Hypomagnesaemia is absent in children with autosomal dominant polycystic kidney disease

BACKGROUND

Hypomagnesaemia is present in 40-50% of children with autosomal dominant renal cysts and diabetes syndrome (RCAD). On the contrary, the prevalence of hypomagnesaemia in children with autosomal dominant polycystic kidney disease (ADPKD) has never been examined. We aimed to investigate whether hypomagnesaemia is present in children with polycystic kidney diseases.

METHODS

Children with cystic kidney diseases were investigated in a cross-sectional study. Serum concentrations of magnesium (S-Mg) and fractional excretion of magnesium (FE-Mg) were tested. Fifty-four children with ADPKD ( n = 26), autosomal recessive polycystic kidney disease (ARPKD) ( n = 16) and RCAD ( n = 12) with median age of 11.2 (0.6-18.6) years were investigated.

RESULTS

Hypomagnesaemia (S-Mg < 0.7 mmol/L) was detected in none of the children with ADPKD/ARPKD and in eight children (67%) with RCAD. Median S-Mg in children with ADPKD/ARPKD was significantly higher than in children with RCAD (0.89 vs. 0.65 mmol/L, P < 0.01). The FE-Mg was increased in 23% of patients with ADPKD/ARPKD (all had chronic kidney disease stages 2-4) and in 63% of patients with RCAD, where it significantly correlated with estimated glomerular filtration rate (r = -0.87, P < 0.01).

CONCLUSIONS

Hypomagnesaemia is absent in children with ADPKD or ARPKD and could serve as a marker for differential diagnostics between ADPKD, ARPKD and RCAD in children with cystic kidney diseases of unknown origin where molecular genetic testing is lacking. However, while hypomagnesaemia, in the absence of diuretics, appears to rule out ADPKD and ARPKD, normomagnesaemia does not rule out RCAD at least in those aged <3 years.

Pitfalls in accelerometer-based measurement of physical activity: The presence of reactivity in an adult population

When a behavior is monitored, it is likely to change, even if no change may be intended. This phenomenon is known as measurement reactivity. We investigated systematic changes in accelerometer-based measures over the days of monitoring as an indicator of measurement reactivity in an adult population. One hundred seventy-one participants from the general population (65% women; mean age = 55 years, range: 42-65 years) wore accelerometers for 7 consecutive days to measure sedentary behavior and physical activity (PA). Latent growth models were used (a) to investigate changes in accelerometer wear time over the measurement days and (b) to identify measurement reactivity indicated by systematic changes in sedentary time (ST), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA). Over the measurement days, participants reduced accelerometer wear time by trend (rate of change [b] = -4.7 min/d, P = .051, Cohen's d = .38), increased ST (b = 2.4 min/d, P = .018, d = .39), and reduced LPA (b = -2.4 min/d, P = .015, d = .38). Participants did not significantly reduce MVPA (P = .537). Our data indicated that accelerometry might generate reactivity. Small effects on ST and LPA were found. Thus, the validity of accelerometer-based data on ST and LPA may be compromised. Systematic changes observed in accelerometer wear time may further bias accelerometer-based measures. MVPA seems to be less altered due to the presence of an accelerometer.

Transition structures and timing of transfer from paediatric to adult-based care after kidney transplantation in Germany: a qualitative study

OBJECTIVES

It is known that transition, as a shift of care, marks a vulnerable phase in the adolescents' lives with an increased risk for non-adherence and allograft failure. Still, the transition process of adolescents and young adults living with a kidney transplant in Germany is not well defined. The present research aims to assess transition-relevant structures for this group of young people. Special attention is paid to the timing of the process.

SETTING

In an observational study, we visited 21 departments of paediatric nephrology in Germany. Participants were doctors (n=19), nurses (n=14) and psychosocial staff (n=16) who were responsible for transition in the relevant centres. Structural elements were surveyed using a short questionnaire. The experiential viewpoint was collected by interviews which were transcribedverbatim before thematic analysis was performed.

RESULTS

This study highlights that professionals working within paediatric nephrology in Germany are well aware of the importance of successful transition. Key elements of transitional care are well understood and mutually agreed on. Nonetheless, implementation within daily routine seems challenging, and the absence of written, structured procedures may hamper successful transition.

CONCLUSIONS

While professionals aim for an individual timing of transfer based on medical, social, emotional and structural aspects, rigid regulations on transfer age as given by the relevant health authorities add on to the challenge.

TRIAL REGISTRATION NUMBER

ISRCTN Registry no 22988897; results (phase I) and pre-results (phase II).

Gewinnung von Jobcenter-Klienten für die Teilnahme an einem kardiopräventiven Untersuchungsprogramm

Ziel: Über die Teilnehmergewinnung für Präventionsmaßnahmen in Bevölkerungen mit niedrigerem Sozialstatus ist wenig bekannt. Ergebnisse proaktiver Kontaktierung für ein 2-stufiges kardiopräventives Untersuchungsprogramm (KUP) in 2 Jobcentern einer norddeutschen Region werden dargestellt.

Methode: Über jeweils 10 Wochen erhielten Jobcenter-Klienten im Alter zwischen 40 und 65 Jahren das Angebot, am KUP teilzunehmen. Dieses umfasste einen ersten Abschnitt im Jobcenter und einen zweiten in einem kardiovaskulären Untersuchungszentrum. Abschnitt 1 beinhaltete eine EDV-gestützte Befragung, und bei Anwesenheit einer medizinischen Fachkraft, eine Blutdruckmessung und/oder Blutentnahme. Teilnehmer ohne kardiovaskuläre Vorerkrankungen, interventionelle/operative Gefäßeingriffe, Diabetes mellitus und einem Body-Maß Index≤35 kg/m2 erhielten das Angebot der Teilnahme an Abschnitt 2. Mittels logistischer Regressionsanalysen wurden für beide Abschnitte Prädiktoren der Teilnahme analysiert. Dazu zählten Lebensalter und Geschlecht, für die Teilnahme an Abschnitt 2 die Entfernung zwischen Wohnadresse und Untersuchungszentrum, kardiovaskuläre Risikofaktoren, subjektive Gesundheit und weitere soziodemografische Merkmale.

Ergebnisse: In Abschnitt 1 nahmen 344 der 1 046 eingeladenen Personen an der Befragung teil. Dabei handelte es sich um überzufällig mehr Frauen als Männer. Von diesen erhielten 253 das Angebot der Blutdruckmessung, der Blutentnahme sowie der postalischen Zusendung der Laborergebnisse. Die Teilnahme von 209 Personen war positiv mit dem Lebensalter assoziiert. An Abschnitt 2 nahmen 138 Personen teil. Je weiter vom Untersuchungszentrum entfernt die Personen wohnten, desto weniger nahmen sie dieses Angebot wahr. Von Tabakrauchern, Personen mit Hauptschulbildung bzw. solche mit nicht erhöhten Blutfetten nahmen ebenfalls weniger teil.

Schlussfolgerungen: Blutdruckmessung und Blutentnahme im Jobcenter treffen auf hohe Akzeptanz. Anforderungen zusätzlicher Wege für präventive kardiovaskuläre Untersuchungsangebote sind gering zu halten.

Predator cues reduce intraspecific trait variability in a marine dinoflagellate

Background

Phenotypic plasticity is commonplace and enables an organism to respond to variations in the environment. Plastic responses often modify a suite of traits and can be triggered by both abiotic and biotic changes. Here we analysed the plastic response towards a grazer of two genotypes of the marine dinoflagellate Alexandrium fundyense, evaluated the similarity of this response and discuss potential strain-specific trade-offs. We compared the expression of the known inducible defensive traits paralytic shellfish toxin content, and chain length. The effectiveness of the induced defense was assessed by monitoring grazing rates in both strains.

Results

Our results show that the grazer cues diminish phenotypic variability in a population by driving the phenotype towards a common defended morphotype. We further showed that the expression of the sxtA gene that initiates the paralytic shellfish toxin biosynthesis pathway does not correlate with an observed increase in the paralytic shellfish toxin analogue saxitoxin, and that toxin induction differs in its physiological characteristics in both strains.

Conclusion

Induced defense response in Alexandrium thus can directly affect further species interactions by reducing phenotypic variation and can result in genotype-dependent ecological trade-offs.

Electronic supplementary material

The online version of this article (doi:10.1186/s12898-017-0119-y) contains supplementary material, which is available to authorized users.

Magnesium Deficiency is Associated with Periodontal Disease

In the multifactorial pathogenesis of periodontitis, there are still unknown factors influencing the outcome of the disease. An association between magnesium and periodontitis has been suggested by preliminary studies. However, relevant clinical data are lacking. We investigated the association between magnesium status and periodontal health in a population-based analysis. We conducted a cross-sectional epidemiological investigation involving 4290 subjects aged 20–80 yrs. We recorded periodontal risk factors and determined concentrations of serum magnesium and calcium, relating them to periodontal parameters. In a matched-pair study, 60 subjects using oral magnesium-containing drugs and 120 without were compared. In subjects aged 40 yrs and older, increased serum Mg/Ca was significantly associated with reduced probing depth (p < 0.001), less attachment loss (p = 0.006), and a higher number of remaining teeth (p = 0.005). Subjects taking Mg drugs showed less attachment loss (p < 0.01) and more remaining teeth than did their matched counterparts. These results suggest that nutritional magnesium supplementation may improve periodontal health.

[Migration Background and Pathological Gambling: Results of a Nationwide Epidemiological Study on the Impact of Region of Origin in Germany]

OBJECTIVE

To investigate the extent to which the presence and number of symptoms of pathological gambling (PG), distinguished by region of origin (RO), differ.

METHODS

Data was obtained from a nationwide telephone survey of 15 023 individuals living in Germany and aged 14-64 years. They were categorized according to their RO and the number of symptoms of PG (0-10 DSM-IV-criteria).

RESULTS

The lifetime prevalence of PG symptoms is 18.1% for people of the RO Turkey, 9.0% for those of the RO Yugoslavia and 6.8% for those without a migration background. Compared to the latter, the two-part count data regression method showed a higher chance of PG symptoms for the RO Turkey as well as a 70.3 and 87.2% increase in the number of symptoms for the RO Turkey and Yugoslavia, respectively.

CONCLUSION

The RO could independently contribute to the presence and amount of symptoms of PG.

['You and I Smoke-free': Implementation and Provision of Brief Smoking Counseling Program in Pregnancy Counseling Centers]

Results of brief smoking counseling program implemented in pregnancy counseling centers are presented. Counseling was provided in 28 of 39 pregnancy counseling centers. A total of 693 out of 719 pregnant women invited to participate in the program during the study period of 6 months agreed to participate. Among the participants, 30.5% were smokers. Proactive approaches can reach a high proportion of the target population.

Transitional Care and Adherence of Adolescents and Young Adults After Kidney Transplantation in Germany and Austria: A Binational Observatory Census Within the TRANSNephro Trial

Transition from child to adult-oriented care is widely regarded a challenging period for young people with kidney transplants and is associated with a high risk of graft failure. We analyzed the existing transition structures in Germany and Austria using a questionnaire and retrospective data of 119 patients transferred in 2011 to 2012. Most centers (73%) confirmed agreements on the transition procedure. Patients' age at transfer was subject to regulation in 73% (18 years). Median age at transition was 18.3 years (16.5-36.7). Median serum creatinine increased from 123 to 132 μmol/L over the 12 month observation period before transfer (P = 0.002). A total of 25/119 patients showed increased creatinine ≥ 20% just before transfer. Biopsy proven rejection was found in 10/119 patients. Three patients lost their graft due to chronic graft nephropathy.Mean coefficient of variation (CoV%) of immunosuppression levels was 0.20 ± 0.1. Increased creatinine levels ≥ 20% just before transfer were less frequently seen in patients with CoV < 0.20 (P = 0.007). The majority of pediatric nephrology centers have internal agreements on transitional care. More than half of the patients had CoV of immunosuppression trough levels consistent with good adherence. Although, 20% of the patients showed increase in serum creatinine close to transfer.