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Biomedical subjects

G Mezei

Publications and source records attributed to G Mezei.

At least 19 recordsLinked to original sources
PubMed2006

Magnetic field exposure and long-term survival among children with leukaemia.

We examined the association between magnetic field (MF) exposure and survival among children with acute lymphoblastic leukaemia (ALL) treated at 51 Pediatric Oncology Group centres between 1996 and 2001. Of 1672 potentially eligible children under treatment, 482 (29%) participated and personal 24-h MF measurements were obtained from 412 participants. A total of 386 children with ALL and 361 with B-precursor ALL were included in the analysis of event-free survival (time from diagnosis to first treatment failure, relapse, secondary malignancy, or death) and overall survival. After adjustment for risk group and socioeconomic status, the event-free survival hazard ratio (HR) for children with measurements >/=0.3 muT was 1.9 (95% confidence interval (CI) 0.8, 4.9), compared to <0.1 muT. For survival, elevated HRs were found for children exposed to >/=0.3 muT (multivariate HR=4.5, 95% CI 1.5-13.8) but based on only four deaths among 19 children. While risk was increased among children with exposures above 0.3 muT, the small numbers limited inferences for this finding.

Adolescent↗
PubMed2006

Occupational 50 Hz magnetic field exposure measurements among female sewing machine operators in Hungary.

Occupational magnetic field (MF) exposure is less thoroughly characterized in occupations typically held by women. Our objective was to characterize occupational 50 Hz MF personal exposure (PE) among female sewing machine operators. We measured the full shift PE of 51 seamstresses, who worked in two shifts (6-14 and 14-22 h) according to their normal work routine. Measurements were conducted using EMDEX PAL meters at chest level. The average duration of the measurement periods was 449 min (range 420-470). The average arithmetic mean exposure for all women was 0.76 microT (range 0.06-4.27). The average of maximum values was 4.30 microT (range 0.55-14.80). Women working with older sewing machines experienced higher exposure than women working on newer sewing machines. For women (n = 10) who operated sewing machines produced in 1990 or earlier, the average arithmetic mean exposure was 2.09 microT, and for women (n = 41) who operated sewing machines produced after 1990, the average arithmetic mean was 0.43 microT. We conclude that women working as sewing machine operators experience higher than average occupational MF exposure compared to other working women. Most important determinant of the women's personal MF exposure was the age of the sewing machine the women operated.

Electromagnetic Fields↗
PubMed2004

Occupational magnetic field exposure among women in Stockholm County, Sweden.

BACKGROUND: Most epidemiological studies on adverse health effects among women in relation to occupational magnetic field exposure have been based on information about men's exposure. AIMS: To create a job-exposure matrix for occupational exposure to extremely low frequency magnetic fields among women. METHODS AND RESULTS: Measurements were performed using personal magnetic field meters (Emdex Lite) carried by the subjects for 24 hours on a normal workday. Subjects were volunteer women working in the occupations identified as common among women in Stockholm County based on the 1980 census. A total of 471 measurements were made in 49 different occupations, with a minimum of 5 and a maximum of 24 measurements in each occupation. The included occupations cover about 85% of the female population gainfully employed in 1980. Parameters representing average and peak magnetic field exposures, temporal change in the exposure, and proportion of time spent above certain exposure levels were calculated both for the workday and for the total 24 hour period grouped by occupational titles. The occupations with higher than average exposure were cashiers, working proprietors in retail trade, air stewardesses, dental nurses, cooks, post-office clerks and kitchen maids. CONCLUSIONS: This new job-exposure matrix substantially increases the knowledge about magnetic field exposure among women and can be used for exposure assessment in future studies.

Adult↗
PubMed2002

Postoperative sore throat after ambulatory surgery.

BACKGROUND: Sore throat is a common complication of anaesthesia that affects patient satisfaction after surgery. METHODS: We studied 5264 ambulatory surgical patients prospectively to determine the patient, anaesthetic, and surgical factors associated with sore throat. RESULTS: In 5264 patients, 12.1% reported a sore throat. Patients with tracheal tube had the greatest incidence, 45.4%, followed by patients with laryngeal mask airway, 17.5%, while patients with a facemask had a lower incidence of sore throat, 3.3%. Female patients had more sore throats than male patients (13.4 vs 9.1%). Airway management had the strongest influence on the incidence of sore throat. Sore throat in ambulatory surgical patients was associated with female sex, younger patients, use of succinylcholine, and gynaecological surgery. CONCLUSION: Airway management, female sex, younger patients, surgery for gynaecological procedure, and succinylcholine predicts postoperative sore throat. Increased awareness of the predictive factors can help to avoid this combination and improve patient satisfaction.

Adolescent↗
PubMed2001

[Molecular biology examination in chronic lymphocytic leukemia].

Chronic lymphocytic leukaemia (CLL) is the most common adult leukaemia characterised by the accumulation of monoclonal CD5 + B-lymphocytes. The pathogenesis and the biology of CLL is complex and many details are still unknown. Several molecular biological methods have been used in the investigation of CLL, among them the study of apoptosis appears to be one of the most important. Initial experiences obtained by the spontaneous and fludarabine induced apoptosis, multidrug resistance (MDR)-test and fluorescent in situ hybridization (FISH) are reported by the authors. Apoptosis of CLL cells could be induced by fludarabine, while more studies should be performed to determine the exact role of MDR-test and FISH.

Adult↗
PubMed2001

Complement activation in the nasal mucosa following nasal ragweed-allergen challenge.

The aim of this study was to explore complement activation in the nasal lavage following a nasal ragweed-allergen challenge. The study was carried out with 15 adolescents who were allergic to ragweed and with six non-allergic healthy volunteers. Following the baseline measurement after the symptoms were registered, subjects were given increasing doses of ragweed allergen. Lavage fluid was collected and tested for a complement-activation product (C3bBbP). The allergic patients responded to allergen provocation with an increase in C3bBbP formation compared to the initial lavage (p = 0.001). The C3bBbP level remained low in the lavage fluids of the non-allergic controls. We found a strong correlation between the threshold dose that induced symptoms and the dose where the maximum complement activation was detected (r = 0.78, p = 0.001). Our findings indicate that in allergic patients nasal challenge with ragweed allergen induces a rise in complement activation in the nasal lavage fluid. These results highlight the role of the complement system in the allergic inflammation on the nasal mucosal surface.

Allergens↗
PubMed2001

Response of preschool children with asthma symptoms to fluticasone propionate.

BACKGROUND: Many uncertainties remain in the diagnosis and treatment of preschool children with asthma symptoms. OBJECTIVE: We sought to determine the subgroups of preschool children (aged 12-47 months) with recurrent asthma symptoms most likely to respond to inhaled fluticasone propionate (200 microg/d). METHODS: Subgroups of pooled data from 2 similar 12-week multicenter studies were analyzed. RESULTS: Children with frequent symptoms (symptoms on > or =3 days per week and a total of > or =75% days with symptoms during the 4-week run-in period; n = 169) showed a significantly greater increase in days without symptoms after fluticasone propionate treatment (0% to 45%) compared with after placebo treatment (0% to 25%, P =.005). Children with a family history of asthma (n = 213) also had a significantly greater increase in days without symptoms after fluticasone propionate (11% to 54%) compared with after placebo (7% to 35%, P =.002) and a significantly higher proportion of exacerbation-free patients (61% to 76%, P =.02). Children with less frequent symptoms, no family history of asthma, or both showed no significant treatment effect. There seemed to be no association between response to fluticasone propionate and history of rhinitis or eczema or the number of previous exacerbations. CONCLUSIONS: Children with frequent symptoms, a family history of asthma, or both showed the greatest response to fluticasone propionate treatment. These findings may help to predict treatment outcome and guide the management of preschool children with recurrent asthma symptoms.

Administration, Inhalation↗
PubMed2000

[Fluorescence in situ hybridization in the diagnosis and follow-up of chronic myelogenous leukemia].

Chronic myelogenous leukaemia is a clonal myeloproliferative stem cell disease. Its cytogenetical hallmark is the Philadelphia chromosome (Ph) or the BCR/ABL fusion gene. Their identification is important both in the diagnosis and the follow-up of the disease. In our department we have investigated the BCR/ABL gene arrangement in 21 patients with fluorescence in situ hybridization. The aim of the analysis in freshly suspected patients without any previous therapy was to confirm diagnosis and mapping the ratio of Philadelphia positive cells. In contrast to the 95-100% Ph-positivity of mononuclear cells by classical cytogenetical examinations we found BCR/ABL gene arrangement only in various but always lower proportions. Therefore the latter examination gives a better representation of residual normal hemopoesis. Out of 9 patients who had received interferon treatment for at least 6 months, 4 gave a major, 4 a minor cytogenetical answer and in 1 case there was no cytogenetical response. Seven patients reached a complete and 2 a partial hematological remission. Among 5 other patients receiving interferon treatment, in 2 cases with double Ph-positivity we found a rapid progression. The data of 3 patients had to be excluded from the evaluation due to the so far short following time.

Diagnosis, Differential↗
PubMed1999

[Current trends in the drug therapy of childhood asthma].

The primary goals of asthma treatment are to minimize symptoms and preventing exacerbations, and decrease the morbidity of asthma. To improve asthma management international guidelines have been introduced which recommend use prophylactic therapy. Current therapeutic strategies for treating asthma focus on suppressing the inflammatory process by using kromones in mild childhood asthma or inhaled steroids in moderate to severe asthma. The beneficial effects of inhaled corticosteroid outweigh their possible impairing effects on linear body growth. The inhaled route of administration of the drugs is the most appropriate way to treat asthma, it means best clinical effect with the smallest systemic side effect. The age of the child is a major determinant of the inhaled therapy which can be used. Drug delivery in infants and toddlers is the most difficult part of asthma treatment.

Anti-Inflammatory Agents↗
PubMed1999

Adverse events in ambulatory surgery. A comparison between elderly and younger patients.

PURPOSE: An increasing number of elderly patients are undergoing ambulatory surgery. We examined whether ambulatory surgery carries a higher risk for the elderly than for younger patients. METHODS: A total of 17,638 consecutive ambulatory surgical patients were enrolled in a prospective cohort study during a three-year period. Preoperative, intraoperative, and postoperative information was collected. Twenty-seven percent of the enrolled patients were 65 yr or older. Incidence rates of intraoperative and postoperative adverse events among the elderly were compared with those among younger patients; we controlled for sex, ASA physical status, body mass index, type of surgery, and duration of procedure, using multiple logistic regression models. RESULTS: Elderly patients had a higher incidence of any intraoperative event (adjusted odds ratio, 1.4; 99.7% confidence interval [CI], 1.0-2.0) and of intraoperative cardiovascular events (adjusted odds ratio, 2.0; 99.7% CI, 1.3-3.0). They also had a lower incidence of any postoperative event (adjusted odds ratio, 0.4; 99.7% CI, 0.3-0.6) and of postoperative pain (adjusted odds ratio, 0.2; 99.7% CI, 0.1-0.4), nausea and vomiting (adjusted odds ratio, 0.3; 99.7% CI, 0.1-0.6), and dizziness (adjusted odds ratio, 0.4; 99.7% CI, 0.2-1.0). CONCLUSION: The risks reported do not constitute a contraindication for elderly patients to undergo ambulatory surgery but this population may require more careful intraoperative cardiovascular management.

Adult↗
PubMed1999

Pre-existing medical conditions as predictors of adverse events in day-case surgery.

We have developed mathematical models to estimate the risk of perioperative adverse events in patients with pre-existing conditions undergoing day-case surgery. We studied 17,638 consecutive day-case surgical patients in a prospective study. Preoperative, intraoperative and postoperative data were collected. Risk modelling was performed with backward stepwise multiple logistic regression and validated on a separate subset of our patients. Eighteen pre-existing conditions were entered into the model. We adjusted for age, sex, and duration and type of surgery. Seven associations between pre-existing medical conditions and perioperative adverse events were statistically significant. Hypertension predicted the occurrence of any intraoperative event and intraoperative cardiovascular events. Obesity predicted intraoperative and postoperative respiratory events, and smoking and asthma predicted postoperative respiratory events. Gastro-oesophageal reflux predicted intubation-related events. The presented models of risk estimation were validated internally and provided a useful tool for accurate risk estimation.

Adolescent↗
PubMed1999

Factors contributing to a prolonged stay after ambulatory surgery.

UNLABELLED: We identified predictors for prolonged postoperative stay after ambulatory surgery using multiple logistic regression models. We collected perioperative data for 16,411 ambulatory surgical patients. A log-transformed time to discharge variable was modeled by multiple linear regression, including patient-, anesthesia-, and surgery-specific variables. The impact of hypothetical elimination of perioperative adverse events on mean length of stay was also estimated. Separate analyses were performed among patients who received general anesthesia (GA) and monitored anesthesia care (MAC). Patients receiving GA stayed 50 min longer than patients receiving MAC. Patients receiving GA and undergoing strabismus, transurethral, or otorhinolaryngological/dental procedures had the longest postoperative stay. Among patients receiving GA, smokers had a 4% shorter stay compared with nonsmokers; among patients receiving MAC, those with congestive heart failure (CHF) had a 11% longer stay compared with patients without CHF. Postoperative nausea and vomiting, dizziness, excessive pain, and cardiovascular events predicted 22%-79% increases in postoperative stay. The hypothetical elimination of all adverse events resulted in a 9.6% decrease in mean length of stay among patients receiving GA, but in only a 3.8% decrease among patients receiving MAC. The length of postoperative stay among ambulatory surgical patients is mainly determined by the type of surgery and by adverse events, such as excessive pain, postoperative nausea and vomiting, dizziness, drowsiness, and cardiovascular events. Patients with CHF and those who underwent long procedures had a higher risk of a prolonged stay. Appropriate prevention and management of postoperative symptoms could significantly decrease the length of stay among patients receiving GA. IMPLICATIONS: The length of postoperative stay among ambulatory surgical patients is mainly determined by the type of surgery and by adverse events, such as excessive pain, postoperative nausea and vomiting, dizziness, drowsiness, and untoward cardiovascular events. Patients with congestive heart failure and those who underwent long procedures had a higher risk of a prolonged stay. Appropriate prevention and management of postoperative symptoms could significantly decrease the length of stay among patients receiving general anesthesia.

Adult↗
PubMed1999

Can postoperative nausea and vomiting be predicted?

BACKGROUND: Iletrospective studies fail to identify predictors of postoperative nausea and vomiting (PONV). The authors prospectively studied 17,638 consecutive outpatients who had surgery to identify predictors. METHODS: Data on medical conditions, anesthesia, surgery, and PONV were collected in the post-anesthesia care unit, in the ambulatory surgical unit, and in telephone interviews conducted 24 h after surgery. Multiple logistic regression with backward stepwise elimination was used to develop a predictive model An independent set of patients was used to validate the model RESULTS: Age (younger or older), sex (female or male), smoking status (nonsmokers or smokers), previous PONV, type of anesthesia (general or other), duration of anesthesia (longer or shorter), and type of surgery (plastic, orthopedic shoulder, or other) were independent predictors of PONV. A 10-yr increase in age decreased the likelihood of PONV by 13%. The risk for men was one third that for women. A 30-min increase in the duration of anesthesia increased the likelihood of PONV by 59%. General anesthesia increased the likelihood of PONV 11 times compared with other types of anesthesia. Patients with plastic and orthopedic shoulder surgery had a sixfold increase in the risk for PONV. The model predicted PONV accurately and yielded an area under the receiver operating characteristic curve of 0.785+/-0.011 using an independent validation set. CONCLUSIONS: A validated mathematical model is provided to calculate the risk of PONV in outpatients having surgery. Knowing the factors that predict PONV will help anesthesiologists determine which patients will need antiemetic therapy.

Adult↗
PubMed1999

Return hospital visits and hospital readmissions after ambulatory surgery.

OBJECTIVE: To determine the overall and complication-related readmission rates within 30 days after ambulatory surgery at a major ambulatory surgical center. SUMMARY BACKGROUND DATA: Currently in North America, 65% of the surgical procedures are carried out in ambulatory settings. The safety of ambulatory surgery is well documented, with low rates of adverse events during or immediately after surgery. The consequences of ambulatory surgery during an extended period, however, have not been studied extensively. METHODS: Preoperative, intraoperative, and postoperative data were collected on 17,638 consecutive patients undergoing ambulatory surgery at a major ambulatory surgical center in Toronto, Ontario. With the use of the database of the Ontario Ministry of Health, the authors identified all return hospital visits and hospital readmissions occurring in Ontario within 30 days after the ambulatory surgery. Return visits were categorized as emergency room visits, ambulatory surgical unit admissions, or inpatient admissions. The readmissions were categorized as those resulting from surgical, medical, or anesthesia-related complications or those not related to the ambulatory surgery. RESULTS: One hundred ninety-three readmissions occurred within 30 days after ambulatory surgery (readmission rate 1.1%). Six patients returned to the emergency room, 178 patients were readmitted to the ambulatory surgical unit, and 9 patients were readmitted as inpatients. Twenty-five readmissions were the result of surgical complications, and one resulted from a medical complication (pulmonary embolism). The complication-related readmission rate was 0.15% (1 in 678 procedures). The complication rate was significantly higher among patients undergoing transurethral resection of bladder tumor (5.7%). No anesthesia-related readmissions or deaths were identified. CONCLUSIONS: The rate of complication-related readmissions was extremely low (0.15%). This result further supports the view that ambulatory surgery is a safe practice.

Adolescent↗
PubMed1998

[Multicenter studies of terfenadine-containing suspensions in children with hayfever].

Authors treated 50 seasonal allergic rhinitis ragweed sensitive patients with a second generation antihistamine, terfenadine containing suspension given twice/day for two weeks in the weeds season of 1996. Nasal (rhinorrhoea, stuffed nose, sneezing, itching) and eye symptoms (hyperaemia, itching, tearing), noted by the physicians and by the patients' diary, blood count, liver function, kidney function and ECG were examined. There was no meaningful difference between the symptoms registrated by the physicians and the patients. It was pointed out that according to both notes at all symptoms there was an improvement already on the 7th day of the treatment, which developed further for the 14th day. The only exception was rhinorrhoea which ameliorated only for the 14th day. ECG deviation related to the terfenadine treatment was not found. Repeated vomiting was experienced at one child. Transitional, slight SGOT, SGPT activity increase appeared in 4 children, the same was observed at two children in se kreatinine and carbamid nitrogen level. Nine patients needed (from the 7th day) supplementary local treatment (cromoglycate eyedrops or nasal spray).

Anti-Allergic Agents↗