ÖZAmaç: Bu çalışmada demografik ve klinik etkenlerin ileri yaşlı Macar nüfusunda ikinci (kontralateral) kalça kırığı insidansı üzerindeki önemi Macaristan'daki ulusal sağlık sigortası veri tabanı kullanılarak araştırıldı. Hastalar ve yöntemler: Çalışmaya 2000 yılında düşük enerjili travma nedeniyle primer monotravmatik femur boyun kırıkları için tedavi edilen toplam 3.783 hasta (917 erkek, 2.866 kadın) dahil edildi. Aşağıdaki prognostik etkenleri değerlendirmek için Cox regresyon ve Kaplan-Meier sağkalım analizleri ve log sıra testi uygulandı: Yaş, cinsiyet, yaşanan yer, primer kırık tipi ve cerrahi girişim, primer kırık için tedavi veren hastane ve eşlik eden hastalıklar. Bulgular: Toplam 312 hastada (%8.2) ikinci kalça kırığı vardı. Tek değişkenli Cox regresyon analizi ikinci kalça kırığı için daha yaşlı (p= 0.001), kadın cinsiyetli (p= 0.022), başkentte yaşayan (p= 0.024) ve artroplastisi olan (p= 0.001) hastalarda anlamlı derecede daha yüksek risk gösterdi. Çok değişkenli analize göre, daha yaş (p≤0.001) ve artroplastili olmak (p= 0.004) ikinci kalça kırıkları için anlamlı risk faktörleri idi. Log sıra testi erkeklere göre kadınlarda (p<0.001) ve osteosentezli olanlara göre artroplastili hastalarda (p= 0.013) anlamlı derecede daha uzun sağkalım olduğunu gösterdi. Sonuç: Etkili korunma stratejileri oluşturmak için yüksek riskli grupların tanımlanması gereklidir. Çalışmamız ikinci kalça kırığına maruz kalma riskinin kadınlarda, ileri yaşlı nüfusta, başkentte yaşayanlarda ve artroplasti geçiren hastalarda daha yüksek olduğunu göstermektedir.Anahtar sözcükler: Yaşlı nüfus; femur boyun kırığı; insidans; risk faktörleri; ikinci kalça kırığı. ABSTRACTObjectives: This study aims to investigate the significance of demographic and clinical factors on incidence of second (contralateral) hip fracture in elderly Hungarian population using the nationwide health insurance database in Hungary. Patients and methods:The study included a total of 3,783 patients (917 males, 2,866 females) treated for primary monotraumatic femoral neck fractures caused by low-energy trauma in the year 2000. Cox regression and Kaplan-Meier survival analyses, and log-rank test were performed to evaluate the following prognostic factors: age, gender, place of living, type of primary fracture and surgical intervention, hospital providing treatment for primary fracture, and comorbidities. Results: A total of 312 patients (8.2%) suffered second hip fractures. The univariate Cox regression analysis showed a significantly higher risk for second hip fracture in patients having advanced age (p= 0.001), female gender (p= 0.022), living in capital (p= 0.024), and having arthroplasty (p= 0.001). Advanced age (p≤0.001) and having arthroplasty (p= 0.004) were significant risk factors for second hip fractures according to multivariate analysis. Log-rank test showed significantly longer survival in females (p<0.001) than in males and in patients with arthroplasty (p= 0.013) compared with those having osteosynthesis. Conclusion: Identification of high-risk groups...

Chronic bone and soft tissue suppurations have become more frequent recently due to the increasing number of high-energy injuries. There are certain antibiotic beads available for local administration, but they cannot always be applied specifically against the pyogenic microorganisms. In the present study, a new technique of local antibiotic therapy for the treatment of infections is described. Polymethylmethacrylate (PMMA) capsules were produced and filled with 0.1 ml Tazocin (0.02 g piperacillin sodium + 0.005 g tazobactam). The efficacy of these Tazocin-filled capsules was examined in vivo using a rabbit osteomyelitis model. Chronic osteomyelitis was induced in rabbit tibia by local injection of Staphylococcus aureus. The treatment included surgical debridement and implantation of Tazocin-containing PMMA capsules into the medullar cavity (n = 12). Simple surgical debridement with no antibiotic implantation was performed in control animals (n = 7). Results were evaluated using microbiological, radiological and histological methods 14 weeks after induction of osteomyelitis. Eight weeks after the implantation of PMMA capsules, complete physical, radiological and histological healing was achieved in 7 animals, initiation of the reparative phase was observed histologically in 3 cases and no reparative signs were detected in 2 rabbits. In the control group, no significant sign of reparation could be seen in any of the cases.

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Background: This study aimed at making local antibiotic therapy wider in cases of chronic suppurations by administering antibiotics which previously could not be given in this way through the conventional polymethylmetacrylate (PMMA) carrier techniques. Capsules from this material were produced with a pressing machine designed and laid out by us. The characteristics of antibiotic penetration from this novel carrier were compared to those of PMMA beads. Methods: The time-dependent outflow of amikacin, clindamycin, pefloxacin, piperacillin + tazobactam, amoxicillin + clavulanic acid and cefotaxime was examined from the capsules and the beads with standard microbiological techniques using the Micrococcus luteus ATCC9341 test strain. The diameter of the inhibitory zones was measured after 24 h incubation at 37°C and converted to µg/ml antibiotic concentrations. Results and Conclusions: Our results revealed that all antibiotics showed longer-lasting and higher concentration outflow from the PMMA capsules than from the beads. Therefore, these capsules can provide a more promising new opportunity for specific local antimicrobial treatment in cases of chronic suppurative bone and soft tissue injuries. In these cases the polymerization has already been completed and the heat does not influence the structure of the antibiotics; therefore, it can be inserted into the capsules in powder or solution form.

Purpose: The aim of our study was to translate the Aberdeen Varicose Vein Questionnaire (AVVQ) into Hungarian, and to investigate the validity and reliability of the Hungarian AVVQ, as well as to assess the health-related quality of life in patients with varicose veins of the leg. Methods: 374 adults participated in this study who were divided into two groups (varicose vein, healthy). We analyzed internal consistency, convergent validity (using the 36-Item Short Form Survey, SF-36), repeatability, and intra-class correlation coefficient of the Hungarian AVVQ. Regarding discriminant validity, we determined the scores of the Hungarian AVVQ in both groups using the Mann-Whitney U-test. Results: The Cronbach-alpha value was 0.890, while the correlation coefficient was R = 1.000. According to the results of the convergent validation, the scores of pain and dysfunction moderately correlated with some scores of the SF-36. The score of cosmetic appearance had a relationship with many scores of the SF-36. We registered a significant relationship between the score of extent of varicosity and some scores of the SF-36. There was significant correlation between the score of complications and numerous scores of the SF-36 (physical functioning, role limitations due to physical health, pain and general health). The score of pain and dysfunction, cosmetic appearance, extent of varicosity, complications and total score of the Hungarian AVVQ showed a significant difference between both groups. Conclusions: The Hungarian AVVQ was a reliable and a valid tool to assess the health-related quality of life among patients with varicose veins and was a useful tool to justify the further treatment of the patients.