Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Feb 2022
[Modern drug therapy for systemic sclerosis associated interstitial lung disease].
Systemic Sclerosis with Interstitial Lung Disease (SSc-ILD) is associated with an increased risk of morbidity and mortality. Because of a lack of approved medications that can effectively influence SSc-ILD disease course, there is a need for new therapeutic options. ⋯ Recently, a phase III study demonstrated the positive effect of the antifibrotic agent nintedanib on the loss of lung volume and thus disease progression in patients with SSc-ILD. Due to its synergistic mechanism of action, combination therapy with nintedanib and mycophenolate could be a complementary treatment approach for SSc-ILD in the future.
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It is part of the natural aging process that cognitive performance declines and the speed of information processing slows down. However, if brain function deteriorates significantly, spatial and temporal disorientation, speech and recognition disorders, as well as behavioral and psychological symptoms of dementia (BPSD) such as apathy, anxiety, depression, social withdrawal or even strong emotional fluctuations with agitation and apathy may occur. ⋯ The current article focuses on the pharmacotherapeutic treatment of the most common dementia syndromes, such as Alzheimer's dementia, vascular dementia, Lewy body dementia, Parkinson dementia, and frontotemporal dementia. Furthermore, pharmacological treatment of accompanying psychopathological symptoms are highlighted.
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Dtsch. Med. Wochenschr. · Feb 2022
Observational Study[How do internal medicine patients choose their hospital? A cross-sectional study].
The free choice of hospital by patients is promoted by health policy and is to be supported by the quality reports of hospitals. But how do patients choose a hospital? How many can decide for themselves, where do they inform themselves and what are their decision criteria in the specific situation? This will be answered for inpatients of internal medicine in comparison to those of other specialties. ⋯ In internal medicine, fewer patients can decide on the hospital themselves. These then decide quite predominantly on the basis of their previous experience with the hospital and continue the renewed treatment in the hospital with which they are also familiar. A small proportion of younger, more educated and less hospital-experienced patients inform themselves more actively before elective procedures. Patients' treatment experiences are central to their own and their relatives' choice of hospital via social exchange.
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Dtsch. Med. Wochenschr. · Feb 2022
[Primary hyperparathyreoidism - diagnostic procedures and management].
Hypercalcemia as a laboratory result is often diagnosed during evaluation for osteoporosis. Any form of hypercalcemia should be evaluated further. Owing to fluctuating calcium levels, the measurement should be repeated and corrected for elevated albumin levels by calculation or by measuring ionized calcium. ⋯ Postsurgical calcium and vitamin-D administration will prevent postsurgical hypocalcemia and hungry-bone disease, and may optimize the outcome of BMD. Treatment of osteoporosis without fractures might not be necessary, owing to normalization of BMD several years after parathyroid surgery. The continuation of specific anti-osteoporotic treatment with bisphosphonates post-surgery did not have any advantage and hence cannot be recommended.
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Dtsch. Med. Wochenschr. · Feb 2022
[Touch Medicine - a complementary therapeutic approach exemplified by the treatment of depression].
Skin-to-skin-contact presents the earliest sensory experience of men and animals. Deprivation of age-relevant touch experiences during infancy results in compromised psychosocial and biological development. The 2021 Nobel Prize in Physiology or Medicine has been awarded for the discoveries of receptors for temperature and touch. ⋯ Controlled studies and systematic reviews have convincingly shown antidepressive, anxiolytic and analgesic effects of salutary touch. The effectiveness and efficacy of touch therapy has also been demonstrated in many areas such as neonatology, pediatrics, oncology, and geriatrics. We discuss the underlying mechanisms on various explanatory levels including interoceptive and oxytocinergic mechanisms as well as the role of C tactile afferent nerve fibers.