985 resultados para Middle Paleolithic period
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Report on a review of selected application controls over the Iowa Department of Transportation’s Driver’s License System for the period May 2, 2011 through May 27, 2011
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Report on a special investigation of the Sunrise Sunset Daycare of the Southeast Warren Community School District for the period September 1, 2010 through September 26, 2011
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Report on a review of selected application controls over the Iowa State University of Science and Technology Facilities Planning and Management - Facilities Administrative Management Information System for the period of April 18, 2011 through May 16, 2011
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Report on a special investigation of the Starmont Community School District for the period July 1, 1993 through November 30, 2010
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Report on a review of selected general and application controls over the Iowa Department of Human Services’ Medicaid Management Information System for the period April 4, 2011 through April 29, 2011
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Agreed upon procedures report on the six Library Service Areas in the State of Iowa for the period July 1, 2010 through June 30, 2011
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Agreed upon procedures report on the Lee County Narcotics Task Force for the period July 1, 2010 through May 31, 2012
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BACKGROUND: The risk of falls is the most commonly cited reason for not providing oral anticoagulation, although the risk of bleeding associated with falls on oral anticoagulants is still debated. We aimed to evaluate whether patients on oral anticoagulation with high falls risk have an increased risk of major bleeding. METHODS: We prospectively studied consecutive adult medical patients who were discharged on oral anticoagulants. The outcome was the time to a first major bleed within a 12-month follow-up period adjusted for age, sex, alcohol abuse, number of drugs, concomitant treatment with antiplatelet agents, and history of stroke or transient ischemic attack. RESULTS: Among the 515 enrolled patients, 35 patients had a first major bleed during follow-up (incidence rate: 7.5 per 100 patient-years). Overall, 308 patients (59.8%) were at high risk of falls, and these patients had a nonsignificantly higher crude incidence rate of major bleeding than patients at low risk of falls (8.0 vs 6.8 per 100 patient-years, P=.64). In multivariate analysis, a high falls risk was not statistically significantly associated with the risk of a major bleed (hazard ratio 1.09; 95% confidence interval, 0.54-2.21). Overall, only 3 major bleeds occurred directly after a fall (incidence rate: 0.6 per 100 patient-years). CONCLUSIONS: In this prospective cohort, patients on oral anticoagulants at high risk of falls did not have a significantly increased risk of major bleeds. These findings suggest that being at risk of falls is not a valid reason to avoid oral anticoagulants in medical patients.
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BACKGROUND: Patients with venous thromboembolism (VTE) treated with anticoagulants are at risk of death from pulmonary embolism (PE) and/or bleeding. However, whether patients who develop VTE in hospital have a higher complication rate than those who develop VTE in an outpatient setting is unclear. PATIENTS AND METHODS: RIETE is an ongoing, prospective registry of consecutive patients with acute, objectively confirmed, symptomatic VTE. We compared the 3-month incidence of fatal PE and fatal bleeding in patients in whom the VTE had developed while in hospital for another medical condition (inpatients) with those who presented to the emergency ward because of VTE (outpatients). RESULTS: Up to April 2008, 22,133 patients with acute VTE were enrolled: 10,461 (47%) presented with PE, 11,672 with deep vein thrombosis. Overall, 6445 (29%) were inpatients. During the study period, those who developed VTE as inpatients had a significantly higher incidence of fatal PE (2.1% vs. 1.5%; odds ratio: 1.4; 95% CI: 1.1-1.7), overall death (7.0% vs. 5.4%; odds ratio: 1.3; 95% CI: 1.2-1.5), and major bleeding (2.9% vs. 2.1%; odds ratio: 1.4; 95% CI: 1.1-1.6) than outpatients. The incidence of fatal bleeding was not significantly increased (0.7% vs. 0.5%; odds ratio: 1.2; 95% CI: 0.9-1.8). In multivariable analysis, inpatient status was significantly associated with a higher risk for fatal PE (odds ratio: 1.3; 95% CI: 1.1-1.7). CONCLUSIONS: VTE occurring in hospitalized patients carries a significantly higher risk for death of PE than in outpatients, underscoring the importance of VTE prevention strategies in the hospital setting.
Special investigation of the City of Scarville for the period January 1, 2006 through March 31, 2011
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Special investigation of the City of Scarville for the period January 1, 2006 through March 31, 2011
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Report on applying agreed-upon procedures of Kossuth Connections, Algona, Iowa, and the Iowa Commission on Volunteer Services within the Iowa Department of Economic Development, now known as the Iowa Economic Development Authority, for the period October 2010 through June 2011
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Report on the Chariton Valley Planning & Development Council of Governments for the period July 1, 2007 through August 31, 2010
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Report on a special investigation of the City of Bloomfield Volunteer Fire Department for the period July 1, 2006 through June 30, 2010
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Report on a special investigation of the Mills County Treasurer’s Office for the period January 1, 2005 through March 31, 2011
