Dtsch Arztebl Int
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Age-related macular degeneration (AMD), a condition of multifactorial origin, is a major cause of irreversible vision loss in industrialized countries. The dry late stage of the disease, known as geographic atrophy (GA), is characterized by progressive loss of photoreceptor cells and retinal pigment epithelial cells in the central retina. An estimated 300 000 to 550 000 people in Germany suffer from GA. ⋯ In Europe at present, there is no approved treatment for GA due to AMD. There is thus a continuing need for preventive and rehabilitative measures such as smoking cessation, a balanced diet, and magnifying visual aids for patients in the advanced stages of the disease.
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Observational Study
The Effect of Parental Weight and Genetics on the BMI of Very Low Birth Weight Infants as They Reach School Age.
Prematurely born individuals are usually of low or normal weight in childhood; in adulthood, however, their probability of being overweight is twice that of persons born at full term. There is not yet any way to predict the weight development of premature babies. ⋯ Extreme values of a polygenic BMI score are strongly associated with the weight development of preterm infants as they develop into children aged 10-14. The large effect size implies that this score may aid in the counseling of prematurely born children and their parents.
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Practice Guideline
The Management of Chronic Kidney Disease not Requiring Renal Replacement Therapy in General Practice.
Chronic kidney disease (CKD) is common in the German adult population, with a prevalence of 10%. This guideline, updated on the basis of current scientific evidence, contains recommendations for the management of CKD in general practice. ⋯ The risk assessment of CKD and the treatment options have been expanded. The updated guideline can improve primary care for patients with CKD and the selection of patients for interdisciplinary care.
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Intelligence is defined as general mental capacity, which includes the abilities to reason, solve new problems, think abstractly, and learn quickly. Genetic factors explain a considerable fraction of inter-individual differences in intelligence. For many years, research on intelligence was limited to estimating the relative importance of genetic and environmental factors, without identifying any individual causal factors. ⋯ At present, the polygenic scores generated from genome-wide association studies are primarily of scientific interest, yet they are becoming increasingly informative and valid for individual prediction. There is, therefore, a need for broad social discussion about their future use.
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Open spinal dysraphism is a congenital malformation that causes major morbidity. Its consequences include sensory and motor impairment as well as bladder- and bowel dysfunction. It is often also associated with prenatal ventriculomegaly, which, in turn, necessitates postnatal treatment with a ventriculoperitoneal shunt in approximately 80% of cases. Prenatal therapy with coverage of neural tube defect can reduce the shunt rate and preserve motor function. In this review, we describe the different surgical procedures and their outcomes. ⋯ Prenatal surgery improves motor function and reduces the shunt rate but long-term outcomes beyond adolescence are still lacking. Transparent and interdisciplinary counseling is essential in prenatal communication to inform parents not only about the potential benefits of this treatment, but also about its limitations and risks.