Overall, complications of Meckel's are managed by simple diverticulectomy or resection with anastomosis. Goebbels recommended that the remaining authors concentrate on books themed on Germanic myths and the concept of blood and soil. States of Nazi Germany. The region 11p15 has been designated WT2 gene and is telomeric of WT1. These laws initially prohibited sexual relations and marriages between Aryans and Jews and were later extended to include "Gypsies, Negroes or their bastard offspring".
Therefore, careful postsurgical monitoring and surveillance can help patients avoid problems caused by such deficiencies. Found in meat and dairy products, vitamin B 12 plays an important role in the growth and replication of cells as well as nervous system functioning. The recommended daily allowance of this nutrient is 2. Bariatric patients are at an increased risk of developing vitamin B 12 deficiency because their digestive tracts have been altered in such a way as to interfere with the natural absorption of this vitamin.
Intrinsic factor—released by the parietal cells in the stomach—binds with vitamin B 12 in the duodenum. The binded vitamin B 12 is then absorbed in the ileum. Common nutritional deficiencies in patients who have had gastric bypass surgery. Specific recommendations for bariatric patients are not available. Dietary supplement fact sheets. Office of Dietary Supplements Web site. Accessed October 20, Vitamin B 12 is a cofactor in two reactions: Therefore, a decrease in vitamin B 12 can result in higher levels of methylmalonic acid and homocysteine.
If physicians are persistent about checking vitamin B 12 levels and, if necessary, methylmalonic acid levels, then serious deficiencies can often be prevented in patients. If a vitamin B 12 deficiency is found, then replacement with oral or injection forms of vitamin B 12 may be necessary. As one of the organic building blocks necessary for all human cells, folate is needed by the body to make new cells such as neurons and red blood cells.
Folate and its synthetic form, folic acid, are found in various foods, including fortified cereals, legumes, leafy vegetables, and other fruits and vegetables.
Folate absorption depends primarily on carrier transport mechanisms across the intestinal wall, pH level, and saturation points, with maximum folate absorption occurring at lower pH concentrations. Processes that interfere with the intestinal wall, such as intestinal surgery, bacterial overgrowth, and celiac sprue, can reduce zinc absorption and cause zinc deficiency. Another essential nutrient for the human body is iron, a metallic element found in red meat and vegetables.
The recommended daily allowance of iron is about 8 mg to 18 mg daily, depending on age and sex. Although the precise mechanism of iron absorption is unclear, the duodenum and jejunum of the small intestine appear to play a primary role.
Iron deficiency remains the most common known cause of anemia in addition to being the most common known nutritional deficiency among adults. As a nutrient involved in various enzymatic reactions, copper is a strong antioxidant essential to the human body.
It is found in meat, vegetables, legumes, and whole grains. Copper deficiencies may accompany iron deficiencies. Individuals with copper deficiency may develop progressive difficulty walking, increased muscle tone or spasticity, heart enlargement, skin changes, or neuropathy. Absorption of copper occurs primarily in the small intestine. There have been multiple reports 35 , 36 of calcium and vitamin D deficiency and hyperparathyroidism in patients who have had recent gastric bypass surgery. Aggressive supplementation of calcium and vitamin D has been recommended around the time of the operation to combat these adverse effects.
Calcium absorption and metabolism are carefully regulated by levels of calcium, vitamin D, and parathyroid hormone. Because these levels may be altered after bariatric surgery, careful monitoring is needed to maintain homeostasis. Good sources of calcium include dairy products such as cheese or milk. Additional supplementation may be needed for these patients. If ganglion cells are present, Hirschsprung's disease is ruled out and the infant probably has a non-surgical diagnosis.
If ganglion cells are absent, the next step depends on the clinical picture and setting. If the pathologist is experienced and confident of the interpretation, the diagnosis of Hirschsprung's disease can be made with confidence. If there is any doubt about the absence of ganglion cells in the suction biopsy, a full thickness biopsy of the rectum a difficult technical procedure requiring a general anesthetic can be done to settle the issue. If Hirschsprung's disease is believed to be the problem, it must be diagnosed histologically before the infant is operated upon because at the time of surgery the site of obstruction may not be apparent and the abdomen may be closed because no obvious site of obstruction is found.
Hypothyroidism in the first two to three months of life can mimic Hirschsprung's disease in all aspects except for a normal rectal biopsy. Another important point to remember is that duodenal atresia is a different disease from jejunal or ileal atresia in terms of their cause. Jejunal and ileal atresia occur as a result of a vascular accident in the small bowel mesentery during fetal life.
Consequently, there is a relatively low incidence of other congenital anomalies except for cystic fibrosis. Duodenal atresia is a different disease in that there is a very high incidence of associated anomalies-- Down's syndrome, imperforate anus, renal anomalies, congenital heart disease, etc. It can be unsafe to rely on parents to observe their infant for problems resulting from the above conditions. Incidence is one in every live births.
The trachea and esophagus initially begin as a ventral diverticulum of the foregut during the third intrauterine week of life. A proliferation of endodermal cells appears on the lateral aspect of this growing diverticulum.
These cell masses will divide the foregut into trachea and esophageal tubes. Whether interruption of this normal event leads to tracheo-esophageal anomalies, or during tracheal growth atresia of the esophagus results because of fistulous fixation of the esophagus to the trachea remians to be proven.
Polyhydramnios is most commonly seen in pure EA. EA causes excessive salivation, choking, coughing, regurgitation with first feed and inability to pass a feeding tube into the stomach.
Contrast studies are rarely needed and of potential disaster aspiration. Correct dehydration, acid-base disturbances, respiratory distress and decompress proximal esophageal pouch Reploge tube. Delayed repair gastrostomy first for all other patients. Repair consists of muscle-sparing thoracotomy, closure of TEF and primary anastomosis.
Esophagogram is done days after repair. Most important predictors of outcome: Increase survival is associated with improvements in perioperative care, meticulous surgical technique and aggressive treatment of associated anomalies.
More than H-type is N-type, due to the obliquity of the fistula from trachea carina or main bronchi to esophageal side see the figure anatomically at the level of the neck root C7-T1. Pressure changes between both structure can cause entrance of air into the esophagus, or esophageal content into the trachea. Thus, the clinical manifestation that we must be aware for early diagnosis are: Diagnosis is confirmed with a well-done esophagogram, or video-esophagogram high success rates, establish level of the TEF.
Barium in the trachea could be caused by aspiration during the procedure. Upon radiologic doubt bronchoscopy should be the next diagnostic step.
Any delay in surgery is generally due to delay in diagnosis rather than delay in presentation. Management consists of surgical closure of the TEF through a right cervical approach.
Working in the tracheo-esophageal groove can cause injury to the recurrent laryngeal nerve with vocal cord paralysis. Recurrence after closure is rare. The three most common anastomotic complications are in order of frequency: Tension on the anastomoses followed by leakage may lead to local inflammation with breakage of both suture lines enhancing the chance of recurrent TEF. Once established, the fistula allows saliva and food into the trachea, hence clinical suspicion of this diagnosis arises with recurrent respiratory symptoms associated with feedings after repair of esophageal atresia.
Diagnosis is confirmed with cineradiography of the esophagus or bronchoscopy. A second thoracotomy is very hazardous, but has proved to be the most effective method to close the recurrent TEF. Either a pleural or pericardial flap will effectively isolate the suture line. Pericardial flap is easier to mobilize, provides sufficient tissue to use and serves as template for ingrowth of new mucosa should leakage occur. Other alternatives are endoscopic diathermy obliteration, laser coagulation, or fibrin glue deposition.
Congenital gastric outlet obstruction is extremely rare. It occurs either in the pyloric or antral region. They probably represent the developmental product of excess local endodermal proliferation and redundancy. The diagnosis should rely on history, contrast roentgenology studies and endoscopic findings. Symptoms are those of recurrent non-bilious vomiting and vary according to the diameter of aperture of the membrane.
There is a slight male predominance with fair distribution between age groups in children. History of polyhydramnios in the mother. Demonstration of a radioluscent line perpendicular to the long axis of the antrum is diagnostic of a web. Endoscopy corroborates the diagnosis. Management can be either surgical or non-surgical.
Surgical Tx is successful in symptomatic pt. Other alternative is endoscopic balloon dilatation or transection of the web. Non-obtructive webs found incidentally can be managed medically with small curd formula and antispasmodics.
The presence of an abnormally dilated gastric bubble in prenatal sonography should alert the physician toward the diagnosis of congenital antro-pyloric obstruction. Is an abnormality of the pyloric musculature hypertrophy causing gastric outlet obstruction in early infancy.
The incidence is 3 per live births. The etiology is unknown, but pylorospasm to formula protein cause a work hypertrophy of the muscle. The treatment consist in correction of hypochloremic alkalosis and state of dehydration and performing a Fredet-Ramstedt modified pyloromyotomy.
Post-operative management consist of: Occur distal or proximal to the ampulla of Vater. Most commonly distal to ampulla and therefore bilious vomiting is present.
Bilious vomiting is surgical until proven otherwise in a baby. The first major event in the differentiation of the duodenum, hepatobiliary tree, and pancreas occurs at about the third week in gestation, when the biliary and pancreatic buds form at the junction of the foregut and the midgut. The duodenum at this time is a solid cord of epithelium, which undergoes vacuolization followed by recanalization and restitution of the intestinal lumen over weeks of normal development.
Failure of recanalization of the second part of the duodenum results in congenital obstruction of the lumen, often in conjunction with developmental malformation of the pancreatic anlagen and the terminal part of the biliary tree. In support of this concept is the high incidence of annular pancreas observed, believed to represent a persistence of the ventral pancreatic anlage in association with intrinsic duodenal obstruction.
Congenital partial obstruction of the duodenum can be either intrinsic membrane, web or pure or extrinsic Ladd's bands, annular pancreas. This does not entail a higher risk of early mortality unless associated with cardiac malformations. Other associated conditions are malrotation midgut volvulus is rare due to absent bowel distension and peristalsis , biliary tract anomalies and Meckel's diverticulum. The diagnosis is suggested in utero by the double-bubble image on ultrasound.
Vomiting is the most frequent presenting symptom. UGIS is diagnostic, showing a dilated stomach and first duodenal portion with scanty passage of contrast material distally.
Management varies accordingly to the type of stenosis: Ladd's bands are lysed. Pure stenosis is opened longitudinally and closed transversely Heineke-Mickulicz. Membranous stenosis is resected. Successful endoscopic membranectomy of duodenal stenosis has been reported. Duodeno-duodenostomy is the procedure of choice for annular pancreas.
Diaphragms can rarely be double. Anastomotic malfunction requiring prolonged intravenous nutrition and hospitalization has prompted development of a diamond shape larger stoma. Tapering or plication of the dilated duodenum is another effective method of improving disturbed transit.
Other complications after surgery are megaduodenum with blind loop syndrome, biliary reflux, cholestatic jaundice, delayed transit and bowel obstruction. Early mortality is associated to prematurity and associated malformations. Long-term follow-up is warranted to identify late problems. The diagnostic characteristics are: The rotation and normal fixation of the intestinal tract takes place within the first three months of fetal life.
In the earliest stages when the intestinal tract is recognizable as a continuous tube, the stomach, small intestine, and colon constitute a single tube with its blood supply arising posteriorly. The midgut portion of this tube, from the second portion of the duodenum to the mid-transverse colon, lengthens and migrates out into an extension of the abdomen, which lies at the base of the umbilical cord.
Here this loop of bowel undergoes a degree counterclockwise twist at its neck. In the center of the twisted loop lie the blood vessels that will become the superior mesenteric artery and vein. After rotation, the small intestine quite rapidly withdraws into the abdominal cavity, with the duodenum and the proximal jejunum going first.
During this process the duodenojejunal junction goes beneath and to the left of the base of the superior mesenteric vessels. This leaves the upper intestine, including the stomach and the duodenum, encircling the superior mesenteric vessels like a horseshoe with its opening on the left side of the embryo. The small intestine then follows into the abdomen, and withdrawal of the right half of the colon takes place so that it lies to the left.
At the next step, the cecum and the right colon begin to travel across the top of the superior mesenteric vessels and then down to the right lower quadrant. The colon now lies draped across the top of the superior mesenteric vessels, again like a horseshoe, with its opening placed inferiorly. The duodenojejunal loop is said to attach to the posterior abdominal wall soon after its turn, whereas the mesenteric attachments of the entire colon and of the remaining small bowel gradually adhere after they arrive in their normal positions.
In malrotation the right colon can create peritoneal attachments that include and obstruct the third portion of the duodenum Ladd's bands. The diagnostic hallmarks are: A UGIS is more reliable than barium enema, most patients present in first month of life neonatal , but may present at any time.
The treatment is immediate operation; volvulus often means strangulation. Needs fluid and electrolyte replacement. Ladd's procedure consist of: In cases of questionable non-viable bowel a second look procedure is required. Meconium ileus is a neonatal intraluminal intestinal obstruction caused by inspissated meconium blocking the distal ileum.
The meconium has a reduced water, abnormal high protein and mucoproteint content, the result of decreased pancreatic enzyme activity and prolonged small bowel intestinal transit time. Meconium Ileus is classified into two types: The distal small bowel cm of distal ileum is relatively small, measuring less than 2 cm in diameter and contains concretions of gray, inspissated meconium with the consistency of thick glue or putty.
It is often beaklike in appearance, conforming to the shape of the contained pellets. Proximally, the mid-ileum is large, measuring up to 7 cm in diameter. It is greatly distended by a mass of extremely thick, tenacious, dark green or tarry meconium. The unused small colon microcolon contains a small amount of inspissated mucus or grayish meconium.
A cystic mass or atresia of the bowel may occur. The degree of obstruction varies, may be cured in mild cases by rectal irrigations. Failure to pass meconium, abdominal distension and vomiting are seen in more severe cases.
The diagnosis is suspected with findings of: Some cases may show calcifications in the peritoneum Meconium peritonitis. This test is not useful in infant during first weeks of life. It consist of a careful gastrograffin enema after the baby is well-hydrated. Gastrograffin is a hyperosmolar aqueous solution of meglumine diatrizoate containing 0. Long-term prognosis depends on the degree of severity and progression of cystic fibrosis pulmonary disease. Total colonic aganglionosis TCA is found in approx.
There are three critical phases for patients with TCA The first period comprises the time from birth until correct diagnosis. Patients with TCA present with a large variety of symptoms. Several authors have outlined the diagnostic problems in patients with TCA 2,4, Atypical symptoms may lead to excessively delayed diagnosis. Patients present with either ileus or symptoms as in typical Hirschsprung's disease but additionally with recurrent vomiting.
In patients presenting with ileus, diagnosis may be delayed for several weeks because causative factors like volvulus or meconium ileus do not primarily warrant investigations for aganglionosis.
Furthermore, TCA may be associated with other anomalies of the gastrointestinal tract. Only a few reports of TCA associated with small bowel atresia and volvulus can be found 3, 7. In cases of midgut volvulus without malrotation, aganglionosis has to be ruled out. Neonatal appendicitis, a very rare disease, may be the leading symptom of TCA. Therefore, rectal biopsies are mandatory in those cases. Additional to the diagnostic problems due to atypical and heterogenic symptoms, histochemical examination of rectal biopsies may prove negative or equivocal because increased acetylcholinesterase activity may not be present in TCA 5,10, Furthermore, there is no typical radiographic pattern 13, Plain abdominal radiographs usually suggests low bowel obstruction whereas barium enema usually does not show pathognomonic features.
If no mechanical obstruction is found at laparotomy in neonates presenting with ileus, it is suggested to resect the appendix to rule out TCA. If rectal mucosal biopsies are negative or equivocal, biopsies should be repeated or a formal sphincterectomy for thorough analysis is done. The second period lasts from the raising of stoma to its closure, including the definite surgical procedure.
Failure to thrive and excessive fluid losses have been reported in patients with ileostomies 2. Post-ileostomy complications, however, have been eliminated after the importance of oral sodium supplementation to maintain the enteral co-transport system has been realized Interestingly, right transversostomies may show a good function even in cases of TCA. Therefore, frozen section biopsies are mandatory when raising a stoma.
The definitive surgical procedure has been debated 2,5,8,9, Colonic patch graft procedures were the first proposals for surgical management of TCA The rational behind were to use the distinctive resorptive function of part of the aganglionic colon 6. Use of the right colon has the theoretical advantage of improved water resorption.
However the colon patch procedures have significant complications, e. Actually, a modified Duhamel's pull-through procedure seems favorable in the treatment of TCA 2, The third critical phase begins with closure of the stoma. Complications in this period are predominantly recurrent episodes of sub-ileus and diarrhea or nocturnal incontinence. The cause for sub-ileus is a raised tone in the residual sphincter. Repeated manual anal dilatations may be mandatory. Side effects of large doses of Loperamide are mental irritability and dyskinesia.
Significantly better survival of the patients with TCA nowadays is mainly attributed to more accurate diagnosis and improved management of infants with ileostomies.
A new approach to total aganglionosis of the colon. Surg Gynecol Obstet Cass DT, Myers N: Pediatr Surg Int 2: Total colonic aganglionosis with or without ileal involvement: A review of 27 cases. J Pediatr Surg Festen C, Severijner R, v. The absorptive function of colonic aganglionoic intestine: Are the Duhamel and Martin procedures rational?
Ikeada K, Goto S: Total colonic aganglionosis with or without small bowel involvement: An analysis of patients. A new surgical approach to extensive aganglionosis. Further experience with the colonic patch graft procedure and long-term results. Suction biopsy in Hirschsprung's disease. Arch Dis Child A possible cause of anastomotic failure following repair of intestinal atresia. Can J Surg Surgical management of Hirschsprung's disease involving the small intestine. Improvements in the management of total colonic aganglionosis.
Pediatr Surg Int 5: The importance of oral sodium replacement in ileostomy patients. Progr Pediatr Surg Diagnosis of congenital megacolon: J Pediatr Surg 7: Imperforate anus IA is a congenital anomaly in which the natural anal opening is absent. Diagnosis of IA is usually made shortly after birth on routine physical examination. The incidence of IA is approximately 1 in live births and it is more common in males. Its etiology is unknown and it runs equally through all racial, cultural and socio-economic groups.
IA is classified as either "high" or "low" depending on the termination of the distal rectum. When the rectum ends above the levator muscles the malformations are classified as high, and when the rectum ends below the levator muscles the malformations are classified as low.
High lesions are more frequent in males, low ones in females. Determination of the level of the lesion by abdominal x-ray or perineal ultrasound is critical for appropriate management.
Children who have IA may also have other congenital anomalies. Vertebral defects, Anal atresia, Cardiac anomalies, Tracheoesophageal fistula, Esophageal atresia, Renal anomalies, and Limb anomalies. Repair of low IA is relatively simple and is usually treated with perineal anoplasty; however, repair of high IA is more complex. Patients are initially given a temporary colostomy and time is given to allow the child to grow.
A pull-through operation is completed at a later date. Independent of the level of the lesion, the goal of the surgery is the creation of adequate nerve and muscle structures around the rectum and anus to provide the child with the capacity for bowel control. Male patients will benefit from perineal inspection to check for the presence of a fistula wait hours of life before deciding.
During this time start antibiotherapy, decompress the GI tract, do a urinalysis to check for meconium cells, and an ultrasound of abdomen to identify urological associated anomalies. Perineal signs in low malformations that will NOT need a colostomy are: These infants can be managed with a perineal anoplasty during the neonatal period with an excellent prognosis. Meconium in urine shows the pt has a fistula between the rectum and the urinary tract.
Flat "bottom" or perineum lack of intergluteal fold , and absence of anal dimple indicates poor muscles and a rather high malformation needing a colostomy.
Patients with no clinical signs at 24 hours of birth will need a invertogram or cross-table lateral film in prone position to decide rectal pouch position. Those cases with high defect are initially managed with a totally diverting colostomy.
Diverting the fecal stream reduces the chances of genito-urinary tract contamination and future damage. These infants require a colostomy before final corrective surgery.
The colostomy can be done electively before discharge from the nursery while the GI tract is decompressed by dilatation of the fistulous tract.
A single orifice is diagnostic of a persistent cloacal defect usually accompany with a small-looking genitalia. Cloacas are associated to distended vaginas hydrocolpos and urologic malformations. This makes a sonogram of abdomen very important in the initial management of these babies for screening of obstructive uropathy hydronephrosis and hydroureter.
Hydrocolpos can cause compressive obstruction of the bladder trigone and interfere with ureteral drainage. Failure to gain weight and frequents episodes of urinary tract infections shows a poorly drained urologic system. A colostomy in cloacas is indicated.
Radiological evaluation will be of help along with a diverting colostomy in this cases. Perineal fistulas can be managed with cutback without colostomy during the neonatal period. The most important prognostic characteristic is the severity of the IA. Patients with low IA have a good probability of having normal stool patterns. Patients with high IA report more problems such as fecal incontinence and constipation. For patients who cannot maintain normal bowel function, the use of a special diet, underpants liners, enemas and drugs have ameliorated their lives.
Long-term follow up with both qualitative and quantitative quality of life considerations of these patients is very important. References 1- Chen CJ: The treatment of imperforate anus: J Pediatr Surg 34 Inheritance of familial congenital isolated anorectal malformations: Am J Med Genetics Do children with repaired low anorectal malformations have normal bowel function?
J Pediatr Surg 32 6: Semin Pediatr Surg 4 1: Management of anorectal malformations during the newborn period. World J Surg 17 3: Posterior sagittal approach for the correction of anorectal malformations. Surgical treatment of high imperforate anus. World J Surg 9 2: J Pediatr Surg 17 5: Although intussusception can occur at any age, the greatest incidence occurs in infants between months of age.
Over half of the cases are in the first year of life. Frequently occurs after a recent upper respiratory infection, by Adenovirus type 3 that causes a reactive lymphoid hyperplasia that act as lead point of Peyer's patch.
Meckel's diverticulum, polyps, Henoch's Schonlein purpura, hematoma, lymphoma, foreign bodies, and duplications. Most children have no lead point and it is felt that enlarged mesenteric nodes or swollen Peyer's patches may be the cause. The baby has intermittent periods of severe discomfort with screaming, stiffening and drawing up of the legs, followed by periods of rest. Vomiting may occur and bloody, mucoid currant jelly stool may be passed.
The baby may become dehydrated and appear acutely ill. Frequently, lethargy may be an early sign. To be successful, the barium must reflux into the terminal ileum. The surgeon should be notified before an attempt at barium reduction, and should be present at the time of study. Recently the use of gas enema reduction has been successful in patients with: Ultrasonography can be used as a rapid sensitive screening procedure in the initial diagnosis of intussusception. Previous adverse clinical features that precluded barium reduction can be replaced during gas reduction.
Predictors of failure of reduction are: Air reduction pneumocolon is a very effective alternative method since it brings less radiation shorter flouroscopy time , less costs and less morbidity in cases of perforations. Failure of hydrostatic reduction requires urgent operation through a right lower quadrant horizontal incision. The intussusception is reduced by pushing on the distal bowel like a tube of toothpaste rather than pulling the proximal bowel.
Most cases are ileo-colic intussusception, and a few are jejuno-jejunal or ileo-ileal intussusception. The traditional method of diagnosing and managing ileo-colic intussusception is barium enema contrast reduction. In China where this is the most common surgical emergency in childhood, pneumatic reduction has been used for more than 25 years.
A recent tendency toward this approach is seen in recent years in Occident. Small bowel aeration is a sign of complete reduction. Gas enema reduction is very successful in patients with: The condition can occur in an isolated form either localized to colon or disseminated throughout the bowel , or associated to other diseases such as Hirschsprung's HD , neurofibromatosis, MEN type IIB, and anorectal malformations.
Medical experiments, many of them pseudoscientific , were performed on concentration camp inmates beginning in Josef Mengele , camp doctor at Auschwitz. Women were a cornerstone of Nazi social policy and the Nazis opposed the feminist movement, claiming that it was the creation of Jewish intellectuals, instead advocating a patriarchal society in which the German woman would recognise that her "world is her husband, her family, her children, and her home".
Courses were offered on childrearing, sewing and cooking. Women were encouraged to leave the workforce and the creation of large families by racially suitable women was promoted through a propaganda campaign. Women received a bronze award—known as the Ehrenkreuz der Deutschen Mutter Cross of Honour of the German Mother —for giving birth to four children, silver for six and gold for eight or more.
Though the measures led to increases in the birth rate, the number of families having four or more children declined by five percent between and After the war started, slave labourers were extensively used. The Nazi regime discouraged women from seeking higher education since Nazi leaders held conservative views about women and endorsed the idea that rational and theoretical work was alien to a woman's nature since they were considered inherently emotional and instinctive — as such, engaging in academics and careerism would only "divert them from motherhood".
The number of women enrolled in post-secondary schools dropped from , in to 51, in However, with the requirement that men be enlisted into the armed forces during the war, women comprised half of the enrolment in the post-secondary system by Women were expected to be strong, healthy and vital.
The BDM's activities focused on physical education, with activities such as running, long jumping, somersaulting, tightrope walking, marching and swimming.
The Nazi regime promoted a liberal code of conduct regarding sexual matters and was sympathetic to women who bore children out of wedlock. Soldier's wives were frequently involved in extramarital relationships. Sex was sometimes used as a commodity to obtain better work from a foreign labourer.
With Hitler's approval, Himmler intended that the new society of the Nazi regime should destigmatise illegitimate births, particularly of children fathered by members of the SS, who were vetted for racial purity. Existing laws banning abortion except for medical reasons were strictly enforced by the Nazi regime.
The number of abortions declined from 35, per year at the start of the s to fewer than 2, per year at the end of the decade, though in a law was passed allowing abortions for eugenics reasons.
Nazi society had elements supportive of animal rights and many people were fond of zoos and wildlife. In , the Nazis enacted a stringent animal-protection law that affected what was allowed for medical research.
The Reich Forestry Office under Göring enforced regulations that required foresters to plant a wide variety of trees to ensure suitable habitat for wildlife and a new Reich Animal Protection Act became law in Evans , The Coming of the Third Reich The regime promoted the concept of Volksgemeinschaft , a national German ethnic community. The goal was to build a classless society based on racial purity and the perceived need to prepare for warfare, conquest and a struggle against Marxism.
In addition to taking control of tens of thousands of previously privately run recreational clubs, it offered highly regimented holidays and entertainment such as cruises, vacation destinations and concerts.
Sub-chambers were set up to control aspects of cultural life such as film, radio, newspapers, fine arts, music, theatre and literature.
Members of these professions were required to join their respective organisation. Jews and people considered politically unreliable were prevented from working in the arts and many emigrated. Books and scripts had to be approved by the Propaganda Ministry prior to publication. Standards deteriorated as the regime sought to use cultural outlets exclusively as propaganda media.
Radio became popular in Germany during the s, with over 70 percent of households owning a receiver by , more than any other country. Radio station staffs were purged of leftists and others deemed undesirable by July As with other media, newspapers were controlled by the state, with the Reich Press Chamber shutting down or buying newspapers and publishing houses. By , over two thirds of the newspapers and magazines were directly owned by the Propaganda Ministry.
Under Goebbels, the Propaganda Ministry issued two dozen directives every week on exactly what news should be published and what angles to use; the typical newspaper followed the directives closely, especially regarding what to omit. Authors of books left the country in droves and some wrote material critical of the regime while in exile.
Goebbels recommended that the remaining authors concentrate on books themed on Germanic myths and the concept of blood and soil. By the end of , over a thousand books—most of them by Jewish authors or featuring Jewish characters—had been banned by the Nazi regime.
In Berlin over 20, books being burned at the square at the State Opera. Pacifist works, as well as literature espousing liberal, democratic tendencies and attitudes were targeted for destruction, as well as any writings supporting the Weimar Republic or those written by Jewish authors. Hitler took a personal interest in architecture and worked closely with state architects Paul Troost and Albert Speer to create public buildings in a neoclassical style based on Roman architecture.
Neither structure was built. Hitler's belief that abstract , Dadaist , expressionist and modern art were decadent became the basis for policy. The exhibition proved wildly popular, attracting over two million visitors.
Movies were popular in Germany in the s and s, with admissions of over a billion people in , and Exports of German films plummeted, as their antisemitic content made them impossible to show in other countries. The two largest film companies, Universum Film AG and Tobis , were purchased by the Propaganda Ministry, which by was producing most German films. The productions were not always overtly propagandistic, but generally had a political subtext and followed party lines regarding themes and content.
Leni Riefenstahl 's Triumph of the Will —documenting the Nuremberg Rally—and Olympia —covering the Summer Olympics —pioneered techniques of camera movement and editing that influenced later films. New techniques such as telephoto lenses and cameras mounted on tracks were employed. Both films remain controversial, as their aesthetic merit is inseparable from their propagandising of National Socialist ideals.
The Allied powers organised war crimes trials, beginning with the Nuremberg trials , held from November to October , of 23 top Nazi officials. They were charged with four counts—conspiracy to commit crimes, crimes against peace, war crimes and crimes against humanity —in violation of international laws governing warfare.
The display or use of Nazi symbolism such as flags, swastikas or greetings is illegal in Germany and Austria   and other restrictions, mainly on public display, apply in various countries. Nazi ideology and the actions taken by the regime are almost universally regarded as gravely immoral.
Evans remarks that the era "exerts an almost universal appeal because its murderous racism stands as a warning to the whole of humanity".
The Nazi era continues to inform how Germans view themselves and their country. Virtually every family suffered losses during the war or has a story to tell, though Germans kept quiet about their experiences and felt a sense of communal guilt, even if they were not directly involved in war crimes.
Once study of Nazi Germany was introduced into the school curriculum starting in the s, people began researching the experiences of their family members. Study of the era and a willingness to critically examine its mistakes has led to the development of a strong democracy in today's Germany, but with lingering undercurrents of antisemitism and neo-Nazi thought.
From Wikipedia, the free encyclopedia. Redirected from Third reich. For the book, see Das Dritte Reich. Das Lied der Deutschen "Song of the Germans". Administrative divisions of Germany, January Nazi one-party totalitarian dictatorship.
The German state from to , under the dictatorship of Adolf Hitler. Adolf Hitler's rise to power. Anschluss and German occupation of Czechoslovakia. Protectorate of Bohemia and Moravia. Mass suicides in Nazi Germany. Territorial evolution of Germany. Government of Nazi Germany.
Economy of Nazi Germany. Nazism and race and Racial policy of Nazi Germany. Anti-Jewish legislation in prewar Nazi Germany. Porajmos and Nazi eugenics.
Nazi crimes against the Polish nation. German mistreatment of Soviet prisoners of war and Generalplan Ost. University education in Nazi Germany. Other religion or irreligious 4. Religion in Nazi Germany. Women in Nazi Germany. Animal welfare in Nazi Germany. If the experience of the Third Reich teaches us anything, it is that a love of great music, great art and great literature does not provide people with any kind of moral or political immunization against violence, atrocity, or subservience to dictatorship.
List of authors banned in Nazi Germany. Nazi architecture and Art of the Third Reich. See Statistisches Jahrbuch It could not be expected that even for a brief period our Air Force could make up for our lack of naval supremacy. Grand Admiral Karl Dönitz believed air superiority was not enough and admitted, "We possessed neither control of the air or the sea; nor were we in any position to gain it. The figure of 2 to 2.
The German Red Cross still maintains that the death toll from the expulsions is 2. Goebbel's propaganda campaigns carried out in the second half of and again in had failed to convert them".
Evans , p. Women in the Third Reich. The German Churches and the Nazi State. End of the Thousand Year Reich. Oxford; New York, NY: The Second World War. A Concise History of Nazi Germany: Germany and Eastern Europe: Cultural Identities and Cultural Differences.
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Lewis, Brenda Ralph