[Facial asymmetry with crying].
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OBJECTIVE: Fewer than 3% of 4 million annual neonatal deaths occur in countries with reliable vital registration (VR) data. Global estimates for asphyxia-related neonatal deaths vary from 0.7 to 1.2 million. Estimates for intrapartum stillbirths are not available. We aimed to estimate the numbers of intrapartum-related neonatal deaths and intrapartum stillbirths in the year 2000. METHODS: Sources of data on neonatal death included: vital registration (VR) data on neonatal death from countries with full (> 90%) VR coverage (48 countries, n = 97,297); studies identified through literature searches (> 4000 abstracts) and meeting inclusion criteria (46 populations, 30 countries, n = 12,355). A regression model was fitted to cause-specific proportionate mortality data from VR and the literature. Predicted cause-specific proportions were applied to the number of neonatal deaths by country, and summed to a global total. Intrapartum stillbirths were estimated using median cause-specific mortality rate by country (73 populations, 52 countries, n = 46,779) or the subregional median in the absence of country data. FINDINGS: Intrapartum-related neonatal deaths were estimated at 0.904 million (uncertainty 0.65-1.17), equivalent to 23% of the global total of 4 million neonatal deaths. Country-level model predictions compared well with population-based data sets not included in the input data. An estimated 1.02 million intrapartum stillbirths (0.66-1.48 million) occur annually, comprising 26% of global stillbirths. CONCLUSION: Intrapartum-related neonatal deaths account for almost 10% of deaths in children aged under 5 years. Intrapartum stillbirths are a huge and invisible problem, but are potentially preventable. Programmatic attention and improved information are required.
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In 80 adult kidney stone formers (52 with reversible and 28 with irreversible renal impairment) laboratory and clinical data were evaluated to estimate the share of abnormalities in the metabolism of stone forming substances in the development of renal impairment, and to search for the causes of the irreversibility of renal impairment. The study confirmed the previous results from this laboratory suggesting a causal relationship between renal impairment and metabolic disorders. No significant differences in the incidence of metabolic disorders or in therapy have been found in patients with irreversible renal impairment as compared to those with progressive deterioration of renal function. Irreversible renal impairment developed in relationship with bilateral kidney stone formation and recurrent urinary infection.
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Wolff's Law describes the relationship between the structure and function of bone. Julius Wolff based his law on a comparison of the stress trajectories in Culmann's crane with the pattern of trabecular bone in the femoral neck. However, his analysis was based on a misinterpretation of mechanical data and a rejection of bone resorption. Wilhelm Roux was the first to accurately describe the adaptation of bone to altered load, so Roux's Law would be a more accurate eponym.
These case reports from a psychosomatic and psychotherapeutic point of view are unusual for a urological journal. Nevertheless, they deal with typical urological disorders. This change of perspective may help urologists, especially when they are confronted with patients for whom "they cannot find anything!" Hopefully, this article will motivate you to initiate other diagnostic and therapeutic measures in such cases.
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