Prevalencia de anormalidades estructurales cardiacas en pacientes con enfermedad isquémica. Bogotá 2007 – 2009

Introducción: Las enfermedades cardiovasculares son la causa de muerte más frecuente en el mundo desarrollado, la mayoría de éstas se relacionan con alteraciones de las arterias coronarias, sin embargo un subgrupo de pacientes presentan como causa de isquemia cardiaca alteraciones estructurales. Material y métodos: Estudio Descriptivo. Se utilizó la base de datos recolectada en un servicio de hemodinamia de Bogotá durante dos años. Se aplicaron criterios de inclusión y exclusión y se determinaron cuatro grupos etáreos, a todos los pacientes se les practicó cateterismo cardiaco diagnóstico. Las variables analizadas fueron: diagnóstico de referencia, antecedentes y resultados del cateterismo incluyendo presencia de anomalías estructurales como las valvulopatias, el origen anómalo de las coronarias y los puentes miocárdicos. Para el análisis descriptivo se utilizó reporte de prevalencias y para el análisis de asociaciones se utilizaron tablas de contingencia y el estadístico de prueba Chi cuadrado, no se realizó análisis multivariado debido a que no se encontraron asociaciones estadísticamente significativas. Resultados: La edad promedio de los pacientes fue de 62 años (DS= 10,5), la representación del género masculino fue del 61,7%, la prevalencia de angina estable fue del 61,6%, los 3 antecedentes más prevalentes fueron: hipertensión arterial (41,4%), la hiperlipidemia (19,1%) y la Diabetes Mellitus (17,7%). La prevalencia de las alteraciones estructurales en la población de estudio de manera general fue del 12,9%, y su distribución por tipo fue: 1,4% para puentes miocárdicos, 0,7% para origen anómalo de las arterias coronarias y 10,8% de enfermedad valvular. Conclusiones: Se encontró una asociación entre los antecedentes médicos y la presencia de valvulopatias cardiacas. Se evidenció que el género no tiene relación con la presencia de alteraciones cardíacas a pesar de la mayor participación de hombres en la población de estudio. Las limitantes de este estudio se relacionaron con el tamaño de muestra, debido a la baja prevalencia de las anomalías estructurales medidas.

Citología de impresión para neoplasias de la superficie ocular

Se estimó la sensibilidad y especificidad de la citología de impresión como prueba diagnóstica en lesiones conjuntivales clínicamente sospechosas de neoplasia usando como patrón de oro la patología. Se estudiaron 60 pacientes, que ingresaron al azar a la Fundación Oftalmológica Nacional, con diagnóstico clínico de neoplasia de superficie ocular o lesión sospechosa de neoplasia, quienes fueron sometidos a citología de impresión y posterior resección quirúrgica completa, más estudio patológico de la lesión. Se realizó un análisis descriptivo, analizando la sensibilidad y la especificidad con el método clásico y análisis bayesiano.

Simulation of monsoon disturbances in the LMD GCM

The monsoon depressions that form over India during the summer are analyzed using simulations from the Laboratoire de Meteorologie Dynamique general circulation model. This type of synoptic system often occurs with a frequency of one to two per month and can produce a strong Indian rainfall. Two kinds of analyses are conducted in this study. The first one is a subjective analysis based on the evolution of the precipitation rate and the pattern of the sea level pressure. The second one is an objective analysis performed using the TRACK program, which identifies and tracks the minima in the sea level pressure anomaly held and computes the statistics for the distribution of systems. The analysis of a 9-yr control run, which simulates strong precipitation rates over the foothills of the Himalayas and over southern India but weak rates over central India, shows that the number of disturbances is coo low and that they almost never occur during August, when break conditions prevail. The generated disturbances more often move north, toward the foothills of the Himalayas. Another analysis is performed to study the effect of the Tibetan Plateau elevation on these disturbances with a 9-yr run carried out with a Tibetan Plateau at 50% of its current height. It is shown that this later integration simulates more frequent monsoon disturbances, which move rather northwestward, in agreement with the current observations. The comparison between the two runs shows that the June-July-August rainfall difference is in large part due to changes in the occurrence of the monsoon disturbances.

Solar influences on dynamical coupling between the stratosphere and troposphere

We use a simplified atmospheric general circulation model (AGCM) to investigate the response of the lower atmosphere to thermal perturbations in the lower stratosphere. The results show that generic heating of the lower stratosphere tends to weaken the sub-tropical jets and the tropospheric mean meridional circulations. The positions of the jets, and the extent of the Hadley cells, respond to the distribution of the stratospheric heating, with low latitude heating displacing them poleward, and uniform heating displacing them equatorward. The patterns of response to the low latitude heating are similar to those found to be associated with solar variability in previous observational data analysis, and to the effects of varying solar UV radiation in sophisticated AGCMs. In order to investigate the chain of causality involved in converting the stratospheric thermal forcing to a tropospheric climate signal we conduct an experiment which uses an ensemble of model spin-ups to analyse the time development of the response to an applied stratospheric perturbation. We find that the initial effect of the change in static stability at the tropopause is to reduce the eddy momentum flux convergence in this region. This is followed by a vertical transfer of the momentum forcing anomaly by an anomalous mean circulation to the surface, where it is partly balanced by surface stress anomalies. The unbalanced part drives the evolution of the vertically integrated zonal flow. We conclude that solar heating of the stratosphere may produce changes in the circulation of the troposphere even without any direct forcing below the tropopause. We suggest that the impact of the stratospheric changes on wave propagation is key to the mechanisms involved.

Numerical simulation of baroclinic waves with a parameterized boundary layer

A dry three-dimensional baroclinic life cycle model is used to investigate the role of turbulent fluxes of heat and momentum within the boundary layer on mid-latitude cyclones. Simulations are performed of life cycles for two basic states, both with and without turbulent fluxes. The different basic states produce cyclones with contrasting frontal and mesoscale-flow structures. The analysis focuses on the generation of potential-vorticity (PV) in the boundary layer and its subsequent transport into the free troposphere. The dynamic mechanism through which friction mitigates a barotropic vortex is that of Ekman pumping. This has often been assumed to be also the dominant mechanism for baroclinic developments. The PV framework highlights an additional, baroclinic mechanism. Positive PV is generated baroclinically due to friction to the north-east of a surface low and is transported out of the boundary layer by a cyclonic conveyor belt flow. The result is an anomaly of increased static stability in the lower troposphere which restricts the growth of the baroclinic wave. The reduced coupling between lower and upper levels can be sufficient to change the character of the upper-level evolution of the mature wave. The basic features of the baroclinic damping mechanism are robust for different frontal structures, with and without turbulent heat fluxes, and for the range of surface roughness found over the oceans.

The influence of a weakening of the Atlantic meridional overturning circulation on ENSO

The influences of a substantial weakening of the Atlantic meridional overturning circulation (AMOC) on the tropical Pacific climate mean state, the annual cycle, and ENSO variability are studied using five different coupled general circulation models (CGCMs). In the CGCMs, a substantial weakening of the AMOC is induced by adding freshwater flux forcing in the northern North Atlantic. In response, the well-known surface temperature dipole in the low-latitude Atlantic is established, which reorganizes the large-scale tropical atmospheric circulation by increasing the northeasterly trade winds. This leads to a southward shift of the intertropical convergence zone (ITCZ) in the tropical Atlantic and also the eastern tropical Pacific. Because of evaporative fluxes, mixing, and changes in Ekman divergence, a meridional temperature anomaly is generated in the northeastern tropical Pacific, which leads to the development of a meridionally symmetric thermal background state. In four out of five CGCMs this leads to a substantial weakening of the annual cycle in the eastern equatorial Pacific and a subsequent intensification of ENSO variability due to nonlinear interactions. In one of the CGCM simulations, an ENSO intensification occurs as a result of a zonal mean thermocline shoaling. Analysis suggests that the atmospheric circulation changes forced by tropical Atlantic SSTs can easily influence the large-scale atmospheric circulation and hence tropical eastern Pacific climate. Furthermore, it is concluded that the existence of the present-day tropical Pacific cold tongue complex and the annual cycle in the eastern equatorial Pacific are partly controlled by the strength of the AMOC. The results may have important implications for the interpretation of global multidecadal variability and paleo-proxy data.

The response of a uniform horizontal temperature gradient to heating

The response of a uniform horizontal temperature gradient to prescribed fixed heating is calculated in the context of an extended version of surface quasigeostrophic dynamics. It is found that for zero mean surface flow and weak cross-gradient structure the prescribed heating induces a mean temperature anomaly proportional to the spatial Hilbert transform of the heating. The interior potential vorticity generated by the heating enhances this surface response. The time-varying part is independent of the heating and satisfies the usual linearized surface quasigeostrophic dynamics. It is shown that the surface temperature tendency is a spatial Hilbert transform of the temperature anomaly itself. It then follows that the temperature anomaly is periodically modulated with a frequency proportional to the vertical wind shear. A strong local bound on wave energy is also found. Reanalysis diagnostics are presented that indicate consistency with key findings from this theory.

Stratosphere-troposphere transport in a numerical simulation of midlatitude convection

The transport of stratospheric air deep into the troposphere via convection is investigated numerically using the UK Met Office Unified Model. A convective system that formed on 27 June 2004 near southeast England, in the vicinity an upper level potential vorticity anomaly and a lowered tropopause, provides the basis for analysis. Transport is diagnosed using a stratospheric tracer that can either be passed through or withheld from the model’s convective parameterization scheme. Three simulations are performed at increasingly finer resolutions, with horizontal grid lengths of 12, 4, and 1 km. In the 12 and 4 km simulations, tracer is transported deeply into the troposphere by the parameterized convection. In the 1 km simulation, for which the convective parameterization is disengaged, deep transport is still accomplished but with a much smaller magnitude. However, the 1 km simulation resolves stirring along the tropopause that does not exist in the coarser simulations. In all three simulations, the concentration of the deeply transported tracer is small, three orders of magnitude less than that of the shallow transport near the tropopause, most likely because of the efficient dilution of parcels in the lower troposphere.

Isolating the signal of ocean global warming

Identifying the signature of global warming in the world's oceans is challenging because low frequency circulation changes can dominate local temperature changes. The IPCC fourth assessment reported an average ocean heating rate of 0.21 ± 0.04 Wm−2 over the period 1961–2003, with considerable spatial, interannual and inter-decadal variability. We present a new analysis of millions of ocean temperature profiles designed to filter out local dynamical changes to give a more consistent view of the underlying warming. Time series of temperature anomaly for all waters warmer than 14°C show large reductions in interannual to inter-decadal variability and a more spatially uniform upper ocean warming trend (0.12 Wm−2 on average) than previous results. This new measure of ocean warming is also more robust to some sources of error in the ocean observing system. Our new analysis provides a useful addition for evaluation of coupled climate models, to the traditional fixed depth analyses.

The Storm-Track Response to Idealized SST Perturbations in an Aquaplanet GCM

The tropospheric response to midlatitude SST anomalies has been investigated through a series of aquaplanet simulations using a high-resolution version of the Hadley Centre atmosphere model (HadAM3) under perpetual equinox conditions. Model integrations show that increases in the midlatitude SST gradient generally lead to stronger storm tracks that are shifted slightly poleward, consistent with changes in the lower-tropospheric baroclinicity. The large-scale atmospheric response is, however, highly sensitive to the position of the SST gradient anomaly relative to that of the subtropical jet in the unperturbed atmosphere. In particular, when SST gradients are increased very close to the subtropical jet, then the Hadley cell and subtropical jet is strengthened while the storm track and eddy-driven jet are shifted equatorward. Conversely, if the subtropical SST gradients are reduced and the midlatitude gradients increased, then the storm track shows a strong poleward shift and a well-separated eddy-driven jet is produced. The sign of the SST anomaly is shown to play a secondary role in determining the overall tropospheric response. These findings are used to provide a new and consistent interpretation of some previous GCM studies concerning the atmospheric response to midlatitude SST anomalies.

Stratospheric influence on baroclinic lifecycles and its connection to the Arctic Oscillation

Using an idealized primitive equation model, we investigate how stratospheric conditions alter the development of baroclinic instability in the troposphere. Starting from the lifecycle paradigm of Thorncroft et al., we consider the evolution of baroclinic lifecycles resulting from the addition of a stratospheric jet to the LC1 initial condition. We find that the addition of the stratospheric jet yields a net surface geopotential height anomaly that strongly resembles the Arctic Oscillation. With the additional modification of the tropospheric winds to resemble the high-AO climatology, the surface response is amplified by a factor 10 and, though dominated by the tropospheric changes, shows similar sensitivity to the stratospheric conditions.

Effect of ENSO phase on large-scale snow water equivalent distribution in a GCM

Understanding links between the El Nino-Southern Oscillation (ENSO) and snow would be useful for seasonal forecasting, but also for understanding natural variability and interpreting climate change predictions. Here, a 545-year run of the general circulation model HadCM3, with prescribed external forcings and fixed greenhouse gas concentrations, is used to explore the impact of ENSO on snow water equivalent (SWE) anomalies. In North America, positive ENSO events reduce the mean SWE and skew the distribution towards lower values, and vice versa during negative ENSO events. This is associated with a dipole SWE anomaly structure, with anomalies of opposite sign centered in western Canada and the central United States. In Eurasia, warm episodes lead to a more positively skewed distribution and the mean SWE is raised. Again, the opposite effect is seen during cold episodes. In Eurasia the largest anomalies are concentrated in the Himalayas. These correlations with February SWE distribution are seen to exist from the previous June-July-August (JJA) ENSO index onwards, and are weakly detected in 50-year subsections of the control run, but only a shifted North American response can be detected in the anaylsis of 40 years of ERA40 reanalysis data. The ENSO signal in SWE from the long run could still contribute to regional predictions although it would be a weak indicator only

Analysis of water-level response to rainfall and implications for recharge pathways in the Chalk aquifer, SE England

Water table response to rainfall was investigated at six sites in the Upper, Middle and Lower Chalk of southern England. Daily time series of rainfall and borehole water level were cross-corretated to investigate seasonal variations in groundwater-level response times, based on periods of 3-month duration. The time tags (in days) yielding significant correlations were compared with the average unsaturated zone thickness during each 3-month period. In general, for cases when the unsaturated zone was greater than 18 m thick, the time tag for a significant water-level response increased rapidly once the depth to the water table exceeded a critical value, which varied from site to site. For shallower water tables, a linear relationship between the depth to the water table and the water-level response time was evident. The observed variations in response time can only be partially accounted for using a diffusive model for propagation through the unsaturated matrix, suggesting that some fissure flow was occurring. The majority of rapid responses were observed during the winter/spring recharge period, when the unsaturated zone is thinnest and the unsaturated zone moisture content is highest, and were more likely to occur when the rainfall intensity exceeded 5 mm/day. At some sites, a very rapid response within 24 h of rainfall was observed in addition to the longer term responses even when the unsaturated zone was up to 64 m thick. This response was generally associated with the autumn period. The results of the cross-correlation analysis provide statistical support for the presence of fissure flow and for the contribution of multiple pathways through the unsaturated zone to groundwater recharge. (c) 2006 Elsevier B.V. All rights reserved.

A dendrochemical study of Pinus sylvestris from Siljansfors Experimental Forest, central Sweden

Inductively coupled plasma mass spectrometry (ICP-MS) was used to investigate changes in trace element concentration in two high resolution sequences of tree rings from central Sweden. Individual annual growth increments from 18002002 to 1930-2002 were sampled from two Scots pine (Pinus sylvestris) trees from the Siljansfors Experimental Forest. The aims of the study were: to test the viability of conventional solution induction ICP-MS as a technique for investigating the multi-elemental chemistry of long tree ring sequences at annual resolution, and, to test this specifically with a view to detecting changes in elemental concentrations of Swedish tree rings contemporary with the major (and relatively proximal) Icelandic eruption of Askja (1875). It was found that despite a time consuming sample preparation process, it was possible to use conventional ICP-MS for multi-elemental analysis of a long sequence of tree rings at annual resolution. Although promising data were produced, no truly conclusive concentration anomaly could be detected in the sequence to indicate the impact of the Askja eruption on environmental chemistry. Overall findings underlined the complexity of the tree/environment interaction and the cautious approach to data interpretation essential for any dendrochemical study. (c) 2006 Elsevier Ltd. All rights reserved.

Two Independent Triggers for the Indian Ocean Dipole/Zonal Mode in a Coupled GCM

The question of whether and how tropical Indian Ocean dipole or zonal mode (IOZM) interannual variability is independent of El Nino-Southern Oscillation (ENSO) variability in the Pacific is addressed in a comparison of twin 200-yr runs of a coupled climate model. The first is a reference simulation, and the second has ENSO-scale variability suppressed with a constraint on the tropical Pacific wind stress. The IOZM can exist in the model without ENSO, and the composite evolution of the main anomalies in the Indian Ocean in the two simulations is virtually identical. Its growth depends on a positive feedback between anomalous equatorial easterly winds, upwelling equatorial and coastal Kelvin waves reducing the thermocline depth and sea surface temperature off the coast of Sumatra, and the atmospheric dynamical response to the subsequently reduced convection. Two IOZM triggers in the boreal spring are found. The first is an anomalous Hadley circulation over the eastern tropical Indian Ocean and Maritime Continent, with an early northward penetration of the Southern Hemisphere southeasterly trades. This situation grows out of cooler sea surface temperatures in the southeastern tropical Indian Ocean left behind by a reinforcement of the late austral summer winds. The second trigger is a consequence of a zonal shift in the center of convection associated with a developing El Nino, a Walker cell anomaly. The first trigger is the only one present in the constrained simulation and is similar to the evolution of anomalies in 1994, when the IOZM occurred in the absence of a Pacific El Nino state. The presence of these two triggers-the first independent of ENSO and the second phase locking the IOZM to El Nino-allows an understanding of both the existence of IOZM events when Pacific conditions are neutral and the significant correlation between the IOZM and El Nino.