Effects of total-body digital photography on cancer worry in patients with atypical mole syndrome.

Importance Cancer worry about developing melanoma in at-risk patients may affect one’s quality of life and adherence to screening. Little is known about melanoma-related worry in patients with atypical mole syndrome (AMS). Objectives To quantify levels and elucidate predictors of worry related to developing melanoma in patients with AMS and to determine whether total-body digital photography (TBDP) in pigmented lesion clinics (PLCs) reduces worry. Design, Setting, and Participants In this pretest-posttest study, patients with AMS from PLCs at 2 academic medical centers were recruited from June 1, 2005, through October 31, 2008, to answer questions about cancer worry before and after undergoing TBDP. Questionnaires used included the new melanoma and recurrent melanoma Revised Impact of Event Scale (RIES), the Melanoma Worry Scale (MWS), the Hospital Anxiety and Depression Scale, and the Life Orientation Test. Interventions All patients underwent TBDP. Main Outcomes and Measures Changes in the MWS and new melanoma RIES scores. Results A total of 138 patients completed baseline questionnaires; 108 patients (78.3%) completed questionnaires after TBDP. Baseline levels of worry were low and reduced further after TBDP. In patients with a personal history of melanoma, worry was reduced on all scales. In patients without a personal history of melanoma, only the new melanoma RIES score was significantly decreased. Predictors of baseline MWS scores include female sex, personal history of melanoma, and higher Hospital Anxiety and Depression Scale scores, adjusted for demographics, family history of melanoma, and Life Orientation Test scores. Adjusted predictors of the baseline new melanoma RIES score were similar but also included lower educational level and did not include sex. Conclusions and Relevance Patients with AMS have low levels of melanoma-related worry, which is similar to data from other populations at high risk of cancers. We found that TBDP is a clinically useful tool that can be used in PLCs to help decrease worry about developing melanoma in at-risk patients

Zidovudine, Didanosine, or Both as the Initial Treatment for Symptomatic HIV-Infected Children

Although treatment with zidovudine significantly reduces the likelihood of mother-to-infant transmission of the human immunodeficiency virus (HIV), 1 perinatally acquired infections still account for the majority of new cases of the acquired immunodeficiency syndrome (AIDS) in children. 2 , 3 Zidovudine has been the recommended treatment for these children, but controlled trials have not been conducted to compare it with other antiretroviral agents or combination therapies in children. Recent studies in adults suggest that combination antiretroviral regimens, particularly those including protease inhibitors, may prolong the period of HIV nonprogression, 4 but comparable studies have not been done in children. In this study, we compared . .