Historia de un campamento del Horizonte Medio de Huarmey, Perú (PV35-4)

Se presenta el estudio de un campamento temporal del Horizonte Medio situado en el desierto costero peruano al norte del valle de Huarmey. Se ha excavado la parte central del mismo pues presentaba la mayor cantidad de basura y dos fogones. Se ha podido establecer a base de la cerámica encontrada, que el sitio corresponde al Horizonte Medio 3. Los artefactos hallados son muy pocos, lo que es lógico dada la corta ocupación del sitio. Sin embargo se ha podido estudiar los abundantes restos botánicos y animales así como los fecales de llama que estaban acumulados en el lugar. También se ha encontrado coprolitos humanos. De ambos se ha realizado el examen polínico. Además de los excrementos humanos se ha efectuado el análisis del contenido de plantas y animales así como el parasitológico.Cet article étudie un campement temporaire de l’Horizon Moyen situé dans le désert côtier péruvien au nord de la vallée de Huarmey. La partie centrale du site a été choisie pour les fouilles car elle offrait la plus grande quantité de déchets ainsi que deux foyers. Il a été établi que le site correspondait à l’Horizon Moyen 3 grâce à la céramique qui y fut trouvée. Peu d’outillage a été trouvé en raison de la courte occupation du site, mais les restes abondants d’animaux et botaniques ainsi que les restes fécaux de llamas et humains accumulés sur le site ont fourni de précieuses indications. Les résultats des examens polliniques des coprolithes ainsi que les analyses du contenu de plantes, animaux et parasytes présents dans les coprolithes humains sont présentés ici.This is a study of a Middle Horizon temporary campsite located in the peruvian north coastal desert of the Huarmey Valley. The excavation was undertaken in the central part of the site since it contained the largest quantity debris and evidence of two bonfires. Its age was established using pieces of ceramic found on the site. A few artifacts were founded, probably due to the brief occupancy of the site, but were able to study the abundant botanical and animal remains, as well as llama and human coprolites. We present the results of tests for pollen in both the llama and human coprolites, as well as of tests for plant, animal, and parasite content in the human fecal remains are presented here

Preterm neonatal morbidity and mortality by gestational age: a contemporary cohort

Although preterm birth less than 37 weeks gestation is the leading cause of neonatal morbidity and mortality in the United States, the majority of data regarding preterm neonatal outcomes come from older studies, and many reports have been limited to only very preterm neonates. Delineation of neonatal outcomes by delivery gestational age is needed to further clarify the continuum of mortality and morbidity frequencies among preterm neonates

Defining failed induction of labor

BACKGROUND: While there are well-accepted standards for the diagnosis of arrested active-phase labor, the definition of a "failed" induction of labor remains less certain. One approach to diagnosing a failed induction is based on the duration of the latent phase. However, a standard for the minimum duration that the latent phase of a labor induction should continue, absent acute maternal or fetal indications for cesarean delivery, remains lacking. OBJECTIVE: The objective of this study was to determine the frequency of adverse maternal and perinatal outcomes as a function of the duration of the latent phase among nulliparous women undergoing labor induction. METHODS: This study is based on data from an obstetric cohort of women delivering at 25 U.S. hospitals from 2008-2011. Nulliparous women who had a term singleton gestation in the cephalic presentation were eligible for this analysis if they underwent a labor induction. Consistent with prior studies, the latent phase was determined to begin once cervical ripening had ended, oxytocin was initiated and rupture of membranes (ROM) had occurred, and was determined to end once 5 cm dilation was achieved. The frequencies of cesarean delivery, as well as of adverse maternal (e.g., cesarean delivery, postpartum hemorrhage, chorioamnionitis) and perinatal outcomes (e.g., a composite frequency of either seizures, sepsis, bone or nerve injury, encephalopathy, or death), were compared as a function of the duration of the latent phase (analyzed with time both as a continuous measure and categorized in 3-hour increments). RESULTS: A total of 10,677 women were available for analysis. In the vast majority (96.4%) of women, the active phase had been reached by 15 hours. The longer the duration of a woman's latent phase, the greater her chance of ultimately undergoing a cesarean delivery (P<0.001, for time both as a continuous and categorical independent variable), although more than forty percent of women whose latent phase lasted for 18 or more hours still had a vaginal delivery. Several maternal morbidities, such as postpartum hemorrhage (P < 0.001) and chorioamnionitis (P < 0.001), increased in frequency as the length of latent phase increased. Conversely, the frequencies of most adverse perinatal outcomes were statistically stable over time. CONCLUSION: The large majority of women undergoing labor induction will have entered the active phase by 15 hours after oxytocin has started and rupture of membranes has occurred. Maternal adverse outcomes become statistically more frequent with greater time in the latent phase, although the absolute increase in frequency is relatively small. These data suggest that cesarean delivery should not be undertaken during the latent phase prior to at least 15 hours after oxytocin and rupture of membranes have occurred. The decision to continue labor beyond this point should be individualized, and may take into account factors such as other evidence of labor progress

Dichorionic twin trajectories: the NICHD Fetal Growth Studies

BACKGROUND: Systematic evaluation and estimation of growth trajectories in twins require ultrasound measurements across gestation, performed in controlled clinical settings. Currently there are few such data for contemporary populations. There is also controversy about whether twin fetal growth should be evaluated using the same benchmarks as singleton growth. OBJECTIVES: Our objective was to empirically define the trajectory of fetal growth in dichorionic twins using longitudinal two-dimensional ultrasonography and to compare the fetal growth trajectories for dichorionic twins with those based on a growth standard developed by our group for singletons. STUDY DESIGN: A prospective cohort of 171 women with twin gestations was recruited from eight U.S. sites from 2012 to 2013. After an initial sonogram at 11w0d–13w6d where dichorionicity was confirmed, women were randomized to one of two serial ultrasonology schedules. Growth curves and percentiles were estimated using linear mixed models with cubic splines. Percentiles were compared statistically at each gestational week between the twins and 1,731 singletons, after adjustment for maternal age, race/ethnicity, height, weight, parity, employment, marital status, insurance, income, education and infant sex. Linear mixed models were used to test for overall differences between the twin and singleton trajectories using likelihood ratio tests of interaction terms between spline mean structure terms and twin-singleton indicator variables. Singleton standards were weighted to correspond to the distribution of maternal race in twins. For those ultrasound measurements where there were significant global tests for differences between twins and singletons, we tested for week-specific differences using Wald tests computed at each gestational age. In a separate analysis, we evaluated the degree of reclassification in small for gestational age, defined as below the 10(th) percentile that would be introduced if fetal growth estimation for twins was based upon an unweighted singleton standard. RESULTS: Women underwent a median of 5 ultrasounds. The 50(th) percentile abdominal circumference and estimated fetal weight trajectories of twin fetuses diverged significantly beginning at 32 weeks, while biparietal diameter in twins was smaller from 34 through 36 weeks. There were no differences in head circumference or femur length. The mean head circumference/abdominal circumference ratio was progressively larger for twins compared with singletons beginning at 33 weeks, indicating a comparatively asymmetric growth pattern. At 35 weeks, the average gestational age at delivery for twins, the estimated fetal weights for the 10(th), 50(th) and 90(th) percentiles were 1960, 2376, and 2879 g for dichorionic twins and 2180, 2567, and 3022 g for the singletons. At 32 weeks, the initial week when the mean estimated fetal weight for twins was smaller than that of singletons, 34% of twins would be classified as small for gestational age using a singleton, non-Hispanic white standard. By 35 weeks, 38% of twins would be classified as small for gestational age. CONCLUSIONS: The comparatively asymmetric growth pattern in twin gestations, initially evident at 32 weeks, is consistent with the concept that the intrauterine environment becomes constrained in its ability to sustain growth in twin fetuses. Near term, nearly 40% of twins would be classified as small for gestational age based on a singleton growth standard

Serious maternal complications after early preterm delivery (24-33 weeks’ gestation)

To describe the prevalence of serious maternal complications following early preterm birth by gestational age (GA), delivery route and type of cesarean incision

TRIPSACUM IN PERU

Volume: 21Start Page: 285End Page: 28

Revisión de las pruebas de la existencia de maíz precerámico de los Andes Centrales

Consideramos que en lo que se refiere al estudio de la etnobotánica en los Andes Centrales, se ha llegado a un punto muerto de! que no se podrá salir hasta que no se hagan nuevos trabajos de campo. En el caso concreto del maíz, los últimos hallazgos son los de Casma en 1985. Es decir, el cuadro no ha variado desde hace 11 años. Podría parecer ocioso, pues, volver a discutir datos tan antiguos y que ya han sido estudiados y reestudiados innúmeras veces. Sin embargo no es así. Si se hace un aná..