Risk factors and outcomes of cutaneous melanoma in women less than 50 years of age.

BACKGROUND: Melanoma is the fifth most common cancer in the United States, with recent reports indicating increasing incidence among young women. OBJECTIVE: This study sought to investigate histopathology, staging, risk factors, and outcomes of cutaneous melanoma in women younger than 50 years. METHODS: All female patients aged up to 49 years with biopsy-proven diagnosis of melanoma between 1988 and 2012 were included. Patients with a follow-up of less than 2 years were excluded. RESULTS: A total of 462 patients were identified, with mean age of 34.7 years. Invasive melanoma was less common in women 19 years of age or younger (P < .0008). Positive sentinel node status (P < .008), recurrence rates, metastatic disease (P < .001), and death rates (P < .008) were higher for women ages 40 to 49 years. The 41 patients with a pregnancy-associated melanoma had a significantly worse prognosis in comparison with a control group of nonpregnant patients, with a 9-fold increase in recurrence (P < .001), 7-fold increase in metastasis (P = .03) and 5-fold increase in mortality (P = .06). LIMITATIONS: This was a retrospective study. CONCLUSION: The increasing incidence of melanoma for women younger than 50 years suggests that regular skin checks and self-examinations are warranted. In addition, in women given the diagnosis of melanoma during or within 1 year after childbirth, regular follow-up and monitoring for recurrence are recommended.

Retained Intrathecal Catheter in a Patient With Baastrup Disease.

Neuraxial catheters are typically removed without complications. In rare cases, however, breakage of the catheter may lead to a retained catheter fragment. We present a case of an epidural catheter inadvertently placed in the intrathecal space. The catheter sheared on attempted removal. The computed tomography scan of the lumbar spine revealed hypertrophic spinous processes (Baastrup disease) and a retained catheter fragment located in the thecal sac at L3-L4, terminating at the anterior portion of the interspinous ligament at L4-L5. Proper precautions should be taken when removing neuraxial catheters to prevent this complication.

How is school psychology doing: Why hasn't school psychology realized its promise?

We take a look back to 1995 when Conoley and Gutkin shared their vision for an adult-focused practice of school psychology with a primary focus on developing health-promoting systems for schoolage children. We then look to the present to what has happened and not happened to substantiate their vision. We found very encouraging developments and continuing challenges in the research targets and practice roles of school psychologists. There is no shortage of evidence-based strategies to improve the school experience of all children. The opportunities offered by, for example, the Multi-Tiered Systems of Support paradigm are promising, but it is unclear whether school psychologists are assuming leadership roles in this work. Furthermore, incorporating postdoctoral specialties is a promising role expansion for school psychologists, but most of the specialties keep the psychologists' focus on individual child assessment and treatment. School psychology is a very large professional tent with room for many approaches to preventing childhood disorders and promoting behavioral and academic success. Graduate education and current practice seem to reflect the traditional test and place roles for psychologists that Conoley and Gutkin hoped to expand beyond 25 years ago. Research efforts and national organization supports are hopeful, however, for a reimagined practice of psychology that makes use of the powerful ecosystems that affect children's well-being. Much work is yet to be done. (PsycInfo Database Record (c) 2021 APA, all rights reserved).