Neues aus Diagnostik und Therapie der spinalen Erkrankungen [Novel aspects of diagnostics and therapy of spinal cord diseases].

BACKGROUND: Both non-traumatic and traumatic spinal cord injuries have in common that a relatively minor structural lesion can cause profound sensorimotor and autonomous dysfunction. Besides treating the cause of the spinal cord injury the main goal is to restore lost function as far as possible. AIM: This article provides an overview of current innovative diagnostic (imaging) and therapeutic approaches (neurorehabilitation and neuroregeneration) aiming for recovery of function after non-traumatic and traumatic spinal cord injuries. MATERIAL AND METHODS: An analysis of the current scientific literature regarding imaging, rehabilitation and rehabilitation strategies in spinal cord disease was carried out. RESULTS: Novel magnetic resonance imaging (MRI) based techniques (e.g. diffusion-weighted MRI and functional MRI) allow visualization of structural reorganization and specific neural activity in the spinal cord. Robotics-driven rehabilitative measures provide training of sensorimotor function in a targeted fashion, which can even be continued in the homecare setting. From a preclinical point of view, defined stem cell transplantation approaches allow for the first time robust structural repair of the injured spinal cord. CONCLUSION: Besides well-established neurological and functional scores, MRI techniques offer the unique opportunity to provide robust and reliable "biomarkers" for restorative therapeutic interventions. Function-oriented robotics-based rehabilitative interventions alone or in combination with stem cell based therapies represent promising approaches to achieve substantial functional recovery, which go beyond current rehabilitative treatment efforts.

Empfehlungen zur Diagnostik und Therapie der behavioralen und psychologischen Symptome der Demenz (BPSD) [Recommendations for diagnosis and therapy of behavioral and psychological symptoms in dementia (BPSD)].

In patients with dementia, Behavioral and Psychological Symptoms of Dementia (BPSD) are frequent findings that accompany deficits caused by cognitive impairment and thus complicate diagnostics, therapy and care. BPSD are a burden both for affected individuals as well as care-givers, and represent a significant challenge for therapy of a patient population with high degree of multi-morbidity. The goal of this therapy-guideline issued by swiss professional associations is to present guidance regarding therapy of BPSD as attendant symptoms in dementia, based on evidence as well as clinical experience. Here it appears to be of particular importance to take into account professional experience, as at this point for most therapeutic options no sufficiently controlled clinical trials are available. A critical discussion of pharmaco-therapeutic intervention is necessary, as this patient-population is particularly vulnerable for medication side-effects. Finally, a particular emphasis is placed on incorporating and systematically reporting psycho-social and nursing options therapeutic intervention.

Depression im Alter : was ist anders ? = Dépression chez la personne âgée : quoi d'autre ?

Depressionen treten bei âlteren Menschen wahrscheinlich nicht haufiger auf ais bei jungen Personen. Es bestehen jedoch Unterschiede hinsichtlich der Symptomatik, der Diagnostik und der Therapie der Depression. Haufig werden depressive Symptome ais normale Begleiterscheinungen im Alter verkannt und bleiben deshalb oft unbehandelt. Eine Depression bei âlteren Menschen ist eine Erkrankung, die mit Hilfe von Psychopharmaka und Psychotherapie erfolgreich behandelt werden kann. Les dépressions ne sont probablement pas plus fréquentes chez les personnes âgées que chez les sujets jeunes. Des différences existent cependant au regard de la symptomatologie, du diagnostic et du traitement de la dépression. Les symptômes dépressifs sont fréquemment considérés comme des manifestations normales associées à la sénescence et restent donc souvent sans traitements. Une dépression chez les personnes âgées est une maladie qui peut être traitée efficacement par des psychotropes et une psychothérapie.

Postmortale Darstellung der Koronararteriendurchmultiphasische Ganzkörper-CT-Angiographie : Vergleich mit Ante-mortem-Koronarangiographien

Die Diagnostik des plötzlichen Herztods durch bildgebende Techniken ist bislang unzureichend evaluiert. Als Validierungsoption für postmortale koronarangiographische Methoden steht der Sektionsbefund zur Verfügung. Sequenziell postmortal durchgeführte alternative angiographische Methoden sind denkbar. Schließlich bietet die ante mortem durchgeführte Koronarangiographie (CA) - ggf. In Verbindung mit der perkutanen transluminalen Koronarangioplastie (PTCA) - weitere Vergleichsmöglichkeiten. Neben deskriptiven sind hier auch potenziell funktionelle Aussagen zum Stenosegrad möglich.