Dtsch Arztebl Int
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An increasing number of persons around the world are receiving the diagnosis of gender incongruence, and most of them are in their reproductive years. Safe contraception and fertility preservation are important issues for counseling. ⋯ GAHT mainly impairs spermatogenesis; thus, counseling on fertility preservation should always be given before GAHT. More than 80% of trans men use contraceptives, mainly for their other effects such as suppression of menstrual bleeding. GAHT is not in itself a reliable method of contraception, and persons about to undergo GAHT should always receive contraceptive counseling.
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The appropriate provision of sedation as a last resort for the relief of suffering in palliative care is dealt with variably in actual practice. This article is intended as an overview of practically relevant information found in treatment recommendations and guidelines. ⋯ There is a broad consensus in favor of sedation to relieve suffering in the last days and hours of life. Recommendations vary for patients with a longer life expectancy and for those with existential distress, and with respect to monitoring.
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It is not yet entirely clear to what extent vaccine-induced or hybrid immunity offers protection from death during the omicron wave of the COVID-19 pandemic in Germany. ⋯ Among elderly persons in Bavaria, a higher immunity level was associated with a substantial degree of protection against death during the Omicron wave; however, the strength of protection may have diminished somewhat over time.