Projecting Changes in Tanzania Rainfall for the 21st century: Scenarios, Downscaling & Analysis

A Non-Homogeneous hidden Markov Model (NHMM) is developed using a 40-years record (1950-1990) of daily rainfall at eleven stations in Tanzania and re-analysis atmospheric fields of Temperature (T) at 1000 hPa, Geo Potential Height (GPH) at 1000 hPa, Meridional Winds (MW) and Zonal Winds (ZW) at 850 hPa, and Zonal Winds at the Equator(ZWE) from 10 to 1000 hPa. The NHMM is then used to predict future rainfall patterns under a global warming scenario (RCP8.5), using predictors from the CMCC-CMS simulations from 1950-2100. The model directly considers seasonality through changes in the driving variables thus addressing the question of how future changes in seasonality of precipitation can be modeled. The future downscaled simulations from NHMM, with predictors derived from the simulations of the CMCC-CMS CGM, in the worst conditions of global warming as simulated by RCP8.5 scenario, indicate that, Tanzania may be subjected to to a reduction of total annual rainfall; this reduction is concentrated in the wet seasons, OND, mainly as a consequence of decreasing of seasonal number of wet days. . Frequency and Intensity of extreme events don’t show any evident trend during the 21 century

Primary mediastinal Castleman's disease

Castleman's disease is a rare entity with an unknown etiology which was first described by Castleman in 1954. It is a lymphoproliferative disorder histologically classified into three types; hyaline-vascular, plasma cell type and mixed type. It might be localized or multicentric and usually involves the mediastinum. We report a case of Castleman's disease discovered accidentally in a case of blunt chest trauma which caused a challenging diagnostic process and management

Hazard Assessment from Storm Tides and Rainfall on a Tidal River Estuary

Here, we report on methods and results for a model-based flood hazard assessment we have conducted for the Hudson River from New York City to Troy/Albany at the head of tide. Our recent work showed that neglecting freshwater flows leads to underestimation of peak water levels at up-river sites and neglecting stratification (typical with two-dimensional modeling) leads to underestimation all along the Hudson. As a result, we use a three-dimensional hydrodynamic model and merge streamflows and storm tides from tropical and extratropical cyclones (TCs, ETCs), as well as wet extratropical cyclone (WETC) floods (e.g. freshets, rain-on-snow events). We validate the modeled flood levels and quantify error with comparisons to 76 historical events. A Bayesian statistical method is developed for tropical cyclone streamflows using historical data and consisting in the evaluation of (1) the peak discharge and its pdf as a function of TC characteristics, and (2) the temporal trend of the hydrograph as a function of temporal evolution of the cyclone track, its intensity and the response characteristics of the specific basin. A k-nearest-neighbors method is employed to determine the hydrograph shape. Out of sample validation tests demonstrate the effectiveness of the method. Thus, the combined effects of storm surge and runoff produced by tropical cyclones hitting the New York area can be included in flood hazard assessment. Results for the upper Hudson (Albany) suggest a dominance of WETCs, for the lower Hudson (at New York Harbor) a case where ETCs are dominant for shorter return periods and TCs are more important for longer return periods (over 150 years), and for the middle-Hudson (Poughkeepsie) a mix of all three flood events types is important. However, a possible low-bias for TC flood levels is inferred from a lower importance in the assessment results, versus historical event top-20 lists, and this will be further evaluated as these preliminary methods and results are finalized. Future funded work will quantify the influences of sea level rise and flood adaptation plans (e.g. surge barriers). It would also be valuable to examine how streamflows from tropical cyclones and wet cool-season storms will change, as this factor will dominate at upriver locations

Metastatic lung cancer presenting as thoracic empyema: A Case report

Increased cancer risk in patients with inflammatory and infectious diseases has been reported in many studies and lung cancer\u2010associated empyema in <0.3% patients. We present a patient with empyema in whom the final diagnosis was metastatic lung adenocarcinoma. Purulent pleural fluid obtained by drainage or thoracentesis must always been examined because the association of malignant tumors and empyema should be taken into consideration

Pneumomediastinum after a swimming race and dental extraction

A 16-year-old male competitive swimmer presented with dyspnea, chest pain, and right neck crepitus after a race. He had undergone an uncomplicated lower right third molar tooth extraction 2 days earlier. He had no known allergies. On examination, he was alert, well-perfused, and afebrile. The peritoneal signs were negative. A chest radiograph showed subcutaneous emphysema with pneumomediastinum. Computed tomography showed submandibular, neck, and mediastinal emphysema (Figure 1). Conservative therapy based on observation and prophylactic parenteral administration of antibiotics (clindamycin 450\u2009mg every 6\u2009h and ceftriaxone 2\u2009g daily for 10 days) was successfully adopted, and he was discharged after 3 days

Unexpected thymoma in a challenging case of hyperparathyroidism

We report the case of a woman with primary hyperparathyroidism suspected of mediastinal ectopic parathyroid adenoma revealed to be a thymoma. Our aim was to focus on some possible criticisms in distinguishing between ectopic parathyroid and thymus