Deutsche medizinische Wochenschrift
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Psychocardiological research has contributed a better understanding of mental health, psychosocial factors and quality of life of in patients with cardiovascular diseases. In this update of psychocardiology in 2021, stressful experiences in childhood and adolescence are found to increase the risk of type II diabetes mellitus, coronary heart disease and stroke along the life course. ⋯ Summarizing the update of psychocardiological interventions, the effectiveness of team-based treatment ("blended collaborative care") in secondary prevention is currently being tested in Germany in the randomized, controlled TEACH multicenter trial of patients with coronary heart disease and distress. Interventions such as positive psychology and mindfulness training can lead to a significant reduction in anxiety, stress and depression in heart patients.
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Changes of lifestyle have a substantial effect on stroke prevention, especially in high-risk patients. Maintaining a healthier lifestyle can have greater effects than most pharmacological therapies of cardiovascular prevention. ⋯ Despite the abundance of observational data and meta-analyses assessing the association of different lifestyle changes and stroke risk, the literature frequently lacks evidence from randomized controlled clinical trial. This article will provide an overview of various forms of lifestyle changes and summarize their potential to modify the risk of stroke.
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Lung involvement is one of the most frequent organ manifestation in rheumatic diseases (CTD-ILD). Especially patients with rheumatoid arthritis, systemic sclerosis, and idiopathic inflammatory myopathies are affected. Interstitial lung diseases (ILD) are still associated with significant morbidity and mortality. ⋯ Methotrexate is probably not a significant cause of lung disease in rheumatoid arthritis but might even delay the presentation of interstitial lung disease (ILD). Tocilizumab could be a treatment option in SSc-ILD, despite the limitations of the current studies. For Systemic Sclerosis-ILD (SSc-ILD) and progressive fibrosing ILD, antifibrotic therapy with nintedanib is now approved.
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Treating sleep disorders is a challenge in individuals with dementia. A precondition for treatment success is thorough diagnostics of sleep disorders. ⋯ Drugs for the treatment of a sleep disorder should only be prescribed with a clear indication and prolongation of prescription should regularly be checked. The active search for and the treatment of sleep disorders should always be performed in individuals with dementia.