Assessing the potential of poplar short rotation plantations to contribute to a low-carbon bioeconomy under water-limited conditions.

Poplar short rotation coppice (SRC) systems are important for biomass production and for short-to medium-term carbon (C) sequestration, contributing to a low-carbon bioeconomy and thus helping to mitigate global warming. The productivity and profitability of these plantations are, however, challenged under restrictive irrigation associated with climate change. This study compares the above- and below-ground C sequestration potential and economic viability of a 12-year plantation cycle (4 rotations of 3 years each) under Mediterranean conditions with optimum irrigation (T1) and 50% irrigation reduction (T2), analysing other promising biomass uses in the form of bioproducts. A total of 138 trees of the highly productive hybrid ('AF2') in a SRC-trial were sampled monthly (first rotation). Additionally, data from an extensive poplar plantation network (30 sites) was used to complete data for the plantation cycle. The average C content for above- and below-ground biomass was 17.04 Mg C ha-1 yr-1 (T1), falling by 24% in T2. The net present value (NPV) in T1 (6461 € ha-1) was 52% lower under T2 conditions. Extra payments for C sequestration increased the NPV to 8023 for T1 and 4331 € ha-1 for T2. Roots represent an important C storage in the soil, accumulating 29.9 Mg C ha-1 (T1) and 22.8 Mg C ha-1 (T2) by the end of the cycle in our study. The mitigation potential is strongly fortified when the share of bioproducts in biomass end-use increases. Assuming a distribution of 50% bioenergy and 50% bioproducts, emission were reduced between -114 Mg CO2eq ha-1 (T1) and -88 Mg CO2eq ha-1 (T2) compared to BAU until end of the century. This scenario plays a crucial sink-effect role by storing C contained in biomass, which is not immediately released into the atmosphere.

On the viability of Mg extraction in MgMoN2: a combined experimental and theoretical approach.

Layered MgMoN2 was prepared by solid state reaction at high temperature between Mo and Mg3N2 in N2 which represents a simple synthetic pathway compared to the previously reported method that used NaN3 as the nitrogen source. The crystal structure of MgMoN2 was studied by synchrotron X-ray and neutron powder diffraction. The feasibility of oxidizing this compound and concomitantly extracting magnesium from the structure was assessed by both chemical and electrochemical approaches, using different protocols. The X-ray diffraction patterns of the oxidized samples do not exhibit any relevant difference with respect to that of the as prepared MgMoN2 and no differences in the cell parameters are deduced from Rietveld refinements. No hints pointing at the presence of any amorphous phase are observed either. These results are rationalized through DFT calculated energy barriers for Mg2+ ion migration in MgMoN2.

Scrutinizing the role of size reduction on the exchange bias and dynamic magnetic behavior in NiO nanoparticles.

NiO nanoparticles (NPs) with a nominal size range of 2-10 nm, synthesized via high-temperature pyrolysis of a nickel nitrate, have been extensively investigated using neutron diffraction and magnetic (ac and dc) measurements. The magnetic behavior of the NPs changes noticeably when their diameter decreases below 4 nm. For NPs larger than or equal to this size, Rietveld analysis of the room temperature neutron diffraction patterns reveals that there is a reduction in the expected magnetic moment per [Formula: see text] ion with respect to bulk NiO, which is linked to the existence of a magnetically disordered shell at the NP surface. The presence of two peaks in the temperature dependence of both the dc magnetization after zero-field-cooling and the real part of the ac magnetic susceptibility is explained in terms of a core (antiferromagnetic, AFM)/shell (spin glass, SG) morphology. The high-temperature peak ([Formula: see text] K) is associated with collective blocking of the uncompensated magnetic moments inside the AFM core. The low-temperature peak ([Formula: see text] K) is a signature of a SG-like freezing of the surface [Formula: see text] spins. In addition, an exchange bias (EB) effect emerges due to the core/shell magnetic coupling. The cooling field and temperature dependences of the EB effect and the coercive field are discussed in terms of the core size and the effective magnetic anisotropy of the NPs. However, NiO NPs of 2 nm in size no longer show AFM order and the [Formula: see text] magnetic moments freeze into a SG-like state below [Formula: see text] K, with no evidence of EB effect.

Beyond biomass production: Enhancing biodiversity while capturing carbon in short rotation coppice poplar plantations.

Biodiversity is essential for the functioning of ecosystems and the provision of services. In recent years, the role of plantations in mitigating climate change through carbon sequestration has been highlighted. In the Mediterranean area, high-density poplar plantations in short-rotation with resprouting management (SRC) have been established for biomass purposes on mostly irrigated agricultural land, coexisting with rainfed and irrigated agricultural crops. This study aims to assess the contribution of these plantations to this type of agroforest ecosystem in terms of biodiversity. For this purpose, both flora and fauna diversity were evaluated both within and outside of the plantation. Additionally, the accumulated carbon in the biomass, as well as in the accompanying vegetation within the plantation, was assessed. Different indices were used to evaluate both the intrinsic diversity of the forest plantation and the degree of substitution and complementarity between the different communities of the landscape. Our findings reveal distinct biodiversity patterns in the land-use scenarios sampled. Specifically, we observed significantly higher flora-species richness in SRC plantations than in the adjacent agricultural land, whereas fauna richness showed a similar but slightly higher level in the forested area. A moderate level of complementarity between land uses was found for insects and mammals (around 45 %), contrasting with high complementarity for birds (87 %) and flora (90 %). This suggests substantial turnover and replacement among these ecological environments. Our results indicate that a second rotation (4 year) plantation could accumulate a total of 61.6 Mg C ha-1, and even though adventitious flora represents <2 % of the total carbon accumulated, its importance in providing ecosystem services is considerable. Hence, these findings evidence the fact that SRC poplar plantations can enhance biodiversity in Mediterranean agroforest ecosystems and actively contribute to various provisioning ecosystem services, including carbon sequestration, reflecting a multi-objective approach that extends beyond biomass production.

Prevalence of osteoporotic fracture risk factors and antiosteoporotic treatments in the Valencia region, Spain. The baseline characteristics of the ESOSVAL cohort.

UNLABELLED: This study provides information on the prevalence of the most important risk factors for osteoporosis and osteoporotic fracture in a large sample of women and men from the Valencia region and also provides the FRAX 10-year major and hip fracture risks for this population, as well as data about the use of diagnostic tests and antiosteoporotic treatments. INTRODUCTION: The purpose of this study was to describe demographic characteristics, osteoporosis risk factors, the 10-year risk of osteoporotic fracture, and the use of densitometry and antiosteoporotic treatments in the Valencia region, Spain. METHODS: A cross-sectional study using the ESOSVAL cohort baseline data was conducted. We analyze the data from 5,310 women and 5,725 men aged 50 and over who attended to 272 collaborating primary care centers in 2009-2010. We collected the demographic, anthropometric, clinical, and pharmacy data from the electronic medical record. RESULTS: The mean age of participants was 64.3 years old for women and 65.6 years old for men. The most frequent fracture risk factors were sedentary life (22.2 %) and previous fracture (15.8 %) in women and low calcium intake (21.4 %) and current smoker (20.9 %) in men. According to FRAX(®), the 10-year risk of presenting a major fracture was 5.5 % for the women and 2.8 % for the men. The 10-year risk for hip fracture was 1.9 and 1.1 % for the women and the men, respectively; 23.8 % of the women and 5.2 % of the men had a densitometry test, 27.7 % of the women and 3.5 % of the men were taking calcium and/or vitamin D supplements, and 28.2 % of the women (22.0 % in the 50-64 age group) and 2.3 % of the men were taking antiosteoporotic drugs. CONCLUSIONS: The prevalence of certain fracture risk factors not included in the FRAX tool (sedentary life, falls, low calcium intake) is high. In young women, their low risks estimated by FRAX contrast with the high figures for densitometry testing and treatment.

Influence of antiviral therapy in the long-term outcome of recurrent hepatitis C virus infection following liver transplantation.

INTRODUCTION: Severity of recurrent hepatitis C virus (HCV) infection in liver transplant recipients (LTR) is variable and the influence of different factors, including the administration of antiviral therapy in the long-term outcome is controversial. METHODS: We analyzed the outcome of a cohort of HCV-infected LTR who were transplanted in our institution. Patients were divided into 2 groups (severe and non-severe HCV disease) depending on the presence of a fibrosis score of F ≥ 2 in the Scheuer index and/or fibrosing cholestasic hepatitis (FCH) in a graft biopsy. Risk factors were studied using logistic regression analysis. Survival of patients was estimated using Kaplan-Meier plots. A total of 146 patients were followed for a mean of 58 months. RESULTS: Fifty-six (34%) patients developed severe HCV disease and showed shorter survival (P < 0.024). Donor age (odds ratio [OR]: 1.04; 95% confidence interval [CI]: 1.02-1.06) and pre-transplant viral load (VL) >10(6) UI/mL (OR: 3.5; 95% CI: 1.42-10.61) were the only factors associated with severe HCV infection. Over-immunosuppression (OR: 2.3; 95% CI: 1.2-4.41) was specifically associated with the development of FCH. Overall, patient survival in recipients who received a full course of anti-HCV therapy was higher than in patients who did not complete antiviral therapy (P = 0.004) or received no treatment (P = 0.007). Patients with non-severe HCV infection have a higher probability of receiving a full course of antiviral therapy (P = 0.033). CONCLUSION: In conclusion, donor age, pre-transplant VL, and over-immunosuppression were associated with the long-term development of severe HCV recurrence in liver grafts. Administration of a full course of antiviral therapy was associated with better survival.

Long-term experience with kidney transplantation from hepatitis C-positive donors into hepatitis C-positive recipients.

Kidney transplantation from hepatitis C virus (HCV) antibody positive donors (HCVD+) into HCV antibody positive recipients (HCVR+) is controversial. We implemented this policy in our units in 1990. Herein, we report the long-term safety of this strategy. From March 1990 to March 2007, 162 HCVR+ received a kidney from HCVD+ (group 1) and 306 from HCVD- (group 2) in our units. Mean follow-up was 74.5 months. Five-and 10-year patient survival was 84.8% and 72.7% in group 1 vs. 86.6% and 76.5% in group 2 (p = 0.250). Three deaths in group 1 and two in group 2 were liver-disease related. Five- and 10-year graft survival was 58.9% and 34.4% versus 65.5% and 47.6% respectively (p = 0.006) while death-censored graft survival was 69% and 47% versus 72.7% and 58.5% (p = 0.055). Decompensated chronic liver disease was similar: 10.3% versus 6.2%. Cox-regression analysis could not identify the donor's HCV serology as a significant risk factor for death, graft failure and severe liver disease in HCVR+. In conclusion, long-term outcome of HCVR+ transplanted with kidneys from HCVD+ seems good in terms of patient survival, graft survival and liver disease. HCVD+ was not a significant risk factor for mortality, graft failure and liver disease among HCVR+. These data strongly suggest that the use of kidneys from HCVD+ in HCVR+ is a safe long-term strategy that helps to prevent kidney loss.

Behçet's disease and Chiari's network.

Behçet's disease (BD) is a chronic, multisystemic, inflammatory process of uncertain origin. Diagnosis criteria consist of recurrent oral ulceration plus two of the following: genital ulceration, ocular and skin lesions, and positive pathergy test. Pulmonary embolism and, especially intracardiac thrombi, are very rare. We report the case of a patient with BD presenting with bilateral pulmonary embolism and intracardiac mass in right atrium.

Outpatient parenteral antimicrobial therapy for infective endocarditis in patients over 80 years.

OBJECTIVE: The incidence of infective endocarditis is progressively increasing, especially in elderly patients. Outpatient parenteral antibiotic therapy (OPAT) is being an excellent alternative for treatment, but advanced age is one of the relative contraindications. The aim of this study is to compare the characteristics and prognosis of patients less or more than 80 years, treated with OPAT. METHODS: One hundred and ninety four patients were included between 1996 and 2015, 31 of them older than 80 years. RESULTS: The most frequently affected valve is the aortic one, mainly native valves. Most used antibiotics are ceftriaxone, ampicillin, cloxacillin and daptomycin. Differences in surgery (39.9% vs 9.7%, p=0.001) and use of infusion pump (55.2% vs 35.5%; p= 0.044) were observed, under 80 years and older respectively. No differences in readmissions and mortality were observed. CONCLUSIONS: OPAT could be considered an effective alternative for appropriately-selected elderly patients with infective endocarditis.

From Soybean residue to advanced supercapacitors.

Supercapacitor technology is an extremely timely area of research with fierce international competition to develop cost-effective, environmentally friendlier EC electrode materials that have real world application. Herein, nitrogen-doped carbons with large specific surface area, optimized micropore structure and surface chemistry have been prepared by means of an environmentally sound hydrothermal carbonization process using defatted soybean (i.e., Soybean meal), a widely available and cost-effective protein-rich biomass, as precursor followed by a chemical activation step. When tested as supercapacitor electrodes in aqueous electrolytes (i.e. H2SO4 and Li2SO4), they demonstrate excellent capacitive performance and robustness, with high values of specific capacitance in both gravimetric (250-260 and 176 F g(-1) in H2SO4 and Li2SO4 respectively) and volumetric (150-210 and 102 F cm(-3) in H2SO4 and Li2SO4 respectively) units, and remarkable rate capability (>60% capacitance retention at 20 A g(-1) in both media). Interestingly, when Li2SO4 is used, the voltage window is extended up to 1.7 V (in contrast to 1.1 V in H2SO4). Thus, the amount of energy stored is increased by 50% compared to H2SO4 electrolyte, enabling this environmentally sound Li2SO4-based supercapacitor to deliver ~12 Wh kg(-1) at a high power density of ~2 kW kg(-1).

Membranous glomerulonephritis associated with hepatitis C virus infection in renal transplant patients.

BACKGROUND: Hepatitis C virus (HCV) infection has been described in association with various types of glomerular diseases, usually type I membranoproliferative glomerulonephritis and rarely membranous glomerulonephritis (MGN). In this article, we describe the first series of MGN exhibited in renal transplant patients and associated with HCV infection. METHODS: From January 1980 to December 1994, 2045 kidney transplantations were performed in our renal transplant units. A retrospective analysis demonstrated an overall 20% prevalence of HCV virus-positive patients; 409 transplanted patients were HCV positive (ELISA and RIBA). RESULTS: Fifteen patients developed an allograft MGN (3.66%) 24 months after renal transplantation. MGN appeared in the form of significant proteinuria (>1.5 g/24 h) with stable renal function. In all cases, graft biopsy demonstrated a thickening of the capillary wall, subepithelial electron-dense deposits, and IgG and C3 diffuse granular deposits along the basal membrane. Ten cases were considered de novo, two cases were considered recurrent MGN, and three cases were considered undetermined because the primary renal disease was chronic glomerulonephritis. All patients showed negative antinuclear antibodies and cryoglobulins, normal complement, and negative rheumatoid factors. During follow-up (an average of 2 years), 12 patients developed a progressive worsening of renal function, with increased serum creatinine and persistent proteinuria; 8 of the 12 patients returned to dialysis. Of the remaining three cases, two patients showed partial remission of nephrotic syndrome after high doses of steroids, and one patient persisted with stable renal function and proteinuria (<2 g/24 h.). CONCLUSIONS: In summary, HCV is preferentially associated with MGN in renal transplant patients, rather than with membranoproliferative glomerulonephritis as in the normal adult population. MGN associated with HCV infection has a similar clinical picture and outcome to posttransplant idiopathic de novo MGN, with persistent massive proteinuria and progressive deterioration of renal function.

Laminin fragment P1 is increased in the lower respiratory tract of patients with diffuse interstitial lung diseases.

Laminin is a 900,000-dalton extracellular matrix glycoprotein involved in a variety of functions, including cellular movement, growth, and differentiation. The aim of this work was to investigate the presence and biologic significance of this substance in the bronchoalveolar lavage fluid (BALF) of diffuse interstitial lung diseases (DILD). Levels of laminin fragment P1 (LFP) were measured by radioimmunoassay in BALF and sera from controls (n = 8) and patients with several types of DILD: sarcoidosis (n = 10), neoplastic pulmonary infiltration (n = 8), pulmonary fibrosis (n = 5), and hypersensitivity pneumonitis (n = 5). Furthermore, their relation to signs of alveolitis (cellular profiles and albumin concentration in BALF) and evidence of pulmonary fibroblast activation (BALF aminoterminal propeptide of type III procollagen) was examined. Laminin fragment P1 immunoreactivity was detectable in BALF, even in the control group, but patients with all types of DILD had higher concentrations than the control subjects. The serum levels of LFP were similar in all groups studied. Neutrophil and lymphocyte proportions were significantly higher in all DILD groups than in the control group. A positive correlation was seen between lymphocyte proportion and laminin fragment P1 in BALF. Moreover, in BALF a positive correlation was found between LFP and albumin and between LFP and the aminoterminal propeptide of type III procollagen. The BALF macrophage-associated laminin fragment P1 was significantly higher in the active sarcoidosis subgroup compared with the control group. Thus, laminin is a normal constituent of the epithelial lining fluid. The increase of laminin in BALF of patients with DILD suggests that laminin may contribute to their pathogenesis.

Hepatitis C virus-related fibrosing cholestatic hepatitis after cardiac transplantation: is azathioprine a contributory factor?

We report a patient who acquired hepatitis C virus (HCV) infection at cardiac transplantation, developing fibrosing cholestatic hepatitis (FCH) with early liver failure and a fatal outcome. FCH is a recently described clinicopathological entity characterized by a cholestatic pattern of serum liver enzyme abnormalities, a progressive course leading to liver failure, and a pathological picture defined by periportal fibrosis, neutrophilic infiltrates and signs of histological cholestasis. Although it was initially described secondary to hepatitis B virus infection, it has also been recently related to HCV infection. Some histopathological features consistent with azathioprine hepatotoxicity like cholestasis, perisinusoidal fibrosis, veno-subocclusive lesions and nodular regenerative hyperplasia were also observed in this case. Therefore, a direct cytopathic effect of HCV and the concurrent pathogenic role of azathioprine hepatotoxicity may be involved in the development of this complication of transplantation.

Hepatitis B vaccination results in 140 liver transplant recipients.

BACKGROUND/AIMS: Human autologous liver transplantation is possible due to an adequate suppression of the body's immune response. This also causes a higher hepatitis infection rate, making hepatitis prevention very important. MATERIALS AND METHODS: We describe our experience with hepatitis B virus vaccination in 140 adult liver transplant recipients, transplanted from 1986 to 1994 with more than one year of follow-up. Excluded were those who had hepatitis B surface antigens or antibodies to those antigens before the transplant. The vaccination schedule was 0-1-2 months with a double dose of recombinant vaccine. RESULTS: The total response rate (surface antigen antibodies > 10 U) was 40% (56/140); the rate was 47.7% in men and 26% in women. At the end of the study, only 17.1% (24/140) of the patients had antibodies > 10 U. The response rate was higher in patients with antibodies to hepatitis B core antigen (66.6%) than in those lacking antibodies (31.7%), and more long lasting (42.4% vs 11.2%). The response rate in 116 patients with booster doses was 12.9%. Six correctly vaccinated patients (4.28%) acquired new hepatitis B virus infections after the operation. CONCLUSIONS: The total response rate in these patients is much lower than in the general population, and there is a rapid decline of titers, probably due to immunosuppression. The role of booster doses in these patients should be clarified.

Liver transplantation and hepatitis C virus. Results in a Spanish center since 1989.

BACKGROUND/AIMS: Hepatitis C-related liver disease is the main indication for liver transplantation in many centers. Viral RNA remains after transplantation in almost 100% of the patients, and more recent reports show a graft hepatitis rate of about 90%. The progression of this hepatitis seems to be quicker than in the nontransplant setting. METHODOLOGY: From June 1989 to October 2000, 197 adult patients had 213 for HCV-related liver disease at our institution. Basal immunosuppression consisted of a triple therapy with cyclosporine, azathioprine and steroids, or dual therapy with tacrolimus and steroids. None of the patients was treated with antivirals after liver transplantation. RESULTS: Pure HCV-related cirrhosis was the indication for liver transplantation in 114 patients, another 14 with hepatocellular carcinoma, 8 associated metabolic diseases, 43 high alcohol intake, 4 hepatitis B, 5 cholestatic diseases, and 3 other diseases. Six patients out of the 197 transplanted in this period were already grafted before this time, and had their first retransplantation of the liver after 1989 (their first liver transplantation was done when HCV was not known). Sixteen additional retransplantation procedures were done in the period considered. Hepatitis was diagnosed in 84.3% of the grafts biopsied later than 90 days after liver transplantation (118/140), and in 92.9% if it was done after one year (92/99). Cirrhosis was diagnosed in 21 grafts at a mean time of 1004.7 days, 21.2% of the grafts biopsied after 1 year and 28.6% after 2 years. Nine grafts in 8 patients were diagnosed as fibrosing cholestatic hepatitis. Patient actuarial survival was 80.9%, 69.7%, 67.5% and 50.6% at 1, 3, 5 and 10 years. Liver failure and hepatoma recurrence were the cause of death in 42.4% of the patients. Actuarial graft survival was 75.2%, 64.9%, 63.5% and 48.6% at 1, 3, 5 and 10 years, and was significantly affected by Child stage (B vs. C, P = 0.004). When compared to 228 non-HCV- infected patients with chronic parenchymatous disease, these had an almost significantly better patient survival (P = 0.0577), but a nonsignificant difference in graft survival. Graft loss related to liver causes was 17.6% in HCV+ patients 14.6% in HCV- patients. Liver causes of death were 14.0% in HCV+ patients and 4.8% in HCV-patients (P = 0.002). CONCLUSIONS: HCV infected liver transplantation recipients present very often graft hepatitis, which may progress to advanced stages in a quite short interval. Mid-term patient and graft survival is comparable to those of non-HCV recipients, but causes of death related directly to liver disease are more common in HCV+. This makes one think that long-term prognosis (more than 10 or 15 years) will be worse in HCV patients.

Twelve-month interferon-alpha therapy induces a similar sustained response in anti-HBe-positive and HBeAg-positive chronic hepatitis B patients.

BACKGROUND/AIMS: We compared the response to interferon-alpha 2a in 35 patients with antibody to HBeAg (anti-HBe) and 20 patients with HBeAg in serum, and histological features of chronic hepatitis B. METHODOLOGY: Patients were treated with 4.5-6 MU of interferon-alpha 2a, three times a week for 12 months, and followed for 30.8 +/- 13.5 additional months. RESULTS: All of them had elevated serum levels of aminotransferases and positive test for hepatitis B virus-DNA in serum. Patients with anti-HBe-positive chronic hepatitis were older and had higher serum aminotransferase levels than HBeAg-positive patients, but no differences were seen between both groups with respect to sex, history of acute hepatitis, mode of transmission of the infection or histological appearance before interferon therapy. Serum levels of alanine transaminase became normal and hepatitis B virus-DNA undetectable by PCR at the end of therapy in 25 (71%) of anti-HBe-positive patients and in 10 (50%) of HBeAg-positive patients (P > 0.05). Although 10 (29%) of the anti-HBe-positive and none of the HBeAg-positive patients relapsed, no significant difference was seen in the rate of sustained response (43% vs. 50%, respectively). The histological improvement was similar in both groups. CONCLUSIONS: The results of this study indicated that biochemical, virological and histological response to 12-month interferon-alpha 2a therapy was similar in patients with anti-HBe antibody than in patients with the classical HBeAg-positive of chronic hepatitis B.

[Prevalence and sequelae of childhood sexual abuse in Spain]. / Prevalencia y consecuencias del abuso sexual al menor en España.

The aim of this research was to determine the prevalence of sexual abuse in Spain and its long and short effects. A representative sample of Spanish society was studied (N = 1.821) through proportional stratified random sampling. Data were obtained by interview (Personal History of Sexual Abuse), carried out in the subjects home and by means of a Self Reporting Questionnaire (S.R.Q.), which the interviewer gave the subject to be returned by post. The results show a high prevalence of sexual abuse prior to age 17 (15% of males and 22% of females) with short-term effects (lack of trust, disgust, fear, hostility towards the aggressor, shame, anxiety, etc.) and in long-term a greater tendency towards mental health problems (F = 7.7; p < .01), as well as other problems throughout the life cycle (running away from home, school failure, sexual dissatisfaction, drug-taking, etc.). The high prevalence and the clear long and short effect make prevention programs and help for the victims advisable.

[Prospective study of cytomegalovirus infection in liver transplant recipients]. / Estudio prospectivo de la infección por citomegalovirus en receptores de trasplante hepático.

BACKGROUND: Cytomegalovirus (CMV) infection is an important cause of morbidity and mortality in liver transplant recipients. The aim of this study was to determine the incidence, clinical characteristics, risk factors and response to treatment of CMV infection in liver transplant recipients. METHODS: Fifty-nine adult patients who underwent a liver transplant in our hospital were prospectively studied. Cell cultures were used to document CMV infection and disease. Ganciclovir treatment was only given to patients with documented CMV disease. RESULTS: Active infection was shown in 47 of 59 patients (80%), and symptomatic infection (disease) in 17 (29%). The most frequent clinical presentation was hepatitis (9 cases) followed by flu-like syndrome (6 cases) and pneumonitis (4 cases). The average time from transplant to the diagnosis of CMV disease was 36 days. The seronegative recipients of seropositive donors developed symptomatic infection more frequently (66%) than other patients (p < 0.05). As well as the CMV serologic status before transplantation, the use of anti-OKT3 antibodies was the only risk factor related to CMV disease (p < 0.01). The treatment with ganciclovir was successful in 17 of 19 symptomatic episodes. CONCLUSIONS: Active and symptomatic CMV infection in recipients of liver transplantation were very frequent in our study. The transplant from seropositive to seronegative and the use of anti-OKT3 antibodies increased the incidence of CMV disease. Ganciclovir appeared as a safe and, apparently, highly efficient drug.

[A comparative randomized controlled study of the efficacy of interferon alfa-2b and interferon alfa-2a in the treatment of chronic hepatitis C]. / Estudio comparativo, aleatorizado y controlado de la eficacia del interferón alfa-2b e interferón alfa-2a en el tratamiento de la hepatitis crónica C.

Interferon (INF) is the treatment of choice in active chronic hepatitis C although the optimum therapeutic schedule remains undefined to date. One forty-eight patients with active chronic hepatitis C were included in a randomized controlled study to compare the therapeutic efficacy of 2 types of recombinant alpha IFN: alpha-2b IFN and alpha-2a IFN. Twelve patients were excluded from the study for different reasons. The groups were made up of 34 untreated patients (group I), 68 patients treated with 5 MU of alpha-2b IFN three times per week for 12 months (group II) and 32 patients with 6 MU of alpha-2a IFN three times per week for one year (group III). On finalization of the treatment 39 patients from group II (57%) and 20 (63%) from group III showed normal transaminases (p > 0.05) while this was not so in any patient from group I (p < 0.001). HCV infection of less than 5 years was significantly associated with complete biochemical response. During the post treatment follow up (16.2 +/- 11.1 months; range: 6-45 months) the transaminase levels reelevated in 26 (67%) responding patients from group II and in 12 (60%) patients from group III (p > 0.05). Therefore complete biochemical response was maintained in only 12 (19%) of the patients from group II and in 8 (25%) of the patients from group III (p > 0.05). Liver biopsy was carried out in the 3 post treatment months in 15 patients from group I, 29 from group II and 18 patients from group III with all the rebiopsied patients from groups II and III having demonstrated complete or partial response to IFN.(ABSTRACT TRUNCATED AT 250 WORDS)