Intravitreal ranibizumab for age-related macular degeneration : optical coherence tomography guided retreatment intervals and their intra- and inter-individual variability

Purpose: To determine whether the need for retreatment after an initial phase of 3 monthly intravitreal injections of ranibizumab shows an intra-individual regular rhythm and to what degree it varies between different patients. Methods: Prospective study with 42 patients with exudative AMD, treatment naïve. Loading dose of 3 monthly doses of ranibizumab (0,5 mg), followed by a 12 months pro re nata (PRN) regimen according to early exudative signs on HD-OCT Cirrus, Zeiss. The follow-up visits were intensified (week 4, 5, 6, 7, 8, 10, 12, 14, 16, 20, etc after each injection) in order to detect recurrences early, and injection followed within 3 days in cases of subretinal fluid, cysts, or central thickness increase of>50microns. Intervals were calculated between injections for the 12 month follow-up with PRN treatment. Variability was expressed as standard deviation (SD). Results: Visual acuity (VA) improved from a mean ETDRS score of 61.6 (SD 10.8) at baseline to 68.0 (SD 10.2) at month 3 and to 74.7(SD 9.0) at month 12. The 15 patients who have already completed the study showed maintenance of the VA improvement. Central foveal thickness improved from a mean value of 366 microns (baseline) to 253 microns (month 3), well maintained thereafter. Mean number of injections was 8.8 (SD 3.5,range 0-12) per 12 months of follow-up (after 3 doses), with mean individual treatment-recurrence (TR) intervals ranging from 28->365 days (mean 58). Intraindividual variability of TR intervals (SD) was 7.1 days as a mean value (range 1.7¡V22.6). It ranged within 20% of the mean intra-individual interval for 30 (91%) and within 15% for 21 patients (64%). The first interval was within 1 week of the mean intra-individual interval in 64% and within 2 weeks in 89% of patients. Conclusions: The majority of AMD patients showed a relatively stable rhythm for PRN injections of ranibizumab after initial loading phase, associated with excellent functional/anatomical results. The initial interval last loading dose-first recurrence may have a predictive value for further need of treatment, potentially facilitating follow-up and patient care.

Audit report on the Crawford County Area Solid Waste Agency Commission for the year ended June 30, 2007

Audit report on the Crawford County Area Solid Waste Agency Commission for the year ended June 30, 2007

Audit report on the ADLM Counties Environmental Public Health Agency for the year ended June 30, 2007

Audit report on the ADLM Counties Environmental Public Health Agency for the year ended June 30, 2007

Working with Persons with Disabilities: Title I of The Americans with Disabilities Act: A Guide for State Supervisors and Managers, 2003

What are a supervisor’s responsibilities when it comes to interviewing, hiring, and retaining persons with disabilities? First and foremost, do not discriminate against persons with disabilities. What this means is that you are required to provide the same level of employment consideration and supervision for a disabled employee that you would for an able-bodied employee. No more – no less. State of Iowa management personnel must be proactive with regard to Title I of the Americans with Disabilities Act, and managers and supervisory personnel should have an operational knowledge of the significant aspects of The Americans with Disabilities Act. This manual is for Iowa management personnel to use.

Report on the Shelby County Area Solid Waste Agency for the year ended June 30, 2008

Report on the Shelby County Area Solid Waste Agency for the year ended June 30, 2008

Iowa Department for the Blind Agency Performance Plan

Agency Performance Plan of the Iowa Department for the Blind.

Iowa Civil Rights Commission, Agency Performance Plan and Action Plan, 2006

Annual Report, Agency Performance plan

Iowa Civil Rights Commission, Agency Performance Plan and Action Plan, 2007

Annual Report, Agency Performance plan

Inter- and intra-individual variation of oxytocin secretion in oestrous mares exposed to stallions

The neuro-peptide hormone oxytocin regulates several reproductive mechanisms in mammals, such as uterine contractions during parturition and milk ejection in the lactating mammary gland. Oxytocin may also influence behavior and behavioral strategies, e.g. pair bonding, social recognition, maternal behavior, trust building, or anxiety. Teasing oestrous mares by a stallion provokes the release of oxytocin. We therefore tested whether such elevated oxytocin levels reveal possible mate preferences as determined in typical preference tests.

Agency Performance Plan, Deaf Services Commission of Iowa, FY08 July 1, 2007 – June 30, 2008

Annual Report, Agency Performance Plan

Agency Performance Plan Quarterly Report, April 1 – June 30, 2008

Annual Report, Agency Performance Plan Quarterly Report

Iowa Department for the Blind Agency Performance Plan, 2008

Agency Performance Plan