University of Iowa Hospitals and Clinics

About: University of Iowa Hospitals and Clinics is a healthcare organization based out in Iowa City, Iowa, United States. It is known for research contribution in the topics: Population & Medicine. The organization has 7201 authors who have published 9476 publications receiving 276995 citations. The organization is also known as: University of Iowa Hospitals & Clinics.

Obesity Adversely Affects Survival in Pancreatic Cancer Patients

Abstract: BACKGROUND: Higher body-mass index (BMI) has been implicated as a risk factor for developing pancreatic cancer, but its effect on survival has not been thoroughly investigated. The authors assessed the association of BMI with survival in a sample of pancreatic cancer patients and used epidemiologic and clinical information to understand the contribution of diabetes and hyperglycemia. METHODS: A survival analysis using Cox proportional hazards by usual adult BMI was performed on 1861 unselected patients with pancreatic adenocarcinoma; analyses were adjusted for covariates that included clinical stage, age, and sex. Secondary analyses incorporated self-reported diabetes and fasting blood glucose in the survival model. RESULTS: BMI as a continuous variable was inversely associated with survival from pancreatic adenocarcinoma (hazard ratio [HR], 1.019 for each increased unit of BMI [kg/m2], P < .001) after adjustment for age, stage, and sex. In analysis by National Institutes of Health BMI category, BMIs of 30 to 34.99 kg/m2 (HR, 1.14; 95% confidence interval [CI], 0.98-1.33), 35 to 39.99 kg/m2 (HR 1.32, 95% CI 1.08-1.62), and ≥40 (HR 1.60, 95% CI 1.26-2.04) were associated with decreased survival compared with normal BMI of 18.5 to 24.99 kg/m2 (overall trend test P < .001). Fasting blood glucose and diabetes did not affect the results. CONCLUSIONS: Higher BMI is associated with decreased survival in pancreatic cancer. Although the mechanism of this association remains undetermined, diabetes and hyperglycemia do not appear to account for the observed association. Cancer 2010. © 2010 American Cancer Society.

MDCT in the evaluation of skeletal trauma: principles, protocols and clinical applications.

Abstract: Multidetector computed tomography (MDCT) scanners have made volume imaging possible and are used extensively to study polytrauma patients, especially in the evaluation of the spine and peripheral skeleton. An MDCT scanner coupled with a modern workstation has become an essential diagnostic tool for any emergency department. Familiarity with the basic physical principles of MDCT such as projection data, section collimation, and beam collimation is important to achieve high-quality imaging while keeping unnecessary radiation to a minimum. After a polytrauma MDCT examination, images can be reconstructed to obtain different slice thickness, slice interval, fields of view, or reconstruction kernels. No additional scanning is needed for imaging the thoracolumbar spine or bony pelvis. High-quality multiplanar reformation (MPR) and three-dimensional (3-D) images can be created at the workstation using the volumetric data. However, MDCT is a high-dose examination, and care should be taken to use as low a dose as possible. In the musculoskeletal system, MDCT has long been used for evaluation of spinal and pelvic trauma; however, the frequency of its use in extremity trauma has been low. In the extremities, radiography seems to underestimate the extent and severity of injury, especially in complex areas such as the shoulder, elbow, wrist, knee, and ankle. MDCT in the extremities is helpful in fracture detection, evaluation, characterization, and treatment planning. The MPR images give excellent structural detail, and the 3-D images help in understanding the spatial relations, which is important for fracture classification and for preoperative planning. MDCT is also helpful in the follow-up of postoperative results, even in the presence of hardware. Tendon injuries can also be evaluated with MDCT.

Factors Affecting Tracking of Coronary Heart Disease Risk Factors in Childrena

Abstract: The public health implications of reducing or preventing the excess increase in blood pressure and the acquisition of obesity during childhood years are important. Many children with high blood pressure, particularly those who are initially obese or become obese as young adults and those with excess left ventricular mass for body size, become adults with high blood pressure. Although blood pressure and cholesterol have been shown to track during childhood and from childhood into the adult years, the use of repeated determinations along with measures of obesity and information concerning family history of diabetes and coronary heart disease can significantly add to the prediction of future elevated levels.

Tertiary microvascular territories define lacunar infarcts in the basal ganglia

Abstract: Lacunar infarcts are commonly found in the basal ganglia, though little is known about the organization of small-scale microvascular territories that presumably subtend lacunae. We investigated microvascular territories of the lenticulostriate arteries, the recurrent artery of Heubner, the anterior choroidal artery, and striate branches of the anterior cerebral and anterior communicating arteries in perfusion-fixed human brains by simultaneous injection of fluorescent dyes and a radio-opaque substance in 5% gelatin. Territories were defined by ultraviolet illumination of dye and high-resolution mammography of radio-opaque substance. Brains were sectioned coplanar with the Talairach proportional grid system and vascular data were plotted, allowing for application to any human brain. The data suggest first that the lenticulostriate artery, recurrent artery of Heubner, and anterior choroidal artery supply distinct territories of the basal ganglia with minimal overlap and sparse anastomoses between major penetrating vessels. Individual territories are spatially consistent across brains and match the extent of major/minor infarcts. Second, branching patterns of parental, second-, and third-order vessels leading to circumscribed terminal vascular beds could account structurally for "lacunar" infarcts.