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Biomedical subjects

Z Papp

Publications and source records attributed to Z Papp.

At least 163 records · Page 9Linked to original sources
PubMed1995

Impact of prenatal mid-trimester screening on the prevalence of fetal structural anomalies: a prospective epidemiological study.

The objective of this study was to evaluate the effectiveness of the measurement of maternal serum alpha-fetoprotein (MSAFP) at 16 weeks and a subsequent routine ultrasound screening at 18-20 weeks' gestation and the impact on the birth prevalence of congenital structural anomalies in an unselected pregnant population of Hungary in a prospective epidemiological study. A total of 63,794 pregnant women (representing one-sixth of the population of Hungary) were offered this screening program over 3 years (1988-90). Of the pregnant population, 75.7% (48,312) received MSAFP screening and in 81.0% (51,675), at least one ultrasound scan was performed. In the screened pregnancies, 496 craniospinal, thoraco-abdominal, urogenital and other severe major anomalies occurred; 317 were detected at 18-20 weeks (sensitivity 63.1%; specificity 100.0%; positive predictive value 100.0%). The sensitivity of ultrasound scanning was significantly higher (p < 0.05) than that of the MSAFP screening. (At the time of ultrasound scanning the MSAFP value was known.) In this study, the less serious anomalies such as hydrocele, hypospadias and undescended testicle were not systematically searched for, but the birth prevalences were calculated. The overall mid-trimester prevalence of severe plus less severe major anomalies was 2.26%. The birth prevalences of severe major anomalies were 0.57 (craniospinal), 4.36 (thoracoabdominal and urogenital) and 1.21 (other severe) per 1000. These values were lower than the mid-trimester prevalences which were 2.94, 5.20 and 2.06 per 1000, respectively. The prevalence values at the age of 1 year were also calculated (0.36, 2.21, 0.54 per 1000, respectively). We conclude that our screening program with availability of termination of pregnancy could significantly (p < 0.05) reduce the prevalence of severe major abnormalities at birth. Training programs in cardiac scanning are required.

Abnormalities, Multiple↗
PubMed1995

Normal puerperium and breast-feeding.

Mothers who have just given birth need support from medical staff and also from their home surroundings. The type of support given to mothers and their new babies varies in different countries and cultures, but should be equally adequate and beneficial. Breast-feeding, as the very best method of early nutrition of the newborn, is the central event of puerperium. Its importance, and other practical approaches during this period are discussed and reviewed.

Breast Feeding↗
PubMed1994

[Prenatal follow-up of fetal tachyarrhythmia].

A case of fetal supraventricular tachycardia complicated by atrial flutter was recognized in the 26th week of gestation and was successfully treated during pregnancy. Cardiotocography could not generate appreciable result at such a fetal tachyarrhythmia. The intrauterine condition was evaluated by the examination of the Doppler blood flow parameters of the fetal vessels. During follow up strong correlation was found between the blood flow parameters, transplacental therapy and the cardiac function. When repeated and long lasting supraventricular tachycardias were observed, due to the atrial flutter, signs of centralization of the fetal circulation could be monitored as a sign of deteriorating peripheral oxygenation. Parallel to the improvement of the arrhythmia and to the reduction of the supraventricular tachycardia a significant correction of the circulatory parameters could be detected. Based on these experiences, investigation of fetal blood flow parameters is a useful tool in monitoring the intrauterine state of the tachyarrhythmic fetus. It can be concluded that in cases of prenatally diagnosed fetal arrhythmias further pre- and perinatal care should be done in appropriate equipped centers.

Adult↗
PubMed1994

[Rupture of extrauterine pregnancy during simultaneous intrauterine pregnancy].

The authors report a case of a simultaneous extrauterine and intrauterine pregnancy which posed a problem of differential diagnosis for both the surgeon and the gynecologist. After surgical treatment of the ruptured ectopic pregnancy the patient was symptom free, and later requested the interruption of her normal intrauterine pregnancy. Diagnosis was confirmed by ultrasonographic examination.

Abortion, Induced↗
PubMed1994

[Management of patients with endometrial cancer in Hungary].

The authors made an investigation of patients suffering from endometrial cancer during a one year period in Hungary. Out of the data of 105 gynecological wards from the 1051 patients 1043 cases were evaluated. Staging was controlled having the histological results and the clinical data on every sheet, fitting the requirements of the latest international classification, and taking into account the grading of histological differentiation. They evaluated the place and the way of diagnosis and the distribution of the methods leading to definitive diagnosis. The different examinations to state a definitive diagnosis were reported. Distributions of age and stages were compared with the published Hungarian cases. Actual situation of management was criticized, studying the present possibilities of operative, irradiative and chemical treatment. They suggest more particular determination of staging and grading of patients suffering from endometrial cancer in order to provide uniform treatment that fits the international requirements.

Combined Modality Therapy↗
PubMed1994

The role of progestationally regulated stromal cell tissue factor and type-1 plasminogen activator inhibitor (PAI-1) in endometrial hemostasis and menstruation.

The physiologic mechanisms whereby the human endometrium maintains hemostasis during endovascular trophoblast invasion, yet permits menstrual hemorrhage, are unknown. This paradoxical relationship was investigated by evaluating endometrial expression of tissue factor (TF), the primary initiator of hemostasis, and plasminogen activator inhibitor-1 (PAI-1), the primary inhibitor of fibrinolysis. We observed increased immunostaining for TF and PAI-1 in sections of decidualized stromal cells from luteal phase and gestational endometrium. To determine whether TF and PAI-1 expression are directly linked to decidualization, both endpoints were monitored in a well described in vitro model of decidualization. Thus, confluent stromal cell cultures were exposed to vehicle control, 10(-8) M estradiol (E2), 10(-8) to 10(-6) M medroxyprogesterone acetate (MPA) or both E2 + MPA for 2-24 days in serum-containing or defined media. The progestin enhanced the content of stromal cell-associated immunoreactive and functionally active TF and PAI-1 released into the medium and elevated levels of stromal cell TF and PAI-1 mRNA. While E2 alone was ineffective, it greatly augmented MPA-enhanced TF and PAI-1 protein and mRNA content. Dose-dependent effects on TF and PAI-1 content were observed between 10(-8) to 10(-6) M MPA +/- E2. Similar results were observed for decidual cells derived from first trimester endometrium and cultured in type 1 collagen gels. Following optimal induction of TF and PAI-1 expression by E2 + MPA in stromal cell cultures, removal of these steroids greatly reduced levels of both TF and PAI-1 protein and mRNA within 4 days. These studies suggest a mechanism whereby endometrial hemostasis is maintained during trophoblast invasion yet reduced at the end of nonfertile cycles to permit menses.

Cells, Cultured↗
PubMed1994

[Management of cervical cancer patients in Hungary].

The authors made an exact investigation of the treatment of patients suffering from cervical cancer during one year period. Out of the data of 101 gynecological wards 1700 cases were evaluated. The authors evaluated the different ways of treatment with respect to the international requirements on the base of hystological results. They elaborated the operative methods in every stage of cervical cancers, with more details on radical hysterectomy and regional lymphadenectomy. The authors suggest that patients suffering from cervical cancer should be treated by standardized principles based on international scientific experiences.

Adult↗
PubMed1994

[Management of cervical cancer patients in Hungary. (Detection)].

The authors made an exact investigation of the patients suffering from cervical cancer during a one-year period. Out of the data of more than 1800 patients of 101 gynaecological wards, 17,006 cases were evaluated. The present publication deals with the issue of diagnosis. Staging was controlled by data sheets, having the histological diagnosis at hand and with due respect to the most recent international staging. The way of diagnosing cervical cancer and the distribution of examinations guaranteeing definite diagnosis were investigated. The different diagnostic methods were evaluated on the basis of the expansion of the different medical interventions. The authors report on the medical interventions performed in the interest of making a definite diagnosis. Comparisons are made, on the basis of age and staging, with the earlier Hungarian and international results and findings. Finally, the authors propose that all the gynaecological examination should, at the same time, be cancer screening, and a proposal is made on the methods of doing it.

Adult↗
PubMed1994

[Laparoscopic management of extrauterine pregnancy by salpingotomy].

The classical therapy of tubal pregnancy has been the salpingectomy for decades. Because of infertility problems caused by previous ectopic pregnancies and the organ preserving philosophy the microsurgical salpingotomy became more popular in the seventies. The technical development in the field of gynaecological endoscopy made it possible to perform the salpingotomy even through the laparoscope. The authors report in detail on their technique based on bipolar coagulation, cold knife linear salpingotomy and leaving the tubal wound open for secondary healing. They summarize their preliminary results after the management of nine patients.

Adult↗
PubMed1994

New trends in the surgery of gynaecological tumours.

Operative treatment of gynaecological tumours includes exploration, staging and removal of tumour for both therapeutic and diagnostic purposes for advanced processes the optimum conditions of postoperative supplementary treatment are to be developed. In contrast with the earlier view suggesting that a malignant tumour of a given organ is always the same in every case, nowadays tumour heterogeneity is emphasized. Multicentrical co-operative surgical research should widen our knowledge. Well-designed and well-equipped centres should be made available for our patients suffering from gynaecological malignancies; gynaecological oncology needs well-planned functioning special clinics/wards.

Endometrial Neoplasms↗
PubMed1993

[Screening of congenital anomalies in the mid-trimester of pregnancy. Prospective epidemiologic study. Developmental anomalies].

Authors report about the data of 60,000 pregnant women from three district counties of Eastern-Hungary between 1988 and 1990, on whom both ultrasound and alfa-fetoprotein screenings were performed. They demonstrate the value of this screening for the detection of fetal malformations and for the birth prevalence rate as well. This effective screening-protocol is proposed for a nation-wide application.

Abortion, Spontaneous↗