Dtsch Arztebl Int
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Clinical guidelines recommend psychosocial care as an integral part of medical treatment, but access is often limited. Technology-based approaches provide an attractive opportunity to optimize health outcomes and quality of life in people with chronic somatic diseases e.g. by means of Internet- and mobile-based interventions (IMIs). The present article provides an overview on the basics of IMIs, applications and their evidence base for people living with chronic somatic diseases. ⋯ IMIs are potentially effective when aiming at lifestyle changes and supporting medical treatment in people with chronic somatic diseases. However, results are still heterogenous and the evidence base is limited regarding specific settings, compounding the discussion of possible ways of implementing IMIs into our healthcare systems.
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The care of elderly patients with comorbid dementia poses an increasing challenge in the acute inpatient setting, yet there remains a lack of representative studies on the prevalence and distribution of dementia in general hospitals. ⋯ Two out of five elderly patients in general hospitals suffer from a cognitive disturbance. Patients with severe impairments such as dementia or delirium often need special care. Guidelines and model projects offer approaches by which the inpatient care of patients with comorbid dementia can be improved.
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The conservative treatment of traumatic thoracolumbar vertebral fractures is often not clearly defined. ⋯ Further comparative studies of the indications for surgery and specific conservative treatment modalities would be desirable.
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There is an ongoing need for clear explanation of the diagnostic entity called "irreversible loss of brain function" (ILBF), as the absolute reliability of this diagnosis and its significance continue to be widely misunderstood. The determination of death as an objective medical-scientific matter is often not clearly distinguished from various other aspects of death, such as its metaphysical and cultural aspects and the ways in which the living deal with the dead. ⋯ ILBF is a reliable sign that a human being is dead. There has never been even one known case of incorrect determination of ILBF after proper application of the standardized diagnostic procedures that are set down in the guideline according to §16 of the German Transplantation Law.
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Seasickness and travel sickness are classic types of motion illness. Modern simulation systems and virtual reality representations can also induce comparable symptoms. Such manifestations can be alleviated or prevented by various measures. ⋯ The various types of motion sickness can be treated with general measures to lessen the intersensory conflict, behavioral changes, and drugs.