Traitement peu invasif d’une breche osteo meningee associee a une hypertension intracranienne benigne

Description L’hypertension intracrânienne bénigne (HTICB) est une augmentation anormale de la pression intracrânienne non associée à un processus occupant de l’espace intracrânien, une thrombose des veinescérébrales ou une hydrocéphalie. Caractérisée par des céphalées invalidantes, des acouphènes pulsatiles, elle peut avoir une évolution péjorative et irréversible entraînant une cécité. La survenue d’une rhinorrhée spontanée dans un contexte d’HTICB a été décrite dans la littérature mais demeure peu fréquente. Objectif et cas cliniqueNous rapportons le cas d’une femme obèse âgée de 40 ans, qui a été admise pour rhinorrhée droite spontanée. Les explorations neuroradiologiques ont permis d’évoquer une hypertension intracrânienne bénigne sur une brèche ethmoïdale antérieure. Le monitoring de la pression a confirmé le diagnostic. Elle abénéficié d’une dérivation ventriculo péritonéale. L’évolution est favorable (disparition des symptômes) avec un delai de recul de 16 mois . Conclusion L’HTICB est une pathologie avec des conséquences irréversibles si le traitement n’est pas adéquat et rapide. En cas de rhinorrhée isolée dans le cadre de l’hypertension intracrânienne bénigne la dérivation ventriculo péritonéale est une attitude thérapeutique simple mais efficace

Potential of the Coupled WRF/WRF-Hydro Modeling System for Flood Forecasting in the Ouémé River (West Africa)

Since the beginning of the 2000s, most of the West-African countries, particularly Benin, have experienced an increased frequency of extreme flood events. In this study, we focus on the case of the Ouémé river basin in Benin. To investigate flood events in this basin for early warning, the coupled atmosphere–hydrology model system WRF-Hydro is used, and analyzed for the period 2008–2010. Such a coupled model allows exploration of the contribution of atmospheric components into the flood event, and its ability to simulate and predict accurate streamflow. The potential of WRF-Hydro to correctly simulate streamflow in the Ouémé river basin is assessed by forcing the model with operational analysis datasets from the European Centre for Medium-Range Weather Forecasts (ECMWF). Atmospheric and land surface processes are resolved at a spatial resolution of 5 km. The additional surface and subsurface water flow routing are computed at a resolution of 500 m. Key parameters of the hydrological module of WRF-Hydro are calibrated offline and tested online with the coupled WRF-Hydro. The uncertainty of atmospheric modeling on coupled results is assessed with the stochastic kinetic energy backscatter scheme (SKEBS). WRF-Hydro is able to simulate the discharge in the Ouémé river in offline and fully coupled modes with a Kling–Gupta efficiency (KGE) around 0.70 and 0.76, respectively. In the fully coupled mode, the model captures the flood event that occurred in 2010. A stochastic perturbation ensemble of ten members for three rain seasons shows that the coupled model performance in terms of KGE ranges from 0.14 to 0.79. Additionally, an assessment of the soil moisture has been developed. This ability to realistically reproduce observed discharge in the Ouémé river basin demonstrates the potential of the coupled WRF-Hydro modeling system for future flood forecasting applications

Decrease in alpha-1 antiproteinase antitrypsin is observed in primary Sjogren's syndrome condition

Primary Sjogren’s syndrome (pSS) is a systemic autoimmune disease that is characterized by the infiltration of immune cells. Although the loss of salivary gland function is a major manifestation observed in pSS, the factors that could promote these changes in salivary gland tissue in pSS is not yet determined. Herein, we provide evidence that loss of alpha-1 antiproteinase antitrypsin could contribute to the induction of pSS. Alpha-1 antiproteinase antitrypsin belongs to the family of serpin proteins that function as protease inhibitors and protect secretory cells against proteases, especially to elastases that is secreted from lymphocytes. Importantly, expression of alpha-1 antiproteinase antitrypsin was decreased (more than 3-fold), along with an increase in elastase expression, in pSS samples when compared with age-matched non-SS-SICCA patients. Consistent with the human data, loss of alpha-1 antiproteinase antitrypsin, as well as an increase in immune infiltration, was observed in IL14α transgenic mice that exhibit SS like symptoms. Moreover, an age-dependent increase in elastase expression was observed in IL14α transgenic mice along with a decrease in total saliva secretion. Importantly, a 4-fold increase in microRNA132 expression, but not in other microRNAs, and increased DNA methylation in the promoter/noncoding region of serpina gene was observed in pSS, which could be responsible for the inhibition of alpha-1 antiproteinase antitrypsin expression in salivary gland cells of pSS patients. Together, these findings demonstrate that epigenetic regulations that include DNA methylation and microRNAs that could modulate the expression of alpha-1 antiproteinase antitrypsin in salivary glands and could be involved in the onset of pSS

A community-based lifestyle and weight loss intervention promoting a Mediterranean-style diet pattern evaluated in the stroke belt of North Carolina: the Heart Healthy Lenoir Project

Abstract Background Because residents of the southeastern United States experience disproportionally high rates of cardiovascular disease (CVD), it is important to develop effective lifestyle interventions for this population. Methods The primary objective was to develop and evaluate a dietary, physical activity (PA) and weight loss intervention for residents of the southeastern US. The intervention, given in eastern North Carolina, was evaluated in a 2 year prospective cohort study with an embedded randomized controlled trial (RCT) of a weight loss maintenance intervention. The intervention included: Phase I (months 1–6), individually-tailored intervention promoting a Mediterranean-style dietary pattern and increased walking; Phase II (months 7–12), option of a 16-week weight loss intervention for those with BMI ≥ 25 kg/m2 offered in 2 formats (16 weekly group sessions or 5 group sessions and 10 phone calls) or a lifestyle maintenance intervention; and Phase III (months 13–24), weight loss maintenance RCT for those losing ≥ 8 lb with all other participants receiving a lifestyle maintenance intervention. Change in diet and PA behaviors, CVD risk factors, and weight were assessed at 6, 12, and 24 month follow-up. Results Baseline characteristics (N = 339) were: 260 (77 %) females, 219 (65 %) African Americans, mean age 56 years, and mean body mass index 36 kg/m2. In Phase I, among 251 (74 %) that returned for 6 month follow-up, there were substantial improvements in diet score (4.3 units [95 % CI 3.7 to 5.0]), walking (64 min/week [19 to 109]), and systolic blood pressure (−6.4 mmHg [−8.7 to −4.1]) that were generally maintained through 24 month follow-up. In Phase II, 138 (57 group only, 81 group/phone) chose the weight loss intervention and at 12 months, weight change was: −3.1 kg (−4.9 to −1.3) for group (N = 50) and −2.1 kg (−3.2 to −1.0) for group/phone combination (N = 75). In Phase III, 27 participants took part in the RCT. At 24 months, weight loss was −2.1 kg (−4.3 to 0.0) for group (N = 51) and −1.1 kg (−2.7 to 0.4) for combination (N = 72). Outcomes for African American and whites were similar. Conclusions The intervention yielded substantial improvement in diet, PA, and blood pressure, but weight loss was modest. Trial registration clinicaltrials.gov Identifier: NCT0143348

Classification of large-scale environments that drive the formation of mesoscale convective systems over southern West Africa

Mesoscale convective systems (MCSs) are frequently observed over southern West Africa (SWA) throughout most of the year. These MCS events are the dominant rain-bearing systems, contributing over 50 % of annual rainfall over SWA. However, it has not yet been identified what variations in typical large-scale environments of the seasonal cycle of the West African monsoon may favour MCS occurrence in this region. Here, nine distinct synoptic states are identified and are further associated with being a synoptic-circulation type of either a dry, transition, or monsoon season using self-organizing maps (SOMs) with inputs from reanalysis data. We identified a pronounced annual cycle of MCS numbers with frequency peaks in April and October that can be associated with the start of rainfall during the major rainy season and the maximum rainfall for the minor rainy season across SWA, respectively. Comparing daily MCS frequencies, MCSs are most likely to develop during transition conditions featuring a northward-displaced moisture anomaly (2.8 MCSs per day), which can be linked to strengthened low-level westerlies. Considering that these transition conditions occur predominantly during the pre- and post-monsoon period, these patterns may in some cases be representative of monsoon onset conditions or a delayed monsoon retreat. On the other hand, under monsoon conditions, we observe weakened low-level south-westerlies during MCS days, which reduce moisture content over the Sahel but introduce more moisture over the coast. Finally, we find a majority of MCS-day synoptic states exhibiting positive zonal wind shear anomalies. Seasons with the strongest zonal wind shear anomalies are associated with the strongest low-level temperature anomalies to the north of SWA, highlighting that a warmer Sahel can promote MCS-favourable conditions in SWA. Overall, the SOM-identified synoptic states converge towards high-moisture and high-shear conditions on MCS days in SWA, where the frequency at which these conditions occur depends on the synoptic state.</p