Nadolol plus isosorbide mononitrate alone or associated with band ligation in the prevention of recurrent bleeding: A multicenter randomized controlled trial.

Background and aims: Previous clinical trials suggest that adding non-selective beta-blockers improves the efficacy of endoscopic band ligation (EBL) in the prevention of recurrent bleeding, but no study has evaluated whether EBL improves the efficacy of beta-blockers + isosorbide-5-mononitrate. The present study was aimed at evaluating this issue in a multicentre randomised controlled trial (RCT) and to correlate changes in hepatic venous pressure gradient (HVPG) during treatment with clinical outcomes. Methods: 158 patients with cirrhosis, admitted because of variceal bleeding, were randomised to receive nadolol+isosorbide-5-mononitrate alone (Drug: n=78) or combined with EBL (Drug+EBL; n=80). HVPG measurements were performed at randomisation and after 4¿6 weeks on medical therapy. Results: Median follow-up was 15 months. One-year probability of recurrent bleeding was similar in both groups (33% vs 26%: p=0.3). There were no significant differences in survival or need of rescue shunts. Overall adverse events or those requiring hospital admission were significantly more frequent in the Drug+EBL group. Recurrent bleeding was significantly more frequent in HVPG non-responders than in responders (HVPG reduction ¿20% or ¿12 mm Hg). Among non-responders recurrent bleeding was similar in patients treated with Drugs or Drugs+EBL. Conclusions: Adding EBL to pharmacological treatment did not reduce recurrent bleeding, the need for rescue therapy, or mortality, and was associated with more adverse events. Furthermore, associating EBL to drug therapy did not reduce the high rebleeding risk of HVPG non-responders.

Customer Focus Newsletter, Fall, 2012, Vol. 9, no. 3

A bi-monthly bulletin to keep the department/agency management teams of state government better informed. We hope to consolidate most of the service update messages we send throughout the month and keep you updated about the work of the Customer Councils. If yours is one of the many departments who participated in the second annual DAS customer satisfaction survey recently, we thank you for taking the time to give us this important feedback. We look forward to sharing survey results with you, and pledge to consider responses carefully as we work to determine benchmarks and set future priorities.

2007 State of Iowa Juvenile Justice and Delinquency Prevention Act Formule Grand Update

This document is Iowa’s 2007 JJDP Act formula grant three year plan update. When specific items of this plan are unchanged from the previously submitted 2006 plan, we have reflected accordingly in the respective topic areas of this document. The bulk of this 2007 plan is an “update” of the program plan completed since submission of the original 2006 plan. The Division of Criminal and Juvenile Justice Planning (CJJP) wrote Iowa’s three year plan update. CJJP is the state agency responsible for administering the JJDP Act in Iowa. Federal officials refer to state administering agencies as the state planning agency (SPA). The Plan was developed and approved by Iowa’s Juvenile Justice Advisory Council. That Council assists with administration of the JJDP Act, and also provides guidance and direction to the SPA, the Governor and the legislature regarding juvenile justice issues in Iowa. Federal officials refer to such state level groups as state advisory groups (SAG’s).

DMC Section: 2009 State of Iowa Juvenile Justic and Delinquency Prevention Act Formula Grant Update, March 2009

This document is the DMC Section of Iowa’s 2009 federal Juvenile Justice and Delinquency Prevention Act (JJDP Act) formula grant three year plan update. The Division of Criminal and Juvenile Justice Planning (CJJP) wrote this update. CJJP is the state agency responsible for administering the JJDP Act in Iowa. Federal officials refer to state administering agencies as the state planning agency (SPA). The Plan was developed and approved by Iowa’s Juvenile Justice Advisory Council. That Council assists with administration of the JJDP Act, and also provides guidance and direction to the SPA, the Governor and the legislature regarding juvenile justice issues in Iowa. Federal officials refer to such state level groups as state advisory groups (SAG’s). The acronyms SPA and SAG are used through this report.

The Latest Word, Fall 2012

Newsletter by IPERS about Iowa Public Employees’ Retirement System news for retirees.

The Latest Word, Fall 2011

Newsletter by IPERS about Iowa Public Employees’ Retirement System news for retirees.

The Latest Word, Fall 2007

Newsletter by IPERS about Iowa Public Employees’ Retirement System news for retirees.

The Latest Word, Fall 2006

Newsletter by IPERS about Iowa Public Employees’ Retirement System news for retirees.

The Latest Word, Fall 2005

Newsletter by IPERS about Iowa Public Employees’ Retirement System news for retirees.

The Latest Word, Fall 2004

Newsletter by IPERS about Iowa Public Employees’ Retirement System news for retirees.

Fall Enrollment Report, 2012

The Iowa Department of Education collects enrollment information from all 15 community colleges on the tenth business day of the fall semester. This report summarizes several key aspects of community college enrollment from fall 2012.

Potential impact of single-risk-factor versus total risk management for the prevention of cardiovascular events in Seychelles.

OBJECTIVE: To assess the prevalence of cardiovascular (CV) risk factors in Seychelles, a middle-income African country, and compare the cost-effectiveness of single-risk-factor management (treating individuals with arterial blood pressure >/= 140/90 mmHg and/or total serum cholesterol >/= 6.2 mmol/l) with that of management based on total CV risk (treating individuals with a total CV risk >/= 10% or >/= 20%).METHODS: CV risk factor prevalence and a CV risk prediction chart for Africa were used to estimate the 10-year risk of suffering a fatal or non-fatal CV event among individuals aged 40-64 years. These figures were used to compare single-risk-factor management with total risk management in terms of the number of people requiring treatment to avert one CV event and the number of events potentially averted over 10 years. Treatment for patients with high total CV risk (>/= 20%) was assumed to consist of a fixed-dose combination of several drugs (polypill). Cost analyses were limited to medication.FINDINGS: A total CV risk of >/= 10% and >/= 20% was found among 10.8% and 5.1% of individuals, respectively. With single-risk-factor management, 60% of adults would need to be treated and 157 cardiovascular events per 100 000 population would be averted per year, as opposed to 5% of adults and 92 events with total CV risk management. Management based on high total CV risk optimizes the balance between the number requiring treatment and the number of CV events averted.CONCLUSION: Total CV risk management is much more cost-effective than single-risk-factor management. These findings are relevant for all countries, but especially for those economically and demographically similar to Seychelles.

The White Cane Magazine, Fall 2012, Vol. 3, no. 4

Quarterly newsletter produced by the Iowa Department of Blind, about the information and activities that are on going in the department.

Iowa Community Colleges Student Fall Enrollment Report, December 2009

Iowa Community Colleges transmit fall enrollment data to the Department of Education after the 14th day of the fall term start date. All data included in this report, except where noted, are taken from the Management Information System (MIS) electronic data files and are confirmed by the community college.

Iowa Community Colleges Student Fall Enrollment Report, December 2001

Iowa Community Colleges transmit fall enrollment data to the Department of Education after the 14th day of the fall term start date. All data included in this report, except where noted, are taken from the Management Information System (MIS) electronic data files and are confirmed by the community college.