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The performance of an atmospheric single-column model (SCM) is studied systematically for stably-stratified conditions. To this end, 11 years (2005-2015) of daily SCM simulations were compared to observations from the Cabauw observatory, The Netherlands. Each individual clear-sky night was classified in terms of the ambient geostrophic wind speed with a $$1\hbox { m} \hbox { s}^{-1}$$ bin-width. Nights with overcast conditions were filtered out by selecting only those nights with an average net radiation of less than $$-\,30\hbox { W }\hbox {m}^{-2}$$ . A similar procedure was applied to the observational dataset. A comparison of observed and modelled ensemble-averaged profiles of wind speed and potential temperature and time series of turbulent fluxes showed that the model represents the dynamics of the nocturnal boundary layer (NBL) at Cabauw very well for a broad range of mechanical forcing conditions. No obvious difference in model performance was found between near-neutral and strongly-stratified conditions. Furthermore, observed NBL regime transitions are represented in a natural way. The reference model version performs much better than a model version that applies excessive vertical mixing as is done in several (global) operational models. Model sensitivity runs showed that for weak-wind conditions the inversion strength depends much more on details of the land-atmosphere coupling than on the turbulent mixing. The presented results indicate that in principle the physical parametrizations of large-scale atmospheric models are sufficiently equipped for modelling stably-stratified conditions for a wide range of forcing conditions. [ABSTRACT FROM AUTHOR]

A patient with seropositive rheumatoid arthritis and recurrent oedema of the forearm was shown to have a leak from a multilobulated olecranon bursa. [ABSTRACT FROM PUBLISHER]

We concluded a randomized, controlled trial to compare once-daily 20 mg piroxicam versus once-daily 20 mg tenoxicam in ankylosing spondylitis. We recorded patients' dosing histories with electronic monitors for an average of 225 days (range 55-379) in 34 recipients of piroxicam and 31 recipients of tenoxicam. Dosing histories with the two agents were similar and are combined. Patients took 81% of prescribed doses; 78% once daily (as prescribed) and 3% as two or more daily doses. On 19% of all monitored days, there was no record of a dose being taken; 68% were single no-dose days, the rest (32%) being 2 to >10 consecutive no-dose days. In 3% of monitored days, extra doses were evidently taken, 88% as twice daily and 12% as three or more doses. Only 22% of all patients (14/65) strictly complied with the regimen: one dose daily every day. The remainder alternated between no-dose days and extra-dose days. We found no correlation between patient compliance and improvement in reported pain or morning stiffness.

We treated a 30-year-old man for whom Plaquenil (hydroxychloroquine) had been prescribed for rheumatoid arthritis, and who had taken 4 g orally to end his life. Symptoms of severe intoxication due to (hydroxy)chloroquine are rapid onset of hypoventilation, cardiovascular collapse with bradycardia, peripheral vasodilation, arrhythmias and convulsions. The lethal dose of chloroquine has been estimated at 3-5 g in adults and at 0.75-I g in young children. Acute intoxication should be treated with aspiration of gastric contents, artificial ventilation in case of hypoventilation and intravenous or intratracheal dopamine, noradrenaline or adrenaline in case of cardiovascular depression and peripheral vasodilation. Arrhythmias and convulsions should be treated symptomatically. The patient in our case survived the intoxication and is now under psychiatric treatment.