Efficacy and safety of a phospholipid emulsion (GR270773) in Gram-negative severe sepsis: results of a phase II multicenter, randomized, placebo-controlled, dose-finding clinical trial.

OBJECTIVE: To assess the survival benefit and safety profile of low-dose (850 mg/kg) and high-dose (1350 mg/kg) phospholipid emulsion vs. placebo administered as a continuous 3-day infusion in patients with confirmed or suspected Gram-negative severe sepsis. Preclinical and ex vivo studies show that lipoproteins bind and neutralize endotoxin, and experimental animal studies demonstrate protection from septic death when lipoproteins are administered. Endotoxin neutralization correlates with the amount of phospholipid in the lipoprotein particles. DESIGN: A three-arm, randomized, blinded, placebo-controlled trial. SETTING: Conducted at 235 centers worldwide between September 2004 and April 2006. PATIENTS: A total of 1379 patients participated in the study, 598 patients received low-dose phospholipid emulsion, and 599 patients received placebo. The high-dose phospholipid emulsion arm was stopped, on the recommendation of the Independent Data Monitoring Committee, due to an increase in life-threatening serious adverse events at the fourth interim analysis and included 182 patients. MEASUREMENTS AND MAIN RESULTS: A 28-day all-cause mortality and new-onset organ failure. There was no significant treatment benefit for low- or high-dose phospholipid emulsion vs. placebo for 28-day all-cause mortality, with rates of 25.8% (p = .329), 31.3% (p = .879), and 26.9%, respectively. The rate of new-onset organ failure was not statistically different among groups at 26.3%, 31.3%, 20.4% with low- and high-dose phospholipid emulsion, and placebo, respectively (one-sided p = .992, low vs. placebo; p = .999, high vs. placebo). Of the subjects treated, 45% had microbiologically confirmed Gram-negative infections. Maximal changes in mean hemoglobin levels were reached on day 10 (-1.04 g/dL) and day 5 (-1.36 g/dL) with low- and high-dose phospholipid emulsion, respectively, and on day 14 (-0.82 g/dL) with placebo. CONCLUSIONS: Treatment with phospholipid emulsion did not reduce 28-day all-cause mortality, or reduce the onset of new organ failure in patients with suspected or confirmed Gram-negative severe sepsis.

Besoins, prescriptions et sécurité des produits sanguins labiles ; autosuffisance en produits sanguins labiles [Roundtables of SFTS Congress 2013: Needs, indications and safety of blood products; self-sufficiency in blood products].

The current issues debate brings together experts around the themes of self-sufficiency (in its national and European aspects) and of needs in cellular blood products. The point of view of the manufacturer and prescribers of blood products are confronted.

Squamous-cell carcinoma arising in a non-irradiated child with recurrent respiratory papillomatosis.

We describe a patient with recurrent respiratory papillomatosis (RRP) associated with human papilloma virus (HPV), who developed a fatal squamous cell carcinoma of the lung. At the age of 1 year he presented with hoarseness, dyspnoea and inspiratory stridor but the diagnosis of RRP was made only 1 year later. At the age of 4 years he was tracheostomized because of upper airway obstruction. In spite of multiple surgical excisions and topic treatment with 5-fluorouracil the papillomata extended to the lung parenchyma. At the age of 16 years he developed a squamous-cell carcinoma of the lung and died 4 months later. Transformation to pulmonary carcinoma is a rare complication in non-irradiated patients with lung papillomatosis. We found only 11 similar cases in the literature.

Improving Traffic Safety Culture in Iowa, 2011

Vehicle crashes rank among the leading causes of death in the United States. In 2006, the AAA Foundation for Traffic Safety “made a long- term commitment to address the safety culture of the United States, as it relates to traffic safety, by launching a sustained research and educational outreach initiative.” An initiative to produce a culture of safety in Iowa includes the Iowa Comprehensive Highway Safety Plan (CHSP). The Iowa CHSP “engages diverse safety stakeholders and charts the course for the state, bringing to bear sound science and the power of shared community values to change the culture and achieve a standard of safer travel for our citizens.” Despite the state’s ongoing efforts toward highway safety, an average of 445 deaths and thousands of injuries occur on Iowa’s public roads each year. As such, a need exists to revisit the concept of safety culture from a diverse, multi-disciplinary perspective in an effort to improve traffic safety. This study summarizes the best practices and effective laws in improving safety culture in the United States and abroad. Additionally, this study solicited the opinions of experts in public health, education, law enforcement, public policy, social psychology, safety advocacy, and traffic safety engineering in a bid to assess the traffic safety culture initiatives in Iowa. Recommendations for improving traffic safety culture are offered in line with the top five Iowa CHSP safety policy strategies, which are young drivers, occupant protection, motorcycle safety, traffic safety enforcement and traffic safety improvement program, as well as the eight safety program strategies outlined in the CHSP. As a result of this study, eleven high-level goals were developed, each with specific actions to support its success. The goals are: improve emergency medical services response, toughen law enforcement and prosecution, increase safety belt use, reduce speeding-related crashes, reduce alcohol-related crashes, improve commercial vehicle safety, improve motorcycle safety, improve young driver education, improve older driver safety, strengthen teenage licensing process, and reduce distracted driving.

Improving Safety for Slow Moving Vehicles on Iowa's High-Speed Rural Roadways, TR-572, 2009

Among the variety of road users and vehicle types that travel on U.S. public roadways, slow moving vehicles (SMVs) present unique safety and operations issues. SMVs include vehicles that do not maintain a constant speed of 25 mph, such as large farm equipment, construction vehicles, or horse-drawn buggies. Though the number of crashes involving SMVs is relatively small, SMV crashes tend to be severe. Additionally, SMVs can be encountered regularly on non-Interstate/non-expressway public roadways, but motorists may not be accustomed to these vehicles. This project was designed to improve transportation safety for SMVs on Iowa’s public roadway system. This report includes a literature review that shows various SMV statistics and laws across the United States, a crash study based on three years of Iowa SMV crash data, and recommendations from the SMV community.

Les fentes labio-palatines: suivi psychologique et investissement de l'enfant dans sa famille [The cleft lip and palate: psychological following child and family investment].

Congrès de la Société Française de Pédiatrie et de l'Association des Pédiatres de Langue Française (APLF)

The State Report Card for No Child Left Behind Iowa Department of Education, December 2011

The No Child Left Behind Act (NCLB) of 2001 requires each state to provide an annual report card to inform stakeholders and the public about the progress of students and schools on indicators of student achievement and other information that relates to student success. The State Report Card provides state level data to serve as a comparison for schools and districts as they consider and implement improvement efforts to increase the success for all Iowa students.

The State Report Card for No Child Left Behind Iowa Department of Education, September 2014

The No Child Left Behind Act (NCLB) of 2001 requires each state to provide an annual report card to inform stakeholders and the public about the progress of students and schools on indicators of student achievement and other information that relates to student success. The State Report Card provides state level data to serve as a comparison for schools and districts as they consider and implement improvement efforts to increase the success for all Iowa students.

The State Report Card for No Child Left Behind Iowa Department of Education, August 2004

The No Child Left Behind Act (NCLB) of 2001 requires each state to provide an annual report card to inform stakeholders and the public about the progress of students and schools on indicators of student achievement and other information that relates to student success. The State Report Card provides state level data to serve as a comparison for schools and districts as they consider and implement improvement efforts to increase the success for all Iowa students.

The State Report Card for No Child Left Behind Iowa Department of Education, September 2009

The No Child Left Behind Act (NCLB) of 2001 requires each state to provide an annual report card to inform stakeholders and the public about the progress of students and schools on indicators of student achievement and other information that relates to student success. The State Report Card provides state level data to serve as a comparison for schools and districts as they consider and implement improvement efforts to increase the success for all Iowa students.

The State Report Card for No Child Left Behind Iowa Department of Education, August 2005

The No Child Left Behind Act (NCLB) of 2001 requires each state to provide an annual report card to inform stakeholders and the public about the progress of students and schools on indicators of student achievement and other information that relates to student success. The State Report Card provides state level data to serve as a comparison for schools and districts as they consider and implement improvement efforts to increase the success for all Iowa students.

The State Report Card for No Child Left Behind Iowa Department of Education, September 2012

The No Child Left Behind Act (NCLB) of 2001 requires each state to provide an annual report card to inform stakeholders and the public about the progress of students and schools on indicators of student achievement and other information that relates to student success. The State Report Card provides state level data to serve as a comparison for schools and districts as they consider and implement improvement efforts to increase the success for all Iowa students.

The State Report Card for No Child Left Behind Iowa Department of Education, September 2013

The No Child Left Behind Act (NCLB) of 2001 requires each state to provide an annual report card to inform stakeholders and the public about the progress of students and schools on indicators of student achievement and other information that relates to student success. The State Report Card provides state level data to serve as a comparison for schools and districts as they consider and implement improvement efforts to increase the success for all Iowa students.

The State Report Card for No Child Left Behind Iowa Department of Education, September 2010

The No Child Left Behind Act (NCLB) of 2001 requires each state to provide an annual report card to inform stakeholders and the public about the progress of students and schools on indicators of student achievement and other information that relates to student success. The State Report Card provides state level data to serve as a comparison for schools and districts as they consider and implement improvement efforts to increase the success for all Iowa students.