Methodist Jennie Edmundson Hospital is one of four major facilities comprising the Nebraska Methodist Health System. The hospital is located at 933 E. Pierce Street in Council Bluffs, Iowa.Established in 1886, Jennie Edmundson Hospital became a Methodist Health System affiliate in 1994. It boasts a 230-bed regional health care center serving southwestern Iowa.The Council Bluffs hospital employs a workforce of 464 full-time and nearly 250 part-time employees, and has an active medical staff of 132 physicians.Methodist Jennie Edmundson Hospital offers a 24-hour Level III Emergency Department that treated approximately 22,000 patient visits last year. The hospital had a total of 5,101 admissions. Its physicians performed 1,718 inpatient and 6,361 outpatient surgeries.It is the only hospital with the capability to perform emergency angioplasty procedures, and that offers nationally accredited cancer and breast cancer programs in the region, with southwest Iowa's only Advanced Wound Center.Jennie has a 20-bed inpatient adult behavior health unit with ECT services. Methodist Jennie Edmundson Hospital offers a full-line of Women's services including a birthing center with LDRP rooms and a Level II nursery where 360 babies were delivered in 2012.Methodist Jennie Edmundson Hospital is a member of VHA and recently completed an $18 million renovation and construction project that netted the hospital nearly 31,000 square feet of new space for the intensive care unit and surgical suite..
Acute coronary syndrome is associated with a high incidence of thrombus. The presence of coronary thrombus is often not appreciated on coronary angiography; however, simultaneous use of angioscopy or intravascular ultrasound increases the detection of thrombus. Forceful coronary injection, passage of intracoronary devices, balloon angioplasty and stenting in the presence of thrombus contribute to distal embolization by disrupting the thrombus. Clinically, intracoronary thrombus is associated with higher rates of death, myocardial infarction and target vessel revascularization. Removal of thrombus results in the improvement of markers of perfusion, which includes resolution of ST segment elevation, higher myocardial blush grade, and an increase in final thrombolysis in myocardial infarction flow as well as lower mortality. In this article, the authors discuss different mechanical thrombectomy devices and the literature available for their use in acute coronary syndrome.
Determining the difference between colonization and infection is critical to an accurate diagnosis of acute exacerbation of chronic bronchitis (AECB). Chronic bronchitis affects 5.4% of the general population in the United States, and many of these patients carry in their bronchi the most common pathogens implicated in AECB. However, many of these individuals already have minimal respiratory reserves, so the impetus to treat for potential bacterial infection is significant. There is also evidence that repeated attacks of AECB may cause damage to respiratory tissue, which in turn creates an environment favorable to continuing exacerbations. In the short term, antimicrobial therapy can reduce the duration of symptoms, prevent progression to pneumonia, and eliminate the need for hospitalization. Long-term benefits may include an interruption in the cycle of progressive airway damage and a prolongation of the period between exacerbations. Although Haemophilus influenzae is the most frequent cause of AECB, Streptococcus pneumoniae and Moraxella catarrhalis are important pathogens as well. Appropriate antibiotics should have activity against likely causative pathogens, resistance to destruction by beta-lactamase, good sputum and bronchial tissue penetration, high tissue concentration: minimum inhibitory concentration ratio, compliance-enhancing features, and cost effectiveness. Because invasive pneumococcal infections have a high fatality rate in patients with underlying conditions, efforts should be made to ensure those with chronic bronchitis receive pneumococcal vaccinations.
Because its function is related to its bony anatomy, ligamentous structures and integrated muscle groups, the knee is one of the most complex joints in the human body. Not surprisingly, knee injuries rank as one of the major causes of physical disability. Prior to the introduction of magnetic resonance imaging, prompt and accurate diagnosis of knee injuries was a challenge. Now, using MRI, a highly accurate diagnosis can be made in 30 minutes or less without patient discomfort. This article reviews knee anatomy, discusses common injuries and describes magnetic resonance techniques for imaging the knee.
