[Quality control of medical documentation of in-patients at the St. Stephen Municipal Hospital in Budapest]. / A fekvöbetegek orvosi dokumentációjának minöségellenörzö vizsgálata a FB1árosi Szent István Kórházban.

Within the frame of hospital quality control programme, the authors have investigated since 1997 the medical documentation concerning in-patients of St. Stephen Hospital Budapest. An assessment form of 26 items related to main elements of medical documentation has been created for the study. Choosing of both order of departments' succession and cases to be investigated took place at random. Evaluation was performed at a scala of 0-3 points, by a five-membered work-group; all members first carried out the qualifications independently of each other, and then they formed the final opinion together at common sessions. Investigation of 204 "first round" cases proved the feasibility of the applied method. As it turned out from the results, the quality of documentation showed statistically significant differences between departments of the hospital and the average standard of documentation could not be declared as satisfying at the period of basic survey. Deficiencies of documentation especially in respect of case history, disease course, personal data and informed consent have been found. On the other hand, registration of status on admission and final report got a relatively high average score-number. The authors call attention to the importance of ordinary control of medical documentation.

Co-incidence of angioleiomyolipoma and renal cyst.

Authors report on a 60-years-old female patient with right renal angiomyolipoma and solitary cyst. Partial resection of the tumour and the cyst was performed during open surgery. Ultrasonography and computerized tomography are mandatory methods of the preoperative investigation. The authors give a review of the related literature.

Diabetes mellitus associated with late onset congenital adrenal hyperplasia: coincidence or causality?

Diabetes mellitus and late onset congenital adrenal hyperplasia due to 11 beta-hydroxylase deficiency were observed in two female siblings aged 51 and 60 years. Not only coincidence but also causality (hyperinsulinism, glucose intolerance due to hyperandrogenism) should be considered when explaining the association of diabetes mellitus with late onset congenital adrenal hyperplasia.

Effects of indomethacin, prostaglandins E2 and I2 on the tone of human isolated femoral arteries.

Strips of endothelium-denuded femoral arteries from operated patients were set up for isometric recording. Indomethacin (IND, 3 mumol 1(-1] enhanced basal tension of the arteries from 0.13 +/- 0.04 to 0.86 +/- 0.12 mN (P less than 0.001; n = 16) and potentiated the contractile responses of the strips to noradrenaline (NA); EC50 for NA was 1.5 +/- 0.3 mumol 1(-1) (n = 6) in the absence, and 0.4 +/- 0.07 mumol 1(-1) (n = 6) in the presence of IND (P less than 0.01). PGI2 produced dose-related relaxation in IND-treated vessels, its IC50 being 15.0 +/- 1.3 nmol 1(-1). Low concentrations of PGE2 (0.85-8.5 nmol 1(-1] reduced whereas its higher concentrations (28-85 nmol 1(-1] increased smooth muscle tone in the presence of IND. These results indicate that human femoral arteries--unlike femoral arteries of some laboratory animals--are highly sensitive to cyclooxygenase inhibition as well as to PGI2 and PGE2.

Formation of cholesterol gallstones: the role of metabolic factors and of congestion.

Cholesterol gallstones were induced in mice by means of a lithogenous diet. Some of the animals were given in addition morphine regularly. The ten-week experiment was concluded with operation. Lithogenesis was recorded, the volume of the gallbladder was measured, the bile collected for analysis and a specimen was taken from the liver for histologic examination. In the animals fed the lithogenous diet were only gallstones found. The occurrence of cholestasis was unequivocally be proved by the volume of the gallbladder and the microscopic examination of the bile sediment in the group treated with morphine. Metabolic factors seem to play the primary role in the formation of cholesterol gallstones; cholestasis is of secondary importance.