Sign of the Times, December 2012-January 2013

Newsletter produced by Deaf Services Commission of Iowa

Ordre de marche pour la confédération qui aura lieu le 14 juillet, & dispositions dans le Champ-de-Mars ([Reprod.]) / [signé Bailly,... La Fayette]

Collection : Les archives de la Révolution française ; 6.2.1105

Prevalence of Acute Coronary Syndrome in Patients Suspected for Pulmonary Embolism or Acute Aortic Syndromes: Rational for "Double" and "Triple" Rule-Out Concepts

PURPOSE To evaluate the prevalence of acute coronary syndrome (ACS) in patients presenting initially with atypical chest pain and suspected to have pulmonary embolism (PE) or acute aortic syndromes (AAS). To evaluate the overlap between ACS, PE and AAS in routine practice and determine how many patients could have benefit from a single CT protocol to rule out ACS at the same time as PE and AAS. METHOD AND MATERIALS Our electronic hospital database revealed 1122 consecutive patients who underwent a thoracic CT angiography for PE or AAS from 2004 to 2006 (mean age, 63±13 years). Patients without chest pain were excluded from this study. Thus, 447 patients presented with isolated atypical chest were included in the analysis. All patients who underwent a thoracic CT scan previously received standard clinical care and were initially considered as non ACS. The final diagnosis was obtained by the hospital stay report. RESULTS Among the 447 patients with atypical chest pain, 25 (5.5%) were finally found to have ACS: 19 patients (4.2%) were suspected for PE and 6 (1. 3%) were suspected for AAS. There were 90 patients diagnosed to have PE, 89 (98.8%) of them were suspected for PE while only 1 (1%) was suspected for AAS. Eleven patients diagnosed to have AAS, 9 (82%) of them were suspected for AAS while 2 (18%) were suspected for PE. CONCLUSION In clinical practice, the overlap between PE, AAS and ACS is limited which make the triple rule-out studies less recommended to be done at the time being because of the high dose radiation. A double rule-out investigation is suggested to be done for patients being evaluated for atypical chest pain and suspected of having AAS or PE because of a significant overlap between the two entities as well it doesn't implicate any increment in radiation dose. CLINICAL RELEVANCE/APPLICATION With 64-slice CT, coronary circulation and total chest can be evaluated at the same time offering new opportunitie for the evaluation of three major life-threatening conditions :ACS,PE and AAS.

Sign Inventory Users Guide, August 2010

This User’s Guide serves as a reference for field personnel using the sign inventory data collection software tool. This tool was developed to simplify and standardize the collection and updating of sign inventory information. The software and collection methodology was developed by the Iowa DOT Sign Management Task Force and the Center for Transportation Research and Education at Iowa State University. Required Equipment -The data collection process requires both a portable computer and a global positioning system (GPS) device (connected via USB cable). Since computer battery performance varies, a DC power converter is recommended. A check-in/out process has also been established which allows updates to sign information from the central database.

Development of a GPS-Based Sign Inventory Tool for Iowa’s Statewide Management System, May 2011

This report is on state-of-the-art research efforts specific to infrastructure inventory/data collection with sign inventory as a case study. The development of an agency-wide sign inventory is based on feature inventory and location information. Specific to location, a quick and simple location acquisition tool is critical to tying assets to an accurate location-referencing system. This research effort provides a contrast between legacy referencing systems (route and milepost) and global positioning system- (GPS-) based techniques (latitude and longitude) integrated into a geographic information system (GIS) database. A summary comparison of field accuracies using a variety of consumer grade devices is also provided. This research, and the data collection tools developed, are critical in supporting the Iowa Department of Transportation (DOT) Statewide Sign Management System development effort. For the last two years, a Task Force has embarked on a comprehensive effort to develop a sign management system to improve sign quality, as well as to manage all aspects of signage, from request, ordering, fabricating, installing, maintaining, and ultimately removing, and to provide the ability to budget for these key assets on a statewide basis. This effort supported the development of a sign inventory tool and is the beginning of the development of a sign management system to support the Iowa DOT efforts in the consistent, cost effective, and objective decision making process when it comes to signs and their maintenance.