Long-term sequelae in children surviving adult respiratory distress syndrome.

Nine children surviving severe adult respiratory distress syndrome were studied 0.9 to 4.2 years after the acute illness. They had received artificial ventilation for a mean of 9.4 days, with an Fio2 greater than 0.5 during a mean time of 34 hours and maximal positive end expiratory pressure levels in the range of 8 to 20 cm H2O. Three children had recurrent respiratory symptoms (moderate exertional dyspnea and cough), and two had evidence of fibrosis on chest radiographs. All patients had abnormal lung function; the most prominent findings were ventilation inequalities, as judged by real-time moment ratio analysis of multibreath nitrogen washout curves (abnormal in eight of nine patients) and hypoxemia (seven of nine). Lung volumes were less abnormal; one patient had restrictive and two had obstructive disease. A significant correlation between intensive care measures (Fio2 greater than 0.5 in hours and peak inspiratory plateau pressure) and lung function abnormalities (moment ratio analysis and hypoxemia) was found. A possibly increased susceptibility of the pediatric age group to the primary insult or respiratory therapy of adult respiratory distress syndrome is suggested.

Innovative Outstanding Weatherization Assistance News October 2005, Vol.3, no.4

This is a quarterly newsletter for the Iowa Weatherization Program. The purpose of the newsletter is to share with you information on all aspects of the program as well as spotlight a couple of agencies in each issue. We will provide information on upcoming events, training schedules, monitoring schedules and general news about the program. There will be a section of questions we have received from you and the answers provided.

Innovative Outstanding Weatherization Assistance News January 2006, Vol.4, no.1

This is a quarterly newsletter for the Iowa Weatherization Program. The purpose of the newsletter is to share with you information on all aspects of the program as well as spotlight a couple of agencies in each issue. We will provide information on upcoming events, training schedules, monitoring schedules and general news about the program. There will be a section of questions we have received from you and the answers provided.

Innovative Outstanding Weatherization Assistance News April 2006, Vol.4, no.2

This is a quarterly newsletter for the Iowa Weatherization Program. The purpose of the newsletter is to share with you information on all aspects of the program as well as spotlight a couple of agencies in each issue. We will provide information on upcoming events, training schedules, monitoring schedules and general news about the program. There will be a section of questions we have received from you and the answers provided.

Innovative Outstanding Weatherization Assistance News July 2006, Vol. 4, no. 3

This is a quarterly newsletter for the Iowa Weatherization Program. The purpose of the newsletter is to share with you information on all aspects of the program as well as spotlight a couple of agencies in each issue. We will provide information on upcoming events, training schedules, monitoring schedules and general news about the program. There will be a section of questions we have received from you and the answers provided.

Innovative Outstanding Weatherization Assistance News October 2006, Vol. 4, no. 4

This is a quarterly newsletter for the Iowa Weatherization Program. The purpose of the newsletter is to share with you information on all aspects of the program as well as spotlight a couple of agencies in each issue. We will provide information on upcoming events, training schedules, monitoring schedules and general news about the program. There will be a section of questions we have received from you and the answers provided.

Innovative Outstanding Weatherization Assistance News January 2007, Vol. 5, no. 1

This is a quarterly newsletter for the Iowa Weatherization Program. The purpose of the newsletter is to share with you information on all aspects of the program as well as spotlight a couple of agencies in each issue. We will provide information on upcoming events, training schedules, monitoring schedules and general news about the program. There will be a section of questions we have received from you and the answers provided.

Innovative Outstanding Weatherization Assistance News July 2007, Vol. 5, no. 3

This is a quarterly newsletter for the Iowa Weatherization Program. The purpose of the newsletter is to share with you information on all aspects of the program as well as spotlight a couple of agencies in each issue. We will provide information on upcoming events, training schedules, monitoring schedules and general news about the program. There will be a section of questions we have received from you and the answers provided.

Innovative Outstanding Weatherization Assistance News, October 2007, Vol. 5, no. 4

This is a quarterly newsletter for the Iowa Weatherization Program. The purpose of the newsletter is to share with you information on all aspects of the program as well as spotlight a couple of agencies in each issue. We will provide information on upcoming events, training schedules, monitoring schedules and general news about the program. There will be a section of questions we have received from you and the answers provided.

Innovative Outstanding Weatherization Assistance News, January 2008, Vol. 1, no. 1

This is a quarterly newsletter for the Iowa Weatherization Program. The purpose of the newsletter is to share with you information on all aspects of the program as well as spotlight a couple of agencies in each issue. We will provide information on upcoming events, training schedules, monitoring schedules and general news about the program. There will be a section of questions we have received from you and the answers provided.

Innovative Outstanding Weatherization Assistance News, January 2009, Vol. 7, no. 1

This is a quarterly newsletter for the Iowa Weatherization Program. The purpose of the newsletter is to share with you information on all aspects of the program as well as spotlight a couple of agencies in each issue. We will provide information on upcoming events, training schedules, monitoring schedules and general news about the program. There will be a section of questions we have received from you and the answers provided.

Innovative Outstanding Weatherization Assistance News, April 2008, Vol. 6, no. 2

This is a quarterly newsletter for the Iowa Weatherization Program. The purpose of the newsletter is to share with you information on all aspects of the program as well as spotlight a couple of agencies in each issue. We will provide information on upcoming events, training schedules, monitoring schedules and general news about the program. There will be a section of questions we have received from you and the answers provided.

Innovative Outstanding Weatherization Assistance News, July 2008, Vol. 6, no. 3

This is a quarterly newsletter for the Iowa Weatherization Program. The purpose of the newsletter is to share with you information on all aspects of the program as well as spotlight a couple of agencies in each issue. We will provide information on upcoming events, training schedules, monitoring schedules and general news about the program. There will be a section of questions we have received from you and the answers provided.

Innovative Outstanding Weatherization Assistance News, October 2008, Vol. 6, no. 4

This is a quarterly newsletter for the Iowa Weatherization Program. The purpose of the newsletter is to share with you information on all aspects of the program as well as spotlight a couple of agencies in each issue. We will provide information on upcoming events, training schedules, monitoring schedules and general news about the program. There will be a section of questions we have received from you and the answers provided.

TRENDS IN HOSPITAL MANAGEMENT OF ACUTE MYOCARDIAL INFARCTION IN SWITZERLAND, 1998 TO 2008 THE REGION MAKES THE DIFFERENCE: DISPARITIES IN MANAGEMENT OF ACUTE MYOCARDIAL INFARCTION WITHIN SWITZERLAND

The aim of this master's thesis was to assess the ten- year trends and regional differences in management and outcome of acute myocardial infarction (AMI) within Switzerland. The thesis is composed of two articles. First, in the article "Trends in hospital management of acute myocardial infarction in Switzerland, 1998 to 2008" over 102,700 cases of AMI with corresponding management and revascularization procedures were assessed. The results showed a considerable increase in the numbers of hospital discharges for AMI, namely due to the increase of between- hospital transfers. Rates of intensive care unit admissions remained stable. All types of revascularization procedures showed an increase. In particular, overall stenting rates increased with drug-eluting stents partly replacing bare stents. Second, in the article "The region makes the difference: disparities in management of acute myocardial infarction within Switzerland" around 25,600 cases of AMI with corresponding management were assessed for the period of 2007-2008 and according to seven Swiss regions. As reported by our results, considerable regional differences in AMI management were stated within Switzerland. Although each region showed different trends regarding revascularization interventions, Leman and Ticino contrast significantly by presenting the minimum and maximum rates in almost all assessed parameters. As a consequence these two regions differ the most from the Swiss average. The impact of the changes in trends and the regional differences in AMI management on Swiss patient's outcome and economics remains to be assessed. Purpose: To assess ten-year trends in management and outcome of acute myocardial infarction (AMI) in Switzerland. Methods: Swiss hospital discharge database for the 1998 to 2008 period. AMI was defined as a primary discharge diagnosis code I21 according to the CIM-10 classification of the World Health Organization. Management and revascularization procedures were assessed. Results: Overall, 102,729 hospital discharges with a diagnosis of AMI were analyzed. The number of hospital discharges increased almost three-fold from 5530 in 1998 to 13,834 in 2008, namely due to a considerable increase in between-hospital transfers (1352 in 1998, 6494 in 2008). Relative to all hospital discharges, Intensive Care Unit admission rate was 38.0% in 1998 and remained stable (36.2%) in 2008 (p for trend=0.25). Percutaneous revascularization rates increased from 6.0% to 39.9% (p for trend<0.001). Non-drug-eluting stent use increased from 1.3% to 16.6% (p for trend<0.05). Drug eluting stents appeared in 2004 and increased to 23.5% of hospital discharges in 2008 (p for trend=0.07). Coronary artery bypass graft increased from 1.0% to 3.0% (p for trend<0.001). Circulatory assistance increased from 0.2% to 1.7% (p for trend<0.001). Thrombolysis showed no significant changes, from 0.5% to 1.9% (p for trend=0.64). Most of these trends were confirmed after multivariate adjustment. Conclusion: Between 1998 and 2008 the number of hospital discharges for AMI increased considerably in Switzerland, namely due to between-hospital transfers. Overall stenting rates increased, drug-eluting stents partly replacing bare stents. The impact of these changes on outcome and economics remains to be assessed.