 cases in the county in 2007 alone.
There are only three doctors in the county who are trained to treat HIV patients, Lanza said. The Task Force reaches out to patients from Toledo to Shelby.
To donate to the Task Force, call (440) 452-5228 or visit. Lanza said 100 percent of all donations go to those in need.
Contact Jason Hawk at 653-6264 or jhawk@chroniclet.com.NEW ORLEANS (AP) - A city news release says workers are preparing to take down a statue of Confederate President Jefferson Davis in New Orleans, the second of four monuments to Confederate era figures the City Council has voted to remove.
Officials had refused to give advance public notice of Thursday morning's removal, citing threats of violence against contractors and workers involved in the effort. The Davis statue has been the scene of protests by supporters and opponents of the monuments' removal.
Late last month, the first monument - a 35-foot-tall granite obelisk - was removed by masked workers under cover of darkness. The obelisk was a tribute to whites who battled a biracial Reconstruction government installed in New Orleans after the Civil War.
Any entity could have significant changes to its financial reporting as a result of this standard. That’s certain to be the case for those with long-term loans, equity investments or any non-vanilla financial assets. It might even be the case for those only holding short-term receivables. It all depends.
International Financial Reporting Standard 9 (IFRS 9) responds to criticisms that International Accounting Standard 39 (IAS 39) is too complex, is inconsistent with the way entities manage their businesses and risks, and defers the recognition of credit losses on loans and receivables until too late in the credit cycle.
The new standard is effective for years beginning on or after January 1, 2018, with earlier adoption permitted. Entities whose predominate activities are insurance-related can delay implementation until 2021.
What does the new standard really mean for you?
The International Accounting Standards Board developed IFRS 9 in three phases, dealing separately with the classification and measurement of financial assets, impairment and hedging.
Entity irrevocably elects at initial recognition to recognize only dividend income on a qualifying investment in profit and loss, with no recycling of changes in fair value accumulated in equity through other comprehensive income. All others should be classified as FVPL.
The third major change that IFRS 9 introduces relates to hedging - IFRS 9 allows more exposures to be hedged and establishes new criteria for hedge accounting that are somewhat less complex and more aligned with the way entities manage their risks than under IAS 39. Companies that have rejected using hedge accounting in the past because of its complexity, and those wishing to simplify, refine or extend their existing hedge accounting, may find the new hedging requirements more accommodating than those in IAS 39.
Ultimately, the question of how an entity is affected by IFRS 9 is that “it depends.” Some entities may find that classification and measurement of their financial assets will be substantially the same as they are currently under IAS 39 and that their impairment allowances may not be affected materially. Others will change substantially.
We can help you re-evaluate your accounting policies, financial statement note disclosures and other areas affected by the new requirements. We can also help you identify changes to your accounting systems and internal controls.
Tobacco smoking is one of the most important risk factors for intracranial aneurysm formation and for an aneurysmal subarachnoid hemorrhage (aSAH).2,6–9,12,13 Previous studies have shown that smoking cigarettes increases the risk for an aSAH up to 6-fold when compared with the risk in the general population.2,12 Results from one study have indicated that smoking also represents a risk factor for the recurrence of an aneurysm after its treatment with endovascular coiling.11 To gain a better understanding of the impact of smoking on long- term outcomes after endovascular embolization of intracranial aneurysms, we studied these outcomes among a consecutive contemporary series of patients treated at our institution. The goal of this study was to determine whether smoking is an independent risk factor for aneurysm recurrence and retreatment after endovascular treatment. We hypothesized that endovascular treatments of aneurysms would result in a higher rate of aneurysm recurrence, retreatment, or of both among patients who smoked or had a history of smoking than among patients who never smoked.
Methods
Patients and Study Design
After receiving approval from the internal review board, we conducted a retrospective chart review of all patients who had received endovascular treatment of intracranial aneurysms from January 2005 through December 2012. The inclusion criteria in this study were that patients had received intrasaccular coil embolization of an intracranial aneurysm, had undergone a follow-up imaging exam at least 6 months later, and had a record of a smoking history. Patients who had undergone a planned and staged multisession embolization were excluded. A retreatment was considered planned and staged if the treating team mentioned in the operative note or follow-up clinical notes that further treatment was recommended to improve aneurysm occlusion. All patients underwent at least 1 follow-up digital subtraction angiography exam or MR angiography exam.
Once the patients were selected, their data were collected, including demographic characteristics (sex, age, and smoking history), aneurysm characteristics (rupture status, maximum diameter, and location), treatment characteristics (type of treatment and retreatment), initial aneurysm occlusion, use of adjunctive devices such as a stent or balloon, length of follow-up, and any aneurysm occlusion at follow-up.
Smoking status was determined from each patient's medical history questionnaire obtained before or during the treatment. The questionnaire asked the following questions: 1) “Do you currently smoke?” and 2) “Have you ever smoked? If so, how long ago did you quit smoking?” Smoking status was then stratified into 3 groups: 1) never a smoker, 2) current smoker (smoked at the time of treatment), and 3) former smoker (quit smoking before treatment). The 2 primary outcomes of this study were aneurysm recurrence and aneurysm retreatment after an endovascular aneurysm treatment. Initial aneurysm occlusion was categorized according to the Raymond scale into the following: 1) residual aneurysm, 2) residual neck, and 3) complete occlusion. Follow-up aneurysm occlusion status was categorized into the following 2 outcomes: 1) stable occlusion and 2) aneurysm recurrence defined as coil compaction, recanalization, or both.
Statistical Analysis
Continuous variables are presented as mean ± SD and categorical variables as frequency (as percentage). Kruskal-Wallis and chi-square tests were used to test statistical significance in aneurysm recurrence or retreatment according to differences in patient characteristics. A univariate logistic regression analysis was performed to test for an association of the primary outcomes, aneurysm recurrence or retreatment, with age, sex, smoking status, aneurysm characteristics (rupture status, initial occlusion, location, and maximum diameter), adjunctive device usage, and length of follow-up. A multivariate logistic regression analysis was then performed, adjusting for the differences in the patient groups with primary outcomes as the dependent variable and smoking status and variables that were significant at the univariate level as the independent variables. All statistical analysis was performed using SAS version 9.3.
Results
Patient and Aneurysm Characteristics
In this study, 384 patients who had a combined total of 411 aneurysms were included. Thirty-nine patients with a combined total of 44 aneurysms treated with flow diversion and 5 patients with 1 aneurysm each who underwent a planned, staged treatment were excluded from this study. Of the patients included, 23 had 2 treated aneurysms, and 2 patients had 3 treated aneurysms. Overall, 106 patients with 111 aneurysms (27.0%) had recurrence of an aneurysm, and of these patients, 78 with 80 aneurysms (19.5%) underwent retreatment for the aneurysm. In the remaining patients with recurrent aneurysms, the recurrence was not considered of clinical significance and observation only was recommended.
The demographics, main aneurysm characteristics, and immediate angiographic results for the 3 patient groups are summarized in Table 1. The mean age of all patients was 61 ± 12.2 years, and the mean length of follow-up was 2.4 ± 2.3 years. An analysis by smoking status showed that 172 patients with 193 aneurysms (47.0%) were current smokers, 95 patients with 99 aneurysms (24.1%) were former smokers, and 117 patients with 119 aneurysms (29.0%) were never smokers. In total, 272 treated aneurysms (66.2%) were unruptured and 139 (33.8%) were ruptured, and the mean diameter of all aneurysms was 7.5 ± 4.3 mm. In total, 186 aneurysms (45.3%) were completely occluded on initial treatment, 185 (45.0%) had a residual neck, and 40 (9.7%) had a residual aneurysm and were not occluded. In a subset of 94 aneurysms (22.9%), an adjunctive device was used, with 93 of these aneurysms (98.9%) receiving balloon-assisted coiling and 1 aneurysm (1.1%) receiving stent-assisted coiling.
Patient demographics and aneurysm characteristics by smoking status*
FU = follow-up.
The p values are results from Kruskal-Wallis or chi-squared tests.
With a mean age of 65.2 ± 11.3 years, former smokers were significantly older than those who were never smokers (61.1 ± 14.4 years) and were current smokers (58.5 ± 10.3 years) (p < 0.001). The aneurysm diameter was not significantly different among the groups (p = 0.35), with mean diameters of 7.8 ± 5.2 mm for those who were never smokers, 7.6 ± 3.5 mm