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At least 19 recordsLinked to original sources
PubMed1979

Early retransfer: a method of optimal bed utilization of NICU beds.

To facilitate increased utility of Neonatal Intensive Care Unit (NICU) beds, we adopted a policy of early discharge (ED) of infants less than 2000 g to the hospital of their birth after recovery from acute illness and when the infant was breathing room air and taking adequate oral feedings. An inservice teaching program at the primary hospitals preceded such policy. In a 24-month period, 446 infants were referred to the NICU. 111 of 446 died; 335 infants survived. 114 of 335 infants were less than 2000 g at birth; 42% (48 of 114) of them were discharged early to the hospital of their birth (ED); 58% were discharged late (LD) to their homes. 59.7% of the ED and 46.3% of the LD required assisted ventilation. Gestational age, birth weight, and final weight at discharge from hospitals were the same in both groups. None of the ED infants developed complications at the hospital of birth after retransfer. The length of NICU stay for LD was significantly higher 40 +/- 6 (p less than 0.001) than the ED; 20 +/- 2.2 days. In addition, a 15% increase in bed utilization was also noted because of ED. We conclude that ED of infants from the NICU 1) increases utilization of beds; 2) decreases the cost of health care; and 3) increases the participation of primary physicians.

Costs and Cost Analysis↗
PubMed1979

Two years of bed procurement for patients with spinal cord lesions. A report on progress and experiences at the Bed Procurement Service at the Industrial Injuries Insurance Institute for Research in Traumatology at Frankfurt/Main.

The total number of beds provided in all specialised centres for the treatment of patients with acute spinal cord lesions in the Federal Republic of Germany is still insufficient. Therefore the attempt to transfer those patients to a centre from another hospital immediately after the lesion has occurred is very difficult. In order to assist physicians of the hospitals (where the patient has been first admitted) in the time-consuming task to find a vacancy in a specialised unit, the Central Association of the Industrial Injuries Insurance Association of the Industrial Injuries Insurance Institutes set up a 'Bed Procurement Bureau for Patients with Spinal Injuries' on 2 August, 1976. The heads of the units concerned set up a special study group in close connection with this clearing-agency in order to elaborate reliable data about the present situation of care for recently paralysed people, and to discuss further problems as well as planning programmes. They meet every 6 months. The organisation of the clearing-agency, the experiences gained within the first 23 months of activity since the opening, the spinal units situation at the present time, and their further development are reported.

Accidents, Occupational↗
PubMed1992

[Bed to bed].

Explore the source record for details and available documents.

Attitude to Death↗
PubMed1976

Measurement of the fractional uptake of macromolecules by the renal vascular bed compared to other vascular beds.

Macromolecules resembling soluble immune complexes can be made from heat-aggregated human gamma globulin (AHGG). In 15 rats, we studied vascular trapping of 125I-labeled AHGG (AHGG)-125I) given by constant I.V. infusion over 1 hour while tissue blood flow was marked by intermittant aortic arch injections of 85Sr-labeled microspheres. Red cells labeled with 51Cr (RBC-51Cr) were also infused so that when the tissues were removed at the end of the experiment, the vascular volume of each tissue specimen could be balculated to correct issue 125I for AHGG-125I which was not trapped but simply in transit in the bascular space at the time the tissue was removed. These data permitted us to calculate the fractional uptake of AHGG-125I (FM) for a given tissue in comparison to any other tissue. We chose to compared the FM of each tissue to the FM of renal cortex. This comparison was expressed as a ratio termed the FM ratio for the given tissue. The following tissues had FM ratios significantly greater than 1.00 (i.e., per unit blood flow, these tissues trapped AHGG-125I more avidly than renal cortex): liver, spleen, skin, stomach, fat, testes, and large bowel. The respective ratios were 381 +/- 74, 15.7 +/- 4.0, 11.8 +/- 4.0, 7.47 +/- 1.95, 6.24 +/- 1.0 +/-, 3.03 +/- 0.67, 2.86 +/- 0.72 (all p less than 0.025). The FM ratio for adrenal, heart, thymus, and diaphragm were not significantly different from 1.00. The FM ratio of lung and brain were significantly less than 1.00: 0.014 +/- 0.008 and 0.14 +/- 0.065, respectively (p less than 0.001 for both). In 13 experiments, glomeruli was 23.8 +/- 3.5 per cent as assessed by recovery of the microspheres contained in renal cortex. Compared to whole renal cortex, the isolated glomeruli contained only minor amounts of AHGG-125I. We conclude that tissues vary widely with respect to their ability to trap macromolecules. When uptake is viewed in terms of the amount of complex trapped per unit delivery rate, many organs trap AHGG-125I for more avidly than renal cortex. Furthermore, under the present experimental conditions, glomeruli are not the major intrarenal site of macromolecule uptake.

Animals↗
PubMed1977

[Trends in tuberculosis hospital and sanatorium beds throughout the world (1960-1975)].

The most important problem facing phthisiologists in the past was how to ensure a sufficient number of sanatorium beds for the management of tuberculosis patients, their rehabilitation and the prevention of transmission of infection by isolating them. There is considerable evidence today, however, that the results obtained with ambulatory treatment are as good as those following in-patient treatment. The latter is now considered unnecessary as it serves merely to prolong duration of the patient's incapacity and to increase the cost of treatment. The presentation of the available information on the trend of beds designated for tuberculosis aims at stimulating the new approach to efficient control of the disease so as to prevent the misuse of available resources. During the period 1960-1965 there were more than 870000 tuberculosis beds reported in the world. Between 1970 and 1975, the number of tuberculosis beds was reduced to 609000. The average percentage of tuberculosis beds to the existing total bed complement was 8.4 in 1960-1uberculosis bed density"--was 3.9 and 3.1 respectively, for the two periods. Owing to the very large variety of reporting systems and sometimes to their defective patterns, international comparisons are hazardous. In general, there is a considerable declining trend in the tuberculosis bed density, in countries with a high initial level, whereas in other countries an upwards trend is sometimes to be found. The analysis of the particular patterns of tuberculosis bed density is difficult, as in many countries the still existing high bed density is actually a combined tuberculosis and respiratory diseases bed density. In countries with a well developed network of institutional units, treatment costs account for approximately half the total cost of the tuberculosis control programme. In a broad public health sense bed strategy is becoming increasingly important since apart from the substantial capital cost of institutional facilities, it also influences both the pattern of service rendered and the use of resources available.

Africa↗
PubMed1976

Plasma vasopressin and renin activity in women exposed to bed rest and +Gz acceleration.

To study the effect of prolonged recumbency on plasma vasopressin and renin activity, eight women (23-34 yr) were subjected to 17 days of absolute bed rest. The +3 Gz tolerance of the subjects was tested before and after 14 days of bed rest. From day 2 and through day 17 of bed rest, plasma arginine vasopressin (AVP) levels were reduced 33%. Plasma renin activity (PRA) increased 91% (P less than 0.05) above ambulatory control values from days 10 through 15 of bed rest. When compared to precentrifuge values, exposure to +3 Gz prior to bed rest provoked a 20-fold rise (P less than 0.05) in mean plasma AVP but resulted in only a slight increase in PRA. After bed rest, acceleration increased plasma AVP 7-fold (P less than 0.02); however, the magnitude of this increase was less than the post +3Gz value obtained prior to bed rest. After bed rest, no significant rise was noted in PRA following +3 Gz. This study demonstrates that prolonged bed rest leads to a significant rise in the PRA of female subjects, while exposure to +Gz acceleration provokes a marked rise in plasma AVP.

Adult↗
PubMed1976

Psychiatric service for the elderly: how many beds?

Reported here is a cohort study of five years' bed usage in the Goodmayes Psychiatric Unit for Old People. Patients first admitted in 1970 continued to use beds, by readmission or by continuing stay, over the next four years; subsequent cohorts of admissions made correspondingly extended use of beds. Bed-usage by men appears now to have stabilized, whilst for women it is still rising. Over the first six years the bed complement was reduced by 40%, despite an increase in referrals of over 40%; this is because the Unit's style of work prevented newly admitted patients from accumulating in beds made available by deaths. It looks as if in future not only will patients who die by replaced by new female admissions but more beds will be needed for these admissions. The present bed-usage is just within the Government's recommended guidelines, and the local issues are considered in the context of national policy.

Aged↗
PubMed1976

Use of a tapered fluidized bed as a continuous bioreactor.

Reactor systems based on tapered fluidized beds are being developed for aqueous bioprocesses in which adhering microorganisms or immobilized active biological fractions are used. The use of a fluidized bed prevents biomass buildup, accommodates particulates in the feed stream, is compatible with gas sparging, and allows easy removal or addition of the active materials. The tapered reactor tends to stabilize the fluidized bed, thus allowing a much wider range of operating conditions. Preliminary experimental results and an empirical mathematical model of the tapered bed indicate that bed stability is associated with a decreasing velocity and void-fraction profile up the bed and the pressure drop across the bed decreases with increasing flow rates. The tapered fluidized bed bioreactor is being evaluated for use in the enzymatic production of hydrogen, microbiological denitrification, and microbiological degradation of coal conversion aqueous waste streams. The enzyme catalyzed conversion of lactose to glucose and galactose was used in the evaluation of the reactor concept.

Biochemistry↗
PubMed1979

The "wavefront phenomenon" of myocardial ischemic cell death. II. Transmural progression of necrosis within the framework of ischemic bed size (myocardium at risk) and collateral flow.

The present study was done to quantitate the evolution of myocardial ischemic cell death within the framework of (1) the anatomical boundaries of the ischemic bed at risk and (2) the magnitude and transmural distribution of collateral blood flow. Myocardial ischemia was produced by proximal circumflex (LCC) occlusions in open chest dogs. Infarcts reperfused at 40 minutes, 3 hours, or 6 hours were compared with permanent infarcts. All dogs were sacrificed at 4 days. Regional myocardial blood flow was measured with 9-micrometer tracer microspheres before, and 20 minutes after, LCC occlusion. The location and size of the ischemic LCC bed at risk was determined by a dye injection technique. Infarct size was quantitated from multiple histologic sections. Necrosis involved 28 per cent, 70 per cent, and 72 per cent of the ischemic bed at risk in infarcts reperfused at 40 minutes, 3 hours, and 6 hours versus 79 per cent following permanent LCC ligation. Viable and potentially salvageable subepicardial muscle persisted for at least 3 hours after the onset of ischemia. Most of the salvageable myocardium was in the subepicardial region. In all groups, the lateral margins of necrosis were sharp in the subendocardial zone and were determined by the anatomical boundaries of the ischemic LCC bed at risk. LCC bed size ranged from 29 to 48 per cent of the left ventricle and thus contributed to variation in infarct size. However, infarct size, as a percentage of bed size, was determined by the transmural extent of necrosis within that bed (r = -0.97). This transmural extent of necrosis was related to subepicardial collateral flow after 3 hours (r = 0.92) and 6 or 96 hours (r = -0.85) but not after 40 minutes (r = -0.26) of ischemia. Thus, irreversible injury of ischemic myocardium developed as a transmural wavefront, occurring first in the subendocardial myocardium but ultimately becoming nearly transmural. Eventual transmural necrosis, and therefore over-all infarct size was determined by, and can be predicted from flow measurements obtained shortly after coronary occlusion.

Animals↗
PubMed1978

[Various patterns in the development of the periganglionic vascular bed of respiratory tube ganglia during human embryogenesis].

The investigation has been performed in 118 serial sections of human embryos. The development of vascular bed in ganglia of the respiratory tube at early embryogenesis has been studied. The main attention has been paid to the formation of periganglial vascular bed. Loop-like and arc-shaped connections between the developing vessels and galglia and rearrangement of periganglial vascular bed during embryogenesis are described. Three stages in the development of blood supply to the ganglia of the respiratory tube are noted: I stage--avascular (embryos are 17-30 mm long); II stage--formation of periganglial vascular bed (embryos are 33-50 mm long); III stage--formation of intraganglial vascular bed (embryos are 55 mm long and more). Within I and II stages, reorganization phases in the vascular bed are described. A suggestion is made that the vascular factor of the development and differentiation of ganglial elements starts acting since the formation of periganglial vascular bed; before this, the mesenchima surrounding the neuronal plexus performs their trophic.

Cell Differentiation↗
PubMed1977

A model for certification of need for long-term-care beds.

A model relating bed supply and utilization is presented in the context of the match between need and service, which is controlled by the screening process that allows or denies access to beds. The conventional cost-minimization approach to certification of need, that of seeking to reduce inappropriate use, is contrasted with a service-delivery approach that seeks to promote appropriate use of facilities. The model expresses the quality of the screening process and the sensitivity and specificity of utilization in terms of bed supply, utilization, and need for service, which allows it to be used for needs assessment. The model is applied to data on supply and use of beds in Massachusetts skilled nursing facilities, with screening quality estimated by Monte Carlo methods; the results suggest that need and bed supply are positively associated and that the regional variation in skilled-nursing beds in Massachusetts may reflect real variations in need.

Bed Occupancy↗
PubMed1978

Vascular actions of arachidonic acid and its metabolites in perfused mesenteric and femoral beds of the dog.

The effects of arachidonate and its major metabolites were examined in vascular beds perfused via the femoral and mesenteric arteries of chloralose-anaesthetised dogs. Close intra-arterial injection of prostacyclin (PGI2, 0.02--2 microgram), PGE2 (0.05--1 microgram) and their precursors, the endoperoxide PGH2 (0.5--2 microgram) and sodium arachidonate (100--550 microgram), all induced vasodilatation. Sodium linoleate (500 microgram) was inactive. Prostacyclin was equally active in both vascular beds, but PGE2 was more potent in the femoral and less so in the mesenteric bed. PGH2 was of similar potency to prostacyclin in both beds, but 6-oxo-PGF 1 alpha (10--100 microgram) was inactive. Thromboxane A2 (TXA2, 1--2 microgram) was a potent vasoconstrictor of the mesenteric bed, but not the femoral bed, although the endoperoxide analogue U46619 was vasocontrictor in both vasculatures. Fatty acid hydroperoxides did not specifically modify the vasodilator effects of PGH2 or arachidonate, presumably because these inhibitors are rapidly reduced in vivo. Indomethacin and meclofenamate potentiated vasodilatation induced by prostacyclin or endoperoxide, but reduced or abolished that caused by arachidonate. The rise in perfusion pressure induced by TXA2 was potentiated and prolonged by indomethacin. Inhibition of synthesis of endogenous prostacyclin, by exacerbating the vasoconstrictor action of TXA2, may have contributed to this effect.

Animals↗
PubMed1975

Amino acid movements across the wall of anuran small intestine perfused through the vascular bed.

1. L-leucine transfer across the wall of the small intestine has been studied in a vascularly perfused preparation from four species of frog. Some properties of the preparation are described. 2. A description is given of the endogenous amino acids appearing in the vascular bed and of the kinetic properties of this washout of endogenous L-leucine. 3. In the steady state of absorption, the transfer function relating the net flux of exogenous L-leucine into the vascular bed to the concentration in the lumen exhibits saturation. Under the conditions of the experiments the apparent concentration in the lumen for half-maximum transfer of L-leucine is found to be 2-1 +/- 0-4 (5) mM. 4. When Na ions are removed from the lumen the transfer of L-leucine into the vascular bed is inhibited. However, the additional removal of Na ions from the fluid in the vascular bed is further inhibitory to the transfer of the amino acid. 5. L-leucine previously absorbed from the lumen appears in the vascular bed in a biphasic fashion. Estimates are deduced of the size of the pool of L-leucine within the tissue which drains into the vascular bed. 6. These results are discussed in relation to previous work on amino acid transport undertaken with various sorts of preparation of small intestine.

Albumins↗
PubMed1979

Sugar transfer from the lumen of the rat small intestine to the vascular bed.

1. A modification of the vascular perfusion technique was used to investigate sugar transfer from the lumen of the rat small intestine to the vascular perfusion technique was used to investigate sugar transfer from the lumen of the rat small intestine to the vascular bed. 2. With this method the transfer of both D-[3H]galactose and L-[14C]glucose were followed in the same experiments. The results indicate that when equimolar concentrations of the two sugars are perfused through the lumen there is a preferential transfer of galactose from the mucosal epithelium to the vascular bed as well as from lumen to the epithelial layer. 3. At high rates of galactose transfer from the lumen to the vascular bed, accumulation of the sugar within the mucosal epithelium is minimal unless the vascular flow is stopped. 4. Phlorizin inhibits galactose transfer from the lumen to the vascular bed, but the inhibition of sugar transfer appears to be restricted to the luminal face of the epithelial cells since the selectivity of the basolateral exit process is unaffected. 5. Replacement of Na+ by K+ in the luminal perfusate reduces the rate of galactose transfer by a factor of 40, but does not completely abolish the preferential transfer of galactose. The presence of luminal Na+ also stimulates the exit of galactose from the mucosal epithelium to the vascular bed. 6. The presence of D-glucose in the vascular perfusate produces a two- to threefold increase in the rate of sugar transfer from the lumen to the vascular bed. This effect is not observed with vascular galactose or luminal glucose.

Animals↗