La anticoncepción en la mujer obesa / Contraception in obese women

La creciente prevalencia de mujeres obesas en edad fértil es una crisis de salud pública y social. La anticoncepción es un tema clave en mujeres con obesidad. Las mujeres obesas tienen una actividad sexual similar a las mujeres de peso normal y en ellas se considera que el uso de anticoncepción es menos eficaz, teniendo mayor riesgo de embarazo no deseado. Debido a una variedad de alteraciones del metabolismo, la obesidad es un factor de riesgo cardiovascular que puede aumentar, cuando se combina con la anticoncepción hormonal. Todos estos factores deben considerarse al elegir un método anticonceptivo en una mujer obesa. El objetivo de esta revisión es evaluar el riesgo-beneficio de cada tipo de anticoncepción disponible y la problemática de anticoncepción después de la cirugía bariátrica, proporcionando al médico una guía práctica sobre el uso de píldoras anticonceptivas orales en mujeres obesas

The increasing prevalence of obese women of childbearing age is a public and social health crisis. Contraception is a key issue in women with obesity. Obese women have a sexual activity no different from women of normal weight, and the use of contraception is considered less effective, as there is a higher risk of having an unwanted pregnancy. Due to a variety of metabolic disorders, obesity is a cardiovascular risk factor that can increase when combined with hormonal contraception. All these factors should be considered when choosing a contraceptive method in an obese woman. The objective of this review is to evaluate the risk-benefit of each type of available contraception, and the problem of contraception after bariatric surgery, in order to provide doctors with a practical guide on the use of oral contraceptive pills in obese women

[Hearing loss due to leisure time noise is on the rise. The ear also needs a rest period]. / Hörschäden durch Freizeitlärm nehmen zu. Auch das Ohr braucht mal Pause.

Noise during leisure time is increasingly leading to temporary and permanent hearing loss, with most victims being adolescents and young adults. Particularly harmful is permanent exposure to noise, since the highly sensitive ear is not designed to tolerate it. On average, youngsters aged between 14 and 20 years spend 3 hours and more listening to music. In discos, concerts in particular, as well as listening to music via headphones, sound levels of 100 dB are regularly reached and exceeded, and levels of 90 dB are already considered to represent a definite risk. Noise is, however, experienced as offensive and painful at levels of about 120-140 dB, and this leads to the danger of its harmful effects being underestimated. Treatment of hearing loss depends on whether it is acute or chronic and comprises infusion therapy, stress reduction, acoustic rest or interposed periods free of noise and, where indicated the fitting of a suitable hearing aid. In view of the immense significance of hearing impairment for the economy, public health, and society at large, its prevention--not only by protective, but also preventive, measures--warrants greater attention.

[40% of hearing aids are not worn. Making sure the device doesn't wind up in the drawer!]. / 40% der Hörhilfen werden nicht getragen. So landet das Gerät nicht in der Schublade!

Early diagnosis of a hearing impairment, follow-up and timely effective intervention are the aims of optimal management of the hard-of-hearing patient. Today, every fifth adult has a hearing problem. This means that the general practitioner not only faces a diagnostic challenge, but also needs to concern himself with the prevention of a hearing loss or its further progression. In the event of a hearing aid being required, the individual needs of the patient must be taken into account. Currently available are behind-the-ear and in-the-ear, both as digital and analog devices. The most expensive, smallest and most modern device is not necessarily the best option for the individual patient, and fitting should be a cooperative effort on the part of the ENT physician and the hearing aid specialist. Required is a specific history, comprehensive counseling of the patient, a phase of testing at home and, where necessary, concomitant acoustic training. The German Society for the Hard-of-Hearing has advice centres in many towns and cities that provide information and counseling on rehabilitation and the legal rights of the deaf.