794 resultados para stools examination
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Two cases of neonatal focal spontaneous colic perforations are reported. The 1st infant, born at 36 3/7 weeks gestational age, presented on day 3 with crying, abdominal distension, and liquid stools. Clinical examination showed a slightly irritable hypothermic (35.7 °C) infant with a distended abdomen and few bowel sounds. Blood tests were normal apart from an elevated C-reactive protein level (59 mg/l). The abdomen x-ray was erroneously considered normal. The infant's condition remained stable for nearly 3 days. After reviewing the initial x-ray, pneumoperitoneum was suspected and confirmed by a cross-table lateral abdominal x-ray. The infant was started on antibiotics and operated. Macroscopically, the entire gut was normal apart from a focal sigmoid perforation, which was stitched. A transmural colic biopsy revealed focal vascular dilation but was negative for necrotising enterocolitis or Hirschsprung disease. The infant recovered quickly. She is now a healthy, normal 3-year-old. The 2nd infant, born at 38 5/7 weeks gestational age, presented between day 1 and 2 with clinical signs of infection associated with slowly progressive ileus. The chest and abdomen x-ray was mistakenly considered normal. Frank septicemia developed. After reviewing the initial x-ray, pneumoperitoneum was suspected and confirmed by a cross-table lateral abdominal x-ray. The infant was operated. Macroscopically, the small intestine was normal, the ascending and transverse colons were dilated, and the descending and sigmoid colons were narrow. Three cecal perforations were discovered and stitched. An ileostomy and multiple colic biopsies were also performed. The postoperative course was complicated by persistent septic ileus due to descending and sigmoid colon leaks, which led to colic resections with end-to-end anastomosis. Rectal aspiration biopsies were also performed. At 1 month of age, the infant was discharged from the hospital. The ileostomy was closed in two steps at 2 and 5 months of age. A normal sweat test excluded cystic fibrosis. All colic and rectal biopsies revealed nonspecific inflammatory signs and excluded necrotizing enterocolitis and Hirschsprung disease. Nonspecific irregular thinning of muscularis mucosae and muscularis propria were observed in the two resected colic segments. The boy is now a healthy 7-year-old. The incidence of neonatal focal spontaneous colic perforations at term or close to term is unknown but probably very rare. Our department is the neonatal referral center for approximately 14,000 annual births. In the last 10 years (2000-2009), out of 5115 neonatal admissions in our unit, only ten cases have presented a neonatal spontaneous intestinal perforation, seven of ten in very-low-birth-weight infants and three of ten in term or near-term neonates (one with Hirschsprung disease and the two cases reported herein). In the same period, 108 infants suffered from necrotizing enterocolitis, seven of 108 were term infants and 6 out of 7 had a congenital heart disease. The medical literature is poor on the subject of focal spontaneous colic perforations at term; no risk factor is described. The most specific clinical sign seems to be the abdominal distension. The presence of pneumoperitoneum on an abdominal x-ray is the most sensitive paraclinical sign. In case of an intestinal perforation, surgery must be performed quickly. The vital prognosis seems to be good. The objective of this study was to draw pediatricians' attention to focal spontaneous colic perforations in term or close to term newborns. In the cases reported, the diagnostic delays could have been prevented if the entity - with its radiological manifestation - had been well known.
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Examination report on the City of Lansing, Iowa for the period July 1, 2012 through June 30, 2013
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Examination report on the City of Atkins, Iowa for the period July 1, 2012 through June 30, 2013
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Examination report on the City of Remsen, Iowa and the Remsen Municipal Utilities for the period July 1, 2012 through June 30, 2013
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Examination report on the City of Manly, Iowa for the period July 1, 2012 through June 30, 2013
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Examination report on the City of Hamburg, Iowa for the period July 1, 2012 through June 30, 2013
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Examination report on the City of Villisca, Iowa for the period July 1, 2012 through June 30, 2013
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Examination report on the Villisca Municipal Power Plant in Villisca, Iowa for the period January 1, 2013 through December 31, 2013
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Examination report on the City of Ocheyedan, Iowa for the period July 1, 2012 through June 30, 2013
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An optimum allocation model has been utilized to examine the existing allocation of highway segments to maintenance garages in the Hamlin study area. The model has also been used to evaluate the financial effect of closing the garage at Hamlin. The examination of the study area shows that only three of 48 highway segments should be reallocated at an annual operational savings of approximately $1,400. The study concludes there would be an annual operational savings of approximately 128,700 if the garage at Hamlin were closed.
Resumo:
During the 1980-81 fiscal year, the Office of Transportation Research conducted a study to examine the existing locations of highway maintenance garages in a study area provided by the Office of Maintenance. The study successfully identified a model referred to as an "Optimum Allocation Model" for examining highway maintenance garage locations in a given area. This model can optimally assign highway segments to maintenance garages and can also be used to evaluate the financial impact of closing or relocating a highway maintenance garage utilizing the highway maintenance-related data currently available at the Iowa DOT. The present study employs the optimum allocation model to examine the existing highway maintenance garage locations in two selected areas in the southeastern and southwestern parts of the state. These areas were selected by the Office of Maintenance and are referred to as "Study Area No. 1" and "Study Area No. 2" in this study. These study areas are shown in Appendices 1 and 2, respectively.
Examination of Existing Highway Maintenance Garage Locations in Tama and Blairstown Study Area, 1983
Resumo:
An optimum allocation model has been utilized to examine the existing allocation of highway segments to maintenance garages in the Tama and Blairstown study area. The model has also been used to evaluate the financial impact of closing the highway maintenance garages at Tama and Blairstown and building a new garage at the junction of U.S. 30 and Iowa 21. The examination of the study area shows that only 13 of 91 highway segments were reallocated under optimum procedures at an annual operational savings of approximately $13,200. The study concludes there would be an annual operational savings of approximately $48,200 if the garages at Tama and Blairstown were closed and a new garage was built at the junction of U.S. 30 and Iowa 21.
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A linear programming model is used to optimally assign highway segments to highway maintenance garages using existing facilities. The model is also used to determine possible operational savings or losses associated with four alternatives for expanding, closing and/or relocating some of the garages in a study area. The study area contains 16 highway maintenance garages and 139 highway segments. The study recommends alternative No. 3 (close Tama and Blairstown garages and relocate new garage at Jct. U.S. 30 and Iowa 21) at an annual operational savings of approximately $16,250. These operational savings, however, are only the guidelines for decisionmakers and are subject to the required assumptions of the model used and limitations of the study.
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Examination report on the City of Ely, Iowa for the period July 1, 2012 through June 30, 2013
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Examination report on the City of Maharishi Vedic City, Iowa for the period July 1, 2012 through June 30, 2013
