Showing papers by "Bethesda Hospital published in 1987"
131 citations
TL;DR: Data indicate that a TDM program can markedly reduce the total dose of aminoglycoside, which can potentially reduce tissue accumulation and toxicity and the hospital costs were $725 less per patient in the study group, which would produce a savings of approximately $640,000 per year at the institution.
Abstract: A prospective evaluation was undertaken to assess the impact of an aminoglycoside therapeutic drug-monitoring (TDM) program on the total dose of aminoglycoside antibiotics, the duration of therapy, the number of serum concentrations determined, the length of hospital stay, and the potential cost reduction in 221 patients with proven or suspected gram-negative infections. The patients were allocated to a group that received individualized aminoglycoside doses (study) or to a group that did not (control). The mean total dose of gentamicin or tobramycin per patient course of therapy was 1,258 mg in the study group and 1,981 mg in the control group (p less than 0.0001). The mean duration of therapy was 5.9 and 10.3 days per patient in the study and control group, respectively (p less than 0.0001). The mean length of hospital stay was 8.4 days in the study group and 11.8 days for the control (p less than 0.005). The type and site of infection, number of serum concentration determinations, and mortality were not statistically different for the groups. These data indicate that a TDM program can markedly reduce the total dose of aminoglycoside, which can potentially reduce tissue accumulation and toxicity. In addition, the hospital costs were $725 less per patient in the study group, which would produce a savings of approximately $640,000 per year at our institution.
49 citations
TL;DR: Analysis of 628 consecutive admissions to the Spinal Injuries Unit, Austin Hospital, between July 1978 and December, 1985 illustrates the value of a comprehensive data collection system which has been developed at the hospital since 1978.
Abstract: Analysis of 628 consecutive admissions to the Spinal Injuries Unit, Austin Hospital, between July 1978 and December, 1985 illustrates the value of a comprehensive data collection system which has been developed at the hospital since 1978. Some brief epidemiological data is presented, together with a detailed analysis of the urological outcome of patients with traumatic lesions whose discharge has been completed. A high rate of catheter-free status and urine sterility at discharge is reported, and factors affecting these results are analysed. The authors hope that an international system of data collection can be developed in the future to allow meaningful comparison of results between units.
9 citations
TL;DR: The aim is to develop a co-ordinated total care concept for people with head injuries from time of injury, through acute care and rehabilitation to long-term follow-up in the community, a flexible system able to respond to the complexity and variability of these common and serious injuries.
Abstract: Major improvements in the acute management and rehabilitation of patients with head injury have developed in recent years, particularly in the United States. Australia has lagged behind in these developments, but a co-operative programme between Bethesda Hospital and the Motor Accidents Board in Victoria has improved services for these serious injuries, at least for those resulting from road accidents. It is proposed that integration of services for head injuries would be improved by developing a system of care, based on the proven model for spinal cord injuries, which should not only allow better co-ordination of individual patient care, but also stimulate a more rational development of new services within the health system. The aim is to develop a co-ordinated total care concept for people with head injuries from time of injury, through acute care and rehabilitation to long-term follow-up in the community, a flexible system able to respond to the complexity and variability of these common and serious injuries.
3 citations
TL;DR: The overall case fatality rate from strangulated external hernia in Nigeria is not very different from that in Europe and the USA, although in Nigeria the resection rate is high.
Abstract: Thirty-six cases of strangulated external hernia were operated upon in Bethesda Hospital Ikachi, Eastern Nigeria, during a period of 27 months. Gut resection was necessary in nine. The causes of an increased case fatality rate after resection are reviewed. Three lesscommon conditions — Reduction en masse, lumbar hernia and Richter's hernia — are discussed. The overall case fatality rate from strangulated external hernia in Nigeria is not very different from that in Europe and the USA, although in Nigeria the resection rate is high.