Agreed-upon procedures report on the City of Manly, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Manly, Iowa for the period July 1, 2014 through June 30, 2015

Report on a special investigation of the City of Dubuque Carnegie-Stout Public Library for the period July 1, 2008 through April 24, 2014

Report on a special investigation of the City of Dubuque Carnegie-Stout Public Library for the period July 1, 2008 through April 24, 2014

Impact of restrictive intravenous fluid replacement and combined epidural analgesia on perioperative volume balance and renal function within a Fast Track program.

BACKGROUND AND OBJECTIVE: Key factors of Fast Track (FT) programs are fluid restriction and epidural analgesia (EDA). We aimed to challenge the preconception that the combination of fluid restriction and EDA might induce hypotension and renal dysfunction. METHODS: A recent randomized trial (NCT00556790) showed reduced complications after colectomy in FT patients compared with standard care (SC). Patients with an effective EDA were compared with regard to hemodynamics and renal function. RESULTS: 61/76 FT patients and 59/75 patients in the SC group had an effective EDA. Both groups were comparable regarding demographics and surgery-related characteristics. FT patients received significantly less i.v. fluids intraoperatively (1900 mL [range 1100-4100] versus 2900 mL [1600-5900], P < 0.0001) and postoperatively (700 mL [400-1500] versus 2300 mL [1800-3800], P < 0.0001). Intraoperatively, 30 FT compared with 19 SC patients needed colloids or vasopressors, but this was statistically not significant (P = 0.066). Postoperative requirements were low in both groups (3 versus 5 patients; P = 0.487). Pre- and postoperative values for creatinine, hematocrit, sodium, and potassium were similar, and no patient developed renal dysfunction in either group. Only one of 82 patients having an EDA without a bladder catheter had urinary retention. Overall, FT patients had fewer postoperative complications (6 versus 20 patients; P = 0.002) and a shorter median hospital stay (5 [2-30] versus 9 d [6-30]; P< 0.0001) compared with the SC group. CONCLUSIONS: Fluid restriction and EDA in FT programs are not associated with clinically relevant hemodynamic instability or renal dysfunction.

Agreed-upon procedures report on the City of Riverdale, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Riverdale, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Joice, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Joice, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Martensdale, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Martensdale, Iowa for the period July 1, 2014 through June 30, 2015

Report on a special investigation of the City of Lakota for the period July 1, 2013 through May 31, 2015

Report on a special investigation of the City of Lakota for the period July 1, 2013 through May 31, 2015

Report on the Status of Findings and Recommendations from the City of Cambridge’s Periodic Examination Report dated September 5, 2014 for the period June 1, 2015 through November 30, 2015

Report on the Status of Findings and Recommendations from the City of Cambridge’s Periodic Examination Report dated September 5, 2014 for the period June 1, 2015 through November 30, 2015

Report on a special investigation of the City of Boyden for the period July 1, 2013 through April 30, 2015

Report on a special investigation of the City of Boyden for the period July 1, 2013 through April 30, 2015

Agreed-upon procedures report on the City of Lansing, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Lansing, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Monroe, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Monroe, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Princeton, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Princeton, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Moravia, Iowa for the period July 1, 2014 through June 30, 2015

Agreed-upon procedures report on the City of Moravia, Iowa for the period July 1, 2014 through June 30, 2015

An age-period-cohort analysis of gastric cancer mortality from 1950 to 2007 in Europe.

PURPOSE: To analyze the components of the favorable trends in gastric cancer in Europe. METHODS: From official certified deaths from gastric cancer and population estimates for 42 countries of the European geographical region, during the period 1950 to 2007, age-standardized death rates (World Standard Population) were computed, and an age-period-cohort analysis was performed. RESULTS: Central and Northern countries with lower rates in the 2005 to 2007 period, such as France (5.28 and 1.93/100,000, men and women respectively) and Sweden (4.49 and 2.21/100,000), had descending period and cohort effects that decreased steeply from the earliest cohorts until those born in the 1940s, to then stabilize. Former nonmarket economy countries had mortality rates greater than 20/100,000 men and 10/100,000 women, and displayed a later start in the cohort effect fall, which continued in the younger cohorts. Mortality remained high in some countries of Southern and Eastern Europe. CONCLUSIONS: The decrease in gastric cancer mortality was observed in both cohort and period effects but was larger in the cohorts, suggesting that the downward trends are likely to persist in countries with higher rates. In a few Western countries with very low rates an asymptote appears to have been reached for cohorts born after the 1940s, particularly in women.

Molecular epidemiology of Pseudomonas aeruginosa in intensive care units over a 10-year period (1998-2007).

Pseudomonas aeruginosa is one of the leading nosocomial pathogens in intensive care units (ICUs). The source of this microorganism can be either endogenous or exogenous. The proportion of cases as a result of transmission is still debated, and its elucidation is important for implementing appropriate control measures. To understand the relative importance of exogenous vs. endogenous sources of P. aeruginosa, molecular typing was performed on all available P. aeruginosa isolated from ICU clinical and environmental specimens in 1998, 2000, 2003, 2004 and 2007. Patient samples were classified according to their P. aeruginosa genotypes into three categories: (A) identical to isolate from faucet; (B) identical to at least one other patient sample and not found in faucet; and (C) unique genotype. Cases in categories A and B were considered as possibly exogenous, and cases in category C as possibly endogenous. A mean of 34 cases per 1000 admissions per year were found to be colonized or infected by P. aeruginosa. Higher levels of faucet contamination were correlated with a higher number of cases in category A. The number of cases in category B varied from 1.9 to 20 cases per 1000 admissions. This number exceeded 10/1000 admissions on three occasions and was correlated with an outbreak on one occasion. The number of cases considered as endogenous (category C) was stable and independent of the number of cases in categories A and B. The present study shows that repeated molecular typing can help identify variations in the epidemiology of P. aeruginosa in ICU patients and guide infection control measures.