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Mycobacterium haemophilum is a rare pathogen belonging to the group of slowly growing nontuberculous mycobacteria (NTM) that can cause infections, especially in immunocompromised patients. Detection by culturing is difficult because M. haemophilum only grows under special cultivation conditions. Therefore, it is believed that the pathogen is too rarely identified as a cause of disease overall. In addition to patients with severe immunodeficiency, e.g. due to acquired immunodeficiency syndrome (AIDS), chemotherapy or immunosuppression after transplantation, patients with underlying rheumatic diseases are increasingly described in the literature, who are at risk due to the immunosuppressive treatment regimen. Clinically, ulcerative skin alterations, lymphadenopathy and arthropathy are in the foreground. In immunosuppressed patients with unclear skin lesions, infections due to M. haemophilum should be considered and specific microbiological diagnostics should be initiated., (© 2021. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Background: Offshore windfarms are constructed in the German North and Baltic Seas. The off-coast remoteness of the windfarms, particular environmental conditions, limitations in offshore structure access, working in heights and depths, and the vast extent of the offshore windfarms cause significant challenges for offshore rescue. Emergency response systems comparable to onshore procedures are not fully established yet. Further, rescue from offshore windfarms is not part of the duty of the German Maritime Search and Rescue Organization or SAR-Services due to statute and mandate reasons. Scientific recommendations or guidelines for rescue from offshore windfarms are not available yet. The present article reflects the current state of medical care and rescue from German offshore windfarms and related questions. The extended therapy-free interval until arrival of the rescue helicopter requires advanced first-aid measures as well as improved first-aider qualification. Rescue helicopters need to be equipped with a winch system in order to dispose rescue personnel on the wind turbines, and to hoist-up patients. For redundancy reasons and for conducting rendezvous procedures, adequate sea-bound rescue units need to be provided. In the light of experiences from the offshore oil and gas industry and first offshore wind analyses, the availability of professional medical personnel in offshore windfarms seems advisible. Operational air medical rescue services and specific offshore emergency reaction teams have established a powerful rescue chain. Besides the present development of medical standards, more studies are necessary in order to place the rescue chain on a long-term, evidence-based groundwork. A central medical offshore registry may help to make a significant contribution at this point.

The author sees the present outbreaks of violence as a confirmation of the continued relevance of the diagnosis of the present-day German condition set out in The Inability to Mourn in 1967. In post-war Germany a pall of silence hung over the subject of Nazi atrocities, guilt and shame were negated and no recollection of, or active mourning for, the millions of German and non-German war victims took place. The author sees an exact parallel to this in the present violence on the part of young people towards foreigners, asylum seekers, Jews and gypsies, and the way it is mutely condoned by a silent majority, interpreting this as an identical instance of the denial of shame and guilt and the incapacity for fellow-feeling towards the poor and the underprivileged. The accusations of part responsibility levelled at the post-1968 generation for the outbreaks of violence among young people are in Mitscherlich's view unfounded. This generation, she argues, was the first to break with the conspiracy of silence in connection with Germany's Nazi past, thus making a process of mourning possible in the first place, and goes on the contend that an increasing sensitivity among the German population towards the prevailing inhumanity that foreigners and the underprivileged are subjected to is an opportunity for renewed self-confrontation with the unbroken virulence of the Nazi mentality and for a resumption of the necessary process of mourning. Here she also sees a possibility of actively curbing the present wave of violence, in contrast to the call to be heard from some politicians for greater toughness in education and upbringing, an approach which she regards as representing not a solution to the problem but rather as a relapse into old authoritarian constraints.

Together, the fall of the Berlin Wall, the reunification of Germany and the public reactions to the war in the Gulf form a syndrome that poses anew the question of the specifically German "ability to mourn". On the one hand, the author registers a continuing rejection of the onerous task of facing up to the reality of the past via recollection and mourning. On the other, she sees indications both on the individual and collective level that this rejection is beginning to crumble, thus encouraging the emergence of attitudes that challenge the validity of German "ideals" to an increasing extent.

National Socialism destroyed the integrity and substance of Psychoanalysis in Germany for a long time to come. The author was among those responsible for the reintroduction of psychoanalytic knowledge and in the organization of psychoanalytic institutions. In this article she tells about the difficulties in reestablishing psychoanalysis in the new Federal Republic, where it met considerable resistance and obstacles. In particular the author gives credit to the significant contribution of German and Austrian emigrants as well as that of psychoanalysis in Anglosaxon countries, especially the London "Schools" of Anna Freud and Melanie Klein.