Temporal variability of downward fluxes of organic carbon off Monterey Bay

17 USC 105 interim-entered record; under review.Sediment traps were deployed at two depths (300 m and 1200 m) off Monterey Bay (36°40′N and 122°25′W, Central California) for 7.3 years (1998–2005). The sediment trap data provided information about the quantity and quality of settling material, and allowed exploration of the relationship of the sinking material with the environmental conditions in this coastal upwelling region. The magnitude and composition of the settling material were highly variable over time. Organic carbon (Corg) fluxes ranged between 4–296 mg C m−2 day−1 and 0.1–142 mg C m−2 day−1 for shallow and deep sediment traps, respectively. The time series of Corg vertical flux was characterized by pulses of intense fluxes that were associated with peaks of primary production, generally during upwelling periods. Despite considerable variability, fluxes varied seasonally with highest values during the upwelling season and the lowest in winter. Attenuation of Corg vertical fluxes with depth (300 m vs. 1200 m) varied between 31% and 24% except for the late upwelling period, when there was an increase with depth likely due to resuspension of material from Monterey Canyon. Calculation of a seasonal vertical budget of organic carbon off Monterey Bay resulted in a transfer between 4.0% and 4.9% of the primary production to the deep ocean, suggesting that coastal upwelling efficiently sequestered CO2.The principal source of support for these measurements was the David and Lucile Packard Foundation. CGC was partially supported by a National Research Council Fellowship at the Naval Postgraduate School.

Coil-Assisted Retrograde Transvenous Obliteration (CARTO) for the Treatment of Portal Hypertensive Variceal Bleeding: Preliminary Results.

ObjectivesTo describe the technical feasibility, safety, and clinical outcomes of coil-assisted retrograde transvenous obliteration (CARTO) in treating portal hypertensive non-esophageal variceal hemorrhage.MethodsFrom October 2012 to December 2013, 20 patients who received CARTO for the treatment of portal hypertensive non-esophageal variceal bleeding were retrospectively evaluated. All 20 patients had at least 6-month follow-up. All patients had detachable coils placed to occlude the efferent shunt and retrograde gelfoam embolization to achieve complete thrombosis/obliteration of varices. Technical success, clinical success, rebleeding, and complications were evaluated at follow-up.ResultsA 100% technical success rate (defined as achieving complete occlusion of efferent shunt with complete thrombosis/obliteration of bleeding varices and/or stopping variceal bleeding) was demonstrated in all 20 patients. Clinical success rate (defined as no variceal rebleeding) was 100%. Follow-up computed tomography after CARTO demonstrated decrease in size with complete thrombosis and disappearance of the varices in all 20 patients. Thirteen out of the 20 had endoscopic confirmation of resolution of varices. Minor post-CARTO complications, including worsening of esophageal varices (not bleeding) and worsening of ascites/hydrothorax, were noted in 5 patients (25%). One patient passed away at 24 days after the CARTO due to systemic and portal venous thrombosis and multi-organ failure. Otherwise, no major complication was noted. No variceal rebleeding was noted in all 20 patients during mean follow-up of 384±154 days.ConclusionsCARTO appears to be a technically feasible and safe alternative to traditional balloon-occluded retrograde transvenous obliteration or transjugular intrahepatic portosystemic shunt, with excellent clinical outcomes in treating portal hypertensive non-esophageal variceal bleeding

Effectiveness of Ledipasvir/Sofosbuvir with/without Ribavarin in Liver Transplant Recipients with Hepatitis C.

Background and Aims: Recurrent infection of hepatitis C virus (HCV) in liver transplant (LT) recipients is universal and associated with significant morbidity and mortality. Methods: We retrospectively evaluated the safety and efficacy of ledipasvir/sofosbuvir with and without ribavirin in LT recipients with recurrent genotype 1 hepatitis C. Results: Eighty-five LT recipients were treated for recurrent HCV with ledipasvir/sofosbuvirwith and without ribavirin for 12 or 24 weeks. The mean (± standard deviation [SD]) time from LT to treatment initiation was 68 (±71) months. The mean (± SD) age of the cohort was 63 (±8.6) years old. Most recipients were male (70%). Baseline alanine transaminase, total bilirubin, and HCV ribonucleic acid (RNA) values (± SD) were 76.8 (±126) mg/dL, 0.8 (±1.3) U/L, and 8,010,421.9 (±12,420,985) IU/mL, respectively. Five of 43 recipients who were treated with ribavirin required drug cessation due to side effects, with 4 of those being anemia complications. No recipient discontinued the ledipasvir/sofosbuvir. Eighty-one percent of recipients had undetectable viral levels at 4 weeks after starting therapy, and all recipients had complete viral suppression at the end of therapy. The sustained viral response at 12 weeks after completion of therapy was 94%. Conclusion : Ledipasvir and sofosbuvir with and without ribavirin therapy is an effective and well-tolerated interferon-free treatment for recurrent HCV infection after LT. Anemia is not uncommon in LT recipients receiving ribavirin

Hepatotoxicity Due to Hydroxycut: A Case Series

Muscletech Hydroxycut® (Iovate Health Sciences Research, Oakville, Ontario) was a popular weight loss supplement that was recalled by the manufacturer in May 2009 based on reports of hepatotoxicity associated with this supplement

Lipid profile, cardiovascular disease and mortality in a Mediterranean high-risk population: the ESCARVAL-RISK study

The potential impact of targeting different components of an adverse lipid profile in populations with multiple cardiovascular risk factors is not completely clear. This study aims to assess the association between different components of the standard lipid profile with all cause mortality and hospitalization due to cardiovascular events in a high-risk population. Methods This prospective registry included high risk adults over 30 years old free of cardiovascular disease (2008±2012). Diagnosis of hypertension, dyslipidemia or diabetes mellitus was inclusion criterion. Lipid biomarkers were evaluated. Primary endpoints were all-cause mortality and hospital admission due to coronary heart disease or stroke. We estimated adjusted rate ratios (aRR), absolute risk differences and population attributable risk associated with adverse lipid profiles. Results 51,462 subjects were included with a mean age of 62.6 years (47.6% men). During an average follow-up of 3.2 years, 919 deaths, 1666 hospitalizations for coronary heart disease and 1510 hospitalizations for stroke were recorded. The parameters that showed an increased rate for total mortality, coronary heart disease and stroke hospitalization were, respectively, low HDL-Cholesterol: aRR 1.25, 1.29 and 1.23; high Total/HDL-Cholesterol: aRR 1.22, 1.38 and 1.25; and high Triglycerides/HDL-Cholesterol: aRR 1.21, 1.30, 1.09. The parameters that showed highest population attributable risk (%) were, respectively, low HDL-Cholesterol: 7.70, 11.42, 8.40; high Total/HDL-Cholesterol: 6.55, 12.47, 8.73; and high Triglycerides/ HDL-Cholesterol: 8.94, 15.09, 6.92. Conclusions In a population with cardiovascular risk factors, HDL-cholesterol, Total/HDL-cholesterol and triglycerides/HDL-cholesterol ratios were associated with a higher population attributable risk for cardiovascular disease compared to other common biomarkers

State of the California Current 2014-15: Impacts of the Warm-Water "Blob"

In 2014, the California Current (~28˚–48˚N) saw average, or below average, coastal upwelling and relatively low productivity in most locations, except from 38˚–43˚N during June and July. Chlorophyll-a levels were low throughout spring and summer at most locations, except in a small region around 39˚N. Catches of juvenile rockfish (an indicator of upwelling-related fish species) remained high throughout the area surveyed (32˚–43˚N). In the fall of 2014, as upwelling ceased, many locations saw an unprecedented increase in sea surface temperatures (anomalies as large as 4˚C), particularly at 45˚N due to the coastal intrusion of an extremely anomalous pool of warm water. This warm surface anomaly had been building offshore in the Gulf of Alaska since the fall of 2013, and has been referred to as the “blob.” Values of the Pacific Decadal Oscillation index (PDO) continued to climb during 2014, indicative of the increase in warm coastal surface waters, whereas the North Pacific Gyre Oscillation index (NPGO) saw a slight rebound to more neutral values (indicative of average productivity levels) during 2014. During spring 2015, the upwelling index was slightly higher than average for locations in the central and northern region, but remained below average at latitudes south of 35˚N. Chlorophyll a levels were slightly higher than average in ~0.5˚ latitude patches north of 35˚N, whereas productivity and phytoplankton biomass were low south of Pt. Conception. Catches of rockfish remained high along most of the coast, however, market squid remained high only within the central coast (36˚–38˚N), and euphausiid abundance decreased everywhere, as compared to the previous year. Sardine and anchovy were nearly absent from the southern portion of the California Current system (CCS), whereas their larvae were found off the coast of Oregon and Washington during winter for the first time in many years. Waters warmed dramatically in the southern California region due to a change in wind patterns similar to that giving rise to the blob in the broader northeast Pacific. For most of the coast, there were intrusions of species never found before or found at much higher abundances than usual, including fish, crustaceans, tunicates and other gelatinous zooplankton, along with other species often indicative of an El Niño. Thus species richness was high in many areas given the close juxtaposition of coastal upwelling-related species with the offshore warm-water intrusive or El Niño-typical taxa. Thus the California Current by 2015 appears to have transitioned to a very different state than previous observations

Features and Outcomes of 899 Patients With Drug-Induced Liver Injury: The DILIN Prospective Study

The drug-induced liver injury network (DILIN) is conducting a prospective study of patients with DILI in the United States. We present characteristics and subgroup analyses from the first 1257 patients enrolled in the study

Temporal variability of downward fluxes of organic carbon off Monterey Bay

13 pages, 11 figures, 2 tablesSediment traps were deployed at two depths (300 m and 1200 m) off Monterey Bay (36°40′N and 122°25′W, Central California) for 7.3 years (1998–2005). The sediment trap data provided information about the quantity and quality of settling material, and allowed exploration of the relationship of the sinking material with the environmental conditions in this coastal upwelling region. The magnitude and composition of the settling material were highly variable over time. Organic carbon (Corg) fluxes ranged between 4–296 mg C m−2 day−1 and 0.1–142 mg C m−2 day−1 for shallow and deep sediment traps, respectively. The time series of Corg vertical flux was characterized by pulses of intense fluxes that were associated with peaks of primary production, generally during upwelling periods. Despite considerable variability, fluxes varied seasonally with highest values during the upwelling season and the lowest in winter. Attenuation of Corg vertical fluxes with depth (300 m vs. 1200 m) varied between 31% and 24% except for the late upwelling period, when there was an increase with depth likely due to resuspension of material from Monterey Canyon. Calculation of a seasonal vertical budget of organic carbon off Monterey Bay resulted in a transfer between 4.0% and 4.9% of the primary production to the deep ocean, suggesting that coastal upwelling efficiently sequestered CO2The principal source of support for these measurements was the David and Lucile Packard Foundation. CGC was partially supported by a National Research Council Fellowship at the Naval Postgraduate SchoolPeer reviewe

De Novo Autoimmune Hepatitis after COVID-19 Infection in an Unvaccinated Patient

Liver test abnormalities have been described during severe acute respiratory syndrome coronavirus (SARS-CoV)-2 infection causing coronavirus disease 2019. Most of them consist of elevation of the aminotransferases that resolve once the infection subsides. There are several reports of autoimmune hepatitis developing after vaccination against COVID-19 and one case of autoimmune hepatitis following COVID-19 infection. We present a patient that was not vaccinated against COVID-19 and developed resistant de novo autoimmune hepatitis following COVID-19 infection requiring aggressive immunosuppression

Intraductal oncocytic papillary neoplasm of the liver: Case and review of a rare variant

Intrahepatic cholangiocarcinoma (ICCA) comprises 10% of all cholangiocarcinoma (CCA). It can be divided into three macroscopic subtypes, the least common of which is characterized by intraductal growth and believed to be more amenable to good outcomes with surgical resection compared to other ICCA. Recently, the rare finding of oncocytic differentiation has been described in this subtype and termed «intraductal oncocytic papillary neoplasm» (IOPN), but it remains unclear if the presence of oncocytes confers a different tumor behavior. We present the eighth reported case of IOPN, which to our knowledge, is the first such case that, due to its location and vascular compromise, required orthotopic liver transplantation (OLT). This case adds to the little that is known about the behavior of IOPN and supports the observation that resection, or OLT when resection is not possible, is a valid treatment option