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Biomedical subjects

I Csaba

Publications and source records attributed to I Csaba.

At least 19 recordsLinked to original sources
PubMed1997

Impact of the NHS reforms on English hospital productivity: an analysis of the first three years.

OBJECTIVES: To evaluate the effect of purchaser mix, market competition, and trust status on hospital productivity within the NHS internal market. METHODS: Hospital cost and activity data were taken from routinely collected data for acute NHS hospitals in England for 1991-2 to 1993-4. Cross sectional and longitudinal regression methods were used to estimate the effect of trust status, competition, and purchaser mix on average hospital costs per inpatient, after adjusting for outpatient activity levels, casemix, teaching activity, regional salary variation, hospital size, scale of activity, and scope of cases treated. RESULTS: Real productivity gains were apparent across the study period for NHS hospitals on average. Casemix adjustment drastically improved cross sectional comparisons between hospitals. Gaining trust status and increasing host district purchaser share were associated with productivity increases after adjustment for casemix, regional salary differences, and hospital size and scope. Hospitals that became trusts during the study period were on average less productive at the beginning of the period than those that did not, and there were no significant productivity differences between trust waves at the end of the period in 1993-4. Market concentration was not associated with productivity differences. CONCLUSION: Further analysis is needed to determine whether overall and trust associated productivity gains are transient effects, one off shifts, or self perpetuating reorientations of organisational behaviour. Hospitals may have chosen to become trusts because they anticipated being able to increase productivity. Increases in the proportions of small purchasers were associated with increasing costs. Importantly, this study could not adjust for changes in the quality of care.

Cross-Sectional Studies↗
PubMed1992

[Treatment of ectopic pregnancy by laparoscopy].

12 ectopic pregnancy were operated by laparoscope. Earlier 2 patients had tubal pregnancy on the same side, and 3 had contralateral ectopic pregnancy. There were used aspiration method in 3 cases and salpingotomy + aspiration in 9 cases. The aspirated blood volume was 103.3 ml in average, the mean hospitalization time period were 3.1 days. The urinary HCG was negative after 1.9 days in average. There was neither early nor late operative complications. The authors suggest, that the introduction of the method has more advantages, when there are subjective and objective circumstances.

Female↗
PubMed1992

[Atrial natriuretic peptides in normal and toxemic pregnancy].

Atrial natriuretic peptide (ANP) is a potent natriuretic and hypotensive substance whose importance in pregnancy has not been fully elucidated. Because abnormalities of sodium and water balance are known to be involved in the pathogenesis of toxemic pregnancy, the authors attempted to evaluate the role of ANP by measuring its plasma concentration in 16 normal and 22 toxemic pregnant women (gestational age 26-40 wks, mean 34.5 +/- 1.2 and 28-40 wks, mean 36.0 +/- 1.0, respectively). The weight gain during pregnancy was significantly higher in the toxemic group (13.9 +/- 1.0 vs 9.1 +/- 1.0 kg, p less than 0.01). Plasma ANP level in the toxemic group (40.65 +/- 6.17 pg/ml) was significantly (p less than 0.05) increased compared to that measured in the normal pregnancy group (22.46 +/- 4.22 pg/ml). There was no statistical correlation between ANP levels and gestational age or weight gain during pregnancy. The results suggest that ANP may play a role in the regulation of impaired water and sodium homeostasis in toxemic pregnancy.

Atrial Natriuretic Factor↗
PubMed1992

[A new method for the termination of cervical pregnancy].

The authors described a 7 weeks old cervical pregnant case, whome was administered 250 mg methotrexate in infusion to eliminate the throphoblastic tissue. 3 days later the HCG was negative in the urine. After the dilatation of cervix by laminaria, the collapsed amniotic sac came from the cervix with minimal hemorrhage. They suggest the method is suitable to prevent the serious complications of cervical pregnancy.

Abortion, Induced↗
PubMed1991

[Prospective hemorheological study in the third pregnancy trimester].

The prospective hemorheological study was performed in the third trimester of pregnancy. Whole blood viscosity, haematocrit, plasma viscosity and haemoglobin were measured. They did not find significant changes of these parameters in healthy pregnancy. The rheological parameters in the macrosomic group (75%) were same than in the normal group at 37th weeks, but later were significantly higher. Higher blood viscosity has been found in those pregnant women, who delivered retarded fetuses. They suggest, that the progressively increasing blood viscosity in the third trimester of pregnancy causes the disturbances in the intervillous microcirculation, and produces intrauterine growth retardation.

Blood Viscosity↗
PubMed1991

[Analysis of noradrenaline, dopamine and serotonin levels in follicular fluid following superovulatory treatment].

The authors measured the noradrenaline (NA), serotonin (5-HT) and dopamine (DA) content of 47 normally maturated and 16 cystically degenerated follicular fluid samples obtained from patients involved in the in vitro fertilisation and gamete transfer program. The patients were given human menopausal gonadotropin (HMG) as a superovulation treatment, and they were given 7500 IE human Chorionic Gonadotropin (HCG) to induce ovulation 34-36 hours prior to the follicular puncture done by laparoscope. The NA content of the normally developed preovular follicles is 11.4 +/- 8.4 micrograms/100 ml on average. For the cystically degenerated follicles the data are following: 1.1 +/- 0.7 micrograms/100 ml (p less than 0.001). 5--HT and DA for the preovulatory follicles are 14.3 +/- 8.9 micrograms/100 ml and 19.3 +/- 8.2 micrograms/100 ml respectively; at the same time for the cystically degenerated follicles they are 12.2 +/- 6.2 micrograms/100 ml, and 12.7 +/- 6.8 micrograms/100 ml respectively. They presume that the higher amount of NA in the follicular fluid might play an important role in the mechanisms of ovulation, the regulation of postovulatory tubal motility, and the release of progesterone from granulosa cells.

Adolescent↗
PubMed1990

Maternal plasma concentrations of magnesium, calcium, zinc and copper in normal and pathological pregnancies.

In this study, plasma levels of magnesium, calcium, zinc and copper were simultaneously determined in pregnancies complicated by either abortion, intrauterine growth retardation (IUGR), diabetes or EPH (edema, proteinuria, hypertension) gestosis. The levels of the four cations in non-pregnant women and in healthy, pregnant women were also determined. Compared with controls, a significant decrease in magnesium, with increase of the Ca/Mg ratio, was found in spontaneous abortions, but not when patients had a successful continuation of pregnancy. In EPH gestosis, total calcium was reduced, with a significant decrease of the plasma Ca/Mg ratio. A slight, but significant, increase in plasma zinc was observed in women affected by either diabetes or IUGR, probably as a result of reduced zinc uptake by the fetus. In addition, higher copper levels were found in the pathologies studied, with the exception of missed abortions. The possible role of an altered Ca/Mg ratio homeostasis in relation to gestational pathologies is discussed.

Abortion, Spontaneous↗
PubMed1990

[Screening for diabetes in obese pregnant women].

Oral glucose tolerance testing (oGTT) was performed according to WHO criteria among obese pregnant women (body mass index greater than 28) who were recruited with the help of computerized pregnancy counselling data base. oGTT was carried out for the first time between gestational ages of 16-20 weeks, and it was repeated monthly as far as possible. Gestational diabetes was diagnosed in 4 cases out of 50 obese patients. Two gestational diabetic patients needed insulin treatment. According to computerized data obese patients have significantly higher risk of having macrosomic infants and/or intrauterine death. Fasting blood glucose values of obese pregnant women were significantly higher in all the gestational ages. It is emphasized that obesity means a risk factor for gestational diabetes, but the onset of carbohydrate intolerance may be prevented or diagnosed as early as possible with the help of repeated oGTT during pregnancy and dietary counselling. In this way fetal complications, especially macrosomia will not develop.

Blood Glucose↗
PubMed1990

[Determination of placental protein 12 (insulin-like growth factor binding protein 25) in pleural effusion of various origins].

It is reported on the possible role of the radioimmunological estimation of placental protein 12 (PP 12; insulin-like growth factor binding protein 25, IGF-BP 25) in pleural effusions of patients with lung cancer, with pleural carcinosis of extrathoracal carcinomas and benign pleural diseases, respectively. There are more PP 12, IGF-BP 25-positive cases at benign diseases than at carcinomas at all. It is discussed the possible importance of PP 12, IGF-BP 25 as a binding protein of growth factor s IGF-I and -II. The clinical validity should be analysed in more detail on the basis of the estimation of more patients.

Adult↗
PubMed1990

Screening for gestational diabetes among women who have previously had a large baby or a stillborn infant.

In Baranya county, Hungary oral glucose tolerance tests were done according to WHO recommendations in pregnant women with a history of a previous baby weighing greater than or equal to 4000 g and/or a previous unexplained intrauterine fetal death. The first oral glucose tolerance test was done at 16-20 weeks gestation, and it was repeated monthly if it was normal. Patients with impaired glucose tolerance or gestational diabetes were treated by diet and/or insulin. 152 patients were involved in the screening program. Twenty-six of 81 patients had a "lag" curve blood glucose still above 5.5 mmol/ at 180 min.

Adolescent↗
PubMed1990

Changes in circulating hormone levels after ovarian wedge resection in patients with polycystic ovary syndrome.

Serum gonadotropin, prolactin, estradiol, sex hormone binding globulin (SHBG) and androgen levels were measured before, 5 days and 6 weeks following ovarian wedge resection in 9 patients with polycystic ovary syndrome. Elevated levels of LH, androstenedione, testosterone and dehydroepiandrosterone-sulphate (DHEA-S) were found before surgery. There was a marked decrease in androstenedione and DHEA-S levels 5 days following wedge resection, but a rebound effect could be observed 6 weeks later. Serum gonadotropin, prolactin, testosterone and SHBG concentrations were practically unaffected by surgery. At 6-12 months follow up patients showed regular, mainly ovulatory cycles, but pregnancy occurred only in two cases.

Adolescent↗
PubMed1990

[Effect of 2 different forms of chemotherapy on remission in patients with advanced ovarian cancer].

Results of combined treatment with two different drug combinations were compared in 82 patients with advanced ovarian carcinoma (stages III-IV). 41 patients received cyclophosphamide, methotrexate, vincristine (CMV) and the other 41 patients were treated with cyclophosphamide, adriamycin and cisplatin (CAP). 34 patients (82.9%) treated with the CAP-regimen and 20 patients (48.8%) treated with CMV had remissions following treatment. The average duration of remission was longer in the CAP group (18.1 months) compared to CMV treatment (11.6 months). The mean survival time 24.3 and 14.7 months respectively. It is concluded that three drug therapy is optimal in advanced ovarian carcinoma.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

[Treatment of cervical cancer using the Wertheim-Latzko radical operation at the Gynecology Clinic of Pécs].

The authors performed 119 Wertheim--Latzko operations from July 1, 1975 to December 31, 1988. 108 patients are still alive. The 5 years survival rate of patients operated on before 1984 was 89.8%. Radical hysterectomy involving careful removal of regional lymphnodes was carried out after lymphography and preoperative irradiation. Postoperative irradiation was made on radiologist's indication. Significance of combined surgical and radiotherapy is emphasised in the management of cervical cancer in stages IB and IIA. Surgery is especially important in adenocarcinomas that are less sensitive to irradiation, in cases of large and necrotic tumors with the barrel formation of endocervical cavity and in cases not showing appropriate regression after radiotherapy. Surgical tumor removal appears to be of much value in young patients, in cases of anaplastic tumors in suspicious lymphographic findings, and in those patients, whose recovery may be expected only from operation and supplementary radiotherapy. Very important condition for obtaining good recovery results and low rate of surgical complications are the team of experienced surgeons and organized regional centres for radical hysterectomies.

Adnexa Uteri↗
PubMed1989

[A new method for treating ectopic pregnancy with methotrexate].

Due to diagnostic methods of the last decades, such as laparoscopy, ultrasonography and radioimmunoassays, early diagnosis of pregnancy and also of ectopic pregnancy became available. Management of ectopic pregnancy has been conservative tubal surgery so far. Local Methotrexate treatment of ectopic pregnancy was reported only recently. The authors treated successfully two cases of ectopic tubal pregnancy with locally administered 50 mg Methotrexate. One of the tubal pregnancies occurred after IVF, and the other one following GIFT. After local Methotrexate treatment both patients are without any complaints or symptoms. This new method in the treatment of early diagnosed ectopic pregnancy is emphasized and prosed.

Administration, Topical↗
PubMed1989

[Early screening of gestational diabetes in high risk pregnancy cases].

Oral glucose tolerance testing was performed according to WHO criteria among pregnant women with historical risk factors for gestational diabetes (a previous baby weighing 4000 g or more, a previous unexplained intrauterine death) in Baranya county. Oral glucose tolerance test was carried out for the first time between gestational ages of 16-20 weeks, and it was repeated monthly in cases of normal curve. Patients with impaired glucose tolerance or diabetes were cared, dietary of prophylactic insulin treatment was introduced. 152 patients were involved in the screening program. 26 patients had gestational diabetes or impaired glucose tolerance. The glucose tolerance test curve was "stretched" in 81 patients. Early screening and management of pregnant women with maternal historical risk factors is emphasised from the view of diminishing complications, especially the frequency of macrosomia.

Birth Weight↗