Mycotic renal artery degeneration and systemic sepsis caused by infected renal artery stent

AbstractA case of Staphylococcus aureus renal artery stent infection was studied. Fourteen days after the procedure, the patient had a fever, hypotension, and an elevated white blood cell (WBC) count. Blood cultures were positive for S aureus on admission and during the patient's hospitalization, despite intravenous vancomycin therapy. Evaluation included serial CT scans, revealing increasing persistent inflammation with development of multiple renal intraparenchymal abscesses, and arteriography, showing marked degeneration of the renal artery. Therapy required resection of the renal artery/stent and nephrectomy. This case confirms the severe nature of S aureus stent infection; we recommend prophylactic antibiotics before these procedures, as well as expeditious evaluation and consideration for aggressive surgical therapy if this complication is suspected. (J Vasc Surg 1998;28:547-50.

An assessment of the Indian Ocean mean state and seasonal cycle in a suite of interannual CORE-II simulations

We present an analysis of annual and seasonal mean characteristics of the Indian Ocean circulation and water masses from 16 global ocean–sea-ice model simulations that follow the Coordinated Ocean-ice Reference Experiments (CORE) interannual protocol (CORE-II). All simulations show a similar large-scale tropical current system, but with differences in the Equatorial Undercurrent. Most CORE-II models simulate the structure of the Cross Equatorial Cell (CEC) in the Indian Ocean. We uncover a previously unidentified secondary pathway of northward cross-equatorial transport along 75 °E, thus complementing the pathway near the Somali Coast. This secondary pathway is most prominent in the models which represent topography realistically, thus suggesting a need for realistic bathymetry in climate models. When probing the water mass structure in the upper ocean, we find that the salinity profiles are closer to observations in geopotential (level) models than in isopycnal models. More generally, we find that biases are model dependent, thus suggesting a grouping into model lineage, formulation of the surface boundary, vertical coordinate and surface salinity restoring. Refinement in model horizontal resolution (one degree versus degree) does not significantly improve simulations, though there are some marginal improvements in the salinity and barrier layer results. The results in turn suggest that a focus on improving physical parameterizations (e.g. boundary layer processes) may offer more near-term advances in Indian Ocean simulations than refined grid resolution

An assessment of the Arctic Ocean in a suite of interannual CORE-II simulations. Part I: Sea ice and solid freshwater

Highlights: • Arctic sea ice extent and solid freshwater in 14 CORE-II models are inter-compared. • The models better represent the variability than the mean state. • The September ice extent trend is reasonably represented by the model ensemble mean. • The descending trend of ice thickness is underestimated compared to observations. • The models underestimate the reduction in solid freshwater content in recent years. Abstract: The Arctic Ocean simulated in fourteen global ocean-sea ice models in the framework of the Coordinated Ocean-ice Reference Experiments, phase II (CORE II) is analyzed. The focus is on the Arctic sea ice extent, the solid freshwater (FW) sources and solid freshwater content (FWC). Available observations are used for model evaluation. The variability of sea ice extent and solid FW budget is more consistently reproduced than their mean state in the models. The descending trend of September sea ice extent is well simulated in terms of the model ensemble mean. Models overestimating sea ice thickness tend to underestimate the descending trend of September sea ice extent. The models underestimate the observed sea ice thinning trend by a factor of two. When averaged on decadal time scales, the variation of Arctic solid FWC is contributed by those of both sea ice production and sea ice transport, which are out of phase in time. The solid FWC decreased in the recent decades, caused mainly by the reduction in sea ice thickness. The models did not simulate the acceleration of sea ice thickness decline, leading to an underestimation of solid FWC trend after 2000. The common model behavior, including the tendency to underestimate the trend of sea ice thickness and March sea ice extent, remains to be improved