Objective: To determine in a systematic review, whether interventions for infant development that involve parents, improve neurodevelopment at 12 months corrected age or older.Study Design: Randomized trials were identified where an infant intervention was aimed to improve development and involved parents of preterms; and long-term neurodevelopment using standardized tests at 12 months (or longer) was reported.Result: Identified studies (n ¼ 25) used a variety of interventions including parent education, infant stimulation, home visits or individualized developmental care. Meta-analysis at 12 months (N ¼ 2198 infants) found significantly higher mental (N ¼ 2198) and physical (N ¼ 1319) performance scores favoring the intervention group. At 24 months, the mental (N ¼ 1490) performance scores were improved, but physical (N ¼ 1025) performance scores were not statistically significant. The improvement in neurodevelopmental outcome was not sustained at 36 months (N ¼ 961) and 5 years (N ¼ 1017). Conclusion:Positive clinically meaningful effects (>5 points) are seen to an age of 36 months, but are no longer present at 5 years.

Lung cancer is the leading cause of cancer-related death in industrialized countries. The overall mortality rate for lung cancer is high, and early diagnosis provides the best chance for survival. Diagnostic tests guide lung cancer management decisions, and clinicians increasingly use diagnostic imaging in an effort to improve the management of patients with lung cancer. This systematic review, an expansion of a health technology assessment conducted in 2001 by the Institute for Clinical and Evaluative Sciences, evaluates the accuracy and utility of 18fluorodeoxyglucose positron emission tomography (PET) in the diagnosis and staging of lung cancer. Through a systematic search of the literature, we identified relevant health technology assessments, randomized trials, and meta-analyses published since the earlier review, including 12 evidence summary reports and 15 prospective studies of the diagnostic accuracy of PET. PET appears to have high sensitivity and reasonable specificity for differentiating benign from malignant lesions as small as 1 cm. PET appears superior to computed tomography imaging for mediastinal staging in non-small cell lung cancer (NSCLC). Randomized trials evaluating the utility of PET in potentially resectable NSCLC report conflicting results in terms of the relative reduction in the number of noncurative thoracotomies. PET has not been studied as extensively in patients with small-cell lung cancer, but the available data show that it has good accuracy in staging extensive- versus limited-stage disease. Although the current evidence is conflicting, PET may improve results of early-stage lung cancer by identifying patients who have evidence of metastatic disease that is beyond the scope of surgical resection and that is not evident by standard preoperative staging procedures. Further trials are necessary to establish the clinical utility of PET as part of the standard preoperative assessment of early-stage lung cancer.

Background Among chickens, meat producing broiler strains are highly prone to develop severe pulmonary hypertension (PH) associated with endothelial dysfunction. However, pulmonary endothelial function appears to be unaffected during prenatal life.Objective To test the hypothesis that exposure to chronic prenatal hypoxia induces endothelial impairment and accelerates the development of PH in chickens prone to the disease.Methods Fertilized eggs from two genetic lines of broiler chickens differing in susceptibility to PH (high sensitivity: HS, low sensitivity: LS) were incubated under normoxic or hypoxic (15% O2) conditions from day 6 to day 19 of a 21-d incubation period. On day 19 isolated intrapulmonary artery segments were mounted in a myograph for isometric tension recording. The contractile responses induced by KCl as well as the relaxations induced by acethylcholine (ACh), the nitric oxide donor sodium nitroprusside (SNP), and the adenylate cyclase activator forskolin were tested.Results Hypoxia produced a reduction in the weight of the HS (31.1 Ϯ 0.6 g vs 27.3 Ϯ 0.6 g, PϽ0,001) and the LS (32.1Ϯ 0.6 vs 28.6 Ϯ 0.9 PϽ0,001) embryos. KCl-induced contraction was unaffected by hypoxia in both groups. Endothelium-dependent (induced by ACh) and -independent (induced by SNP and forskolin) relaxations were also unaffected by hypoxia in both groups. AChinduced relaxation was reduced by the NO synthase inhibitor L-NAME (10 mM) and abolished by the soluble guanylyl cyclase inhibitor ODQ (10 microM). L-NAME induced inhibition of ACh-induced relaxation was less marked in normoxic embryos of the HS group than in the other three groups.Conclusions Chronic hypoxia during incubation reduced embryonic growth but did not influence vascular reactivity in chicken embryos prone to postnatal pulmonary hypertension. INTESTINAL PERMEABILITY AND MECHANICAL VENTILATION IN PRE-TERM INFANTS CONCLUSIONS. IN CONTRAST TO OUR HYPOTHESIS, WE DID NOT FIND A HIGHER INTESTINAL PERMEABILITY IN MECHANICAL VENTILATED INFANTS COMPARED TO NON-VENTILATED INFANTS, MEASURED Ͻ48 H AFTER BIRTH. FURTHERMORE, WE DID NOT FIND A SMALLER DECREASE IN INTESTINAL PERMEABILITY IN THE FIRST WEEK OF LIFE IN VENTILATED INFANTS COMPARED TO NON-VENTILATED INFANTS. FURTHER STUDIES ARE NEEDED TO ELUCIDATE THE EFFECT OF MECHANICAL VENTILATION ON INTESTINAL PERMEABILITY IN PRETERM INFANTS. FOLLOW UP AFTER AABR NEONATAL HEARING SCREENING IN NICU GRADUATES.HLM VAN Goal To explore the severity and type of bilateral HL as wel as the prognostic value of the first diagnostic BERA.Methods NICU graduates with bilateral HL from one NICU (Zwolle) were included. Severity of HL was established as mild (20 -39dB), moderate (40 -59dB), severe (60 -90 dB) or profound (Ͼ90dB). Type of HL was conductive, perceptive, combined, or auditory neuropathy. Improvement of Ͼ 20 dB between the first BERA and observation audiometry at Ͼ 2 years at follow up was considered as clinically relevant.Results Severity of HL after first diagnostic BERA of 37 newborns with bilateral HL was 6 mild, 7 mo...

This is a commentary on a Cochrane review, published in this issue of EBCH, first published as: Spittle AJ, Orton J, Doyle LW, Boyd R. Early developmental intervention programs post hospital discharge to prevent motor and cognitive impairments in preterm infants. Cochrane Database of Systematic Reviews 2007, Issue 2. Art. No.: CD005495. DOI: 10.1002/14651858.CD005495.pub2.Further information for this Cochrane review is available in this issue of EBCH in the accompanying EBCH Summary and Characteristics and Key Findings Tables articles. Copyright © 2008 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. The Cochrane Collaboration

S588evaluate whether the value of SUVmax and RI can diagnose as lung cancer or the presence of lymph node metastasis. Results: Eighty-one patients were diagnosed as lung cancer and the median SUVmax was 9.2 (range, 0.8 to 24). Ten patients were diagnosed as benign nodules and the median SUVmax was 3.1 (range, 1.6 to 8.9). There was a significant difference of SUVmax between lung cancer and benign tumor (p<0.001). The correlation between tumor size in lung cancer and SUVmax were recognized (r=0.67). If the cutoff value of SUVmax was 3.5 or greater to depict malignant tumors, the sensitivity and specificity in all pulmonary nodules were 84% and 80%. The sensitivity and specificity in tumors more than 3cm in diameter were 98% and 100%. On the other hand, in tumors less than 3cm in diameter, the sensitivity and specificity were 48% and 86%. However, if the tumor with either RI of more than 10% or SUVmax of more than 3.5 is classified as lung cancer, the sensitivity and specificity was 83% and 86% in tumors less than 3cm in diameter. Four hundred and sixty lymph nodes of the hilum and the mediastinum were dissected. Twentyone of those were metastatic lymph nodes (4.6%). If the lymph nodes with 1cm or greater in minor diameter at the chest CT scan are judged with metastasis, the sensitivity, specificity and accuracy were 50%, 97% and 33%, respectively. Whereas if the cut-off value of SUVmax is 3.5 or greater to depict lymph node metastasis at FDG-PET/CT, the sensitivity, specificity and accuracy were 80%, 99% and 76%, respectively. There were 14 false-positive lymph nodes at the chest CT scan and 5 false-positive ones at FDG-PET/CT. Conclusion:In the tumors more than 3 cm in diameter, the value of SUVmax was a very useful tool for diagnosis of lung cancer. However, in the tumors less than 3 cm in diameter, the value of RI in addition to SUVmax was useful for diagnosis. FDG-PET/CT was significantly better than the chest CT scan for diagnosis of lymph node metastasis.