Association of hyperglycaemia with hospital mortality in nondiabetic COVID-19 patients: A cohort study.

OBJECTIVE: Diabetes is a known risk factor for mortality in Coronavirus disease 2019 (COVID-19) patients. Our objective was to identify prevalence of hyperglycaemia in COVID-19 patients with and without prior diabetes and quantify its association with COVID-19 disease course. RESEARCH DESIGN AND METHODS: This observational cohort study included all consecutive COVID-19 patients admitted to John H Stroger Jr. Hospital, Chicago, IL from March 15, 2020 to May 3, 2020 and followed till May 15, 2020. The primary outcome was hospital mortality, and the studied predictor was hyperglycaemia [any blood glucose ≥7.78 mmol/L (140 mg/dL) during hospitalization]. RESULTS: Of the 403 COVID-19 patients studied, 51 (12.7%) died; 335 (83.1%) were discharged while 17 (4%) were still in hospital. Hyperglycaemia occurred in 228 (56.6%) patients; 83 of these hyperglycaemic patients (36.4%) had no prior history of diabetes. Compared to the reference group no-diabetes/no-hyperglycaemia patients the no-diabetes/hyperglycaemia patients showed higher mortality [1.8% versus 20.5%, adjusted odds ratio 21.94 (95% confidence interval 4.04-119.0), P < 0.001]; improved prediction of death (P = 0.01) and faster progression to death (P < 0.01). Hyperglycaemia within the first 24 and 48 h was also significantly associated with mortality (odds ratio 2.15 and 3.31, respectively). CONCLUSIONS: Hyperglycaemia without prior diabetes was common (20.6% of hospitalized COVID-19 patients) and was associated with an increased risk of and faster progression to death. Development of hyperglycaemia in COVID-19 patients who do not have diabetes is an early indicator of progressive disease.

Audit of cataract surgery in Cadiz: visual outcomes and complications. / Auditoría de la cirugía de catarata senil en Cádiz: resultados visuales y complicaciones.

OBJECTIVE: To publish the outcomes and complications of age-related cataract surgery in Cadiz (Spain). Due to the lack of national audits, a comparison was made between the results obtained here and those of the most recent European audit, EUREQUO (2013), and the British audit RCOphth NOD (2015). METHODS: A prospective, longitudinal, before-after study of 312 patients undergoing cataract surgery in the University Hospitals of Puerta del Mar and Puerto Real (Cadiz), in 2013-14. Outcome measurements included sociodemographic characteristics, visual acuity (VA), symptoms secondary to cataract, ocular comorbidity, waiting time, expertise of surgeon (consultant vs. trainee), rate and type of surgical complications. RESULTS: The median age at surgery was 73.92±7.31. Almost all (98.3%) of patients at consultation had a VA ≥0.60logMAR, with a mean pre-surgical VA of 1.01logMAR (0.92-1.10). There was a 6.7% complication rate, with 3.8% posterior capsule ruptures and 2.8% corneal decompensations. No cases of endophthalmitis occurred. The mean post-operative VA was 0.28logMAR (0.22-0.33). More than three-quarters (78.8%) of cases achieved a post-operative VA ≤0.3logMAR, and 27.6% of cases achieved a VA ≤0.0logMAR. CONCLUSIONS: Our success rate was inferior to the EUREQUO and RCOphth NOD studies, with the percentage of patients acquiring a postoperative VA ≤0.3logMAR being 98% and 89%, respectively. However, the populations were not comparable. It is hoped that this study will encourage other public hospitals in Spain to undertake audits and share their results, in order to provide a tool for constructive criticism and quality improvement initiatives.

Surface micro- and nano-texturing of stainless steel by femtosecond laser for the control of cell migration.

The precise control over the interaction between cells and the surface of materials plays a crucial role in optimizing the integration of implanted biomaterials. In this regard, material surface with controlled topographic features at the micro- and nano-scales has been proved to affect the overall cell behavior and therefore the final osseointegration of implants. Within this context, femtosecond (fs) laser micro/nano machining technology was used in this work to modify the surface structure of stainless steel aiming at controlling cell adhesion and migration. The experimental results show that cells tend to attach and preferentially align to the laser-induced nanopatterns oriented in a specific direction. Accordingly, the laser-based fabrication method here described constitutes a simple, clean, and scalable technique which allows a precise control of the surface nano-patterning process and, subsequently, enables the control of cell adhesion, migration, and polarization. Moreover, since our surface-patterning approach does not involve any chemical treatments and is performed in a single step process, it could in principle be applied to most metallic materials.

Direct laser writing of nanorough cell microbarriers on anatase/Si and graphite/Si.

The formation of hierarchical structures consisting of microstripe barriers decorated with nanorough ablated materials prepared by direct laser writing is described. Linear features of circa 25µm width and 12µm height are achieved on amorphous and crystalline titania and graphitic carbon films deposited on silicon. Ablated protrusions build up barriers decorated by nanoscale Si-film reconstructions, as indicated by EDX maps and micro-Raman spectroscopy. Wettability tests show a dramatic change in water contact angle, which leads to almost full wetting after irradiation, irrespective of the original film composition. Fluorescence microscopy images of human mesenchymal stem cells cultured on 1D and 2D structures demonstrate the short term biocompatibility of the ablated surfaces. It is shown that cells adhere, extend and polarize on feature edges, independently of the type of surface, thus suggesting that the created nanoroughness is at the origin of the antifouling behavior. In particular, irradiated anatase and graphite surfaces demonstrate an increased performance of crystalline films for the creation of cell guiding and trapping devices. The results suggest that such laser processing of films may serve as a time-and-cost-efficient method for the design of few-cells analytical surfaces.

Calcium phosphate/porous silicon biocomposites prepared by cyclic deposition methods: spin coating vs electrochemical activation.

Porous silicon (PSi) provides an excellent platform for bioengineering applications due to its biocompatibility, biodegradability, and bioresorbability. However, to promote its application as bone engineering scaffold, deposition of calcium phosphate (CaP) ceramics in its hydroxyapatite (HAP) phase is in progress. In that sense, this work focuses on the synthesis of CaP/PSi composites by means of two different techniques for CaP deposition on PSi: Cyclic Spin Coating (CSC) and Cyclic Electrochemical Activation (CEA). Both techniques CSC and CEA consisted on alternate Ca and P deposition steps on PSi. Each technique produced specific morphologies and CaP phases using the same independent Ca and P stem-solutions at neutral pH and at room temperature. The brushite (BRU) phase was favored with the CSC technique and the hydroxyapatite (HAP) phase was better synthesized using the CEA technique. Analyses by elastic backscattering spectroscopy (EBS) on CaP/PSi structures synthesized by CEA supported that, by controlling the CEA parameters, an HAP coating with the required Ca/P atomic ratio of 1.67 can be promoted. Biocompatibility was evaluated by bone-derived progenitor cells, which grew onto CaP/PSi prepared by CSC technique with a long-shaped actin cytoskeleton. The density of adhered cells was higher on CaP/PSi prepared by CEA, where cells presented a normal morphological appearance and active mitosis. These results can be used for the design and optimization of CaP/PSi composites with enhanced biocompatibility for bone-tissue engineering.

Reprogramming hMSCs morphology with silicon/porous silicon geometric micro-patterns.

Geometric micro-patterned surfaces of silicon combined with porous silicon (Si/PSi) have been manufactured to study the behaviour of human Mesenchymal Stem Cells (hMSCs). These micro-patterns consist of regular silicon hexagons surrounded by spaced columns of silicon equilateral triangles separated by PSi. The results show that, at an early culture stage, the hMSCs resemble quiescent cells on the central hexagons with centered nuclei and actin/ß-catenin and a microtubules network denoting cell adhesion. After 2 days, hMSCs adapted their morphology and cytoskeleton proteins from cell-cell dominant interactions at the center of the hexagonal surface. This was followed by an intermediate zone with some external actin fibres/ß-catenin interactions and an outer zone where the dominant interactions are cell-silicon. Cells move into silicon columns to divide, migrate and communicate. Furthermore, results show that Runx2 and vitamin D receptors, both specific transcription factors for skeleton-derived cells, are expressed in cells grown on micropatterned silicon under all observed circumstances. On the other hand, non-phenotypic alterations are under cell growth and migration on Si/PSi substrates. The former consideration strongly supports the use of micro-patterned silicon surfaces to address pending questions about the mechanisms of human bone biogenesis/pathogenesis and the study of bone scaffolds.

Design and characterization of biofunctional magnetic porous silicon flakes.

Magnetic porous silicon flakes (MPSF) were obtained from mesoporous silicon layers formed by multi-step anodization and subsequent composite formation with Fe oxide nanoparticles by thermal annealing. The magnetic nanoparticles adhered to the surface and penetrated inside the pores. Their structure evolved as a result of the annealing treatments derived from X-ray diffraction and X-ray absorption analyses. Moreover, by tailoring the magnetic load, the dynamic and hydrodynamic properties of the particles were controlled, as observed by the pressure displayed against a sensor probe. Preliminary functionality experiments were performed using an eye model, seeking potential use of MPSF as reinforcement for restored detached retina. It was observed that optimal flake immobilization is obtained when the MPSF reach values of magnetic saturation >10(-4)Am(2)g(-1). Furthermore, the MPSF were demonstrated to be preliminarily biocompatible in vitro. Moreover, New Zealand rabbit in vivo models demonstrated their short-term histocompatibility and their magnetic functionality as retina pressure actuators.

Have we changed the liver retransplantation survival?

INTRODUCTION: Orthotropic liver retransplantation (RT) is the therapeutic option for the failure of an allograft. Patient and graft survival rates after RT are inferior to primary liver transplantation (OLT). Because of the limited number of donors, it is essential that we optimize their use. We reviewed 68 consecutive retransplantations to evaluate their results. MATERIALS AND METHODS: Using registry data from our Liver Transplantation Unit, we performed a retrospective cohort study of adult RT between 1991 and 2010. Patients were divided into 2 groups (urgent vs elective RT) to compare the utility of RT. We also analyzed data collected at the time of RT, including age, gender, indications for primary OLT and RT (hepatitis C virus [HCV]+ and HCV-). At various stages (1991-2000, 2001-2006, and 2007-2010), we calculated probability survival curves according to the Kaplan-Meier method with comparisons using the log-rank test. RESULTS: Among 771 adult liver transplantations, 68 (8.8%) underwent late secondary OLT. 21 (31%) cases were urgent and 47 elective RT (69%). Vascular complications was the most common cause for urgent RT, and chronic rejection, for elective RT. Differences were also detected in the overall survival of RT patients; mortality was significantly lower among the urgent procedures (15% vs 47.8%). Significantly differences were also detected in overall survival for RT patients between 2007 and 2010 (81.7% with urgent RT and 76.5% with elective situations). CONCLUSION: These data confirmed the utility of RT in elective and emergency situations. Overall survival of elective RT patients has improved in recent years. Liver RT requires a multidisciplinary team to decide the inclusion and prioritization of elective RT cases on the OLT waiting list.

Social inequalities in HIV-TB and non-HIV-TB patients in two urban areas in southern Spain: multilevel analysis.

SETTING: Two towns in Campo de Gibraltar, southern Spain, with a small foreign population and higher tuberculosis (TB) incidence and human immunodeficiency virus (HIV) prevalence than the national average. OBJECTIVE: To determine the relationship between HIV-TB and non-HIV-TB incidence and social deprivation and other potential individual and contextual determinants. METHODS: In a cross-sectional longitudinal study, individual TB case variables were identified from three sources--routine surveillance, laboratory and hospital discharge records--from 1997 to 2007. Community variables were obtained at the census tract level. A deprivation index was calculated based on percentages of unemployment, low educational level and unskilled labour. Multilevel Poisson models were estimated for TB incidence rates for patients with and without HIV. RESULTS: A total of 490 TB cases were included. Sex and age at individual level and deprivation and residence in the port area at census tract level were associated both with HIV-related TB and with non-HIV-TB. Household crowding contextual variables were also associated with HIV-related TB incidence. Full models account for 78.9% and 51.7% reductions in second-level variance. CONCLUSION: Socio-economic deprivation is associated with higher rates of HIV-TB and non-HIV-TB. Diverse individual and contextual potential risk factors suggest different pathways of transmission. It is necessary to extend the framework for intervention beyond individual-based strategies to the socio-economic contexts in which people live.

[New technologies: support opportunities for network research]. / Nuevas tecnologías: posibilidades de apoyo a la investigación en red.

The consolidation of a support area for network research, which promotes collaborative research, training and the dissemination of knowledge through the use of ICTs, requires the organization of a work methodology to share and exchange resources in a specific network that is already running. The establishment of communication mechanisms between researchers from different groups will be necessary along with the introduction of the ICTs in the teaching and advanced environments of research training, different inventories of the research resources that are available for exchanges and shared use between groups and laboratories, and finally, a shared scientific documentation system with the appropriate maintenance of the previously listed tools. Large administrative structures and detailed plans are not needed to comply with all of the above functions. The availability of effective tools, however, to combine efforts and search for resources in all of these areas is needed, with the agility and flexibility that allow us to currently use new communication and information technologies. The results of this research support area should lead to an increase in the efficacy and quality of the network by increasing the flow of information and the inter-group collaboration in teaching, research and professional development, along with the transfer and dissemination of research results.

Characterization and cytocompatibility of hybrid aminosilane-agarose hydrogel scaffolds.

Agarose hydrogels containing aminopropyl triethoxy silane (APTS) have been prepared and evaluated as scaffolds for adhesion and proliferation of human mesenchymal stem cells (hMSCs). The preparation of the hydrogels involved the conventional melting of agarose in water followed by addition of APTS as functional group carrier. The resulting hydrogel supports have been studied by Fourier transformed infrared spectroscopy in order to get an insight into the hybrid molecular structure. X-ray photoelectron spectroscopy has been used for the analysis of the surface chemical composition of the hydrogels. It is deduced from these data that the resulting hybrid structure presents two phases with a clear tendency toward APTS surface segregation. Moreover, the observation of the desiccated hydrogel surfaces by atomic force microscopy shows that the films acquire a filament-mesh structure for increasing APTS content, while the pure agarose supports exhibit a granular structure. As a result of such a structure, the hydrogel surfaces show a hydrophobic behavior, as determined by water contact angle measurements. The biocompatibility of such platforms is supported by adhesion-proliferation assays performed with hMSCs. It is concluded that although adhesion is lower on APTS rich scaffolds, the proliferation rate on these surfaces is higher so that total number of proliferating cells does not significantly depend on APTS content in the hydrogels.

[Habits and lifestyles modifiable in children with overweight and obesity]. / Hábitos y estilos de vida modificables en niños con sobrepeso y obesidad.

INTRODUCTION: In the prevention for being overweight and for obesity, much attention is given to the influence of dietary factors, making the joint evaluation with other modifiable factors necessary. OBJECTIVES: The aim of this project is to study the association between modifiable factors (physical activity, sedentary lifestyle, and dietary habits) with the prevalence of being overweight or obese in the youth population. METHODS: Cross-Sectional study of 1283 school children between the ages of 3 and 16 years old, with measurements of the MBI, dietary habits, physical activity, sedentary lifestyle and family history of being overweight. Physical activity measured in MET was classified according to Pate criteria. RESULTS: 22.4% of the boys and 32.9% of the girls were overweight. The presence of a BMI>25 in parents multiplied by 2.4 the risk of being overweight in children (OR CI 95% 1.5-3.7). 63.6% of overweight boys meet physical activity recommendations compared with 52.2% of girls, although in their case, it was greater than the average (45%). Sedentary time was 141 minutes for men and 128 minutes for women, with more sedentary behaviors associated with being overweight, especially in girls over 12 years of age (66.7%). Consuming cereal (OR 0.8) and having five meals per day (OR 0.5) act as protective factors. CONCLUSIONS: In subjects with overweight, the levels of physical activity are close to those recommended levels, so which the values of a sedentary lifestyle together with dietary habits (if the parents have overweight) acquire a new relevance in intervention strategies of this problem.

Life-style factors associated with overweight and obesity among Spanish adults.

OBJECTIVES: To assess the relationship between life styles and eating habits with the overweight and obesity prevalence in a Spanish adult population. METHODS: A population-based, cross-sectional study conducted on 2640 subjects older than 15 years, in Cádiz (Spain). Surveys were conducted in subjects' homes to obtain life styles, eating habits, and anthropometric data. Logistic regression has been used to study the association between the life style variables and overweight and obesity. RESULTS: Prevalence of overweight and obesity in Cadiz is 37% and 17%, respectively; higher in males and increases with age. BMI has an inverse relationship with educational level (PR = 2.3, 1.57-2.38). The highest levels of obesity are associated with daily alcohol consumption (PR = 1.39, 1.29-1.50), greater consumption of television,and sedentary pursuit (PR 1.5, 1.07-1.24). A lower prevalence of obesity is observed among those with active physical activity (10.9% vs 21.6%), with differences between sex. Following a slimming diet is more frequent in the obese and in women but dedicate more hours than men to passive activities. In men is greater the consumption of alcohol, high energy foods and snacks. Overweight and obesity is associated with the male sex (OR = 3.35 2.75-4.07), high consumption of alcohol (OR = 1.38 1.03-1.86) and watching television (OR = 1.52 1.11-2.07), and foods likes bread and cereals (OR = 1.47 1.13-1.91). Exercise activities is a protective factor (OR = 0.76 0.63-0.98). CONCLUSIONS: Life styles factors associated with overweight and obesity present different patterns in men and women and is necessary to understand them to identify areas for behavioural intervention in overweight and obesity patients.

Hybrid titania-aminosilane platforms evaluated with human mesenchymal stem cells.

The properties of hybrid aminopropyltriethoxysilane-tetraisopropylorthotitanate (APTS-TIPT) platforms prepared by a sol-gel route have been explored, and their biocompatibility was assayed after culture of human mesenchymal stem cells (hMSCs). The organic content of this material was observed to be preferably surface-oriented as indicated by microanalytical techniques. Furthermore, the surface showed characteristic amino-silane bands when explored by Raman spectroscopy as well as indications of silane and titanate condensation. Surface activity of the amino groups was probed by ultraviolet-visible spectroscopy imine derivatization and chemical force spectroscopy, showing a pH-dependent surface charge-induced potential. hMSCs cultured onto these surfaces showed relevant differences with respect to their behavior on gelatin-coated glass plates. Even if with a lower proliferative rate than controls, the cells develop long cytosolic prolongations in osteogenic differentiation medium, thus, supporting the idea of an APTS-TIPT stimulated process.

Micro-spot, UV and wetting patterning pathways for applications of biofunctional aminosilane-titanate coatings.

The micropatterning of functional films for biomedical applications is a key part of the process leading to a precise application. In the present work we present three different methodologies to micro-design biofunctional aminosilane-titanate coatings. The chemical functionality of the surface immobilized amino groups was initially tested by surface characterization techniques. X-ray photoelectron spectroscopy was used to analyze the films before and after derivatization with Trifluoromethylbenzaldehyde while atomic force microscopy was used to study the adsorption kinetics onto these hybrid films. The three micropatterning pathways were selected for three different kinds of applications: (1) 300 microm spots were satisfactorily used for oligonucleotide immobilization, (2) Masked regions protected from UV irradiation were intensively coated by colloidal gold nanoparticles creating a drastic contrast with respect to the UV exposed areas, and (3) radial micro stripes, used afterwards for culturing cells, were created onto Si substrates by wetting from modified precursor solutions. The results are a clear indication of the versatility of hybrid aminosilane-titanate coatings for biomedical applications requiring micropatterned biofunctional surfaces.

Characteristics of eating disorders in a university hospital-based Spanish population.

OBJECTIVE: To describe the personal and family antecedents and clinical characteristics of patients with eating disorders (EDs) in a population of the south of Spain; to analyse the influence of lifestyles, family functioning, socioeconomic status (SES), and psychological characteristics in these processes. DESIGN: A university-based case-control study. SETTING: University Hospital (Andalusia, Spain). SUBJECTS: A total of 120 patients with EDs and 240 controls. INTERVENTIONS: SCOFF, EDI, APGAR family, and SES questionnaires. RESULTS: In all, 67.5% of patients presented anorexia (AN), 15% bulimia (BN), and 17.5% mixed forms. EDs emerged at around 18-20 y (95% CI 17.9-19.8). Factors associated with EDs are psychiatric conditions (depression OR: 4.16, anxiety OR: 4.59), more frequent use of medication (OR: 2.26), dietary fibre (OR: 2.59), and laxatives (OR: 3.47). Toxics consumption, sport activity, SES, and family antecedents of pathology are not associated with EDs. An inverse relationship was found between family functioning and the scores in various subscales of the EDI. CONCLUSIONS: Eating disorders in Andalusia (Spain) are influenced significantly more by psychological, family, and cultural factors than by social factors.

Cellular localization and changes in expression of prolactin receptor isoforms in sheep ovary throughout the estrous cycle.

The actions of prolactin (PRL) on target cells depend on the type of prolactin receptor (PRLr) predominantly expressed, particularly whether the long PRLr isoform is expressed. The aims of this study were to determine the cellular localization and the changes in expression of long and short PRLr isoforms in sheep ovary throughout the estrous cycle. Long and short PRLrs were localized mostly in the same ovarian cells. Maximum signal intensity, particularly for long PRLrs, was found in stromal cells surrounding primordial and primary follicles, and, for both PRLrs, in granulosa cells of preantral follicles and in luteal cells. Moderate signal intensity for PRLrs was found in theca cells of preantral to ovulatory follicles, and in granulosa cells of antral follicles up to the gonadotropin-dependent stage. Decreasing immunoreactivity to PRLrs was found in granulosa cells of gonadotropin-dependent to ovulatory follicles. For long PRLrs in particular, no signal was found in mural granulosa cells of gonadotropin-dependent follicles; for both isoforms, no signal was found in most granulosa cells of ovulatory follicles. In primordial to gonadotropin-dependent follicles, cellular localization of PRLr was similar on days 0, 10 and 15 of the cycle. Oocytes consistently showed positive immunostaining for PRLrs. Comparative RT-PCR analysis of long and short PRLr expression showed that the short isoform is evenly expressed throughout the estrous cycle, whereas the expression of the long form increases at the time of estrus and decreases at mid-luteal phase and at the onset of the follicular phase. Expression of long PRLrs was greater than that of short PRLrs on day 0 of cycle; expression of both isoforms was similar on day 10 and on day 15, long PRLrs expression was lower than that of short PRLrs. Our results indicate that in sheep ovary, the maximum responsiveness to PRL might occur during the preovulatory phase of the estrous cycle.

The fate of chondrocyte in osteoarthritic cartilage of transgenic mice expressing bovine GH.

OBJECTIVE: The aim of the present study was to demonstrate whether bGH transgenic mice develop OA. We therefore studied in this animal model the structural features of cartilage and the subchondral bone changes of the knee joints that may be associated with osteoarthritic lesion. METHOD: Degenerative changes in the knee joints of bGH transgenic female mice (N = 11) and control mice (N = 11) were histologically analyzed at the age of 7 months. Histochemical and stereological studies were conducted. Immunohistochemistry on cell cyclin activity (assessed by anti-PCNA labeling) and cell viability (assessed by bcl-2 expression), as well as ribosomal activity (AgNOR), TNF-alpha expression and apoptosis (TUNEL technique) were performed. In ten 7-month-old female mice (Tg+ N = 5; control N = 5) the knee articular cartilages were studied with electron microscopy techniques. RESULTS: Disruption of the articular surface (18.2%), cleft (63.7%), cloning (81.8%), hypocellularity of chondrocytes (18.2%), moderate (54.6%) to severe (45.4%) loss of safranin-O staining, and duplication and rupture of the tidemark (54.5%) were some of the main features observed in articular cartilage chondrocytes of bGH transgenic mice. Furthermore, cell cyclin activity and cell viability decreased, while TNF-alpha expression and TUNEL+ cells increased. These chondrocytes also showed an increase in the number of black dots per cell, as revealed by the AgNOR technique. CONCLUSION: Our results show that bGH transgenic mice develop a lesion of the articular cartilage consistent with that described in osteoarthritis.

Epidemiological study of the influence of family and socioeconomic status in disorders of eating behaviour.

OBJECTIVE: To analyse the differences in family functioning and socioeconomic status between subjects with disorders of eating behaviour and the healthy population, considering the possible relationship of these factors with the psychic characteristics of patients, with consumption of various substances, and with sexual practices. DESIGN: Case-control study. SETTING: 'Puerta del Mar' University Hospital (Andalusia, Spain). SUBJECTS: Conducted on a sample of 120 patients with AN and BN, and 240 controls with an identical distribution by age and sex. INTERVENTIONS: SCOFF, eating disorder inventory (EDI), Apgar family and socioeconomic questionnaires are utilised. RESULTS: Patients with disorders of eating behaviour present greater family dysfunctioning than controls; among cases, this difference is greater in the acute forms, but there are no differences between recent situations or crises due to previous episodes. Family dysfunction is associated with higher scores of multiple subscales of the EDI, which is corroborated on analysing each of the Apgar parameters independently. Family functioning is not associated with other variables such as breast-feeding or consumption of toxic substances. Socioeconomic status does not differentiate cases from controls, or acute situations from evolving ones, or new episodes from other crisis episodes, although differences may be found in the psychic manifestations according to social class. CONCLUSIONS: It is confirmed that family functioning has an influence in these types of disorder, in their evolution and in the psychic characteristics of the patients, without any evidence being found of a relationship between these disorders and socioeconomic status.

Expression of CCAAT/enhancer-binding protein-beta (C/EBPbeta) and CHOP in the murine growth plate. Two possible key modulators of chondrocyte differentiation.

Our aim was to evaluate the expression of transcription factors CCAAT/enhancer-binding protein-beta (C/EBPbeta) and C/EBP-homologous protein (CHOP) in the growth plate. Proximal tibial epiphyseal growth plates from ten 15-day-old Wistar rats were used. Additionally, anti-proliferating cell nuclear antigen (PCNA), anti-5-bromo-2'-deoxyuridine (BrdU) immunostaining, terminal transferase dUTP nick end-labelling (TUNEL) and nucleolar organiser region-associated proteins (AgNOR) techniques were peformed. The histological morphology of the growth plate from C/EBPbeta knock-out mice was also analysed. The normal growth plate showed that C/EBPbeta and CHOP factors are expressed both in the germinative/ upper proliferative and in the lower proliferative zones. Furthermore, BdrU+ and PCNA+ cells were present exclusively in the germinative and proliferative zones, while TUNEL+ and AgNOR+ cells were seen in all three zones of the growth plate. Acellular areas, hypocellularity, the increase in cell death and anomalies in the architecture of the cell columns were observed in the growth plates of C/EBPbeta (-/-) knockout mice. We suggest that C/EBPbeta and CHOP transcription factors may be key modulators participating in the chondrocyte differentiation process in the growth plate.