Metastatic lung adenocarcinoma in a 20-year-old patient.

Lung cancer is rare disease in patients under 25 years of age. It typically occurs in older patients with a history of tobacco use. This case concerns a 20-year-old man with no history of tobacco use who complained of several months of cough and lower back pain and an 11.3-kg weight loss. He was treated for pneumonia after a chest radiograph showed total opacification of the right lung. Computed tomography imaging subsequently revealed a superior right hilar mass and mediastinal lymphadenopathy. Further imaging studies showed diffuse metastatic disease. Mediastinal biopsy showed poorly differentiated epithelioid tumour with desmoplastic stromal reaction, neutrophil infiltration, and squamous differentiation. Tissue immunostaining confirmed a non-small-cell lung cancer. Unfortunately, despite aggressive therapy, the patient's disease progressed, and he died within 9 months. In this paper, we hope to illustrate the unique challenges in diagnosing and treating young patients with metastatic lung cancer.

Primary ovarian malignant lymphoma presenting as ovarian carcinomatosis: a case report and literature review.

INTRODUCTION: Primary ovarian lymphoma may present with a clinical scenario consistent with advanced epithelial ovarian carcinoma. Although ovarian lymphoma is a rare entity, accounting for 0.5% of all non-Hodgkin's lymphoma and 1.5% of all ovarian neoplasms, it should be included in the differential diagnosis of an ovarian mass. CASE: We report a case of a 78-year-old woman who presented with an ovarian neoplasm suggestive of advanced ovarian carcinoma. During diagnostic laparoscopy, biopsies were obtained with frozen section analysis revealing malignant lymphoma. Further histopathologic analysis revealed a diffuse large B-cell lymphoma (DLBCL). The treatment plan was for six cycles of R-CHOP chemotherapy. A drammatic response was noted after only three cycles of R-CHOP. CONCLUSION: Primary ovarian lymphoma presenting as an ovarian tumor is exceedingly rare. Since the prognosis and treatment of lymphoma differs significantly from ovarian carcinoma, a representative tissue sample of the adnexal tumor should be obtained and sent for frozen section analysis to establish the diagnosis. Principal treatment for non-Hodgkin's lymphoma is chemotherapy without surgical cytoreductive efforts.

Long-term consequences of the Alzheimer's caregiver role: a qualitative analysis.

A qualitative analysis was performed on responses of 51 participants to open-ended questions about the experience of being family caregivers for a loved one affected by Alzheimer's disease. Participants had been in the caregiver role for at least eight years. Results indicated a pattern of adapting successfully or unsuccessfully to the caregiver role, experiencing initial caregiver burden, finding relief in social support when available, and long-term distress or long-term positive change. Memories and feelings were strong about individuals and institutions that had been helpful or indifferent many years earlier as the caregivers struggled to cope with their unplanned predicament.

Psychopathology in caregivers of the chronically ill: personality and clinical syndromes.

The purpose of this study was to examine the caregivers of the chronically physically ill across personality and clinical psychopathology dimensions. The MCMI-II inventories of 30 caregivers and 28 matched controls were analyzed. Differences between the two groups were found on the clinical scales of anxiety, somatoform, dysthymia, and major depression. This suggests that differences exist between caregivers and non-caregivers on several clinical syndromes including psychosomatic variables. Professional, paraprofessional, and lay hospice support personnel should be aware of these possibilities, actively assess for them, and be prepared to intervene.

Teacher-ratings and self-ratings of social competency in adolescents with low- and high-depressive symptoms.

A comparison of teacher-ratings and self-ratings of adolescents' social competency was investigated. One hundred five high school students completed the Reynolds Adolescent Depression Scale (RADS; Reynolds, 1987) and were divided according to their scores into three groups: the lowest quartile [low-depressive symptoms (LDS) group (n = 27)], the highest quartile [high-depressive symptoms (HDS) group (n = 28)], and the remainder. Students also rated themselves and were rated by their teachers on a social competency scale. A 2 (High- and Low-Depressive Groups) x 2 (Teacher-Ratings and Self-Ratings) ANOVA was conducted using social competency rating scores as the dependent variable. The two main effects were significant (p < .01). Adolescents with low-depressive symptoms rated themselves and were rated by their teachers as more socially competent than adolescents with high-depressive symptoms; additionally, self-ratings of social competency were higher than teacher-ratings. Results are discussed in the context of an adolescent optimistic bias or a teacher pessimistic bias.