Amelogenin peptide analyses reveal female leadership in Copper Age Iberia (c. 2900-2650 BC).

Given the absence of written records, the main source of information available to analyze gender inequalities in early complex societies is the human body itself. And yet, for decades, archaeologists have struggled with the sex estimation of poorly preserved human remains. Here we present an exceptional case study that shows how ground-breaking new scientific methods may address this problem. Through the analysis of sexually dimorphic amelogenin peptides in tooth enamel, we establish that the most socially prominent person of the Iberian Copper Age (c. 3200-2200 BC) was not male, as previously thought, but female. The analysis of this woman, discovered in 2008 at Valencina, Spain, reveals that she was a leading social figure at a time where no male attained a remotely comparable social position. Only other women buried a short time after in the Montelirio tholos, part of the same burial area, appear to have enjoyed a similarly high social position. Our results invite to reconsider established interpretations about the political role of women at the onset of early social complexity, and question traditionally held views of the past. Furthermore, this study anticipates the changes that newly developed scientific methods may bring to prehistoric archaeology and the study of human social evolution.

Valor de la procalcitonina com a marcador pronòstic en el pacient politraumàtic en una unitat de cures intensives pediàtrica / Valor de la procalcitonina como marcador pronóstico en el paciente politraumático, en una unidad de cuidados intensivos pediátricos / The value of procalcitonin as a prognostic indicator in polytraumatized patients in a pediatric critical care unit

Fonament: el politraumatisme (PT) greu té una morbimorta-litat elevada. La procalcitonina (PCT) podria ser útil com a indicador pronòstic. Objectiu: definir els nivells de PCT en el pacient politraumàtic (PPT) i la seva implicació pronòstica. Mètode: estudi prospectiu observacional. Criteris d'inclusió: pacients menors de 16 anys, ingressats per PT en una unitat de cures intensives pediàtrica (UCIP), amb determinació de PCT a l'ingrés i al cap de 24-48 hores. Període d'estudi: novembre del 2009 - novembre del 2011. Tractament estadístic mitjançant el paquet SPSS(R) versió 17.0. Resultats: de seixanta-set pacients amb politraumatisme, vint complien criteris. La mitjana d'edat era de 13,6 ± 4,2 anys i 19 (95%) eren homes. La puntuació del Pediatric Risk of Mortality Score Index (PRISM-III) era de 9,8 ± 7,38 i l'Índex de Trauma Pediàtric (ITP) de 5,5 ± 2,08. Els nivells mitjans de PCT a les 24 hores eren de 7,67 ± 18,05 ng/ml. Es van diagnosticar vuit casos d'infecció bacteriana. Cap pacient va ser èxitus. La PCT es va correlacionar amb la puntuació PRISM-III (R 0,6; p = 0,048). Els nivells mitjans de PCT eren significativament superiors en el grup que va necessitar ventilació mecànica respecte als que no en van necessitar (p = 0,046) i en el grup de pacients infectats (p = 0,039). Es va objectivar una tendència a la correlació entre els valors mitjans de PCT a l'ingrés i els dies d'ingrés (R 0,393, p = 0,1). Conclusions: els valors de la PCT van ser elevats, per la freqüència de la complicació bacteriana en els PPT. La PCT podria ser útil com a factor pronòstic

Fundamento. El politraumatismo (PT) grave tiene una elevada morbimortalidad. La procalcitonina (PCT) podría ser útil como indicador pronóstico. Objetivo. Definir los niveles de PCT en el paciente politraumático (PPT) y su implicación pronóstica. Método. Estudio prospectivo observacional. Criterios de inclusión: pacientes menores de 16 años, ingresados por PT en una unidad de cuidados intensivos pediátrica, con determinación de PCT al ingreso y entre las 24-48 horas del mismo. Periodo de estudio: noviembre de 2009 - noviembre de 2011. Tratamiento estadístico mediante paquete SPSS® versión 17.0. Resultados. De 67 pacientes con PT, 20 cumplieron criterios. La edad media fue de 13,6 ± 4,2 años y 19 (95%) fueron varones. La puntuación del Pediatric Risk of Mortality Score Index (PRISMIII) fue de 9,8 ± 7,38 y la del Índice de Trauma Pediátrico (ITP) de 5,5 ± 2,08. Los niveles medios de PCT a las 24 h fueron de 7,67 ± 18,05 ng/ml. En ocho casos se realizó el diagnóstico de infección bacteriana. Ningún paciente fue éxitus. La PCT correlacionó con la puntuación del PRISM-III (R 0,6; p = 0,048). Los niveles medios de PCT fueron significativamente superiores en el grupo que necesitó ventilación mecánica respecto a los que no la necesitaron de forma significativa, p = 0,046 y en el grupo de pacientes infectados, p = 0,039. Existió una tendencia a que los valores medios de PCT al ingreso correlacionaran con los días de ingreso (R 0,393, p = 0,1). Conclusiones. Los valores de PCT fueron elevados, por lo frecuente de la complicación infecciosa bacteriana en los PPT. La PCT podría ser útil como factor pronóstico (AU)

Background. Severe polytrauma (PT) is associated with a high morbidity and mortality. Procalcitonin (PCT) may be a useful prognostic indicator. Objective. To describe the levels of PCT in the polytraumatized patient (PTP) and to determine its prognostic implications. Method. This was a prospective observational study conducted between November 2009 and November 2011. The inclusion criteria were age less than 16 years, admission for PT in the Pediatric Critical Care Unit, and availability of PCT values on admission and for 24-48 hours. Statistical analysis was with SPSS version 17.0 package. Results. Twenty of the 67 PTP met the inclusion criteria. The mean age was 13.6±4.2 years, and 19 (95%) were male. The Pediatric Risk of Mortality Score Index (PRISM-III) was 9.8±7.3, and the Pediatric Trauma Score was 5.5±2.0. Mean PCT levels at 24 hours from admission were 7.6±18.0 ng/ml. In eight cases the diagnosis of a concurrent bacterial infection was made. There were no deaths. PCT correlated with PRISM-III score (R 0.6, p=0.048). Mean PCT levels were significantly higher in the group of patients that required mechanical ventilation, compared to those who did not require it (p=0.046) and in those with a concurrent infection (p=0.039). There was a tendency for the mean PCT values on admission to correlate with the length of hospital stay (R 0.393, p=0.1). Conclusions. Due to the high frequency of bacterial infections that PCT values were high in our study. PCT levels may be useful as prognostic factor (AU)

Recurrent invasive pneumococcal disease in children: underlying clinical conditions, and immunological and microbiological characteristics.

PURPOSE: Clinical, immunological and microbiological characteristics of recurrent invasive pneumococcal disease (IPD) in children were evaluated, differentiating relapse from reinfection, in order to identify specific risk factors for both conditions. METHODS: All patients <18 years-old with recurrent IPD admitted to a tertiary-care pediatric center from January 2004 to December 2011 were evaluated. An episode of IPD was defined as the presence of clinical findings of infection together with isolation and/or pneumococcal DNA detection by Real-Time PCR in any sterile body fluid. Recurrent IPD was defined as 2 or more episodes in the same individual at least 1 month apart. Among recurrent IPD, we differentiated relapse (same pneumococcal isolate) from reinfection. RESULTS: 593 patients were diagnosed with IPD and 10 patients died. Among survivors, 23 episodes of recurrent IPD were identified in 10 patients (1.7%). Meningitis was the most frequent form of recurrent IPD (10 episodes/4 children) followed by recurrent empyema (8 episodes/4 children). Three patients with recurrent empyema caused by the same pneumococcal clone ST306 were considered relapses and showed high bacterial load in their first episode. In contrast, all other episodes of recurrent IPD were considered reinfections. Overall, the rate of relapse of IPD was 0.5% and the rate of reinfection 1.2%. Five out of 7 patients with reinfection had an underlying risk factor: cerebrospinal fluid leak (n = 3), chemotherapy treatment (n = 1) and a homozygous mutation in MyD88 gene (n = 1). No predisposing risk factors were found in the remainder. CONCLUSIONS: recurrent IPD in children is a rare condition associated with an identifiable risk factor in case of reinfection in almost 80% of cases. In contrast, recurrent IPD with pleuropneumonia is usually a relapse of infection.