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Stuttgart, Germany

Schmidt T.,Universitatsklinikum Jena | Baljic I.,Helios Klinikum Erfurt GmbH
HNO | Year: 2016

Background: The Freiburg monosyllabic test (FBE) was introduced into clinical routine almost 60 years ago. Recently, there has been renewed scientific interest in the FBE. Nevertheless, neither the earlier nor the later publications showed any evidence for a training effect. For this reason, this aspect is examined in more detail in the present study. Methodology: All 20 test lists of the FBE were presented in a fixed, predetermined order to 40 suitable otologically normal subjects. According to DIN 45626-1, the 50 % speech discrimination score is expected at a level of 29.3 dB SPL (Sound Pressure Level). In this study, the test material was presented at a level of 29 dB SPL. The speech discrimination scores were analyzed depending on the particular test run. Results: The mean speech recognition score (43.2 %) depended on the test run. An increase in speech recognition by 13 percent points was observed in the first three test runs. After two test runs, no further increase in speech recognition was observed. Conclusion: When using the FBE in clinical routine, two test lists should be heard by the patients before the actual test starts. This procedure helps to improve the quality of the FBE. © 2016 Springer-Verlag Berlin Heidelberg Source

Wagenlehner F.M.E.,Justus Liebig University | Hoyme U.,Helios Klinikum Erfurt GmbH | Kaase M.,Ruhr University Bochum | Funfstuck R.,Sophien und Hufeland Klinikum GmbH | And 2 more authors.
Deutsches Arzteblatt | Year: 2011

Background: Urinary tract infections (UTIs) are among the most common types of bacterial infection in outpatient medicine. Rising rates of antibiotic resistance and a better understanding of the ecological adverse effects (collateral damage) of antibiotics warrant a reevaluation of the treatment recommendations for uncomplicated UTI. The new S3 guideline contains updated recommendations. Methods: The new S3 guideline is based on a review of publications on uncomplicated UTI retrieved by a systematic search of the Medline and Cochrane Library databases. Guidelines from abroad were also considered in the review. Results: Uncomplicated UTI is classified as either uncomplicated cystitis (UC) or uncomplicated pyelonephritis (UP). The choice of a suitable antibiotic is determined by the following main criteria: the patient's individual risk profile and prior antibiotic treatment, if any; the spectrum of pathogens and antibiotic susceptibility; the proven efficacy of the antibiotic; the ecological adverse effects (collateral damage) of antimicrobial therapy; the side effects for the patient under treatment. On the basis of these criteria, co-trimoxazole/trimethoprim and fluoroquinolones can no longer be recommended as first-line empirical treatment for UC. Rather, the new recommended treatment of first choice consists of fosfomycin-trometamol, nitrofurantoin, or pivmecillinam. High-dose fluoroquinolones are still recommended, however, as first-line oral treatment for UP. Asymptomatic bacteriuria should only be treated in exceptional situations such as pregnancy or before urological procedures that will probably injure the mucosa of the urinary tract. Conclusion: The new S3 guideline on uncomplicated UTI incorporates a forward- looking approach to the use of antibiotics in treating this common type of infection. It is intended to bring about a sustained improvement in the quality of care. Source

Blum M.,Helios Klinikum Erfurt GmbH | Sekundo W.,University of Marburg
Ophthalmologe | Year: 2010

Starting in 2006 a new "all femto" method of refractive correction for myopia and myopic astigmatism was introduced. This new method was originally introduced as femtosecond lenticule extraction (FLEx) and further developed with a small incision into SMILE (small incision lenticule extraction). To simplify the terminology the manufacturer brought this onto the market in April 2010 as ReLEx (refractive lenticule extraction). In this procedure a lenticule of intrastromal corneal tissue and a flap-like access cut are subsequently cut utilizing the VisuMax® femtosecond system (Carl Zeiss Meditec, Jena, Germany). The lenticule is then manually removed and the flap repositioned (only by FLEx). In approximately 1,000 successful surgical operations only few side effects were found. The number of eyes treated is currently being expanded in order to further standardize this new clinical procedure. © 2010 Springer-Verlag. Source

Schulz T.,Helios Klinikum Erfurt GmbH | Esser D.,Helios Klinikum Erfurt GmbH
Laryngo- Rhino- Otologie | Year: 2013

Bleeding in the oral cavity, nose or ear are common events in the daily routine of ENT specialists. Apart from trivial cases that often get outpatient treatment, there are numerous cases of serious bleeding that require stationary treatment and if necessary, an operative or interven-tional therapy. In the following section the most frequent types of bleeding, their diagnosis and therapy will be explained. © Georg Thieme Verlag KG Stuttgart. Source

Post-therapeutic imaging is crucial for treatment planning and control in patients with malignant lesions in the head and neck. Focussed on CT, PET-CT and MRI, imaging strategies for post-therapeutic follow-up have been developed and investigated during the last few years. This review should help to interpret the results of these studies and make the reader familiar with the latest developments. © 2010 Springer-Verlag. Source

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