959 resultados para University of Pennsylvania
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Audit report of Iowa State University of Science and Technology, Ames, Iowa, (Iowa State University) for the year ended June 30, 2009
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Audit report of the State University of Iowa, Iowa City, Iowa, (University of Iowa) for the year ended June 30, 2009
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Introduction: Low brain tissue oxygen pressure (PbtO2) is associated with worse outcome in patients with severe traumatic brain injury (TBI). However, it is unclear whether brain tissue hypoxia is merely a marker of injury severity or a predictor of prognosis, independent from intracranial pressure (ICP) and injury severity. Hypothesis: We hypothesized that brain tissue hypoxia was an independent predictor of outcome in patients wih severe TBI, irrespective of elevated ICP and of the severity of cerebral and systemic injury. Methods: This observational study was conducted at the Neurological ICU, Hospital of the University of Pennsylvania, an academic level I trauma center. Patients admitted with severe TBI who had PbtO2 and ICP monitoring were included in the study. PbtO2, ICP, mean arterial pressure (MAP) and cerebral perfusion pressure (CPP = MAP-ICP) were monitored continuously and recorded prospectively every 30 min. Using linear interpolation, duration and cumulative dose (area under the curve, AUC) of brain tissue hypoxia (PbtO2 < 15 mm Hg), elevated ICP >20 mm Hg and low CPP <60 mm Hg were calculated, and the association with outcome at hospital discharge, dichotomized as good (Glasgow Outcome Score [GOS] 4-5) vs. poor (GOS 1-3), was analyzed. Results: A total of 103 consecutive patients, monitored for an average of 5 days, was studied. Brain tissue hypoxia was observed in 66 (64%) patients despite ICP was < 20 mm Hg and CPP > 60 mm Hg (72 +/- 39% and 49 +/- 41% of brain hypoxic time, respectively). Compared with patients with good outcome, those with poor outcome had a longer duration of brain hypoxia (1.7 +/- 3.7 vs. 8.3 +/- 15.9 hrs, P<0.01), as well as a longer duration (11.5 +/- 16.5 vs. 21.6 +/- 29.6 hrs, P=0.03) and a greater cumulative dose (56 +/- 93 vs. 143 +/- 218 mm Hg*hrs, P<0.01) of elevated ICP. By multivariable logistic regression, admission Glasgow Coma Scale (OR, 0.83, 95% CI: 0.70-0.99, P=0.04), Marshall CT score (OR 2.42, 95% CI: 1.42-4.11, P<0.01), APACHE II (OR 1.20, 95% CI: 1.03-1.43, P=0.03), and the duration of brain tissue hypoxia (OR 1.13; 95% CI: 1.01-1.27; P=0.04) were all significantly associated with poor outcome. No independent association was found between the AUC for elevated ICP and outcome (OR 1.01, 95% CI 0.97-1.02, P=0.11) in our prospective cohort. Conclusions: In patients with severe TBI, brain tissue hypoxia is frequent, despite normal ICP and CPP, and is associated with poor outcome, independent of intracranial hypertension and the severity of cerebral and systemic injury. Our findings indicate that PbtO2 is a strong physiologic prognostic marker after TBI. Further study is warranted to examine whether PbtO2-directed therapy improves outcome in severely head-injured patients .
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Agreed-upon procedures report on the Iowa State Center Business Office of Iowa State University of Science and Technology for the year ended June 30, 2009
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El pasado mes de junio se celebró en Pittsburgh, EE.UU., el duodécimo simposio internacional sobre tesis electrónicas: Electronic Thesis and Dissertations Conference (ETD2009). Fue organizado por Networked Digital Library of Theses and Dissertations (NDLTD). La mayoría de los ponentes explicaron las experiencias de su propia universidad. Además, hubo expertos invitados entre los cuales se pueden destacar Stevan Harnad (Univ. Southampton), Karla Hahn (Association of Research Libraries) y Deanna Marcum (Library of Congress). Estos simposios pretenden promover la adopción, creación, uso, difusión y preservación de las tesis electrónicas. De hecho, el éxito ha sido tal, que algunas universidades ya prescinden de la copia en papel para el depósito y preservación del documento. Un caso reciente es el de la University of Albany cuya nueva política, anunciada durante el simposio, consiste en que a partir de setiembre del 2009 ya no requiere el depósito de una copia impresa de las tesis aprobadas en aquella universidad.
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Report on a review of selected general and application controls over the Iowa State University of Science and Technology (Iowa State University) Purchase Order/Requisition System for the period of March 20 through April 28, 2009
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Report on the review of selected general and application controls over the State University of Iowa (University of Iowa) ePro System for the period June 15, 2009 through July 31, 2009
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Report on the State University of Iowa, Iowa City, Iowa for the year ended June 30, 2009
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Report on the University of Northern Iowa for the year ended June 30, 2009
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Report on Iowa State University of Science and Technology, Ames, Iowa, for the year ended June 30, 2009
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Report on a review of selected general and application controls over the University of Northern Iowa Accounts Payable/Purchasing System for the period of June 10, 2009 through August 20, 2009
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Audit report on the Student Health Facility Revenue Bond Funds of Iowa State University of Science and Technology for the year ended June 30, 2010
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Report on a review of selected general and application controls over the State University of Iowa BuildUI System for the period June 14, 2010 through July 19, 2010
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Report on a review of selected general and application controls over the Iowa State University of Science and Technology Accounts Receivable System for the period of March 29, 2010 through May 6, 2010
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Report on a review of selected application controls over the University of Northern Iowa Non-Student Accounts Receivable System for the period June 10, 2010 through July 23, 2010