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.

Prospective analysis of nosocomial infection rates, antibiotic use, and patterns of resistance in a burn population.

Abstract: Despite significant advances in burn care, infection remains a major cause of morbidity and mortality in burn patients. We sought to determine accurate infection rates, risk factors for infection, and the percentage of infections caused by resistant organisms. In addition, we attempted to identify interventions to decrease the use of antimicrobial drugs. Data were collected prospectively from 157 burn patients admitted to the University of Iowa Carver College of Medicine burn treatment center from October 2001 to October 2002. A research assistant reviewed the medical record for each patient identified by burn surgeons as being infected to determine whether these episodes met the infection control criteria for nosocomial infections. The infection control assessment agreed with the surgeon's assessment for 16.7% of the pneumonias, 70.0% of the burn wound infections, 57.1% of the urinary tract infections, and 70.0% of the bloodstream infections. By multiple logistic regression analysis, body surface area burned, comorbidities, and use of invasive devices were significantly related to acquisition of nosocomial infections as identified by both the burn surgeons and the infection control criteria. Staphylococcus aureus and Pseudomonas were the most common resistant organisms identified. In our population, surgeons could decrease antimicrobial use by using explicit criteria for identifying patients with hospital-acquired infections, limiting perioperative prophylaxis to patients at highest risk of infection, and decreasing the incidence of nosocomial infection with reduced use of devices and strict adherence to aseptic technique.

Randomized study comparing endoscopic ultrasound-guided Trucut biopsy and fine needle aspiration with high suction.

Abstract: H. Gerke, M. K. Rizk, A. D. Vanderheyden and C. S. Jensen Randomized study comparing endoscopic ultrasound-guided Trucut biopsy and fine needle aspiration with high suction Objectives: Endoscopic ultrasound (EUS)-guided Trucut biopsy (TCB) enables acquisition of tissue cores for histological assessment. Because of the rigid needle and the spring mechanism, tissue acquisition can be difficult from regions that require sharp angulation of the echoendoscope. Fine needle aspiration with high suction (FNAHS) has been proposed as a method to obtain histological tissue cores while affording the flexibility to obtain specimens even with extreme endoscope angulation. The objective was to compare prospectively these two methods in their ability to obtain specimens for histological assessment and in their diagnostic accuracy, including cytological diagnosis when achieved. Methods: Eighty lesions in 77 patients were amenable to transoesophageal, transgastric or transrectal biopsy and were randomized to TCB (n = 44) or FNAHS (n = 36). Each specimen was assessed for adequacy (scoring system where a score of 0 was no material, 1–2 was considered cytological, and 3–5 was considered histological). Follow-up information was obtained to establish a gold standard final diagnosis. Results: The median histological scores for FNAHS and TCB were 2 and 5, respectively. Histological cores were obtained in 95.3% of TCB, as opposed to 27.8% in the FNAHS group (P < 0.0001). Although the diagnostic accuracy for TCB was greater than that for FNAHS (88.3% and 77.8%, respectively), this was not statistically significant (P = 0.24). Conclusion: If histological information is required, TCB is superior to FNAHS. The difference in diagnostic accuracy did not reach statistical significance due to low numbers and the fact that FNAHS often enabled a cytological diagnosis.

TBC1D24 mutation causes autosomal-dominant nonsyndromic hearing loss.

Abstract: Hereditary hearing loss is extremely heterogeneous. Over 70 genes have been identified to date, and with the advent of massively parallel sequencing, the pace of novel gene discovery has accelerated. In a family segregating progressive autosomal-dominant nonsyndromic hearing loss (NSHL), we used OtoSCOPE® to exclude mutations in known deafness genes and then performed segregation mapping and whole-exome sequencing to identify a unique variant, p.Ser178Leu, in TBC1D24 that segregates with the hearing loss phenotype. TBC1D24 encodes a GTPase-activating protein expressed in the cochlea. Ser178 is highly conserved across vertebrates and its change is predicted to be damaging. Other variants in TBC1D24 have been associated with a panoply of clinical symptoms including autosomal recessive NSHL, syndromic hearing impairment associated with onychodystrophy, osteodystrophy, mental retardation, and seizures (DOORS syndrome), and a wide range of epileptic disorders.

Comparison of two-dimensional orthoradially reformatted computed tomography and panoramic radiography for dental implant treatment planning

Abstract: The widespread use of dental implants in partially and completely edentulous patients has brought about a need to preoperatively depict and quantify accurate bone height and contour. A number of conventional intraoral and extraoral radiographic techniques have been used, including the relatively new modality of two-dimensional orthoradially reformatted computed tomography. Despite rapid advances in imaging technology, many clinicians continue to rely on techniques such as panoramic radiography that produce images that distort the jaws nonuniformly. This study compared bone height measurements of jaws made with these two imaging modalities. Nineteen sites in 10 patients were imaged with both techniques and mean bone height was determined for each imaging technique and site. Significant differences were found between mean bone heights measured with the two imaging modalities ( p