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Introduction: According to data in the literature, the number of nosocomial infections in the ICU is far higher than in non-ICU patients. As a result of improving lifesaving technologies, the risk of nosocomial infections increases in ICUs. Utilization of epidemiological methods is recommended for the detection and follow up of nosocomial infections., Aims: Prospective surveillance to assess the epidemiology of nosocomial infections in an ICU., Methods: Kenézy Hospital is a country hospital with 1637 beds and a 16-bed central ICU. During the investigated period (01. 04. 2004-31. 03. 2006) 1490 patients, with a total 8058 ICU days, were hospitalised in the mixed medical-surgical ICU. The commonest primary diagnosis were respiratory failure, multiple trauma and head injury. Surveillance was performed by a trained infection control nurse and was supervised by an infection control physician and infectious disease physician. CDC definitions were used to define nosocomial infections., Results: A total of 194 nosocomial infections in 134 patients were detected during the study period. The overall incidence and incidence density of nosocomial infections were 13.0 per 100 patients and 24.0 per 1000 patient-days. Respiratory tract infections (44.3%) were the most frequent nosocomial infection, followed by urinary tract (21.1%) and bloodstream infections (20.1%)., Conclusions: Nosocomial surveillance is useful in detecting nosocomial infections in ICU. A multidisciplinary approach and partnership between the physicians and infection control nurses is needed. Patient-to-nurse ratio is an independent risk factor for nosocomial infections in intensive care, this must be kept in mind when planning rationalization of the number of nursing staff.

Introduction: The histological properties of the femoral press-fit fixation in anterior cruciate ligament reconstruction have not been extensively examined. The purpose of the study was to analyse the histological properties of the bone-patellar tendon graft in the bone tunnel area during the early stages of healing in an animal model. Furthermore the authors wanted to draw conclusions for the postoperative rehabilitation program on the basis of their data., Material and Methods: ACL reconstruction was performed in pigs using femoral press-fit fixation. After 3 and 6 weeks the incorporation of the bone block in the femur in 2 pigs was histological and radiological evaluated., Results: After 3 and 6 weeks the examination showed almost similar histology on the bony side the grafts except (1) a higher amount of fibrotic tissue in-between the lamellae of the inserted patellar bone after 6 weeks, (2) the presence of direct osseous unions between the two lamellar systems and (3) thicker lamellae at the base than toward the condylar tissue., Conclusions: Concerning the progression of graft healing by histological findings our study showed, that after 6 weeks the femoral press-fit fixation appear to have good incorporation after ACL reconstruction.

Introduction: Disorders around the patella are the most frequent knee complaints seen in adolescents. In the literature many intrinsic and extrinsic risk factors have been linked to Patellofemoral Pain Syndrome (PFPS), but the role of these risk factors is controversial., Aim: The goal of this study was to evaluate the prevalence of PFPS in a group of adolescents aged 12-20 years in Hungary, and to gain more information on the relationship between the biomechanical anomalies of the lower extremity and the PFPS., Material and Methods: In this epidemiological study the authors investigated the effect of sporting activity in the maturation of symptoms among 586 randomly selected students. Different physical examinations, anthropometric measurements, stability tests, footscan analysis were performed., Results: Concerning the prevalence of this syndrome they could not find any differences between males (n = 60, 20.41%) and females (n = 61, 20.89%). The authors could not identify any statistically significant intrinsic risk factors, although changes in the Q angle may be linked to increased prevalence of PFPS. The study supports the theory of the importance of "overload", for there was a significant correlation between the prevalence of PFPS and the different levels of sporting activities (competitive, recreational and non-athletes)., Conclusion: The authors concluded that the prevalence of PFPS among Hungarian students is 20.65%.

Unlabelled: The authors have reported the experiences at femoral press-fit fixation technique used in anterior cruciate ligament reconstruction with bone-patellar tendon-bone autograft. Their surgical technique have been described and early results have been compared with those from anterior cruciate ligament plasties with the interference screw fixation technique during a prospective study., Patients and Methods: 665 anterior cruciate ligament reconstructions were performed between September 1997 and August 1999 at the Department of Sports Surgery of the National Institute for Sports Medicine. 418 of them were operated on by transtibial technique using free bone--patellar tendon--bone autografts with 265 femoral press-fit and 153 interference screw fixations. 110 patients from the press-fit and 72 from the interference screw group could be followed-up (average follow-up period: 19 months). Physical examination, evaluation by International Knee Documentation Committee and Lysholm scores, radiology, and stability test by KT-1000 arthrometer were used as follow-up tests with statistical comparison., Results: According to the International Knee Documentation Committee score, 77% of the patients with the interference screw and 87% of the patients from the press-fit group turned out to get to the normal or nearly normal categories. Neither the Lachman, anterior drawer and pivot shift tests, nor the results of the KT-1000 measurements have shown statistically significant difference between the two groups of patients. Mild (3-5 degrees) extension deficit has been detected at 14% of the patients with interference screw and 8% of the patients in the press-fit group. Mild (6-15 degrees) flexion deficit has been observed at 22% of the patients with interference screw and 24% of the patients from press-fit group with moderate (16-25 degrees) of flexion deficit at 4% of the patients. The subjective opinions of more than 90% of the patients were that the operation proved to be excellent or good. Based on the functional and stability data of the follow-up study, 87% of the patients operated on with femoral press-fit autograft fixation technique for their anterior cruciate ligament have shown excellent or good results., Conclusions: When compared with the interference screw technique well-accepted in the literature, no statistically significant difference could be found, therefore this method can be recommended as alternative one for the femoral fixation of the anterior cruciate ligament graft.

The application of gene therapy to sports medicine is in its infancy, but it holds much promise as a novel procedure to improve the clinical management of sports injuries. Gene therapy will be particularly useful in initiating and accelerating the repair of cartilage, meniscus, tendon, and ligament. Several growth factors and other cytokines have been identified as important mediators of a successful healing process. Such molecules have promise as novel agents for the treatment of sports injuries, but there is presently no clinically useful way to deliver them. Gene transfer may be used to serve this purpose. Gene therapy functions as a type of local biological drug delivery system. Recent studies have shown the feasibility of transferring marker genes to synovium, chondrocytes, meniscal fibrochondrocytes, tenocytes and ligamental fibroblasts, prompting optimism about the eventual success of this approach.

Introduction: Based on the literature data in the last ten years the endoscopic carpal tunnel release seems to be an advantageous alternative method in the treatment of carpal tunnel syndrome., Aims: Based on minimum 5 year follow-up the authors report the long-term results of endoscopic surgery introduced since 1993., Patients and Methods: On 46 hand of 42 patients endoscopic procedure was performed. Thirty-two patients returned to follow-up, they filled out questionnaire, underwent physical examination and 15 patients had electrophysiological test., Results: Twenty-eight patients were without any complaints and symptoms, 3 patients had thenar atrophy. One patient was reoperated on because of residual symptoms. The authors make a comparison between their data and the great experienced Chow's results and they review the literature data of open procedure., Conclusions: They conclude that the long-term results of the endoscopic surgery are similar to the outcome of the open procedures. The electrophysiologic tests have not always any relationship with the patient's complaints and symptoms.

Authors treated 34 patients from 1989 to 1992 with restricted knee movements in the Department of Sport Medicine. The average age of the patients was 32 years, the youngest was 16 and the eldest was 54 years old, and the female male ratio was 14/20. 71% of the patients had some kind of ligament surgery in the past. Arthrolysis was performed in 24 cases. 13 cases out of 24 was performed arthroscopically and the rest was done following arthrotomy. Manipulation under anaesthesia was satisfactory in 5 cases, 4 patients had combined treatment and 1 had extraarticular intervention only. The range of motion was 0-11-81 degrees to start with, and it has improved up to 0-2-124 degrees in average 13 month time following the arthrolysis. There was correlation between the restriction and between the time of primary ligament reconstruction, the sex and the age of the patients. To perform the arthrolysis in time is important and the physiotherapist and the constant passive motion is inevitable.

On the Traumatological Orthopaedic Surgery Department of the Hungarian National Institute of Physical Education and Sports Hygiene 1629 arthroscopic operations of the knee joint were made between 1984-87. From these arthroscopic meniscectomy was made in 543 cases. A follow up study was performed in 302 arthroscopic meniscectomised and in 326 traditionally operated patients from the point of view of objective therapeutic results, hospitalization, convalescence and economic efficacy as well. The average follow up period was 8.2 months. The objective estimation of the therapeutic result was made by Lysholm score and Tapper-Hoover's functional classification. The mean hospitalization was 2 days after arthroscopic meniscectomy and 7 days following the traditional meniscectomy respectively. Twenty days shorter convalescence was observed in the arthroscopic meniscectomy cases. The patients were able to start regular physical activity 43 days earlier than traditionally operated athletes. The difference in Lysholm scores was 12 in favour of arthroscopic operations. On basis of the above considerable several millions reduction of expenses could be revealed what evidently proved the economic efficacy of arthroscopy.