The concurrent and predictive validity of the Dutch version of the Communicative Development Inventory in children with Down Syndrome for the assessment of expressive vocabulary in verbal and signed modalities.

The expressive vocabulary of children with Down Syndrome (DS) is generally measured with parental reports, such as the Communicative Development Inventory (CDI), given that standardized tests for assessing vocabulary levels may be too difficult for most young children with DS. The CDI provides important insight into the parents' perception of their child's vocabulary development. The CDI has proven to be a valid measurement of expressive vocabulary, spoken and gestural, in typical and atypical populations. The validity in children with DS is not well established and signed vocabulary is often not included. This longitudinal study examined the concurrent and predictive validity of the Dutch version of the CDI (N-CDI) in children with DS between 2;0 and 7;6 years old to assess spoken and signed vocabulary. N-CDI scores were assessed on strength of association with mental age, an expressive vocabulary test and spontaneous language analyses in a play setting with parents at T1 and T2 (1.5 years later), and a therapy setting with speech language pathologists at T1. The results of the present study show that the N-CDI is a valuable and valid measurement of expressive vocabulary in children with DS. Strengths and weaknesses of several assessment methods for expressive vocabulary are discussed.

Poly(3-alkylthiophene)s show unexpected second-order nonlinear optical response.

Regioregular poly(3-hexylthiophene)s with chain lengths varying from 5 to 100 monomers are synthesized. Poly(3-hexylthiophene)s show in solution an unexpectedly significant second-order nonlinear optical response. The increase in transition dipole moment upon oligomerisation causes the significant second-order nonlinear optical response.

Breast cancer in pregnancy: a literature review.

Breast cancer is the most common cancer diagnosed during pregnancy. The incidence of breast cancer in pregnancy (BCP) is expected to increase since women tend to postpone childbearing until later in life and since the incidence of breast cancer increases with age. The management of this co-incidence is a clinical and ethical multidisciplinary challenge for all involved medical care workers since two lives are at risk. Breast cancer treatment is possible during pregnancy. Still, little prospective research data are available on this condition. In this review, we present an overview of the current knowledge about the safety of diagnostic imaging, staging methods and treatment options of BCP. We also discuss the prognosis, neonatal outcome and recommendations concerning prenatal care.

[Non-invasive bi-level ventilation in paediatric status asthmaticus]. / Ventilation non invasive chez un nourrisson en état de mal asthmatique.

Invasive ventilation in status asthmaticus is associated with an increased mortality and morbidity. To avoid intubation associated complications, non-invasive bi-level ventilation is often used in adults and children. We report the clinical history of an 11-month old infant, which encountered intubation criteria but was treated successfully by full-face mask non-invasive bi-level ventilation. Despite difficulties in application due to young age and lack of age related material, non-invasive bi-level ventilation is a good tool in the treatment of children with status asthmaticus.

Therapy, glycaemic control and complications in type 1 diabetic patients: results from a single centre cohort of 465 subjects.

We analysed the clinical characteristics, the degree of glycaemic control and the prevalence of complications in 465 type 1 diabetic adult patients (232 males), in view of current recommendations for metabolic and blood pressure control. Age and diabetes duration were 45 +/- 17 and 20 +/- 13 years respectively (mean +/- 1 SD). Daily insulin dose was 0.65 +/- 0.24 U/kg b.w. 73% of patients received > or = 3 injections/day, while 11% had continuous subcutaneous insulin infusion. All were practicing home blood glucose monitoring. Current HbA1c was 8.5% [7.7-9.3%] (median [percentiles 25-75]). There was no difference in HbA1c according to number of injections or CSII use. When patients were divided according to HbA1c quintiles, significantly lower prevalences of retinopathy and neuropathy were found in quintile 1 individuals. A mean of 53 severe hypoglycaemic episodes was reported per 100 patients/year, and they were more frequent in subjects exhibiting better glycaemic control. High blood pressure levels were found in 27% of subjects according to JNC-VI criteria. Fasting cholesterol (C), LDL-C, HDL-C and triglycerides were within normal range. However, according to current guidelines emphasizing on lower target thresholds, up to 27% of patients exhibited some degree of dyslipidaemia, in particular LDL-C higher than 3.3 mmol/l. In conclusion, in this large cohort of type 1 diabetic patients regularly attending a University Centre, overall glycaemic control remains above the satisfactory levels inferred from optimization studies. Although mean blood pressure and blood lipids were up to recently deemed adequate, a (too) high proportion of diabetic patients exhibited either hypertension and/or dyslipidaemia according to revised therapeutic goals cut-offs.

Peritoneal carcinomatosis following laparoscopic resection of an adrenocortical tumor causing primary hyperaldosteronism.

A clinical syndrome combining hypertension and hypokalemic alkalosis led to the diagnosis of primary hyperaldosteronism, caused by a right-sided, 2 cm large, apparently benign aldosterone-producing adenoma. The adrenal tumor was completely resected by laparoscopic adrenalectomy. Six months after surgery, the patient exhibited a severe relapse of hyperaldosteronism. Extensive peritoneal metastases of a mixed aldosterone- and cortisol-secreting adrenocortical carcinoma were found at abdominal laparotomy. In the light of this case report, we discuss the possibility that laparoscopic resection of adrenocortical tumors might contribute to their subsequent peritoneal dissemination.