PubMed Health⌕ Search

Biomedical subjects

B B Jacobs

Publications and source records attributed to B B Jacobs.

At least 19 recordsLinked to original sources
PubMed1992

The effect of the new trauma DRGs on reimbursement.

Reimbursement for trauma care based on prospective payment has not been satisfactory. The Health Care Financing Administration introduced four new Multiple Significant Trauma (MST) DRGs in 1991 with the intention of covering patients who have had at least two body sites injured. To determine the effect if any on reimbursement, a sample of patients who were assigned the new DRGs over a 5-month period were analyzed. The analysis compared the calculated reimbursement for these 49 patients based on their total accumulated charges, DRG weights, and the average Medicare dollar blend along with the additional weight factor specific for the study facility. This analysis was compared with an additional analysis determining the reimbursement performed on the same patient sample but with DRG weights determined from DRGs derived from the 1989 DRG GROUPER/FINDER. During the 5-month study period, 5.5% of the patients discharged from the hospital has sustained at least one injury covered by ICD-9-CM codes. Of these, 49 (3.9%) were classified into one of the four new MST DRGs. The majority of patients were male (75.5%), the mean age was 31.8 years, and the total charges accumulated were $1,809,192.23. The calculated DRG-based reimbursement was $1,183,495.40, or 65.5% of the total charges. In the second part of the study, using the DRGs available in 1989 for the same sample of patients, the DRG-based reimbursement was $691,437.72, or only 38.2% of the accumulated charges.(ABSTRACT TRUNCATED AT 250 WORDS)

Diagnosis-Related Groups↗
PubMed1989

A three-year report of the medical helicopter transportation system of Connecticut.

Over 63% of the patients transported by the LIFE STAR crew are the victims of trauma. The system has transported 2,215 ill and/or injured patients, the majority of whom are critical, either from the scene of an injury or from a medical facility to another of greater specialization. With the audit procedure indicating a 95% positive predictive value for summoning this service, LIFE STAR has contributed to the care of critically ill or injured persons in Connecticut and surrounding areas.

Adult↗
PubMed1986

Seroepidemiology of malaria in northern Thailand: II. Focal and temporal variations in endemicity.

Four population groups from regions of Northern Thailand were surveyed for the presence of antibodies to Plasmodium falciparum using the indirect immunofluorescent antibody (IFA) test. Each of the four populations was selected from areas known to represent different patterns of malaria transmission. Group 1 was from an area where there had been no malaria transmission for approximately 30 years. Individuals in this group below age 40 showed an extremely low prevalence of malaria antibodies. Group 2 was chosen from an area where low levels of transmission have continued despite more than 30 years of DDT spraying. In this group the age related pattern of malaria antibodies varied from village to village but in all villages there was a sharp increase in the prevalence of IFA positive tests in individuals over 30. The third group has had continuously high levels of transmission. Although there are differences in the age related prevalence of IFA positives when individual villages are compared, there is a greater prevalence at all ages than in the first two groups. The fourth group was selected from an area where transmission had recently resumed after freedom from indigenous cases for approximately six years. There was little difference in the prevalence of IFA positive individuals below the age of 25 but above that there was a steady increase in prevalence with age. The correlation of IFA antibody positives with known patterns of malaria transmission in these four areas demonstrates the usefulness of this serological technique in assessing malaria endemicity and the effectiveness of control measures as well as in the interpretation of other malaria statistics.

Adolescent↗
PubMed1978

Spontaneous hepatomas in mice inbred from Ha:ICR Swiss stock: effects of sex, cedar shavings in bedding, and immunization with fetal liver or hepatoma cells.

Mice from Ha:ICR noninbred Swiss stock were mated brother X sister for 21--25 generations and then maintained up to the age of 33 months. Hepatomas developed in 62.8% of 86 males autopsied at 349--999 days of age (mean age = 21.1 mo). Of 130 females, 6.9% had hepatomas when autopsied at 328-825 days of age (mean age = 18.7 mo). Hepatoma incidence in males at 18 months of age was not affected by the presence or absence of cedar shavings in the bedding or by immunization of 3-month-old males with 2 weekly inoculations of 150 microgram (protein) sonicate of fetal liver or spontaneous hepatoma cells.

Animals↗
PubMed1978

Tumor acceptance modified by passage in hybrids with graft-versus-host reaction.

A graft-versus-host reaction (GVHR) was produced in adult F1 hybrid mice by the injection of 10(8) parental strain spleen cells and 8 days later they were challenged with allogeneic third-party tumor. BALB/c Leydig cell tumor (C4092), C57BL/6 sarcoma (30795), and DBA/1 melanoma (S91) often grew progressively in B6D1F1, CD1F1, B6CF1 or their reciprocal hybrid recipients, respectively, when GVHR had been induced in these animals. Control, without GVHR, hybrids always rejected the tumor. The C4092 tumor was serially transplantable in untreated hybrids after its initial passage in unrelated GVHR-treated mice; the S91 grew in its first passage into untreated B6CF1 mice but thereafter was rejected by these hybrids; while the B6 tumor 30795 grew progressively only in the initial GVHR-treated CD1F1 or reciprocal hybrids. Reduced immunogenicity of tumors resulting from passage in unrelated recipients immunosuppressed in association with a GVHR is comparable to allograft adaptation achieved by such techniques as organ culture pretreatment and presents an additional method for attenuating rejection of allotransplants.

Animals↗
PubMed1976

Role of donor immunocompetent cells in allograft rejection.

Allotransplantable lines of the BALB/c (H-2d) Leydig cell tumor C4092 were established in DBA/1 (H-2q) mice after maintenance in organ culture. These modified tumors had reduced immunogenicity but were recognized and rejected by previously sensitized DBA/1 mice. The addition of 3.4 X 10(3)-1 X 10(5) peritoneal exudate cells (PEC) from untreated BALB/c mice to cell suspensions of the modified tumor did not restore Immunogenicity when the cell mixture was Inoculated sc Into DBA/1 recipients. However, when equivalent numbers of PEC or spleen cells were inoculated iv into animals receiving the tumor cell suspension sc, the acceptance of the tumors was significantly reduced or prevented. This indicated that the BALB/c lymphoid cells inoculated iv stimulated the immune system of the host, which in turn recognized the tumor cell inoculum. The lack of effect of the BALB/c lymphoid cells when admixed with the tumor did not support the assumption that the loss of passenger lymphoid cells was responsible for the allotransplantability of grafts after organ culture explantation. Additional evidence was presented that supports our view that the reduced immunogenicity was associated with a phenotypic modification of the tumor cells per se.

Animals↗
PubMed1975

Transplantation behavior of allotransplantable tumor lines derived from immunologically modified hosts.

The strain-specific BALB/c tumor C4092 was conditioned to grow in H-2 incompatible DBA/1 mice by prior maintenance in vitro as an organ culture explant. It then was serially transplantable in DBA/1 mice and regained its specificity with one passage in BALB/c mice. Changes in transplantation behavior were similar in vivo if the recipients were conditioned by neonatal thymectomy, immunologic enhancement, rabbit antimous serum treatment, or immunization with mitomycin C-inactivated C4092 tumor cells. In vivo- and in vitro-modified tumors differed in degree of transplantability and in the stability of immunogenic changes. However, because of conspicuous similarities in the behavior of these lines, it was concluded that ADAPTations of both host and graft ultimately contribute to graft survival.

Animals↗
PubMed1975

Induction of peritoneal ascites fluid by Freund's adjuvant: Genetic and hormonal influences.

Strain differences among inbred mice is demonstrated for the relative amounts of peritoneal ascites fluid induced by the injection of Freund's adjuvant and antigen. Females tend to produce more fluid than males; the lower level in males is attributable to the action of male hormone. Both genetic and epigenetic factors are determinants in the response levels; genetic factors differentiate the inbred strains of mice, epigenetic factors underlie the variations within a strain and the difference between sexes.

Animals↗