The Influence of the Affinity between Aggregate and Bitumen on the Mechanical Performance Properties of Asphalt Mixtures.

Two of the main problems encountered in flexible pavements are the stripping of coarse aggregates and the formation of rut depth due to increases in the volume of road traffic and heavy vehicle loads, especially in areas where speeds are low. The existence of rut depth also affects the comfort and safety of road users due to the water accumulation on the pavement surface and reducing tire/pavement friction, which can lead to hydroplaning phenomena. In this research, it was proven that the use of fillers of different origins influences the affinity between aggregates and the binder. The effect of an adhesion promoter in the mix design (such as the amine included in cellulosic fiber pellets) was also studied. Several tests were carried out to determine the binder/aggregate adhesiveness, water sensitivity and resistance to permanent deformation, to evaluate the performance of different blends. It was found that the addition of this additive increased 10% of the aggregate surfaces covered with bitumen when compared with the aggregates without this addition. As expected, the water sensitivity tests showed that the mixture with granitic filler had the lowest indirect tensile strength ratio (ITSR) value (70%), while the mixtures with limestone filler led to the highest percentages (ranging from 83 to 93%). As for the results of the wheel tracking tests (WTT), it was confirmed that the use of limestone filler translates into an improvement in the performance against the permanent deformation of the asphalt mixtures. The mixture with higher bitumen content and adhesion promoter revealed the best average results.

Prevalence and characteristics of Epstein-Barr virus-associated gastric carcinomas in Portugal.

BACKGROUND: Gastric cancer (GC) is one of the most common malignant tumors of the digestive tract and is the third leading cause of cancer death worldwide. Epstein-Barr virus (EBV) has been associated with approximately 10% of the total cases of gastric carcinomas. No previous study has analyzed the prevalence of EBV infection in gastric cancer of the Portuguese population. METHODS: In the present study, we have analyzed 82 gastric carcinoma cases and 33 healthy individuals (control group) from Coimbra region for the presence of EBV by polymerase chain reaction (PCR) and by in situ hybridization (ISH) for EBV-encoded small RNAs (EBERs). The status of H. pylori infection was assessed by serology and by PCR. RESULTS: EBV was detected by PCR in 90.2% of stomach cancer cases, whereas EBERs were detected in 11%. In our series, EBV-associated gastric carcinoma (EBVaGC) were significantly associated with gender and the majority of them presented lymph node metastasis. These cases were generally graded in more advanced pTNM stages and, non-surprisingly, showed worse survival. H. pylori infection was detected in 62.2% of the gastric cancers and 64.7% of these patients were CagA+. On the other hand, the H. pylori prevalence was higher in the EBV-negative gastric carcinomas (64.4%) than in those carcinoma cases with EBV+ (44.4%). CONCLUSIONS: The present study shows that prevalence of EBVaGC among Portuguese population is in accordance with the worldwide prevalence. EBV infection seems to be associated to poorer prognostic and no relation to H. pylori infection has been found. Conversely, the presence of H. pylori seems to have a favourable impact on patient's survival. Our results emphasize that geographic variation can contribute with new epidemiological data on the association of EBV with gastric cancer.

[Gallbladder polyps: how should they be treated and when?].

OBJECTIVE: The objective of this study was to determine the correct therapeutic management for patients with gallbladder polyps (GPs), what type of surveillance should be employed and how to differentiate between benign and malignant polyps in addition to also to providing reassurance in cases of "cancerophobia". STUDY DESIGN: This was a 5-years retrospective study. LOCATION: The study was conducted at a Surgery Department at the Hospitais da Universidade de Coimbra. POPULATION: We analyzed all patients operated on at the Surgery Service II from January 2003 to December 2007 who had had a preoperative diagnosis of GP. METHODS: Clinicopathological correlations were traced for all patients. The following were analyzed: demographic data, clinical presentation, principal symptoms, associated pathologies, supplementary tests and diagnoses. RESULTS: We studied 93 patients, 91 of whom had benign polyps and two of whom had malignant polyps. Of the 91 benign polyps, 73 (78.5%) were cholesterol polyps, 14 (15%) were hyperplastic and two (2.2%) were adenomas. Two (2.2%) patients had malignant polyps, both adenogallbladder carcinomas. The mean diameter of benign polyps was 6 mm and 40 (43%) patients had multiple lesions. The mean diameter of malignant and premalignant polyps taken together was 18.8 mm, all were single polyps and the mean age of this patient subset was 57.7 years. CONCLUSION: It was concluded that the surgical option for GPs is cholecystectomy and that this should only be undertaken in cases where there are clinical signs of GP; polyps with diameters greater than 10 mm; fast-growing polyps; sessile polyps or wide-based polyps; polyps with long pedicles; patient aged over 50; concurrent gallstones; polyps of the gallbladder infundibulum or abnormal gallbladder wall ultrasound.

Pólipos da vesícula biliar: como e quando tratar? / Management of gallbladder polyps

OBJETIVO: O objetivo do estudo é saber qual a orientação terapêutica para os doentes com pólipos vesiculares (PVs), que tipo de vigilância realizar, saber diferenciar entre um pólipo benigno e um pólipo maligno e proporcionar uma tranquilização em relação à "cancrofobia". Tipo de estudo: Realizou-se um estudo retrospectivo de cinco anos. Local: O estudo foi realizado nos Hospitais da Universidade de Coimbra, num Serviço de Cirurgia. População: Foram estudados todos os doentes operados no Serviço de Cirurgia II com o diagnóstico pré-operatório de PV, entre janeiro de 2003 e dezembro 2007. MÉTODOS: Foi feita correlação clínico-patológica de todos os doentes. Feita avaliação: de dados demográficos, da apresentação clínica, dos principais sintomas, das patologias associadas e exames complementares de diagnóstico realizados. RESULTADOS: Foram estudados 93 doentes, sendo que em 91 doentes tratava-se de pólipos benignos e em dois doentes de pólipos malignos. Dos 91 pólipos benignos, 73 (78,5 por cento) eram pólipos de colesterol, 14 (15 por cento) hiperplasias e dois (2,2 por cento) adenomas. Em dois (2,2 por cento) doentes tratava-se de pólipos malignos, adenocarcinoma da vesícula biliar. O diâmetro médio dos pólipos benignos é de 6 mm, 40 (43 por cento) doentes apresentavam lesões múltiplas. Nos pólipos malignos e pré-malignos (adenomas) o diâmetro médio é de 18,8 mm, são todas lesões solitárias e a idade média destes doentes é de 57,7 anos. CONCLUSÃO: Conclui-se que o tratamento cirúrgico dos PVs é a colecistectomia e só deve ser realizado quando existe: clínica relacionada com o PV; pólipos de diâmetro superior a 10 mm; crescimento do pólipo num curto espaço de tempo; pólipo séssil ou base de inserção larga; pólipo com longo pedículo; idade do doente superior a 50 anos; coexistência de litíase vesicular; pólipos localizados no infundíbulo da vesícula ou alterações ecográficas na parede vesicular.

OBJECTIVE: Appropriate treatment and timing hinge on whether the lesion is benign or malignant. Study: A five years retrospective descriptive analysis was performed. Location : Department of General Surgery in Hospitals of the University of Coimbra. Patients: We present a series of 93 consecutive patients who had elective surgery for known gallbladder polyps, treated from January 2003 to December 2007. METHODS: An analysis was performed using clinical and radiological files of patients electively treated for gallbladder polyp. Ninety-three consecutive patients were evaluated, treated and followed in a Department of General Surgery in a Central Hospital in that period. Biographic, clinical and radiological data were compiled. RESULTS: In 91 patients a benign lesion was found. Two (2.16 percent) patients had adenocarcinoma. Among benign polyps, 73 (78,5 percent) were cholesterol polyps, 14 (15 percent) were hyper-plastic and 2 (2.19 percent) were premalignant adenomas. Mean diameter of benign polyps, excluding adenomas, was 6 mm. In 40 (43 percent) patients, multiple lesions were found. The mean diameter in the subset of malignant and premalignant polyps was 18.8 mm, in all instances these were found to be single lesions; and mean age at presentation was 57,7 years. CONCLUSION: Cholecystectomy is the appropriate surgical treatment for gallbladder polyps, when removal is warranted. Patients benefitting from surgery are those who are symptomatic, whose polyps exceed 10 mm in diameter and , have shown to be enlarging, to be sessile or broad-based, to have long pedicles;and also have . infundibular polyps, coexisting gallstones or changes on the gallbladder wall appearance at ultrasonography.

Jejuno-jejunal invagination caused by epithelioid sarcoma: a case report.

INTRODUCTION: Jejuno-jejunal invagination is a rare condition and is usually caused by a benign lesion. We describe the case of a patient with a jejunal epithelioid sarcoma. Epithelioid sarcoma is a rare histologic subtype of sarcoma and few cases have been published. CASE PRESENTATION: A 70-year-old Caucasian man presented with vomiting and anemia. A jejuno-jejunal invagination was diagnosed and the patient underwent surgery. An epithelioid sarcoma of the wall of the jejunum was found on the invaginated ansa. CONCLUSION: To the best of our knowledge, an epithelioid sarcoma has never been reported to arise at the wall of the proximal jejunum or to present with jejuno-jejunal invagination.