnormalities, cognitive, learning and memory deficits are also prevailing in T2DM patients. We previously suggested that microvascular pathologies involving blood-brain barrier (BBB) breakdown results in leakage of serum-derived components into the brain parenchyma, leading to neuronal dysfunction manifested as psychiatric illnesses. The current postulate focuses on the molecular mechanisms controlling BBB permeability in T2DM, as key contributors to the pathogenesis of mental disorders in patients. Revealing the mechanisms underlying BBB dysfunction and inflammatory response in T2DM and their role in metabolic disturbances, abnormal neurovascular coupling and neuronal plasticity, would contribute to the understanding of the mechanisms underlying psychopathologies in diabetic patients. Establishing this link would offer new targets for future therapeutic interventions

Phonon Thermal Transport of URu2Si2: Broken Translational Symmetry and Strong-Coupling of the Hidden Order to the Lattice

A dramatic increase in the total thermal conductivity (k) is observed in the Hidden Order (HO) state of single crystal URu2Si2. Through measurements of the thermal Hall conductivity, we explicitly show that the electronic contribution to k is extremely small, so that this large increase in k is dominated by phonon conduction. An itinerant BCS/mean-field model describes this behavior well: the increase in kappa is associated with the opening of a large energy gap at the Fermi Surface, thereby decreasing electron-phonon scattering. Our analysis implies that the Hidden Order parameter is strongly coupled to the lattice, suggestive of a broken symmetry involving charge degrees of freedom.Comment: 17 pages including figures, updated author institutions and acknowledgement

Behavioral attitudes and preferences in cooking practices with traditional open-fire stoves in Peru, Nepal, and Kenya: implications for improved cookstove interventions.

Global efforts are underway to develop and promote improved cookstoves which may reduce the negative health and environmental effects of burning solid fuels on health and the environment. Behavioral studies have considered cookstove user practices, needs and preferences in the design and implementation of cookstove projects; however, these studies have not examined the implications of the traditional stove use and design across multiple resource-poor settings in the implementation and promotion of improved cookstove projects that utilize a single, standardized stove design. We conducted in-depth interviews and direct observations of meal preparation and traditional, open-fire stove use of 137 women aged 20-49 years in Kenya, Peru and Nepal prior in the four-month period preceding installation of an improved cookstove as part of a field intervention trial. Despite general similarities in cooking practices across sites, we identified locally distinct practices and norms regarding traditional stove use and desired stove improvements. Traditional stoves are designed to accommodate specific cooking styles, types of fuel, and available resources for maintenance and renovation. The tailored stoves allow users to cook and repair their stoves easily. Women in each setting expressed their desire for a new stove, but they articulated distinct specific alterations that would meet their needs and preferences. Improved cookstove designs need to consider the diversity of values and needs held by potential users, presenting a significant challenge in identifying a "one size fits all" improved cookstove design. Our data show that a single stove design for use with locally available biomass fuels will not meet the cooking demands and resources available across the three sites. Moreover, locally produced or adapted improved cookstoves may be needed to meet the cooking needs of diverse populations while addressing health and environmental concerns of traditional stoves

Charge Transport in Manganites: Hopping Conduction, the Anomalous Hall Effect and Universal Scaling

The low-temperature Hall resistivity \rho_{xy} of La_{2/3}A_{1/3}MnO_3 single crystals (where A stands for Ca, Pb and Ca, or Sr) can be separated into Ordinary and Anomalous contributions, giving rise to Ordinary and Anomalous Hall effects, respectively. However, no such decomposition is possible near the Curie temperature which, in these systems, is close to metal-to-insulator transition. Rather, for all of these compounds and to a good approximation, the \rho_{xy} data at various temperatures and magnetic fields collapse (up to an overall scale), on to a single function of the reduced magnetization m=M/M_{sat}, the extremum of this function lying at m~0.4. A new mechanism for the Anomalous Hall Effect in the inelastic hopping regime, which reproduces these scaling curves, is identified. This mechanism, which is an extension of Holstein's model for the Ordinary Hall effect in the hopping regime, arises from the combined effects of the double-exchange-induced quantal phase in triads of Mn ions and spin-orbit interactions. We identify processes that lead to the Anomalous Hall Effect for localized carriers and, along the way, analyze issues of quantum interference in the presence of phonon-assisted hopping. Our results suggest that, near the ferromagnet-to-paramagnet transition, it is appropriate to describe transport in manganites in terms of carrier hopping between states that are localized due to combined effect of magnetic and non-magnetic disorder. We attribute the qualitative variations in resistivity characteristics across manganite compounds to the differing strengths of their carrier self-trapping, and conclude that both disorder-induced localization and self-trapping effects are important for transport.Comment: 29 pages, 20 figure

Association Between Socioeconomic Factors and the Choice of Dentifrice and Fluoride Intake by Children

It is questionable whether socioeconomic factors influence the choice of marketed children’s dentifrices and whether these products are associated with greater fluoride (F) intake in children. The present cross-sectional study involving 197 children (mean age: 40.98 ± 6.62 months) was carried out in Montes Claros, Brazil. Parents completed a questionnaire on socioeconomic status and the tooth brushing habits of their children. The children brushed their teeth and saliva residues were collected for F analysis. F intake from dentifrice was determined with an ion-specific electrode. Univariate analysis and logistic regression were used to test whether the type of dentifrice (children’s or family) and F dose (<0.05 and ≥0.05 mg F/Kg of body weight/day) were associated with the independent variables (p < 0.05). No differences were found between children’s and family dentifrices regarding daily F intake (0.046 and 0.040 mg F/Kg/day, respectively; p = 0.513). The following were strong predictors for the use of a children’s dentifrice: studying at a private kindergarten (OR: 6.89; p < 0.001); age that the child begun to tooth brush <2 years (OR: 2.93; p = 0.041), and the interaction between the variables “use of the same dentifrice as parents” and “type of tooth brush used” (OR: 27.20; p < 0.001). “The amount of dentifrice used” and “frequency of tooth brushing” (p ≤ 0.004) had a statistically and synergistic effect over the daily F dose. The present study found a social influence over the choice of dentifrice: children with a high socioeconomic status tend to use a children’s dentifrice. The amount of dentifrice used can strongly increase the risk of exposure to higher doses of F, regardless of the type of dentifrice