[Congenital malformations--a systematic cohort study from Mecklenburg-Western Pomerania (Germany)]. / Angeborene Fehlbildungen - eine systematische Kohortenstudie aus Mecklenburg-Vorpommern.

AIM: We aimed to set-up a passive malformations registry for 2002-2004 for the German Federal State of Mecklenburg-Western Pomerania in order to estimate the prevalence of congenital malformations among live births, stillbirths, miscarriages, and induced abortions. POPULATION AND STUDY DESIGN: Under the guidance of the working group "Neonatology Mecklenburg-Vorpommern" a standardised malformations record form modelled after the Mainz registry was developed and used to record malformations among live births, stillbirths, miscarriages, and induced abortions in all 21 obstetric departments in Mecklenburg-Western Pomerania between 2002 and 2004. We compared the population of neonates with malformations with a general population sample from the German Perinatal Survey of 1995-1997. RESULTS: There were 768 neonates with at least one major malformation among a total of 37 634 neonates in Mecklenburg-Western Pomerania; this means that the prevalence of major malformations was 203.53 per 10 000 neonates. The prevalence of major malformations in liveborn infants was 178.61 per 10 000. The most common malformations in the total study population were ventricular septal defect (prevalence: 37.2 per 10 000), hydronephrosis (16.7 per 10 000), hypospadias (14.8 per 10 000), Down syndrome (10.1 per 10 000), and cleft lip and palate (9.0 per 10 000). Among the induced abortions the most common diagnoses were Down syndrome, anencephalus, Edwards syndrome, and congenital hydrocephalus. The preterm birth rate among the 637 liveborn and stillborn infants with malformations was 19.6%; 5.6% were born before 32 completed weeks of gestation. The small for gestational age rate for infants with malformations was 14.2% for girls and 14.5% for boys, thus increased compared with the general population sample (9.7%). CONCLUSIONS: Congenital malformations are important determinants of childhood morbidity and mortality. Malformation prevalence and types of malformations, along with morbidity and mortality, are important parameters in perinatal medicine. The establishment of active malformation registries is therefore an important task.

Two years of clinical experience with Procera titanium crowns.

PURPOSE: The purpose of the study were to evaluate the clinical performance of the Procera porcelain-fused-to-titanium crown system in general practice during a 2-year period, and to evaluate the performance of a new low-fusing porcelain as a veneering material on titanium. MATERIALS AND METHODS: A number of consecutive complete-coverage crowns (40) in 25 patients (14 women and 11 men) with a mean age of 53.1 years (range 35 to 79 years) were made according to the Procera (Nobel Biocare) technique in a 3-month period. The titanium copings were fabricated from solid rods of pure titanium using spark erosion and copy-milling technique, whereafter they were veneered with a new type of low-fusing ceramic material. The crowns were evaluated using the CDA criteria at baseline and after 2 years. RESULTS: The general failure rate was low and was restricted to one carious lesion, one porcelain fracture, and one loss of a crown resulting from failure of retention of a post and core. The most frequent single reason that the "excellent" color level was not recorded was a "too-high value." A slightly dull or granular porcelain surface was observed both at baseline and after 2 years. Overall, the responses of the patients were positive. CONCLUSION: Within the limitations of the study it can be concluded that porcelain-veneered Procera titanium crowns can be used as an alternative to other porcelain-fused-to-metal systems. However, conclusions should be made with caution from the results of this study because of the limited number of patients and crowns and the short observation period.

Betablocking drugs in essential hypertension: transdermal bupranolol compared with oral metoprolol.

In the present study the antihypertensive efficacy and tolerability of transdermal bupranolol (30 mg once-daily) was compared with oral metoprolol (100 mg once-daily). Blood pressure measurements were performed in the office, at home, and with ambulatory 24-h blood pressure devices. Systemic and local side-effects, as well as compliance and acceptance, were evaluated every two weeks. The treatment period lasted eight weeks. The results showed a significant decrease in blood pressure under the bupranolol transdermal therapeutic system in the office, at home, and with 24-h blood pressure measurements day- (08h00-20h00) and night-time (20h00-08h00). Under oral metoprolol there was a significant blood pressure decrease in the office, at home, and in the mean daytime values of the 24-h blood pressure measurements. The night-time values, however, demonstrated only a slight decrease in blood pressure, being significant only for diastolic values. Systemic side-effects were comparable in both groups. 69% of the patients had local side-effects at the patch side (erythema, papulous exanthema, pruritus). Six patients dropped out because of localized urticarial exanthema (five patients treated with transdermal bupranolol, one patient treated with oral metoprolol). In comparison to the oral form, twice as many patients had admitted to have been non-compliant with the patches (13 versus 7 patients). At the end of the study, 24 out of 32 patients preferred to be treated with capsules.