nach oben

Erschienen in:

27.05.2021 | Neurology • Original Article

Eight-week high-intensity interval training is associated with improved sleep quality and cardiorespiratory fitness in patients with depressive disorders

verfasst von: Haitham Jahrami, Ahmed S. BaHammam, Brendon Stubbs, Ali Sabah, Zahra Saif, Nicola Luigi Bragazzi, Michael V. Vitiello

Erschienen in: Sleep and Breathing | Ausgabe 1/2022

Einloggen, um Zugang zu erhalten

Abstract

Purpose

This study aimed to examine the effect of high-intensity interval training (HIIT) on both sleep and cardiorespiratory fitness in patients with depression.

Methods

Using a single pre- and post-test study design with no control group, 82 patients diagnosed with depressive disorders underwent HIIT comprising a total of 24 15-min sessions, three times per week for 8 weeks. Depressive symptoms, sleep quality, and cardiorespiratory fitness were evaluated using the Beck depression inventory-II, the Pittsburgh sleep quality index (PSQI), and cardiopulmonary exercise testing (CPET) in the form of maximum oxygen uptake (VO₂ max), respectively.

Results

All 82 patients completed the intervention. HIIT training was associated with significant improvements in BDI-II score (diff = − 1.57 [95% CI − 2.40 to − 0.73], P = 0.001), PSQI score (diff = − 1.20 [95% CI − 2.10 to − 0.32], P = 0.008), and CPET VO₂ max (diff = 0.95 [95% CI 0.62–1.28], P = 0.001). Effect size calculations revealed that the greatest improvement occurred in CPET VO₂ max (Cohen’s d = 0.64) and that improvements in the BDI-II and PSQI scores were somewhat smaller in magnitude (Cohen’s d = − 0.41 and − 0.30, respectively). Sleep quality improvements were observed in sleep latency, habitual sleep efficiency, and the use of sleep-promoting medications (Cohen’s d = 0.18, 0.19, and 0.25, respectively). Change in cardiorespiratory fitness successfully predicted change in sleep quality but not in depressive symptoms. Adverse effects were limited to minor injuries which did not interfere with completion of training.

Conclusions

HIIT training delivered over 8 weeks was associated with improvements in depression symptoms, sleep quality, and cardiorespiratory fitness in patients with depressive disorders.

Nur mit Berechtigung zugänglich

Patel V, Chisholm D, Parikh R, Charlson FJ, Degenhardt L, Dua T et al (2016) Addressing the burden of mental, neurological, and substance use disorders: key messages from Disease Control Priorities, 3rd edition. Lancet 387(10028):1672–85. https://doi.org/10.1016/s0140-6736(15)00390-6

Becker NB, Jesus SN, João K, Viseu JN, Martins RIS (2017) Depression and sleep quality in older adults: a meta-analysis. Psychol Health Med 22(8):889–895. https://doi.org/10.1080/13548506.2016.1274042CrossRefPubMed

Zhai L, Zhang H, Zhang D (2015) Sleep duration and depression among adults: a meta-analysis of prospective studies. Depress Anxiety 32(9):664–670. https://doi.org/10.1002/da.22386CrossRefPubMed

Wang X, Cheng S, Xu H (2019) Systematic review and meta-analysis of the relationship between sleep disorders and suicidal behaviour in patients with depression. BMC Psychiatry 19(1):303. https://doi.org/10.1186/s12888-019-2302-5CrossRefPubMedPubMedCentral

Alvaro PK, Roberts RM, Harris JK (2013) A systematic review assessing bidirectionality between sleep disturbances, anxiety, and depression. Sleep 36(7):1059–1068. https://doi.org/10.5665/sleep.2810CrossRefPubMedPubMedCentral

Schuch FB, Vancampfort D, Firth J, Rosenbaum S, Ward PB, Silva ES et al (2018) Physical activity and incident depression: a meta-analysis of prospective cohort studies. Am J Psychiatry 175(7):631–648. https://doi.org/10.1176/appi.ajp.2018.17111194CrossRefPubMed

Schuch FB, Stubbs B, Meyer J, Heissel A, Zech P, Vancampfort D et al (2019) Physical activity protects from incident anxiety: a meta-analysis of prospective cohort studies. Depress Anxiety 36(9):846–858. https://doi.org/10.1002/da.22915CrossRefPubMed

Stubbs B, Vancampfort D, Smith L, Rosenbaum S, Schuch F, Firth J (2018) Physical activity and mental health. Lancet Psychiatry 5(11):873. https://doi.org/10.1016/S2215-0366(18)30343-2CrossRefPubMed

Itani O, Jike M, Watanabe N, Kaneita Y (2017) Short sleep duration and health outcomes: a systematic review, meta-analysis, and meta-regression. Sleep Med 32:246–256. https://doi.org/10.1016/j.sleep.2016.08.006CrossRefPubMed

10.

Cunningham C, O’Sullivan R, Caserotti P, Tully MA (2020) Consequences of physical inactivity in older adults: a systematic review of reviews and meta-analyses. Scand J Med Sci Sports. 30(5):816–27. https://doi.org/10.1111/sms.13616CrossRefPubMed

11.

Chaabane S, Chaabna K, Abraham A, Mamtani R, Cheema S (2020) Physical activity and sedentary behaviour in the Middle East and North Africa: an overview of systematic reviews and meta-analysis. Sci Rep 10(1):9363. https://doi.org/10.1038/s41598-020-66163-xCrossRefPubMedPubMedCentral

12.

Strand LB, Laugsand LE, Wisløff U, Nes BM, Vatten L, Janszky I (2013) Insomnia symptoms and cardiorespiratory fitness in healthy individuals: the Nord-Trøndelag Health Study (HUNT). Sleep 36(1):99–108. https://doi.org/10.5665/sleep.2310CrossRefPubMedPubMedCentral

13.

Lin X, Zhang X, Guo J, Roberts CK, McKenzie S, Wu W-C et al (2015) Effects of exercise training on cardiorespiratory fitness and biomarkers of cardiometabolic health: a systematic review and meta-analysis of randomized controlled trials. J Am Heart Assoc 4(7):e002014. https://doi.org/10.1161/JAHA.115.002014CrossRefPubMedPubMedCentral

14.

Jahrami H, Saif Z, AlHaddad M, Faris MA, Hammad L, Ali B (2020) Assessing dietary and lifestyle risk behaviours and their associations with disease comorbidities among patients with depression: a case-control study from Bahrain. Heliyon 6(6):e04323. https://doi.org/10.1016/j.heliyon.2020.e04323CrossRefPubMedPubMedCentral

15.

King AC, Whitt-Glover MC, Marquez DX, Buman MP, Napolitano MA, Jakicic J et al (2019) Physical activity promotion: highlights from the 2018 Physical Activity Guidelines Advisory Committee systematic review. Med Sci Sports Exerc 51(6):1340–1353. https://doi.org/10.1249/mss.0000000000001945CrossRefPubMed

16.

WHO (2010) WHO Global recommendations on physical activity for health. World Health Organization, pp 60. Available online https://www.who.int/dietphysicalactivity/global-PA-recs-2010.pdf

17.

Vancampfort D, Stubbs B, Firth J, Hallgren M, Schuch F, Lahti J et al (2017) Physical activity correlates among 24,230 people with depression across 46 low- and middle-income countries. J Affect Disord 221:81–88. https://doi.org/10.1016/j.jad.2017.06.012CrossRefPubMed

18.

Firth J, Rosenbaum S, Stubbs B, Gorczynski P, Yung AR, Vancampfort D (2016) Motivating factors and barriers towards exercise in severe mental illness: a systematic review and meta-analysis. Psychol Med 46(14):2869–2881. https://doi.org/10.1017/S0033291716001732CrossRefPubMedPubMedCentral

19.

Ross R, Blair SN, Arena R, Church TS, Després JP, Franklin BA et al (2016) Importance of assessing cardiorespiratory fitness in clinical practice: a case for fitness as a clinical vital sign: a scientific statement from the American Heart Association. Circulation 134(24):e653–e699. https://doi.org/10.1161/cir.0000000000000461CrossRefPubMed

20.

Korman N, Armour M, Chapman J, Rosenbaum S, Kisely S, Suetani S et al (2020) High intensity interval training (HIIT) for people with severe mental illness: a systematic review & meta-analysis of intervention studies–considering diverse approaches for mental and physical recovery. Psychiatry Res 284:112601. https://doi.org/10.1016/j.psychres.2019.112601CrossRefPubMed

21.

Stubbs B, Rosenbaum S, Vancampfort D, Ward PB, Schuch FB (2016) Exercise improves cardiorespiratory fitness in people with depression: a meta-analysis of randomized control trials. J Affect Disord 190:249–253. https://doi.org/10.1016/j.jad.2015.10.010CrossRefPubMed

22.

Banno M, Harada Y, Taniguchi M, Tobita R, Tsujimoto H, Tsujimoto Y et al (2018) Exercise can improve sleep quality: a systematic review and meta-analysis. Peer J. 6:e5172-e. https://doi.org/10.7717/peerj.5172CrossRef

23.

Zeiher J, Ombrellaro KJ, Perumal N, Keil T, Mensink GBM, Finger JD (2019) Correlates and determinants of cardiorespiratory fitness in adults: a systematic review. Sports Medicine - Open 5(1):39. https://doi.org/10.1186/s40798-019-0211-2CrossRefPubMedPubMedCentral

24.

Busch AM, Ciccolo JT, Puspitasari AJ, Nosrat S, Whitworth JW, Stults-Kolehmainen M (2016) Preferences for exercise as a treatment for depression. Ment Health Phys Act 10:68–72. https://doi.org/10.1016/j.mhpa.2015.12.004CrossRefPubMedPubMedCentral

25.

Sabag A, Little JP, Johnson NA. Low-volume high-intensity interval training for cardiometabolic health. J Physiol https://doi.org/10.1113/JP281210.

26.

Longlalerng K, Sonsuwan N, Uthaikhup S, Kietwatanachareon S, Kamsaiyai W, Panyasak D et al (2020) High-intensity interval training combined with resistance training improved apnea-hypopnea index but did not modify oxygen desaturation index and oxygen saturation nadir in obese children with obstructive sleep apnea. Sleep Breath 24(2):571–580. https://doi.org/10.1007/s11325-019-01899-zCrossRefPubMed

27.

Martland R, Mondelli V, Gaughran F, Stubbs B (2020) Can high intensity interval training improve health outcomes among people with mental illness? A systematic review and preliminary meta-analysis of intervention studies across a range of mental illnesses. J Affect Disord 263:629–660. https://doi.org/10.1016/j.jad.2019.11.039CrossRefPubMed

28.

Des Jarlais DC, Lyles C, Crepaz N (2004) Improving the reporting quality of nonrandomized evaluations of behavioral and public health interventions: the TREND statement. Am J Public Health 94(3):361–366. https://doi.org/10.2105/ajph.94.3.361CrossRefPubMedPubMedCentral

29.

World Health O (2005) International classification of diseases (ICD). World Health Organization, Geneva

30.

Adams R (1999) Revised physical activity readiness questionnaire. Can Fam Physician 45:992–1005PubMedPubMedCentral

31.

Shephard RJ (2015) Qualified fitness and exercise as professionals and exercise prescription: evolution of the PAR-Q and Canadian aerobic fitness test. J Phys Act Health 12(4):454–461. https://doi.org/10.1123/jpah.2013-0473CrossRefPubMed

32.

Shephard RJ (1988) PAR-Q, Canadian home fitness test and exercise screening alternatives. Sports Med 5(3):185–195. https://doi.org/10.2165/00007256-198805030-00005CrossRefPubMed

33.

Whitfield GP, Pettee Gabriel KK, Rahbar MH, Kohl HW 3rd (2014) Application of the American Heart Association/American College of Sports Medicine Adult Preparticipation Screening Checklist to a nationally representative sample of US adults aged >=40 years from the National Health and Nutrition Examination Survey 2001 to 2004. Circulation 129(10):1113–1120. https://doi.org/10.1161/circulationaha.113.004160CrossRefPubMedPubMedCentral

34.

Schwartz J, Mas-Alòs S, Takito MY, Martinez J, Cueto MEÁ, Mibelli MSR et al (2019) Cross-cultural translation, adaptation, and reliability of the Spanish version of the Physical Activity Readiness Questionnaire for Everyone (PAR-Q+). Health Fit J Can 12(4):3–14

35.

Stubbs B, Vancampfort D, Rosenbaum S, Ward PB, Richards J, Soundy A et al (2016) Dropout from exercise randomized controlled trials among people with depression: a meta-analysis and meta regression. J Affect Disord 190:457–466. https://doi.org/10.1016/j.jad.2015.10.019CrossRefPubMed

36.

WHO: Body mass index - BMI. https://www.euro.who.int/en/health-topics/disease-prevention/nutrition/a-healthy-lifestyle/body-mass-index-bmi Accessed 6/01/2020 2020

37.

Naja S, Al-Kubaisi N, Chehab M, Al-Dahshan A, Abuhashem N, Bougmiza I (2019) Psychometric properties of the Arabic version of EPDS and BDI-II as a screening tool for antenatal depression: evidence from Qatar. BMJ Open. 9(9):e030365-e. https://doi.org/10.1136/bmjopen-2019-030365CrossRef

38.

Suleiman KH, Yates BC, Berger AM, Pozehl B, Meza J (2010) Translating the Pittsburgh sleep quality index into Arabic. West J Nurs Res 32(2):250–268. https://doi.org/10.1177/0193945909348230CrossRefPubMed

39.

Chambers D, Wisely N (2019) Cardiopulmonary exercise testing—a beginner’s guide to the nine-panel plot. Bja Educ 19(5):158–164CrossRef

40.

Borg G (1990) Psychophysical scaling with applications in physical work and the perception of exertion. Scand J Work Environ Health 16(Suppl 1):55–58. https://doi.org/10.5271/sjweh.1815CrossRefPubMed

41.

Tabata I, Nishimura K, Kouzaki M, Hirai Y, Ogita F, Miyachi M et al (1996) Effects of moderate-intensity endurance and high-intensity intermittent training on anaerobic capacity and VO2max. Med Sci Sports Exerc 28(10):1327–1330. https://doi.org/10.1097/00005768-199610000-00018CrossRefPubMed

42.

Haltom RW, Kraemer RR, Sloan RA, Hebert EP, Frank K, Tryniecki JL (1999) Circuit weight training and its effects on excess postexercise oxygen consumption. Med Sci Sports Exerc 31(11):1613–1618. https://doi.org/10.1097/00005768-199911000-00018CrossRefPubMed

43.

Klika B, Jordan C (2013) High-intensity circuit training using body weight: maximum results with minimal investment. ACSMs Health Fit J 17(3):8–13. https://doi.org/10.1249/FIT.0b013e31828cb1e8CrossRef

44.

Perraton LG, Kumar S, Machotka Z (2010) Exercise parameters in the treatment of clinical depression: a systematic review of randomized controlled trials. J Eval Clin Pract 16(3):597–604. https://doi.org/10.1111/j.1365-2753.2009.01188.xCrossRefPubMed

45.

Cohen J (2013) Statistical power analysis for the behavioral sciences. Academic press

46.

Stata. 16.1. (2020) College Station: StataCorp.

47.

Martland R, Mondelli V, Gaughran F, Stubbs B (2020) Can high-intensity interval training improve physical and mental health outcomes? A meta-review of 33 systematic reviews across the lifespan. J Sports Sci 38(4):430–469. https://doi.org/10.1080/02640414.2019.1706829CrossRefPubMed

48.

Sultana RN, Sabag A, Keating SE, Johnson NA (2019) The effect of low-volume high-intensity interval training on body composition and cardiorespiratory fitness: a systematic review and meta-analysis. Sports Med 49(11):1687–1721. https://doi.org/10.1007/s40279-019-01167-wCrossRefPubMed

49.

Kandola A, Ashdown-Franks G, Stubbs B, Osborn DPJ, Hayes JF (2019) The association between cardiorespiratory fitness and the incidence of common mental health disorders: a systematic review and meta-analysis. J Affect Disord 257:748–757. https://doi.org/10.1016/j.jad.2019.07.088CrossRefPubMedPubMedCentral

50.

Gujral S, Aizenstein H, Reynolds CF 3rd, Butters MA, Erickson KI (2017) Exercise effects on depression: possible neural mechanisms. Gen Hosp Psychiatry 49:2–10. https://doi.org/10.1016/j.genhosppsych.2017.04.012CrossRefPubMedPubMedCentral

51.

Firth J, Stubbs B, Vancampfort D, Schuch F, Lagopoulos J, Rosenbaum S et al (2018) Effect of aerobic exercise on hippocampal volume in humans: a systematic review and meta-analysis. Neuroimage 166:230–238. https://doi.org/10.1016/j.neuroimage.2017.11.007CrossRefPubMed

52.

Li MY, Huang MM, Li SZ, Tao J, Zheng GH, Chen LD (2017) The effects of aerobic exercise on the structure and function of DMN-related brain regions: a systematic review. Int J Neurosci 127(7):634–649. https://doi.org/10.1080/00207454.2016.1212855CrossRefPubMed

53.

Zheng G, Ye B, Zheng Y, Xiong Z, Xia R, Qiu P et al (2019) The effects of exercise on the structure of cognitive related brain regions: a meta-analysis of functional neuroimaging data. Int J Neurosci 129(4):406–415. https://doi.org/10.1080/00207454.2018.1508135CrossRefPubMed

54.

Schuch FB, Deslandes AC, Stubbs B, Gosmann NP, Silva CT, Fleck MP (2016) Neurobiological effects of exercise on major depressive disorder: a systematic review. Neurosci Biobehav Rev 61:1–11. https://doi.org/10.1016/j.neubiorev.2015.11.012CrossRefPubMed

55.

Kandola A, Ashdown-Franks G, Hendrikse J, Sabiston CM, Stubbs B (2019) Physical activity and depression: towards understanding the antidepressant mechanisms of physical activity. Neurosci Biobehav Rev 107:525–539. https://doi.org/10.1016/j.neubiorev.2019.09.040CrossRefPubMed

56.

Firth JA, Smith L, Sarris J, Vancampfort D, Schuch F, Carvalho AF et al (2020) Handgrip strength is associated with hippocampal volume and white matter hyperintensities in major depression and healthy controls: a UK biobank study. Psychosom Med 82(1):39–46. https://doi.org/10.1097/psy.0000000000000753CrossRefPubMed

57.

Lang C, Kalak N, Brand S, Holsboer-Trachsler E, Puhse U, Gerber M (2016) The relationship between physical activity and sleep from mid adolescence to early adulthood. A systematic review of methodological approaches and meta-analysis. Sleep Med Rev. 28:32–45. https://doi.org/10.1016/j.smrv.2015.07.004CrossRefPubMed

58.

Yamanaka Y, Hashimoto S, Takasu NN, Tanahashi Y, Nishide SY, Honma S et al (2015) Morning and evening physical exercise differentially regulate the autonomic nervous system during nocturnal sleep in humans. Am J Physiol Regul Integr Comp Physiol 309(9):R1112–R1121. https://doi.org/10.1152/ajpregu.00127.2015CrossRefPubMed

59.

Nystrom MB, Neely G, Hassmen P, Carlbring P (2015) Treating major depression with physical activity: a systematic overview with recommendations. Cogn Behav Ther 44(4):341–352. https://doi.org/10.1080/16506073.2015.1015440CrossRefPubMed

60.

Brupbacher G, Gerger H, Zander-Schellenberg T, Straus D, Porschke H, Gerber M et al (2021) The effects of exercise on sleep in unipolar depression: a systematic review and network meta-analysis. Sleep Med Rev 59:101452. https://doi.org/10.1016/j.smrv.2021.101452CrossRefPubMed

61.

Spiegelhalder K, Regen W, Nanovska S, Baglioni C, Riemann D (2013) Comorbid sleep disorders in neuropsychiatric disorders across the life cycle. Curr Psychiatry Rep 15(6):364. https://doi.org/10.1007/s11920-013-0364-5CrossRefPubMed

62.

Pandi-Perumal SR, Monti JM, Burman D, Karthikeyan R, BaHammam AS, Spence DW et al (2020) Clarifying the role of sleep in depression: a narrative review. Psychiatry Res 291:113239. https://doi.org/10.1016/j.psychres.2020.113239CrossRefPubMed

63.

Moldoveanu AI, Shephard RJ, Shek PN (2001) The cytokine response to physical activity and training. Sports Med 31(2):115–144. https://doi.org/10.2165/00007256-200131020-00004CrossRefPubMedPubMedCentral

64.

Dinoff A, Herrmann N, Swardfager W, Lanctot KL (2017) The effect of acute exercise on blood concentrations of brain-derived neurotrophic factor in healthy adults: a meta-analysis. Eur J Neurosci 46(1):1635–1646. https://doi.org/10.1111/ejn.13603CrossRefPubMed

65.

Formenti D, Ludwig N, Gargano M, Gondola M, Dellerma N, Caumo A et al (2013) Thermal imaging of exercise-associated skin temperature changes in trained and untrained female subjects. Ann Biomed Eng 41(4):863–871. https://doi.org/10.1007/s10439-012-0718-xCrossRefPubMed

66.

Brupbacher G, Gerger H, Wechsler M, Zander-Schellenberg T, Straus D, Porschke H et al (2019) The effects of aerobic, resistance, and meditative movement exercise on sleep in individuals with depression: protocol for a systematic review and network meta-analysis. Syst Rev 8(1):105. https://doi.org/10.1186/s13643-019-1018-4CrossRefPubMedPubMedCentral

67.

Lall GS, Atkinson LA, Corlett SA, Broadbridge PJ, Bonsall DR (2012) Circadian entrainment and its role in depression: a mechanistic review. J Neural Transm (Vienna) 119(10):1085–1096. https://doi.org/10.1007/s00702-012-0858-zCrossRef

68.

Edwards BJ, Reilly T, Waterhouse J (2009) Zeitgeber-effects of exercise on human circadian rhythms: what are alternative approaches to investigating the existence of a phase-response curve to exercise? Biol Rhythm Res 40:53–69. https://doi.org/10.1080/09291010802067072CrossRef

69.

Meeusen R, De Meirleir K (1995) Exercise and brain neurotransmission. Sports Med 20(3):160–188. https://doi.org/10.2165/00007256-199520030-00004CrossRefPubMed

Titel: Eight-week high-intensity interval training is associated with improved sleep quality and cardiorespiratory fitness in patients with depressive disorders
verfasst von: Haitham Jahrami
Ahmed S. BaHammam
Brendon Stubbs
Ali Sabah
Zahra Saif
Nicola Luigi Bragazzi
Michael V. Vitiello
Publikationsdatum: 27.05.2021
Verlag: Springer International Publishing
Erschienen in: Sleep and Breathing / Ausgabe 1/2022
Print ISSN: 1520-9512
Elektronische ISSN: 1522-1709
DOI: https://doi.org/10.1007/s11325-021-02388-y

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

19.04.2024 | Vorhofflimmern | Nachrichten

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Eight-week high-intensity interval training is associated with improved sleep quality and cardiorespiratory fitness in patients with depressive disorders

Abstract

Purpose

Methods

Results

Conclusions

Leitlinien kompakt für die Innere Medizin

Neu im Fachgebiet Innere Medizin

Parodontalbehandlung verbessert Prognose bei Katheterablation

Prostatakarzinom: EU initiiert neues Screeningkonzept

Blasenkarzinom – Biomarker statt Zytologie?

Antihypertensiva schützen auch alte Menschen noch vor Demenz

Update Innere Medizin

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 1/2022

Economic evaluation of CPAP therapy for obstructive sleep apnea: a scoping review and evidence map

Positive airway pressure therapy for chronic pain in patients with obstructive sleep apnea—a systematic review

Evaluation of affective temperament profile and levels of depressive symptoms and anxiety in patients with restless legs syndrome

Effects of sleep duration and sleep quality in early pregnancy and their interaction on gestational diabetes mellitus

Validation of snoring detection using a smartphone app

Multiple genetic variations of chronic rhinosinusitis with nasal polyps are associated with respiratory parameters in men with obstructive sleep apnea

Leitlinien kompakt für die Innere Medizin

Neu im Fachgebiet Innere Medizin

Parodontalbehandlung verbessert Prognose bei Katheterablation

Prostatakarzinom: EU initiiert neues Screeningkonzept

Blasenkarzinom – Biomarker statt Zytologie?

Antihypertensiva schützen auch alte Menschen noch vor Demenz

Update Innere Medizin