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    Im Verborgenen: Ausbeutung in Privathaushalten

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    Opfer von Menschenhandel zwecks Arbeitsausbeutung zu erkennen und Betroffenen zu ihrem Recht zu verhelfen, ist schwierig – insbesondere in der prekären Zone des Privathaushalts. In diesem Beitrag schildern Sarah Schilliger und Nora Riss (Juristin FIZ) die Schwierigkeiten, Opfer von Menschenhandel zwecks Arbeitsausbeutung zu erkennen - und zeigen den politischen Handlungsbedarf für die Schweiz auf

    Primary central nervous system lymphomas: EHA-ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up.

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    This EHA-ESMO Clinical Practice Guideline provides key recommendations for managing primary DLBCL of the CNS.The guideline covers clinical, imaging and pathological diagnosis, staging and risk assessment, treatment and follow-up.Algorithms for first-line and salvage treatments are provided.The author group encompasses a multidisciplinary group of experts from different institutions and countries in Europe.Recommendations are based on available scientific data and the authors' collective expert opinion

    North and South in Medieval Iberia: A historical and environmental estimate through isotopic analyses.

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    The Middle Ages in the Iberian Peninsula is a period of special interest for studying the relationship of climate change with historical and socioeconomic processes. Between the 8th and 15th centuries AD, the Peninsula was characterized not only by complex political, cultural, and social transitions but also by major variations in the climate. The objective of this study was to examine differences in diet and mobility between distinct populations of the Peninsula and explore the possible relationship of diet, mobility, and culture with environmental variables and geographical settings. For this purpose, we obtained stable isotopic ratios of carbon and oxygen (δ13C and δ18O) from the enamel apatite of first upper incisors from 145 individuals at eight archeological sites that represent both Christian and Islamic communities and both rural and urban social settings. Results revealed a dietary difference between Christian and Islamic populations, observing a greater contribution of C4 plants, possibly sorghum, in the diet of the latter, especially in a rural setting. The disparity in oxygen isotopic ratios between populations from the North and South of the Peninsula is consistent with modern climatic differences between these regions. In this line, intraregional variability in oxygen isotopic ratios may hint at diachronic occupation phases under varying climatic conditions. The few isotopic outliers in our sample suggest overall low mobility levels

    Impacted maxillary canine: Assessment of prevalence, severity and location of root resorption on maxillary incisors: A retrospective CBCT study.

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    BACKGROUND The maxillary permanent canine is one of the most frequently impacted teeth, which often requires multidisciplinary management. A common complication of canine impaction is root resorption of the adjacent dentition. The aim of this retrospective study was to report the prevalence of root resorption of maxillary incisors adjacent to impacted maxillary canines from small volume CBCT images by trained clinicians. A secondary objective was to report the location and severity of root resorption. MATERIAL AND METHODS CBCT images of patients with impacted maxillary canines (unilateral and bilateral) who attended a joint orthodontic/surgical multidisciplinary clinic were screened. Descriptive statistics were used to investigate associations of patient characteristics and presence of root resorption. Generalized estimating equations (GEE) logistic regression model were used to identify predictors of root resorption. RESULTS In all, 148 impacted maxillary canines (122 patients) were analysed. The majority of patients were under 18 years of age (71.6%) with impacted canines present in more females (68.2%) than males (31.8%). Maxillary lateral incisors showed the highest prevalence of root resorption (38.5%). The apical region was the most common location of resorption for lateral incisors (20.9%) with a variable degree of severity evident: slight (10.1%), moderate (15.6%), and severe (12.8%). Although no significant predictors of root resorption were identified, a weak association was evident for age and root development. CONCLUSIONS In this cohort of patients, the roots of maxillary lateral incisors are most likely to suffer from root resorption in the presence of an impacted maxillary canine. Clinicians should consider the extent, location and severity of resorption of adjacent teeth when planning treatment decisions and mechanics in cases of impacted maxillary canines

    The way towards ethical anesthesia care: no aim - no game - no fame or blame?

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    PURPOSE OF REVIEW This review explores the intricacies of ethical anesthesia, exploring the necessity for precision anesthesia and its impact on patient-reported outcomes. The primary objective is to advocate for a defined aim, promoting the implementation of rules and feedback systems. The ultimate goal is to enhance precision anesthesia care, ensuring patient safety through the implementation of a teamwork and the integration of feedback mechanisms. RECENT FINDINGS Recent strategies in the field of anesthesia have evolved from intraoperative monitorization to a wider perioperative patient-centered precision care. Nonetheless, implementing this approach encounters significant obstacles. The article explores the evidence supporting the need for a defined aim and applicable rules for precision anesthesia's effectiveness. The implementation of the safety culture is underlined. The review delves into the teamwork description with structured feedback systems. SUMMARY Anesthesia is a multifaceted discipline that involves various stakeholders. The primary focus is delivering personalized precision care. This review underscores the importance of establishing clear aims, defined rules, and fostering effective and well tolerated teamwork with accurate feedback for improving patient-reported outcomes. The Safe Brain Initiative approach, emphasizing algorithmic monitoring and systematic follow-up, is crucial in implementing a fundamental and standardized reporting approach within patient-centered anesthesia care practice

    A Multi-Country Survey on the Availability of Intraoperative Use of Echocardiography for Noncardiac Surgery.

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    BACKGROUND This survey aimed to explore the availability and accessibility of echocardiography during noncardiac surgery worldwide. METHODS An internet-based 45-item survey was sent, followed by reminders from August 30, 2021, to August 20, 2022. RESULTS 1189 responses were received from 62 countries. Nearly seventy-one percent of respondents had intraoperatively used transesophageal or transthoracic echocardiography (TEE and TTE, respectively) for monitoring or examination. The unavailability of echocardiography machines (30.3%), lack of trained personnel (30.2%), and absence of clinical indications (22.6%) were the top 3 reasons for not using intraoperative echocardiography in noncardiac surgery. About 61.5% of participants had access to at least one echocardiography machine. About 41% had access to at least 1 TEE probe, and 62.2% had access to at least 1 TTE probe. Seventy-four percent of centers had a procedure to request intraoperative echocardiography if needed for noncardiac cases. Intraoperative echocardiography service was immediately available in 58% of centers. CONCLUSIONS Echocardiography machines and skilled echocardiographers are still unavailable at many centers worldwide. National societies should aim to train a critical mass of certified TEE/TTE anesthesiologists and provide all anesthesiologists access to perioperative TEE/TTE machines in anesthesiology departments, considering the increasing number of older and sicker surgical patients scheduled for noncardiac surgery

    Vitality of autologous retromolar bone grafts for alveolar ridge augmentation after a 3-months healing period: A prospective histomorphometrical analysis.

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    OBJECTIVES The incorporation of retromolar bone grafts used for alveolar ridge augmentation is not well understood. This prospective observational study aims to supply histomorphometrical data from bone graft biopsies taken at the time of retrieval and after a 3-month healing period using patient-matched biopsies. MATERIALS AND METHODS In 17 patients, trephine biopsies of the graft were acquired at the time of graft retrieval and after a 3-month healing period. The biopsies were compared histomorphometrically regarding the number of osteocytes, appearance of osteocyte lacunae, quantity, surface area, and activity of the Haversian canals. RESULTS All grafts appeared clinically stable after screw removal and 17 implants were placed. Histomorphometric analysis revealed no significant difference in the number of osteocytes (p = .413), osteocyte lacunae (p = .611), the ratio of filled/empty osteocyte lacunae (p = .467) and active Haversian canals (p = .495) between the biopsies retrieved after a 3-months healing period with those at the time of grafting. The only significant difference was noted in the mean surface area of the Haversian canals (p = .002). Specifically, the grafts post 3-month healing showed a significantly larger mean area (0.069 mm2) compared to the time of grafting (0.029 mm2). CONCLUSION This study demonstrates, compared to other data, a high rate of vital structures in retromolar bone block grafts after 3 months of healing, exhibiting the same histological features in comparison to the biopsies from the native alveolar ridge. Standard histomorphometrical parameters, e.g., the amount of filled or empty osteocyte lacunae for the description of the vitality of the graft need to be reappraised

    Case Reports: The Very Foundations of Medical Research.

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    Severity of rotator cuff disorders and additional load affect fluoroscopy-based shoulder kinematics during arm abduction.

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    BACKGROUND Rotator cuff disorders, whether symptomatic or asymptomatic, may result in abnormal shoulder kinematics (scapular rotation and glenohumeral translation). This study aimed to investigate the effect of rotator cuff tears on in vivo shoulder kinematics during a 30° loaded abduction test using single-plane fluoroscopy. MATERIALS AND METHODS In total, 25 younger controls, 25 older controls and 25 patients with unilateral symptomatic rotator cuff tears participated in this study. Both shoulders of each participant were analysed and grouped on the basis of magnetic resonance imaging into healthy, rotator cuff tendinopathy, asymptomatic and symptomatic rotator cuff tears. All participants performed a bilateral 30° arm abduction and adduction movement in the scapular plane with handheld weights (0, 2 and 4 kg) during fluoroscopy acquisition. The range of upward-downward scapular rotation and superior-inferior glenohumeral translation were measured and analysed during abduction and adduction using a linear mixed model (loads, shoulder types) with random effects (shoulder ID). RESULTS Scapular rotation was greater in shoulders with rotator cuff tendinopathy and asymptomatic rotator cuff tears than in healthy shoulders. Additional load increased upward during abduction and downward during adduction scapular rotation (P < 0.001 in all groups but rotator cuff tendinopathy). In healthy shoulders, upward scapular rotation during 30° abduction increased from 2.3° with 0-kg load to 4.1° with 4-kg load and on shoulders with symptomatic rotator cuff tears from 3.6° with 0-kg load to 6.5° with 4-kg load. Glenohumeral translation was influenced by the handheld weights only in shoulders with rotator cuff tendinopathy (P ≤ 0.020). Overall, superior glenohumeral translation during 30° abduction was approximately 1.0 mm with all loads. CONCLUSIONS The results of glenohumeral translation comparable to control but greater scapular rotations during 30° abduction in the scapular plane in rotator cuff tears indicate that the scapula compensates for rotator cuff deficiency by rotating. Further analysis of load-dependent joint stability is needed to better understand glenohumeral and scapula motion. LEVEL OF EVIDENCE Level 2. TRIAL REGISTRATION Ethical approval was obtained from the regional ethics committee (Ethics Committee Northwest Switzerland EKNZ 2021-00182), and the study was registered at clinicaltrials.gov on 29 March 2021 (trial registration number NCT04819724, https://clinicaltrials.gov/ct2/show/NCT04819724 )

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