Untersuchungen an Rattenmesangialzellen in Kultur mit Cyclosporin A und Magnesium — Ist Magnesium nephroprotektiv bei Cyclosporin A-Therapie?

Summary One serious side effect of Cyclosporine A therapy is its acute nephrotoxicity characterized by a marked decrease in the glomerular filtration rate. A main determinant of the glomerular filtration rate is the ultrafiltration coefficient which is thought to be regulated by the contractile state of the cells of the mesangium. Cyclosporine A enhances contractions of mesangial cells elicited with angiotensin II. By way of lowered ultrafiltration coefficient this effect of Cyclosporine A may be partly responsible for its acute nephrotoxicity.Hypomagnesaemia is often associated with Cyclosporine A therapy. Profound tubular magnesium wasting by Cyclosporine A has been claimed its cause.We have investigated the effect of low and high magnesium concentration on the contractility of mesangial cells pretreated with Cyclosporine A. Without magnesium 80% of the cells contracted upon addition of angiotensin II. A marked decrease in the contractility was seen when the magnesium concentration was elevated to 2 mmol/l (34%).From these observations we conclude that magnesium serum levels even in the high normal range might be protective against the decrease of the glomerular filtration rate seen with CsA theraPY.

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Abkürzungen AG Aminoglykosid - AII Angiotensin II - cAmp zyklisches Adenosinmonophosphat - Ca Kalzium - [Ca²⁺]_i intrazelluläre Kalziumkonzentration - CsA Cyclosporin A - GFR glomeruläre Filtrationsrate - HBSS Hanks' balanced salt solution - MC Mesangialzellen - Mg Magnesium - PGE₂ Prostaglandin E₂ Wir danken Sabine Gießelmann für die Betreuung der Zellkulturen, Cornelia Hansen für die Graphik und Gisela Thaler für die sorgfÎltige Fertigstellung des Manuskriptes. Ratgeber für die statistische Auswertung war Dr. med. T. Mansky.Unser besonderer Dank gilt Herrn Prof. Dr. W. Jelkmann.     

The World Health Organization child growth standards: expected implications for clinical and epidemiological research

In 2006 and 2007, the World Health Organization (WHO) released two sets of child growth standards (World Health Organization, WHO Child Growth Standards. Methods and development. Length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age. WHO, Geneva, 2006; World Health Organization, WHO Child Growth Standards: Methods and Development. Head circumference-for-age, arm circumference-for-age, triceps skinfold-for-age and subscapular skinfold-for-age. WHO, Geneva, 2007) to replace the National Center for Health Statistics references (Hamill et al., National Center for Health Statistics, Vital and Health Statistics Series 11, No 165, 1977) as an international tool for growth and nutritional assessment. This paper explores the scope of implications for future anthropometric research, highlighting foreseeable effects on the choice of research questions, choice of nutritional indices, training of measurers, and issues of internal and external validity of research results. The conclusion drawn is that the introduction of the WHO child growth standards is expected to have wide implications for growth and nutrition research. The full scope of this effect will gradually become clear while researchers, similar to health care workers, make the transition to using the new standards, re-evaluate results of past approaches, and explore the uses and functional validity of the standards, including those for indices that were not previously available.     

Dioxins, the aryl hydrocarbon receptor and the central regulation of energy balance

Dioxins are ubiquitous environmental contaminants that have attracted toxicological interest not only for the potential risk they pose to human health but also because of their unique mechanism of action. This mechanism involves a specific, phylogenetically old intracellular receptor (the aryl hydrocarbon receptor, AHR) which has recently proven to have an integral regulatory role in a number of physiological processes, but whose endogenous ligand is still elusive. A major acute impact of dioxins in laboratory animals is the wasting syndrome, which represents a puzzling and dramatic perturbation of the regulatory systems for energy balance. A single dose of the most potent dioxin, TCDD, can permanently readjust the defended body weight set-point level thus providing a potentially useful tool and model for physiological research. Recent evidence of response-selective modulation of AHR action by alternative ligands suggests further that even therapeutic implications might be possible in the future.     

脑性耗盐综合征的诊断和治疗进展

低钠血症是神经科重症患者最常出现的电解质紊乱。脑性耗盐综合征（CSW）是由颅内疾病引起的肾性失钠导致的低钠血症和细胞外液的丢失。其发病机制仍末完全清楚。除一些利钠因子的作用外，交感神经反射在CSW中也发挥了作用。CSW和（抗利尿激素分泌异常综合征）SIADH的鉴别存在困难，关键在予容量的状态。排除一些其他的原因也非常必要。治疗有赖于液体的支持和盐的平衡。盐皮质激素在一些复杂的病例中可能有用。     

从脾肾虚损论治中风后抑郁症

目前中医药在中风后抑郁症的治疗中发挥了很大作用,导师认为,中风后抑郁症属“因病而郁”,单纯的疏肝解郁法往往难以取得较好的疗效,而脾肾虚损是中风后抑郁症病机的重要方面,从脾肾虚损为主辨证论治中风后抑郁症具有重要意义。     

Prediction of Creatinine Clearance from Serum Creatinine in Patients with Rheumatoid Arthritis: Comparison of Six Formulae and One Nomogram

The estimation of glomerular filtration rate is important for the medical treatment of patients with rheumatoid arthritis (RA). However, the determination of endogenous creatinine clearance (Clcr) from a 24-h urine collection is an unreliable and time-consuming procedure. We therefore tested the accuracy of six equations and one nomogram for the prediction of Clcr from serum creatinine (Scr) in 38 patients with RA and 20 controls. A positive correlation was found for all methods in the controls (r= 0.83–0.94) and RA patients (r= 0.51–0.69). The methods did not overestimate Clcr in RA. In the RA group the simple formula published by Cockcroft [Clcr = ((140 − age) × body weight)/(72 × Scr), × 0.85 for females] showed the best correlation with the measured Clcr. In RA the Cockroft formula can reliably be used to predict Clcr from Scr. Received: 8 February 1999 / Accepted: 4 June 1999     

脑盐耗综合征的诊断和治疗进展

低钠血症是神经科重症患者最常出现的电解质紊乱。脑性耗盐综合征（CSW）是由颅内疾病引起的肾性失钠导致的低钠血症和细胞外液的丢失。其发病机制仍未完全清楚。除一些利钠因子的作用外,交感神经反射在CSW中也发挥了作用。CSW和（抗利尿激素分泌异常综合征）SIADH的鉴别存在困难,关键在于容量的状态,排除一些其他的原因也非常必要。治疗有赖于液体的支持和盐的平衡。盐皮质激素在一些复杂的病例中可能有用。     

Nutritional status of school-age children - A scenario of urban slums in India

Objectives

This article aims at describing, in a Belgian town, the frequency of the fear of falling and of subsequent activity restriction among non-institutionalised people aged 65 years and over, and at identifying persons affected by these two issues.

Methods

Cross-sectional survey conducted in Fontaine l'Evêque (Belgium) in 2006, using a self-administered questionnaire.

Results

The participants could fill in the questionnaire on their own or with the help of a third party if needed. The latter were not taken into account in this article. Analyses covered 419 questionnaires. Fear of falling and activity restriction were reported by, respectively, 59.1% and 33.2% of participants. They were more frequent among fallers but also affected non-fallers. In logistic regression analyses: gender, the fact of living alone and the number of falls were significantly associated with fear of falling; gender, age and the number of falls were significantly associated with activity restriction.

Conclusions

Our study, despite various limitations, shows the importance of fear of falling and of subsequent activity restriction among older people, among fallers as well as among non-fallers. It also provides information, though limited, concerning persons affected by these two issues in Belgium, and in other contexts as well. Given the ageing of our populations, it is important to take these problems into account when caring for older people.