Biomedical subjects

Tibor Nyári

Publications and source records attributed to Tibor Nyári.

12 recordsLinked to original sources

PubMed2006

[What does fetal renal echogenicity mean in intrauterine growth retardation?].

AIMS: The object of this study was to investigate the fetal renal and middle cerebral arterial blood flows in patients with normal and hyperechogenic kidneys during the fetal period. MATERIAL AND METHODS: Study group consisted of 82 pregnancies with intrauterine growth retardation. Group included pregnant women from the third trimester. Hyperechogenic medullae were detected in 17 out of 82 pregnancies with intrauterine growth retardation. RESULTS: Fetal renal hyperechogenicity appears to be an indicator of fetal arterial circulatory depression, correlated with pathological changes in the pulsatility index for the fetal renal arteries. The fetal renal arterial blood flow pulsatility index was significantly lower in hyperechogenic cases, while in the middle cerebral artery flow was in the normal range. This may also be an indication of subsequent intrauterine and neonatal complications, such as cesarean section because of fetal distress (47%), treatment in a neonatal intensive care unit (71%) or increased perinatal mortality (12%) in our cases. CONCLUSIONS: Detailed ultrasound of renal parenchyma and Doppler examination of renal and middle cerebral arteries appear to be an useful method in the prenatal diagnosis of reduced renal perfusion and of intrauterine hypoxia so as to detect possible pathological fetal conditions in utero.

Adult↗

PubMed2006

Collaborative/active participation per se does not decrease anxiety in breast cancer.

The information needs of breast cancer patients on their disease, its treatment, the prognosis, and their attitude to decision-making concerning treatment were assessed. One hundred and fifty early and 45 metastatic breast cancer patients were recruited into the study. The amount of information and role in the treatment decision-making process preferred by the patient were independently estimated by the patient and the oncologist, using questionnaires. Information was provided in accordance with the wishes of the patient as perceived by the physician. Test of anxiety was performed before, and one week after the consultation. Most of the patients claimed to anticipate the provision of extensive information and an active role in the decision-making, but real interest during the consultation was found less frequently. The post-consultation anxiety test revealed a significant decrease in situational anxiety; this was not related to the patient's information needs or her attitude to the decision-making concerning treatment. Our study demonstrates that a significant decrease in anxiety may be achieved via a consultation tailored to the needs of the patient. Loading the patient with information and involvement in the decision regarding therapy as much as the patient seems comfortable with lowers distress.

Access to Information↗

PubMed2006

Remaining in or leaving the profession: the view of medical students.

Views held by medical students on their remaining in a medical career or leaving it and the relationship with other elements of becoming a doctor are described. The study was carried out with a self-administered questionnaire with general medical students randomly selected in Hungary. Depending on whether they want to remain in the profession or want to leave it, medical students were divided into two groups. A significant difference was revealed between the two groups with regard to the strength of their dedication to the profession. The medical students indicated that their decision to leave or stay with medicine is conditioned by subjective factors. Our results could contribute to shaping of a better professional identity during training/socialisation, as well as to a better understanding of job abandoners.

Career Choice↗

PubMed2006

The determinants of self-rated health among ethnic minorities in Hungary.

BACKGROUND: The health status of a population is largely determined by the mutually interrelated factors of social and financial conditions, and by lifestyle, including health-related behaviour. The aim of the study was to investigate the factors influencing self-rated health among different ethnic minorities living in closed communities in the South-East Hungarian region. METHODS: The cross-sectional survey was based on interviewer-administered questionnaires on socio-demographic variables, lifestyle and health status. In the study 100-120 persons were recruited from Serbian, Croatian, Romanian, German minorities and the Hungarian population. Univariate and multivariate logistic regression models were used. RESULTS: In the univariate analyses, poor self-rated health correlated with all the factors examined except marital status. In the multivariate logistic regression model, poor health was found to be significantly associated with age, educational level, ethnicity, body mass index and chronic diseases. Poor self-rated health was observed in the Croatians and in the Hungarian control group. CONCLUSION: In South-East Hungary, demographic parameters, especially being a member of a minority, and objective health status are highly important determinants of self-rated health. Several of the parameters studied in our survey indicated no effect or no special differences within the population of the region as concerns of self-rated health; certain other factors, however, proved to be special features for the studied ethnic minority, justifying the launching of target group-oriented health intervention programmes.

Adolescent↗

PubMed2006

Elevated levels of circulating insulin-like growth factor-I, IGF-binding globulin-3 and testosterone predict hormone-dependent breast cancer in postmenopausal women: a case-control study.

There is increasing evidence that different types of breast cancers are related to distinct risk factors. We analyzed the risk of breast cancer with respect to circulating insulin-like growth factor (IGF)-I, IGF-binding protein (IGFBP)-3, 17beta-estradiol, estrone, testosterone, androstenedione and sex hormone-binding globulin (SHBG), taking into consideration the characteristics of the tumors. Plasma hormone levels of 102 postmenopausal patients with breast cancer detected by mammography screening, and 102 matched controls were analyzed in relation to the histological type, the status of the estrogen receptor (ER), the progesterone receptor (PR) and the HER2 in the tumors. Significant positive associations were revealed between the IGF-I concentration and the overall risk of breast cancer (OR=3.1, 95% CI: 1.5-6.2), ER+PR+ breast cancer (OR=2.4, 95% CI: 1.1-5.4) and ER+PR- breast cancer (OR=4.3, 95% CI: 1.2-14.3) when the highest and the lowest ranges of IGF-I were compared. Significant associations were also found between the highest and the lowest quartiles of testosterone, resulting in OR=4.1 (95% CI: 1.8-9.4) for the risks of breast cancer and OR=5.8 (96% CI: 2.1-16.2) of ER+PR+ breast cancer. A synergy was seen between IGF-I and testosterone levels. When both plasma IGF-I and testosterone were in the highest quartile ranges, an OR=26.4 (95% CI: 1.6-426.5, p=0.021) was computed for breast cancer overall. No significant synergistic effects could be demonstrated with other parameters. There were significant, 2.5-fold (95% CI: 1.2-5.6), and 16-fold (95% CI: 2.0-133.5) increases in the overall risks of breast cancer and of ER+PR- breast cancer, respectively, when the highest and the lowest quartiles of IGFBP-3 were compared. No associations were found between any of the hormones and the risk of ER-PR- tumors. The increased prevalence of ER+ breast cancers in patients with higher levels of IGF-I, IGFBP-3 or testosterone implicate these hormones in the etiology of hormone-dependent breast cancer. Additional analyses specific for breast cancer subtypes may shed light on the value of hormone determinations for tailored chemoprevention.

Aged↗

PubMed2005

Human papillomavirus infection and cervical intraepithelial neoplasia in a cohort of low-risk women.

OBJECTIVE: This study was a prospective examination of the incidence of human papillomavirus (HPV) infection in a low-risk female population and an assessment of the risk of development of LSIL with HPV infection. STUDY DESIGN: In a longitudinal study, women aged 19-60 years--non-smokers, and married or living with a constant partner, who presented for cervical cancer screening at an outpatient clinic--were invited to participate in a prospective study of cervical HPV infection, and were examined every 3 months. RESULTS: Of the 464 women at risk, 20 presented with HPV infections during the follow-up. Low-grade squamous intraepithelial lesions (LSIL) event developed in 18 women. Among these women, 13 were HPV-positive (10 high-risk and 3 low-risk types). The average duration of new LSIL was 20.1 months (95% CI: 13.9-26.3) and 55.3 months (95% CI: 45.7-64.9) in the HPV-positive and negative groups, respectively, the difference was statistically significant (p<0.001). With the use of Cox proportional hazard regression, we estimated the relative risk as 90.0 for a first instance of LSIL among women testing positive for HPV as compared with women testing negative for HPV. CONCLUSION: This study has provided evidence that HPV infection is associated with an increased risk of LSIL.

Adult↗

PubMed2005

[Biparietal diameter/kidney length ratio in cases with chronic hypoxic state].

AIMS: The object of this study was to investigate the fetal biparietal diameter/kidney length ratio in normal and hyperechogenic kidneys during the third trimester of gestation. MATERIAL AND METHODS: The selected cases were characterized by pregnancy-associated hypertension and/or proteinuria, which was associated with fetal hypoxia due to the depression of placental blood flow. Depending on the renal manifestation of intrauterine chronic hypoxia, cases were divided into two study groups. Group I was composed of 21 fetuses with pregnancy-associated hypertension and/or proteinuria and hyperechogenic renal medullae. Group II consisted of 162 fetuses with pregnancy-associated hypertension and/or proteinuria and normal echoic kidney. Both study groups included pregnant women from the third trimester. RESULTS: Fetal renal hyperechogenicity correlated with the pathological growth of fetal kidney. The fetal biparietal diameter/kidney length ratio was significantly lower in cases of hyperechogenicity. CONCLUSIONS: The fetal renal hyperechogenicity is a relevant indicator of diminution of fetal renal perfusion. This can lead to abnormal development of the affected kidney and can result in a pathological reduction of biparietal diameter/kidney length ratio, which may also be an in utero indicator of subsequent intrauterine and neonatal complications. Detailed ultrasound examinations of renal parenchyma and kidney length seem to be a useful method in the prenatal diagnosis of decreased renal perfusion and of intrauterine hypoxia and serve to detect pathological conditions in utero.

Adult↗

PubMed2005

Oral glucose tolerance testing at gestational weeks < or =16 could predict or exclude subsequent gestational diabetes mellitus during the current pregnancy in high risk group.

BACKGROUND: An oral glucose tolerance test with a result that is negative but close to the diagnostic cut-off in early pregnancy was hypothesized to serve as a predictor of subsequent gestational diabetes in a high risk group. The aim of the study was to determine those cut-off values of OGTT at gestational weeks < or =16, which can predict or exclude subsequent onset of GDM in a high risk group. METHODS: Pregnant women at high risk of gestational diabetes (n = 163) underwent a 2-h, 75-g oral glucose tolerance test at gestational weeks < or =16 were analyzed in this study. In the event of a negative result, subsequent oral glucose tolerance tests were performed at gestational weeks 24-28 and 32-34. The sensitivity, the specificity, the positive and negative predictive values and the Odds ratio of the best cut-off values of fasting and postload glucose levels were calculated. RESULTS: The best cut-off values to exclude subsequent GDM for fasting and postload glucose were 5.0 and 6.2 mmol/l, respectively. In combination, the best cut-off values were 5.3 mmol/l for fasting and 6.8 mmol/l for postload glucose, with negative predictive values of 0.97 and 0.71 and sensitivities of 96.9 and 86.3 at gestational weeks 24-28 and 32-34, respectively. Combination of these cut-off values with obesity proved to be very predictive for gestational diabetes by gestational weeks 32-34, with an Odds ratio of 6.0 [95% confidence interval: 1.7-21.0]. CONCLUSIONS: With regard to the very high negative predictive value of the method, pregnant women with glucose levels of < or =5.3 mmol/l at fasting and of < or = 6.8 mmol/l at postload in gestational weeks < or =16 should undergo subsequent oral glucose tolerance testing merely at gestational weeks 32-34. Approximately a quarter (24.5%) of the pregnant women at risk of gestational diabetes satisfied these criteria.

Adult↗

PubMed2004

Large cell neuroblastoma: a distinct phenotype of neuroblastoma with aggressive clinical behavior.

BACKGROUND: Among cases of undifferentiated and poorly differentiated tumors in the neuroblastoma (Schwannian stroma-poor) category, the authors histologically identified a group of rare tumors, known as large cell neuroblastomas (LCNs), that are composed of large cells with sharply outlined nuclear membranes and 1-4 prominent nucleoli. METHODS: Histologic and immunohistochemical features of LCN were characterized. Morphologic characteristics, clinical features, and MYCN status were compared between LCNs and conventional neuroblastomas documented in the files of two European centers (the Sir James Spence Institute of Child Health, Royal Victoria Infirmary, University of Newcastle, Newcastle upon Tyne, United Kingdom, and the Medical and Health Sciences Center, University of Pécs, Pécs, Hungary). RESULTS: Of 92 peripheral neuroblastic tumors (pNTs; including neuroblastoma [n = 81]; ganglioneuroblastoma, intermixed [n = 6]; and ganglioneuroblastoma, nodular [n = 5]), 7 (7.6%) qualified as LCN. All 7 LCNs were classified as having unfavorable histology (UH) according to the International Neuroblastoma Pathology Classification. The LCNs were composed of monomorphous undifferentiated neuroblasts and shared certain histologic features, such as a high incidence of high mitosis-karyorrhexis index and a low incidence of calcification, with other neuroblastomas in the conventional UH (c-UH) group. These features were significantly different from those of neuroblastomas in the conventional favorable histology (c-FH) group. On immunohistochemical analysis, LCN tumor cells were positive for neuron-specific enolase (5 of 5 cases), protein gene product 9.5 (5 of 5 cases), synaptophysin (5 of 5 cases), tyrosine hydroxylase (focally in 3 of 3 cases), and NB84 (3 of 5 cases) and negative for CD99. Patients with LCN and patients with c-UH disease had similar clinical features (diagnosis at age > 1 year, often with distant metastasis). The clinical features of these patients also were significantly different from those of patients with c-FH disease. Further analysis demonstrated that the LCN group was significantly different from both the c-UH and c-FH groups with respect to MYCN status (MYCN amplification, 4 of 5 vs. 3 of 17 vs. 8 of 17, respectively; P = 0.023) and survival rate (4-year expected survival, 0% vs. 71% vs. 17%, respectively; P < 0.01). CONCLUSIONS: Because of its unique clinicopathologic features, the authors propose that LCN be recognized as a distinct entity within the undifferentiated and poorly differentiated subtypes of the neuroblastoma category.

Child↗

PubMed2003

Should all sexually active young women in Hungary be screened for Chlamydia trachomatis?

OBJECTIVE: Cost-effectiveness analysis was carried out to develop screening strategy for Chlamydia trachomatis to assess the possibility of preventing pelvic inflammatory disease and its sequelae. STUDY DESIGN: An 18 months epidemiological study of prevalence of chlamydial infection among pregnant women was carried out in Hungary. RESULTS: The policy of testing and treating was less cost-effective than neither testing nor treating, unless the cost of the diagnostic test were less than or equal to US$ 10, or the prevalence of infection in women were greater than 8.3. CONCLUSIONS: Since the prevalence of chlamydial infection amongst 15-24 years old women in this study was 8.0%, the cost of screening in Hungary only barely outweighs the benefit in economic terms. Given the undesirable potential consequences of the infection, it is thus recommended that Hungarian clinicians should screen all young, sexually active women for C. trachomatis at the same time as they perform routine pelvic examinations.

Adolescent↗

PubMed2002

What is biparietal diameter/kidney length ratio in cases with renal hyperechogenicity?

The object of this study was to investigate the fetal biparietal diameter/kidney length ratio in normal and hyperechogenic kidneys during the 3rd trimester of gestation. Screened pregnancies were chronically hypoxic [i.e. intrauterine growth retardation (IUGR)]. Depending on the renal manifestation of the intrauterine chronic hypoxia, the cases were divided into two study groups. Group I was composed of 28 fetuses with IUGR and hyperechogenic renal medullae. Group II consisted of 62 fetuses with IUGR and normal echoic kidney. Both study groups included pregnant women from the 3rd trimester. Fetal renal hyperechogenicity is an indicator of depression of fetal renal perfusion, correlated with pathological growth in the fetal kidney development. The fetal biparietal diameter/kidney length ratio was significantly higher in hyperechogenic cases. This may also be an in utero indicator of subsequent intrauterine and neonatal complications. Detailed ultrasound examinations of renal parenchyma and length appear to be useful in the prenatal diagnosis of reduced renal perfusion and of intrauterine hypoxia, allowing detection of possible pathological fetal conditions in utero.

Female↗

PubMed2002

[Social background of small-for-gestational-age infants].

INTRODUCTION: The Small for Gestational Age birth rate is still unchanged during the last decades opposite to the premature birth frequency. This fact needs further examinations. AIM AND METHODS: The association of socio-economic status and the development of intrauterine growth retardation was analysed in a two year prospective study. The study group consisted of 34 patients having small-for-gestational-age newborns. The control group consisted of those 68 women having normal term birth. RESULTS: Significant differences were found in the Body Mass Index, smoking habits during pregnancy, education, and poverty status. The difference in age was expressed, but not significant. There were no significant differences among alcohol and coffein consumption, family status, household crowding and employment. CONCLUSION: Beside the effective medical prenatal care the importance of education and social support is emphasised.

Attitude to Health↗