[Five-year follow up of patients with femoral neck fractures]. / Combnyaktáji törés miatt kezelt betegek sorsának ötéves követése.

The authors report on follow-up of 754 patients (among them 713 patients aged over 50 years) with hip fracture, treated in the National Institute of Traumatology, in 1990. Excess mortality in a year amounted 23% of cases. One third (254) of the injured survived after 5 years, current health condition of 199 out of them has been evaluated in a questionnaire type survey. Analysis of results according to age, sex and fracture type was made. Definite correlation has been observed with the age, the increase being parallel to it, while age-specific mortality is higher in men. Again, mortality was higher in trochanteric fractures. On analyzing the patients' condition from the aspect of using walking aids, walking ability and complaints, particularly the high rate of painfulness differed from the literature data, though inadequate rehabilitation, already stated before, is reflected in other indicators, too. In addition to the improvement of early rehabilitation, based on their own results the authors emphasize, that further care of patients with complaints is also of great importance.

Sequential hospitalwide outbreaks of resistant Serratia and Klebsiella infections.

Late in 1973 at the Nashville Veterans Administration Hospital, an intrusion of Serratia marcescens infections that were resistant to gentamicin sulfate and other antimicrobial agents occurred. This abated somewhat, only to be superseded by another wave of multiply-resistant infections due to Klebsiella pneumoniae beginning in the spring of 1974. Approximately 400 patients had substantial infections with these organisms during the 2 1/4 year period, imposing considerable morbidity and mortality. Due to the serious and lasting impact that these events imposed on patient care in our hospital, we sought explanations for the sequential infectious outbreaks. Both may have arisen because of the same persisting pressures favoring prevalence of multidrug-resistant bacteria. Indirect evidence including the sequential order of the outbreaks, similarity of antibiotograms, transferable multiple drug resistance from Serratia to Klebsiella, and possession of approximately equal molecular weight plasmids supported the notion that the two outbreaks were causally related.