Safety and accuracy of robot-assisted versus fluoroscopy-guided pedicle screw insertion for degenerative diseases of the lumbar spine: a matched cohort comparison.

Object Recent years have been marked by efforts to improve the quality and safety of pedicle screw placement in spinal instrumentation. The aim of the present study is to compare the accuracy of the SpineAssist robot system with conventional fluoroscopy-guided pedicle screw placement. Methods Ninety-five patients suffering from degenerative disease and requiring elective lumbar instrumentation were included in the study. The robot cohort (Group I; 55 patients, 244 screws) consisted of an initial open robot-assisted subgroup (Subgroup IA; 17 patients, 83 screws) and a percutaneous cohort (Subgroup IB, 38 patients, 161 screws). In these groups, pedicle screws were placed under robotic guidance and lateral fluoroscopic control. In the fluoroscopy-guided cohort (Group II; 40 patients, 163 screws) screws were inserted using anatomical landmarks and lateral fluoroscopic guidance. The primary outcome measure was accuracy of screw placement on the Gertzbein-Robbins scale (Grade A to E and R [revised]). Secondary parameters were duration of surgery, blood loss, cumulative morphine, and length of stay. Results In the robot group (Group I), a perfect trajectory (A) was observed in 204 screws (83.6%). The remaining screws were graded B (n = 19 [7.8%]), C (n = 9 [3.7%]), D (n = 4 [1.6%]), E (n = 2 [0.8%]), and R (n = 6 [2.5%]). In the fluoroscopy-guided group (Group II), a completely intrapedicular course graded A was found in 79.8% (n = 130). The remaining screws were graded B (n = 12 [7.4%]), C (n = 10 [6.1%]), D (n = 6 [3.7%]), and E (n = 5 [3.1%]). The comparison of "clinically acceptable" (that is, A and B screws) was neither different between groups (I vs II [p = 0.19]) nor subgroups (Subgroup IA vs IB [p = 0.81]; Subgroup IA vs Group II [p = 0.53]; Subgroup IB vs Group II [p = 0.20]). Blood loss was lower in the robot-assisted group than in the fluoroscopy-guided group, while duration of surgery, length of stay, and cumulative morphine dose were not statistically different. Conclusions Robot-guided pedicle screw placement is a safe and useful tool for assisting spine surgeons in degenerative spine cases. Nonetheless, technical difficulties remain and fluoroscopy backup is advocated.

Child Passenger Safety Guide, May 2006

The left side of this guide outlines Iowa’s Child Restraint Law. The right side of this guide outlines National Safety Recommendations. El lado izquierdo describe la ley de proteccion vehicular para los niños El lado derecho describe las recomendaciones de la oficina National Safety

Subconjunctival Injection of XG-102, a JNK Inhibitor Peptide, in Patients with Intraocular Inflammation: A Safety and Tolerability Study.

Abstract Purpose: We aimed to investigate the safety, tolerability, and systemic diffusion of a single escalating dose of XG-102 (a 31-D-amino-acid peptide inhibiting JNK pathway activation), administered subconjunctivally in the treatment of post-surgery or post-trauma intraocular inflammation. Methods: This is a dose-escalating, tolerance Phase Ib study. Twenty patients with post-surgery or post-traumatic intraocular inflammation were assigned to 1 of the 4 dose escalating (45, 90, 450, or 900 μg XG-102) groups of 5 patients each. Patients were evaluated at 24, 48 h, 8, and 28 days following the administration of XG-102, including laboratory tests, standard eye examinations, vital signs, and occurrence of adverse events. A single plasma quantification of XG-102 was performed 30 min after administration, according to previous pharmacokinetics studies performed on volunteers. Results: A total of 17 non-serious adverse events, considered unrelated to the study treatment, were reported for 10 patients. The adverse event incidence was not related to the drug dose. All patients experienced a decrease in intraocular inflammation as of 24 h post-administration and this decrease was sustained up to 28 days thereafter. No patient required local injection or systemic administration of corticoids following the administration of XG-102. XG-102 was undetectable in the first 3 dose groups. In the fourth-dose group (900 μg) the XG-102 plasma levels were above the limit of detection for 3 patients and above the limit of quantification for 1 patient. Conclusions: In this first clinical trial using XG-102, administered as a single subconjunctival injection as adjunct therapy, in patients with recent post-surgery or post-trauma intraocular inflammation is safe and well tolerated. Further studies are required to evaluate its efficacy.

Report on the Iowa Department of Public Safety for the year ended June 30, 2009

Report on the Iowa Department of Public Safety for the year ended June 30, 2009

Iowa Highway Safety Program, Iowa Department of Public Safety, 2009

Annual Highway Safety Report for Iowa Department of Public Safety.

Iowa's Blueprint for Safety,

To identify traffic safety problems and thereon develop and implement traffic safety programs designed to reduce death and injury on Iowa’s streets and highways through partnerships with local, county, state and private sector agencies.

S.F. 376 - Report on Status of Projects - Bridge Safety Fund

Pursuant to section 34, subsection 1 of S.R. 376 passed by the 2010 session of the 83rd Iowa General Assembly, please find attached the report on the status of all bridge projects, completed or in progress, that were funded with the Bridge Safety Fund established by S.F. 376.

Management of nanomaterials safety in research environment

Despite numerous discussions, workshops, reviews and reports about responsible development of nanotechnology, information describing health and environmental risk of engineered nanoparticles or nanomaterials is severely lacking and thus insufficient for completing rigorous risk assessment on their use. However, since preliminary scientific evaluations indicate that there are reasonable suspicions that activities involving nanomaterials might have damaging effects on human health; the precautionary principle must be applied. Public and private institutions as well as industries have the duty to adopt preventive and protective measures proportionate to the risk intensity and the desired level of protection. In this work, we present a practical, 'user-friendly' procedure for a university-wide safety and health management of nanomaterials, developed as a multi-stakeholder effort (government, accident insurance, researchers and experts for occupational safety and health). The process starts using a schematic decision tree that allows classifying the nano laboratory into three hazard classes similar to a control banding approach (from Nano 3 - highest hazard to Nano1 - lowest hazard). Classifying laboratories into risk classes would require considering actual or potential exposure to the nanomaterial as well as statistical data on health effects of exposure. Due to the fact that these data (as well as exposure limits for each individual material) are not available, risk classes could not be determined. For each hazard level we then provide a list of required risk mitigation measures (technical, organizational and personal). The target 'users' of this safety and health methodology are researchers and safety officers. They can rapidly access the precautionary hazard class of their activities and the corresponding adequate safety and health measures. We succeed in convincing scientist dealing with nano-activities that adequate safety measures and management are promoting innovation and discoveries by ensuring them a safe environment even in the case of very novel products. The proposed measures are not considered as constraints but as a support to their research. This methodology is being implemented at the Ecole Polytechnique de Lausanne in over 100 research labs dealing with nanomaterials. It is our opinion that it would be useful to other research and academia institutions as well. [Authors]

Iowa Comprehensive Highway Safety Plan, September 2006

In Iowa, hundreds of people die and thousands more are injured on our public roadways each year despite decades of efforts to end this su�ffering. Past safety e�efforts have resulted in Iowans bene�fiting from one of the best state roadway systems in the nation. Due to multi-agency e�efforts, Iowa has achieved 90 percent compliance with the state’s mandatory front seat belt use law, earned the nation’s second-lowest percent of alcohol involvement in fatal crashes and made safety gains in system-wide roadway design and operational improvements. Despite these ongoing e�efforts, the state’s annual average of 445 deaths and thousands of life-changing injuries is a tragic toll and an unacceptable public health epidemic in our state. To save more lives on our roadways, Iowans must be challenged to think �differently about lifesaving measures addressing young drivers, safety belts, and motorcycle helmet use and accept innovative designs such as roundabouts. Iowa must apply evidence-based strategies and create a safety culture that motivates all citizens to travel more responsibly. They must demand a lower level of tolerance for Iowa’s roadway deaths and injuries. The Iowa Comprehensive Highway Safety Plan (CHSP) engages diverse safety stakeholders and charts the course for this state, bringing to bear sound science and the power of shared community values to change the culture and achieve a standard of safer travel for our citizens. How many roadway deaths and injuries are too many? Iowa’s highway safety stakeholders believe that, “One death is one too many” and e�effective culture-changing policy and program strategies must be implemented to help reduce this death toll from an annual average of 445 to 400 by the year 2015.

The biotechnology of lactic acid bacteria with emphasis on applications in food safety and human health

Selostus: Terveyttä ja ruoan turvallisuutta edistävät maitohappobakteerien biotekniset sovellukset

Audit report on Highway Safety Projects administered by The Integer Group Midwest for the year ended September 30, 2007

Audit report on Highway Safety Projects administered by The Integer Group Midwest for the year ended September 30, 2007

Audit report on Highway Safety Projects administered by The Integer Group Midwest for the year ended September 30, 2008

Audit report on Highway Safety Projects administered by The Integer Group Midwest for the year ended September 30, 2008

Audit report on Highway Safety Projects administered by The Integer Group Midwest for the year ended September 30, 2009

Audit report on Highway Safety Projects administered by The Integer Group Midwest for the year ended September 30, 2009

Vaccinia immune globulin: current policies, preparedness, and product safety and efficacy.

In 1980 the World Health Organization declared that smallpox was eradicated from the world, and routine smallpox vaccination was discontinued. Nevertheless, samples of the smallpox virus (variola virus) were retained for research purposes, not least because of fears that terrorist groups or rogue states might also have kept samples in order to develop a bioweapon. Variola virus represents an effective bioweapon because it is associated with high morbidity and mortality and is highly contagious. Since September 11, 2001, countries around the world have begun to develop policies and preparedness programs to deal with a bioterror attack, including stockpiling of smallpox vaccine. Smallpox vaccine itself may be associated with a number of serious adverse events, which can often be managed with vaccinia immune globulin (VIG). VIG may also be needed as prophylaxis in patients for whom pre-exposure smallpox vaccine is contraindicated (such as those with eczema or pregnant women), although it is currently not licensed in these cases. Two intravenous formulations of VIG (VIGIV Cangene and VIGIV Dynport) have been licensed by the FDA for the management of patients with progressive vaccinia, eczema vaccinatum, severe generalized vaccinia, and extensive body surface involvement or periocular implantation following inadvertent inoculation.