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.

Report of the Section of Agencies and Institutions Division of Child Welfare State Department of Social Welfare, 1943

History of child and social welfare in the State of Iowa including legal responsibilities, rules and regulations, inspections and licensing and supervision. it also covers cooperation with state agencies. It also describes in detail the histories, functions and problems of individual welfare homes and schools.

Equipment and Vehicle Purchase Report for Fiscal Year 2009 as required by Iowa Code section 307.47

Attached is the Equipment and Vehicle Purchase Report for Fiscal Year 2009 as required by Iowa Code section 307.47. The report is sorted by Iowa Department of Transportation accounting object codes.

Audit report on the Iowa Water Pollution Control Works Financing Program (Clean Water Program) and the Iowa Drinking Water Facilities Financing Program (Drinking Water Program), joint programs of the Iowa Finance Authority and the Iowa Department of Natural Resources for the year ended June 30, 2009

Audit report on the Iowa Water Pollution Control Works Financing Program (Clean Water Program) and the Iowa Drinking Water Facilities Financing Program (Drinking Water Program), joint programs of the Iowa Finance Authority and the Iowa Department of Natural Resources for the year ended June 30, 2009

Informe del seminari Library and Information Science Education in Europe: "Issues in joint curriculum development and Bologna perspectives" (Copenhaguen, Dinamarca, 11-12 d'agost de 2005)

Els dies 11 i 12 d'agost va tenir lloc a Copenhaguen, Dinamarca, el seminari de treball Library and Information Science Education in Europe: ¿Issues in joint curriculum development and Bologna perspectives¿. Aquest seminari, que va estar coordinat per la Royal School of Library and Information Science de Dinamarca, amb la col·laboració de l'European Association for Library and Information Education and Research (EUCLID), es va organitzar en el marc d'un projecte europeu subvencionat pel programa Sòcrates. La Facultat de Biblioteconomia i Documentació de la Universitat de Barcelona, present entre 2001 i 2005 en la Junta de Govern de l'EUCLID, va participar-hi com a soci del projecte. L'objectiu del seminari era aplegar una cinquantena d'experts europeus de l'àrea de Biblioteconomia i Documentació ¿tots ells professors d'escoles i de facultats d'universitats europees¿ per discutir qüestions relacionades amb els plans d'estudis dels ensenyaments des de la perspectiva del procés de Bolonya. El seminari consistí en dues conferències i en les reunions de treball de dotze grups formats per experts que examinaren dotze grans temes ¿prèviament acordats pels organitzadors de l'esdeveniment¿ relacionats amb els plans d'estudis d'aquells ensenyaments.