Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

Sarance Nº42 (2019) Full Issue

Background: the impact of different maneuvers to reduce shoulder pain after gynecological laparoscopy surgery was investigated.Methodology: A systematic review and meta-analysis was carried out by searching in the databases PUBMED, SCIENCEDIRECT, LILLACS and COCHRANE. We included studies published from 2008 to 2017, which compared different maneuvers for the prevention of shoulder pain after gynecological laparoscopic surgery. The statistical meta-analysis was performed using the RevMan 5.1 program.Results: Of the 56 articles analyzed, 6 were included that fulfilled the selection criteria, for a total of 743 patients. Of which 302 (40%) were given manual pulmonary insufflations with change of position, 104 (14%) were instilled with physiological saline in the peritoneal cavity, and 337 (46%) were treated with conventional evacuation that included passive extraction or gentle pressure on the abdominal wall with open trocars. We found that when performing instillation of physiological serum in the peritoneal cavity, the shoulder pain was significantly reduced at 12 hours with a Means Difference (MD) of -16. 90 (CI 95% -25.45- -8.34), at 24h with a MD of -22.71 (IC 95% -30.62- -14.80) and at 48h with a MD of -14.42 (CI 95% -20.67- -8, 17). On the other hand, using manual pulmonary insufflations with change of position of the patient, the shoulder pain was significantly reduced at 12h (MD: -16.84, CI 95%: -22.66, -11.01), at 24h (MD: -11.66, CI 95%: -14.80- -8.51) and 48 h (DM: -9.25; CI 95%: -11.94- -6.56). When observing the results by subgroup of the different interventions, we found that the instillation maneuver of physiological serum in the peritoneal cavity has better results than manual pulmonary insufflations and the control for the prevention of postoperative pain in gynecological laparoscopic surgery.Conclusion: Our study suggests that the maneuvers associated with forced expulsion of CO2, with pulmonary insufflation with change of position or instillation of the abdominal cavity with physiological solution, are effective measures for the prevention and reduction of shoulder pain after gynecological laparoscopy, compared with the passive extraction of CO2. Preventive measures should be routinely incorporated into gynecological laparoscopic procedures, as long as patients are clinically fit for these procedures.

Background: Low and middle income countries are experiencing growth rates of population aging, as well as the incidence of people with cognitive impairment. The objective of this study was to estimate the prevalence of cognitive impairment or dementia, and the frequency of associated factors in older adults in the canton of Santo Domingo de Heredia, Costa Rica. Methodology: A descriptive study of prevalence, in adults older than 65 years in the aforementioned community was carried out. A sample of 101 older adults identified by the "knocking on doors" strategy was selected (house by house, detecting those where at least one older adult resided). The protocol developed by the Group 10/66 Dementia Research Group of the International Alzheimer's Association was used, which has six questionnaires, namely: 1. Interview about the home, 2. Sociodemographic and risk factors interview , 3. Clinical interview, 4. Cognitive test battery, 5. Physical and neurological examination and 6. Interview with the informant (in cases where there is a companion). We calculated prevalence of cognitive impairment and frequency of some factors associated with the risk of dementia. Results: The average performance in the tests was 32.62 points (DS: 5.99, range: 10-43). 60.4% of the participants were below this 50th percentile (34 points), a cutoff point that determines some degree of cognitive impairment. Significant figures of smoking habit were found at some point in life and alcohol consumption; the presence of risk factors such as hypertension, diabetes mellitus and evidence of damage such as heart disease in 20% of cases; In the same way, 20% of the cases reported a history of dementia in family members and problems that affect their daily life. Finally, significant changes in cognitive ability and perception of memory problems could be established in verbal fluency tests in about 45% of the inhabitants. Conclusions: The study showed dementia prevalence figures similar to those reported by other similar studies worldwide. This reflects the need to focus on public health risk reduction strategies as well as the urgency to activate actions of the Alzheimer Plan of Costa Rica.

Electromagnetic stimuli are an ideal resource in the management of ulcers of any kind. Their effects stimulate the release of fibroblasts and macrophages in the affected area as well as growth and cell differentiation. Likewise, it allows to efficiently direct endogenous bioelectricity which represents an essential factor in the body's healing process. The case report is an 87-year-old women, who consults Santa Paula Clinic for a venous vascular ulcer in her left leg with one year of evolution. It had been treated with medical and pharmacological procedures without positive results. The High Voltage and Microcurrent electrical modalities were applied without any other treatment or exercise during 21 sessions with an average attendance every 7.8 days. The wound diameter improved by 4.47% per session and obtained a complete resolution in 4 months of treatment. Conclusions: Electro physical agents such as Microcurrent and High Voltage are ideal resources to facilitate endogenous processes of tissue repair. Clinical reasoning and meticulous daily evaluation are fundamental for a correct dosage as there are no established protocols for their treatment.

Introduction: Urinary incontinence is a potentially treatable condition, which can be a cause of significant anxiety and shame for women. Historically, the retropubic access TVT was considered gold-standard for the surgical management of this condition. Over a decade ago, the transobturator approach emerged as a surgical alternative to avoid complications associated with the retropubic approach. The aim of this study is to compare the effectiveness of both approaches (Retropubic and Transobturator) as well as the complications associated with these.Methodology: A systematic search was conducted in the literature in PUBMED, LILACS and CENTRAL; 117 studies were initially identified, of which 14 were included in our analysis according to inclusion/exclusion criteria. Among the results of interest, we analyzed the objective and subjective cure rate, and the rate of associated complications to both approaches, by estimation of relative risk with a confidence interval of 95%.Results: A total of 3022 women who underwent surgical interventions for urinary incontinence were included; 1496 women were subjected to the transobturator approach and 1526 women underwent the retropubic approach. We analyzed the subgroup of transobturator TVT IN-OUT vs retropubic TVT without finding significant differences compared to our initial analysis. We determined that the objective cure rate between transobturator approach vs retropubic is similar, with a tendency to favor cure in the retropubic group, a difference that was only statistically significant 12 months post-surgery. The subjective cure rate, on the other hand, didn’t reach a statistically significant difference between both surgical approaches in any of the periods analyzed. Among the complications observed, we found a higher incidence of post-operative pain in the transobturator approach (RR:2,14; 95% CI, 1.42-3.22); a higher incidence of emptying anomalies was found in the patients who underwent a retropubic TVT compared to the group that underwent the transobturator TVT, specifically in the IN-OUT group (TVT-O VS TVT: RR 0.61, 95% CI, 0.39-0.94); and in regards to the rate of bladder injury, there was a lower incidence after the transobturator approach (RR: 0.20, 95% CI, 0.11-0.37). No other complication reached statistically significant differences.Conclusion: As was found in the existing literature, when comparing the transobturator and retropubic approach, no difference was found between the rates of objective cure and subjective cure, nevertheless there is a clear tendency towards a higher rate of objective cure in the patients subjected to a retropubic TVT. However, there is a higher incidence of post-surgical pain related to the transobturator approach and a higher rate of bladder injury and emptying disorders after a retropubic approach.

We have identified a scarcely known river otter population from the Upper Río Conchos basin, northern Mexico, finding a well-established population of the Nearctic otter Lontra canadensis.  A pioneer study of these otters at Río San Pedro, a tributary of the Río Conchos, described them as Neotropical otters, Lontra longicaudis; at that time, no specimens or photographs of these otters were available from the locality.  Therefore, its taxonomic status remained unclear for various decades.  Río Conchos is one of the major tributaries of Río Grande (Río Bravo in Mexico) and its headwaters are located high in the Sierra Madre Occidental.  A juvenile otter fur obtained from Río San Pedro was compared to two furs of Neotropical otters from Oaxaca and Sonora, with the aim to compare the structure of primary hairs (PH) and secondary hairs (SH) in order to know their specific status.  Camera traps were set-up at Río San Pedro in Chihuahua and in Arroyo Bamochi (occupied by L. longicaudis) in Sonora in 2015 to compare individuals, population structure and occupation in both places.  Two other places were surveyed to confirm the presence of river otters: Río Conchos and Río Santa Isabel.  Based on hair characteristics (primary and secondary hairs from the juvenile) and photographic evidence from camera-traps, we confirm that otters from Río San Pedro, belong to the Nearctic otter, Lontra canadensis.  And presumably in other localities visited in the Concho’s river basin that also has presence of otters, such as Río Santa Isabel and Río Conchos.  The population structure from Arroyo Bamochi and Río San Pedro were similar in both areas, but the density of otters is higher at Arroyo Bamochi than at Río San Pedro, even though there is no significant difference between the two sites.  Specimens of river otters from Río Grande basin have been identified as L. canadensis lataxina, Cuvier, 1823.  The former distribution area of this species ranges from inland US across the Río Grande basin in the Rocky Mountains, the Río Pecos, further East, flowing south and southeast into the Gulf of Mexico.  The finding reported here represents a major area occupied by this species, and a significant conservation issue for their protection in Mexico, as well as an indicator of the healthy conservation status of the upper Río Conchos

Evolutionary radiations stemming from colonization of archipelagos provide valuable insights into mechanisms and modes of speciation.  For this reason, the fauna inhabiting the Galápagos Islands has been the focus of numerous emblematic ecological and evolutionary studies.  However, studies focused on rodents have been scarce.  Rice rats radiated in situ into at least seven endemic species: Aegialomys galapagoensis, Nesoryzomys narboroughi, N. swarthi, N. fernandinae, N. indefessus, N. darwini and Megaoryzomys curioi.  Only the first four species remain extant on the archipelago.  These species are considered vulnerable, mainly due to human activities and invasive species.  Despite their interesting evolutionary history, questions surrounding phylogenetic relationships, colonization events, genetic diversity and demography of populations remain unresolved.  We used the D-loop region of mtDNA to infer phylogenetic relationships, colonization events, date divergences, and conduct population genetic analyses of the four extant endemic species inhabiting the Galápagos Islands.  We found that all species were monophyletic. A. galapagoensis is sister to A. xanthaeolus from the continent, and both of them are the sister clade of the genus Nesoryzomys.  Our results also showed that there were two colonization events to the islands.  The first event was the arrival of the ancestor of Nesoryzomys during the Pliocene, when divergences between genera occurred.  The second was Aegialomys during middle Pleistocene, when species diversification began.  Populations on each island show high genetic diversity and most show signals of recent expansion.  However, future studies are needed to accurately assess the conservation status of these populations.  We suggest ongoing monitoring of these vulnerable endemic species, including ecological and population genetic studies.  In addition, future studies using genome-wide molecular markers and additional species from the continent, as well as sampling extinct species from the islands, will improve our knowledge about the origin and relationships of the endemic rodents of the Galápagos Islands.

The ecological importance of small mammals includes their role as dispersers of seeds, spores and propagules of plants, fungi and lichens, decomposers of organic matter and controllers of invertebrates as well as prey of a great number of vertebrates. The objective of this research was to determine the relationship between non-volant small mammals (Rodentia and Didelphimorphia) to vegetation structure and the extent of degradation of the forest in an area near the western boundary of the Upper Parana Atlantic Forest, and to evaluate seasonal and interannual variation in species’ abundances. The study was conducted in the Mbaracayú Forest Natural Reserve, Paraguay. Mark-capture methodology was employed in three sites with different degrees of degradation, in two seasons of the year (dry and rainy), in 2015 and 2016. A multivariate analysis was performed with ANOVA and MANOVA, evaluating degree of habitat disturbance and annual and seasonal variation as independent variables and species abundances as dependent variables. Sixteen small-mammal species were recorded, with 1,161 captures of 598 individuals and 563 recaptures throughout the sampling. Twelve species were of the Order Rodentia (all of the family Cricetidae, subfamily Sigmodontinae), and four of the Order Didelphimorphia (family Didelphidae). Variables that were significant for the most abundant species (Akodon montensis) were interannual variation and habitat degradation. The most common didelphid species in the study was Gracilinanus agilis, which appears well-adapted to different degrees of habitat degradation, given its occurrence in all sites. Plant communities, including their composition and degree of habitat disturbance, are important for small-mammal communities which are interacting in the different habitats of the forest. In this study we observed that Akodon montensis was most abundant in the habitat of moderate disturbance in the dry season (June). This habitat was characterized by large trees with grasses predominant in the understory. Hylaeamys megacephalus was most abundant in the dry season (June) and less so in the rainy season (November). Oligoryzomys nigripes is a habitat generalist and is less specialized in food preference. Abundance of the didelphid species Gracilinanus agilis was quite variable among sampling periods, but the species was present in all three levels of habitat degradation. The various species (especially the most abundant) exhibited different responses to habitat degradation and to interannual and seasonal variations.

Northwestern Argentina (NOA) is one of the least studied areas in Argentina with respect to ectoparasites of the order Siphonaptera; previous investigations, until this study, were scarce and specific.  The objective of this study was to contribute to the knowledge of the diversity of siphonaptera that parasitize small mammals from the NOA, emphasizing in their systematics and distribution.  Specimens of fleas collected in several localities of NOA, and stored in the “Annexes” of the Colección Mamíferos Lillo, Universidad Nacional de Tucuman, Argentina, were studied.  Fleas were manually removed from the host pelage, fixed in alcohol 70 % and prepared following conventional techniques for later observation under microscope.  For specimen identification, the original descriptions of species and subspecies were reviewed and compared with specimens stored in systematic collections.  Nine families, 22 genera, 53 species, and eight subspecies were recorded.  A new family, a new genus, and three new species are recorded for the first time in Argentina; five species are new for NOA and nine are new to science.  The distribution of 11 species and two subspecies are extended in the NOA, new records are added to different provinces and new flea-hosts associations are reported.  The greatest diversity of fleas in the Yungas is the reflection of one of the areas with the highest biodiversity in the Neotropical region, such as the Yungas forests, which also includes mammals, as sigmodontine rodents and bats among them.  The similarity analysis among eco-regions showed a major faunistic congruence between the Yungas and the Dry Chaco.  The greatest differentiation was given by the High Andes and Puna compared with the other eco-regions, probably because these areas are the least surveyed and with the lowest richness and abundance of small mammal species.  From the total of 82 new flea-host associations, 81 belong to sigmodontine rodent hosts and one to a marsupial.

Understanding the ecological niche and spatial distribution of wildlife species is important for the conserving and enhancing of biodiversity in a landscape system. Banteng (Bos javanicus) is a vital and important source of germplasm and protected by Indonesia law and considered to be Endangered under the International Union for Conservation of Nature list. During 2015 to 2017, surveys were undertaken on the largest population of wild banteng occurring in Ujung Kulon National Park. Data were gathered from a long-term camera trapping to assess the ecological niche and distribution of banteng using Maximum Entropy Modelling (Maxent) algorithm. Over a period of 30,149 trap nights there were high photo rates, indicating areas of high conservation importance for these species within the park. Distribution prediction indicated that habitat variables such as secondary forest, predation by Cuon alpinus and human impacts such as cultivated area and illegal activity, are critical to determining the habitat use of banteng. The results showed that banteng within the national park, mainly used the centre areas of the park with similar spatial use, both in wet and dry seasons. This study provides essential documentation of large Bovidae distribution in one of the four remaining habitats on Java, information for the development of management strategies within the park, and a basis upon which to develop future research on banteng.