Patient Safety Culture in EU Legislation.

Patient safety means a condition in which a patient does not suffer any unnecessary actual harm, nor is exposed to any potential harm related to healthcare. The World Health Organization's recognition of patient safety, as one of the most important factors in determining high quality healthcare, initiated the systematic introduction of changes in the approach to this issue, both globally and on the level of individual healthcare service providers. In order to enhance the quality and ensure the safety of healthcare services provided, national, European Union, and worldwide institutions focus on the introduction of a so-called patient safety culture. The creation of this safety culture would not be possible without the establishment of its legal framework. The purpose of this article is to shed light on the legislative achievements of the European Union within patient safety, taking into consideration acts that summarize the level of implementation of individual recommendations. This study can be useful both for those who focus their scientific interests on the subject of patient safety and those who need concise information on the legislative measures of the Community in this respect, as well as for medical personnel who want to become acquainted with this issue without reading comprehensive legal acts.

An attempt to control Cameraria ohridella using an attract-and-kill technique.

This study estimates the efficacy of an attract-and-kill (A&K) technique to control the horse chestnut leaf miner, Cameraria ohridella Deschka and Dimic (Lepidoptera, Gracillariidae), an invasive insect pest of the horse chestnut, Aesculus hippocastanum L. (Hippocastanaceae). The A&K formulation was dispensed as 50 µl droplets of paste-like matrix, containing C. ohridella sex pheromone, (8E,10Z)-tetradeca-8,10-dienal (85% + pure; 0.16% w/w) and a fast acting contact toxicant, pyrocides (94% pure; 6% w/w), applied directly to the bark of the trees. It was tested in 2003 at rates of 30 and 45 droplets/tree at the Ostrobramska site and at rates of 30, 60 and 90 droplets/tree at the Woloska site in Warsaw, Poland, for the first insect generation. A set of untreated plots (0 droplets/tree) was established at each site as well. The treatment efficacy was estimated using two indices: (1) moth catches in pheromone traps and (2) the number of mines per leaf. Trap catches were significantly higher in the untreated plots than in the treated plots regardless of the application rate in all sites. However, there were no significant differences in leaf damage amongst all plots on each site. At the "Lazienki Krolewskie" park the attractiveness of two types of pheromone sources were compared: traps were baited with rubber septum lures or with A&K droplets. The catches of C. ohridella in traps baited with lures were lower than captures in A&K droplet-baited traps, but the difference was not significant. Possible reasons for the low efficacy of the A&K method in management of C. ohridella and reducing leaf damage are discussed.

Minimally invasive techniques in total hip replacement--our clinical experience.

The article presents the general concept of minimally invasive surgery, including theoretical benefits and risks. The indications, contraindications, technical requirements and necessary precautions are discussed. An overview of different surgical approaches is presented together with a detailed description of the surgical technique of minimally invasive cementless total hip replacement that is used at the Department of Orthopedics and Traumatology of Locomotor System, Medical University of Warsaw. Techniques for enhancing the precision of placement of prosthetic elements and leg length equalization used in clinical practice are also presented.

Total hip arthroplasty for treatment of bone metastases.

Background. Bone metastases are observed in many patients with neoplastic disease. Frequently, the first sign of metastasis is a pathological fracture in weight bearing regions. The proximal end of the femur is the most common site of long bone involvement by metastatic disease and pathological fracture. Treatment of metastatic disease should be multidisciplinary: both oncologic and orthopedic. The target of operative procedure is a relief of pain and regaining the ability to walk. In case of changes in proximal end of the femur, the tumor resection and total hip arthroplasty is a procedure of choice.
Material and methods. In the Orthopedic Clinic in Warsaw, 27 patients with bone metastases in proximal end of the femur had total hip arthroplasty performed in the period of 1998-2002. In 16 cases it was possible to collect data about postoperative period - these patients were analyzed. In 14 patients postresective prostheses were used and in 2 procedures - standard prostheses.
Results and Conclusions. This type of treatment reduced pain, restored weight bearing ability of the limb and improved comfort of life. Subjective estimation of treated patients was good. Only in one case the clinical result was poor. Total hip arthroplasty is an efficacious palliative treatment in patients with metastases in proximal end of the femur. Final effect of therapy depends on individual precise preoperative planning and multidisciplinary specialist postoperative care.