Two New Species of Pristimantis (Anura: Strabomantidae) from Amazonas Department in Northeastern Peru

We describe two new species of terrestrial-breeding frogs in the genus Pristimantis from the Andes of northeastern Peru, Amazonas Department. Both species share several characters with other congeners from northern Peru, such as the presence of prominent conical tubercles on their eyelids and heel, prominent conical tubercles along the outer edge of the tarsus, and discs on fingers and toes widely expanded. However, both species can be diagnosed from morphologically similar Pristimantis in the region. Pristimantis kiruhampatu has axillae, groins, and hidden surfaces of hindlimbs that are cherry with white minute flecks, tympanic membrane and tympanic annulus evident, conical tubercles along the edge of snout and outer edge of tibia, and \/ shaped folds in the scapular region. Pristimantis paulpittmani has yellow or dirty cream groins and hidden surfaces of hindlimbs, whitish cream irises with scattered dark brown reticulations, and a thin vertical dark brown streak at the middle of the eye, snout subacuminate with a conical tubercle at the tip, and lacks a tympanic annulus and membrane. Additionally, we provide a short description of the advertisement call of P. kiruhampatu.

Analysis of the Different Lymphatic Drainage Patterns during Sentinel Lymph Node Biopsy for Skin Melanoma

In the last two decades, studies of lymphoscintigraphy imaging in lymphatic mapping reported an extreme heterogeneity of skin lymphatic drainage of some skin area, in contrast with the previous scientific literature. The aim of this study was to investigate the presence of any correlations between the topographical location of cutaneous melanoma and the topographical location of sentinel lymph nodes. Data from 165 patients undergoing sentinel lymph node biopsy between January 2013 and May 2021 were analyzed, demonstrating that melanomas in the Lumbar region presented a significant more heterogeneous drainage by site than those in the Scapular region (p < 0.01) and that melanomas in the Subscapular region were significantly more heterogeneous by laterality (unilateral vs. bilateral) than those in the Scapular region (p < 0.05). Results of this study supported the evidence of multiple lymphatic drainage as regards the sentinel node biopsy performed in skin melanoma located on the dorsal subscapular region and lumbar region. For this reason, the association of preoperative lymphoscintigraphy with another imaging evaluation is needed in these critical cutaneous areas. Recent technical developments enabling fluorescence lymphography together with indocyanine green have significantly improved the visualization of lymphatic drainage patterns at a microscopic level. In the preoperative phase, any doubt can be resolved by associating the SPET-CT scan to lymphoscintigraphy, while during the intraoperative phase, an additional evaluation with indocyanine green can be performed in doubtful cases. The aim of the duplex lymphatic mapping (pre and/or intraoperative) is an accurate search of sentinel nodes, in order to reduce the rate of false negatives.

The use of a “chimeric” autotissue complex from the subscapularis vascular basin for maxillary reconstruction after malignant tumors resection

The objective of this work – to evaluate the results of reconstructive interventions using free revascularized tissue complexes of the scapular region in patients after maxillary resection for malignant tumors. Materials and methods. Between 2014–2020 the post-resection maxillary defects were replaced with free blood-sup plied flaps of the scapular region in 19 patients. In Group 1 (n = 10), the defect was eliminated after total maxillectomy with preservation of the eyeball using a “chimeric” tissue complex, parts of which were positioned in several planes. In Group 2 (n = 9), total and subtotal defects of the hard palate and alveolar process were replaced using a free flap with the inclusion of the scapula angle, which was placed horizontally. The functional and aesthetic results of the reconstructions, the degree of morphological correspondence of the reconstructed structures, as well as the incidence of postoperative complications were assessed. Results. In Group 1 total necrosis of the flap was noted in 2 cases (20 %), in 1 (10 %) case – necrosis of the skin fragment). In Group 2 graft necrosis was observed in 1 (11 %) patient. Satisfactory and excellent aesthetic and functional results were achieved in 6 (60 %) patients in Group 1 and 8 (89 %) patients in Group 2. Conclusion. The scapular flap has a number of advantages for microsurgical reconstruction, including the presence of a long vascular pedicle with large vessels, inclusion of different tissues, possibility of harvesting a “chimeric” version (with significant mobility of parts), low rate of vascular lesions in the area, and most importantly, morphologically close location of bone tissue of the scapula to the maxilla, which ensures successful application of this flap for maxillary repair in patients with advanced cancer of the upper jaw.

The Flap Based on the Subscapular Artery: A Cross-sectional Study

Background: The lateral thoracic-lumbar-scapular region is an ideal source to supply flaps. The study towards improving the method of taking flaps towards conserving a part of the muscle needs to clarify the ratio of branching forms of the arteries in the muscle. Objectives: This study was done to describe the typical anatomy, the anatomical and size variations of subscapular and circumflex scapular vessels, the branching and distribution of vascular pedicle supplying latissimus dorsi muscle flap, and serratus anterior muscle flap of circumflex scapular vessels. Methods: We conducted a cross-sectional study on 24 corpses of adults of both genders. The flap vessels were revealed through two stages of surgery, including the axillary region and the lumbar-scapular region. We classified the collected information and recognized typical and transformed forms based on statistical data. Results: The subscapular artery was separated by the axillary artery, the general origin of the circumflex scapular artery, and the thoracodorsal artery. Subscapular vessels were found in 40/42 cases, accounting for 95.2%, and the length and diameter were 3.04 ± 0.51 cm and 2.85 ± 0.46mm, respectively. The circumflex scapular artery, which had originated from the subscapular artery, was found in 40/42 cases. It also showed origin from subscapular artery with 2/42 cases. The length of the circumflex scapular artery was 3.14 ± 0.70 cm, and its diameter was 2.46 ± 0.48 mm. Terminal branches of the circumflex scapular artery were very variable. Almost all branching forms of the artery in the latissimus dorsi muscle were external branches, but they might be present or not in internal and recurrent branches. Conclusions: The vascular pedicle’s distribution, size, and presence were influenced by the subscapular artery supply flaps. Due to the diverse blood supply from the flaps’ vessels, the surgeon can use the flaps based on the subscapular artery in many forms. These flaps could be used as a seamless vascular flap or a free flap in orthopedic surgery.

Effect of Strumming Manipulation in Pain Parameters in Myofascial Pain Syndrome of the Para-scapular Region in Males of the Age Group of 20-30 Years

Background: Treatment of myofascial trigger points can be considered a promising approach for the treatment of patients with myofascial pain syndrome. It would be worthwhile to identify predictors/means of successful myofascial trigger point treatment and to investigate whether the treatment is more successful when used alone or combined such as electrotherapy, thermotherapy and manual therapy. Previous studies have examined the effect of single ischemic compression and a combination of ischemic compression and stretching and concluded that both interventions had positive effects on patients' recovery. However the effects of single component of deep tissue massage such as a brief strummimg manipulation in pain parameters is not understood completely in clinical decision making. Objective: To study the effects of brief strumming manipulation in pain parameters in myofascial pain of the para-scapular region in males of the age group of 20-30 years. Materials and Methods: Experimental study design with 25 male participants were recruited on the basis of inclusion and exclusion criteria for the study, active trigger point either over the rhomboid or levator scapulae was identified and marked as per diagnostic criteria described by Simon DG (1999 and 2002). Baseline readings for VAS and PPT were recorded on day one before the intervention and final readings were taken 10 minutes after the sixth session (3 days a week on alternate day basis for two weeks). Each treatment session of strumming manipulation was for 2 - 3 minutes followed by a rest period of 2 - 3 minutes and repeated 3 times (total duration of the session was for 12 - 15 minutes) followed by 10 - 15 minutes of Ice compression over the manipulated area. Subjects were instructed to continue ice compression at home 2 - 3 times a day for 10 - 15 minutes each session during the non-interventional days and not to carry out any unaccustomed work like lifting heavy things, straining activities of upper limb during study period. Data collected as pre and post intervention values are analysed statistically. Result: The Pre-VAS mean of 6.88±0.78 and the Post-VAS mean of 2.44±1.29 and the paired t-test mean difference of 4.44±1.15 with t (24) =19.17 with pre and post statistical significance of p=0.000. The Pre-PPT mean of 2.79±1.13 and the Post-PPT mean of 4.98±1.22 and the paired t-test mean difference of -2.18±1.30 with t (24) = -8.39 with pre and post statistical significance of p=0.000. Conclusion: Strumming manipulation followed by ice compression is efficacious in reducing pain and muscle tenderness in male patients with para-scapular region with active MTrPs. Its immediate and short-term effects established in this combination may serve as a prime treatment plan in the clinical setting to counteract pain and muscle tenderness due to active MTrPs. Key words: myofascial pain syndrome; trigger points; manipulation; massage; visual analog pain scale; pain threshold.

On the issue of interscapular-thoracic amputation in malignant neoplasms of the shoulder-scapular region

In view of the fact that the question of the use of one or another type of surgical intervention for malignant neoplasms of the shoulder of the scapular region has not yet been fully clarified (which is partly overtaken by the comparative rarity of this disease), and that each insufficiently radical operation leads in these cases to a serious outcome, while on the contrary, a timely radical operation gives good results, surgeons are forced to report the corresponding individual cases, so that in the future, on the basis of statistical data, they can build correct conclusions.

Effect of the Inoculation Site of Bovine and Avian Purified Protein Derivatives (PPDs) on the Performance of the Intradermal Tuberculin Test in Goats From Tuberculosis-Free and Infected Herds

The single and comparative intradermal tuberculin (SIT and CIT) tests are used for the ante-mortem diagnosis of caprine tuberculosis (TB). The tuberculin injection site has been associated with a different performance of the test in cattle. In contrast to that required in cattle in Europe (cervical injection), it can be carried out in the scapular region in goats. Nevertheless, there are no previous data concerning the effect of the injection site on the performance of the test in goats. The aim of the present study was to evaluate the effect of two different inoculation sites (cervical and scapular) on the performance of the SIT/CIT tests. This was done by intradermally inoculating 309 goats from two infected herds and one TB-free herd with both avian and bovine PPDs in the mid-cervical and scapular regions. None of the animals from the TB-free herd had positive reactions, and the number of reactors was not significantly higher, regardless of the inoculation site, in the high and low prevalence herds. However, significantly higher increases in skin fold thickness were observed on the cervical site when compared to the scapular site after the avian and bovine PPD inoculations in the TB-free herd (p &lt; 0.001) and after the bovine PPD injection in the high prevalence herd (p = 0.003). The presence of clinical signs was also more evident on the cervical site when using avian and bovine PPDs in the high prevalence herd (p &lt; 0.01). In contrast, increases in higher skin fold thickness were observed on the scapular site when compared to the cervical site after the bovine and avian PPD inoculations were employed in the low prevalence herd (p &lt; 0.01). These results suggest that the cervical injection of PPDs may improve the sensitivity of the intradermal tuberculin test in high TB prevalence caprine herds, mainly owing to the increased presence of local clinical signs and a better performance of the CIT test. Moreover, specificity was not affected when using standard interpretations, although further analyses in a great number of herds are required in order to confirm these findings.

Skin Strain Analysis of the Scapular Region and Wearables Design

Monitoring scapular movements is of relevance in the contexts of rehabilitation and clinical research. Among many technologies, wearable systems instrumented by strain sensors are emerging in these applications. An open challenge for the design of these systems is the optimal positioning of the sensing elements, since their response is related to the strain of the underlying substrates. This study aimed to provide a method to analyze the human skin strain of the scapular region. Experiments were conducted on five healthy volunteers to assess the skin strain during upper limb movements in the frontal, sagittal, and scapular planes at different degrees of elevation. A 6 × 5 grid of passive markers was placed posteriorly to cover the entire anatomic region of interest. Results showed that the maximum strain values, in percentage, were 28.26%, and 52.95%, 60.12% and 60.87%, 40.89%, and 48.20%, for elevation up to 90° and maximum elevation in the frontal, sagittal, and scapular planes, respectively. In all cases, the maximum extension is referred to the pair of markers placed horizontally near the axillary fold. Accordingly, this study suggests interesting insights for designing and positioning textile-based strain sensors in wearable systems for scapular movements monitoring.