[Data protection. Barrier or helpful orientation for cooperation in early intervention?]

From birth until the age of 3 years, the health care system is the central help system and point of contact for parents with their children. Professionals in health care are given considerable trust. However, many of the essential services, especially for families with increased needs, can only be found in the child welfare system. The authors describe a plan for a lawful and functionally adequate transition between the two systems that eases access to additional help. Functional data protection secures a relationship of trust between the doctor and patient. It requires the promotion of a consensual transition. If the transmission of information is necessary, not without the knowledge but without the consent of the parents, the law permits the transfer of information under certain conditions. For doctors, midwifes, pediatric nurses, and other health professionals, this results in a legal examination program with respect to the supporting relationship to their patient. On the one hand, it contains an assessment of the child's endangerment and, on the other hand, an estimation of the sustainability of the assistance they entered into for the prevention of further harm or the solicitation of voluntary utilization of additional help. The article introduces the different new federal state laws on data transfer without consent in cases of potential child endangerment.

Increased genomic damage in lymphocytes of patients before and after long-term maintenance hemodialysis therapy

This study investigates spontaneous genomic damage in peripheral lymphocytes of 19 patients with severe end-stage renal disease not enrolled onto a maintenance hemodialysis (MHD) program (creatinine level, 5.4 to 10.5 mg/dL) and 16 long-term MHD patients (111 to 282 months on MHD) and the possible association of genomic damage with the degree of renal insufficiency and duration of MHD. Genomic damage was assessed by evaluating the numbers of micronuclei (MN), which are cytoplasmic DNA-containing structures. The average number of MN in the control group of 23 healthy subjects was 15.3 +/- 4.7 MN/1,000 binucleate (BN) cells. The MN frequencies in the long-term MHD group were significantly greater (44.3 +/- 13.7 MN/1,000 BN) than the control frequencies. A significant increase in MN frequencies (28.2 +/- 9.4 MN/1,000 BN) was also seen in patients with advanced renal failure. The major findings of the study, high MN frequencies in long-term hemodialysis and advanced chronic renal failure patients, may result from decreased DNA repair previously shown and may contribute to the increased cancer incidence in these patients.