This study evaluated the association between depressive symptoms and health related quality of life (HRQoL) in patients with chronic pulmonary disease using both general and disease-specific HRQoL measures. A cross-sectional analysis of HRQoL measures completed by patients enrolled in the Department of Veteran Affairs Ambulatory Care Quality Improvement Project. 1252 patients with chronic pulmonary disease screened positive for emotional distress and returned the Hopkins Symptom Checklist-20 (SCL-20). 733 of 1252 had a score of 1.75 or greater on the SCL-20 indicating significant depressive symptoms. Depressive symptoms were associated with statistically significantly worse general and pulmonary health as reflected by lower scores on all sub-scales of both the Medical Outcomes Short Form-36 and the Seattle Obstructive Lung Disease Questionnaire. In fact, 11% to 18% of the variance in physical function sub-scales was attributed to depressive symptoms alone. Patients with chronic pulmonary disease and depressive symptoms reported significantly more impaired functioning and worse health status when compared to those patients without depressive symptoms. Because there are highly effective treatments for depression, selective screening of patients with chronic pulmonary disease for depression may identify a group that could potentially benefit from treatment interventions.

Adaptation, Psychological↗

PubMedDate not supplied

The frequency of histologically dysplastic nevi in 199 pediatric patients.

Many uncertainties surround the definition, frequency, and significance of dysplastic nevi in children. Consequently the management of dysplastic nevi in the pediatric population has been largely derived from the studies of adults. Biopsies are usually performed on this young age group because of lesion change or abnormal appearance. One might therefore assume that the frequency of histologically diagnosed dysplastic nevi would be higher in children than in adults. We decided to attempt to verify this assumption by determining the frequency of dysplastic nevi diagnosed histologically in the pediatric population. To do this we reviewed 199 cutaneous pathology reports of nevi removed from patients less than 18 years old and submitted to a community-based dermatopathology laboratory. The diagnosis of dysplastic nevus was made based on histologic criteria recommended by the World Health Organization Melanoma Program. We found that 3 of 199 nevi submitted for histologic analysis met the histologic criteria for dysplastic nevus. There were no melanomas. Our data suggest that there is an extremely low frequency of histologically confirmed dysplastic nevi within the general pediatric population.

Adolescent↗

PubMedDate not supplied

Immunoperoxidase demonstration of carcinoembryonic antigen in pleural and peritoneal effusions.

Ninety-eight consecutive pleural or peritoneal effusions from 76 patients with various malignant diseases were studied by cytomorphologic evaluation and immunoperoxidase staining for carcinoembryonic antigen (CEA). Cells easily identified as mesothelial cells were always negative in the immunoperoxidase stain. Sixty-seven effusions were from patients with carcinoma. By cytomorphology, 32 of these 67 effusions contained malignant epithelial cells, 15 were suspect, and the remaining 20 were negative. By immunoperoxidase staining, 35 of the 67 effusions contained cells with a positive intracellular reaction for CEA; 13 of these were among the cytomorphologically suspect or negative cases. None of the 31 effusions from patients with nonepithelial malignancies showed positive immunostaining for CEA. A positive immunoperoxidase stain for CEA can thus be used to confirm the presence of malignant epithelial tumor cells in effusions when the cytomorphologic evaluation is uncertain or negative.

Animals↗