Proliferative vitreoretinopathy and its relationship with inflammatory serum biomarkers.

AIM: To analyze if a relationship between levels of inflammatory serum biomarkers and severity of primary proliferative vitreoretinopathy (PVR) exists. METHODS: A retrospective case-control study. The healthy adult patients with rhegmatogenous retinal detachment and primary PVR were included in the PVR group. For the control group, healthy adults who underwent cataract surgery were included. The grade of PVR was classified according to the Retinal Society Terminology Committee. Blood samples were obtained before surgery, and processed in MYTHIC 18. Measures of interest were neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR), the time between the decrease in visual acuity and surgery, PVR grade, type of surgery, final best corrected visual acuity, and rate of re-detachment. RESULTS: Totally 240 patients were included, 120 in each group, 79 (65.8%) and 56 (46.7%) were male in the PVR and control group, respectively. PVR A had greater levels of monocytes (0.28±0.18 vs 0.12±0.32, P=0.002), neutrophils (4.59±1.51 vs 3.92±1.27, P=0.006), and LMR (9.32±4.42 vs 7.43±3.90, P=0.01). PVR B had a greater monocyte count (0.30±0.13 vs 0.12±0.32, P=0.001), and PVR C demonstrated higher levels in monocytes (0.27±0.12 vs 0.12±0.32, P=0.004), neutrophils (4.39±1.13 vs 3.92±1.27, P=0.004), and LMR (9.63±3.24 vs 7.43±3.90, P=0.002) compared to control, respectively. An LMR cut-off value of 9.38 predicted PVR with a sensibility of 54.2% and specificity of 77.5% and NLR cut-off of 1.70 predicted PVR with a sensibility of 62% and specificity of 54.2%. CONCLUSION: Patients with primary PVR demonstrate greater neutrophil, monocyte, and LMR levels than the control group. Cut-off values obtained from ratios could be useful in a clinical setting when no posterior view of the fundus is possible due to media opacity.

Suprachoroidal silicone oil as an intraoperative complication during Pars Plana Vitrectomy: A case report.

INTRODUCTION AND IMPORTANCE: Complications related to silicone oil tamponade are frequent. There are reports of events related to silicone oil (SO) injection during Pars Plana Vitrectomy (PPV). This case presents the unexpected injection of SO in the suprachoroidal space. The proper management of this complication along with the preventive measures are discussed. CASE PRESENTATION: A 38-year-old male presented with a one-week history of decreased vision in his right eye (OD). His visual acuity was hand motion (HM). A late-onset retinal detachment recurrence with proliferative vitreoretinopathy (PVR) in his OD was diagnosed. Cataract surgery and PPV were scheduled. During PPV, a choroidal detachment (CD) secondary to the suprachoroidal injection of silicone oil (SO) was noted. Suprachoroidal SO was identified timely and was managed with external drainage through a posterior sclerotomy. CLINICAL DISCUSSION: Suprachoroidal silicone oil injection is a potential complication during PPV. For the management of this complication, the drainage of the silicone oil from the suprachoroidal space through a posterior sclerotomy may be considered as an option. This complication may be avoided by periodically checking the correct position of the infusion cannula during the PPV, by injecting the SO into the vitreous cavity under direct visualization and by using automated injection systems. CONCLUSION: Suprachoroidal silicone oil injection is an intraoperative complication that might be avoided by cross-checking the correct position of the infusion cannula and by injecting SO under direct visualization.

Diversidad y estado de conservación de pequeños mamíferos de Loreto, Perú / Diversity and conservation status of small non-volant mammals of Loreto, Peru

Resumen En este trabajo realizamos una revisión exhaustiva de bases de datos de colecciones científicas y literatura especializada con el objetivo de actualizar la lista de los mamíferos menores no voladores (<1000 g aprox.) del departamento de Loreto. Como resultado se contabilizaron 536 localidades en la que se registran 75 especies, agrupadas en cuatro órdenes y seis familias, equivalente al 13% y 28.6% de la diversidad de mamíferos de Perú y Loreto, respectivamente. Además, cinco de las 83 especies de mamíferos endémicos a nivel nacional están presentes en Loreto: Akodon orophilus, Neusticomys peruviensis, Hadrosciurus "sp. 3", Marmosops (Marmosops) soinii y Monodelphis (Mygalodelphys) handleyi; siendo las tres últimas, especies con registros sólo en este departamento. Asimismo, 23 especies son consideradas especies raras y 12 comunes, dos están consideradas como Vulnerables y tres como datos insuficientes por la legislación peruana, y alrededor de 16 especies no han sido evaluadas por la International Union for Conservation of Nature (IUCN). Por otro lado, mientras que la diversidad de especies de mamíferos pequeños no voladores está comparativamente bien representada en las distintas provincias de Loreto, algunas como Putumayo es una de las menos exploradas (< 15 localidades) y registra solamente 10 especies. Además, se evidenciaron cinco zonas de vacíos de información, distribuidas principalmente en las zonas fronterizas con otros departamentos o países: 1) toda la provincia del Putumayo y noreste de Maynas, 2) sur del río Amazonas en la provincia de Mariscal Ramón Castilla, 3) norte de la provincia del Datem del Marañón, 4) suroccidente del Datem del Marañón y 5) al sur y occidente de la provincia de Ucayali; cuya extensión podría explicar por qué la diversidad de los mamíferos menores no voladores estaría subestimada en este departamento.

Abstract In this work, we conducted an exhaustive review of databases of scientific collections and specialized literature with the goal to update the list of the smaller non-volant mammals (<1000 g approx.) of the department of Loreto. Results show 536 localities where are including records of 75 species, grouped in four orders and six families, this represent to 13% and 28.6% of the mammal diversity of Peru and Loreto, respectively. In addition, five of the 83 endemic mammal species of Peru occur in Loreto: Akodon orophilus, Neusticomys peruviensis, Hadrosciurus "species 3", Marmosops (Marmosops) soinii and Monodelphis (Mygalodelphys) handleyi; the last three species are only recorded in this department. Likewise, 23 species are considered rare and 12 common. In addition, two are considered Vulnerable and three as Data Deficient by Peruvian legislation, and about 16 species have not been evaluated by the International Union for Conservation of Nature (IUCN). On the other hand, while the species diversity of small non-volant mammals is comparatively well represented in the different provinces of Loreto, Putumayo province is the least explored with only 10 species. In addition, five large areas of information gaps were found, distributed mainly in the border areas: 1) the entire province of Putumayo and northeast of Maynas, 2) south of the Amazon River in the province of Mariscal Ramón Castilla, 3) north of the province of Datem del Marañón, 4) southwest of Datem del Marañón and 5) south and west of the province of Ucayali, which explain why the diversity of this group is largely underestimated in this department.

Diversidad y conservación de los murciélagos de Loreto, Perú / Diversity and conservation of bats from Loreto, Peru

Resumen En este trabajo presentamos una lista actualizada de los murciélagos de Loreto basada en la revisión de bases de datos, colecciones científicas y literatura especializada. Encontramos que Loreto es el departamento con mayor diversidad de murciélagos del Perú, con 114 especies agrupadas en 7 familias (19.9% de la mastofauna peruana), y que incluyen dos de las nueve especies endémicas para Perú: Micronycteris (Micronycteris) matses y Hsunycteris dashe. Además, se encontraron 444 localidades diferentes con registros de especímenes, principalmente ubicadas a lo largo de ríos. Las especies registradas en cuatro o menos localidades únicas fueron consideradas como raras, mientras que las especies registradas en 111 o más localidades únicas fueron consideradas comunes. Presentamos un mapa de las ecorregiones de Loreto con las localidades únicas, tanto históricas como contemporáneas, además de un mapa de densidad de localidades por cada 25 km2 donde se identifican 6 zonas de vacíos de información: 1) norte y centro de Putumayo 2) noroeste de Maynas y noreste de Loreto, 3) centro de Maynas, 4) centro-norte del Datem del Marañón, norte de Alto Amazonas y extremo occidental de Loreto, 5) centro-sur de Requena y extremo oriental de Ucayali y 6) extremo occidental de Ucayali. Finalmente presentamos mapas de distribución para cada especie aquí reportada para Loreto.

Abstract In this work, an updated list of species of bats from Loreto is presented, this was elaborated using information of databases, zoological collections, and specialized literature. The results confirm Loreto as the most diverse department of Peru with 114 species of bats grouped into 7 families (19.9% of the Peruvian mastofauna), which include two of the nine endemic species to Peru: Micronycteris (Micronycteris) matses and Hsunycteris dashe. Additionally, 444 different locations were found with specimen records, located mainly along rivers. Species recorded in four or less different locations are considered rare, while species recorded in 111 or more different locations are considered common. We present a map of the Loreto ecoregions with the different localities, both historical and contemporary, as well as a map of density of locations per 25 km2, which identifies 6 areas of information gaps: 1) North and middle Putumayo, 2) Northwest Maynas and northeast Loreto, 3) Middle Maynas, 4) North-middle Datem del Marañón, north Alto Amazonas and western end of Loreto, 5) South-middle Requena and eastern end of Ucayali and 6) Western end of Ucayali. Finally we present distribution maps for each species reported here for Loreto.

Diversidad y conservación de los mamíferos mayores de Loreto, Perú / Diversity and conservation of the large mammals from Loreto, Peru

Resumen En el presente trabajo, presentamos una lista actualizada de mamíferos mayores para Loreto compuesta por 72 especies en 8 órdenes y 25 familias. Esta lista fue elaborada a partir de la minuciosa revisión de bases de datos, colecciones zoológicas y publicaciones científicas. En Loreto se encuentran 5 especies endémicas nacionales: Lagothrix flavicauda, Saguinus (Leontocebus) illigeri, Saguinus (Leontocebus) nigrifrons, Pithecia aequatorialis y Pithecia isabela, siendo las tres últimas también endémicas para Loreto. Se encontraron 292 localidades diferentes a partir de 3286 registros de mamíferos mayores. Se presenta un mapa de distribución de las localidades analizadas remarcando ecorregiones y registros históricos (antes del 2001) y contemporáneos (después del 2001). Asimismo, se presentan mapas con la distribución de las localidades donde han sido registradas las 72 especies estudiadas, y un mapa de densidad de las localidades registradas, el cual permite identificar dos zonas con vacíos de información: 1) la zona Datem del Marañón-Loreto y 2) la zona Alto Amazonas-Ucayali. Estas zonas requieren evaluaciones urgentes para complementar el conocimiento de la biodiversidad de Loreto y sustentar adecuadamente los planes de conservación y desarrollo sustentable.

Abstract In this work, we present an updated list of large mammals for Loreto composed of 72 species in 8 orders and 25 families. This list is elaborated from review of databases, zoological collections, and scientific publications. In Loreto is registered five Peruvian endemic species: Lagothrix flavicauda, Saguinus (Leontocebus) illigeri, Saguinus (Leontocebus) nigrifrons, Pithecia aequatorialis and Pithecia isabela; the last three have presence only in Loreto. We found 292 different locations and 3286 records of large mammals and build a distribution map highlighting ecoregions and historical (before 2001) and contemporary (after 2001) records. Likewise, we build maps for each of the 72 species with records in Loreto, and a density map that reveal two areas with information gaps: 1) the Datem del Marañón-Loreto zone, and 2) the Alto Amazonas-Ucayali zone. These zones require urgent evaluations to complement knowledge of Loreto's biodiversity and adequately support conservation and sustainable development plans.

Lista actualizada de la diversidad de los mamíferos del Perú y una propuesta para su actualización / Updated list of the diversity of mammals from Peru and a proposal for its updating

Resumen La lista de mamíferos del Perú más reciente, publicada en el año 2020, compiló un total de 569 especies y 82 especies endémicas, sin embargo, en corto tiempo varios cambios taxonómicos han ocurrido y obligan a presentar otra lista actualizada de todas las especies de mamíferos con registros en el Perú. Esta nueva lista actualizada hasta noviembre de 2021 incluye 573 especies, 223 géneros, 51 familias y 13 órdenes: Didelphimorphia (47), Paucituberculata (2), Sirenia (1), Cingulata (5), Pilosa (7), Primates (42), Lagomorpha (2), Eulipotyphla (3), Carnivora (33), Perissodactyla (2), Artiodactyla (46, incluyendo 32 cetáceos), Rodentia (194) y Chiroptera (189); de las cuales, 87 especies son endémicas para el país. Por otro lado, la necesidad de contar con listas taxonómicas válidas y actualizadas para el uso en toma de decisiones, nos lleva a proponer como una estrategia óptima que la Asociación de Mastozoólogos del Perú (AMP) asuma el rol de mantener actualizada una lista que cubra las necesidades de los diferentes usuarios, tal como organizaciones similares lo vienen haciendo en países vecinos con el apoyo del Estado y ONGs.

Abstract The most recent list of mammals in Peru, published in 2020, compiled a total of 569 species, including 82 endemic species. However, several taxonomic changes have occurred in this short time, and it makes necessary to publish an updated list of all mammalian species recorded in Peru. This new list is updated until November 2021 and includes 573 species, 223 genera, 51 families and 13 orders: Didelphimorphia (47), Paucituberculata (2), Sirenia (1), Cingulata (5), Pilosa (7), Primates (42), Lagomorpha (2), Eulipotyphla (3), Carnivora (33), Perissodactyla (2), Artiodactyla (46, including 32 cetaceans), Rodentia (194) and Chiroptera (189); of which 87 species are endemic to the country. On the other hand, the need to have valid and updated taxonomic lists for use in decision-making, leads us to propose as an optimal strategy that the Asociación de Mastozoólogos del Perú (AMP) assume the role to produce and maintain an updated list to satisfy the needs of different users, as similar organizations are doing in neighboring countries with the support of the State and NGOs.

A new species of Thomasomys Coues, 1884 (Rodentia: Sigmodontinae) from the montane forests of northern Peru with comments on the "aureus" group

We describe a new species of the cricetid rodent Thomasomys (Sigmodontinae) of the "aureus" group based on four specimens collected from Carmen de la Frontera, Piura Department, Peru. This new species has a very long and white tail, very long mystacial vibrissae that extend posteriorly beyond the pinnae, and a distinctive cranial and dental morphology that differ from any other known species of Thomasomys. It is also one of the largest species of Thomasomys, exceeded in size only by T. apeco. A phylogenetic analysis using sequences of Cytb recovered this species within a non-monophyletic "aureus" group with a genetic distance between 5.47% (with T. auricularis) to 10.17% (with Thomasomys sp. 1). In addition to this finding, the phylogenetic position of T. apeco, T. praetor, and T. pyrrhonotus are presented for the first time, prompting a discussion on the nature of the "aureus" group.

Describimos una nueva especie de roedor cricétido Thomasomys (Sigmodontinae) del grupo "aureus" a partir de cuatro especímenes colectados en Carmen de la Frontera, en el departamento de Piura, Perú. Esta nueva especie tiene una cola muy larga y blanca, vibrisas mistaciales muy largas que sobrepasan ampliamente el pabellón auricular y una morfología craneal y dental distintiva que difiere de cualquier otra especie conocida de Thomasomys. También es una de las especies de Thomasomys más grandes, superado en tamaño solo por T. apeco. Un análisis filogenético recuperó esta especie dentro de un grupo "aureus" no monofilético con una distancia genética entre 5.47% (con T. auricularis) y 10.17% (con Thomasomys sp. 1). Además, se presenta por primera vez la posición filogenética de T. apeco, T. praetor y T. pyrrhonotus, lo que suscita una discusión sobre la naturaleza del grupo "aureus".

Tercera Cumbre Nacional de Delegados y Vocales de la Asociación Mexicana para Estudio y Tratamiento del Dolor (AMETD) / Third National Summit of Delegates and Vocals of the Mexican Association for the Study and Treatment of Pain (AMETD)

Resumen: La Asociación Mexicana para el Estudio y Tratamiento del Dolor nació en la década de los ochenta. Desde su fundación ha intervenido activamente en la educación continua de la nación y ha colaborado en la elaboración de documentos gubernamentales sobre diversos tópicos. En esta ocasión, durante la tercera reunión de delegados y vocales, se ponen a consideración diversas recomendaciones generales en materia de educación y regulación de opioides.

Abstract: The Mexican Association for the Study and Treatment of Pain was born in the eighties. Since its foundation, it has actively participated in the continuing education of the Nation and has collaborated in the preparation of government documents on various subjects. On this occasion, during the third meeting of delegates and members, various general recommendations regarding education and regulation of opioids are put for consideration.

Efficacy, Safety, and Cost-Minimization Analysis of Continuous Infusion of Low-Dose Gemcitabine Plus Cisplatin in Patients With Unresectable Malignant Pleural Mesothelioma.

BACKGROUND: Malignant pleural mesothelioma (MPM) is rare and aggressive neoplasia, with a poor prognosis; furthermore, the monetary cost of its treatment represents a major challenge for many patients. The economic burden this malignancy imposes is underscored by the fact that asbestos exposure, which is the most frequent risk factor, is much more prevalent in the lower socioeconomic population of developing countries. The aims of the present study were to evaluate the efficacy, safety, and cost of continuous infusion of low-dose Gemcitabine plus Cisplatin (CIGC) as a treatment strategy for patients with unresectable MPM. METHODS: We performed a prospective cohort study to determine efficacy and safety of continuous infusion gemcitabine at a dose of 250 mg/m2 in a 6-h continuous infusion plus cisplatin 35 mg/m2 on days 1 and 8 of a 21-day cycle in patients with unresectable MPM. We also performed a cost-minimization analysis to determine if this chemotherapy regimen is less expensive than other currently used regimens. RESULTS: The median number of chemotherapy cycles was six (range 1-11 cycles); objective response rate was documented in 46.2%, and disease control rate was seen in 81.2%. Median PFS was 8.05 months (CI 95% 6.97-9.13); median OS was 16.16 months (CI 95% 12.5-19.9). The cost minimization analysis revealed savings of 66.4, 61.9, and 97.7% comparing CIGC with short-infusion gemcitabine plus cisplatin (SIGC), cisplatin plus pemetrexed (CP), and cisplatin plus pemetrexed and bevacizumab (CPB), respectively. Furthermore, this chemotherapy regimen proved to be safe at the administered dosage. CONCLUSION: CIGC is an effective and safe treatment option for patients with unresectable MPM; besides, this combination is a cost-saving option when compared with other frequently used chemotherapy schemes. Therefore, this treatment scheme should be strongly considered for patients with unresectable MPM and limited economic resources.

Trabajos originales Mamíferos pequeños de humedales de la costa central del Perú / Small mammals from central Peruvian coast wetlands

Resumen Los humedales son ecosistemas frágiles e importantes que, a pesar de su gran biodiversidad, se conoce poco sobre la diversidad de mamíferos. Por ello, en este estudio se documenta la diversidad y abundancia de los mamíferos pequeños de cuatro humedales de la costa central peruana: Albufera de Medio Mundo, Refugio de vida silvestre Pantanos de Villa, Ensenada San Antonio y Caucato. Se realizó una evaluación convencional con trampas y redes, complementada con el método acústico. El esfuerzo de muestreo fue de 4651 trampas/noche, 145 redes/noche y 48 horas/detector. Registramos 5 especies nativas de roedores, 3 roedores introducidos, 12 murciélagos y un marsupial. El roedor Akodon mollis y los murciélagos Nyctinomops laticaudatus y N. macrotis son primeros registros para el departamento de Lima. El cuy silvestre se distribuye en el centro y sur de la costa y confirmamos la presencia del marsupial Didelphis pernigra a nivel del mar. La mayoría de los humedales están fuertemente impactados por la alta abundancia relativa de roedores introducidos, especialmente de Mus musculus y Rattus rattus. La diversidad β fue moderada a pesar de la relativa cercanía entre los humedales. Resaltamos la alta diversidad de mamíferos pequeños nativos en los humedales y alertamos sobre el impacto que los roedores introducidos pueden producir sobre la sobrevivencia de las demás especies. Además, hipotetizamos que la fauna nativa aquí reportada estuvo presente en la región de Lima al menos todo el periodo republicano. Estos humedales requieren protección continua, monitoreo e implementación de medidas de restauración para asegurar la conservación de su biota.

Abstract Wetlands are fragile, unique and important ecosystems that harbour great biodiversity. However, mammalian diversity in wetlands along the Peruvian coast is poorly known. We present data on the diversity and abundance of small mammals from four wetlands located on the central Peruvian coast: Albufera de Medio Mundo, Pantanos de Villa Wildlife Refuge, Ensenada San Antonio, and Caucato. We used conventional traps to survey rodents and mist nets combined with acoustic recording methods to survey bats. Our sampling effort totalled 4651 traps/night, 145 nets/night, and 48 hours/detector. We recorded 5 native species of rodents, 3 non-native rodents, 12 species of bats, and one marsupial. The rodent Akodon mollis and the bats Nyctinomops laticaudatus and N. macrotis are the first records for the department of Lima. The wild guinea pig is distributed along the central and southern Peruvian coast, and the presence of the Andean White-eared Opossum, Didelphis pernigra, at sea level is confirmed. The majority of wetlands we surveyed are highly impacted by non-native species, notably Mus musculus and Rattus rattus which have a high relative abundance in Pantanos de Villa and Caucato. β diversity among the four wetlands is moderate despite the relatively short distance between them. We highlight the high diversity of small native mammals in coastal wetlands and warn about the harmful impact the high relative abundance of introduced rodents can produce on the survival of native species. Furthermore, we hypothesized that native fauna reported here was present in Lima region at least throughout the Republican period. These wetlands require continuous protection, monitoring and implementation of restoration measures to ensure the conservation of their biota.

Diversidad y distribución de los mamíferos del Perú I: Didelphimorphia, Paucituberculata, Sirenia, Cingulata, Pilosa, Primates, Lagomorpha, Eulipotyphla, Carnivora, Perissodactyla y Artiodactyla / Diversity and distribution of mammals from Peru I: Didelphimorphia, Paucituberculata, Sirenia, Cingulata, Pilosa, Primates, Lagomorpha, Eulipotyphla, Carnivora, Perissodactyla, and Artiodactyla

Resumen Este trabajo presenta una síntesis actualizada del conocimiento de la diversidad y distribución de 11 órdenes de mamíferos del Perú. La información de especies es presentada a nivel de país, ecorregión y por primera vez por departamento. Además, identificamos las especies endémicas para el país y damos los rangos de elevación por especie. Para ello se realizó una revisión exhaustiva tanto de la literatura como de ejemplares en colecciones científicas, además de consultas con especialistas. Aquí, reportamos 191 especies pertenecientes a los órdenes Didelphimorphia (46 spp.), Paucituberculata (2), Sirenia (1), Cingulata (5), Pilosa (8), Primates (42), Lagomorpha (2), Eulipotyphla (3), Carnivora (33), Perissodactyla (2) y Artiodactyla (47, incluyendo 32 cetáceos), de los cuales 22 especies son endémicas para el país. Debido a su alta diversidad y al alto número de cambios taxonómicos los órdenes Chiroptera y Rodentia serán tratados separadamente en futuros artículos. Los registros de especies presentadas en este trabajo, aunado a los reportes recientes de murciélagos (189 especies) y roedores (189 especies) totalizan a una diversidad de 569 especies de mamíferos para el Perú. Finalmente, proporcionamos notas taxonómicas de las especies que presentan cambios con respecto a la anterior lista de mamíferos peruanos. Esperamos que este primer listado de mamíferos por departamentos incentive estudios más detallados de la diversidad peruana a nivel regional.

Abstract This work summarizes recent knowledge regarding the diversity and distribution of 11 Orders of mammals from Peru. Species information is presented for the country, ecoregions and, for the first time, by individual departments. Furthermore, we identified endemic species for the country and provided elevation ranges per species. To compile our information, we conducted an exhaustive review of the scientific literature and specimens in scientific collections, consulting with specialists when needed to verify records. We report 191 species belonging to the orders Didelphimorphia (46 spp.), Paucituberculata (2), Sirenia (1), Cingulata (5), Pilosa (8), Primates (42), Lagomorpha (2), Eulipotyphla (3), Carnivora (33), Perissodactyla (2), and Artiodactyla (47, including 32 cetaceans); 22 of these are endemic to Peru. Due to their high diversity and number of taxonomic changes, the Orders Chiroptera and Rodentia will be treated separately in future articles. The species records presented here, together with previous reports of bats (189 spp.) and rodents (189 spp.) yield a current total 569 species of mammals for Peru. Finally, we provide taxonomic notes for species that exhibit differences with respect to the previously published list of Peruvian mammals. We hope that this first list of mammals by department encourages further studies of Peruvian mammalian diversity at the regional level.

Risk of New Fractures in Vertebroplasty for Multiple Myeloma. A Retrospective Study.

OBJECTIVE: Vertebroplasty is a percutaneous minimally invasive procedure indicated for vertebral collapse pain treatment. Among the known complications of the procedure is the augmented risk of new vertebral fractures. There are no specific studies in this patient population describing the risk of new vertebral fractures after vertebroplasty. This study analyzed risk factors associated with new vertebral fractures after vertebroplasty in patients with multiple myeloma. METHODS: Observational retrospective study in patients with multiple myeloma. The data collection took place from January 1, 2010, to December 30, 2017, at the National Cancer Institute. Clinical data and procedural variables such as cement volume, cement leaks, fracture level, number of treated vertebrae, pedicular disease, and cement distribution pattern, with two years follow-up, were analyzed with the Wilcoxon test, and a logistic regression model was used to identify risk factors related to new vertebral fractures. A confidence interval of 95% was used for analysis. RESULTS: At one-year follow-up, 30% of fractures were reported after vertebroplasty, most of them at low thoracic and lumbar level (50% adjacent level). Vertebroplasty was most commonly performed at the thoracolumbar and lumbar area. We demonstrated a 70.7% median numerical rating scale reduction at one-year follow-up; a significant decrease in opioid consumption occurred only during the first month. CONCLUSIONS: Pedicle involvement, disc leakage, cement volume, thoracolumbar and lumbar level, and number of treated vertebrae by intervention are important risk factors when performing vertebroplasty. Prospective randomized studies are needed to evaluate these factors in this specific population.

Effectiveness of Superior Hypogastric Plexus Neurolysis for Pelvic Cancer Pain.

BACKGROUND: The superior hypogastric plexus block has been indicated for visceral pelvic pain treatment associated with malignancy. The first international report of this technique was published by Plancarte et al, in which a posterior percutaneous approach guided by fluoroscopy was described by applying neurolytic agents. The considerable variability in the data reported gave rise to 2 clinical approaches to those who performed the blockade early and those who executed it at a later stage of cancer. OBJECTIVES: The present study aims to provide more evidence regarding the effectiveness of this procedure. STUDY DESIGN: This is a retrospective, longitudinal, descriptive study. SETTING: The study was held at the pain unit service of the National Cancer Institute, Mexico City. METHODS: A nonprobabilistic sample was selected; the data collection took place from January 2006 to December 2016 with patients diagnosed with pelvic pain, confirmed by imaging and biopsy studies. Patients who received any other type of intervention of the sympathetic axis, patients with a different approach than the classic or paravertebral technique, and patients with low survival rate were excluded. The Student t test was used to measure the significant difference between Visual Analog Scale (VAS) and morphine equivalent daily dose. The Cochran-Mantel-Haenszel test and the Gamma test were used to measure the association between the initial Karnofsky and blockade success. RESULTS: The study included a total of 180 patients. The success rate was 59.4% at 1 month, 55.5% at 3 months, and 48.8% at 6 months. There was a sustained and significant VAS reduction that was 49.55% at 3 months. A significant reduction in opioid consumption of 12.55% was found at 3 months. There was no significant statistical evidence related to either opioid consumption or the functionality of the patient before the blockade as an influential variable in the success of the procedure. LIMITATIONS: Retrospective study, developed in a single center. CONCLUSIONS: Although opioids remain the cornerstone of cancer pain treatment, they produce many deleterious side effects. The superior hypogastric plexus neurolysis represents a reproducible and effective alternative in the management of pain in this group of patients. KEY WORDS: Pelvic pain, neoplasms, chemical neurolysis, pain management, cancer pain, palliative care, analgesia, nerve block.

Primer reporte de albinismo para el cuy silvestre Cavia tschudii (Mammalia: Rodentia) / First albinism report for the wild guinea pig Cavia tschudii (Mammalia: Rodentia)

En mamíferos silvestres los patrones de coloración atípica como el albinismo ocurren en baja frecuencia y en la literatura científica sus reportes son escasos. Por lo cual los hallazgos de este tipo son importantes para comprender mejor este fenómeno. En el presente trabajo realizamos el primer reporte de albinismo para el cuy silvestre Cavia tschudii (Rodentia) en la costa central de Perú. Este hallazgo también representa el primer registro de albinismo para el género Cavia en el Neotrópico.

In wild mammals, atypical coloration patterns such as albinism occur at a low frequency and are poorly reported in the literature. Therefore, discovery of cases of coloration anomalies are important to better understand this phenomenon. Here, we describe the first reported case of albinism in Cavia tschudii "Wild Guinea Pig" from the central coast of Peru. This discovery also represents the first record of albinism for the genus Cavia in the Neotropics.

A capture of a lesser bandicoot rat Bandicota bengalensis (Rodentia, Muridae) at Callao Port, Perú: anecdotal record or potential invasive alien species? / Captura de una rata bandicota menor Bandicota bengalensis (Rodentia, Muridae) en el puerto de Callao, Perú: ¿registro anecdótico o especie exótica invasora?

The Lesser bandicoot rat Bandicota bengalensis (Gray and Hardwicke, 1833) is a murid rodent distributed mostly in Asia that can cause substantial negative economic impact in urban and rural areas. Until now, the species has been mostly restricted to the Asian region; and no specimen has been captured or reported as a stowaway arriving to an American port. Here, I report on one specimen captured in Callao's maritime port, Peru, during sanitary inspection surveillance, identified based on external and cranial characteristics, and similar meristic reported values. This finding shows the potential threat of this species as an invasive alien species and highlights the need for strengthening invasive species protocols on ships.

La rata bandicota menor Bandicota bengalensis (Gray & Hardwicke, 1833) es un roedor múrido distribuido principalmente en Asia que puede causar un impacto económico negativo sustancial en las zonas urbanas y rurales. Hasta ahora, la especie se ha restringido principalmente a la región asiática y ningún espécimen ha sido capturado o reportado como polizón en un puerto americano. Aquí, reporto un espécimen capturado en el puerto marítimo del Callao, Perú, durante una inspección sanitaria, identificado en base a características externas y craneales, y valores morfométricos similares. Este hallazgo muestra la amenaza potencial de esta especie como especie exótica invasora y destaca la necesidad de fortalecer los protocolos de especies invasoras en los barcos.

Therapeutic applications based on cannabinoids action / Aplicaciones terapéuticas por acción de los cannabinoides

The interest on cannabinoids became evident between the 1940 and 1950 decades. Although the active substance of the plant was not known, a series of compounds with cannabinomimetic activity were synthesized, which were investigated in animals and clinically. The most widely tested was Δ6α, 10α-THC hexyl. Δ6α, 10α-THC dimethylheptyl (DMHP) antiepileptic effects were studied in several children, with positive results being obtained in some cases. DMHP differs from sinhexyl in that its side chain is DMHP instead of n-hexyl. The first cannabinoid isolated from Cannabis sativa was cannabinol, although its structure was correctly characterized several years later. Cannabidiol was isolated some years later and was subsequently characterized by Mechoulam and Shvo. In 2013, the National Academy of Medicine and the Faculty of Medicine of the National Autonomous University of Mexico, through the Seminar of Studies on Entirety, decided to carry out a systematic review on a subject that is both complex and controversial: the relationship between marijuana and health. In recent years, studies have been conducted with cannabis in several diseases: controlled clinical trials on spasticity in multiple sclerosis and spinal cord injury, chronic, essentially neuropathic, pain, movement disorders (Gilles de Latourette, dystonia, levodopa dyskinesia), asthma and glaucoma, as well as non-controlled clinical trials on Alzheimer’s disease, neuroprotection, intractable hiccups, epilepsy, alcohol and opioid dependence and inflammatory processes.

Dieta y estructura trófica de un ensamblaje de murciélagos en los bosques montanos del Santuario Nacional Pampa Hermosa, Junín, Perú / Diet and trophic structure in an assemblage of bats in montane forest of Pampa Hermosa National Sanctuary, Junin, Peru

Se estudia la dieta y la estructura trófica de 36 especies de murciélagos del Santuario Nacional Pampa Hermosa. Se analizaron muestras fecales y geles con polen. En las fecas se encontraron semillas, polen y restos de artrópodos. Los murciélagos se clasificaron en seis grupos funcionales. En la dieta de los frugívoros sedentarios (FS), frugívoros nómades (FN) y nectarívoros (N) se identificaron 70 morfoespecies de semillas y polen; en la dieta de los insectívoros aéreos (IA) e insectívoros recolectores (IR) se identificaron nueve morfo especies de artrópodos. El análisis de componentes principales muestra la separación de los murciélagos y sus dietas. Carollia brevicauda-Piperaceae (Piper spp.), Vampyressa melissa-Moraceae (Ficus spp.), Sturnira lilium-Solanaceae; Anoura peruana y Anoura cultrata separados por el consumo de Fabaceae y Bombacaceae, respectivamente, y Myotis spp. por el consumo de artrópodos. La amplitud de nicho alimentario fue menor de 0.50, en todo el ensamblaje. Los valores de solapamiento de dieta fueron mayores de 0.5 entre: A. cultrata-A. caudifer (0.59), Sturnira lilium-Uroderma bilobatum (0.55), V. melissa-Platyrrhinus masu (0.62), y en general para los IA e IR. El análisis de agrupamiento basado en los valores de solapamiento de dieta, agrupa a los frugívoros estrictos Sternodermatinae separándolos de los murciélagos con dietas insectívoras, como Carollia spp. y Anoura spp.

We study the diet and trophic structure of 36 bat species from the Pampa Hermosa National Sanctuary. Faeces samples and gels with pollen were analyzed; seeds, pollen and remains of arthropods were found in the feces. Bats were classified in six functional groups. We found in the diet of the sedentary frugivores (FS), frugivorous nomads (FN) and nectarivores (N), 70 morphospecies of seed and pollen; in the diet of the aerial insectivorous (IA) and foliage gleaners (IR), nine morphospecies of arthropods. Principal component analysis shows the separation of bats and their diets; Carollia brevicauda-Piperaceae (Piper spp.), Vampyressa melissa-Moraceae (Ficus spp.), Sturnira lilium-Solanaceae; Anoura peruana and Anoura cultrata were separated by the consumption of Fabaceae and Bombacaceae, respectively, and Myotis spp. for the consumption of arthropods. The niche breadth was less than 0.50, in the assemblage. The values of dietary overlap were higher than 0.5, between: A. cultrata-A. caudifer (0.59), Sturnira lilium-Uroderma bilobatum (0.55), V. melissa-Platyrrhinus masu (0.62), in for the almost of AI and IR. The cluster analysis based on dietary overlap grouped to the strict frugivores Sternodermatinae in a different cluster than bats with insectivorous diets, as Carollia spp. and Anoura spp.

Diversidad de mamíferos en el bosque montano de Carpish, Huánuco, Perú / Mammalian diversity of Carpish montane forest, Huánuco, Peru

A pesar de la alta diversidad de mamíferos conocidos para el Perú, son pocos los estudios en las yungas centrales, lo que no permite un adecuado conocimiento de su diversidad. Aquí se da a conocer los resultados de una evaluación de la diversidad de mamíferos de Carpish, Huánuco, un bosque montano en estado crítico de conservación. El estudio se realizó entre 2001 y 2002 con cinco expediciones en las localidades de Carpish de Mayobamba (2730 - 3080 m) y San Pedro de Carpish (1780 - 2400 m). Se emplearon métodos de captura, avistamientos y entrevistas, los que representan un esfuerzo de 28500 trampas noche y 190 redes noche. Registramos 35 especies de mamíferos en el área de estudio. Los órdenes más diversos fueron los murciélagos y roedores (74.3 %), estos incluyen cuatro especies endémicas para el país, cuatro especies en alguna categoría de conservación y el primer registro de la marmosita grácil Gracilinanus aceramarcae para Huánuco. La riqueza y los índices de diversidad (H' y Simpson) para roedores no muestran correlación significativa con respecto a la elevación. El roedor Thomasomys ischyrus y el murciélago Anoura aequatoris fueron las especies con mayor abundancia relativa. Nuestros registros, más los de la literatura y la revisión de colecciones científicas, sustentan la ocurrencia de 45 especies de mamíferos en el bosque de Carpish. Esta riqueza de especies, los endemismos y la acelerada pérdida de bosque son base para recomendar el establecimiento de un área de conservación que garantice la protección de los bosques montanos de Carpish.

Despite the high diversity of the well-known mammals of Peru, there are few studies in the central yungas, which does not allow an adequate knowledge of their diversity. Here we present the results of an evaluation of mammal diversity of Carpish, Huanuco, a montane forest in a critical state of conservation. The study was carried out between 2001 and 2002 with five expeditions in the localities of Carpish de Mayobamba (2730 - 3080 m) and San Pedro de Carpish (1780 - 2400 m). We used capture methods, sightings and interviews, which represent an effort of 28 500 trap-nights and 190 net-nights. We recorded 35 species of mammals in the study area. The most diverse orders were bats and rodents (74.3%); these include four endemic species for the country, four species in some conservation category and the first record of the gracile opossum Gracilinanus aceramarcae for Huánuco. Species richness and diversity index (H' and Simpson) for rodents show no significant correlation with respect to elevation. The rodent Thomasomys ischyrus and the bat Anoura aequatoris were the species with the highest relative abundance. Our records, plus those from literature and review of scientific collections, support the occurrence of 45 mammal species in the Carpish forest. This species richness, endemism and the accelerated forest loss are the basis for recommending the establishment of a conservation area that guarantees the protection of the Carpish's montane forests.

Identifying barriers and finding solutions to implement best practices for cancer surgery at Maputo Central Hospital, Mozambique.

PURPOSE: The aim of this study was to assess the surgical resources and surgical oncology team skills at the Surgical Department of Maputo Central Hospital (MCH) in Mozambique in order to define an educational program to support surgical oncology practice. METHODS: From January 2017 to December 2017, a general evaluation of the resources of MCH was carried out, as well as its offerings in oncological care in different services. Data were obtained by reviewing documents, visiting surgical services and interviewing key-informants and others informally. In addition, a group of seven surgeons of the Surgical Department of MCH answered a questionnaire about the quality of the cancer units (The Cancer Units Assessment Checklist for low- or middle-income African countries). Subsequently, surgical, anaesthesiology and intensive care facilities were evaluated according to the Portuguese-speaking African Countries Assessment of Surgical Oncology Capacity Survey (PSAC-Surgery). All the data were triangulated in order to identify gaps, develop an action plan and define an educational program. RESULTS: Breast, oesophagus and colorectal cancers were the most commonly treated neoplasms in MCH. A range of technical and resource needs as well as the gaps in knowledge and skills were identified. All surgeons recognised the need to create a training program in oncology at the undergraduate level, specific training for residents and continuing oncological education for general surgeons to improve the practice of surgical oncology. It was evident that all these interventions needed to be formalised, appropriately certified and count for professional career progression. Based on the local epidemiological data and on these study findings, oncology education programs were developed for surgeons. CONCLUSIONS: The findings of this study contributed to the development of an educational program in surgical oncology, considered essential to the training of surgeons at MCH. The cancer educational programs and the mobilisation of adequate resources will ensure the provision of adequate surgical oncology treatments for MCH. The training requirements should be tailored to suit the local needs based on the most prevalent malignancies diagnosed in the region. In our view, this methodology may apply to other countries with similar realities in the formation of surgical oncologists.