Biomedical subjects
Publications and source records attributed to G Maxwell.
Flexible monitoring helped to establish an intermediate care unit, close an intensive care unit (ICU) and reduce cost by decreasing length of stay (LOS) and matching patients to appropriate care. These efforts saved the hospital $3,260,215 over the first year while maintaining positive patient outcomes.
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Lymphoma of the colon is rare and has different radiographic presentations. The least common of these presentations is diffuse polyposis. Here we describe 4 cases of diffuse lymphomatous polyposis of the colon, each having a distinct radiographic appearance.
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The effect of dopamine upon the oxygen consumption (QO2) of brown fat adipocytes was measured by polarography. The results showed a marked stimulation of QO2 by dopamine, similar to that induced by noradrenaline. The dopamine response could be blocked by haloperidol, butaclamol, propranolol and by high concentrations of tolazoline. These results suggest a role for dopamine in energy release from brown fat.
The purpose of this study was to assess how patients with burns perceive their physical, psychological, social, and economic status since their burn injuries and to examine the question, "Does burn severity or age at the time of injury affect the patient's perception of his or her quality of life after burn injury?" A 25-item questionnaire was mailed to 1837 former patients who had been hospitalized in our adult burn center from 1975 to 1987, and 245 (13.1%) completed questionnaires were returned. The chi 2 test suggests that the patient sample overall did not experience a change in perceptions after burn injuries. However, when the adult group is divided by burn severity (grouped into low and high percent of burn) and by age at the time of injury (grouped into young and old), both the young and the older persons with high burn severity identify impairments in their quality of life after burn injury.
The stress of burn injury can have an especially profound psychologic effect on individuals with recent histories of stress life events. A review of the literature reveals a model for this effect and documents the possibility of burn-prone patients, a concept that may explain the high number of patients with burns who also report a high level of stress before injury. This study was designed to assess the proportion of patients with burns reporting previous stress and to assess the relationship of this stress to burn injury and its exacerbating effects. A definite correlation between previous stress and burn injury was found, indicating that many patients with burns may have been in a vulnerable state at injury. Since such vulnerable patients will show a more severe reaction and more serious level of psychologic dysfunction than the seriousness of their injuries might indicate, their identification would have decided benefits in their psychologic rehabilitation.
If burn centers are to survive in the current fixed-payment environment, managers and physicians must be knowledgeable of the parameters and regulators of reimbursement. The purpose of this study was to assess the reimbursement status of a burn center in a private, not-for-profit facility. The analysis included both internal and external constraints imposed on the hospital. Data from fiscal year 1989-90 were used to identify the most frequently coded burn diagnosis-related groups and third-party payers. Actual reimbursement rates per diagnosis-related group were examined, and the average charge per patient discharge was compared with reimbursement per patient. Total billed charges versus received revenue for Medicaid patients were explored. Problems and solutions were identified and discussed after completion of the assessment.
The purposes of this study were (1) to identify the percentage of patients with burns or intergenerational family members who have had previous burn injuries that required hospitalization and (2) to assess the need for an inpatient burn prevention program for patients and families. This study revealed an increase from 8% to 19% "burn repeaters," with a yearly average of 13% in a 5-year census and a 20.1% etiologic fraction related to the marker of increased risk (previous burn injury). These results strongly substantiate the necessity for an inpatient prevention program for patients and families to promote injury control by reduction of subsequent burn injury and thus break the burn injury cycle.