Long-term follow-up of non-A, non-B (type C) post-transfusion hepatitis.

One hundred and thirty-five patients who developed non-A, non-B post-transfusion hepatitis mostly after cardiac surgery, were followed for a mean (+/- S.D.) of 90 +/- 41 months (range: 13-180) to evaluate clinical and histological outcome. Thirty-one cases resolved within 12 months, while 104 (77%) progressed to chronicity. Twenty-one of 65 (32%) biopsied patients developed cirrhosis at the end of the follow-up, and one further progressed to hepatocellular carcinoma. One patient had a complete histological remission (1%). The remaining cases had chronic active (37%), chronic persistent (27%) or chronic lobular hepatitis (3%). About half of the cases with cirrhosis developed portal hypertension, and three of these died due to esophageal varices hemorrhage, one due to liver failure, and one due to hepatocellular carcinoma. Out of 26 patients with the initial histologic diagnosis of chronic hepatitis that were rebiopsied during follow-up, 13 (50%) progressed to cirrhosis. These patients were significantly older than patients who did not develop cirrhosis (mean age 57 and 45 years respectively; p < 0.01). During acute hepatitis anti-HCV was positive in all but one of the 114 patients tested. Percentages were similar for patients who recovered (95%) and those who developed chronic hepatitis (100%). However, during follow-up, 71% of the 1st generation and 21% of the 2nd generation ELISA test patients with acute resolved hepatitis became anti-HCV negative, while the same figures in chronic cases were only 8.5% (p < 0.0001) and 1.4% (p = 0.012). This suggests a correlation between anti-HCV antibody activity, hepatitis C virus replication, and the development of chronic liver disease

Thin-shelled bivalve buildup of the lower Bajocian, South Iberian paleomargin: development of opportunists after oceanic perturbations

An exceptional buildup of thin-shelled bivalves (3.5 m thick and more than 12 m long), apparently the largest in the literature, is reported from the External Subbetic (Betic Cordillera, southern Spain). Calcareous nannofossils indicate the NJT8 biozone (late Aalenian) below the buildup and the NJT9 biozone (early Bajocian) at the base of the buildup. The thin-shelled bivalves, commonly referred to as filaments, are Bositra-like forms, an opportunistic bivalve that flourished under stressed conditions. Geochemical proxies (carbon isotopes, P-org and Ba-bio, and Cr/Al, V/Al and Ni/Co ratios) indicate that the marine environment was subjected to changes in oxygenation and trophic conditions, which, under the optimum states, promoted extremely high rates of production of the thin-shelled bivalves. The large buildup accumulated on the sea-floor under favorable hydrodynamic conditions and local topography. The significance of these depositional characteristics in relation to the previous literature is discussed