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Introducción y objetivos: Los programas de rehabilitación cardíaca (PRC) fase III han sido poco investigados tanto por los métodos de entrenamiento como por las modalidades de administración. Estudiamos los efectos en capacidad funcional, composición corporal y adherencia a la actividad física de un PRC interdisciplinar basado en ejercicio terapéutico aeróbico combinado con fuerza muscular tras síndrome coronario agudo. Diseño del estudio: Ensayo clínico aleatorizado. Métodos: Ochenta pacientes con cardiopatía isquémica estable y función sistólica preservada fueron incluidos posteriormente a un PRC fase II. Se distribuyeron en grupo control (GC), con ejercicio autónomo y grupo experimental (GE), con ejercicio aeróbico combinado con fuerza muscular comunitaria, además de estrategia educativa de mensajería telefónica instantánea. Ambos grupos realizaron terapia grupal hospitalaria. Se compararon los resultados de capacidad funcional, composición corporal y nivel de actividad física tras 12 meses. Resultados: La capacidad funcional presentó niveles más altos en el GE en la prueba de marcha de 6min, 26,03m (DE: 27,4; p<0,001), y en la ergometría incremental convencional, 0,6METs (DE: 2,2; p=0,021). El nivel de actividad física domiciliaria medido con el cuestionario IPAQ en el GE incrementó 90,38min/semana (DE: 79,7; (p=0,047), y disminuyó el tiempo sedentario entresemana −50,3min/día (DE: 94,5; p=0,001). Ambos grupos aumentaron el tejido adiposo, sobre todo el GC 1,4% (DE: 3,1; p=0,039). Conclusiones: Los pacientes con síndrome coronario agudo que realizaron un PRC fase III comunitario durante 12 meses, mediante ejercicio terapéutico aeróbico combinado con fuerza muscular y estrategias educativas de mensajería telefónica instantánea, presentaron niveles más altos en capacidad funcional y actividad física reportada.(AU)

Introduction and objectives: The effects of a phase III cardiac rehabilitation program (CRP) have been insufficiently studied in terms of training methods and administration. We studied the impact on functional capacity, body composition and physical activity engagement of interdisciplinary program based on aerobic and community strength therapeutic exercise after an acute coronary syndrome. Trial design: Randomised clinical trial. Methods: Eighty consecutive patients with stable ischemic heart disease and preserved systolic function before phase II CRP were included. They were distributed into a control group (CG), with autonomous exercise, and an experimental group (EG), that follows supervised community program based on aerobic exercise and overload dynamic muscle strength, and an educational strategy through short messaging. Both groups underwent monthly inpatient group therapy. Results were compared after 12 months. Results: Functional capacity presented higher levels in the EG and measured by the 6-min walk test (26.0±27.4m; P<.001), and maximal exercise test (0.6±2.2METs; P=.021). Home physical activity measured in minutes by IPAQ questionnaire increased more in the EG (90±78min/week) (P=.047), and the sitting time during the week decreased (−50.25±94.48min/day) (P=.001). There were no differences in body mass index, although we found a higher percentage of adipose tissue in CG after 12 months (P=.039). Conclusions: A multidisciplinary community phase III CRP based on aerobic and dynamic muscle strength therapeutic exercise combined with a short message service educational strategy was feasible. After 12 months, patients in the EG presented higher levels on functional capacity, reported higher physical activity engagement compared to the CG.(AU)

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INTRODUCTION AND OBJECTIVES: The effects of a phase III cardiac rehabilitation program (CRP) have been insufficiently studied in terms of training methods and administration. We studied the impact on functional capacity, body composition and physical activity engagement of interdisciplinary program based on aerobic and community strength therapeutic exercise after an acute coronary syndrome. TRIAL DESIGN: Randomised clinical trial. METHODS: Eighty consecutive patients with stable ischemic heart disease and preserved systolic function before phase II CRP were included. They were distributed into a control group (CG), with autonomous exercise, and an experimental group (EG), that follows supervised community program based on aerobic exercise and overload dynamic muscle strength, and an educational strategy through short messaging. Both groups underwent monthly inpatient group therapy. Results were compared after 12 months. RESULTS: Functional capacity presented higher levels in the EG and measured by the 6-min walk test (26.0±27.4m; P<.001), and maximal exercise test (0.6±2.2METs; P=.021). Home physical activity measured in minutes by IPAQ questionnaire increased more in the EG (90±78min/week) (P=.047), and the sitting time during the week decreased (-50.25±94.48min/day) (P=.001). There were no differences in body mass index, although we found a higher percentage of adipose tissue in CG after 12 months (P=.039). CONCLUSIONS: A multidisciplinary community phase III CRP based on aerobic and dynamic muscle strength therapeutic exercise combined with a short message service educational strategy was feasible. After 12 months, patients in the EG presented higher levels on functional capacity, reported higher physical activity engagement compared to the CG.

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Antecedentes y objetivo: La rehabilitación cardíaca tiene el máximo nivel de evidencia en las guías médicas de referencia, sin embargo, existen todavía modalidades de entrenamiento poco exploradas. Estudiamos los efectos de un programa interdisciplinar tras síndrome coronario agudo (SCA) en prevención secundaria fase II. Métodos: Entre enero 2008 y diciembre 2018 se incluyeron 439 pacientes con cardiopatía isquémica estable y función sistólica preservada, máximo dos meses después del SCA. Se aplicó un entrenamiento combinado de resistencia aeróbica en método continuo variable de alta intensidad y de tonificación muscular dinámica con sobrecarga y/o lastre, además de asesoramiento nutricional y terapia psicológica-educativa durante 12 semanas. Resultados: Finalizaron 378 pacientes. La capacidad funcional aumentó en la prueba de esfuerzo incremental (1,76 METS; IC 95% 1,59 a 1,96 p < 0,001) y en la prueba de marcha de seis minutos (32,58 m; IC 95% 29,24 a 35,92 p < 0,001). Aumentó la actividad física de ocio en el IPAQ (763,27 min/semana; IC 95% 583,31 a 943,16 p < 0,001) y disminuyó el tiempo sentado entre semana (-28,85 min/día; IC 95% -43,94 a -13,77 p < 0,001). Además, mejoraron los hábitos alimentarios en el PREDIMED (2,58 unidades; IC 95% 1,43 a 3,73 p < 0,001), disminuyó el peso corporal (-0,88 kg; IC 95% -1,26 a -0,49 p < 0,001), el perímetro abdominal (1,57 cm; IC 95% 2,23 a 0,90 p < 0,001) y el tejido adiposo (-0,80%; IC 95% -1,10 a -0,51 p < 0,001). Conclusiones: Un programa interdisciplinar con entrenamiento continuo variable de alta intensidad combinado con tonificación muscular dinámica produce mejorías en la capacidad funcional, en el nivel de actividad física, en la composición corporal y en los hábitos alimentarios en pacientes con SCA.(AU)

Introduction and objectives: Cardiac rehabilitation has the highest level of recognition in medical guideline references, however there are still little-explored training modalities. We study the effects of an interdisciplinary program after acute coronary syndrome (ACS) in phase II secondary prevention. Methods: Between January 2008 and December 2018, 439 patients with stable ischemic heart disease and preserved systolic function were included, as maximum 2 month after the ACS. A combined aerobic resistance training program in a variable continuous method and muscle toning with overload and/or ballast was applied, in addition to nutritional counseling and psychological-educational therapy for 12 weeks. Results: 378 patients finished. The functional capacity increases in the incremental stress test (1.76 METS; CI 95%: 1.59–1.96, p < 0.001) and in the six minutes walking test (32.58 m; CI 95%: 29.24–35.92, p < 0.001). Leisure physical activity in IPAQ increased (763.27 min/week; CI 95%: 583.31–943.16, p < 0.001) and the time sitting during the week decreased (−28.85 min/day; CI 95%: −43.94 to −13.77, p < 0.001). Also, eating habits improved in PREDIMED (2.58 units; CI 95%: 1.43–3.73, p < 0.001), decreased body weight (−0.88 kg; CI 95%: −1.26 to −0.49, p < 0.001), the abdominal perimeter (1.57 cm; CI 95%: 2.23–0.90, p < 0.001) and adipose tissue (−0.80%; CI 95%: −1.10 to −0.51, p < 0.001). Conclusions: An interdisciplinary program with high intensity variable continuous training combined with dynamic muscle toning increases functional capacity, the level of physical activity, improves body composition and eating habits in ACS patients.(AU)

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Introducción y objetivo: La rehabilitación cardíaca tiene el máximo nivel de evidencia en las guías médicas de referencia. Estudiamos los efectos de un programa interdisciplinar dirigido mediante telemedicina tras síndrome coronario agudo en prevención secundaria fase ii en periodo de confinamiento por COVID-19. Métodos: Entre el 2 y 11 de marzo de 2020 se incluyeron 37 pacientes predominantemente con cardiopatía isquémica estable (76,4%) y función sistólica preservada sometidos a tratamiento 12 semanas. Se aplicó un programa de entrenamiento de tonificación muscular dinámico con sobrecarga domiciliario, además de asesoramiento nutricional y terapia psicológica y educativa mediante telemedicina. Resultados: De la cohorte inicial, finalizaron 30 pacientes. La capacidad funcional aumentó en la prueba de marcha de seis minutos (47,13m; IC95% 32,82 a 61,45; p<0,001), donde se produjo también un descenso de la sensación subjetiva de disnea inicial (−0,5unidades; IC95% −0,76 a −0,24; p=0,001) en la escala de Borg modificada y de la tensión arterial sistólica inicial (−6,67mmHg; IC95% −10,98 a −2,35; p=0,004) y final (−7mmHg; IC95% −12,86 a −1,14; p=0,021). Se observó un aumento del nivel de actividad física en el tiempo de ocio en el IPAQ (1162,93min/semana; IC95% 237,36 a 2088,5; p=0,016) y mejoraron los hábitos alimentarios mediterráneos en el test PREDIMED (2,1unidades; IC95% 1,32 a 2,28; p<0,001). Conclusiones: Los pacientes que realizaron 3 meses de rehabilitación cardíaca domiciliaria aumentaron la capacidad funcional y mejoraron los hábitos higiénico-alimentarios, además disminuyeron su sensación de disnea inicial. La rehabilitación cardíaca domiciliaria mediante telemedicina produce una mejoría del paciente tras sufrir síndrome coronario agudo.(AU)

Introduction and objective: Cardiac rehabilitation has the highest level of recognition in medical guideline references. The rise of COVID-19 pandemic, particularly during the first months of strict containment, cause to temporally stop most of the ongoing programs. We studied the effects of an interdisciplinary phase II secondary prevention in patients diagnosed with a recent acute coronary syndrome with the use of new technologies, home-exercise and telemedicine. Methods: Between the 2nd and 11th of March 2020, we included 37 patients with recent acute coronary syndrome (76.4%), low-risk and preserved systolic function and underwent a 12-week treatment. A dynamic muscle toning with overload domiciliary training program was applied, in addition to nutritional counselling, as well as psychological and educational therapy. Results: Of the initial cohort, 30 patients finished. At the end of the program, we observed and increased functional capacity over the 6-min walking test (+47.13m; 95% CI: 32.82-61.45, P<.001), and improvement to the subjective feeling of dyspnoea on the modified Borg scale (−0.5 units; 95% CI: −0.76 to −0.24, P=.001), and an improvement over both initial and final training systolic blood pressure (−6.67mmHg; 95% CI: −10.98 to −2.35, P=.004) (−7mmHg; 95% CI: −12.86 to −1.14, P=.021). We also observed an increase in the level of physical activity during leisure time in the IPAQ questionnaire (+1162.93min/week; 95% CI: 237.36–2088.5, P=.016), and in the Mediterranean eating habits on the PREDIMED test (+2.1units; 95% CI: 1.32–2.28, P<.001). Conclusions: After three months of a domiciliary cardiac rehabilitation program, patients increased their functional capacity, feeling of dyspnoea, blood pressure and eating habits. Domiciliary telemedicine cardiac rehabilitation program produces an improvement in the patient after acute coronary syndrome.(AU)

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INTRODUCTION AND OBJECTIVE: Cardiac rehabilitation has the highest level of recognition in medical guideline references. The rise of COVID-19 pandemic, particularly during the first months of strict containment, cause to temporally stop most of the ongoing programs. We studied the effects of an interdisciplinary phase II secondary prevention in patients diagnosed with a recent acute coronary syndrome with the use of new technologies, home-exercise and telemedicine. METHODS: Between the 2nd and 11th of March 2020, we included 37 patients with recent acute coronary syndrome (76.4%), low-risk and preserved systolic function and underwent a 12-week treatment. A dynamic muscle toning with overload domiciliary training program was applied, in addition to nutritional counselling, as well as psychological and educational therapy. RESULTS: Of the initial cohort, 30 patients finished. At the end of the program, we observed and increased functional capacity over the 6-min walking test (+47.13m; 95% CI: 32.82-61.45, P<.001), and improvement to the subjective feeling of dyspnoea on the modified Borg scale (-0.5 units; 95% CI: -0.76 to -0.24, P=.001), and an improvement over both initial and final training systolic blood pressure (-6.67mmHg; 95% CI: -10.98 to -2.35, P=.004) (-7mmHg; 95% CI: -12.86 to -1.14, P=.021). We also observed an increase in the level of physical activity during leisure time in the IPAQ questionnaire (+1162.93min/week; 95% CI: 237.36-2088.5, P=.016), and in the Mediterranean eating habits on the PREDIMED test (+2.1units; 95% CI: 1.32-2.28, P<.001). CONCLUSIONS: After three months of a domiciliary cardiac rehabilitation program, patients increased their functional capacity, feeling of dyspnoea, blood pressure and eating habits. Domiciliary telemedicine cardiac rehabilitation program produces an improvement in the patient after acute coronary syndrome.

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INTRODUCTION AND OBJECTIVES: Cardiac rehabilitation has the highest level of recognition in medical guideline references, however there are still little-explored training modalities. We study the effects of an interdisciplinary program after acute coronary syndrome (ACS) in phase II secondary prevention. METHODS: Between January 2008 and December 2018, 439 patients with stable ischemic heart disease and preserved systolic function were included, as maximum 2 month after the ACS. A combined aerobic resistance training program in a variable continuous method and muscle toning with overload and/or ballast was applied, in addition to nutritional counseling and psychological-educational therapy for 12 weeks. RESULTS: 378 patients finished. The functional capacity increases in the incremental stress test (1.76 METS; CI 95%: 1.59-1.96, p < 0.001) and in the six minutes walking test (32.58 m; CI 95%: 29.24-35.92, p < 0.001). Leisure physical activity in IPAQ increased (763.27 min/week; CI 95%: 583.31-943.16, p < 0.001) and the time sitting during the week decreased (-28.85 min/day; CI 95%: -43.94 to -13.77, p < 0.001). Also, eating habits improved in PREDIMED (2.58 units; CI 95%: 1.43-3.73, p < 0.001), decreased body weight (-0.88 kg; CI 95%: -1.26 to -0.49, p < 0.001), the abdominal perimeter (1.57 cm; CI 95%: 2.23-0.90, p < 0.001) and adipose tissue (-0.80%; CI 95%: -1.10 to -0.51, p < 0.001). CONCLUSIONS: An interdisciplinary program with high intensity variable continuous training combined with dynamic muscle toning increases functional capacity, the level of physical activity, improves body composition and eating habits in ACS patients.

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Prior to 1971, type Ia glycogen storage disease was marked by life-threatening hypoglycemia, lactic acidosis, severe failure to thrive, and developmental delay. With the introduction of continuous feeds in the 1970s and cornstarch in the 1980s, the prognosis improved, but complications almost universally developed. Changes in the management of type Ia glycogen storage disease have resulted in improved metabolic control, and this manuscript reviews the increasing evidence that complications can be delayed or prevented with optimal metabolic control as previously was seen in diabetes.

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The plant cell wall is a dynamic structure whose constant modification is necessary for plant cells to grow and divide. In the cell walls of chickpea (Cicer arietinum) there are at least four ß-galactosidases, whose presence and location in embryonic axes during the first 48 h of seed imbibition are discussed in this paper. We examined their roles as cell wall-modifying enzymes in germinative and/or post-germinative events. At the start of germination, only ßV-Gal, and to a lesser extent ßIV-Gal, appear in the axes before rupture of the testa, suggesting they are related to germination sensu stricto. Once the testa has broken, the four ß-galactosidases are involved in growth and differentiation of the axes. Immunolocation of the different proteins in axes, which in part confirms previous results in seedlings and plants, allows assignment of post-germinative roles to ßI-Gal and ßIII-Gal as cell wall modifiers in vascular tissue elements. ßIV-Gal and ßV-Gal participate in the initial events of germination in which cell walls are involved: ßV-Gal in cell proliferation, detachment of root cap cells and initial vascular tissue differentiation; both of them in xylem maturation; and ßIV-Gal in thickening of the primary cell wall. Together with other cell wall-modifying enzymes, such as expansins and XTH, chickpea galactosidases might function in a sequential order in turnover of the primary cell wall, allowing the elongation of embryonic axes during seed germination.

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Objetivo. Evaluar el rendimiento diagnóstico de la PET-TC con 18F-FDG y su relación con los niveles séricos de tiroglobulina (Tg) en los pacientes con cáncer diferenciado de tiroides con sospecha de persistencia o recurrencia de enfermedad y rastreo con radioyodo negativo. Material y métodos. Análisis retrospectivo de 35 estudios PET-TC en 25 pacientes (17 mujeres, edad media 48,8±15,2 años). Los resultados se comprobaron histológicamente, o mediante ecografía y seguimiento clínico. Se analizó la relación entre el rendimiento diagnóstico de la PET-TC y 3 niveles de Tg: ≤2ng/ml; entre 2 y 10 ng/ml, y >10ng/ml. Resultados. Se obtuvieron 26 verdaderos positivos, un falso positivo, 3 verdaderos negativos y 5 falsos negativos. De los 18 pacientes con una PET-TC clasificada como verdadero positivo, 3 mostraron lesiones en el lecho postiroidectomía, 15 mostraron afectación ganglionar y 5 presentaron metástasis a distancia. La sensibilidad fue del 83,9% (IC95%: 69,3-98,4%) y la especificidad del 75% (IC95%: 20-100%). Para 3 intervalos de Tg, la PET-TC mostró una tasa de verdaderos positivos del 37,5, del 83 y del 100% en los pacientes con niveles de Tg <2, entre 2 y 10, y >10 ng/ml, respectivamente. Conclusiones. La PET-TC con 18F-FDG muestra un alto rendimiento diagnóstico de la enfermedad locorregional y a distancia en la población de pacientes con cáncer diferenciado de tiroides en situación de persistencia de enfermedad y rastreo con yodo negativo con niveles de Tg >2ng/ml(AU)

Objective. To assess the diagnostic performance of 18F-FDG PET-CT scan and its relation to serum thyroglobulin (Tg) levels in patients with differentiated thyroid carcinoma with suspicion of persistence or recurrence of the disease and negative radioiodine scans. Materials and methods. This is a retrospective analysis of 35 PET-CT studies in 25 patients (17 women, average age 48.8±15.2 years). The results were confirmed by histology or by ultrasonography and clinical follow-up. We analyzed the relationship between the diagnostic performance of the PET-CT scans and three levels of Tg: ≤2ng/ml; between 2 and 10 ng/ml, and >10ng/ml. Results. We obtained 26 true-positives (TP), one false-positive (FP), 3 true-negatives (TN) and 5 false-negatives (FN). Of the 18 patients with PET-CTs classified as TP, 3 showed lesions at the post-thyroidectomy bed, 15 showed lymph node metastases and 5 were distant metastases. Sensitivity was 83.9% (95%CI: 69.3%-98.4%) and specificity was 75% (95%CI: 20%-100%). Regarding the three intervals of Tg, PET-CT scan showed TP rates of 37.5%, 83% and 100% in patients with Tg levels <2ng/ml, between 2 and 10ng/ml, and >10ng/ml, respectively. Conclusions. 18F-FDG PET-CT demonstrates high diagnostic yield in local disease and distant lesions for the population of patients with differentiated thyroid carcinoma and persistence of the disease with negative radioiodine scans at Tg levels above 2ng/ml(AU)

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OBJECTIVE: To assess the diagnostic performance of (18)F-FDG PET-CT scan and its relation to serum thyroglobulin (Tg) levels in patients with differentiated thyroid carcinoma with suspicion of persistence or recurrence of the disease and negative radioiodine scans. MATERIALS AND METHODS: This is a retrospective analysis of 35 PET-CT studies in 25 patients (17 women, average age 48.8±15.2 years). The results were confirmed by histology or by ultrasonography and clinical follow-up. We analyzed the relationship between the diagnostic performance of the PET-CT scans and three levels of Tg: ≤2ng/ml; between 2 and 10 ng/ml, and >10ng/ml. RESULTS: We obtained 26 true-positives (TP), one false-positive (FP), 3 true-negatives (TN) and 5 false-negatives (FN). Of the 18 patients with PET-CTs classified as TP, 3 showed lesions at the post-thyroidectomy bed, 15 showed lymph node metastases and 5 were distant metastases. Sensitivity was 83.9% (95%CI: 69.3%-98.4%) and specificity was 75% (95%CI: 20%-100%). Regarding the three intervals of Tg, PET-CT scan showed TP rates of 37.5%, 83% and 100% in patients with Tg levels <2ng/ml, between 2 and 10ng/ml, and >10ng/ml, respectively. CONCLUSIONS: (18)F-FDG PET-CT demonstrates high diagnostic yield in local disease and distant lesions for the population of patients with differentiated thyroid carcinoma and persistence of the disease with negative radioiodine scans at Tg levels above 2ng/ml.

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We report localisation of the chickpea ßI-Gal, a member of the chickpea ß-galactosidase family, which contains at least four members. After generation of specific antibodies, the distribution and cellular immunolocalisation of the protein in different organs and developmental stages of the plant was studied. ßI-Gal protein is much longer than the other chickpea ß-galactosidases because of the presence of a lectin-like domain in the carboxyl terminus of the protein. Western blot experiments indicated that the active ßI-Gal retains this lectin-like domain for its function in the plant. The ßI-Gal protein was mainly detected in cell walls of elongating organs, such as seedling epicotyls and stem internodes. An immunolocation study indicated a very good correlation between the presence of this ßΙ-galactosidase and cells whose walls are thickening, not only in aged epicotyls and mature internodes in the final phase of elongation, but mostly in cells with a support function, such as collenchyma cells, xylem and phloem fibres and a layer of sclerenchyma cells surrounding the vascular cylinder (perivascular fibres). These results could suggest a function for the ßI-Gal in modification of cell wall polymers, leading to thicker walls than the primary cell walls.

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OBJECTIVES: To demonstrate the value of three-dimensional (3D) ultrasound in the diagnosis of uterine malformations and its concordance with magnetic resonance imaging (MRI). METHODS: This study included 286 women diagnosed with uterine malformation by 3D ultrasound, having been referred to our clinics on suspicion of uterine malformation following clinical and/or conventional two-dimensional ultrasound examination. With the exception of three with intact hymen, patients underwent both bimanual examination and speculoscopy before and/or after sonography. MRI was performed in 65 cases. We analyzed the diagnostic concordance between the techniques in the study of uterine malformations. RESULTS: Using 3D ultrasound we diagnosed: one case with uterine agenesis; 10 with unicornuate uterus, four of which also underwent MRI; six with didelphic uterus, one of which had MRI; 45 with bicornuate uterus, 12 of which had MRI; 125 with septate uterus (18 with two cervices), 42 of which had MRI (six with two cervices); 96 with arcuate uterus, three of which had MRI; and three with diethylstilbestrol (DES) iatrogenic uterine malformations, all of which had MRI. Among the 65 which underwent MRI, the diagnosis was: four cases with unicornuate uterus, 10 with bicornuate uterus (two with two cervices), 45 with septate uterus (five with two cervices), three with arcuate uterus and three with DES-related uterine malformations. The concordance between 3D ultrasound and MRI was very good (kappa index, 0.880 (95% CI, 0.769-0.993)). Discrepancies in diagnosis between the two techniques occurred in four cases. There was very good concordance in the diagnosis of associated findings (kappa index, 0.878 (95% CI, 0.775-0.980)), this analysis identifying differences in two cases. CONCLUSIONS: There is a high degree of concordance between 3D ultrasound and MRI in the diagnosis of uterine malformations, the relationship between cavity and fundus being visualized equally well with both techniques. 3D ultrasound should be complemented by careful gynecological exploration in order to identify any alterations in the cervix.

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Cell wall hydrolases have been assumed to be involved in the regulation of seed germination, mostly through their contribution to the cell wall disassembly associated with endosperm cap weakening. In Cicer arietinum (a non-endospermic leguminosae seed), we have focused our research directly on the elongation process of the embryonic axes themselves during germination. The genes encoding cell wall proteins, previously implicated in the elongation of chickpea epicotyls, might also be involved in the expansion of embryonic axis cells, and the modulation of their expression could be part of the control of the germinative process. Thus, chickpea alpha-expansins and xyloglucan endotransglycosylase/hydrolase (XTH) acting on the cellulose/xyloglucan network seem to be involved in the elongation of both chickpea epicotyls and embryonic axes, although the products of different genes perform their actions on each organ. Among the four known cDNAs encoding chickpea alpha-expansins, Ca-EXPA1 was the only isoform highly expressed in embryonic axes during germination. In contrast to epicotyl elongation, the genes encoding cell wall beta-galactosidases, involved in pectin degradation, were not expressed during germination, suggesting no role in embryonic axis elongation, mainly due to the different metabolism of pectins during cell wall loosening in embryonic axis or epicotyl cells. The results concerning CanST-1 and -2, encoding two growth-related cell wall proteins, suggested that these genes were not involved in elongation of embryonic axes during germination. The transcription pattern of Cap28, which encodes a glutamic acid rich cell wall protein of unknown function, indicated a role in the development of the embryonic axes during germination.

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Objetivos. El objetivo principal es conocer la relación entre la disfunción familiar y la presencia de trastorno mental. El objetivo secundario es conocer la prevalencia y la distribución de los principales tipos de patología mental en la población atendida en atención primaria. Diseño y emplazamiento. Estudio descriptivo y transversal realizado en 6 consultas de medicina de familia de un área básica de salud semiurbana. Método. Se seleccionaron 280 sujetos mediante muestreo aleatorio sistemático de los que acudieron espontáneamente a la consulta. Mediante entrevista se recogieron las variables de estudio: dinámica familiar (medida mediante el test de APGAR familiar), estructura familiar, variables sociodemográficas y presencia de trastorno mental detectado mediante la Mini International Neuropsyquiatric Interview (MINI-DSM IV). Resultados. Aceptaron participar 264 sujetos. Un 64,4 por ciento era mujer y la media de edad fue de 45,6 años (DE, 16,7). Se detectó patología mental en 87 participantes (33 por ciento), siendo la patología más frecuente trastorno de ansiedad generalizada, distimia y depresión mayor. Se encontró alteración de la dinámica familiar en 32 personas (12,3 por ciento). No se observaron diferencias significativas en la frecuencia de presentación de patología mental entre el grupo con disfunción familiar y el resto. Conclusiones. Los trastornos de salud mental son frecuentes entre los pacientes que acuden a las consultas de atención primaria. No encontramos asociación entre las alteraciones de la dinámica familiar y los trastornos de salud mental, lo que podría deberse a la dificultad para detectar disfunción familiar con el test de APGAR (AU)

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OBJECTIVE: To describe the relation between the main variables related with social inequality and the utilization of primary care services. METHODS: Socio-demographic variables and the number of consultations were collected in a cross-sectional study. RESULTS: 264 subjects were interviewed. 66% of the population belonged to social classes IV and V. There was statistical signification between age and number of visits (p = 0.0014) and between number of visits and monoparental families (p = 0.01). CONCLUSIONS: Most of the attended population belonged to the low and middle socio-economic levels. The relationship between non-structured families and hyper-utilization and the relationship between age and hyper-utilization is confirmed.

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OBJECTIVES: The purpose is to describe the relationship between family disfunction and mental disorder. The secondary objective is to know the prevalence and distribution of mental disorders in primary care attended population. DESIGN: A cross-sectional study was conducted in a primary care setting. PATIENTS AND METHODS: Random sample was selected over 280 subjects from consultant population. The variables (family function, family structure, social and economic conditions and mental disorders) were collected through interview. APGAR test and Mini International Neuropsychiatric Interview test were performed. RESULTS: 264 patients were finally included (64% women). Mean age was 45.6 years (SD 16.7). Mental disorders were detected in 87 patients (33%). The most prevalent disorders were generalized anxiety disorder, dysthymia and major depression, family disfunction was found in 32 patients (12.3%). Prevalence of mental disorders wasn't statistically different in the group with family disfunction. CONCLUSION: Mental disorders are a common problem between primary care attended population. There wasn't any association between family disfunction and mental disorders, because of the limitations in the APGAR test in detecting family disfunction.

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Thyroid nodules in children are extremely uncommon and in most cases present as asymptomatic neck masses. The significance of a thyroid nodule in a child involves the underlying risk of malignancy. The purpose of this study was to assess the validity of results of fine-needle aspiration biopsy (FNAB) of thyroid nodules in the pediatric population and its usefulness in pediatric patient management. FNAB was performed on a total of 57 thyroid nodules from 57 patients between 1992 and 1997. The patients included 46 females and 11 males ranging in age from 9 to 20 years (average 16.5 years). Surgical and/or clinical follow up was available in all patients. FNAB diagnoses included papillary thyroid carcinoma (PTC) (12.3% [7/57]), follicular neoplasm (FN) (15.8% [9/57]), atypical cytology (8.8% [5/57]) and nonneoplastic thyroid (63.2% [36/57]). Surgical follow-up available in all patients with cytological diagnoses of PTC, FN, and atypical cytology revealed malignancy in 13 cases. Of the 36 patients with nonneoplastic cytological diagnosis, surgical excision was performed in 3 patients and the rest were followed up clinically. Surgical excision in these 3 patients revealed follicular carcinoma (FC) (1 case) and multinodular goiter (2 cases). Overall, 14 patients (24.6%) had malignant thyroid lesions, including 11 PTC and 3 FC. In conclusion, the majority of pediatric thyroid nodules are benign. The prevalence of malignancy in pediatric patients with thyroid nodules in our series was 24.6%. High diagnostic accuracy of thyroid FNAB improves selection of pediatric patients requiring surgery.

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A cDNA clone, CanTUB, encoding a putative beta-tubulin protein was isolated from a cDNA library constructed from 5-day old chickpea (Cicer arietinum) epicotyls. Analysis of its deduced amino acid sequence showed all the typical structural motifs of plant beta-tubulins. Putative sequences for autoregulation and tubulin mRNA stability, GTP and Ca2+/MAPs (microtubule-associated proteins) binding sites were present. Southern blot analysis of chickpea genomic DNA revealed that there are multiple beta-tubulin genes. The level of expression of beta-tubulin genes was correlated with the rate of growth in either seedlings and adult plants. The transcript levels of beta-tubulin genes were higher in actively elongating tissues such as etiolated epicotyls, roots and stem tissues of adult plants. Brassinolide-induced growth in chickpea epicotyls was accompanied by promotion of the expression of the gene coding for beta-tubulin.

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