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.

[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.

[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.

[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.