Search PubMed⌕ Search

Biomedical subjects

M A Cox

Publications and source records attributed to M A Cox.

32 records · Page 2Linked to original sources
PubMed1993

Hip fractures: an increasing health care cost.

Studies in several countries have indicated that there is likely to be a dramatic increase in the number of hip fractures in the early part of the 21st century. At a time when health care costs are coming under close scrutiny internationally, the added financial burden of the increasing number of fractures is of concern. This study analyzes the cost of treating hip fractures in New Zealand in 1990 and projects forward the costs of treatment and the percentage of that portion of the government's health budget for the years 2001 and 2011.

Aged↗
PubMed1991

Indirect costs of teaching in Canadian hospitals.

We sought to determine whether there are indirect costs of teaching in Canadian hospitals. To examine cost differences between teaching and nonteaching hospitals we estimated two cost functions: cost per case and cost per patient-day (dependent variables). The independent variables were number of beds, occupancy rate, teaching ratio (number of residents and interns per 100 beds), province, urbanicity (the population density of the county in which the hospital was situated) and wage index. Within each hospital we categorized a random sample of patient discharges according to case mix and severity of illness using age and standard diagnosis and procedure codes. Teaching ratio and case severity were each highly correlated positively with the dependent variables. The other variables that led to higher costs in teaching hospitals were wage rates and number of beds. Our regression model could serve as the basis of a reimbursement system, adjusted for severity and teaching status, particularly in provinces moving toward introducing case-weighting mechanisms into their payment model. Even if teaching hospitals were paid more than nonteaching hospitals because of the difference in the severity of illness there should be an additional allowance to cover the indirect costs of teaching.

Bed Occupancy↗
PubMed1990

An enhancer within the divergent promoter of Epstein-Barr virus responds synergistically to the R and Z transactivators.

The EA-R and NotI repeat genes of Epstein-Barr virus (EBV) are oriented head to head and separated by a 1,000-base-pair (bp) divergent promoter region. We have identified functional domains within this divergent promoter which are important for regulation of the rightward EA-R gene. Both the R transactivator (Rta) and the Z transactivator (Zta) increase the abundance of correctly initiated EA-R transcripts. A 258-bp fragment (-114 to -372 from the EA-R cap site) contained the primary Rta and Zta response elements and was capable of transferring Rta and Zta activity to a heterologous promoter in an orientation- and position-independent manner. Rta activated this 258-bp enhancer region in both EBV-positive and EBV-negative cells. However, Zta activity appeared to be dependent on another EBV gene product, since Zta activated the enhancer efficiently (500- to 2,000-fold) in EBV-positive cells but had little or no activity in EBV-negative cells. The combination of Rta and Zta produced a striking synergistic effect on the enhancer in the absence of any additional EBV components, suggesting that the interaction between Zta and Rta accounts for the Zta response observed in EBV-positive cells. An Rta response element was mapped to a domain located 60 bp away from a Zta-binding site within the enhancer. Although Rta activated the enhancer and other early promoters without additional EBV- or B-cell-specific factors, it did not activate the lytic cycle of EBV, in contrast to Zta. Immunofluorescence patterns of Rta and Zta with antipeptide antisera indicated that they have overlapping but different subcellular localizations. Both transactivators were found in the nucleus, but Rta was also found in the cytoplasm.

Animals↗
PubMed1987

Multiple pterygium syndrome: a case complicated by malignant hyperthermia.

The autosomal recessive multiple pterygium syndromes are a heterogeneous group of disorders in which multiple joint contractures are associated with cutaneous webbing. Recently, we evaluated a 33 week gestation male in whom multiple pterygia were one feature of a broader pattern of malformation. Clinical management was adversely affected by malignant hyperthermia. In this report we present the clinical, radiographic and pathologic data of this patient and those of an affected stillborn female sibling. We believe that these represent the features of a newly recognized disorder.

Abnormalities, Multiple↗
PubMed1985

Factors influencing triacylglycerol delivery into mesenteric lymph.

The transport of triacylglycerol (TG) in mesenteric lymph was studied in rats with duodenal and mesenteric lymphatic cannulas with or without bile fistulas. Rats were infused with 135 mumol glycerol trioleate (TO) for 4 h, followed by 5 h of NaCl infusion. Rats with intact fistulas prefed 20% corn oil had nearly twice the maximum output of TG in lymph as controls. Decay from peak values was zero order for controls and indeterminate for rats prefed corn oil. In rats with bile fistulas, less TG was transported in lymph than in those in which 2 mM phosphatidylcholine (PC) was added to the infusate. The decay from maximum values was zero order for controls and first order for rats infused with PC and TO. Recovery of infused [3H]glycerol trioleate in controls was 43% and increased to 68% on inclusion of PC in the infusate. We conclude that in chow-fed rats lymph TG delivery rates were well below infusion rates, suggesting alternate TG transport routes, TG transport was improved by supplementing the infusate with PC or prefeeding with 20% TG in chow, and PC may be limiting in TG transport in rats with bile fistulas.

Animals↗
PubMed1981

Pituitary oligopeptide regulation of phosphatidylcholine synthesis by fetal rabbit lung cells: lack of effect with prolactin.

Phosphatidylcholine (PC) synthesis in cultured fetal rabbit lung cells was studied after exposure to various pituitary peptides. Because of reports of an association between lung maturation and prolactin, 2 different preparations of ovine prolactin were studied in concentrations ranging from 0.1 to 10.0 microgram/ml. Increased saturated phosphatidylcholine (SPC) synthesis without an increase in synthesis of total PC, and increased SPC/PC, was observed after exposure to Sigma prolactin. NIH prolactin in the same concentrations had no effect on synthesis of either PC or SPC. Adrenocorticotropic hormone, luteinizing hormone and thyroid stimulating hormone increased synthesis of both PC and SPC, but none increased the SPC/PC ratio. A cold ethanol extraction of Sigma prolactin yielded fractions with no demonstrable biologic activity, and other initial attempts to characterize the active factor in the Sigma prolactin samples were unsuccessful. We concluded that prolactin per se has no direct effect on PC or SPC synthesis in the lung, but that certain other pituitary peptides have a direct effect on lung synthesis of PC and SPC.

Adrenocorticotropic Hormone↗
PubMedDate not supplied

Ethnic differences in cirrhosis of the liver in a British city: alcoholic cirrhosis in South Asian men.

AIMS AND METHODS: We studied the ethnic origin of cirrhotic patients retrospectively over the 14-year period 1987-2000 and compared the ethnic make-up of the cirrhotic patients with the ethnic make-up of the local catchment population. RESULTS AND CONCLUSIONS: Of 381 cirrhotics, 64.1% were white, 29.1% South Asian, 4.7% Afro-Caribbeans and 2.1% other races. These proportions were different from those of the local community in that South Asians were over-represented and Afro-Caribbeans were under-represented. Alcohol was the commonest cause of cirrhosis (60.9%) and South Asian non-Moslem males with alcoholic cirrhosis were over-represented and were younger at diagnosis than white alcoholic cirrhotics.

Adult↗
PubMedDate not supplied

Closed interlocking nailing of humeral shaft fractures with the Russell-Taylor nail.

OBJECTIVE: To assess the role of the Russell-Taylor humeral nail in the treatment of humeral shaft fractures. STUDY DESIGN: Retrospective with a mean radiologic and clinical follow-up at thirty-two months. SETTING: University teaching hospital. PATIENTS: Total of thirty-seven patients treated with the Russell-Taylor humeral nail. INTERVENTION: All patients were treated with the Russell-Taylor humeral nail inserted in an antegrade fashion. OUTCOME MEASURES: Radiologic union and shoulder function in terms of pain, power, range of movement, and activities of daily living. RESULTS: There were four established nonunions and four cases of delayed union (time to union > four months). Age of patient was the only predictor of nonunion. There was one infection and one intraoperative fracture. Two prominent proximal screws required removal, and one nail was removed after union because of impingement. Three patients required manipulation under anesthesia to improve shoulder movement. At review, six patients had residual poor shoulder function as per Constant score, four attributable to shoulder stiffness and two to residual pain. CONCLUSION: The authors' findings indicate a significant rate of delayed or nonunion in the elderly patient. When the high rate of union with conservative treatment is considered, the indications and rationale for intramedullary humeral nailing should be clearly defined.

Adult↗