Search

The state of Aguascaliente’s pre-Hispanic history did not become the subject of systematic studies until recently, in the 21st century. Moreover, despite all this new recent archaeological research, archaeologists investigating Aguascalientes’s past often fail to communicate and disseminate their findings to the public despite additional archaeological information that is increasingly created and circulated among specialized audiences (i.e.,,, academics, practitioners, and governmental agencies). This dissertation aims to fill the knowledge gap related to the archaeological investigation of the Mexican state of Aguascalientes by producing new knowledge on the Cerro de en Medio (CDEM) site. The project documented 215 architectonical features and created a photogrammetric 3D record of buildings from the ground surveys and drone-based photographs. Afterward, the project excavated in 3 household’s compounds and analyzed recovered archaeological artifacts to finally integrate this knowledge within a regional perspective of the Mesoamerican Northern Frontier. Then, the project design and develop Meaningful Divulgation practices to convey the societal importance of the investigated cultural heritage to the Mexican society at large and critically reflect on what it takes to do so. Finally, this dissertation explores a ‘theoretical outline for Serious Game development’ planned to engage the non-specialized audience interested in Aguascalientes archaeological heritage through a “serious game.” This project argues that combining digital technologies and communication strategies is necessary to effectively produce viable divulgation in museums and sites. In doing so, the project takes a step forward in the conservation and preservation of the archaeological heritage of Aguascalientes, which, although it may be irrelevant to nationalist narratives, is vital for the local population. The local Indigenous cultural traditions can receive new invigorating airs because their depth in time is often ignored, although they are still alive. In this sense, this research seeks to play an essential role in preserving local social memory and heritage.

Nonobstetric surgery during pregnancy should be avoided if possible, but when surgery is required, an obstetrician should be part of the perioperative team. In general, preoperative assessment is similar regardless of whether a woman is pregnant, but cardiovascular, pulmonary, hematologic, and renal changes of pregnancy can increase surgical risk and must be taken into account. Special management considerations include pregnancy-associated laboratory changes, timing of surgery, anesthesia choice, intubation precautions, patient positioning, preoperative blood typing, intraoperative fetal monitoring, and venous thromboembolism prophylaxis.

INTRODUCTION AND HYPOTHESIS: Ureteral injuries are a source of morbidity, and delays in diagnosis can increase the risk for long-term sequelae. Our aim was to quantify and describe iatrogenic ureteral injuries in a rural tertiary care center. Our secondary goal was to evaluate the impact of delayed diagnosis of ureteral injury on patient outcomes and whether cystoscopy had any influence on these outcomes. METHODS: A retrospective chart review was undertaken for ureteral injuries, identified by the ICD-9 code from 1997 to 2017 at West Virginia University (WVU) Hospital. Injuries were categorized by procedure, surgeon specialty, location (WVU versus community hospital), and intraoperative cystoscopy. A delay in diagnosis was defined as a ureteral injury sustained during surgery not diagnosed intraoperatively. RESULTS: Forty-six patients were identified with iatrogenic ureteral injury at WVU. Twenty-seven occurred during gynecologic procedures (59%). Fourteen ureteral injuries were sustained at community hospitals and transferred to WVU for evaluation and treatment. Fifty percent of those had a known delay in diagnosis. The average delay in diagnosis for transferred patients was 6.5 days vs. 3.6 days for patients with ureteral injury sustained at WVU. Cystoscopy was only utilized in 37% (10/27) of gynecologic cases involving a ureteral injury. When cystoscopy was utilized, it was 80% (8/10) effective in helping to identify ureteral injury. CONCLUSIONS: Within a rural population, approximately half of patients with ureteral injuries were transferred to a tertiary care center for evaluation and treatment. Transferred patients were more likely to have a delay to diagnosis than patients who had injuries sustained at WVU. The delayed diagnosis patients had comparatively worse outcomes. Gynecologic surgeons working in rural hospitals should be adequately trained to perform diagnostic cystoscopy.

Biosurgical compounds and pharmacologic agents can serve as surgical adjuncts to prevent or curtail intraoperative bleeding. Medline, PubMed, and Cochrane electronic data bases were used to search the English literature from 1966 to March 2007 using the terms topical, hemostatic agents, and gynecologic surgery. Several effective topical hemostatic agents are available to reduce intraoperative blood loss. Data on their application in gynecologic surgery are limited, and guidelines for selecting one over another for specific indications are lacking.