Der Anaesthesist
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Recent epidemiologic studies reveal both an increasing incidence and an escalation in resistance of invasive fungal infections in intensive care units. Primary therapy fails in 70 % of cases, depending on the underlying pathogens and diseases. The purpose of this review is to raise awareness for the topic of antifungal therapy failure, describe the clinical conditions in which it occurs, and suggest a possible algorithm for handling the situation of suspected primary therapy failure.
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Baroreceptor stimulators are novel implantable devices that activate the carotid baroreceptor reflex. This results in a decrease in activity of the sympathetic nervous system and inhibition of the renin-angiotensin-aldosterone system. ⋯ Many common anesthetic agents, such as inhalation anesthetics and propofol dampen or inhibit the baroreceptor reflex and complicate or even prevent successful placement. Therefore, a specific anesthesia and pharmacological management is necessary to ensure successful implantation of baroreceptor reflex stimulators.
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The Medical Devices Law is a relatively new legal system, which has replaced the still well-known medical devices regulations in Germany. The Medical Devices Law in Germany is based on European directives, which have been translated into national law with the Medical Devices Act. ⋯ Overall, the Medical Devices Act represents a very complex legal system, which needs to be permanently observed with respect to continuous updating and adjustment. In this article the design and the structure are described but most of all the article filters significant problem areas that need to be considered when using and operating medical devices, especially for anesthesiologists.
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The human resources situation in the healthcare system is characterized by a manpower shortage. Recruiting medical staff is of great importance for hospitals and particularly in anesthesiology. Approaching and recruiting staff usually happens through external personnel marketing (PM); however, up until now the efficacy of these PM measures has barely been empirically investigated. ⋯ The results of this PM study can contribute to the development of an effective and efficient conception of PM measures by hospitals. Addressing applicants through traditional job and internet-based advertisements should be supplemented by personalized targeting of potential applicants and innovative targeting instruments must be systematically developed and promoted in order to become effective. It remains questionable whether the target group of external PM can be reached with exclusively or even predominantly image-cultivating measures on behalf of the healthcare company, such as image campaigns. The most effective PM tools create good working conditions and develop factors contributing to the employer's attractiveness. These two tools should be given priority in human resource development also taking material incentives into consideration, all of which support the effective set-up of an employer branding.