Agreed-upon procedures report on the City of Breda, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Breda, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Ainsworth, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Ainsworth, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Victor, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Victor, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Ely, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Ely, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Remsen, Iowa and the Remsen Municipal Utilities for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Remsen, Iowa and the Remsen Municipal Utilities for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Wall Lake, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Wall Lake, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Bedford, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Bedford, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Manly, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Manly, Iowa for the period July 1, 2014 through June 30, 2015

Reactive rise in blood pressure upon cuff inflation: cuff inflation at the arm causes a greater rise in pressure than at the wrist in hypertensive patients.

OBJECTIVE: Cuff inflation at the arm is known to cause an instantaneous rise in blood pressure, which might be due to the discomfort of the procedure and might interfere with the precision of the blood pressure measurement. In this study, we compared the reactive rise in blood pressure induced by cuff inflation when the cuff was placed at the upper arm level and at the wrist. PARTICIPANTS AND METHODS: The reactive rise in systolic and diastolic blood pressure to cuff inflation was measured in 34 normotensive participants and 34 hypertensive patients. Each participant was equipped with two cuffs, one around the right upper arm (OMRON HEM-CR19, 22-32 cm) and one around the right wrist (OMRON HEM-CS 19, 17-22 cm; Omron Health Care Europe BV, Hoofddorp, The Netherlands). The cuffs were inflated in a double random order (maximal cuff pressure and position of the cuff) with two maximal cuff pressures: 180 and 240 mmHg. The cuffs were linked to an oscillometric device (OMRON HEM 907; Omron Health Care). Simultaneously, blood pressure was measured continuously at the middle finger of the left hand using photoplethysmography. Three measurements were made at each level of blood pressure at the arm and at the wrist, and the sequence of measurements was randomized. RESULTS: In normotensive participants, no significant difference was observed in the reactive rise in blood pressure when the cuff was inflated either at the arm or at the wrist irrespective of the level of cuff inflation. Inflating a cuff at the arm, however, induced a significantly greater rise in blood pressure than inflating it at the wrist in hypertensive participants for both systolic and diastolic pressures (P<0.01), and at both levels of cuff inflation. The blood pressure response to cuff inflation was independent of baseline blood pressure. CONCLUSIONS: The results show that in hypertensive patients, cuff inflation at the wrist produces a smaller reactive rise in blood pressure. The difference between the arm and the wrist is independent of the patient's level of blood pressure.

The effect of positive airway pressure during pre-oxygenation and induction of anaesthesia upon duration of non-hypoxic apnoea

Résumé de l'étude. L'application d'une pression positive (PEEP) pendant la phase d'induction d'une anesthésie générale peut prévenir la formation d'atélectasies pulmonaires. Ceci pourrait permettre d'accroître la durée d'apnée non hypoxique par l'augmentation de la capacité pulmonaire résiduelle fonctionnelle (CRF). Nous avons étudié le bénéfice de l'application d'une PEEP durant la phase d'induction d'une anesthésie générale sur la durée d'apnée avant que la saturation périphérique en oxygène atteigne 90%. Quarante patients ASA I-II ont été randomisés en deux groupes distincts. - Dans le groupe PEEP (n=20), les patients ont été pré-oxygénés durant 5 minutes avec une Fi02 à l00% par l'intermédiaire d'un appareil de CPAP (6cmH2O). Après induction de l'anesthésie, les patients furent ventilés mécaniquement (PEEP 6cmH2O) durant 5 minutes supplémentaires. - Dans le groupe ZEEP (n=20), aucune pression positive (ni CPAP, ni PEEP) ne fut utilisée. La durée d'apnée pour atteindre une saturation périphérique de 90% fut mesurée. La durée d'apnée non hypoxique était plus longue dans le groupe PEEP par rapport au groupe ZEEP (599 +/- 135 s vs 470 +/- 150 s, p= 0,007). Nous concluons que l'application d'une pression positive durant la phase d'induction d'une anesthésie générale chez l'adulte prolonge la durée d'apnée non hypoxique de plus de 2 minutes.

Agreed-upon procedures report on the City of Riverdale, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Riverdale, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Joice, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Joice, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Martensdale, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Martensdale, Iowa for the period July 1, 2014 through June 30, 2015

Expansion of gamma delta+ T cells in BALB/c mice infected with Leishmania major is dependent upon Th2-type CD4+ T cells.

T cells belong to either the alpha beta+ or gamma delta+ lineage as defined by their antigen receptor. Although both T-cell subsets have been shown to be involved in the immune response to the parasite Leishmania major, very little is known about possible interactions between these two populations. In this study, using a mouse model of infection with L. major, we showed that expansion of a subset of gamma delta+ T cells in vivo is dependent upon the presence of alpha beta+ CD4+ T cells. Moreover, this effect appears to be mediated via the secretion of lymphokines by CD4+ cells with a T-helper 2 (Th2) functional phenotype. Results showing that activation of Th2-type cells in mice treated with anti-immunoglobulin D antibodies or infected with Nippostrongylus brasiliensis also results in gamma delta+ T-cell expansion suggest that this effect of the Th2-type CD4+ cells is a general phenomenon not restricted to infection with L. major.

Agreed-upon procedures report on the City of Lansing, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Lansing, Iowa for the period July 1, 2014 through June 30, 2015