Quick Reads, September 27, 2010

IDPH Quick Reads is an electronic newsletter produced by the Director’s Office at the Iowa Department of Public Health. IDPH Quick Reads are published every three to four weeks.

Friday Facts, November 27, 2009, Vol. 43

Bureau of Nutrition and Health Promotion part of the Iowa Department of Public Health produces of weekly newsletter about the Iowa WIC Program for the State of Iowa citizen.

Dramatic malignant progression of a pigmented villonodular synovitis of the knee after 27 years of multimodality treatment

Introduction: Pigmented villonodular synovitis (PVNS) is a rare benign tumour of the synovium, most commonly arising around the knee. Resection remains the treatment of choice. The diffuse variant of the disease is prone to local recurrence (30-50%). However distant dissemination is extremely rare. We report the case of a patient with massive loco-regional and late distant spread to the lungs of PVNS originating in the knee. Case report: A 69 yo women presented to our service 27 years ago with PVNS in her knee. Despite multible surgical resections, synoviorthesis and external beam radiotherapy, no local control was achieved. The disease spread in all thigh compartments. Due to the resistance to all convetional treatment modalities, isolated limb perfusion with TNFα and Melphalan was performed, without any effect on local control. After the disease was diagnosed in iliac lymph nodes, the patient was subjected to a systemic chemotherapy protocol with imitamib, which had to be abandoned, due to intolerance. Due to a giant lymphoedema of the entire limb, making up for a considerable part of the patient's body weight and in view of significant skin invasion, a hip disarticulation was performed. Finally, rapidly growing lung metastases appeared on CT scan, confirmed by core-needle biopsy. Palliative chemotherapy was initiated. Interestingly, histological analysis of the disease throughout the years remained consistent with classic benign PVNS. No sarcomatous dedifferentiation was observed, not even in the pulmonary lesions. Conclusion: PVNS is a benign tumour, with a high risk of local recurrence. Malignant behaviour, with loco-regional and distant metastases remains extremely rare. A histologically benign appearance does not exclude a clinically malignant behaviour with systemic spread.

Friday Facts, August 27, 2010, Vol. 69

Bureau of Nutrition and Health Promotion part of the Iowa Department of Public Health produces of weekly newsletter about the Iowa WIC Program for the State of Iowa citizen.

EPI Update, May 27, 2011

Weekly newsletter for Center For Acute Disease Epidemiology of Iowa Department of Public Health.

Progeny, March 2011, Vol. 27, no. 1

This newsletter from The Department of Public Health about perinatal health care and statistics.

Progeny, June 2011, Vol. 27, no. 2

This newsletter from The Department of Public Health about perinatal health care and statistics.

Characteristics and outcome of 27 elbow periprosthetic joint infections: results from a 14-year cohort study of 358 elbow prostheses.

Elbow arthroplasty is increasingly performed in patients with rheumatic and post-traumatic arthritis. Data on elbow periprosthetic joint infection (PJI) are limited. We investigated the characteristics and outcome of elbow PJI in a 14-year cohort of total elbow arthroplasties in a single centre. Elbow prosthesis, which were implanted between 1994 and 2007 at Schulthess Clinic in Zurich, were retrospectively screened for infection. PJI was defined as periprosthetic purulence, the presence of sinus tract or microbial growth. A Kaplan-Meier survival method and Cox proportional hazard analysis were performed. Of 358 elbow prostheses, PJI was identified in 27 (7.5%). The median patient age (range) was 61 (39-82) years; 63% were females. Seventeen patients (63%) had a rheumatic disorder and ten (37%) had osteoarthritis. Debridement and implant retention was performed in 78%, followed by exchange or removal of the prosthesis (15%) or no surgery (7%).The relapse-free survival (95% CI) was 79% (63-95%) after 1 year and 65% (45-85%) after 2 years. The outcome after 2 years was significantly better when patients were treated according to the algorithm compared to patients who were not (100% vs. 33%, p <0.05). In 21 patients treated with debridement and retention, the cure rate was also higher when the algorithm was followed (100% vs. 11%, p <0.05). The findings of the present study suggest that the treatment algorithm developed for hip and knee PJI can be applied to elbow PJI. With proper patient selection and antimicrobial therapy, debridement and retention of the elbow prosthesis is associated with good treatment outcome.

Friday Facts, May 27, 2011, Vol. 103

Bureau of Nutrition and Health Promotion part of the Iowa Department of Public Health produces of weekly newsletter about the Iowa WIC Program for the State of Iowa citizen.

Iowa 2088 Summer Storms After-Action Report Final, April 27, 2009

In the summer of 2008, the state of Iowa suffered from a series of severe storms that produced tornadoes and heavy rainfall, which resulted in widespread flooding. The Summer Storms1 lasted from late May through mid-August, with the most intense storms occurring over a month-long period from May 25 to June 25. The Summer Storms exacted a major human and economic toll on Iowa, resulting in 18 fatalities and 106 injuries, forcing the evacuation of approximately 38,000 Iowans, and impacting 21,000 housing units. Iowa’s public and private sectors suffered significant monetary damages. Eighty-six of the ninety-nine counties in the state were included in the Governor’s disaster declarations. Presidential disaster declarations made residents in 84 counties eligible for Public Assistance and 78 counties for Individual Assistance. The Rebuild Iowa Advisory Commission estimated $798.3 million in damages to publicly owned buildings and infrastructure, including damages of $53 million to public transportation and $342 million to public utilities. The 2008 Summer Storms presented unique coordination challenges for the Iowa Homeland Security and Emergency Management Division (HSEMD) and the State Emergency Operations Center (SEOC). These challenges arose from three interrelated factors: the large number of local jurisdictions and areas impacted, the prolonged period of time that response operations were conducted, and the increasing complexity of overall response operations. These events caused the SEOC to coordinate response, mitigation, recovery, and preparedness operations simultaneously. HSEMD and the SEOC implemented a variety of measures to enhance their ability to coordinate operations and assistance to localities. The SEOC expanded its organizational structure, implemented innovative techniques, and incorporated new partners into its activities. These steps enabled HSEMD and SEOC to coordinate operations more effectively, which undoubtedly helped save lives and property, while mitigating the effects of the 2008 Summer Storms.

Iowa Crop and Weather Report, November 27, 2011, Vol. 11. no. 39

Report produced by the The Department of Agriculture and Land Stewardship, Climatology Bureau. Iowa Secretary of Agriculture Bill Northey today commented on the Iowa Crops and Weather report released by the USDA National Agricultural Statistical Service. The report is released weekly from April through October.

Iowa Crop and Weather Report, September 6, 2011, Vol. 11. no. 27

Report produced by the The Department of Agriculture and Land Stewardship, Climatology Bureau. Iowa Secretary of Agriculture Bill Northey today commented on the Iowa Crops and Weather report released by the USDA National Agricultural Statistical Service. The report is released weekly from April through October.