'Persilscheine' für den Schreibtischtäter: das Beispiel des NS-Kriminalbiologen Dr. Dr. Robert Ritter

Der Arzt Robert Ritter war als Kriminalbiologe in den Diensten des Reichsgesundheits- und Reichskriminalpolizeihauptamtes maßgeblich an der Vorbereitung des Völkermords an Sinti und Roma beteiligt. Der Autor hat in seiner Habilitationsschrift von 1991 das unheilvolle Wirken Ritters beschrieben. Der vorliegende Beitrag versteht sich als eine Art Ergänzung. Erstmals wird seine Personalakte bei der Stadt Frankfurt/Main ausgewertet. Sie gibt Aufschluß über die Strategie Ritters, sich in der Nachkriegszeit als vom Nationalsozialismus unbelastet darzustellen und eine neue Karriere als Arzt und Psychiater zu beginnen. Beschrieben wird die 'Reinigung' der eigenen Biografie durch die damals weitverbreitete Jagd nach 'Persilscheinen' und Gefälligkeitsgutachten in den alten 'Seilschaften'. (pmb

Die nationalsozialistische 'Euthanasie' in sächsischen Anstalten und ihre strafrechtliche Ahndung in der SBZ

Zahllose Patienten - Experten sprechen von über einhunderttausend Menschen - starben im Laufe des Zweiten Weltkriegs in psychiatrischen Kliniken und Anstalten des Deutschen Reichs und in den besetzten Ländern den 'Euthanasie'-Tod. Sie galten als 'Ballastexistenzen' und 'unnütze Esser'. Mit Giftgas, Medikamenten und durch 'Hungerkuren' brachte man ihr als 'lebensunwert' befundenes Leben zum Erlöschen. Im Sommer 1947 standen in Dresden Ärzte, Krankenschwestern und Pfleger vor Gericht, die in der 'Tötungsanstalt' Sonnenstein/Pirna viele tausend Menschen ermordet hatten. Unter den Angeklagten befand sich auch einer der Hauptschuldigen an der von Hitler selbst angeordneten 'Tötungsaktion' im Dritten Reich, der am Ende des Prozesses zum Tode verurteile Arzt Professor Dr. Paul Nitsche. Bis zum Herbst 1989 unterblieb die sozialhistorische Aufarbeitung der 1933-1945 vollzogenen Geschehnisse in Anstalten, die sich auf dem Gebiet der ehemaligen DDR befanden. Der vorliegende Beitrag sichtet und kommentiert die umfangreichen Akten zum Dresdener 'Euthanasie'-Prozeß. (ICE)'During the second World War innumerable patients - experts say more than 100 000 people - were killed in psychiatric clinics and other institutions in Germany and its occupied territories. Being considered as 'ballast creatures' ('Ballastexistenzen') and 'useless eaters' euthanasia became their fate. Their existence, classified 'unworth living' was extinguished by means of poison gas, medicaments and so-called 'hunger treatments'. In the summer of 1947 physicians, nurses and orderlies, who had killed thousands of people within the 'killing premises' (Tötungsanstalt) of Sonnenstein/Pirna had to stand trial in Dresden. Among the accused was the physician Prof. Dr. Paul Nitsche, one of the main offenders within Hitler's 'IIIrd Reich killing scheme'. At the end of the trial, he was sentenced to death. A sociohistorical investigation of what happened within psychiatric institutions on the territory of the former GDR between 1933 and 1945 has not been effected until autumn 1989. After the opening of the German-German border, the author of the article had the opportunity to analyse a larg quantity of documents, particularly about the 'Dresden - euthanasia trial', so far kept by the Chief State Prosecutor of the former GDR. His article is bases upon these documents.' (author's abstract

'Wie viel lieber würde ich mich richtig verabschieden...': 'Republikflüchtige' DDR-Lehrer in den Jahren 1949-1961

Zu den Flüchtlingen, die zwischen 1949 und 1961 die DDR verließen, gehören bemerkenswerterweise mehrere Tausend Lehrer, die ihre Ausbildung im SED-Staat erhalten hatten. Eine Aufarbeitung der häufigen Fluchten innerhalb des Schulwesens selbst blieb die Ausnahme. Es genügte gewöhnlich, daß sich die Kollegen von dem betreffenden Lehrer distanzierten und eine Art Treuegelöbnis zur DDR abgaben. Nimmt man das im vorliegenden Beitrag erstmals veröffentlichte statistische Material als Spiegelbild der Gesamtgesellschaft der DDR kurz vor Errichtung des 'antifaschistischen Schutzwalls' im August 1961, so war die Unzufriedenheit mit den gegebenen Verhältnissen allseits vorhanden; sie betraf Frauen wie Männer im Lehrerberuf, ging durch alle Altersgruppen und Qualifikationen, und auch und gerade die Mitgliedschaft in der SED verhinderte es nicht, der DDR den Rücken zu kehren. (ICE)'Soon after the end of the Second World War the Soviet Occupation Zone saw politically guiltless teachers beginning to do their job. Newcomer teachers from different professional backgrounds joined them. In some cases they had finished school very recently and obtained pedagogical qualifications by doing furhter education courses at the same time. In the period until the construction of the German-German border in 1961 many of these teachers left the German Democratic Republic because they were dissatisfied with their educatinal possibilities or with the political system in general. Additionally the Federal Republic of Germany enticed some of them away from the GDR. In order not to lose their teachers, the leaders of the GDR tried to improve the social and cultural situation of the teachers. Simultaneously they collected statistical information on the problem of illegal emigration of teachers. The material proved that teachers from all parts of the GDR fled for different reasons. Young teachers fled more frequently than older ones. Only the construction of the wall in 1961 put a stop to the illegal emigration of teachers.' (author's abstract

Refining the criteria for immediate total-body CT after severe trauma

Objectives Initial trauma care could potentially be improved when conventional imaging and selective CT scanning is omitted and replaced by immediate total-body CT (iTBCT) scanning. Because of the potentially increased radiation exposure by this diagnostic approach, proper selection of the severely injured patients is mandatory. Methods In the REACT-2 trial, severe trauma patients were randomized to iTBCT or conventional imaging and selective CT based on predefined criteria regarding compromised vital parameters, clinical suspicion of severe injuries, or high-risk trauma mechanisms in five trauma centers. By logistic regression analysis with backward selection on the 15 study inclusion criteria, a revised set of criteria was derived and subsequently tested for prediction of severe injury and shifts in radiation exposure. Results In total, 1083 patients were enrolled with median ISS of 20 (IQR 9-29) and median GCS of 13 (IQR 3-15). Backward logistic regression resulted in a revised set consisting of nine original and one adjusted criteria. Positive predictive value improved from 76% (95% CI 74-79%) to 82% (95% CI 80-85%). Sensitivity decreased by 9% (95% CI 7-11%). The area under the receiver operating characteristics curve remained equal and was 0.80 (95% CI 0.77-0.83), original set 0.80 (95% CI 0.77-0.83). The revised set retains 8.78 mSv (95% CI 6.01-11.56) for 36% of the non-severely injured patients. Conclusions Selection criteria for iTBCT can be reduced from 15 to 10 clinically criteria. This improves the positive predictive value for severe injury and reduces radiation exposure for less severely injured patients

A multicenter, randomized controlled trial of immediate total-body CT scanning in trauma patients (REACT-2)

Contains fulltext : 110874.pdf (publisher's version ) (Open Access)BACKGROUND: Computed tomography (CT) scanning has become essential in the early diagnostic phase of trauma care because of its high diagnostic accuracy. The introduction of multi-slice CT scanners and infrastructural improvements made total-body CT scanning technically feasible and its usage is currently becoming common practice in several trauma centers. However, literature provides limited evidence whether immediate total-body CT leads to better clinical outcome then conventional radiographic imaging supplemented with selective CT scanning in trauma patients. The aim of the REACT-2 trial is to determine the value of immediate total-body CT scanning in trauma patients. METHODS/DESIGN: The REACT-2 trial is an international, multicenter randomized clinical trial. All participating trauma centers have a multi-slice CT scanner located in the trauma room or at the Emergency Department (ED). All adult, non-pregnant, severely injured trauma patients according to predefined criteria will be included. Patients in whom direct scanning will hamper necessary cardiopulmonary resuscitation or who require an immediate operation because of imminent death (both as judged by the trauma team leader) are excluded. Randomization will be computer assisted. The intervention group will receive a contrast-enhanced total-body CT scan (head to pelvis) during the primary survey. The control group will be evaluated according to local conventional trauma imaging protocols (based on ATLS guidelines) supplemented with selective CT scanning. Primary outcome will be in-hospital mortality. Secondary outcomes are differences in mortality and morbidity during the first year post trauma, several trauma work-up time intervals, radiation exposure, general health and quality of life at 6 and 12 months post trauma and cost-effectiveness. DISCUSSION: The REACT-2 trial is a multicenter randomized clinical trial that will provide evidence on the value of immediate total-body CT scanning during the primary survey of severely injured trauma patients. If immediate total-body CT scanning is found to be the best imaging strategy in severely injured trauma patients it could replace conventional imaging supplemented with CT in this specific group. TRIAL REGISTRATION: ClinicalTrials.gov: (NCT01523626)

Comorbidity of eczema, rhinitis, and asthma in IgE-sensitised and non-IgE-sensitised children in MeDALL: a population-based cohort study

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Emergency Bleeding Control Interventions After Immediate Total-Body CT Scans in Trauma Patients

Background: Immediate total-body CT (iTBCT) is often used for screening of potential severely injured patients. Patients requiring emergency bleeding control interventions benefit from fast and optimal trauma screening. The aim of this study was to assess whether an initial trauma assessment with iTBCT is associated with lower mortality in patients requiring emergency bleeding control interventions. Methods: In the REACT-2 trial, patients who sustained major trauma were randomized for iTBCT or for conventional imaging and selective CT scanning (standard workup; STWU) in five trauma centers. Patients who underwent emergency bleeding control interventions following their initial trauma assessment with iTBCT were compared for mortality and clinically relevant time intervals to patients that underwent the initial trauma assessment with the STWU. Results: In the REACT-2 trial, 1083 patients were enrolled of which 172