Chronic liver disease and cirrhosis among patients with hepatitis B virus infection in northern Portugal with reference to the viral genotypes.

J Med Virol. 2011 Jan;83(1):71-7. Chronic liver disease and cirrhosis among patients with hepatitis B virus infection in northern Portugal with reference to the viral genotypes. Mota A, Areias J, Cardoso MF. SourceICBAS Abel Salazar Biomedical Institute, University of Porto, Porto, Portugal. Abstract The prevalence of infection with hepatitis B virus in Portugal is around 1% of the population; 20-30% of those infected typically develop cirrhosis. The study focuses on the epidemiological profile of patients with hepatitis B infection and liver damage, in particular, cirrhosis. Of the 358 individuals that comprised the study, a liver biopsy was performed in 249 to identify the presence of cirrhosis. Cirrhosis was observed in 59 patients (23.7%) The Child-Pugh classification was used to assess the prognosis of cirrhosis: 3 out of the 59 patients were classified as Child-Pugh grade C, the most severe, 17 (28.8%) as grade B, and 39 (66.2%) as grade A. Patients classified as grade B were older, drank more, and showed higher levels of AST and alkaline phosphatase when compared with individuals classified as grade A. Genotypes A and D were predominant, and no significant differences with respect to genotype distribution were observed. Analysis of the hematological parameters showed that patients classified as Child's grade B had lower levels of platelets and higher levels of prothrombin time than those classified as Child's grade A. The profile of the patients with cirrhosis, including an extended number of individual characteristics, provides useful information, however, only a prospective study could evaluate definitively if liver disease is influenced by these factors. Future studies would benefit from the analysis of the impact of genotypes on liver disease, particularly genotypes A and D, the most predominant genotypes in northern Portugal. © 2010 Wiley-Liss, Inc

FINITE STRAIN ANALYSIS OF LIMESTONE/BASALTIC MAGMA INTERACTION AND FRACTURE: LOW ORDER MIXED TETRAHEDRON AND REMESHING

In this investigation, we use a recent constitutive framework and remising technique for tetrahedra to analyse the pressure-driven crack propagation of limestone intruded by basaltic magma. Limestone is represented by an least-plastic capped Drucker-Prager model with an hypo elastic term in order to account for inelastic effects from plastic signature. Kinematic hardening is considered for limestone, whereas magma is modelled by means of a compressible Bingham fluid. Classical limit surfaces of the capped model are used to initiate the crack events in the limestone. Propagation is performed by a local remising technique with mesh smoothing for untracked elements. Arnold's MINI element is used to avoid locking in the quasi-incompressible case. Verification (for limestone) examples and a crack propagation example in 3D are performed. A mesh convergence study is performed, exhibiting very promising results

Alcohol consumption among patients with hepatitis B infection in northern Portugal considering gender and hepatitis B virus genotype differences

Alcohol. 2010 Mar;44(2):149-56. Epub 2010 Jan 29. Alcohol consumption among patients with hepatitis B infection in northern Portugal considering gender and hepatitis B virus genotype differences. Mota A, Guedes F, Areias J, Pinho L, Cardoso MF. SourceInstituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Portugal. Abstract Alcohol abuse is an important public health problem. In Portugal with a population of 10 millions of inhabitants, there are around 10% of alcoholics or excessive alcohol drinkers and 1% of chronically infected patients with hepatitis B virus (HBV). To examine the characteristics of patients with higher levels of alcohol consumption and to investigate the association between alcohol consumption and liver damage a total of 298 chronically infected individuals, with HBV genotyped and submitted to liver biopsy, were classified with Child's grading and separated by habits of alcohol intake, less and greater than 20g/day. No significant differences were observed about genotype but genotypes A and D were predominant in both of them. A higher percentage of males (P<.001) were observed in the group with alcohol intake above 20g/day, as well a lower proportion of patients with HBeAg negativity (P< or =.035). In this group, biochemistry parameters, such as alanine aminotransferase (P=.006), aspartate aminotransferase (P=.001), gamma-glutamyl transferase (P<.001) were elevated in a significantly higher proportion than in the other group. The analysis of hematological parameters showed significantly lower values of platelets (P=.042) and mean corpuscular volume (P<.001) and significantly higher values of prothrombin time (P<.001) in the group with higher levels of alcohol consumption. The characteristics of biopsy (P<.001) and Child-Phug's classification (P=.002) revealed more severe results in this group. Logistic regression showed a positive association between liver damage and alcohol intake, increasing with age. In female patients, a strong positive association between alcohol intake and liver damage was also found (odds ratio: 9.379; 95% confidence interval: 0.859-468.422; P = .037); however, the most severe cases were only observed in women older than 45 years. In patients with HBV infection, alcohol is associated with a more severe liver disease. No evidence was found concerning association with HBV genotype. 2010 Elsevier Inc. All rights reserved

Complexo Migmatítico de Mindelo (NW de Portugal). Anatexia e relações petrogenéticas

Na orla litoral do norte de Portugal aflora uma faixa referida cartograficamente como “Complexo Granito-Migmatítico” inserida na formação Complexo Xisto-Grauváquico (CXG) [1]. Nesta faixa afloram litologias diversas, nomeadamente: i) rochas metassedimentares; ii) rochas migmatíticas; e, iii) rochas graníticas. O paleossoma metassedimentar apresenta foliação e bandado composicional marcado por bandas ricas em biotite, estaurolite e almandina e bandas ricas em quartzo e oligóclase(An12-19). As rochas migmatíticas dividem-se em quatro tipos distintos: i) metatexitos mosqueados; ii) metatexitos bandados; iii) diatexitos; e iv) resisters calcossilicatados. Os metatexitos mosqueados caracterizam-se pela ocorrência de neossoma in situ inserido numa matriz idêntica ao paleossoma. Este define-se por pequenas manchas constituídas por quartzo, plagióclase e cordierite circunscritas por selvedge de biotite. Os metatexitos bandados apresentam alternância entre melanossoma com biotite, silimanite, cordierite e rara almandina e leucossoma quartzofeldspático. Os diatexitos são rochas de composição essencialmente granítica de grão médio a grosseiro contendo remanescências de material metassedimentar (schlieren) constituídos por alinhamentos de biotite, silimanite, cordierite e rara almandina. O feldspato potássico é geralmente anédrico, substitui a plagioclase, e contém inclusões de todos minerais paragenéticos. A biotite tem bordos arredondados ou simpletíticos em associação com cordierite subédrica. Os resisters são rochas que pela sua constituição mineralógica não sofreram fusão parcial. Estão inseridos nos migmatitos e são constituídos por metagrauvaques cálcicos com textura granoblástica. Apresentam-se em nódulos elipsoidais, zonados, com espessura e comprimento centimétricos. O zonamento concêntrico destas rochas apresenta um núcleo mais rico em Ca, com diópsido, anortite(An82-92), grossulária(Grs70-90) e quartzo passando a um bordo menos rico em Ca composto por hornblenda, anortite, granada(Grs36-46) e quartzo. Estes núcleos calcossilicatados estão inseridos em camadas tabulares de metagrauvaque com quartzo, plagioclase(An36-44), biotite dispersa e rara almandina. Nas zonas mais ricas em Ca, no núcleo dos nódulos os metagrauvaques permanecem inalterados mas nas zonas exteriores mais pobres em Ca fundem parcialmente resultando um metatexito relativamente rico em Ca e Na. As rochas graníticas apresentam variação textural desde grão fino a médio. Têm mineralogia típica de granitos de duas micas, por vezes com raros alinhamentos de biotite e silimanite. Contêm xenólitos de metatexito e formam diques discordantes com o encaixante. Geoquimicamente os metatexitos pelíticos apresentam teores em elementos maiores , traço e padrão de terras raras similares aos xistos estaurolíticos e ao NIBAS [2]. Os nódulos calcossilicatados apresentam enriquecimento em Ca e Mn (Ca>9% e Mn>0,18) no núcleo com empobrecimento gradual para o exterior . Os granitos são do tipo S, peraluminosos, alcalino-cálcicos, medianamente diferenciados. Os diatexitos são calco-alcalinos e menos diferenciados do que os granitos. Em todas as litologias, a variação nos teores em “HSFE” (TR, Zr, Hf, Y) está positivamente relacionada com o teor em Fe2O3(t)+MgO. As variações na composição em elementos traço nas litologias referidas serão consequência da variabilidade na incorporação de minerais acessórios a partir do protólito, maioritariamente associados à biotite, condicionada pelas diferenças na composição mineralógica do mesmo e do grau de equilíbrio com o melt.. A assinatura isotópica de todas as litologias é crustal, com εSr330 > 121 e εNd < 0. Relativamente ao εNd330 distinguem-se dois grupos: um grupo que inclui xistos estaurolíticos, migmatitos mosqueados, diatexitos e granitos com valores entre -2,05 e -5,08 e o grupo dos resisters com valores entre -8,12 e -9,30. Os migmatitos bandados apresentam valores que variam entre estes dois grupos distintos. Estes valores permitem considerar uma relação genética entre os granitos, os migmatitos e os xistos estaurolíticos e uma fonte distinta para os metagrauvaques. Os aspetos litológicos, petrográficos e geoquímicos sugerem três etapas de anatexia/cristalização: i) um primeiro melt resultante da fusão incongruente de biotite, produz minerais anidros (cordierite + plagioclase + quartzo); ii) circulação de fluidos ricos em K por cristalização e diferenciação de melts de níveis mais profundos, onde a taxa de fusão é superior, e que atingindo os migmatitos superiores levam à cristalização de ortoclase e à feldspatização da plagioclase. Esses fluidos, com circulação condicionada estruturalmente, não atingiram todo o complexo migmatítico uma vez que há metatexitos e diatexitos sem feldspato; iii) Nos níveis de maior taxa de fusão há formação de magmas graníticos de tipo S. Estes são menos densos do que as rochas encaixantes o que promove a sua ascensão e instalação, gerando granitos de duas micas, que incorporam xenólitos de migmatitos (metatexíticos e diatexíticos)

COPD and cardiovascular disease

COPD is one of the major public health problems in people aged 40 years or above. It is currently the 4th leading cause of death in the world and projected to be the 3rd leading cause of death by 2020. COPD and cardiac comorbidities are frequently associated. They share common risk factors, pathophysiological processes, signs and symptoms, and act synergistically as negative prognostic factors. Cardiac disease includes a broad spectrum of entities with distinct pathophysiology, treatment and prognosis. From an epidemiological point of view, patients with COPD are particularly vulnerable to cardiac disease. Indeed, mortality due to cardiac disease in patients with moderate COPD is higher than mortality related to respiratory failure. Guidelines reinforce that the control of comorbidities in COPD has a clear benefit over the potential risk associated with the majority of the drugs utilized. On the other hand, the true survival benefits of aggressive treatment of cardiac disease and COPD in patients with both conditions have still not been clarified. Given their relevance in terms of prevalence and prognosis, we will focus in this paper on the management of COPD patients with ischemic coronary disease, heart failure and dysrhythmia.Novartis Portugal Novartisinfo:eu-repo/semantics/publishedVersio

Semi-implicit finite strain constitutive integration and mixed strain/stress control based on intermediate configurations

A new semi-implicit stress integration algorithm for finite strain plasticity (compatible with hyperelas- ticity) is introduced. Its most distinctive feature is the use of different parameterizations of equilibrium and reference configurations. Rotation terms (nonlinear trigonometric functions) are integrated explicitly and correspond to a change in the reference configuration. In contrast, relative Green–Lagrange strains (which are quadratic in terms of displacements) represent the equilibrium configuration implicitly .In addition, the adequacy of several objective stress rates in the semi-implicit context is studied. We para- metrize both reference and equilibrium configurations, in contrast with the so-called objective stress integration algorithms which use coinciding configurations. A single constitutive framework provides quantities needed by common discretization schemes. This is computationally convenient and robust, as all elements only need to provide pre-established quantities irrespectively of the constitutive model. In this work, mixed strain/stress control is used, as well as our smoothing algorithm for the complemen- tarity condition. Exceptional time-step robustness is achieved in elasto-plastic problems: often fewer than one-tenth of the typical number of time increments can be used with a quantifiable effect in accuracy. The proposed algorithm is general: all hyperelastic models and all classical elasto-plastic models can be employed. Plane-stress, Shell and 3D examples are used to illustrate the new algorithm. Both isotropic and anisotropic behavior is presented in elasto-plastic and hyperelastic examplesinfo:eu-repo/semantics/publishedVersio