[Quitting Attempts and Utilisation of Smoking Cessation Aids among Smokers in Germany: Results from the 2012 Epidemiological Survey of Substance Abuse]. / Ausstiegsversuche und Hilfsmittelnutzung unter Rauchern in Deutschland: Ergebnisse aus dem Epidemiologischen Suchtsurvey 2012.

Aim: This study presents current data on smoking cessation and usage of smoking cessation aids among smokers in a representative sample of German smokers. Data of 2012 will be compared with data of the year 2000. Methods: The sample of the 2012 Epidemiological Survey of Substance Abuse (ESA) was randomly drawn from population registers and consisted of 9 084 individuals aged 18-64 years. A mixed-mode design including questionnaires, telephone and Internet interviews was applied. The response rate was 53,6%. Number of smoking cessation attempts and usage of smoking cessation aids were assessed among actual and former smokers. Results: Of the 4 261 persons who had smoked in their lifetime 54,1% are actual and 45,9% former smokers. Among actual smokers 64,5% have tried to quit smoking at least once; 24,3% within the last 12 months. Quit attempts were mostly undertaken without formal help (53,7%). Users of smoking cessation aids report that they used social support (22,6%), self-help material (13,3%), nicotine replacement products (11,3%) and E-cigarettes (8,4%). Conclusions: Compared to the year 2000 the number of former smokers has increased. While the number of smoking cessation attempts among smokers is unchanged, more smokers use smoking cessation aids. Using E-cigarettes for smoking cessation is becoming more important.

[Smoking cessation in rehabilitation centres: outcome and predictors of participation]. / Tabakentwöhnung in Rehabilitationskliniken: Outcome und Prädiktoren der Teilnahme.

OBJECTIVE: The focus of investigation in this study were the characteristics of participants and non-participants in a modern smoking cessation programme for inpatient rehabilitation centres as well as the effects of the programme on participants' smoking behavior. METHODS: Smoking patients (N=313) from 10 Bavarian rehabilitation centres including 203 participants and 110 non-participants of a newly implemented group programme were asked about socio-demographics, smoking behaviour and willingness to change both at the beginning and at the end of their inpatient stay. RESULTS: Univariate analyses showed there to be no difference between participants and non-participants with regard to socio-demographics and smoking behaviour. Multivariate analyses detected a higher intention to quit smoking, the stage of contemplation, and the marital status "single" to be significant predictors of participation. 42.6% of participants stopped smoking during their stay, 18.2% were abstinent until the time of discharge. These rates are significantly lower among non-participants (stop: 16.9%; abstinence 1.8%). CONCLUSION: Participation in a smoking cessation programme essentially depends on a smoker's motivation to quit. The investigated programme can provide useful support for smokers willing to quit.

Smoking cessation in groups--who benefits in the long term?

The 'Rauchfrei Programm' is the most widespread cognitive behavioral group program for smoking cessation in Germany. The aim of this study was to evaluate smoking cessation in the routine care setting and to investigate whether certain characteristics predict long-term abstinence. The study is a longitudinal field study with a one group pre-post-follow-up design. Participants were 1319 smokers, who were asked to complete questionnaires before and after the program. Twelve months later, participants were followed-up by phone. 48.1% of participants attended every session. At the end of the program, 60.9% of the participants were smoke-free. After one year, the abstinence rate accounted for 31.8% (Intention-to-treat). A logistic regression analysis showed that male gender, higher age, being married, lower level of nicotine dependence as well as adherence to the program significantly increased the likelihood of abstinence, whereas education and employment did not. No significant influence of self-payment on the rates of abstinence was observed. It is concluded that the modern smoking cessation program is highly recommendable as it achieves sufficient abstinence rates in a real-life setting. However, it still remains a challenge to increase adherence rates and to achieve comparable success rates in smokers with different characteristics.

Os trigonum syndrome.

The os trigonum is a frequently encountered accessory bone of the foot. It is located at the posterior aspect of the talus, and may appear either as a separate ossicle or fused to the talus. The separate ossicle may represent an accessory bone or a fracture of the posterior process (also called the trigonal process) of the talus. The author reviews the mechanism of injury and the diagnosis and treatment. A case report of a fracture of the trigonal process is presented.

Modified V-Y capsulorrhaphy in hallux abducto valgus surgery.

The two-stage capsular closure modification of the V-Y capsulorrhaphy in hallux abducto valgus surgery is a technique for restoring the soft tissue anatomical relationships of the first metatarsophalangeal joint in a bunion deformity. The first stage of the V-Y capsulorrhaphy corrects the plantar and lateral deviation of the abductor hallucis tendon. The second stage of the V-Y capsulorrhaphy closure allows for the correction of abductus and valgus rotation of the hallux. Inasmuch as each element of the soft tissue deformity in hallux abducto valgus deformity is corrected individually, greater precision can be applied to each constituent of the hallux abducto valgus deformity.

The systemic treatment of onychomycosis.

The systemic treatment of fungal infections has changed considerably over the past 10 to 20 years. Griseofulvin, the only drug approved by the Food and Drug Administration for the systemic treatment of onychomycosis, has a cure rate that seldom exceeds 40%. Many new drugs are targeting the three main kinds of drug therapy for fungal nails: reduction of treatment times, improvement of cure rates with a minimum of side effects, and the achievement of long-term remissions in recalcitrant infections. As the public becomes aware of newer therapies, we will see more patients with nail infections. Although these new agents for superficial fungal infections are not yet approved in the United States, they have been used extensively in Europe.

The surgical pathology of ainhum (dactylolysis spontanea).

Ainhum (dactylolysis spontanea) is a poorly understood disease characterized by spontaneous autoamputation of the fifth toe. Its incidence is highest among blacks and in the tropical and subtropical climates. The present study is the first to present certain gross and semimicroscopic findings. Moreover, scanning electron microscopic and histochemical data are presented and these reportings are believed to be unique. Hyperkeratosis and parakeratosis, together with elongation of the epidermal rete pegs and acanthosis, are observed and these findings are associated with the presence of numerous fibroblasts and wound repair phenomena. The leukocytic infiltrate is identified as being principally of T lymphocyte type, suggesting the existence of an unknown immunologic response. Relevant intraoperative data, radiographs, and light microscopy, as well as transmission electron microscopy, have been reported in this study. The spontaneous amputation of the fifth toe, designated as dactylolysis spontanea, has no known etiology, and no treatment short of amputation. The worldwide incidence of this condition is rare. Two cases have been observed at the Baltimore Veterans Administration Medical Center in the last 5 years. One patient is in an early stage of the disease. The present study involves the single instance in which amputation was elected as the treatment of choice. Because the occurrence of ainhum (dactylolysis spontanea) is rare, discussion of the disease is lacking in medical literature. It is the intent of the present study to be the definitive analysis of clinical, surgical, and surgical-pathologic data of this rare disease. Unique applications of semimicroscopic, histochemical, and light microscopic findings, as well as transmission and electron microscopy, will be presented. Speculation as to the implications of immunologic and/or wound repair responses as implicated in ainhum needs to be explored.