Lest We Forget

Confronting the Holocaust and its implications represents a challenge we should not evade -- and a responsibility we should not avoid

H-Diplo Roundtable XX-20 on Matthew J. Ambrose. The Control Agenda: A History of the Strategic Arms Limitation Talks

A set of reviews of Matthew J. Ambrose\u27s The Control Agenda: A History of the Strategic Arms Limitation Talks, with a response from the author

In memory of the “Two Helmuts”: the lives, legacies, and historical impact of Helmut Schmidt and Helmut Kohl: a forum with Clayton Clemens, Ronald Granieri, Mathias Haeussler, Mary Elise Sarotte, Kristina Spohr, and Christian Wicke

Between them, the chancellorships of the “two Helmuts” span nearly a quarter-century of German history. Helmut Schmidt led the country from 1974 to 1982; his successor, Helmut Kohl, served until 1998. But the verdict on their respective tenures has been very different. Kohl was seen as a bumbling provincial when he came to office in 1982 but, by the end of his second term, he had won a place in the history books as the “Chancellor of Unity” (Einheitskanzler). By the time he lost the election for what would have been his fifth term, he was hailed as the “master-builder” (Baumeister) of Europe for his decisive role in furthering the European Community's political and economic integration through the Maastricht Treaty and the introduction of the Euro. Schmidt, by contrast, came to office with a reputation for high administrative competence and intellectual prowess, but left the chancellery under a cloud. Der Spiegel spoke for many commentators when it dismissed him as a “good chancellor with a bad record”; few features of his period in office stood out as “proof of success.” Schmidt, it was said, had been a mere crisis manager and “problem-solver” (Macher) who lacked broader vision, so that “little endured of historical significance.” This has also been the verdict of many historians

The INF Treaty of 1987

Der von Ronald Reagan und Michail Gorbatschow am 8. Dezember 1987 unterzeichnete »Intermediate-Range Nuclear Forces Treaty«, kurz INF-Vertrag, stellte einen Meilenstein der nuklearen Abrüstungsverhandlungen zwischen den Vereinigten Staaten von Amerika und der Sowjetunion dar. Im Jahr 2019 wurde er von Russland und den USA gekündigt. Der englischsprachige Band untersucht die Vorgeschichte des Abkommens, dessen Implementierung und Folgen sowohl in den beiden Supermächten als auch in den mit ihnen verbündeten Staaten. Er ist damit die erste umfassende Darstellung eines der wichtigsten Abrüstungsabkommen der jüngsten Zeit

ECLAPTE: Effective Closure of LAParoTomy in Emergency-2023 World Society of Emergency Surgery guidelines for the closure of laparotomy in emergency settings

Laparotomy incisions provide easy and rapid access to the peritoneal cavity in case of emergency surgery. Incisional hernia (IH) is a late manifestation of the failure of abdominal wall closure and represents frequent complication of any abdominal incision: IHs can cause pain and discomfort to the patients but also clinical serious sequelae like bowel obstruction, incarceration, strangulation, and necessity of reoperation. Previous guidelines and indications in the literature consider elective settings and evidence about laparotomy closure in emergency settings is lacking. This paper aims to present the World Society of Emergency Surgery (WSES) project called ECLAPTE (Effective Closure of LAParoTomy in Emergency): the final manuscript includes guidelines on the closure of emergency laparotomy

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research