[New possibilities with retroflexed functional endoscopy]. / Neue Wege der Funktionsendoskopie mit Retroflexion.

BACKGROUND: Anterograde transnasal flexible endoscopy of the pharynx, larynx, and proximal trachea without sedation has been established since the 1990s. Retroflexed endoscopic functional analysis has recently been introduced. OBJECTIVES: Adding retroflexed functional endoscopy from the oral cavity up to the duodenum to anterograde diagnostics allows the precise demonstration of how different factors interact in a complex way, e. g., in case of dysphagia or pathological reflux. MATERIALS AND METHODS: A 70-cm-long high-definition endoscope without a channel system is equipped with a 200° retroflexed view, a mm-cm scale, and a roller system. The endoscope can be lengthened, stopped, or shortened during the procedure. Standard positions, viewing directions and display details ensure that findings are comparable. Mastication, food transport and digestion are observed in the unsedated patient. RESULTS: Depending on indication and symptoms, we defined a diagnostic algorithm including three specific pathways: (1) for conditions that originate in the oral cavity, larynx or pharynx, (2) for suspected reflux disease, or for neurological or neuromuscular disorders of food transport, (3) for duodenogastric, gastroesophageal and esophagopharyngeal reflux, as well for benign or malignant tumors. CONCLUSION: The advantages of functional endoscopy have an impact not only on the medical staff and patients. Its precise and participatory approach is relevant to healthcare, enlarges the diagnostic horizon, and forms a basis for interdisciplinary collaboration.

The transnasal VideoPanendoscopy (ViP): diagnostics of the upper aerodigestive tract using an anatomically correct model from the model to the patient.

Endoscopy of the upper aerodigestive tract (UADT) develops rapidly. New endoscopes in combination with special imaging techniques allow complete examinations of the UADT in an ambulatory setting. Therefore, it is necessary to educate and train young physicians in a standardized protocol. A special anatomical training model has been designed to allow a stepwise endoscopy training course. It can be used by specialists who would like to take advantage of transnasal VideoPanendoscopy for examination of suitable candidate patients. This method offers advantages for ENT doctors, gastroenterologists as well as endoscopic surgeons.

Smoking among pregnant women in small towns in Poland.

OBJECTIVES: The aim of the work was to assess among pregnant women from small towns and villages in Poland: the prevalence of smoking, credibility of smoking, and influence of socioeconomic factors on smoking status. METHODS: The data came from 4512 interviews with women in different trimesters of pregnancy. The interviews were collected in 2007 and 2008 year in towns up to 8000 citizens in 12 voivodeships. RESULTS: Prevalence of smoking in the beginning of pregnancy was confirmed by 34.6 % of women. During the pregnancy 14.7 % of women declared quitting smoking and 19.9 % continued smoking. Cigarette smoking was most frequent in those with a primary education, unemployed, very low incomes in household, and having both smoking parents. In multifactorial analysis, risk of smoking was highest (95 % CI 1.74-6.06) for women that were divorced or not living with a partner compared with married. CONCLUSIONS: Rates of active smoking among a population of pregnant women living in small towns in Poland are very high. Since the correlates of smoking during pregnancy are a low education level and a low economic status of the pregnant woman, these socioeconomic groups should be first priority targets.

[Is hearing of the students damaged by environmental noise in their leisure time? (author's transl))]. / Wird das Hörvermögen durch Umweltlärm in der Freizeit geschädigt?

An examination of 1300 students between the ages of 10 and 20 who had not yet been exposed to industrial noise was performed in order to establish to what extent general environmental noise influences hearing. The fact that there was no age-dependent increase of high tone hearing loss, as well as the small correlation between hearing loss and total noise load are evidence that there is no hearing loss produced by increasing environmental noise exposure of teenagers in Germany. Middle ear infections, infections diseases and skull trauma are suggested as causes of the usually minimal high tone hearing losses.

Letter: Sterilization guidelines.

PIP: It is argued that tubal closure for women who do not desire any more children should be accepted as a contraceptive method. Psychological contraindications, such as loss of "self-image," "self-esteem," and "ego-identity," advanced by another author, are dismissed. Rather, the fear of pregnancy and the choice of abortion or mandatory motherhood are regarded as a more likely source of psychological damage.^ieng

[Late results of stapedectomy after 15 years (author's transl)]. / Spätergebnisse nach über 15 Jahren Stapedektomie

Stapedectomy in Otosclerosis in using polyethylene struts or stainless-steel wire protheses results in permanent correction of the postoperative gap. The use of stainless-steel wire protheses however is successful with 94% of the patients regarding the postoperative gap, compared to 89% of the patients in using the polyethylene struts. The postoperative decrement of bone conduction is statistically significantly lower in the stainless-steel wire protheses than in polyethylene struts.