Female reproductive energetics in mantled howler monkeys (Alouatta palliata): A follow-up study.

OBJECTIVE: Reproduction entails several challenges to primate females, among which energetic costs are remarkable at certain stages of the reproductive cycle. Still, females may use behavioral and physiological strategies to cope with those challenges. We had previously reported covariation between female energetic condition through the reproductive cycle and time-budget adjustments in mantled howler monkeys (Alouatta palliata). Accordingly, we suggested that behavioral flexibility allowed coping with the energetic challenges of reproduction. Subsequent evidence from the same population, however, suggested otherwise, so we performed a follow-up study on the variation in female reproductive energetics based on a larger sample of females. METHODS: We studied 48 free-ranging adult females at Los Tuxtlas (Mexico). We assessed energy balance via urinary C-peptide concentrations (2717 urine samples), behavioral energy intake and expenditure (5728 sampling hours), and physiological energy expenditure via fecal triiodothyronine metabolites (fTH3; 3138 fecal samples). RESULTS: We found that energy balance varied among reproductive states: (a) cycling was a period of low C-peptide concentrations; (b) the highest C-peptide concentrations occurred during gestation; and (c) the beginning of lactation marked a notable decrease in C-peptide concentrations, which then improved at mid-lactation to again decline at lactation offset. These peaks and valleys in energy balance did not seem to be associated with variation in energy acquisition but were rather mirrored by activity levels and fTH3 during lactation. DISCUSSION: Energy balance was not preserved through the reproductive cycle, supporting previous contentions that the reproductive performance of female mantled howler monkeys may be energetically constrained. The contrast between these and results that we have previously reported, highlights the importance of conducting follow-up studies to continually improve our understanding of the reproductive energetics of primate females.

Vocal and movement responses of mantled howler monkeys (Alouatta palliata) to natural loud calls from neighbors.

Loud calls (i.e., long-range acoustic signals) regulate resource competition among neighboring groups of conspecifics in several nonhuman primate species. Ultimate explanations for primate loud calls include mate, offspring, and food defense. Additionally, loud calls may provide valuable information pertaining to the identity and health status of callers, their competitive abilities, and their spatial location. The loud calls of howler monkeys (Alouatta) have been thoroughly studied and seem to play an important function in the defense of valuable resources in a variety of socioecological contexts. Here, we examined whether the behavioral responses of mantled howler monkeys (Alouatta palliata) to natural loud calls from neighbors are linked to three factors: food availability, familiarity, and distance between groups. We studied three groups of mantled howler monkeys at La Flor de Catemaco (Los Tuxtlas, Mexico) for 15 months (1817 observation hours), during which we recorded 236 neighbor loud calls. Food availability per se did not influence the behavior of groups receiving loud calls, although males produced longer vocal responses toward unfamiliar neighbors when food availability decreased. Groups vocalized quicker and both vocalized and moved for longer after loud calls from unfamiliar neighbors. Additionally, groups vocalized and moved for longer at shorter distances from unfamiliar neighbors compared with familiar neighbors. Finally, groups usually moved away from calling neighbors that were closer. These results indicate that the behavioral responses of mantled howler monkeys to loud calls from neighbor groups are associated with the integration of information pertaining to caller identity as well as to their ecological and spatial context.

Elite professional goalkeepers report high rate of sport resumption after shoulder surgery.

PURPOSE: The aim of this study is to evaluate the return to sport after surgical treatment of shoulder injuries in professional goalkeepers in relationship with the mechanism of injury and the pattern of related shoulder lesions. METHODS: Twenty-six shoulders in nineteen elite male professional soccer goalkeepers were retrospectively analyzed considering multiple diseases (instability, rotator cuff, biceps or other tendon injuries). Data was collected for injury modality and context, pathological findings, surgical procedures, time, level of return to sport, and complications. RESULTS: The mechanism of injury was "mild trauma without contact" in 46% of the cases and 54% of injuries happened during training. 11 patients (42%) reported multiple pattern lesions and 9 patients (35%) classic anterior instability lesions. The mean time for return to differentiated training and unrestricted sport activity was 14 and 20.2 weeks, respectively. 15 athletes (62.5%) reported 100% return to sport, 4 (16.7%) to 90%, 1 (4.2%) to 85%, 3 (12.5%) to 80% and 1 athlete to 50%, stopping professional activity. 21% of the cases reported the persistence of some shoulder symptoms. 3 cases experienced a new injury. Patients with classic anterior instability had significantly lower age (30.7 vs 19.8 years, P = 0.001), experienced injury in different context and reported symptoms more frequently compared to multiple lesion patients (4/8 vs 0/10, P = 0.011). CONCLUSION: Professional elite goalkeepers which required shoulder surgery for different causes demonstrated high-rate level of return to play despite the persistence of mild symptoms. The high frequency of multiple lesions, patients' characteristics, injury context and mechanism, increase the concern for injuries in overstressed shoulder for this category of sport. LEVEL OF EVIDENCE: IV.

Sex differences in leadership during group movement in mantled howler monkeys (Alouatta palliata).

Benefits of group life depend in large part on whether animals remain cohesive, which often requires collective decisions about where and when to move. During a group movement, the leader may be considered as the individual occupying the vanguard position of the group progression, when its movement evokes following by other group members. In nondespotic societies, individuals with greater incentives to move frequently are leaders. During 15 months of observations (1,712 contact hours), we investigated two mantled howler monkey (Alouatta palliata) groups at La Flor de Catemaco (Los Tuxtlas, Mexico) to examine whether sex and female reproductive state influenced leadership likelihood in two contexts: movements toward feeding trees; movements associated with loud calls, a group-defense behavior used by males of this genus. Females led and occupied forward positions during group movements toward feeding trees more often than adult males. Adult females led these movements more frequently when they were gestating than when they were lactating or cycling. There were no differences between sexes in the leadership of group movements associated with loud calls. Leadership by gestating females is perhaps the result of their higher nutritional/energetic needs when compared with cycling females, and of their greater mobility when compared with lactating females carrying dependent offspring. Female leadership during movements toward feeding trees may be a mechanism to optimize access to food resources in mantled howler monkeys.

Open capsular and ligament reconstruction with semitendinosus hamstring autograft successfully controls superior and posterior translation for type V acromioclavicular joint dislocation.

PURPOSE: Appropriate surgical management for type V complete acromioclavicular (AC) joint dislocation remains controversial. The purpose of this paper is to retrospectively report the clinical and radiographic outcomes of an open surgical technique consisting for AC joint ligamentous and capsular reconstruction using autologous hamstring tendon grafts and semi-permanent sutures. METHODS: Between January 2005 and December 2011, 32 consecutive patients with symptomatic type V complete AC joint dislocation underwent surgical treatment using the same technique. The median time from injury to surgery was 45 days (range 24-90). The average median postoperative clinical and radiographic follow-up time was 30 months (range 24-33). Clinical outcomes measures included the ASES score, the visual analog score (VAS), and subjective patient satisfaction score. Minimum follow-up was 2 years. RESULTS: ASES score increased from a median of 38.2 ± 6.2 preoperative to 92.1 ± 4.7 postoperatively (p ≤ 0.05). The median VAS score improved from 62 mm (range 45-100 mm) preoperatively to 8 mm (range 0-20 mm) at final follow-up (p ≤ 0.05). No patient experienced pain or discomfort with either direct palpation of the AC joint or with cross-body adduction. Final radiographs demonstrated symmetric AC joint contour in 25/32 (78%) patients. Seven patients (22%) radiographically demonstrated superior translation of the distal clavicle relative to the superior margin of the acromion but less than 50% of the clavicular width. 30/32 patients (93%) were able to return to their pre-injury level of work and sports activities. CONCLUSIONS: This novel surgical technique using a free graft and braided suture for simultaneous coracoclavicular ligament and AC joint capsular reconstruction successfully controls superior and posterior translations after type V AC joint dislocation and minimizes the incidence of persistent postoperative AC joint subluxation. LEVEL OF EVIDENCE: Retrospective case series, Level IV.

Variations of the intra-articular portion of the long head of the biceps tendon: a classification of embryologically explained variations.

BACKGROUND: Although the intra-articular portion of the long head of the biceps (LHB) usually runs free, different types of fusions with the inferior surface of the capsule are known to be possible. Anatomic variations of this part of the LHB have been previously described and were nearly always considered to be innocent. MATERIALS AND METHODS: Out of 2 populations of 1500 arthroscopies each, we collected prospectively and retrospectively all possible variations of the proximal portion of the LHB. RESULTS: We included 57 cases (1.91%) of this total population in an attempt to describe the complete range of these form variants: the simple vinculum or pulley-like sling, the partial or complete mesotenon between biceps and capsule, the complete adherent LHB, the double-tendon origin, the reversed-type split-tendon, and the complete absence of the LHB. We suggest a classification of 12 variations of the intra-articular portion of the LHB. DISCUSSION: By taking into account an extensive literature review, we suggest that these conditions are congenital and consider them as a result of partial detachment from the mesothelial or synovial fusion with the inferior surface of the capsule. The incidence of these variants and their associated pathologies are investigated. CONCLUSION: By offering this new classification and a physiopathologic hypothesis, we try to explain why some of these anatomic variants may also acquire a pathologic significance.

Health-related quality of life and subjective outcome after shoulder replacement for proximal humeral fractures.

Shoulder replacement has increased exponentially in recent decades, and previous studies have documented the effectiveness of this procedure. Pain relief, physical functional level, and health-related quality of life, however, were often not assessed. To our knowledge, no published articles have assessed quality of life in shoulder replacement for fracture. The main purpose of this study was to assess the patient-relevant outcomes in patients who underwent shoulder replacement for proximal humeral fractures. Standardized quality of life and shoulder-specific, self-administered questionnaires were used. On the Medical Outcomes Study Short Form 36 Health Survey, as expected, we observed a lower score in the domain compared with healthy Italian subjects. A surprising finding was that in the General Health and Role-Emotional domains, our sample had a better picture than the healthy one, probably because patients had experienced severe trauma and major surgery previously. These data represent the first step toward the definition of outcome for this procedure. This study does not address the necessity of therapy, but if this were included in future publications, it might provide useful data for therapeutic recommendations.

Italian version of the International Knee Documentation Committee Subjective Knee Form: cross-cultural adaptation and validation.

PURPOSE: Patient-oriented measures, represented by self-administered questionnaires, have become an important aspect of clinical outcome assessment. To be used with different language groups and in different countries, questionnaires must be translated and adapted to new cultural characteristics, and then validated by a widely accepted process to evaluate reliability and validity, fundamental characteristics for each measure. The aim of the study was to perform the cross-cultural adaptation and to assess the reliability and validity of the Italian version of the International Knee Documentation Committee (IKDC) Subjective Knee Form. TYPE OF STUDY: A cross-cultural adaptation and cross-sectional study of a sample of patients undergoing anterior cruciate ligament (ACL) reconstruction with a subsample followed up prospectively for retest reliability. METHODS: The IKDC Subjective Knee Form was culturally adapted for Italian-speaking people, following the simplified Guillemin criteria. Reliability and validity were assessed in a cross-sectional study of 50 consecutive patients undergoing ACL reconstruction. A subsample of 20 patients was followed up prospectively for retest reliability. RESULTS: The results were compared with other validated patient-oriented measures. The principal IKDC scale showed a high correlation with other patient-oriented measures as hypothesized, and it also showed good values with regard to reproducibility, consistency, and validity, compared with the versions of IKDC published in other languages. CONCLUSIONS: These findings suggest that the evaluation capacities of the IKDC Italian version are equivalent to those of other language versions of the IKDC. LEVEL OF EVIDENCE: Level II.