Five-year follow-up of patients with chronic C hepatitis and sustained virological response.

OBJECTIVE: to assess persistence of sustained viral response at 5 years of follow-up in patients with chronic viral hepatitis C treated with pegylated interferon and ribavirin. DESIGN: a descriptive study. PATIENTS: from August 2001 to May 2004, all patients treated at our center with pegylated interferon and ribavirin who achieved a sustained viral response were consecutively enrolled (93 patients). Demographic, histological, biochemical, and virological data were collected during treatment and 5 years after achievement of the sustained viral response. Eighty-six percent of patients enrolled (n = 80) attended the control visit at 5 years. RESULTS: mean age of enrolled patients was 41 years (standard deviation = 10 years), and 30.1% (n = 28) were women. Liver biopsy had been performed before treatment in 68.8% of patients (n = 64), showing no or mild fibrosis in 62.3% (F0 and F1) and significant fibrosis and cirrhosis in 37.7% (F ≥ 3). Genotype distribution was: 58.1% genotype 1 (n = 54); 8.6% genotype 2 (n = 8); 24.7% genotype 3 (n = 23); 7.5% genotype 4 (n = 7), and indeterminate in one patient. Only one patient experienced virological recurrence. All other patients had negative HCV RNA levels and, in the absence of other liver diseases, normal ALT levels. CONCLUSION: in patients treated with pegylated interferon and ribavirin with sustained viral response, long-term recurrence rate was very low.

Global CO2 emissions from dry inland waters share common drivers across ecosystems.

Many inland waters exhibit complete or partial desiccation, or have vanished due to global change, exposing sediments to the atmosphere. Yet, data on carbon dioxide (CO2) emissions from these sediments are too scarce to upscale emissions for global estimates or to understand their fundamental drivers. Here, we present the results of a global survey covering 196 dry inland waters across diverse ecosystem types and climate zones. We show that their CO2 emissions share fundamental drivers and constitute a substantial fraction of the carbon cycled by inland waters. CO2 emissions were consistent across ecosystem types and climate zones, with local characteristics explaining much of the variability. Accounting for such emissions increases global estimates of carbon emissions from inland waters by 6% (~0.12 Pg C y-1). Our results indicate that emissions from dry inland waters represent a significant and likely increasing component of the inland waters carbon cycle.

[Diagnosis and treatment of hepatic encephalopathy in Spain: results of a survey of hepatologists]. / Diagnóstico y tratamiento de la encefalopatía hepática en España: resultados de una encuesta dirigida a hepatólogos.

INTRODUCTION: Hepatic encephalopathy is a common complication of cirrhosis. Recent studies have challenged the efficacy of nonabsorbable disaccharides and have reported that protein restriction may pose risks to patients with cirrhosis and hepatic encephalopathy. AIM: To determine the diagnostic and therapeutic practices of physicians treating patients with hepatic encephalopathy. MATERIAL AND METHODS: We designed a 20-item questionnaire, which was mailed to the members of the Spanish Society for the Study of the Liver. RESULTS: We received 128 questionnaires, completed by physicians with wide clinical experience. They reported that the most common precipitating factors in episodic encephalopathy were infections (22%), diuretics (21%), and gastrointestinal bleeding (21%). The usual treatment of episodic encephalopathy was administration of nonabsorbable disaccharides (90%) and protein restriction (52%). Patients with chronic encephalopathy were also usually treated with nonabsorbable disaccharides (94%) and protein restriction (40%). Fifty-nine percent of the hepatologists never carried out neurophysiologic or neuropsychologic assessment for the diagnosis of minimal hepatic encephalopathy. CONCLUSION: Although their efficacy has been questioned, nonabsorbable disaccharides and protein restriction are the most commonly prescribed treatments for hepatic encephalopathy. Future studies are needed to assess the efficacy and risks of these treatments. Most hepatologists never assess minimal hepatic encephalopathy in patients with cirrhosis.

Chronological reconstruction of metal contamination in the Port of Maó (Minorca, Spain).

In this work we discuss the historical record of metals as derived from a sediment core from the Port of Maó (Minorca, Spain), the second natural largest harbour in Europe. The sedimentation rate derived from radionuclide profiles increased by a factor of five since the 1960s due to the urbanisation of the town waterfront. Metal concentrations showed two different trends: (i) Pb and Sn inputs started during the second half of the 19th century and remained relatively high until mid-20th century; and (ii) Ag, Cd, Ni, Zn, Cu and Cr accumulation began in the 1940s, peaking in the late 1970s. The commissioning of a submarine outfall in 1978 reduced metal concentrations in subsequently deposited sediments since, thereafter, urban and industrial wastes have been dumped out of the estuary. This study also shows that evaluating the quality of sediments on the basis of surface concentrations may be misleading.