Failure of the surgical treatment in 115 infected hip arthroplasties-­analysis of a 12-­year prosthetic joint cohort study (1999-­2010)

Background:¦Infection after total or partial hip arthroplasty (HA) leads to significant long-­term morbidity and high healthcare cost. We evaluated reasons for treatment failure of different surgical modalities in a 12-­year prosthetic hip joint infection cohort study.¦Method:¦All patients hospitalized at our institution with infected HA were included either retrospectively (1999-­‐2007) or prospectively¦(2008-­‐2010). HA infection was defined as growth of the same microorganism in ≥2 tissues or synovialfluid culture, visible purulence, sinus tract or acute inflammation on tissue histopathology. Outcome analysis was performed at outpatient visits, followed by contacting patients, their relatives and/or treating physicians afterwards.¦Results:¦During the study period, 117 patients with infected HA were identified. We excluded 2 patients due to missing data. The average age was 69 years (range, 33-­‐102 years); 42% were female. HA was mainly performed for osteoarthritis (n=84), followed by trauma (n=22), necrosis (n=4), dysplasia(n=2), rheumatoid arthritis (n=1), osteosarcoma (n=1) and tuberculosis (n=1). 28 infections occurred early(≤3 months), 25 delayed (3-­‐24 months) and 63 late (≥24 months after surgery). Infected HA were¦treated with (i) two-­‐stage exchange in 59 patients (51%, cure rate: 93%), (ii) one-­‐stage exchange in 5 (4.3%, cure rate: 100%), (iii) debridement with change of mobile parts in 18 (17%, cure rate: 83%), (iv) debridement without change of mobile¦parts in 17 (14%, cure rate : 53% ), (v) Girdlestone in 13 (11%, cure rate: 100%), and (vi) two-­‐stage exchange followed by¦removal in 3 (2.6%). Patients were followed for an average of 3.9 years (range, 0.1 to 9 years), 7 patients died unrelated to the infected HA. 15 patients (13%) needed additional operations, 1 for mechanical reasons(dislocation of spacer) and 14 for persistent infection: 11 treated with debridement and retention (8 without change; and 3 with change of mobile parts) and 3 with two-­‐stage exchange. The average number of surgery was 2.2 (range, 1 to 5). The infection was finally eradicated in all patients, but the functional outcome remained unsatisfactory in 20% (persistent pain or impaired mobility due to spacer or Girdlestone situation).¦Conclusions:¦Non-­‐respect of current treatment concept leads to treatment failure with subsequent operations. Precise analysis of each treatment failure can be used for improving the treatment algorithm leading to better results.

Statewide Transportation Improvement Program 2010-2013

Iowa’s Statewide Transportation Improvement Program (STIP) has been developed in conformance with the guidelines prescribed by 23 USC. The STIP is generated to provide the Federal Highway Administration (FHWA) and Federal Transit Administration (FTA) a listing of all projects that are candidates for federal aid from the FHWA and FTA for four federal fiscal years (FFY). Preceding the listings of federal-aid candidates are general comments concerning Iowa’s public participation process for selection of federal-aid projects and the basis for funding the proposed projects. Documents evidencing the Iowa Department of Transportation’s (Iowa DOT) authority to act concerning matters related to transportation, federal-aid expenditures and approvals of Metropolitan Planning Organizations’ (MPOs) Transportation Improvements Programs (TIPs) have been provided in past STIP’s and can be provided again upon request. The projects identified within the 2010-2013 STIP are divided into two groups. Projects proposed for funding from FHWA programs are shown first. FTA programs follow. Maps are included that identify locations of Iowa DOT District Planners, Metropolitan Planning Organizations (MPOs), Regional Planning affiliations (RPAs), and transit systems.

Migración M.O.S.S. 2007 a SharePoint 2010 de Hospital Universitario Virgen del Rocío

En el presente trabajo se ha descrito el análisis y diseño que motiva el proyecto de migración de Microsoft SharePoint Server 2007 a la versión SharePoint Server 2010 que desarrolla la intranet de uno de los mayores complejos hospitalarios de nuestro país.

2010 Iowa Drug Control Strategy

Iowa's Drug Control Strategy serves as a comprehensive blueprint for coordinated prevention, treatment, and enforcement actions to protect citizens from the dangers posed by substance abuse. This holistic plan, developed by Iowa's Drug Policy Advisory Council, embraces a performance-oriented process to align resources with long-term goals, and supports three desired results: All Iowans are healthy and drug-free, Iowa communities are free from illegal drugs, all Iowans are safe from drug abusing offenders. This report also contains a mix of recent accomplishments and pending challenges.

Consumer Advisory Bulletin; Beware of “Foreclosure Rescue Scams, January 2010

The Attorney General’s Consumer Protection Division receives hundreds of calls and consumer complaints every year. Follow these tips to avoid unexpected expense and disappointments. This record is about:Beware of “Foreclosure Rescue Scams

Motor Vehicle Crash Fatalities for Week Ending, January 1, 2010

Motor Vehicle Crash Fatalities

International Update, January-February 2010

International Business news from the Iowa International Office, Business Development Division of the Iowa Department of Economic Development

School Leader Update, January 2010

Monthly newsletter produced by Iowa Department of Education

Iowa Health Focus, January-February, 2010

Monthly newsletter for the Iowa Department of Public Health

Motor Vehicle Crash Fatalities for Week Ending, January 8, 2010

Motor Vehicle Crash Fatalities

Sign of the Times, January 2010

Newsletter produced by Deaf Services Commission of Iowa

EPI Update, January 8, 2010

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

Condition of the State of Iowa, 2010

A transcript of the Condition of the State of Iowa speech by Governor Chet Culver delivered at the State Capitol on January 12, 2010.

Neighborhood News, Issue. No. 1, 2010

Iowa Neighborhood development news...