Transmission of Guanarito and Pirital viruses among wild rodents, Venezuela.

Samples from rodents captured on a farm in Venezuela in February 1997 were tested for arenavirus, antibody against Guanarito virus (GTOV), and antibody against Pirital virus (PIRV). Thirty-one (48.4%) of 64 short-tailed cane mice (Zygodontomys brevicauda) were infected with GTOV, 1 Alston's cotton rat (Sigmodon alstoni) was infected with GTOV, and 36 (64.3%) of 56 other Alston's cotton rats were infected with PIRV. The results of analyses of field and laboratory data suggested that horizontal transmission is the dominant mode of GTOV transmission in Z. brevicauda mice and that vertical transmission is an important mode of PIRV transmission in S. alstoni rats. The results also suggested that bodily secretions and excretions from most GTOV-infected short-tailed cane mice and most PIRV-infected Alston's cotton rats may transmit the viruses to humans.

The delicate pygmy rice rat (Oligoryzomys delicatus) is the principal host of Maporal virus (family Bunyaviridae, genus Hantavirus).

Choclo virus (CHOV) and Maporal virus (MAPV) are enzootic in Panama and western Venezuela, respectively. The results of previous studies suggested that the fulvous pygmy rice rat (Oligoryzomys fulvescens) is the principal host of both viruses. The results of an analysis of nucleotide sequence data in this study indicated that the rodent associated with CHOV is the Costa Rican pygmy rice rat (Oligoryzomys costaricensis) and that the rodent associated with MAPV is the delicate pygmy rice rat (Oligoryzomys delicatus). As such, MAPV is ecologically distinct from CHOV and should be considered a species separate from CHOV.

Natural host relationships of hantaviruses native to western Venezuela.

Strains of Caño Delgadito virus (CADV) and Maporal virus (MAPV) were isolated from 25 (8.9%) of the 280 rodents captured on farms in 1997 in western Venezuela. The results of analyses of laboratory and zoographic data indicated that Alston's cotton rat (Sigmodon alstoni) is the principal host of CADV, horizontal virus transmission is the dominant mode of CADV transmission in Alston's cotton rat in nature, a pygmy rice rat (Oligoryzomys sp.) is the principal host of MAPV, and the natural host relationships of CADV and MAPV are highly specific.

[Randomised study of the use resorbable mesh for the prevention of evisceration in colorectal surgery]. / Estudio aleatorizado sobre la utilización de mallas reabsorbibles para la prevención de la evisceración en la cirugía colorrectal.

INTRODUCTION: Evisceration is a complication that causes high morbidity and mortality, and its incidence in colorectal surgery varies between 2% and 3.5%. We evaluated the results of the use of resorbable meshes in the primary closure of laparotomies, with the purpose of preventing evisceration in colorectal surgery. PATIENTS AND METHOD: One hundred and forty three patients were included (63 females/80 males) and divided in two groups: simple closed laparotomy (Group A) (72 patients) and closed with polyglycolic mesh (Group B) (73 patients), mean age 64 years (range 24-93). We evaluated: general and previous clinical data, as well as evisceration, infection, seroma and other acute complications after the surgery. RESULTS: There were no differences between group distribution by general performances, associated pathology, clinical state and primary diagnosis. Most of Group B had programmed surgery (p = 0.045); mesh was used in 4 of 5 patients with faecal peritonitis, as expected drainage requirements were significant in Group B was needed significantly needed use drainages (Group A, 2.8%; Group B, 97.2%; p < 0.0005) and subsequent FNA after their withdrawal (p < 0.05). Overall incidence of evisceration was 3.5%, with Group A 5.6% and Group B 1.4%, with no significant differences. There were no differences in wounded infection. CONCLUSIONS: This study has not been able to demonstrate that primary closure with mesh in these patients prevents evisceration, due to small sample size, and having a high incidence of seromas. Until further studies are carried out, its use should be reserved for selected cases, as it can be used in the presence of pus or faeces.

Estudio aleatorizado sobre la utilización de mallas reabsorbibles para la prevención de la evisceración en la cirugía colorrectal / Randomised study of the use resorbable mesh for the prevention of evisceration in colorectal surgery

Introducción. La evisceración es una complicación que causa una elevada morbimortalidad, y cuya incidencia en la cirugía colorrectal oscila entre el 2 y el 3,5%. Evaluamos los resultados de la utilización de mallas reabsorbibles para la prevención de la evisceración en la cirugía colorrectal. Pacientes y método. Se incluyó a 143 pacientes (63 mujeres/80 varones) divididos en dos grupos: cierre en un plano (grupo A) (72 pacientes) y cierre con malla de ácido poliglucólico (grupo B) (73 pacientes). Media de edad de 64 (24-93) años. Valoramos: datos generales y clínicos previos, así como evisceración aguda, infección de la herida, seromas y otras complicaciones precoces tras la cirugía. Resultados. Los dos grupos no presentan diferencias respecto a: datos generales, afecciones concomitantes, estado clínico, diagnóstico primario. La mayoría del grupo B tuvo una cirugía programada (p = 0,045); en 4 de 5 pacientes con peritonitis fecaloidea se utilizó malla, como es lógico el grupo B necesitó significativamente la utilización de drenajes (grupo A, 2,8%; grupo B, 97,2%; p < 0,0005) y posteriores PAAF tras su retirada (p < 0,05). La evisceración total fue del 3,5%; en el grupo A, del 5,6% y en el grupo B, del 1,4%, sin diferencias significativas. No hubo diferencias en infección de la herida. Conclusiones. Este estudio no ha podido demostrar que el cierre primario con malla en estos pacientes prevenga la evisceración, debido probablemente a la falta de un adecuado tamaño muestral, y con una alta incidencia de seromas. Hasta que no se realicen nuevos estudios, su uso debiera estar reservado a casos seleccionados; incluso se puede emplear cuando hay pus o heces (AU)

Introduction. Evisceration is a complication that causes high morbidity and mortality, and its incidence in colorectal surgery varies between 2% and 3.5%. We evaluated the results of the use of resorbable meshes in the primary closure of laparotomies, with the purpose of preventing evisceration in colorectal surgery. Patients and method. One hundred and forty three patients were included (63 females/80 males) and divided in two groups: simple closed laparotomy (Group A) (72 patients) and closed with polyglycolic mesh (Group B) (73 patients), mean age 64 years (range 24-93). We evaluated: general and previous clinical data, as well as evisceration, infection, seroma and other acute complications after the surgery. Results. There were no differences between group distribution by general performances, associated pathology, clinical state and primary diagnosis. Most of Group B had programmed surgery (p = 0.045); mesh was used in 4 of 5 patients with faecal peritonitis, as expected drainage requirements were significant in Group B was needed significantly needed use drainages (Group A, 2.8%; Group B, 97.2%; p < 0.0005) and subsequent FNA after their withdrawal (p < 0.05). Overall incidence of evisceration was 3.5%, with Group A 5.6% and Group B 1.4%, with no significant differences. There were no differences in wounded infection. Conclusions. This study has not been able to demonstrate that primary closure with mesh in these patients prevents evisceration, due to small sample size, and having a high incidence of seromas. Until further studies are carried out, its use should be reserved for selected cases, as it can be used in the presence of pus or faeces (AU)

Referencias de hábitat de Sigmodon alstoni y Zygodontomys brevicauda (Rodentia, Cricetidae) en agroecosistemas de los Llanos de Venezuela / Habitat preferences of Sigmodon alstoni and Zygodontomys brevicauda (Rodentia, Cricetidae) in agroecosystems of the Venezuelan Plains

Se estudiaron las preferencias de hábitat de Sigmodon alstoni y Zygodontomys brevicauda en agroecosistemas de los llanos venezolanos. Se realizó un esfuerzo de muestreo correspondiente a 37748 trampas Sherman. Se capturaron 1624 especímenes de S. alstoni y 1398 de Z. brevicauda. Se determinó que poseen preferencias de hábitat similares. Los cultivos mecanizados, principalmente sorgo y maíz, y los pastizales, constituyeron los hábitat más importantes. Al considerar el eje temporal, se detectó que S. alstoni está más asociado y utiliza con mayor homogeneidad los cultivos mecanizados, seguido en orden de importancia por pastizales y vegetación herbácea. En cuanto a Z. brevicauda, los cultivos mecanizados son primordiales y utiliza los pastizales con menor regularidad, pero mayor homogeneidad. Se asocia intensamente a la vegetación herbácea en breves lapsos de tiempo. Debido a que son vectores de la fiebre hemorrágica venezolana y probablemente otras enfermedades, es necesario monitorear la abundancia poblacional de estos roedores, con el objeto de aplicar medidas de control. De acuerdo con los resultados obtenidos, las estrategias deben estar dirigidas hacia el manejo del hábitat y de las comunidades humanas, sustentadas en programas de educación ambiental, formal e informal, con el fin de disminuir y evitar el contacto del hombre con el roedor.

[Laparoscopic treatment of ventral hernia under spinal anesthesia]. / Tratamiento laparoscópico de la hernia ventral con anestesia intradural.

INTRODUCTION: Laparoscopic surgery is usually performed with the patient under general anesthesia. In open surgery, regional anesthesia has been found to have fewer adverse effects than general anesthesia. We studied whether spinal anesthesia is feasible in laparoscopic ventral hernia repair. PATIENTS AND METHOD: Bupivacaine and fentanyl were administered to obtain T2 block; midazolam was used for sedation. Patients underwent laparoscopic intraperitoneal hernia repair using an ePTFE prosthesis fixed with a double crown technique. An intra-abdominal pressure of 12 mmHg and low-flow insufflation (1.5 L/minute) were used for pneumoperitoneum. RESULTS: Nineteen out of 23 patients underwent laparoscopic ventral hernia repair under spinal anesthesia; conversion to open surgery or general anesthesia was required in four patients. Additional sedation successfully relieved pain in patients with abdominal and shoulder discomfort (10.5%). Hypotension occurred in 68% of patients but was easily resolved by fluid administration. CONCLUSIONS: Spinal anesthesia is feasible and well tolerated in laparoscopic hernia repair. Studies comparing spinal and general anesthesia in this field are warranted.

Tratamiento laparoscópico de la hernia ventral con anestesia intradural / Laparoscopic treatment of ventral hernia under spinal anesthesia

Introducción. Tradicionalmente, se ha asociado la cirugía laparoscópica a la anestesia general; mientras que en la cirugía abierta las técnicas de anestesia intradural han demostrado una menor morbilidad. En este estudio proponemos la anestesia intradural para la reparación laparoscópica de la hernia ventral. Pacientes y método. Realizamos un bloqueo intradural a nivel de T con bupivacaína hiperbárica y fentanilo, y se añadió una sedación con midazolam. La reparación de la eventración se realizó por vía laparoscópica con prótesis de PTFEe fijada según técnica de doble corona, y se mantuvo una presión intraabdominal máxima de 12 mmHg insuflando el gas a 1,5 l/min. Resultados. De 23 pacientes se intervino a 19 con anestesia intradural, en 4 fue necesario convertir a cirugía abierta o precisaron anestesia general. Fue necesario profundizar la sedación en pacientes que refirieron molestias derivadas del neumoperitoneo (10,5%). El 68% de los pacientes sufrió episodio de hipotensión que se resolvió aumentando el aporte de volumen. Conclusiones. La anestesia intradural es factible y bien tolerada para la eventroplastia laparoscópica. Serán necesarios más estudios que comparen la anestesia espinal con la general en este campo (AU)

Introduction. Laparoscopic surgery is usually performed with the patient under general anesthesia. In open surgery, regional anesthesia has been found to have fewer adverse effects than general anesthesia. We studied whether spinal anesthesia is feasible in laparoscopic ventral hernia repair. Patients and method. Bupivacaine and fentanyl were administered to obtain T2 block; midazolam was used for sedation. Patients underwent laparoscopic intraperitoneal hernia repair using an ePTFE prosthesis fixed with a double crown technique. An intra-abdominal pressure of 12 mmHg and low-flow insufflation (1.5 L/minute) were used for pneumoperitoneum. Results. Nineteen out of 23 patients underwent laparoscopic ventral hernia repair under spinal anesthesia; conversion to open surgery or general anesthesia was required in four patients. Additional sedation successfully relieved pain in patients with abdominal and shoulder discomfort (10.5%). Hypotension occurred in 68% of patients but was easily resolved by fluid administration. Conclusions. Spinal anesthesia is feasible and well tolerated in laparoscopic hernia repair. Studies comparing spinal and general anesthesia in this field are warranted (AU)

Eventroplastia laparoscópica: abordaje bilateral / Laparoscopic ventral hernioplasty: bilateral approach

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Maporal virus, a hantavirus associated with the fulvous pygmy rice rat (Oligoryzomys fulvescens) in western Venezuela.

Oryzomine rodents in the southeastern United States, Panama, and southern South America are natural hosts of 6 of the 13 viruses known to cause hantavirus pulmonary syndrome. The purpose of this study was to extend our knowledge of the geographical distribution and genetic diversity of the hantaviruses associated with oryzomine rodents in South America. An infectious hantavirus was isolated from two fulvous pygmy rice rats captured in western Venezuela. Analyses of complete nucleocapsid protein and glycoprotein precursor sequences indicated that the isolates are strains of a novel hantavirus (proposed name "Maporal") which is phylogenetically most closely related to the viruses known to cause hantavirus pulmonary syndrome in southern South America.