Audit report on the Central Iowa Juvenile Detention Center in Eldora, Iowa for the year ended June 30, 2009

Audit report on the Central Iowa Juvenile Detention Center in Eldora, Iowa for the year ended June 30, 2009

Mise en place d'un cathéter veineux central chez l'adulte. 1. Indications, précautions et complications [Bases of central venous catheterization]

La pose d'un cathéter veineux central est un geste fréquent dans un service de médecine interne. En suivant la formation des médecins-assistants, nous nous sommes aperçus que certaines questions, doutes ou craintes concernant cette procédure nous sont régulièrement adressées: «Est-ce qu'un cathéter sous-clavier peut être posé avec une thrombocytopénie modérée?»; «Quel site de ponction présente le moins de risques pour le patient?»; «Après combien de jours un cathéter doit-il être changé?». Cet article se propose de répondre à ces questions et à d'autres, en partant d'une mini-revue de la littérature actuelle. Central venous catheterization is a frequently performed procedure in internal medicine units. Residents in training frequently share the same questions, doubts and fears about this procedure : "Should I perform a subclavian catheterization in a patient with mild thrombopenia?"; "Which site has the lesser complication rate?"; "After how long does a catheter need to be replaced?". This mini-review of the current literature tries to answer this and other questions

A selective nociceptive block is not sufficient to prevent central changes after peripheral nerve injury

Background: Providing analgesia without suppressing motor or sensory function is a challenge for regional anesthesia and postoperative pain management. Resiniferatoxin (RTX), an ultrapotent agonist for transient receptor potential subtype-1 (TRPV1) can produce this selective blockade, as TRPV1 is selectively expressed on nociceptors. Futhermore, after peripheral nerve injury, spontaneous ectopic activity arises from all types of nerve fibers that can affect spinal neurons and glial cells. The goal of the present experiment is to determine whether spontaneous activity generated in C-fibers or in both A&C-fibers is required for microglia activation. Method: We applied RTX (0.01%) or bupivacaine microspheres to the sciatic nerve of rats to block the conduction of C-fibers or A&C-fibers, respectively, before spared nerve injury (SNI). Behavior was tested and all the rats were sacrificed 2 days later; immunohistochemistry was performed on their spinal cord for mitogen-activated protein kinase (MAPK) p38, bromodeoxyuridine (BrdU, marker of proliferation) and Iba1 (microglial marker). Result: At day 2 after SNI robust mechanical allodynia and p38 activation in spinal microglia were documented. There was also a substantial cell proliferation in the spinal cord, all proliferating cells (BrdU+) being microglia (Iba1+). RTX blocked heat sensitivity and produced heat hypoalgesia without affecting mechanical allodynia and motor function. Microglial proliferation and p38 activation in the spinal cord were not affected by RTX (p >0.05). In contrast, a complete sensory and motor blockade was seen with bupivacaine which also significantly inhibited p38 activation and microglial proliferation in the spinal cord (p <0.05). Conclusion: We conclude that (1) RTX can provide a selective nociceptive blockade but that (2) blocking only nociceptive fibers does not impair the development of mechanical allodynia and microglia activation. Therefore (3) if microglia activation is important for chronic pain development then specific nociceptive blockade won't be sufficient to prevent it.

Efeito da colheita seletiva de madeira sobre algumas características físicas de um latossolo amarelo sob floresta na Amazônia Central

A colheita seletiva de madeira pode vir a ser uma forma sustentável de uso da terra para ecossistemas florestais da Amazônia, uma vez que permite a manutenção de parte considerável da biomassa florestal, diminuindo, assim, a perturbação nas áreas exploradas. Neste sentido, o presente estudo teve como objetivo avaliar o efeito da exploração seletiva de madeira sobre as características físicas de um Latossolo Amarelo. A área de estudo localiza-se a cerca de 80 km ao norte de Manaus e a vegetação é do tipo Floresta Ombrófila Densa. O número de árvores retiradas com um trator de esteiras D6, por arraste, em 1993, variou de sete a dez árvores/ha (DAP > 55 cm). O delineamento experimental foi do tipo blocos ao acaso, com três repetições. Seis tratamentos foram avaliados, equivalendo às seguintes classes de perturbação identificadas na área: trilha de trator, centro de clareira, borda da clareira/floresta, borda da floresta/clareira, floresta remanescente e floresta-controle. A colheita seletiva de madeira provocou modificações nas características físicas do solo, principalmente nas trilhas de trator, e representou, em média, 13,8 % da área total explorada. Os valores de densidade do solo e resistência à penetração foram maiores para o solo sob estas áreas, enquanto a macroporosidade e o volume de água disponível para as plantas apresentaram-se menores do que nas demais classes de perturbação. Estas classes foram menos afetadas, não se estabelecendo diferenças significativas para as características físicas do solo entre estas e a floresta-controle, indicando, assim, a colheita seletiva como uma prática de menor impacto para o solo dos ecossistemas florestais da Amazônia.

Una nueva concepción de la función del archivo en la Administración. La experiencia del Arxiu Central Administratiu del Departament de Cultura de la Generalitat de Catalunya

A pesar de que todavía se suele identificar al archivero con el profesional que se dedica exclusivamente a la clasificación, descripción y difusión de los documentos históricos o, como mucho, de aquellos que ya han acabado su función administrativa, esta concepción no se corresponde con el trabajo que actualmente desarrolla un número cada vez mayor de expertos.

The Soja and Luzzone-Terri nappes: discovery of a Briançonnais element below the front of the Adula nappe (NE Ticino, Central Alps)

The classical Soja nappe, in NE Ticino, actually consists of two distinct tectonic units with verydifferent stratigraphic contents: (1) The smaller one, in the Val Soi (the type-locality), is by definitionthe Soja unit s.str.. It is pinched between Simano and Adula and consists of various Paleozoic gneissesand a dolomitic Triassic cover analogous to the Triassic of other Lower Penninic nappes. (2) The largerone extends along the Lago di Luzzone and continues eastwards through the Piz Terri mountain. Wename it the Luzzone-Terri nappe. It consists of: (a) a paragneiss series that presents striking similaritieswith the Permian of the Zone Houillère in Valais; (b) a Triassic cover typical of the Briançonnaisdomain where one clearly recognizes the St-Triphon Formation and other characteristic units of theBriançonnais Triassic; (c) a thick series of black calcschists and metapelites of Liassic age, similarto the cover of the neighbouring Gotthard massif. This stratigraphic superposition of a Liassic seriesof Helvetic type on a Briançonnais Triassic is unique in the Alps and has important paleogeographicconsequences. It is difficult to reconcile this observation with speculative reconstructions that proposean original position of the Briançonnais domain far from the Helvetic basins. Morover the Briançonnaischaracter of its Triassic series indicates an ultra-Adula origin of the Luzzone-Terri nappe.

Infection of the central nervous system caused by varicella zoster virus reactivation: a retrospective case series study.

BACKGROUND: Recent data suggest that varicella zoster virus (VZV)-associated complications of the central nervous system (CNS) are more common and diverse than previously thought. The main purpose of this article is to describe the clinical characteristics and the outcome of patients suffering from meningitis and encephalitis caused by VZV reactivation. METHODS: A retrospective case study of adult patients (≥16 years old) diagnosed with a VZV reactivation in the CNS was performed. The cases were identified by a qualitative PCR DNA assay of the cerebrospinal fluid (CSF) at the Regional Hospital of Lugano between January 1, 2003 and July 31, 2010. RESULTS: Eleven out of 519 CSF samples (2.1%), submitted from patients with a clinical diagnosis of viral meningitis or encephalitis, were positive for VZV. A vesiculo-pustular skin eruption was observed in only five patients (45%). In six cases (55%), a systemic inflammatory syndrome was absent. The clinical outcome was favorable in eight patients (73%). Only one out of 11 patients (9%) died. The four patients with encephalitis had a less favorable prognosis: one patient recovered without residual neurological sequelae; two had a chronic neuropsychological handicap, speech difficulties, facial nerve palsy, and focal seizures; one patient died. We estimated an annual incidence rate of VZV infection of the CNS of 1.02/100 000 inhabitants for southern Switzerland. CONCLUSIONS: Screening of CSF for VZV by PCR is recommended for all patients with encephalitis and for those with viral meningitis of unclear origin in order to better target antiviral treatment.

Report on the Iowa Department of Human Services – Central Distribution Center for the year ended June 30, 2009

Report on the Iowa Department of Human Services – Central Distribution Center for the year ended June 30, 2009

Localization and characterization of an active fault in an urbanized area in central Guatemala by means of geoelectrical imaging

The Polochic and Motagua faults define the active plate boundary between the North American and Caribbean plates in central Guatemala. A splay of the Polochic Fault traverses the rapidly growing city of San Miguel Uspantan that is periodically affected by destructive earthquakes. This fault splay was located using a 2D electrical resistivity tomography (ERT) survey that also characterized the fault damage zone and evaluated the thickness and nature of recent deposits upon which most of the city is built. ERT images show the fault as a similar to 50 m wide, near-vertical low-resistivity anomaly, bounded within a few meters by high resistivity anomalies. Forward modeling reproduces the key aspects of the observed electrical resistivity data with remarkable fidelity thus defining the overall location, geometry, and internal structure of the fault zone as well as the affected lithologies. Our results indicate that the city is constructed on a similar to 20 m thick surficial layer consisting of poorly consolidated, highly porous, water-logged pumice. This soft layer is likely to amplify seismic waves and to liquefy upon moderate to strong ground shaking. The electrical conductivity as well as the major element chemistry of the groundwater provides evidence to suggest that the local aquifer might, at least in part, be fed by water rising along the fault. Therefore, the potential threat posed by this fault splay may not be limited to its seismic activity per se, but could be compounded its potential propensity to enhance seismic site effects by injecting water into the soft surficial sediments. The results of this study provide the basis for a rigorous analysis of seismic hazard and sustainable development of San Miguel Uspantan and illustrate the potential of ERT surveying for paleoseismic studies.

The central Sesia-Lanzo zone (Western Italian Alps) - New field observations and lithostratigraphic subdivisions

An extensive study of the central part of the Sesia Lanzo Zone has been undertaken to identify pre-Alpine protoliths and to reconstruct the lithologic and tectonic setting of this part of the Western Alps. Three main complexes have been defined: 1) the Polymetamorphic Basement Complex, corresponding to the lower unit of the Sesia Lanzo Zone after COMPAGNONI et al. (1977), is further subdivided into the three following units: a) an Internal Unit characterized by eo-Alpine high pressure (HP) assemblages (DAL PIAZ et al., 1972) (Eclogitic Micaschists); b) an Intermediate Unit where HP parageneses are partially re-equilibrated under greenschist conditions and c) an External Unit where the main foliation is defined by a greenschist paragenesis (Gneiss Minuti auct.). 2) the Monometamorphic Cover Complex, subdivided into the followings: a) the Bonze Unit, composed of sheared metagabbros, eclogitized metabasalts with MORB geochemical affinity and related metasediments (micaschists, quartzites and Mn-cherts) and b) the Scalaro Unit, containing predominantly metasediments of supposed Permo-Triassic age (yellow dolomitic marbles, calcschists and conglomeratic limestones, micaschists and quartzites with thin levels of basic rocks with within plate basalts [WPB] geochimical affinity). Multiple lithostratigraphic sequences for the Monometamorphic Cover Complex are proposed. The contact between the Bonze and Scalaro Units is defined by repetitions of dolomitic marbles and metabasalts; the ages of the metasediments have been assigned solely by analogy with other sediments of the Western Alps, due to the absence of fossils. The Monometamorphic Cover Complex can be considered as the autochthonous cover of the Sesia Lanzo Zone because of the primary contacts with the basement and because of the presence of preAlpine HT basement blocks in the cover sequences. 3) The pre-Alpine high temperature (HT) Basement Complex (or `'Seconda Zona Diorito-Kinzigitica''), comprises HT Hercynian rocks like kinzigites, amphibolites, granulites and calcite marbles; this Complex is always located between the Internal and the External Units and can be followed continuously for several kilometers south of the Gressoney Valley to the Orco Valley. A schematic evolution for the Sesia Lanzo Zone is proposed; based on available data together with new geochronological data, this study shows that the internal and external parts of the polymetamorphic basement of the Sesia Zone experienced different cooling histories .

Audit report on the South Central Iowa Regional E-911 Service Board for the year ended June 30, 2010

Audit report on the South Central Iowa Regional E-911 Service Board for the year ended June 30, 2010

Report on the Central Iowa Center for Independent Living (CICIL) for the period July 1, 2008 through June 30, 2009

Report on the Central Iowa Center for Independent Living (CICIL) for the period July 1, 2008 through June 30, 2009

Central Horner's syndrome with contralateral ataxic hemiparesis: a diencephalic alternate syndrome.

OBJECTIVE: To assess whether thalamic strokes presenting with a central Horner's syndrome (HS) show specific clinicoanatomic patterns. METHODS: From the Lausanne Stroke Registry (period 1993 to spring 2002), the authors selected all patients with thalamic stroke presenting with ipsilateral HS. Patients with complete infarction of the posterior cerebral artery territory, with involvement of middle cerebral artery territory or bilateral lesions, were excluded. Lesions on brain MRI were correlated with standard neuroanatomic templates. RESULTS: Nine patients with thalamic infarction presenting with central HS were found; all showed contralateral ataxic hemiparesis (AH). Lesions involved the anterior or paramedian thalamus and extended to the hypothalamic or rostral paramedian mesencephalic area in all but one subject. Associated clinical signs included dysphasia (two patients), somnolence (six), vertical gaze paresis (two), asterixis (two), and hemihypesthesia (three). CONCLUSION: The alternate clinical pattern of central HS with contralateral AH is a stroke syndrome of the diencephalic-mesencephalic junction, resulting from the involvement of the common arterial supply to the paramedian/anterior thalamus, the posterior hypothalamus and the rostral paramedian midbrain.

Audit report on the Honey Creek Resort Operations Account maintained by Central Group Management, LLC for the year ended June 30, 2010

Audit report on the Honey Creek Resort Operations Account maintained by Central Group Management, LLC for the year ended June 30, 2010