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Before a forensic addiction treatment can be ordered by the court according to sec. 64 of the German Criminal Code (StGB), a prognosis of success must be made and affirmed. In recent years, several studies have been devoted to the search for appropriate predictors of a “sufficiently concrete” prospect of success. Legal probation after release is the legally stipulated criterion for success in forensic addiction treatment.

As the second part of a two-part review on the determinants of success in forensic addiction treatment, this paper aims to provide an overview of the current evidence on predictors of legal probation after forensic addiction treatment and relates this to the evidence to the predictors of the discharge mode.

Based on systematic literature research, the results of eight empirical studies published between 2002-2019 were processed in depth and presented in an overview table.

Despite heterogeneous findings in detail, the presence of motivational, practical life and social resources, on tther the information base for experts could be improved, for example, through a probationary phase.

The limitations of the current state of research suggest a two-step approach for the preparation of a treatment prognosis first, the predictors of the discharge mode could be used to examine the question of the likelihood of success of a regular course of treatment; then, the predictors of legal probation could be used to examine whether any conclusions can be drawn on the relapse-preventive effect of forensic addiction treatment. Both parts of the review can thus support forensic psychiatric experts in making a reliable prognosis of treatment prospects. In addition, consideration should be given to whether the information base for experts could be improved, for example, through a probationary phase.

Soft tissue reconstructions of the hand require a thin and resistant flap palmarly as well as sliding abilities between the extensor tendons and the flap on the dorsum of the hand. Elasticity is required to maintain the normal wrist range of motion. One option in these cases is the free serratus fascia flap that sometimes shows limitations regarding resistance as well as reliability. Here, we describe an easy modification including a thin muscle cuff in the serratus fascia flap – the serratus carpaccio flap – that improves the ease of flap harvest and morbidity rates.

The indications for the serratus carpaccio flap, the technique of flap harvest and contouring as well as flap inset are described in detail. Clinical examples are given.

The main advantage of the serratus carpaccio flap is the ability of the surgeon to adapt the flap thickness to the recipient site requirements. Sapitinib This allows excellent results regarding contour and function. Split thickness skin grafting fromthe instep region of the foot additionally allows optimal results for palmar as well as plantar defect reconstruction. Eighteen flaps for soft tissue defects of the hand (n = 5), foot (n = 10), and lower leg (n = 3) were performed. Complications included one flap loss, one venous re-anastomosis, two partial wound dehiscences and one postoperative hematoma at the donor site. Seventeen flaps survived completely. Secondary thinning procedures were not required.

The serratus carpaccio flap is an excellent option for the reconstruction of medium-sized skin and soft tissue defects of the dorsum of the hand or foot, the palm, and the distal forearm.

The serratus carpaccio flap is an excellent option for the reconstruction of medium-sized skin and soft tissue defects of the dorsum of the hand or foot, the palm, and the distal forearm.It is unknown if birthing people in same-sex relationships have different perinatal outcomes than people in different-sex relationships, despite differences in risk factors such as use assisted reproductive technologies, obesity, smoking, and poor mental health. Marriage equality has established birth certificates as a promising new source of population-based data on births to same-sex married parents. We used birth certificate data from Massachusetts for 201,873 singleton births to married parents from 2012 to 2016. We estimated the association between several birth outcomes and having a birth parent in a same-sex marriage, using a propensity-score matched and unmatched sample. We also tested whether these associations were modified by use of assisted reproductive technologies. Birthing people in same-sex marriages had similar perinatal outcomes related to decreased fetal growth and preterm birth compared to their peers in different-sex marriages. Use of assisted reproductive technology was associated with decreased fetal growth and increased risk of preterm birth for infants with different-sex parents, but not for infants with same-sex parents. More research is needed across other states, and to understand why use of assisted reproductive technology is not a risk factor for poor birth outcomes for those in same-sex marriages.

In diabetic subjects, early visual functional alterations such as color vision deficiencies (CVDs) are known to precede clinically apparent diabetic retinopathy. Prominent photoreceptor outer segment degeneration and an increase in the number of retinal dual cones (co-expressing S- and M-opsins simultaneously) have been described in diabetic rat models, suggesting a connection with the development of CVDs. As cone opsin expression is controlled by thyroid hormones, we investigated the diabetic retina in association with thyroid hormone alterations.

In rat models of type 1 and 2 diabetes, dual cones were labeled by immunohistochemistry, and their numbers were analyzed in relation to free triiodothyronine (fT3) and free thyroxine (fT4) levels. Quantification of dual cones was also performed in human postmortem retinas. Additionally, a cross-sectional case-control study was performed where thyroid hormone levels were measured and color vision was assessed with Lanthony desaturated D15 discs.

A higher number of dual cones was detectable in diabetic rats, correlating with fT4 levels. Dual cones were also present in postmortem human retinas, with higher numbers in the three diabetic retinas. As expected, age was strongly associated with CVDs in human patients, and the presence of diabetes also increased the risk. However, the current study failed to detect any effect of thyroid hormones on the development of CVDs.

Our results point toward the involvement of thyroid homeostasis in the opsin expression changes in diabetic rats and human samples. The evaluation of the possible clinical consequences warrants further research.

Our results point toward the involvement of thyroid homeostasis in the opsin expression changes in diabetic rats and human samples. The evaluation of the possible clinical consequences warrants further research.