Erythromycin before endoscopy in upper GI bleeding : a meta-analysis of randomized controlled trials

Upper gastrointestinal bleeding (UGIB) is a common medical emergency that accounts for numerous hospital admissions each year. Given its significant morbidity and mortality, urgent endoscopy with adequate gastric mucosal visualization is imperative for identification and treatment of bleeding lesions. Various studies have been done evaluating the effectiveness of erythromycin infusion prior to endoscopy to improve visibility and therapeutic potential of endoscopy; however, the results have been controversial. To evaluate further, we performed a meta-analysis comparing the efficacy of erythromycin infusion before endoscopy in acute UGIB

Upper GI bleeding with myocardial infarction : evaluation of safety for endoscopy

Upper gastrointestinal bleeding (UGIB) in the setting of acute myocardial infarction (MI) is a complex medical condition with substantial morbidity and mortality. The anemia due to the UGIB may exacerbate the MI or the anticoagulation for the MI may contribute to UGIB. In addition, both have many significant complications. Several studies have been performed in studying the safety of EGD after MI; however, these studies vary in definitions and results. This study evaluated the safety and effect of EGD in patients with acute MI in a tertiary-care center

Hurricane Gustav (2008) Waves and Storm Surge: Hindcast, Synoptic Analysis, and Validation in Southern Louisiana

Hurricane Gustav (2008) made landfall in southern Louisiana on 1 September 2008 with its eye never closer than 75 km to New Orleans, but its waves and storm surge threatened to flood the city. Easterly tropical-storm-strength winds impacted the region east of the Mississippi River for 12-15 h, allowing for early surge to develop up to 3.5 m there and enter the river and the city's navigation canals. During landfall, winds shifted from easterly to southerly, resulting in late surge development and propagation over more than 70 km of marshes on the river's west bank, over more than 40 km of Caernarvon marsh on the east bank, and into Lake Pontchartrain to the north. Wind waves with estimated significant heights of 15 m developed in the deep Gulf of Mexico but were reduced in size once they reached the continental shelf. The barrier islands further dissipated the waves, and locally generated seas existed behind these effective breaking zones. The hardening and innovative deployment of gauges since Hurricane Katrina (2005) resulted in a wealth of measured data for Gustav. A total of 39 wind wave time histories, 362 water level time histories, and 82 high water marks were available to describe the event. Computational models-including a structured-mesh deepwater wave model (WAM) and a nearshore steady-state wave (STWAVE) model, as well as an unstructured-mesh "simulating waves nearshore'' (SWAN) wave model and an advanced circulation (ADCIRC) model-resolve the region with unprecedented levels of detail, with an unstructured mesh spacing of 100-200 m in the wave-breaking zones and 20-50 m in the small-scale channels. Data-assimilated winds were applied using NOAA's Hurricane Research Division Wind Analysis System (H*Wind) and Interactive Objective Kinematic Analysis (IOKA) procedures. Wave and surge computations from these models are validated comprehensively at the measurement locations ranging from the deep Gulf of Mexico and along the coast to the rivers and floodplains of southern Louisiana and are described and quantified within the context of the evolution of the storm

Global to Channel Scale Water Level Forecasting and Analysis

A multi-step process to creating better grids and to get to a global tidal model for ADCIRC 1. Process of merging shoreline databases together for better mesh development. 2. High resolution optimal meshes for the US East and Gulf of Mexico coasts 3. Hindcast of Hurricane Irma using ADCIRC + SWAN (to learn about how system performs) 4. Development of 30m and 120m meshes for the US East and Gulf Coasts 5. ADCIRC global tidal model developmen

ADCIRC Version 54

This presentation is an overview of the new features and bug fixes of ADCIRC version 54 and future developments

Enhancing Flood Hazard Assessments in Coastal Louisiana Through Coupled Hydrologic and Surge Processes

Traditional coastal flood hazard studies do not typically account for rainfall-runoff processes in quantifying flood hazard and related cascading risks. This study addresses the potential impacts of antecedent rainfall-runoff, tropical cyclone (TC)-driven rainfall, and TC-driven surge on total water levels and its influence in delineating a coastal flood transition zone for two distinct coastal basins in southeastern Louisiana (Barataria and Lake Maurepas watersheds). Rainfall-runoff from antecedent and TC-driven rainfall along with storm surge was simulated using a new rain-on-mesh module incorporated into the ADCIRC code. Antecedent rainfall conditions were obtained for 21 landfalling TC events spanning 1948–2008 via rain stations. A parametric, TC-driven, rainfall model was used for precipitation associated with the TC. Twelve synthetic storms of varying meteorological intensity (low, medium, and high) and total rainfall were utilized for each watershed and provided model forcing for coastal inundation simulations. First, it was found that antecedent rainfall (pre-TC landfall) is influential up to 3 days pre-landfall. Second, results show that antecedent and TC-driven rainfall increase simulated peak water levels within each basin, with antecedent rainfall dominating inundation across the basin\u27s upper portions. Third, the delineated flood zones of coastal, transition, and hydrologic show stark differences between the two basins