Use of the child development inventory to screen high-risk populations.

This study examined the validity of a parent-report inventory, the Child Development Inventory (CDI), as a developmental screening instrument in high-risk toddlers and preschoolers. Seventy-six children, aged 15-70 months, were assessed in a neonatal high-risk developmental follow-up clinic. The data included the completion of CDIs by parents/caregivers and developmental evaluations by a physician using either the Clinical Adaptive Test/Clinical Linguistic Auditory Milestone Scale (CAT/CLAMS) (15-35 months) or Slosson Intelligence Test (36-70 months). Analysis revealed a good level of sensitivity (true "abnormals"--73%) and specificity (true "normals"--87%) for the CDI General Development score. The findings suggested that the CDI is a valid and useful screening instrument for high-risk infants.

Advances in interventional radiology. The search for less invasive management sparks new approaches.

Many new, minimally invasive interventional radiology procedures are now viable alternatives to traditional invasive therapy. The radiology procedures can often be performed in the outpatient setting, and although expensive technology may be required, the overall cost to the patient may be lower in the long run. Endovascular repair of abdominal aortic aneurysms with stent grafts and radiofrequency tumor ablation are examples of rapidly expanding technologies in interventional radiology. Patient enthusiasm and interest are the primary forces driving these advances in management. Familiarity with these procedures is vital as medicine moves into the new millennium.

Radiographic evaluation of cervical spine trauma. Procedures to avoid catastrophe.

A cervical spine series that includes three views (ie, lateral, open-mouth odontoid, and anteroposterior) is usually adequate to exclude unstable injuries that have the potential for producing spinal cord injury. The films should be of the highest quality and need to be carefully and systematically viewed. Knowledge of cervical spine anatomy and of common types of injuries (including their mechanisms) is essential for accurate interpretation. Conventional tomography, computed tomography, and flexion and extension lateral views may be helpful when findings on the three-view series are equivocal. In patients with neurologic deficits, further radiographic evaluation is also warranted.

Thoracic paravertebral block for analgesia following liver mass radiofrequency ablation.

A 66-year-old man presented for a second attempt of radiofrequency ablation of a metastatic carcinoid liver lesion. The first attempt using intravenous sedation was unsuccessful because of inadequate pain control and subsequent patient combativeness. Despite fentanyl being given during general anaesthesia, the patient complained of severe right flank pain after emergence. A thoracic paravertebral block was performed without complication and the patient's pain decreased to "3 out of 10" on a standard 10-point scale after 10 min, and "0 out of 10" after 30 min. The patient's pain score remained 0 throughout the following day, and no further analgesics were required. Thoracic paravertebral block can provide complete and lasting analgesia following hepatic radiofrequency ablation, and warrants further study for patients undergoing hepatic radiological interventions.

Wechsler Adult Intelligence Scale and Wechsler Adult Intelligence Scale-Revised in a neurologically impaired population.

Compared Verbal, Performance, and Full Scale IQ scores from two groups of neurologically impaired patients (N = 114) similar in age, years of education, occupation, race, sex, and etiology and location of cerebral dysfunction. One group had been given the WAIS and the other the WAIS-R. All three IQ scores were higher for the WAIS group, with Full Scale and Verbal scores significantly (p less than .05) higher. Changes in item content and standardization sample cohort effects are offered as partial possible explanation for the results. The IQ scores from the two tests cannot be considered as interchangeable for neurological patients.

Intra-abdominal sacrococcygeal mature teratoma or fetus in fetu in a third-trimester fetus.

This case report describes a fetus with a large intra-abdominal, complex, vascular mass, displacing the normal intra-abdominal organs due to its large size. Extension to the presacral area was also identified, facilitating the diagnosis of a sacrococcygeal teratoma. Because of its highly mature nature, this was considered a fetus in fetu which was totally intra-abdominal.