[Hemodiafiltration compared to hemodialysis regarding all-cause mortality and quality of life: a systematic review]. / Medizinischer Zusatznutzen von Hämodiafiltration gegenüber Hämodialyse bezüglich Mortalität und Lebensqualität: Eine systematische Übersicht.

BACKGROUND: Patients with end-stage renal disease are dependent on chronic renal replacement therapy. Outcomes regarding the clinical benefits of hemodiafiltration (HDF) compared to hemodialysis (HD) have been inconclusive so far. The aim of this systematic review is to evaluate the effect of HDF on all-cause mortality and quality of life compared to HD. METHODS: A systematic review of published literature was conducted using two bibliographic databases and two trial registers. The review was conducted in September and October 2013. RESULTS: The search yielded 14 relevant studies. Out of 3 large randomized controlled trials reporting the outcome mortality, 1 reported a significantly lower mortality in the HDF-arm; the other 2 did not show significant differences between arms. 1 large randomized controlled trial reporting the outcome quality-of-life was identified, no significant differences were reported. The remaining body of evidence was assessed as non-robust. DISCUSSION: A positive influence of HDF on overall survival appears probable if high-volume fluid exchange is achieved. Only one large randomized controlled trial reports significantly lower overall mortality after treatment with HDF for all patients. There is no reliable evidence for better quality-of-life after treatment with HDF.

Assessing the role of regulatory bodies in managing health professional issues and errors in Europe.

OBJECTIVE: This paper explores how medical regulatory bodies in nine European countries manage professional issues involving quality and patient safety, to build on limited existing information on procedures for regulating medical professionals in Europe. DESIGN: Twelve vignettes describing scenarios of concerns about standards of physicians were developed, covering clinical, criminal and administrative matters. Medical regulatory bodies in nine European countries were asked what action they would normally take in each situation. Their responses were related to their regulatory mandate. RESULTS: Responses varied greatly across participating countries. Regulators are always involved where patients are at risk or where a criminal offence is committed within the clinical setting. Non-criminal medical issues were generally handled by the employer, if any, at their discretion. Countries varied in the use of punitive measures, the extent to which they took an interest in issues arising outside professional activities, and whether they dealt with issues themselves or referred cases to another regulatory authority or took no action at all. CONCLUSIONS: There is little consistency across Europe on the regulation of medical professionals. There is considerable diversity in the range of topics that regulatory bodies oversee, with almost all covering health care quality and safety and others encompassing issues related to reputation, respect and trust. These inconsistencies have significant implications for professional mobility, patient safety and quality of care.

Poland: health system review

The Health Systems in Transition (HiT) country profiles provide an analytical description of each health system and of policy initiatives in progress or under development. They aim to provide relevant comparative information to support policy-makers and analysts in the development of health systems and reforms in the countries of the WHO European Region and beyond. The HiT profiles are building blocks that can be used: to learn in detail about different approaches to the financing, organization and delivery of health services; to describe accurately the process, content and implementation of health reform programmes; to highlight common challenges and areas that require more in-depth analysis; and to provide a tool for the dissemination of information on health systems and the exchange of experiences of reform strategies between policy-makers and analysts in countries of the WHO European Region. This series is an ongoing initiative and material is updated at regular intervals.

Dichromated pullulan as a novel photosensitive holographic material.

We found that pullulan [an a -glucan with (1?4) and (1?6) linkages] doped with chromium ions posseses promising holographic properties. It is environmentally stable and is capable of registering high spatial frequencies (as many as 1500 lines/mm) and producing surface relief. At 1000 lines/mm pullulan's diffraction efficiency was 4%. Chemical treatment of pullulan with a mixture of water and isopropyl alcohol is simple. However, as expected from analogy with dichromated gelatin, pullulan is sensitive in only the blue-green region of the spectrum.

Solid-state laser pumping with a planar compound parabolic concentrator.

A novel solid-state laser-pumping scheme is proposed that combines a reflective lamp chamber and a compound parabolic concentrator (CPC) as a light guide. The CPC is made of a transparent material of high refractive index, and light is guided by the total internal reflection, with drastically reduced reflection losses. Material is chosen so that the absorption losses are minimized in the pumping wavelength range. The lamp chamber is designed with the principles of nonimaging optics, which ensures that the radiation is efficiently transferred from the lamp to the input aperture of the CPC. The pumping efficiency was first estimated theoretically, which gave us enough justification for the more accurate calculations with ray tracing. Single as well as multiple pumping cavities are discussed. New pumping geometry results in significantly increased pumping efficiency compared with conventional geometries. Also the lamp and the laser rod are separated, leading to reduced thermal load. We found that the proposed pumping method is also applicable to diode-pumped lasers.

[Diagnosis of coronary insufficiency using bicycle ergometry]. / Zur Diagnostik der Koronarinsuffizienz mittels Fahrradergometrie

The bicycle ergometry has proved as screening test for the diagnostics of the latent coronary insufficiency. Taking into consideration well-known prerequisites, indications, contraindications, the criteria of withdrawal and the ECG criteria in coronary insufficiency own results and experiences from an analysis of 1,000 bicycle ergometries are presented and compared with literary data.