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

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

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

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

Report on a special investigation of the Region 4 Fusion Office in Atlantic, Iowa for the period March 1, 2006 through August 31, 2009

Report on a special investigation of the Region 4 Fusion Office in Atlantic, Iowa for the period March 1, 2006 through August 31, 2009

Report on the Central Iowa Center for Independent Living (CICIL) for the period July 1, 2008 through June 30, 2009

Report on the Central Iowa Center for Independent Living (CICIL) for the period July 1, 2008 through June 30, 2009

Reaudit report on Skiff Medical Center in Newton, Iowa for the period July 1, 2008 through June 30, 2009

Reaudit report on Skiff Medical Center in Newton, Iowa for the period July 1, 2008 through June 30, 2009

Special investigation of the City of Humboldt and Mid Iowa Growth Partnership for the period January 1, 2007 through June 10, 2010

Special investigation of the City of Humboldt and Mid Iowa Growth Partnership for the period January 1, 2007 through June 10, 2010

A review of relocation benefits of state agencies and regent institutions for the period July 1, 2005 through June 30, 2009

A review of relocation benefits of state agencies and regent institutions for the period July 1, 2005 through June 30, 2009

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

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

Report on a review of selected application controls over the Iowa Department of Human Services’ KinderTrack system for the period March 12, 2010 through April 2, 2010

Report on a review of selected application controls over the Iowa Department of Human Services’ KinderTrack system for the period March 12, 2010 through April 2, 2010

Reaudit report on Cass County Memorial Hospital in Atlantic, Iowa for the period July 1, 2008 through June 30, 2009

Reaudit report on Cass County Memorial Hospital in Atlantic, Iowa for the period July 1, 2008 through June 30, 2009

Report on the Charter Agency Initiative administered by the Department of Management for the period July 1, 2003 through June 30, 2008

Report on the Charter Agency Initiative administered by the Department of Management for the period July 1, 2003 through June 30, 2008

Intrathecal analgesia and restrictive perioperative fluid management within enhanced recovery pathway: hemodynamic implications.

BACKGROUND: Intrathecal analgesia and avoidance of perioperative fluid overload are key items within enhanced recovery pathways. Potential side effects include hypotension and renal dysfunction. STUDY DESIGN: From January 2010 until May 2010, all patients undergoing colorectal surgery within enhanced recovery pathways were included in this retrospective cohort study and were analyzed by intrathecal analgesia (IT) vs none (noIT). Primary outcomes measures were systolic and diastolic blood pressure, mean arterial pressure, and heart rate for 48 hours after surgery. Renal function was assessed by urine output and creatinine values. RESULTS: One hundred and sixty-three consecutive colorectal patients (127 IT and 36 noIT) were included in the analysis. Both patient groups showed low blood pressure values within the first 4 to 12 hours and a steady increase thereafter before return to baseline values after about 24 hours. Systolic and diastolic blood pressure and mean arterial pressure were significantly lower until 16 hours after surgery in patients having IT compared with the noIT group. Low urine output (<0.5 mL/kg/h) was reported in 11% vs 29% (IT vs noIT; p = 0.010) intraoperatively, 20% vs 11% (p = 0.387), 33% vs 22% (p = 0.304), and 31% vs 21% (p = 0.478) for postanesthesia care unit and postoperative days 1 and 2, respectively. Only 3 of 127 (2.4%) IT and 1 of 36 (2.8%) noIT patients had a transitory creatinine increase >50%; no patients required dialysis. CONCLUSIONS: Postoperative hypotension affects approximately 10% of patients within an enhanced recovery pathway and is slightly more pronounced in patients with IT. Hemodynamic depression persists for <20 hours after surgery; it has no measurable negative impact and therefore cannot justify detrimental postoperative fluid overload.

Report on the City of Truesdale for the period July 1, 2006 through December 31, 2010

Report on the City of Truesdale for the period July 1, 2006 through December 31, 2010

Agreed upon procedures report on the City of Lohrville, Iowa for the period December 1, 2008 through October 31, 2010

Agreed upon procedures report on the City of Lohrville, Iowa for the period December 1, 2008 through October 31, 2010