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Biomedical subjects

E Hicks

Publications and source records attributed to E Hicks.

12 recordsLinked to original sources
PubMed1999

The development of funding policies for hospices: is casemix-based funding an option?

The 1993 health reforms, with their emphasis on the purchasing of defined amounts or units of service, have led to the implementation of casemix-based funding for the acute medical and surgical services of the public hospitals. Despite growing interest in New Zealand in casemix-based funding for non-acute services such as palliative care, the nature of this service and the characteristics of its patient population pose particular difficulties for the development and implementation of casemix. This paper examines the feasibility of implementing casemix-based funding for hospice/palliative care services and discusses the development of casemix classification systems for palliative care. Problems associated with implementing casemix-based funding are considered including: the dual funding of hospices, the multi-agency nature of palliative care service provision and the need for the Health Funding Authority to identify and specify the hospice services it is willing to fund. While it is concluded that these problems will impede the introduction of casemix-based funding of hospice care, they highlight important issues that the hospice movement must address if it is to ensure its future within the new health environment.

Diagnosis-Related Groups↗
PubMed1997

The prostaglandin receptor EP4 triggers remodelling of the cardiovascular system at birth.

Survival of newborn placental mammals depends on closure of the ductus arteriosus (DA), an arterial connection in the fetus which directs blood away from the pulmonary circulation and towards the placenta where oxygenation occurs. Here we show that morphological changes resulting in closure of the DA in mice are virtually identical to those observed in larger mammals, including humans, and that maintenance of the DA in the open, or patent, state in fetal mice is dependent on prostaglandin synthesis. This requirement is absent in mice lacking the prostaglandin E2 EP4 receptor (EP4(-/-) mice). In EP4(-/-) mice of the 129 strain, remodelling of the DA fails to occur after birth, resulting in a left-to-right shunt of blood and subsequently in death. This suggests that the neonatal drop in prostaglandin E2 that triggers ductal closure is sensed through the EP4 receptor. In contrast, 5% of EP4(-/-) mice of mixed genetic background survive, and selective breeding of these mice leads to a 21% survival rate, suggesting that alleles at other loci can provide an alternative mechanism for ductal closure.

Animals↗
PubMed1997

Gall stone ileus following multiple endoscopic retrograde cholangiopancreatographies.

Endoscopic retrograde cholangiopancreatography (ERCP) is used as a diagnostic and therapeutic procedure and common bile duct (CBD) stones can be removed using this technique. Early complications of ERCP are well recognized, but there is little in the literature concerning complications developing later. Gall stone ileus following ERCP has been previously reported but not with a delay of up to 2 months. This case illustrates such a delayed complication following multiple ERCPs for CBD stones.

Aged↗
PubMed1996

Anaphylaxis mediated through a humanized high affinity IgE receptor.

Mast cells and basophils, which are activated by IgE and allergens through the high affinity IgE receptor (Fc epsilon RI), play a prominent role in anaphylaxis in the mouse. Mice deficient in this receptor become resistant to passive anaphylaxis. As a first step in developing an in vivo model that more closely mimics the IgE-mediated responses in man, we used a combination of transgenic and embryonic stem cell technology to generate a mouse line in which the murine Fc epsilon RI alpha-chain has been replaced with its human homologue. We demonstrate here that these mice express a tetrameric high affinity IgE receptor, in which the human alpha-chain associates with the murine beta- and gamma-chains, and that upon triggering with relevant Ag, this receptor mediates the initiation of the expected intracellular events. In addition, we show that the human alpha-chain restores an anaphylactic response to the nonresponsive alpha-deficient parental mouse line. This "humanized" mouse represents a potentially important model system, not only for studying the role of IgE in human immune responses, but also for testing potential therapeutic reagents that can interfere with responses mediated through the human Fc epsilon RI receptor.

Anaphylaxis↗
PubMed1989

Unilateral digital ischaemia secondary to embolisation from subclavian atheroma.

Four cases of unilateral digital ischaemia in the upper limb secondary to embolisation from atheromatous plaques in the proximal subclavian artery are presented. Digital subtraction angiography or arch aortography were used to demonstrate the site of atheroma. In one case diagnostic delay resulted from failure to visualise the site of embolisation on the original aortogram and a repeat examination was necessary. Subclavian endarterectomy was undertaken in each case and irreversibly ischaemic digits were managed by local amputation in two cases. Direct surgery to remove the site of embolisation was preferred to bypass or transposition procedures. No further embolic episodes have been recorded with a follow-up of 6 months to 3 years. The important diagnostic features and options in surgical management of this syndrome are discussed.

Arteriosclerosis↗
PubMed1976

Study of neonatal gastric aspirate related to amniotic fluid and to the occurrence of the idiopathic respiratory distress syndrome.

The lecithin/sphingomyelin ratio (L/S) has been shown to be of use in the prediction of the idiopathic respiratory distress syndrome (I.R.D.S) when performed on amniotic fluid. Gastric contents at birth consist mainly of amniotic fluid. Our study was designed to determine what the relationship was between the L/S ratios of amniotic fluid and gastric aspirate obtained at birth and to examine whether the L/S ratios of gastric aspirate was of any value in the prediction of I.R.D.S.

Amniotic Fluid↗