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The article informs about what patients need to pay attention to when traveling abroad with narcotic-containing medications. In general, these medications can be taken along to ensure medical care. However, certain rules apply to avoid problems with customs or the police. When traveling to member states of the Schengen Agreement, a certificate from the doctor is required, while when traveling to other countries, a multilingual certificate should be issued according to the "Guidelines for Travellers" of the International Narcotics Control Board. There are no internationally harmonized regulations for the transportation of narcotics, so patients should inform themselves about the applicable legal provisions in the destination country before starting their journey. [Extracted from the article]

The article "Legal Risks in Prescribing Medications Containing Controlled Substances" discusses the legal risks associated with prescribing medications that contain substances regulated by drug laws. A case is mentioned in which a general practitioner was charged because he had prescribed medications containing controlled substances to patients in an unreasonable manner and quantity. The doctor was found guilty and sentenced to imprisonment. The article also emphasizes the importance of patient autonomy and proper documentation of medical treatments. It is noted that accurate documentation and the correct date of recording are important to avoid incorrect conclusions. [Extracted from the article]

Background: The number of organs donated after brain death in Germany is far lower than the demand. This underlines the importance of providing the brain-dead donor with optimal medical care throughout the donation process to decrease the risk of graft dysfunction. Several international guidelines and national recommendations guide the intensivists in organ-protective intensive care management of the brain-dead donor.Objective: The anesthetist is a key member during organ retrieval procedures and plays a crucial role in physiological donor management; however, evidence-based recommendations for the perioperative anesthetic management, drug treatment strategies and target values are lacking. Anesthesia literature about donor management is scarce and predominantly composed of reviews of practice, with little exploration of the scientific foundations. The aim of this review is to guide the anesthetist in the organ-protective perioperative therapy. The pathophysiological changes in patients who progress to brain death are briefly summarized. The available evidence, guidelines and expert opinions regarding medical treatment strategies and therapeutic goals in organ-protective therapy are reviewed. The ethical and pathophysiological considerations regarding the performance of anesthesia during organ retrieval are discussed.Methods: This review is based on a selective literature search in PubMed for publications regarding organ donation after brain death (keywords: "brain dead donor", "organ procurement", "organ protective therapy", "donor preconditioning", "perioperative donor management", "ethical considerations of brain dead donor"). International guidelines, national recommendations and expert opinions were given special consideration.Results: Overall, the evidence for optimal perioperative organ-protective care of the brain-dead donor is limited. Most elements in the current recommendations and guidelines are based on pathophysiological reasoning, epidemiological observations or extrapolations from general organ-protective management strategies, and not on evidence from randomized controlled trials. National and international recommendations on treatment goals and drug therapy differ considerably in some aspects. The therapy concepts applied are very heterogeneous. Apart from medical challenges, the ethical circumstances are an additional burden for the entire treatment team. Whether anesthesia is reasonable during organ retrieval remains unclear. There is uncertainty about possible organ-protective effects of anesthetic drugs. Furthermore, ethical considerations raise the question of whether the determination of brain death and the use of anesthetic drugs during the procedure of organ retrieval are compatible with each other.Conclusion: Due to the lack of evidence, perioperative treatment should be guided by intensive care therapy strategies. The discussion about using anesthetic drugs during organ retrieval remains controversial. Pathophysiological considerations support the use of volatile anesthetics because of possible organ-protective effects. The use of neuromuscular blocking is justified to control any possible motor response resulting from spinal cord reflexes, whereas there is no evidence for a benefit from using opioids. Apart from that, it seems ethically problematic to anesthetise a brain-dead donor. Consequently, knowledge about the pathophysiological processes caused by brain death and about organ-protective therapy concepts are just as much a basic requirement as the consideration of ethical problems in organ donation after brain death. Only then are the caregivers able to do justice to both the organ recipient and the organ donor, as well as their relatives in this challenging situation. [ABSTRACT FROM AUTHOR]

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§ 5 Straßenverkehrsordnung 1960 (StVO 1960)1 verpflichtet in öffentlichen Krankenanstalten diensthabende Ärzte klinische Untersuchungen bzw Blutabnahmen an alkohol- und/oder suchtgiftbeeinträchtigten Verkehrsteilnehmern zum Zwecke der Feststellung der Beeinträchtigung durch Alkohol oder Drogen korrekt vorzunehmen. Die ggstl Abhandlung soll einen Überblick über die wesentlichen Inhalte und Verpflichtungen dieser äußerst komplexen Materie bieten. [ABSTRACT FROM AUTHOR]

Copyright of Der Ophthalmologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Schmerz is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article presents a report on the government order to examine the medical abuse of narcotic drugs in Germany. Topics discussed here include the formal requirements for instructions under civil service law, suitability for practicing the medical profession, and narcotics prescriptions referring to an increased number of regulations.

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Background: Opioids are the oldest and most potent drugs for the treatment of severe pain but they are burdened by detrimental side effects, such as respiratory depression, addiction potential, sedation, nausea and constipation. Their clinical application is undisputed in the treatment of acute (e.g. perioperative) and cancer pain but their long-term use in chronic pain has met increasing criticism and has contributed to the current "opioid crisis".Objectives: This article reviews the pharmacological principles and new research strategies aiming at novel opioids with reduced side effects. The basic mechanisms underlying pain and opioid analgesia and other effects of opioids are outlined. To illustrate the clinical situation and medical problems, the plasticity of opioid receptors, intracellular signaling pathways, endogenous and exogenous opioid receptor ligands, central and peripheral sites of analgesic and side effects are discussed.Conclusion: The epidemic of opioid misuse has shown that there is a lack of fundamental knowledge about the characteristics and management of chronic pain, that conflicts of interest and validity of models must be more intensively considered in the context of drug development and that novel analgesics with less addictive potential are urgently needed. Currently, the most promising perspectives appear to be augmenting endogenous opioid actions and the selective activation of peripheral opioid receptors. [ABSTRACT FROM AUTHOR]

The following article analyses the nexus of sex and gender, pathology and autofiction in Ingeborg Bachmann's prose through Preciado's self-experiment Testo Junkie, one of the most controversial works on gender, sexuality and society of the last decade. In Bachmann's novel Malina metaphors of injection and infection shape the relationships between the three protagonists. The margins between genders, drugs as medicine and drugs as narcotics turn out to be continuously shifting - those dynamics are not restricted to motifs but also affect style. According to Preciado, we live in a pharmapornographic regime in which the ways we shape our bodies and minds are controlled by authorities who restrict the access to mind- and body-altering drugs. The manipulation of one's biocode without diagnosis and state supervision, the creation of a new narrative of the self in a rogue operation is therefore an act of resistance and gender-terrorism. Bachmann's self-observing autobiographical notes, dreams and the imagined speech to the medical faculty (»Rede an die Ärzteschaft«) in Male Oscuro display the consequences of not being able to identify oneself with the illness-narrative created by doctors - in particular when it turns out to be a thinly disguised version of classic female hysteria. By reclaiming her symptoms as an individual expression of artistic value, Bachmann is able to free herself from such harmful prescriptions. [ABSTRACT FROM AUTHOR]

Copyright of Rechtsmedizin is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Illicit markets especially those dealing with narcotics constitute grievous issues to the world’s economies, putting to test global safety, economic progress as well as security and many other aspects. Seemingly, illicit narcotics trade in the last decade – that is 2000 to 2011 underwent a significant boom, resulting from a wide spectrum of illegal drugs such as cocaine as well as heroin among many other hard drugs. In today’s global society, several concerns are emerging on the rise of illicit narcotics trade accompanied with organized crime, chiefly as major hindrances to consistent global economic progress. Apparently, some of the effects of illicit narcotics trade are that; this trade gradually turns upside down business rules, opening way for new unruly market players besides reconfiguring influence in global economics as well as politics. Surprisingly, the revenue from illegal drugs in 2011 alone was roughly 10% of the global GDP. Hence, exaggerating local economies’ incomes and triggering ceaseless conflicts among market players, while at the same time reducing legal business activities likewise disintegrating socioeconomic conditions. An empirical research method was adopted for this study, analyzing illicit trade in narcotics on the global arena as from 2000 to 2011 and its resultant effects. The research findings indicate that, illegal drugs trade particularly on the world economy besides growing at a high rate, it endangers the overall welfare of humans likewise the business environment. This is ostensibly because this trade has high chances of engrossing regional economies into illegal drugs business activities, causing them to neglect sustainable ethical businesses. Now, to effectively address negative economic issues related to illegal drugs trade, there is apparent need for integrated efforts from local as well as international authorities. Such efforts are chiefly to control not only the harmful effects resulting from the use of illicit narcotics, but also from the trade itself and to build sustainable economies. The findings of this study are crucial for regulatory authorities in the global economy, for them to adequately comprehend the effects of illicit trade in narcotics hence inform their decisions to take necessary measures. This paper is on the effect of illicit trade in narcotics on global economy, touching on issues like peace along with social cohesion as well as security and economic progress.

Drug consumption has been normalized for young people nowadays. They start consuming hashish in an early age. Some of them keep that consumption with small amounts or quit, and others increase it and even enlarge the range of substances to consume. Those juveniles accumulating school failure can’t reach the rest of students’ level and can’t pass the academic tests, which results in expulsions, leisure time and relationships with other individuals in the same circumstances: they spend most of the time idle, gathering in groups in the same circumstances of idleness and disruptive conducts. Boredom leads them to start consuming hashish and other narcotic substances, which ends sometimes in very serious addictions, and judicial problems.

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Copyright of Rechtsmedizin is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The increased use of phytotherapeutic drugs means that anesthetists are more often confronted with these drugs. In this case report possible problems which can occur are demonstrated exemplified by silexan. Silexan is a phytotherapeutic anxiolytic which is used in anxiety disorders. Because of its potential mechanism of action via the neurotransmitter gamma-aminobutyric acid (GABA) receptors interactions with narcotic drugs are possible. The case of an 18-year-old girl who underwent an operation under general anesthesia while taking silexan as long-term medication is presented. The desired depth of narcosis could only be reached by inhalative induction with sevoflurane after unsuccessful induction attempts using intravenous propofol and thiopental. Possible explanations for this route and inhalative induction as a possible alternative are discussed. [ABSTRACT FROM AUTHOR]

Copyright of Notfall & Rettungsmedizin is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Schmerz is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Umweltwissenschaften und Schadstoff-Forschung is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of GMS Medizinische Informatik, Biometrie und Epidemiologie is the property of German Medical Science Publishing House gGmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Schmerz is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Percutaneous transhepatic biliary drainage (PTBD) and stenting are very painful procedures in interventional radiology and require potent analgesia; employing remifentanil in spontaneously breathing patients may be one possible strategy.Patients and Methods: The study group was composed of 18 men and 2 women with a mean age of 63+/-10 (mean+/-SD) years. Pain intensity was measured with a VAS score before the procedure, after local anesthesia on the rib cage, after stenting and after the radiology procedure.Results: Remifentanil infusion (dosage: 0.12-0.30 microg/kg body weight/min) was infused throughout the entire radiology procedure according to physical status, past medical history, individual pain, and clinical assessment. During insufflation of 10l O(2)/min via a venturi mask, oxygen saturation did not fall below 96% at any time-point during the procedure. In the VAS score, we noted a decrease after starting the remifentanil infusion towards the end of procedure. All patients were able to move into bed without help. Postoperatively, no analgesics and no antiemetics were needed.Conclusions: Employing a remifentanil infusion for brief interventional radiology procedures in palliative treatment of patients resulted in high patient and radiologist comfort. [ABSTRACT FROM AUTHOR]

Because of demographic developments, the fraction of the German population over 65 years of age in the year 2025 will have risen to 20% and will continue to rise so that in 2030 this number will have doubled compared to today's numbers. This has a huge impact on the requirements for anaesthesiologic procedures. In addition to the frequent multi-morbidity in this age group, physiologic changes also occur in the elderly which have to be taken into consideration during the entire perioperative management of these patients. Renal, cardiovascular and hepatic function are impaired in many elderly patients. A major concern in addition to cardiovascular and operative complications is the postoperative cognitive dysfunction (POCD), not only because of its implications for the patient but also because of economical consequences. Regional anaesthesia has some benefits when compared to general anaesthesia as it leads to a reduction in thromboembolic and respiratory complications. [ABSTRACT FROM AUTHOR]

Background: Untreated, one third of patients who undergo surgery will have postoperative nausea and vomiting. Although many trials have been conducted, the relative benefits of prophylactic antiemetic interventions given alone or in combination remain unknown.Methods: In a randomized, controlled trial of factorial design, 5,199 patients at high risk for postoperative nausea and vomiting were randomly assigned to 1 of 64 possible combinations of 6 prophylactic interventions: 1) 4 mg of ondansetron or no ondansetron; 2) 4 mg of dexamethasone or no dexamethasone; 3) 1.25 mg of droperidol or no droperidol; 4) propofol or a volatile anesthetic; 5) nitrogen or nitrous oxide; 6) remifentanil or fentanyl. The primary aim parameter was nausea and vomiting within 24 h after surgery, which was evaluated blindly.Results: Ondansetron, dexamethasone, and droperidol each reduced the risk of postoperative nausea and vomiting by about 26%, propofol reduced the risk by 19%, and nitrogen by 12%. The risk reduction with both of these agents (i.e., total intravenous anesthesia) was thus similar to that observed with each of the antiemetics alone. All the interventions acted independently of each other and independently of the patients' baseline risk. Consequently, the relative risks associated with the combined interventions could be estimated by multiplying the relative risks associated with each intervention. However, absolute risk reduction was a critical function of patients' baseline risk.Conclusions: Because antiemetic interventions are similarly effective and act independently, the safest or least expensive should be used first. Prophylaxis is rarely warranted in low-risk patients, moderate-risk patients may benefit from a single intervention, and multiple interventions should be reserved for high-risk patients. [ABSTRACT FROM AUTHOR]

We report on the preclinical management of a 4-year-old child who was found in a comatose condition with respiratory failure after accidental ingestion of methadone. Emergency airway management was carried out with endotracheal intubation instead of administering the antagonist naloxone. The child could be extubated 12 h later and was released from hospital after 3 days with no neurological symptoms. The authors attempt to formulate an algorithm for the preclinical management of opioid intoxication with reference to the literature and own experience. Endotracheal intubation seems to be superior to the use of the antagonist naloxone, especially in a critical situation. This is the only way to ensure a rapid oxygenation with adequate airway protection and with the simultaneous avoidance of the side-effects of naloxone. A restrictive and critical administration of the opioid antagonist naloxone is recommended when there is suspicion of opioid ingestion but no signs of intoxication. [ABSTRACT FROM AUTHOR]

The article presents ruling of Germany's Federal Fiscal Court on the value-added tax (VAT) treatment of services through pharmacies, flu vaccinations and visas of substitution drugs. It mentions about the narcotics prescription ordinance substitution drugs to the patient for immediate leave consumption; and there will be no complaints if the entrepreneur is his services.

Copyright of Rechtsmedizin is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Transvaginal puncture for oocyte retrieval is a short-lasting but painful procedure. We hypothesized that a sole infusion of the ultra-short acting mu-agonist remifentanil may be a suitable and well-controllable single-agent analgesic technique that can dose-dependently be applied to spontaneously breathing patients.Methods: Fifty consenting adult women were enrolled in this prospective trial. A sedative premedication was omitted, all patients received 3 L/min of inhaled oxygen, and a sole remifentanil infusion was started with 0.25 microg/kg/min. Remifentanil was adjusted as needed for pain relief (in steps of 0.05 microg/kg/min) and finished after the last puncture. Dosage requirements, vital functions, oxygen saturation (as achieved by pulse oximetry, psO(2)), adverse drug effects and the level of sedation (LOS 1-5; 1 = asleep/unarousable, 4 = calm/awake) were recorded. Remifentanil plasma concentrations were achieved by STANPUMP pharmacokinetic simulation. Data are presented as mean +/- SD.Results: A total of 50 women (31.8 +/- 5.1 yr, 67.3 +/- 14. ASA I or II ) were investigated. Follicular aspiration lasted 10.8+/-5.2 min, and remifentanil was infused for 19.7+/-8.3 min. Dosage requirements were 0.25 microg/kg/min in 70% of all patients, 0.3 microg/kg/min in 22%, 0.2 microg/kg/min in 6%, and 0.4 microg/kg/min in 2% of all cases. Vital signs (baseline, after 1(st) puncture, end of surgery) nearly remained unchanged: heart frequency = 85 +/- 15, 87 +/- 17, 90 +/- 17 bpm, systolic blood pressure = 129 +/- 12, 132 +/- 13, 131 +/- 14 mmHg; respiratory rate = 116 +/- 4, 15 +/- 4 breaths/min; psO(2) = 99 +/- 1, 99 +/- 1, 99 +/- 2%. LOS was 4.0 (all), 3.9 +/- 0.3, 3.9 +/- 0.3. Remifentanil plasma concentrations were 5.0 +/- 1.3 ng/mL at the start, 6.6 +/- 1.3 at the end of surgery and 1.2 +/- 0.5 at PACU arrival. Adverse drug effects: 54% itching, no muscle rigidity. 94% of all women would choose this technique again.Conclusions: The sole infusion of remifentanil is a suitable and satisfying single-agent monitored anaesthesia care technique for oocyte retrieval. However, close anaesthetic observation - especially of the respiratory function - is mandatory. [ABSTRACT FROM AUTHOR]

This article gives insights into the work of the self-help- and research-group of the "Projekt Selbstverständigung über Drogengebrauch" as an example of participatory research in psychology. In a first step the basics of the project will be discussed by distinguishing it from other approaches in drug research, positioning it within the field of participatory research and analyzing it in regard to its theoretical basics. In a second step the practical work of the project will be described to illustrate problems that emerged as well as first solutions that could be helpful for further development of participatory research.