Termination of pregnancy at 9-13 weeks' amenorrhoea with mifepristone and misoprostol

The effectiveness of a combined regimen of mifepristone and vaginal misoprostol for termination of pregnancies of 9-13 weeks of gestation was investigated in 120 UK abortion patients (median age, 22.1 years; median duration of amenorrhea, 10.3 weeks). Each woman received a single oral dose of 200 mg of mifepristone 36-48 hours before admission, at which time 800 mcg of misoprostol was administered vaginally. Where indicated, a further two doses of 400 mcg of misoprostol (vaginal or oral) were provided every 3 hours. All 120 women aborted on the day of prostaglandin administration; however, 6 women (5%) required exploratory curettage after the procedure for retained placenta. The median prostaglandin dose was 1200 mcg (range, 800-1600 mcg). The median time from misoprostol administration to abortion was 4.33 hours (range, 1.3-16.0 hours). 60 women (50%) required oral analgesics and 26 (22%) received parenteral analgesia. Diarrhea occurred in 38 women (32%). The median duration of bleeding after abortion was 12.5 days (range, 3-43 days). In questionnaires administered to 73 women, only 3 (4%) expressed dissatisfaction with medical abortion, because of pain or prolonged bleeding. The relatively high dose of misoprostol used in this study and the vaginal route of administration are presumed to account for the 95% success rate. Extension of medical abortion to later gestation times would decrease the need for surgery and expand women's choice of methods of pregnancy termination.     

Cognitive shifting as a predictor of progress in social understanding in high-functioning adolescents with autism: a prospective study

The pyrolytic behavior of inulin, a (2-->1)-linked fructofuranan, is described. Parallel investigations of the pyrolysis of glucose and of fructose were conducted to supplement the inulin results and to aid comparison with previous results from glucans. Effects of neutral and basic additives are emphasized. As with glucans, the addition of such additives (especially basic) increases the yields of the one-, two-, and three-carbon products (as well as of hexosaccharinolactones), while generally decreasing the yields of anhydro sugar and furan derivatives. The former products include glycolaldehyde, acetol, dihydroxy-acetone, acetic acid, formic acid, and lactic acid. Mechanistic speculations are made regarding the origins of these compounds, as well as of furan derivatives and saccharinic acid lactones. Parallels with alkaline degradation are considered.     

New climate change scenarios for the Netherlands.

A new set of climate change scenarios for 2050 for the Netherlands was produced recently. The scenarios span a wide range of possible future climate conditions, and include climate variables that are of interest to a broad user community. The scenario values are constructed by combining output from an ensemble of recent General Climate Model (GCM) simulations, Regional Climate Model (RCM) output, meteorological observations and a touch of expert judgment. For temperature, precipitation, potential evaporation and wind four scenarios are constructed, encompassing ranges of both global mean temperature rise in 2050 and the strength of the response of the dominant atmospheric circulation in the area of interest to global warming. For this particular area, wintertime precipitation is seen to increase between 3.5 and 7% per degree global warming, but mean summertime precipitation shows opposite signs depending on the assumed response of the circulation regime. Annual maximum daily mean wind speed shows small changes compared to the observed (natural) variability of this variable. Sea level rise in the North Sea in 2100 ranges between 35 and 85 cm. Preliminary assessment of the impact of the new scenarios on water management and coastal defence policies indicate that particularly dry summer scenarios and increased intensity of extreme daily precipitation deserves additional attention in the near future.