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One of the most significant parameters for seismic hazard assessment analyses is the fault slip rate. The combination of both geological (long-term) and geodetic (short-term) data offers a more complete characterization of the seismic potential of active faults. Moreover, geodetic data are also a helpful tool for the analysis of geodynamic processes. In this work, we present the results of a local GPS network from the Baza sub-Basin (SE Spain). This network, which includes six sites, was established in 2008 and has been observed for seven years. For the first time, we obtain short-term slip rates for the two active faults in this area. For the normal Baza Fault, we estimate slip rates ranging between 0.3 ± 0.3 mm/yr and 1.3 ± 0.4 mm/yr. For the strike-slip Galera Fault, we quantify the slip rate as 0.5 ± 0.3 mm/yr. Our GPS study shows a discrepancy for the Baza Fault between the short-term slip rates and previously reported long-term rates. This discrepancy indicates that the fault could be presently in a period with a displacement rate higher than the mean of the magnitude 6 seismic cycle. Moreover, the velocity vectors that we obtained also show the regional tectonic significance of the Baza Fault, as this structure accommodates one-third of the regional extension of the Central Betic Cordillera. Our GPS-related slip rates form the basis for future seismic hazard analysis in this area. Our results have further implications, as they indicate that the Baza and Galera Faults are kinematically coherent and they divide the Baza sub-Basin into two tectonic blocks. This points to a likely physical link between the Baza and Galera Faults; hence, a potential complex rupture involving both faults should be considered in future seismic hazard assessment studies., We acknowledge the comments of Editor Prof. Irina M. Artemieva and two anonymous reviewers, which significantly improved the quality of this paper. This research was funded by the Spanish Ministry of Science, Innovation and University (Research Projects: RTI2018-100737-BI00 and CGL2016-80687-R), the University of Alicante (Research Project: VIGROB053), the University of Jaén (PAIUJA 2019-2020 and Programa Operativo FEDER Andalucía 2014-2020 - call made by UJA 2018), the University of Granada (B-RNM-301-UGR18) and the Junta de Andalucía regional government (RNM148, RNM282, and RNM370 and P18-RT-3275 research groups). We thank all observers who collected the data of survey-mode GPS measurements.

Soil erosion modeling in olive groves requires precise and accurate spatial data for the representation of topography associated with each time epoch considered. The precision and accuracy of altimetric values affect the quality of the digital elevation model (DEM) and therefore these requirements must be added to the necessity to generate high resolution DEMs. The increase of quality implies: 1. Improving the quality of the instrumentation and methodology applied in the field data collection and 2. Minimizing errors from the interpolation algorithm used to generate the digital terrain model. Currently, RTK networks are an indispensable complement to global navigation satellite systems (GNSS) precise positioning. The availability of highly accurate three-dimensional real time positioning has opened the door to new applications, making network-based real time kinematic (NRTK) positioning an attractive spatial data source for modeling soil erosion in small areas. This paper analyzes the quality of NRTK altimetric positioning supported by a local active network and its application in a test olive grove in SE Spain for soil erosion modeling. An evaluation procedure was implemented at several test sites distributed throughout an olive grove environment with special emphasis on filtering and checking the NRTK solutions in the vertical component. The precision in this component revealed a mean value of 15 mm and the vertical accuracy reached maximum values of 30 mm. In order to generate high resolution and accuracy DEM from the NRTK data, cross sections on the test olive grove were surveyed. The average altimetric quality value (CQ1D) of points surveyed was 0.017 m, according to the standard deviation estimated at test points. Based on the quality results, NRTK positioning is an accurate and reliable methodology for monitoring the erosion processes of small areas in an olive grove environment.

The Padul Fault is located in the Central Betic Cordillera, formed in the framework of the NW-SE Eurasian-African plate convergence. In the Internal Zone, large E-W to NE-SW folds of western Sierra Nevada accommodated the greatest NW-SE shortening and uplift of the cordillera. However, GPS networks reveal a present-day dominant E-W to NE-SW extensional setting at surface. The Padul Fault is the most relevant and best exposed active normal fault that accommodates most of the NE-SW extension of the Central Betics. This WSW-wards dipping fault, formed by several segments of up to 7 km maximum length, favored the uplift of the Sierra Nevada footwall away from the Padul graben hanging wall. A non-permanent GPS network installed in 1999 constrains an average horizontal extensional rate of 0.5 mm/yr in N66°E direction. The fault length suggests that a (maximum) 6 magnitude earthquake may be expected, but the absence of instrumental or historical seismic events would indicate that fault activity occurs at least partially by creep. Striae on fault surfaces evidence normal-sinistral kinematics, suggesting that the Padul Fault may have been a main transfer fault of the westernmost end of the Sierra Nevada antiform. Nevertheless, GPS results evidence: (1) shortening in the Sierra Nevada antiform is in its latest stages, and (2) the present-day fault shows normal with minor oblique dextral displacements. The recent change in Padul fault kinematics will be related to the present-day dominance of the ENE-WSW regional extension versus ~ NNW-SSE shortening that produced the uplift and northwestwards displacement of Sierra Nevada antiform. This region illustrates the importance of heterogeneous brittle extensional tectonics in the latest uplift stages of compressional orogens, as well as the interaction of folding during the development of faults at shallow crustal levels. This research was funded by PAIUJA 2017/2018, UJA2016/00086/001 project, CGL2016-80687-R AEI/FEDER, UE project and RNM148 and RNM282 research groups of Junta de Andalucía.

The Gibraltar Arc, located in the western Mediterranean Sea, is an arcuate Alpine orogen formed by the Betic and Rif Cordilleras, separated by the Alboran Sea. New continuous GPS data (2008–2013) obtained in the Topo-Iberia stations of the western Betic Cordillera allow us to improve the present-day deformation pattern related to active tectonics in this collision area between the Eurasian and African plates. These data indicate a very consistent westward motion of the Betic Cordillera with respect to the relatively stable Iberian Massif foreland. The displacement in the Betics increases toward the south and west, reaching maximum values in the Gibraltar Strait area (4.27 mm/yr in Ceuta, CEU1, and 4.06 mm/yr in San Fernando, SFER), then progressively decreasing toward the northwestern mountain front. The recent geological structures and seismicity evidence moderate deformation in a roughly NW–SE to WNW–ESE compressional stress setting in the mountain frontal areas, and moderate extension toward the internal part of the cordillera. The mountain front undergoes progressive development of folds affecting at least up to Pliocene deposits, with similar recent geological and geodetical rates. This folded strip helps to accommodate the active deformation with scarce associated seismicity. The displacement pattern is in agreement with the present-day clockwise rotation of the tectonic units in the northern branch of the Gibraltar Arc. Our data support that the westward emplacement of the Betic Cordillera continues to be active in a rollback tectonic scenario.

The main segment of the active Balanegra Fault Zone (SE Spain) is monitored through high-precision levelling profiles in order to determine its short-term activity. It belongs to the NW–SE oriented normal and normal–oblique widespread fault set of the Betic Cordillera related to the Eurasian–African plate boundary, and constitutes the possible source of four moderate-size earthquakes (Mw 4.5–6.7) over the last five centuries at a minimum ∼100-year recurrence interval. Successive measurements since 2006 along two levelling profiles determined varying temporal behaviour. A general increase in vertical throw occurred between May 2007 and September 2010, within a remarkable low seismic activity and deformation build-up period, followed by a subordinate regional relaxation stage probably associated to nearby low magnitude earthquakes. In the longest northern profile deformation of up to 1.88 mm and rates reaching 0.78 mm/year with a mean rate of 0.14 mm/year are observed. The shortest southern profile, which is close to the area where the main earthquakes of the 1993–1994 series nucleated, records similar interseismic deformation behaviour although with lower deformation than the northern profile. The Balanegra Fault Zone illustrates complex behaviour in the period comprised between major earthquakes, exemplifying the temporal variability of deformation.

From 2001 to 2008, the National Geographic Institute of Spain (IGN) carried out the REDNAP project to the establishment of a National High Precision Levelling Network in the whole Spanish territory. Within REDNAP, spirit levelling and gravity observations were complemented by GNSS data. The levelling network of the continental area and those of the main islands were referred to different tide gauges thus producing different height systems. In the paper, the GOCO-05S model from the GRACE and GOCE gravity missions is used to unify such systems. More precisely, it is used to estimate the normal heights of the mean sea level at the reference tide gauges, i.e. the height system biases. In the proposed solution such biases are determined through the least squares adjustment of the differences between height anomalies derived from GNSS/levelling and height anomalies derived from a proper combination of global gravity models. An accurate modelling of the observation error covariances is taken into account as well. The estimated accuracies of the resulting biases are in the order of few centimetres apart from that of continental Spain which is an order of magnitude better.

The seismic activity of the Guardamar-Torrevieja zone (Eastern Betic Cordillera, SE Spain) can be associated with the Bajo Segura fault zone, an E-W reverse blind fault with secondary NW-SE dextral faults. A high-precision levelling profile 30 kilometers long was set up and levelled in 1997 to monitor the vertical displacement of this active fault zone. This profile runs parallel to an older high-precision levelling line included in the Spanish first order levelling network measured by the Instituto Geografico Nacional (IGN) in two different campaigns (1934 and 1976). The 1997 line was relevelled in 2003 and 10 new benchmarks were set up, both to increase benchmark density and to restore some of the 1997 benchmarks that had been destroyed. We have used the 1976 IGN and the 2003 measurement to construct a recent vertical movements profile with a significant time difference (27 years). This recent vertical movements profile shows that the vertical movements are very small, nearly equal to the error bars, with a 0.2 mm/year rise in the town of Guardamar, and a 0.2 mm/year subsidence of the southern part of the profile (Punta Prima) respect to the town of Torrevieja. These movements could be related to the activity of the Bajo Segura and the San Miguel faults respectively. Using geological markers we have deduced uplift rates of 0.1 mm/year during the last 3 million years. Therefore, these preliminary results indicate that geodetically (short-term deformation) determined uplift rates are similar to those estimated from geological markers (long term deformation).

Two new GPS surveys have been carried out to check the accuracy of an existing gravimetric geoid in a test area located in northern Andalusia (Spain). The fast collocation method and the remove-restore procedure have been used for the computation of the quasigeoid model. The Spanish height system is based on orthometric heights, so the gravimetrically determined quasigeoid has been transformed to a geoid model and then compared to geoid undulations provided by GPS and levelling at benchmarks belonging to the Spanish first-order levelling network. The discrepancies between the gravimetric solution and GPS/levelling undulations amount to +/-2 cm for one survey and FS cm for another after fitting a plane to the geoid model.

In this paper, we present a first estimation, using the GIPSY-OASIS software, of the crustal velocity and strain rate fields in the Balearic Islands (Spain), based on continuous GPS observations from the XGAIB network spanning the period 2010-2013. The XGAIB network consists of nine permanent, widely distributed stations that have operated continuously since 2010. In this paper, we describe the XGAIB network and the CGPS data processing and present our principle results in terms of the position time series and velocities of all of the sites, which were observed for more than three and a half years. In addition, strain tensors were estimated from the velocity field to obtain the first realistic crustal deformation model of the archipelago. The strains exhibit gradual variation across the Balearic Islands, from WNW-ESE extension in the southwest (Ibiza and Formentera) to NW-SE compression in the northeast (Menorca). These results constitute an advance in our knowledge of the tectonics of the western Mediterranean region. This research was partly funded by the Spanish Ministry of Science and Innovation through the AYA2010-15501, CGL2011-30153-C02-02 and CSD2006-0041 projects (European Regional Development Fund-ERDF).

The Bajo Segura Fault Zone, located at the NE end of the Eastern Betic Shear Zone, has been the site of some of the most intense seismic activity on the Iberian Peninsula in the historical and instrumental time periods. This structure is an active blind fault that does not show any surface rupture. It is characterised by a set of ENE-WSW trending blind thrust faults that offset the Triassic basement and cause active folding of the Upper Miocene-Quaternary sedimentary cover. The main active structures of this fault zone are two ENE-WSW striking reverse blind faults, the Torremendo and the Bajo Segura Faults, and several secondary NW-SE striking dextral faults (San Miguel de Salinas, Torrevieja and Guardamar Faults). These structures continue offshore to the east. From geological, geomorphological and geodetic data, we obtain fault slip rates between 0.2 and 0.4 mm/yr, whereas other authors have proposed higher values ranging between 0.75 and 1 mm/yr. The fault zone can generate earthquakes with maximum estimated magnitudes (Mw) from 6.6 to 7.1 and has approximate recurrence intervals between 4.500 and 21.500 years, Departamento de Ciencias de la Tierra y del Medio Ambiente, Universidad de Alicante, España, Unitat de Tecnologia Marina, Centre Mediterrani d’Investigacions Marines i Ambientals, España, Departamento de Ingeniería Cartográfica, Geodésica y Fotogrametría, Universidad de Jaén, España, Instituto Geológico y Minero de España, España, Departamento de Geología, Universidad de Jaén, España

Hepatitis C virus infection evolves into chronic progressive liver disease in a significant percentage of patients. Monocytes constitute a diverse group of myeloid cells that mediate innate and adaptive immune response. In addition to proinflammatory CD16+ monocytes, a Tie-2+ subgroup - Tie-2 expressing monocytes (TEMs) - that has robust proangiogenic potential has been recently defined.To study the heterogeneity of peripheral blood monocytes in chronic hepatitis C (CHC) patients and to examine their proposed pathophysiological roles on disease progression and response to antiviral therapy.We studied CD16+ and Tie-2+ peripheral monocyte subpopulations in 21 healthy subjects and 39 CHC patients in various stages of disease and responses to antiviral treatment using flow cytometry. Expression profiles of proangiogenic and tissue remodelling factors in monocyte supernatants were measured using ELISA and protein arrays. Intrahepatic expression of CD14, CD31 and Tie-2 was analysed using immunofluorescence.Increases of certain peripheral monocyte subsets were observed in the blood of CHC patients, wherein those cells with proinflammatory (CD16+) or proangiogenic (TEMs) potential expanded (P0.005, both). Notably, TEMs were significantly increased in nonresponders, particularly those with lower CD16 expression. In addition, many angiogenic factors were differentially expressed by peripheral monocytes from control or CHC patients, such as angiopoietin-1 and angiogenin (P0.05). Interestingly, intrahepatic TEMs were distinguished within portal infiltrates of CHC patients.These findings suggest for the first time the relevance of peripheral monocytes phenotypes for the achievement of response to treatment. Hence, the study of monocyte subset regulation might effect improved CHC prognoses and adjuvant therapies.

Interferon-alfa-based therapy is effective in the treatment of Hepatitis C. However, some patients fail to respond and others relapse, after initially responding. Our objective was to assess the efficacy, safety and predictive factors for sustained virological response (SVR) to peginterferon plus ribavirin in chronic hepatitis C patients who failed to interferon-alfa (IFNα)-based therapy.Seventy-five consecutive patients who failed to IFNα-based therapy were retreated with peginterferon plus ribavirin. Of these patients, 85% were infected by genotype 1. The primary endpoint was SVR.Of 75 non-responder (n = 54) or relapser patients (n = 21), 50 were previously treated with IFNα-monotherapy and 25 with IFNα plus ribavirin. Global SVR rate was 41.3%: for patients re-treated with IFNα the response was 48% whilst for those retreated with IFNα plus ribavirin, it was 28%. For previous non-responders the SVR rate was 37% and for relapsers it was 52.4%.Retreatment with peginterferon plus ribavirin is an effective option for some chronic hepatitis C non-responder or relapser patients. Higher SVR rate was achieved in relapsers and in those patients who received IFNα monotherapy previously.

The Campo de Dalias is an area with relevant seismicity associated to the active tectonic deformations of the southern boundary of the Betic Cordillera. A non-permanent GPS network was installed to monitor, for the first time, the fault- and fold-related activity. In addition, two high precision levelling profiles were measured twice over a one-year period across the Balanegra Fault, one of the most active faults recognized in the area. The absence of significant movement of the main fault surface suggests seismogenic behaviour. The possible recurrence interval may be between 100 and 300 y. The repetitive GPS and high precision levelling monitoring of the fault surface during a long time period may help us to determine future fault behaviour with regard to the existence (or not) of a creep component, the accumulation of elastic deformation before faulting, and implications of the fold-fault relationship.

Infection by the hepatitis C virus (HCV) is a major public health problem, with more than 170 million people infected throughout the world. The infection prevalence, with small regional differences, is estimated in 1-3% of the global population. HCV is the most frequent cause of chronic liver disease and 20-30% of patients develop cirrhosis with a risk of hepatocellular carcinoma. Nowadays, pegylated interferon-a (PEG-IFN) in combination with ribavirin, a nucleoside analogue, is the current treatment for chronic hepatitis C (CHC), with less adverse effects and better compliance. Dosage and duration depend on some factors as weight, genotype, viral load and a rapid virological response presented by the patient. One of the most relevant aspects in the treatment of CHC is how to manage the group of non-responder or relapser patients to previous treatments. As such, a substantial proportion of patients had already been unsuccessfully treated with interferon-based therapies and these patients claim for an optimal therapeutic option. The future treatment of CHC walk along through the association of two or three drugs, including nucleoside/nucleotide analogues, higher PEG-IFN initial dosages (induction) or longer treatments duration, or combination of helicase and protease inhibitors.

13 páginas, 8 figuras., In the Guadix-Baza Basin (Betic Cordillera) lies the Baza Fault, a structure that will be described for the first time in this paper. Eight gravity profiles and a seismic reflection profile, coupled with surface studies, indicate the existence of a NE-dipping normal fault with a variable strike with N-S and NW-SE segments. This 37-km long fault divides the basin into two sectors: Guadix to the West and Baza to the East. Since the Late Miocene, the activity of this fault has created a half-graben in its hanging wall. The seismic reflection profile shows that the fill of this 2,000–3,000 m thick asymmetric basin is syntectonic. The fault has associated seismicity, the most important of which is the 1531 Baza earthquake. Since the Late Tortonian to the present, i.e. over approximately the last 8 million years, extension rates obtained vary between 0.12 and 0.33 mm/year for the Baza Fault, being one of the major active normal faults to accommodate the current ENE–WSW extension produced in the central Betic Cordillera. The existence of this fault and other normal faults in the central Betic Cordillera enhanced the extension in the upper crust from the Late Miocene to the present in this regional compressive setting., This study was partly financed by Projects BTE2001-5230-E, CGL200401636/BTE, CGL2006-06001, CSD2006- 00041 and by the Generalitat Valenciana (GRUPOS03/085, OCYT).

8 páginas, 6 figuras, 5 tablas.-- Edited by Fernando Sansò and Antonio J. Gil.-- Trabajo presentado en el IAG Symposium; Jaen (España), del 17 al 19 de Marzo del 2005., The Betic Cordillera, located in the south of the Iberian Peninsula, is currently subjected to NW-SE compression and NE-SW extension. Until a few years ago, there were hardly any geodetic studies to quantify the tectonic deformation taking place in the Betic Cordillera. In 1999, in the framework of an interdisciplinary research project to monitor the deformation, several geodetic studies were initiated by the Universities of Jaén, Granada and Alicante. These studies were centred on the basins of Granada and the Bajo Segura (Alicante), sectors in which the last two destructive earthquakes in the Iberian Peninsula took place. This paper describes the geodynamic context of these study areas and the main features of the geodetic studies, focusing on the deformation analysis of the three observation surveys carried out in 1999, 2000 and 2001 over a non-permanent GPS network established in the Granada Basin. The results agree with the low rates of deformation previously calculated from geological data. To detect such small rates, observation over a longer time span will be needed., The authors gratefully acknowledge the support given by Dirección General de Enseñanza Superior e Investigación Científica (Spain) (Project PB97-1267-C03). This study was also partly financed by the Projects BTE2000-3337-E, BTE2003-1113 and by the Generalitat Valenciana (GRUPOS03/085, OCYT).

12 pages, 5 figures., The internal zones of the Betic Cordilleras show a present-day relief that is mainly controlled by kilometre-size, symmetrical or north-vergent folds which developed mostly since Middle Miocene times. The Sierra Nevada, Sierra Alhamilla, Sierra de Los Filabres, Sierra Tejeda and Sierra de Gádor, among others, are roughly E–W trending high mountain ranges, corresponding to antiforms where metamorphic rocks crop out. The surrounding depressions are located in synforms, where Neogene rocks are preserved from erosion. Field evidence shows that the growth of the folds is coeval with fault development, and that at least three of them, i.e. the Padul Fault, the Zafarraya Fault, and the Balanegra Fault, may be considered to be active seismogenetic structures. The Zafarraya Fault, in particular, is thought to be responsible for the 1884 Andalucía Earthquake. The fault is located at the northern limb of the Sierra Tejeda antiform, and could be interpreted as a collapse structure developed along the external arch of the uplifted fold. The Padul and Balanegra faults are located at the southeastern border of the Granada Basin and south of the Sierra de Gádor, respectively. They belong to a set of NW–SE oriented faults that are mainly normal in character and indicate NE–SW extension. The set up, since 1999, of a GPS network within and around the Granada Basin and the planed installation of a new network in the Sierra Tejeda, will give us new insights on the present-day deformation behaviour of both folds and faults in the area., The constructive reviews of Dr. G. Cello and Z. Garfunkel have greatly improved this contribution. This research was supported by project BTE-2000-1490-C02-01 and BTE 2001-5230 of the CICYT, the RNM-0217 and RNM-148 groups of research the Junta de Andalucía.

The effectiveness and tolerability of combination therapy for 12 months have not been evaluated sufficiently in chronic hepatitis C relapsers to interferon.To evaluate the sustained response to interferon plus ribavirin for 12 months in chronic hepatitis C relapsers.We included 55 chronic hepatitis C relapsers in a 12-month treatment protocol with interferon (3 MU thrice weekly) plus ribavirin (1-1.2 g/day). The effectiveness was evaluated using serum aminotransferase and hepatitis C virus RNA levels, alanine aminotransferase normalization and viraemia clearance after 12 months, defining the end-of-treatment response, and 6 months after completion of therapy, defining the sustained response. Adverse effects were recorded.End-of-treatment response and sustained response were achieved in 47 (85%) and 37 (67%) patients, respectively; there were 10 (21%) relapsers after combination therapy. Predictive factors of sustained response included the genotype (non-1 95% vs. 1 48%; P0.001), lower viraemia (503 917 +/- 553 230 vs. 901 393 +/- 548 267 copies/mL; P0.005), higher alanine aminotransferase levels (137 +/- 75 vs. 103 +/- 41 IU/L; P0.05) and a lower gamma-glutamyl transpeptidase/alanine aminotransferase ratio (0.30 +/- 0.23 vs. 0.49 +/- 0.39; P0.05). Tolerance to therapy was good, with no withdrawals.Interferon plus ribavirin treatment for 12 months in chronic hepatitis C relapsers yields high sustained response rates and is well tolerated. The sustained response is related to a non-1 genotype, lower baseline viraemia, higher alanine aminotransferase level and a lower gamma-glutamyl transpeptidase/alanine aminotransferase ratio.

The role of combination therapy is poorly defined in chronic hepatitis C patients who are non-responders to interferon.To assess the efficacy, safety and tolerance of interferon alfa-2b plus ribavirin in chronic hepatitis C patients who do not respond to interferon monotherapy.A total of 127 non-responder patients with chronic hepatitis C received 3 mU t.i.w. of interferon alfa-2b plus 1000-1200 mg ribavirin daily for 48 weeks. Effects of therapy were evaluated by serum aminotransferases and hepatitis C virus (HCV) RNA levels.Twenty-nine (23%) patients had an end-of-treatment response. Six months after treatment, 20 (16%) patients were sustained responders. Early loss of HCV RNA was the strongest predictor of a sustained response (P0.0001). Remission was also more frequent in patients with genotype 1b (P0.02), elevated alanine aminotransferase (P0.03) and low gamma glutamiltranspeptidase (P0.002). Treatment was discontinued in 21 (17%) patients: in 14 for intolerance and in seven due to side-effects.Combination therapy with interferon plus ribavirin produced a sustained response in 16% of chronic hepatitis C patients who were non-responders to interferon. This combination was safe and well tolerated.

To analyze the epidemiological risk factors related to clinical and pathological patterns on presentation in patients with chronic hepatitis C (CHC) without cirrhosis.This prospective study, carried out in the Liver Unit of the Princesa University Hospital, includes a population of 253 patients with CHC without clinical features of cirrhosis evaluated for clinical, virological and histological assessment. A standardized questionnaire was used to identify the presence of risk factors for hepatitis C virus (HCV) infection. Anti-HCV was tested by ELISA-2 and RIBA-2 assays. HCV RNA was analyzed by nested PCR. Liver biopsies were obtained percutaneously or in some cases by laparoscopy.The mean age of patients was 43+/-15 years and 154 were males, being significantly younger than females (39+/-13 versus 50+/-14 years). A source of infection was ascertained in 204 (80.6%) patients and only 37 (14.6%) referred a history of acute hepatitis. Anti-HCV was ELISA-2 positive in all 253, and 133 were tested by RIBA-2 (131 positive, 1 negative, 1 indeterminate) and by nested PCR to detect HCV RNA, with positivity in all except 3, including both the RIBA-2 negative and indeterminate. No differences appeared in the histological activity index according to routes of infection, but in comparing sexes, females had a significantly higher total score as well as the inflammatory/hepatitic index and fibrosis.In CHC no epidemiological, clinical or biochemical patterns are indicative of pathological features. The more severe disease in females could be attributed to the fact that they were older and it could be assumed that viral infection progressed longer. This slow progression calls for a therapeutical option over many years.

A more effective therapy for chronic hepatitis C virus-infected patients is needed.To evaluate the efficacy, tolerance and timing of response to interferon alpha plus ribavirin in 60 patients with no response or reactivation after interferon alpha alone.Sixty patients, 42 non-responders and 18 relapsers, received 3 million units three times weekly of interferon alpha-2b plus 1-1.2 g ribavirin daily, for 6 months. Basal biochemical and virological (HCV RNA and genotype) parameters were determined. Clinical examination, recording adverse effects, and laboratory tests, including viraemia, were carried out at 1, 2, 3 and 6 months.A significant (P0.001) progressive decrease of HCV RNA and alanine transaminase (ALT) levels was observed during treatment. On finalizing the sixth month, 42 patients (70%) had normal ALT and 26 (43.3%) were HCV RNA negative. Of these 26 complete responders, in 20 the viraemia was undetectable by the third month, while a late clearance at the sixth month of treatment was observed in six patients. Response rates were higher in previous responders to interferon alone (P0.05). Mild adverse effects appeared in 46 patients (79.6%), but only three were withdrawn due to serious side-effects. Significantly (P0.001), haemoglobin and leucocytes decreased, and bilirubin, ferritin and uric acid increased in the first month of treatment, with no changes thereafter.Interferon alpha plus ribavirin progressively decreased HCV RNA and ALT levels, achieving a complete response in the six months of treatment in 26 (43.3%) patients. This combined therapy was well tolerated.

We report a patient with a mitral insufficiency due to myxomatous valve change, with a regurgitation murmur heard principally at aortic area and radiating to the neck base. Even though the topography of the murmur seemed to suggest aortic stenosis, the other auscultation findings and the initial clinical tests clearly supported its source in a mitral insufficiency. The echocardiography allowed us not only to confirm our suspicion, but also to explain this auscultation finding mechanism, to show a severe mitral insufficiency with a anterior and medial jet, which struck the aorta and atrial septum. The surgery found a clear aortic vibration, which disappeared after implanting the mitral protheses. Our case illustrates the value of new diagnostic image techniques to complement the semiologic findings.