Different Safety Pattern of an Inactivated SARS-CoV-2 Vaccine (CoronaVac®) According to Age Group in a Pediatric Population from 3 to 17 Years Old, in an Open-Label Study in Chile.

During the COVID-19 pandemic, the importance of vaccinating children against SARS-CoV-2 was rapidly established. This study describes the safety of CoronaVac® in children and adolescents between 3- and 17-years-old in a multicenter study in Chile with two vaccine doses in a 4-week interval. For all participants, immediate adverse events (AEs), serious AEs (SAEs), and AEs of special interest (AESIs) were registered throughout the study. In the safety subgroup, AEs were recorded 28 days after each dose. COVID-19 surveillance was performed throughout the study. A total of 1139 individuals received the first and 1102 the second dose of CoronaVac®; 835 were in the safety subgroup. The first dose showed the highest number of AEs: up to 22.2% of participants reported any local and 17.1% systemic AE. AEs were more frequent in adolescents after the first dose, were transient, and mainly mild. Pain at the inoculation site was the most frequent AE for all ages. Fever was the most frequent systemic AE for 3-5 years old and headache in 6-17 years old. No SAEs or AESIs related to vaccination occurred. Most of the COVID-19 cases were mild and managed as outpatients. CoronaVac® was safe and well tolerated in children and adolescents, with different safety patterns according to age.

Depth-Dependent Control in Vision-Sensor Space for Reconfigurable Parallel Manipulators.

In this paper, a control approach for reconfigurable parallel robots is designed. Based on it, controls in the vision-sensor, 3D and joint spaces are designed and implemented in target tracking tasks in a novel reconfigurable delta-type parallel robot. No a priori information about the target trajectory is required. Robot reconfiguration can be used to overcome some of the limitations of parallel robots like small relative workspace or multiple singularities, at the cost of increasing the complexity of the manipulator, making its control design even more challenging. No general control methodology exists for reconfigurable parallel robots. Tracking objects with unknown trajectories is a challenging task required in many applications. Sensor-based robot control has been actively used for this type of task. However, it cannot be straightforwardly extended to reconfigurable parallel manipulators. The developed vision-sensor space control is inspired by, and can be seen as an extension of, the Velocity Linear Camera Model-Camera Space Manipulation (VLCM-CSM) methodology. Several experiments were carried out on a reconfigurable delta-type parallel robot. An average positioning error of 0.6 mm was obtained for static objectives. Tracking errors of 2.5 mm, 3.9 mm and 11.5 mm were obtained for targets moving along a linear trajectory at speeds of 6.5, 9.3 and 12.7 cm/s, respectively. The control cycle time was 16 ms. These results validate the proposed approach and improve upon previous works for non-reconfigurable robots.

The hidden side of infective endocarditis: Diagnostic and management of 500 consecutive cases in noncardiac surgery centers (2009-2018).

BACKGROUND: We aimed to describe infective endocarditis cases from noncardiac surgery centers, as current knowledge on infective endocarditis is derived mostly from cardiac surgery hospitals. METHODS: An observational retrospective study (2009-2018) was conducted in 9 noncardiac surgery hospitals in Central Catalonia. All adult patients diagnosed with definitive infective endocarditis were included. Transferred and nontransferred cohorts were compared, and a logistic regression model was used to ascertain the prognostic factors. RESULTS: Overall, 502 infective endocarditis episodes were included: 183 (36.5%) were transferred to the cardiac surgery center, whereas 319 were not, with (18.7%) and without (45%) surgical indications. Cardiac surgery was performed in 83% of transferred patients. In-hospital (14% vs 23%) and 1-year (20% vs 35%) mortality rates were significantly lower in transferred patients (P < .001). Among the patients not undergoing cardiac surgery despite an indication, 55 (54%) died within 1 year. The multivariate analysis identified the following independent predictive factors for in-hospital mortality: Staphylococcus aureus infective endocarditis (odds ratio: 1.93 [1.08, 3.47]), heart failure (odds ratio: 3.87 [2.28, 6.57]), central nervous system embolism (odds ratio: 2.95 [1.41, 5.14]), and Charlson score (odds ratio: 1.19 [1.09, 1.30]), whereas community acquisition (odds ratio: 0.52 [0.29, 0.93]), cardiac surgery (odds ratio: 0.42 [0.20, 0.87]), but not transfer (odds ratio: 1.23 [0.84, 3.95]) were identified as protective factors. One-year mortality was associated with S. aureus infective endocarditis (odds ratio: 1.82 [1.04, 3.18]), heart failure (odds ratio: 3.74 [2.27, 6.16]), and Charlson score (odds ratio: 1.23 [1.13, 1.33]), whereas cardiac surgery (odds ratio: 0.41 [0.21, 0.79]) was identified as a protective factor. CONCLUSION: Patients not transferred to a referral cardiac surgery center have a worse prognosis compared to those ultimately transferred, as cardiac surgery is associated with lower mortality rates.

Inactivated Vaccine-Induced SARS-CoV-2 Variant-Specific Immunity in Children.

Multiple vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been evaluated in clinical trials. However, trials addressing the immune response in the pediatric population are scarce. The inactivated vaccine CoronaVac has been shown to be safe and immunogenic in a phase 1/2 clinical trial in a pediatric cohort in China. Here, we report interim safety and immunogenicity results of a phase 3 clinical trial for CoronaVac in healthy children and adolescents in Chile. Participants 3 to 17 years old received two doses of CoronaVac in a 4-week interval until 31 December 2021. Local and systemic adverse reactions were registered for volunteers who received one or two doses of CoronaVac. Whole-blood samples were collected from a subgroup of 148 participants for humoral and cellular immunity analyses. The main adverse reaction reported after the first and second doses was pain at the injection site. Four weeks after the second dose, an increase in neutralizing antibody titer was observed in subjects relative to their baseline visit. Similar results were found for activation of specific CD4+ T cells. Neutralizing antibodies were identified against the Delta and Omicron variants. However, these titers were lower than those for the D614G strain. Importantly, comparable CD4+ T cell responses were detected against these variants of concern. Therefore, CoronaVac is safe and immunogenic in subjects 3 to 17 years old, inducing neutralizing antibody secretion and activating CD4+ T cells against SARS-CoV-2 and its variants. (This study has been registered at ClinicalTrials.gov under no. NCT04992260.) IMPORTANCE This work evaluated the immune response induced by two doses of CoronaVac separated by 4 weeks in healthy children and adolescents in Chile. To date, few studies have described the effects of CoronaVac in the pediatric population. Therefore, it is essential to generate knowledge regarding the protection of vaccines in this population. Along these lines, we reported the anti-S humoral response and cellular immune response to several SARS-CoV-2 proteins that have been published and recently studied. Here, we show that a vaccination schedule consisting of two doses separated by 4 weeks induces the secretion of neutralizing antibodies against SARS-CoV-2. Furthermore, CoronaVac induces the activation of CD4+ T cells upon stimulation with peptides from the proteome of SARS-CoV-2. These results indicate that, even though the neutralizing antibody response induced by vaccination decreases against the Delta and Omicron variants, the cellular response against these variants is comparable to the response against the ancestral strain D614G, even being significantly higher against Omicron.

A Novel Velocity-Based Control in a Sensor Space for Parallel Manipulators.

It is a challenging task to track objects moving along an unknown trajectory. Conventional model-based controllers require detailed knowledge of a robot's kinematics and the target's trajectory. Tracking precision heavily relies on kinematics to infer the trajectory. Control implementation in parallel robots is especially difficult due to their complex kinematics. Vision-based controllers are robust to uncertainties of a robot's kinematic model since they can correct end-point trajectories as error estimates become available. Robustness is guaranteed by taking the vision sensor's model into account when designing the control law. All camera space manipulation (CSM) models in the literature are position-based, where the mapping between the end effector position in the Cartesian space and sensor space is established. Such models are not appropriate for tracking moving targets because the relationship between the target and the end effector is a fixed point. The present work builds upon the literature by presenting a novel CSM velocity-based control that establishes a relationship between a movable trajectory and the end effector position. Its efficacy is shown on a Delta-type parallel robot. Three types of experiments were performed: (a) static tracking (average error of 1.09 mm); (b) constant speed linear trajectory tracking-speeds of 7, 9.5, and 12 cm/s-(tracking errors of 8.89, 11.76, and 18.65 mm, respectively); (c) freehand trajectory tracking (max tracking errors of 11.79 mm during motion and max static positioning errors of 1.44 mm once the object stopped). The resulting control cycle time was 48 ms. The results obtained show a reduction in the tracking errors for this robot with respect to previously published control strategies.

The Kapitza's Pendulum as a Concurrent Strategy for Maintaining Upright Posture.

A Kapitza's pendulum shows that it is possible to stabilize an inverted pendulum by making its base oscillate vertically. This action seems to introduce an inertial effect which will produce an attractor about the upright vertical position. This work shows that the upright posture of the trunk achieved while walking can be explained using a combination of a vertical oscillation and an angular stiffness regulation at the pelvis. This is shown with an estimated oscillation and stiffness obtained from video recordings of an unimpaired and a Parkinsoninan gaits. By simulating the dynamic model of the pendulum for a range of parameters, a series of stability conditions are found. They show that the introduction of the vertical oscillation results in a fast stabilization of the trunk and point to control strategies which rely on the system's dynamics.

Extra virgin olive oil improved body weight and insulin sensitivity in high fat diet-induced obese LDLr-/-.Leiden mice without attenuation of steatohepatitis.

Dietary fatty acids play a role in the pathogenesis of obesity-associated non-alcoholic fatty liver disease (NAFLD), which is associated with insulin resistance (IR). Fatty acid composition is critical for IR and subsequent NAFLD development. Extra-virgin olive oil (EVOO) is the main source of monounsaturated fatty acids (MUFA) in Mediterranean diets. This study examined whether EVOO-containing high fat diets may prevent diet-induced NAFLD using Ldlr-/-. Leiden mice. In female Ldlr-/-.Leiden mice, the effects of the following high fat diets (HFDs) were examined: a lard-based HFD (HFD-L); an EVOO-based HFD (HFD-EVOO); a phenolic compounds-rich EVOO HFD (HFD-OL). We studied changes in body weight (BW), lipid profile, transaminases, glucose homeostasis, liver pathology and transcriptome. Both EVOO diets reduced body weight (BW) and improved insulin sensitivity. The EVOOs did not improve transaminase values and increased LDL-cholesterol and liver collagen content. EVOOs and HFD-L groups had comparable liver steatosis. The profibrotic effects were substantiated by an up-regulation of gene transcripts related to glutathione metabolism, chemokine signaling and NF-kappa-B activation and down-regulation of genes relevant for fatty acid metabolism. Collectivelly, EVOO intake improved weight gain and insulin sensitivity but not liver inflammation and fibrosis, which was supported by changes in hepatic genes expression.

Modeling the neuro-mechanics of human balance when recovering from a fall: a continuous-time approach.

BACKGROUND: Balance control deteriorates with age and nearly 30% of the elderly population in the United States reports stability problems. Postural stability is an integral task to daily living reliant upon the control of the ankle and hip. To this end, the estimation of joint parameters can be a useful tool when analyzing compensatory actions aimed at maintaining postural stability. METHODS: Using an analytical approach, this study expands on previous work and analyzes a two degrees of freedom human model. The first two modes of vibration of the system are represented by the neuro-mechanical parameters of a second-order, time-varying Kelvin-Voigt model actuated at the ankle and hip. The model is tested using a custom double inverted pendulum and healthy volunteers who were subjected to a positional step-like perturbation during quiet standing. An in silico sensitivity analysis of the influence of inertial parameters was also performed. RESULTS: The proposed method is able to correctly identify the time-varying visco-elastic parameters of of a double inverted pendulum. We show that that the parameter estimation method can be applied to standing humans. These results appear to identify a subject-independent strategy to control quiet standing that combines both the modulation of stiffness, and the use of an intermittent control. CONCLUSIONS: This paper presents the analysis of the non-linear system of differential equations representing the control of lumped muscle-tendon units. It utilizes motion capture measurements to obtain the estimates of the system's control parameters by constructing a simple time-dependent regressor for estimating the time-varying parameters of the control with a single perturbation. This work is a step forward into the understanding of the neuro-mechanical control parameters of human recovering from a fall. In previous literature, the analysis is either restricted to the first vibrational mode of an inverted-pendulum model or assumed to be time-invariant. The proposed method allows for the analysis of hip related movement for stability control and highlights the importance of core training.

RNA interference of NADPH-cytochrome P450 reductase increases susceptibilities to multiple acaricides in Tetranychus urticae.

The two-spotted spider mite, Tetranychus urticae, is a polyphagous pest feeding on over 1100 plant species, including numerous highly valued economic crops. The control of T. urticae largely depends on the use of acaricides, which leads to pervasive development of acaricide resistance. Cytochrome P450-mediated metabolic detoxification is one of the major mechanisms of acaricide resistance in T. urticae. NADPH-cytochrome P450 reductase (CPR) plays as a crucial co-factor protein that donates electron(s) to microsomal cytochrome P450s to complete their catalytic cycle. This study seeks to understand the involvement of CPR/P450 in acaricide resistance in T. urticae. The full-length cDNA sequence of T. urticae's CPR (TuCPR) was cloned and characterized. TuCPR was ubiquitously transcribed in different life stages of T. urticae and the highest transcription was observed in the nymph and adult stages. TuCPR was constitutively over-expressed in six acaricide resistant populations compared to a susceptible one. TuCPR transcriptional expression was also induced by multiple acaricides in a time-dependent manner. Down-regulation of TuCPR via RNA interference (RNAi) in T. urticae led to reduced enzymatic activities of TuCPR and cytochrome P450s, as well as a reduction of resistance to multiple acaricides, abamectin, bifenthrin, and fenpyroximate. The outcome of this study highlights CPR as a potential novel target for eco-friendly control of T. urticae and other related plant-feeding pests.

Point-of-care detection of neutrophils in live skin microsamples using chemiluminescence.

Many skin diseases are defined by the presence of neutrophils, which are among the first cells to respond to infection and inflammation. Currently, neutrophil identification in the skin is costly and slow. The objectives of the present work are to investigate the feasibility of detecting the presence of neutrophils in live skin microsamples using chemiluminescence and develop a device and procedures that will enable preclinical and clinical investigations. Our approach consists of collecting skin microsamples and exposing them to reagents that activate neutrophils and amplify the light emission produced by chemiluminescence. Experiments using live pig skin with and without inflammation show that it is feasible to detect the presence of neutrophils in the skin. The proposed method is minimally invasive, simple, fast, and does not require user specialization. The developed system is compact in size with a small footprint, which makes it portable and suitable for point-of-care diagnostics.

[Complex regional pain syndrome]. / Syndrome douloureux régional complexe.

The Complex Regional Pain Syndrome (previously algodystrophy) is a rare affliction that usually affects a distal extremity (hand, foot). It occurs most frequently within weeks following a traumatic injury or stroke. It is a syndromic entity whose diagnosis is based on precise criteria, known as the Budapest criteria, excluding any disease that better explains the symptoms. The treatment must be given early. Functional restoration (physiotherapy, occupational therapy) is at the heart of the treatment, along with psychoeducation. Inappropriate disuse and avoidance, often encountered, must be combated. Bisphosphonates or steroids are first-line drugs at early stages. The evolution is often long, but the prognosis is favorable in about 75 % of cases (≤ 1 year).

Le syndrome douloureux régional complexe (anciennement algodystrophie) est une affection rare qui touche préférentiellement une extrémité (main, pied). Il se développe le plus souvent dans les semaines qui suivent un traumatisme ou un accident vasculaire cérébral. Il s'agit d'une entité syndromique dont le diagnostic repose sur des critères précis, dits de Budapest, excluant toute atteinte expliquant mieux les symptômes. Le traitement doit être précoce. La restauration fonctionnelle en est le cœur (physiothérapie, ergothérapie), associée à une psychoéducation. L'immobilisation inappropriée et l'évitement, souvent rencontrés, doivent être combattus. Bisphosphonates ou corticoïdes sont les médicaments de premier choix des formes précoces. L'évolution est souvent longue, mais le pronostic favorable dans environ 75 % des cas (≤ 1 an).

Ethnic and language influence on parents' perception of paediatric behaviour management techniques.

BACKGROUND: Parental preference for various behaviour management techniques (BMTs) used in paediatric dentistry has been shown to be influenced by many factors, including ethnicity. AIM: To measure parental acceptability of BMTs used in paediatric dentistry and how it is influenced by ethnicity and language. DESIGN: Parents of patients presenting to a paediatric dentistry residency clinic in Houston, Texas, USA or Medellín, Colombia watched ten video BMT vignettes and rated their acceptance on a visual analog scale (VAS). Participants were categorized into six groups based on language, ethnicity, and country of residence. RESULTS: Parental acceptance of BMTs was affected by language, ethnicity, and country of residence (P = 2.2 × 10-16 ). Ethnic groups in the USA had a mean overall acceptance rate of all BMTs. Colombians rated all BMTs less acceptable than the US cohorts (P < 0.05), with the exception of voice control, which Colombians rate less acceptable than English-speaking Caucasians and Spanish-speaking Hispanics in the USA (P < 0.05). The Colombian population were not accepting of conscious sedation, nitrous oxide, general anaesthesia, and protective stabilization. CONCLUSIONS: Parents from different ethnic groups express different preferences in BMTs. Parents continue to prefer noninvasive techniques over pharmacologic and advanced techniques, with the exception of voice control.

Experimental Estimation of a Second Order, Double Inverted Pendulum Parameters for the study of Human Balancing.

Balance control deteriorates naturally with age and is reliant upon the control of the ankle and hip joints. To this end, the estimation of ankle and hip parameters in quiet standing can be a useful tool when analyzing compensatory actions aimed at maintaining postural stability. This work presents an experimental study of a theoretical approach built upon previous results where the physiological parameters a second-order time-varying Kelvin-Voigt model are estimated for the actuation of the ankle and hip. These estimates are obtained using a double inverted pendulum based model subject to a step-like perturbation. Making use of RGB camera data to obtain the estimates of the system's visco-elastic parameters, the approach employed is capable of estimating the time-varying values for the body's control parameters. This work presents the first results of the method demonstrating the viability of a low-cost technique for regular testing of subjects with a high fall risk.

Máscara laríngea en la emergencia pediátrica. Presentación de un caso / Laryngeal mask in pediatric emergencies. Presentation of a case

La intubación endotraqueal es el método ideal para abordar la vía aérea durante la reanimación cardiopulmonar. Sin embargo, en ocasiones, esta resulta imposible de efectuarla, aun por manos experimentadas. Por tal motivo, se realizó esta presentación de caso, que tuvo como objetivo describir la conducta ante un lactante que no pudo ser intubado mediante laringoscopia directa, y necesitaba una vía aérea artificial. Se revisó la literatura y se consideró las opiniones de varios autores. Se concluyó que la máscara laríngea es una alternativa para la ventilación y oxigenación durante la reanimación cardiopulmonar pediátrica cuando no se puede intubar la tráquea, a menos que existan contraindicaciones para ello.

The endotracheal intubation is an ideal method to reach the aerial way during the cardiopulmonary reanimation. Nevertheless, sometimes it is impossible to make, even for the most experienced hands. For that reason, we prepared this presentation of a case, aimed to describe the behavior with a young child who could not be intubated through direct laryngoscopy, and needed to have an artificial aerial way. We reviewed the literature and took into consideration the opinions of some authors. We concluded that laryngeal mask is an alternative for ventilation and oxygenation during pediatric cardiopulmonary reanimation when it is impossible to intubate the trachea when there are not contraindications for that.

Quilotórax congénito: presentación de un caso / Congenital quilothorax: presentation of a case

Se presenta una paciente que presentó en el estudio ultrasonográfico prenatal efusión pleural bilateral. Posterior a su nacimiento se estableció el diagnóstico de quilotórax bilateral de etiología no determinada, limitándose el mismo con la terapéutica empleada en los primeros 7 días de vida. Se comentan sus principales manifestaciones clínicas, estudios para establecer el diagnóstico y tratamiento utilizado.

We present a patient who showed a bilateral pleural effusion at the prenatal ultrasonographic study. After she was born, the diagnostic was established: bilateral quilothorax of unknown etiology, limited with the therapy applied during the first 7 days of life. We state the main clinical manifestations, trials to arrive to a diagnostic and used treatment.

Sexualidad y reproducción en adolescentes / Sexuality and reproduction in adolescents

Objetivos: caracterizar y explorar aspectos relacionados con sexualidad y reproducción en un grupo de adolescentes de 15 a 19 años de politécnicos del municipio Cotorro (diciembre 2007). Métodos: investigación observacional, descriptiva, prospectiva y transversal. Universo: 2153 efebos de los cuales se tomó al azar una muestra de 1292. Se estudiaron: edad, sexo, edad de iniciación en vida sexual, conocimientos sobre sexualidad y reproducción, infecciones de transmisión sexual y fuentes de información. RESULTADOS: edades entre 15 y 18 años, 61,9 por ciento, varones 56,7 por ciento y 70,9 por ciento se habían iniciado en la vida sexual. Responsabilidad de evitar embarazo obtuvo el porcentaje más elevado de respuestas correctas (81,4 por ciento), 79,3 por ciento señaló el condón como anticonceptivo ideal. En riesgos de infecciones de transmisión sexual, 61,9 por ciento acertó. Los pares, fueron la primera fuente de información en 55,7 por ciento y principal en 68,1 por ciento. CONCLUSIONES: predominaron los menores de 18 años y el sexo masculino de los iniciados en la vida sexual. La primera y principal fuente de información fue el grupo de pares.

Objectives: to characterize and explore aspects related to sexuality and reproduction in a group of adolescents aged 15-19 from the polytechnics of Cotorro municipality (December 2007). METHODS: an observational, descriptive, prospective and cross-sectional research was undertaken. The universe was composed of 2153 adolescents, of whom a sample of 1292 was taken at random. Age, sex, age at the beginning of sexual relations, knowledge about sexuality and reproduction, sexually tranasmited infections, and iniformation sources were studied. Results: 61.9 percent were between 15 and 18 years old, 56.7 percent of them were males and 70.9 percent had already initiated sexual relations. The responsability for preventing pregnancy obtained the highest percent of correct answers (81.4 percent). 79.3 percent referred to condom as the ideal contraceptive. As regards risks for sexually transmitted infections 61.9 percent were right. The peer groups were the first source of information in 55.7 percent and the main in 68.1 percent. CONCLUSIONS: It was observed a predominance of adolescents under 18, of males and of those who had started their sexual life. The main source of information was the peer group.

Empleo de Misoprostol para inducir el aborto hasta 9 semanas / Use of Misoprotol to induce abortion up to 9 weeks

Objetivo: evaluar la eficacia y seguridad de la auto-administración vaginal de 800 mg de Misoprostol, 1 dosis cada 8 horas hasta un máximo de 3 dosis y 2 ciclos en un período de 48 horas, para provocar el aborto en un grupo de 214 pacientes con menos de 63 días de embarazo. Métodos: se hizo un estudio clínico, descriptivo y prospectivo, cuyo universo de trabajo quedó constituido por todas las pacientes que acudieron a la consulta de planificación familiar del Hospital Universitario Ginecoobstétrico América Arias desde el 15 de enero de 2006 al 21 de noviembre de 2006. Resultados: el método se consideró eficaz cuando provocó el aborto completo sin requerir procedimientos quirúrgicos y esto ocurrió en 193 pacientes (90,2 E por ciento). La mayor efectividad se logró con el primer ciclo de tratamiento en 185 casos (86,4 por ciento). Se presentaron 21 fallos (9,8 por ciento), en 15 de ellos fue por fracaso del método después de administrada la 3ra dosis del 2do ciclo, en 4 por decisión médica y 2 por decisión de la paciente. Los efectos secundarios más significativos fueron los escalofríos (55,1 por ciento), las náuseas (32,7 por ciento), el dolor pélvico (73,8 por ciento) y el sangrado uterino mayor que el menstrual (63,1 por ciento). Conclusiones: los resultados obtenidos sugieren que la administración de una dosis de 800 mg de Misoprostol cada 8 horas por vía vaginal es un método adecuado para interrumpir el embarazo entre las 6 y 9 semanas de gestación.

Objective: to evaluate the efficiency and safety of self-vaginal administration of 800 µg of Misoprostol, one dose every 8 hours up to a maximum of 3 doses and 2 cycles in a period of 48 hours to induce abortion in a group of 214 patients with less than 63 days of gestation. Methods: a clinical, descriptive and prospective study was conducted. The universe consisted of all the patients that were seen at the familiy planning department of América Arias Gynecoobstetric University Hospital from January 15 2006 to November 21 2006. RESULTS: the method was considered efficient when the complete abortion was attained with no surgical procedures, which occurred in 193 patients (90,2 E percent). The highest effectiveness was obtained with the first cycle of treatment in 185 cases (86.4 percent). There were 21 fails (9.8 percent), 15 of them due to failure of the methods after the administration of the third dose of the second cycle, 4 for medical decision and 2 because of patient's decision. The most significant secondary effects were chills (55.1 percent), nausea (32.7 percent), pelvic pain (73.8 percent) and uterine bleeding above the menstrual bleeding (63.1 percent). Conclusions: the results suggest that the administration of a dose of 800 µg of Misoprostol every 8 hours by vaginal route is an adequate method to interrupt pregnancy between the 6 and 9 weeks of gestation.

Eficacia del Misoprostol en la interrupción del embarazo del 2do trimestre / Efficacy of Misoprostol in the interruption of the 2nd trimester of pregnancy

Objetivos: evaluar la eficacia, seguridad y aceptación de la administración vaginal de tabletas de 400 ìg de Misoprostol hasta un máximo de 3 dosis en un período de 24 horas (1 cada 8 horas), para provocar el aborto entre las 13 y 15 semanas de gestación, y 200 mg de Misoprostol en la misma forma, para embarazos entre 16 y 20 semanas. Métodos: se realizó un estudio clínico, descriptivo y prospectivo, en el hospital América Arias, que incluyó un universo de 470 pacientes, que acudieron a la consulta de planificación familiar del centro, para solicitar la interrupción del embarazo. De ellas se seleccionó una muestra de 189, que cumplieron los criterios de inclusión y dieron su consentimiento para participar en la investigación. Resultados: el método se consideró eficaz cuando provocó el aborto completo sin requerir procedimientos quirúrgicos. En la muestra predominaron las mujeres entre 20 y 30 años (51,8 por ciento), solteras (58,7 por ciento), con nivel escolar de Preuniversitario (41,3 por ciento), mestizas (36,0 por ciento), paridad (55,0 por ciento), y no abortos previos (51,8 por ciento). Los efectos secundarios más significativos fueron: escalofríos (47,6 por ciento), náuseas (28,5 por ciento), dolor pélvico (27,5 por ciento) y sangrado uterino mayor que el menstrual (45,5 por ciento). La mayor efectividad del método se logró, con la segunda dosis empleada en ambos grupos. El éxito se logra también en el 92,6 por ciento de los casos. Se presentaron 14 fallos: 3 por decisión de las pacientes, 3 fueron abortos fallidos, y 8 fallos del método, que en total representan 7,4 por ciento. Conclusiones: por los resultados obtenidos se puede afirmar que la dosis empleada de Misoprostol cada 8 horas es un método válido para la interrupción del embarazo entre 13 y 20 semanas.

Objective: to evaluate the efficacy, safety and acceptance of the vaginal administration of Misoprostol tablets 400 µg up to a maximum of 3 doses in a period of 24 hours (one every 8 hours) to induce abortion between 13 and 15 weeks of gestation, and 200 µg of Misoprostol in the same way for pregnancies from 16 to 20 weeks. Methods: a clinical, descriptive and prospective study was carried out in América Arias Hospital with a universe of 470 patients that visited the family planning department of the center to request pregnancy interruption. Of them, a sample of 189 was selected that fulfilled the inclusion criteria and gave their consent to participate in the research. Results: The method was considered efficient when it provoked a complete abortion and no surgical procedures were necessary. There was a prevalence of females aged 20-30 (51.8 percent), 58.7 percent of them were single, 41.3 percent had preuniversity level, 36.0 percent were black, parity was 55 percent and 51.8 percent had no previous abortions. The most significant secondary effects were chills (47.6 percent), nausea (28.5 percent), pelvic pain (27.5 percent) and uterine bleeding higher than the menstrual (45.5 percent). The highest effectivity was attained with the second dose used in both groups. Success was achieved in 92.6 percent of the cases. There were 14 fails: 3 due decision of the patients, 3 were failed abortions and 8 were failures of the method that in all account for 7.4 percent. Conclusions: According to the results it may be affirmed that the dose used of Misoprostol every 8 hours is a valid method to interrupt pregnancy between 13 and 20 weeks.

Resultados perinatales del crecimiento intrauterino retardado / Perinatal results of intrauterine growth retardation

Se analizan algunas de las características del crecimiento intrauterino retardado (CIUR) en el hospital ginecoobstétrico América Arias de Ciudad de la Habana , durante el período comprendido entre el 1ro. de enero de 2003 y el 31 de diciembre de 2004. Se revisaron los expedientes clínicos correspondientes a los 172 casos (RN vivos o muertos) que fueron diagnosticados como CIUR al egreso y se estudiaron los factores de riesgo seleccionados. La incidencia de CIUR para este centro se estimó en un 2,1 por ciento