The formation of a new landscape in Post-roman Central Iberia: the Site of La Genestosa (Casillas de Flores, Salamanca)

RESUMEN: Este artículo presenta los datos de las intervenciones arqueológicas realizadas en la Genestosa (Casillas de Flores, Salamanca) en los años 2012 y 2013. Gracias al estudio de los materiales recuperados (cerámicas, vidrios, pizarras numera- les), del estudio de las viviendas y de los análisis polínicos, se puede comprender la dinámica del paisaje rural en este sector del centro de la península ibérica. Sedetecta la colonización de espacios de uso flexible con fines ganaderos, que serían la consecuencia de una iniciativa por grupos campesinos con diferencias internas, quienes crearon nuevos asentamientos. La coincidencia con el episodio frío altomedieval (450-950 d. C.) conllevó que determinados espacios húmedos se convirtiesen en áreas críticas, condicionando los patrones de asentamiento.ABSTRACT: This paper is based on the data from archaeological surveys at La Genestosa (Casillas de Flores, Salamanca) in 2012 and 2013. The study of the uncovered material (pottery, glasses, numerical slates), the interpretation of building techniques and pollen analysis provided information about the dynamics of rural landscape in Central Iberia. The initiative of peasant groups.Este trabajo ha sido financiado por los Proyectos de Investigación CRATAEM Colapso y regeneración en la Antigüedad Tardía y la Alta Edad Media: el caso del Noroeste peninsular (HAR2013-47889-C3-1-P) y DESIRÈ Dinámicas socio-ecológicas, resiliencia y vulnerabilidad en un paisaje de montaña: el Sistema Central (9000 cal. BC-1850 cal. AD) (HAR2013- 43701-P) del Plan Nacional de I+D+i del Ministerio de Economía y Competitividad

Enfermedad cerebrovascular hemorrágica en la eclampsia asociada al síndrome HELLP

Introduction: Eclampsia (E) and HELLP syndrome (H) are two complications of preeclampsia that increase maternal morbidity and mortality. The main complication and the main cause of death of this EH / HE association is the hemorrhagic cerebrovascular disease (HCD). Objectives: To determine differences between women with EH / HE who presented HCD and those who did not. To define the types of HCD in women with EH / HE. Design: Cross-sectional comparative study. Patients: Cases of EH / HE at the Hospital Regional Docente de Cajamarca, Peru, 2015. Interventions: Patients with EH / HE were divided into two groups: those without HCD and those with HCD. SPSS 20.0 was used. The comparison of groups was done with Mann Whitney U and chi square tests. Significant differences were when p <0.05. Results: There were 23 women with EH / HE: 18 (78.3%) without HCD and 5 (21.7%) with HCD. We compared women with EH / HE who had HCD and those who did not. HCD had OR = 4.44 (95% CI 1.19-16.55) p = 0.043 for risk of death, and platelets less than 30 000 had OR = 4.44 (95% CI 1.19-16,55) with p = 0.043 risk for HCD. In addition, the stay in ICU was longer in those with HCD than without HCD. Mortality was 60%; 80% of the HCD had ventricular compromise. There was 66.7% of the patients presented subarachnoid hemorrhage and 66.7%, intraventricular hemorrhage (IVH). In IVH, 100% had lobar compromise of which 66.7% had occipital compromise. Conclusions: Hemorrhagic cerebrovascular disease in women with HELLP syndrome associatedwith eclampsia is related to lower platelet levels; this increases the risk of death and prolongs stay in the intensive care unit.Introducción. La eclampsia (E) y el síndrome HELLP (H) son dos complicaciones de la preeclampsia que, asociadas, pueden aumentar la morbimortalidad materna. La principal complicación y la causa principal de muerte de esta asociación EH/HE es la enfermedad cerebrovascular hemorrágica (ECH). Objetivos. Determinar diferencias entre las mujeres con EH/HE que presentan ECH y las que no. Definir los tipos de ECH en mujeres con EH/HE. Diseño. Estudio transversal comparativo. Pacientes. Casos de EH/HE en el Hospital Regional Docente de Cajamarca, Perú, 2015. Intervenciones. Se dividió las pacientes con EH/HE en dos grupos: sin ECH y con ECH. Se utilizó el software SPSS 20.0. La comparación de los grupos se realizó con la U de Mann Whitney y chi cuadrado. Fueron diferencias significativas cuando p< 0,05. Resultados. Hubo 23 mujeres con EH/HE: 18 (78,3%) sin ECH y 5 (21,7%) con ECH. Comparamos las mujeres con EH/HE que tenían o no ECH. ECH tuvo OR 4,44 (IC95% 1,19 a 16,55) con p=0,043 de riesgo de muerte, y las plaquetas menores de 30 000 tuvieron OR 4,44 (IC95% 1,19 a 6,55) con p=0,043 de riesgo de ECH. Además, la permanencia en UCI fue mayor que en las que no tuvieron ECH. La mortalidad fue 60%. El 80% de las ECH mostró compromiso ventricular. Hubo 66,7% de hemorragia subaracnoidea y 66,7% de hemorragia intraventricular (HIC). En las HIC, el 100% tuvo compromiso lobar, de las cuales 66,7% mostró compromiso occipital. Conclusiones. La ECH en mujeres con síndrome HELLP asociado a eclampsia estuvo relacionado a valores más bajos de plaquetas y aumentó el riesgo de muerte y estancia en cuidados intensivos

In-utero exposure to antihypertensive medication and neonatal and child health outcomes:A systematic review

Background: Although medication is generally avoided wherever possible during pregnancy, pharmacotherapy is required for the treatment of pregnancy associated hypertension, which remains a leading cause of maternal and fetal morbidity and mortality. The long-term effects to the child of in-utero exposure to antihypertensive agents remains largely unknown. Objective: The aim of this study was to systematically review published studies on adverse outcomes to the child associated with in-utero exposure to antihypertensive medications. Methods: OVID, Scopus, EBSCO Collections, the Cochrane Library, and Web of Science databases were searched for relevant publications published between January 1950 and October 2016 and a total of 688 potentially eligible studies were identified. Results: Following review, 47 primary studies were eligible for inclusion. The Critical Appraisal Skills Programme checklist was used to assess study quality. Five studies were of excellent quality; the remainder were either mediocre or poor. Increased risk of low birth weight, low size for gestational age, preterm birth, and congenital defects following in-utero exposure to all antihypertensive agents were identified. Two studies reported an increased risk of attention deficit hyperactivity disorder following exposure to labetalol, and an increased risk of sleep disorders following exposure to methyldopa and clonidine. Conclusion: The current systematic review demonstrates a paucity of relevant published high-quality studies. A small number of studies suggest possible increased risk of adverse child health outcomes; however, most published studies have methodological weaknesses and/or lacked statistical power thus preventing any firm conclusions being drawn