Hemorragia postoperatoria en histerectomía por patología benigna: Estudio unicéntrico / Postsurgical bleeding in hysterectomy due to benign pathoogy unicentric experience

Introducción: la histerectomía es la intervención quirúrgica más frecuente en el ámbito de la ginecología. Si bien se trata de un procedimiento de bajo riesgo, las infecciones y la hemorragia post-operatoria son sus principales complicaciones. Nuestro objetivo ha sido evaluar la hemorragia post-operatoria en nuestro medio durante la realización de histerectomías por patología benigna. Material y métodos: durante 2 años se ha realizado una recogida prospectiva de todos los casos de histerectomía realizados en contexto de patología benigna en único centro. Realizamos un estudio descriptivo de las características de los pacientes y un análisis univariado de la hemorragia post-operatoria significativa (pérdida de hemoglobina mayor a 2g/dl). Resultados: de un total de 256 histerectomías; 125 (48.8%) han sido totales y 131 (51.2%) subtotales. La edad media de los pacientes era de 49.1 ± 8,7 años y la tasa de hemorragia significativa ha sido del 62.5% (n=160). El único predictor de hemorragia significativa ha sido la cirugía abierta (95 vs 87.5%, p=0,05), sin diferencias significativas en el tipo de histerectomía, la realización de anexectomía concomitante o en el tiempo de cirugía. La necesidad de transfusión ha sido mayor (4.4 vs 0%, p=0.048) pero no la necesidad de reintervención (3.8 vs 5.2%, p=0.752). No se han producido exitus. Conclusión: La hemorragia significativa definida por la pérdida de 2 g/dl de hemoglobina es una complicación frecuente de la histerectomía por patología benigna, siendo uno de sus predictores la vía quirúrgica abierta

Introduction: the hysterectomy is the most frequent surgical procedure in gynecology. It is a low risk procedure, but infections and post-operative bleeding are their main complications. Our aim has been to evaluate the post-operative bleeding in our environment in the context of hysterectomies due to benign pathology. Material and methods: during 2 years we have been prospectively recruiting all of the hysterectomies performed in our centre due to benign pathology. We did a descriptive study of the main features of these patients and a univariate analysis of significant post-operative bleeding (lost of hemoglobin more than 2 g/dl). Results: among 256 hysterectomies, 125 (48.8%) have been total hysterectomies and 131(51.2%) subtotal hysterectomies. Mean age of patients was 49.1 ± 8,7 years old and the rate of significant post-operative bleeding was 62.5% (n=160). The unique predictor of significant bleeding was the open operative surgical procedure (95 vs 87.5%, p=0,05), without significant differences among the type of hysterectomy, the concomitant annexectomy or the surgery duration. Need of transfusion was greater (4.4 vs 0%, p=0.048) but not the need of new intervention (3.8 vs 5.2%, p=0.752). There were no deaths. Conclusion: significant postoperative bleeding defined by the lost of haemoglobin greater than 2g/dl is a frequent complication of hysterectomy in the context of benign pathology, being the open operative surgical procedure one of its predictors

The occurrence of amphibians in bromeliads from a southeastern Brazilian restinga habitat, with special reference to Aparasphenodon brunoi (Anura, Hylidae).

Five species of anuran amphibians, all belonging to the family Hylidae, were collected at Praia das Neves, municipality of President Kennedy, southeastern Brazil. The species were represented by four genera: Scinax, Hyla, Aparasphenodon, and Trachycephalus. Four species (A. brunoi, Hyla albomarginata, Scinax altera, and S. cuspidatus) were found during the dry season (August 1999), and two (A. brunoi and Trachycephalus nigromaculatus) in the rainy season (February 2000). Aparasphenodon brunoi was the most abundant species in Praia das Neves. Some reproductive aspects and feeding habits of this hylid were investigated. Aparasphenodon brunoi was found mainly inside the bromeliad Aechmea lingulata, the largest plant analyzed. Fifteen specimens were collected during the dry season (August 1999) (11 males and 4 females). During the rainy season (February 2000), we collected 14 specimens (3 males, 10 females, and 1 juvenile). Sex-ratio was 1:1. Frogs ranged in snout-vent length from 31.2 to 69.3 mm. Females were larger than males. One female had 1,451 fully developed oocytes in her ovaries. The major groups of prey found in the stomachs were: Insecta, Myriapoda, and Arachnida. Blattodea, Orthoptera, Lepidoptera, and Hymenoptera (only ants) were the main food types in frequency, number, and weight. Aparasphenodon brunoi is a threatened species in many habitats of southeastern Brazil. Only natural vegetation protection may guarantee its survival during the immediate future.

The occurrence of amphibians in bromeliads from a Southeastern Brazilian restinga habitat, with special reference to Aparasphenodon brunoi (Anura, Hylidae)

Five species of anuran amphibians, all belonging to the family Hylidae, were collected at Praia das Neves, municipality of Presidente Kennedy, southeastern Brazil,. The species were represented by four genera: Scinax, Hyla, Aparasphenodon, and Trachycephalus. Four species (A. brunoi, Hyla albomarginata, Scinax altera, and S. cuspidatus) were found during the dry season (August 1999), and two (A. brunoi and Trachycephalus nigromaculatus) in the rainy season (February 2000). Aparasphenodon brunoi was the most abundant species in Praia das Neves. Some reproductive aspects and feeding habits of this hylid were investigated. Aparasphenodon brunoi was found mainly inside the bromeliad Aechmea lingulata, the largest plant analyzed. Fifteen specimens were collected during the dry season (August 1999) (11 males and 4 females). During the rainy season (February 2000), we collected 14 specimens (3 males, 10 females, and 1 juvenile). Sex-ratio was 1:1. Frogs ranged in snout-vent length from 31.2 to 69.3 mm. Females were larger than males. One female had 1,451 fully developed oocytes in her ovaries. The major groups of prey found in the stomachs were: Insecta, Myriapoda, and Arachnida. Blattodea, Orthoptera, Lepidoptera, and Hymenoptera (only ants) were the main food types in frequency, number, and weight. Aparasphenodon brunoi is a threatened species in many habitats of southeastern Brazil. Only natural vegetation protection may guarantee its survival during the immediate future

The occurrence of amphibians in bromeliads from a Southeastern Brazilian restinga habitat, with special reference to Aparasphenodon brunoi (Anura, Hylidae)

Five species of anuran amphibians, all belonging to the family Hylidae, were collected at Praia das Neves, municipality of Presidente Kennedy, southeastern Brazil,. The species were represented by four genera: Scinax, Hyla, Aparasphenodon, and Trachycephalus. Four species (A. brunoi, Hyla albomarginata, Scinax altera, and S. cuspidatus) were found during the dry season (August 1999), and two (A. brunoi and Trachycephalus nigromaculatus) in the rainy season (February 2000). Aparasphenodon brunoi was the most abundant species in Praia das Neves. Some reproductive aspects and feeding habits of this hylid were investigated. Aparasphenodon brunoi was found mainly inside the bromeliad Aechmea lingulata, the largest plant analyzed. Fifteen specimens were collected during the dry season (August 1999) (11 males and 4 females). During the rainy season (February 2000), we collected 14 specimens (3 males, 10 females, and 1 juvenile). Sex-ratio was 1:1. Frogs ranged in snout-vent length from 31.2 to 69.3 mm. Females were larger than males. One female had 1,451 fully developed oocytes in her ovaries. The major groups of prey found in the stomachs were: Insecta, Myriapoda, and Arachnida. Blattodea, Orthoptera, Lepidoptera, and Hymenoptera (only ants) were the main food types in frequency, number, and weight. Aparasphenodon brunoi is a threatened species in many habitats of southeastern Brazil. Only natural vegetation protection may guarantee its survival during the immediate future.

Cinco espécies de anfíbios anuros ocorreram em bromélias localizadas na restinga de Praia das Neves, Município de Presidente Kennedy, Sudeste do Brasil, as quais pertenceram a quatro gêneros: Aparasphenodon, Hyla, Scinax e Trachycephalus. Quatro espécies (A. brunoi, Hyla albomarginata, Scinax altera e S. cuspidatus) foram coletadas durante o período seco (agosto de 1999), mas somente duas (A. brunoi e Trachycephalus nigromaculatus) durante o período de chuva (fevereiro de 2000). Aparasphenodon brunoi foi a espécie mais representada e é um anfíbio anuro que se esconde durante o dia, principalmente dentro da bromélia-tanque Aechmea lingulata. A dieta e alguns aspectos da fecundidade desse hilídeo foram investigados. Quinze exemplares foram coletados durante o período de seca (agosto de 1999) (11 machos e 4 fêmeas) e 14 (3 machos, 10 fêmeas e 1 juvenil) durante o período de chuva (fevereiro de 2000). A razão sexual total macho/fêmea foi de 1:1. Aparasphenodon brunoi variou no comprimento rostro-anal de 31,2 a 69,3 mm. Fêmeas eram maiores do que os machos. Apenas uma fêmea tinha ovários com ovócitos completamente desenvolvidos, em um total de 1.451 ovócitos. Os principais grupos de presas encontrados nos estômagos foram: Insecta, Myriapoda e Arachnida. Blattodea, Orthoptera, Lepidoptera e Hymenoptera (só formigas) representaram as principais presas de A. brunoi, tanto na freqüência de ocorrência quanto no número relativo de presas ingeridas e no peso. Aparasphenodon brunoi é uma espécie ameaçada de extinção em diferentes habitats no Sudeste do Brasil. Somente a proteção da cobertura vegetal de seus ambientes naturais poderá garantir a existência desse hilídeo nos próximos anos.