Tumor necrosis factor alpha and interleukin 1beta help regulate the development of lung ischemia-reperfusion injury. They appear to promote injury by altering expression of proinflammatory and anti-inflammatory cytokines and influencing tissue neutrophil recruitment.

Developmental screening tests are widely used for early identification but few are studied for their accuracy—the percentage of children with and without problems correctly detected. The absence of such data makes it difficult for professionals to choose measures wisely and to avoid those that under-detect or over-refer. In this article, the accuracy of three developmental screening tests was assessed. Measures included the Academic Scale of the Developmental Profile-II (DP-II), the Denver II, and the Battelle Developmental Inventory Screening Test (BDIST). Each was administered, along with a criterion battery of intelligence, adaptive, language, and achievement measures, to 89, 7- to 70-month-old children, enrolled in one of five day care centers. Twenty percent of the children tested were found to have developmental disabilities, including language delays, mental retardation, developmental delay, and autism. The Academic Scale identified fewer than one in four of the children with diagnoses, although under-referrals were minimal. The Denver-II detected the majority of children with difficulties, but most children without problems also failed the measure. The BDIST, using the 1.5 cut-offs, was more accurate than the other screening tests and identified correctly 72% of the children with difficulties, and 76% of the children without diagnoses.

No abstract

Timely provision of early developmental intervention depends on accurate developmental screening tests. The Developmental Profile-II (DP-II) relies on parent report to assess children from birth to 7 years old. One of its subtests, the Academic scale, is designed for developmental screening. To test its accuracy in detecting children with problems, the scale was administered to parents of 94 children between 6 and 75 months old. Each child was also given a battery of tests, such as the Bayley Scales of Infant Development and the Stanford-Binet Intelligence Scale. The Academic scale detected only 21% of the 19 children thus determined as having developmental problems, while 85% of the nondiagnosed children received normal or advanced scores on DP-II. Analysis revealed that DP-II scoring criteria are far too lenient and that many items are poorly placed in relation to age expectations. Alternative cutoff scores greatly improved sensitivity. DP-II is a potentially accurate measure that needs updating and restandardizing. Alternative tests include the Minnesota Child Development Inventory and the Battelle Developmental Inventory Screening Test.

The distribution o f carotid plaque ultrasound appearance has been evaluated using duplex ultraround in symptomatic and asymptomatic patients. There were I34 patients with unilateral carotid territory *yiiiptoiiis who subsequently underwent endarterectomy of the symptomatic carotid bifurcation. and 92 asyii,ploiii;itic patients. Both carotid bifurcations in all patients were examined. thus providing three groups ol' vcssels lor study: (i) asymptomatic vessels in asymptomatic patients 01 = 184): (ii) asyniptoniatic vessels in symptomatic patients ( n = 134); and (iii) asymptomatic contralateral vessels in symptomatic patients 01 = 1341.ultrasound appearances were classified as types I -4. This classification has previously k e n compared prospectively with endarterectomy specimen pathology where the more echolucent type I and 2 lesion\ correlated well with the presence of intraplaque haemorrhage or ulceration.In the symptomatic arteries, type I and 2 lesions were predominant. whereas in the asymptomatic paticntr the most comnion lesions were types 3 and 4. This difference was statistically significant ( P < 0.01 ). Evalu;ition of the asymptomatic contralateral vessel in the symptomatic patients showed a pattern ol' plaque lypc distribution between the other two groups.