192 research outputs found
A rare case of zolendronate infusion complication leading to glaucoma filtration surgery
Zolendronic acid is a nitrogenous biphosphonate commonly used as an intravenous infusion for the management of Pagetâs disease, osteoporosis, and hypercalcemia of malignancy. We report a rare and challenging complication of zolendronate infusion: unilateral acute anterior uveitis followed by persistently raised intraocular pressure despite being on four different classes of antiglaucoma medication. The challenge was that the patient required topical steroid to treat her uveitis in the background of known glaucoma with corresponding steroid response. She eventually underwent a left phacotrabeculectomy augmented with 5-fluorouracil. Four weeks postoperatively she developed an encapsulated bleb and underwent needling with 5-fluorouracil. This case highlights the importance of having a high index of suspicion for anterior uveitis in patients with a red and painful eye after initiating biphosphonate therapy. Caution should also be exercised when prescribing biphosponates to glaucoma patients
Assessing the phenomenology of the Cretan Sea shelf area using coupling modelling techniques
International audienceIn this work the ability of nesting two hydrodynamical models, the high-resolution Cretan Sea shelf model and the lower resolution regional ALERMO model, was investigated. A new database was developed by objectively analysing raw climatological data from the MODB database enriched with in situ measurements collected by the Institute of Marine Biology of Crete. Prior to nesting with the ALERMO model, the Cretan Sea model was integrated using this new hydrological database, in order to investigate the capability of the model setup to describe the phenomenology of the Cretan Sea. Results show that the model can successfully reproduce the complex general circulation characteristics of the area, such as the dipole of a cyclone and an anticyclone, and the flow reversal between winter and summer. As a next step, the shelf-model was one-way nested with the ALERMO model and was integrated on a climatological basis. The evolution of the circulation characteristics of the Cretan Sea was compared, qualitatively and quantitatively, against the results of the regional model, and proved that the nesting between the two models can provide reliable information while overcoming at the same time the computational constraints imposed by high-resolution models
Operational ocean forecasting in the Eastern Mediterranean: implementation and evaluation
The Cyprus Coastal Ocean Forecasting and Observing System (CYCOFOS) has been producing operational flow forecasts of the northeastern Levantine Basin since 2002 and has been substantially improved in 2005. CYCOFOS uses the POM flow model, and recently, within the frame of the MFSTEP project, the flow model was upgraded to use the hourly SKIRON atmospheric forcing, and its resolution was increased from 2.5 km to 1.8 km. The CYCOFOS model is now nested in the ALERMO regional model from the University of Athens, which is nested within the MFS basin model. The Variational Initialization and FOrcing Platform (VIFOP) has been implemented to reduce the numerical transient processes following initialization. Moreover, a five-day forecast is repeated every day, providing more detailed and more accurate information. Forecast results are posted on the web page http://www.oceanography.ucy.ac.cy/cycofos. The new, daily, high-resolution forecasts agree well with the ALERMO regional model. The agreement is better and results more reasonable when VIFOP is used. Active and slave experiments suggest that a four-week active period produces realistic results with more small-scale features. For runs in September 2004, biases with remote sensing sea surface temperature are less than 0.6°C with similar expressions of the flow field present in both. Remotely-observed coastal upwelling south of Cyprus and advection of cool water from the Rhodes Gyre to the southern shores of Cyprus are also modeled. In situ observed hydrographic data from south of Cyprus are similar to the corresponding forecast fields. Both indicate the relatively fresh subsurface Atlantic Water and a near-surface anticyclone south of Cyprus for August/September of 2004 and September 2005. Plans for further model improvement include assimilation of observed XBT temperature profiles, CTD profiles from drifters and gliders, and CT data from the CYCOFOS ocean observatory
Type 2 diabetes mellitus and microvascular complications 1Â year after Roux-en-Y gastric bypass: a case-control study.
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Mediterranean Sea response to climate change in an ensemble of twenty first century scenarios
The Mediterranean climate is expected to become warmer and drier during the twenty-first century. Mediterranean Sea response to climate change could be modulated by the choice of the socio-economic scenario as well as the choice of the boundary conditions mainly the Atlantic hydrography, the river runoff and the atmospheric fluxes. To assess and quantify the sensitivity of the Mediterranean Sea to the twenty-first century climate change, a set of numerical experiments was carried out with the regional ocean model NEMOMED8 set up for the Mediterranean Sea. The model is forced by airâsea fluxes derived from the regional climate model ARPEGE-Climate at a 50-km horizontal resolution. Historical simulations representing the climate of the period 1961â2000 were run to obtain a reference state. From this baseline, various sensitivity experiments were performed for the period 2001â2099, following different socio-economic scenarios based on the Special Report on Emissions Scenarios. For the A2 scenario, the main three boundary forcings (river runoff, near-Atlantic water hydrography and airâsea fluxes) were changed one by one to better identify the role of each forcing in the way the ocean responds to climate change. In two additional simulations (A1B, B1), the scenario is changed, allowing to quantify the socio-economic uncertainty. Our 6-member scenario simulations display a warming and saltening of the Mediterranean. For the 2070â2099 period compared to 1961â1990, the sea surface temperature anomalies range from +1.73 to +2.97 °C and the SSS anomalies spread from +0.48 to +0.89. In most of the cases, we found that the future Mediterranean thermohaline circulation (MTHC) tends to reach a situation similar to the eastern Mediterranean Transient. However, this response is varying depending on the chosen boundary conditions and socio-economic scenarios. Our numerical experiments suggest that the choice of the near-Atlantic surface water evolution, which is very uncertain in General Circulation Models, has the largest impact on the evolution of the Mediterranean water masses, followed by the choice of the socio-economic scenario. The choice of river runoff and atmospheric forcing both have a smaller impact. The state of the MTHC during the historical period is found to have a large influence on the transfer of surface anomalies toward depth. Besides, subsurface currents are substantially modified in the Ionian Sea and the Balearic region. Finally, the response of thermosteric sea level ranges from +34 to +49 cm (2070â2099 vs. 1961â1990), mainly depending on the Atlantic forcing
Retinal thinning in Gaucher disease patients and carriers: results of a pilot study
Both Gaucher disease patients and heterozygous glucocerebrosidase mutation carriers are at increased risk of Parkinson's disease. Retinal thinning has been reported in early Parkinson's disease. Here we used optical coherence tomography to demonstrate thinning of the retinal ganglion cell layer in Gaucher disease patients and carriers who manifest clinical markers of potential early neurodegeneration. Optical coherence tomography may help identify Gaucher disease patients and carriers at increased risk of developing Parkinson's disease
Characterizing, modelling and understanding the climate variability of the deep water formation in the North-Western Mediterranean Sea
Observing, modelling and understanding the climate-scale variability of the deep water formation (DWF) in the North-Western Mediterranean Sea remains today very challenging. In this study, we first characterize the interannual variability of this phenomenon by a thorough reanalysis of observations in order to establish reference time series. These quantitative indicators include 31 observed years for the yearly maximum mixed layer depth over the period 1980â2013 and a detailed multi-indicator description of the period 2007â2013. Then a 1980â2013 hindcast simulation is performed with a fully-coupled regional climate system model including the high-resolution representation of the regional atmosphere, ocean, land-surface and rivers. The simulation reproduces quantitatively well the mean behaviour and the large interannual variability of the DWF phenomenon. The model shows convection deeper than 1000 m in 2/3 of the modelled winters, a mean DWF rate equal to 0.35 Sv with maximum values of 1.7 (resp. 1.6) Sv in 2013 (resp. 2005). Using the model results, the winter-integrated buoyancy loss over the Gulf of Lions is identified as the primary driving factor of the DWF interannual variability and explains, alone, around 50 % of its variance. It is itself explained by the occurrence of few stormy days during winter. At daily scale, the Atlantic ridge weather regime is identified as favourable to strong buoyancy losses and therefore DWF, whereas the positive phase of the North Atlantic oscillation is unfavourable. The driving role of the vertical stratification in autumn, a measure of the water column inhibition to mixing, has also been analyzed. Combining both driving factors allows to explain more than 70 % of the interannual variance of the phenomenon and in particular the occurrence of the five strongest convective years of the model (1981, 1999, 2005, 2009, 2013). The model simulates qualitatively well the trends in the deep waters (warming, saltening, increase in the dense water volume, increase in the bottom water density) despite an underestimation of the salinity and density trends. These deep trends come from a heat and salt accumulation during the 1980s and the 1990s in the surface and intermediate layers of the Gulf of Lions before being transferred stepwise towards the deep layers when very convective years occur in 1999 and later. The salinity increase in the near Atlantic Ocean surface layers seems to be the external forcing that finally leads to these deep trends. In the future, our results may allow to better understand the behaviour of the DWF phenomenon in Mediterranean Sea simulations in hindcast, forecast, reanalysis or future climate change scenario modes. The robustness of the obtained results must be however confirmed in multi-model studies
High resolution nested model for the Cyprus, NE Levantine Basin, eastern Mediterranean Sea: implementation and climatological runs
Relationships between retinal layer thickness and brain volumes in the UK Biobank cohort
BACKGROUND: Current methods to diagnose neurodegenerative diseases are costly and invasive. Retinal neuroanatomy may be a biomarker for more neurodegenerative processes and can be quantified in vivo using optical coherence tomography (OCT), which is inexpensive and noninvasive. We examined the association of neuroretinal morphology with brain MRI image derived phenotypes (IDPs) in a large cohort of healthy older people. METHODS: UK Biobank participants aged 40 to 69 years old underwent comprehensive examinations including ophthalmic and brain imaging assessments. Macular retinal nerve fibre layer (mRNFL), ganglion cell-inner plexiform layer (mGCIPL), ganglion cell complex (mGCC) and total macular thicknesses were obtained from OCT. MRI IDPs assessed included total brain, grey-matter, white-matter and hippocampal volume. Multivariable linear regression models were used to evaluate associations between retinal layers thickness and brain MRI IDPs, adjusting for demographic factors and vascular risk factors. RESULTS: A total of 2,131 participants (mean age 55 years; 51% women) with both gradable OCT images and brain imaging assessments were included. In multivariable regression analysis, thinner mGCIPL, mGCC, and total macular thickness were all significantly associated with smaller total brain (p<0.001), grey-matter and white-matter volumes (p<0.01), and grey-matter volume in the occipital pole (p<0.05). Thinner mGCC and total macular thicknesses were associated with smaller hippocampal volume (p<0.02). No association was found between mRNFL and the MRI IDPs. CONCLUSION: Markers of retinal neurodegeneration are associated with smaller brain volumes. Our findings suggest that retinal structures may be a biomarker providing information about important brain structures in healthy, older adults
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