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Diagnosis and treatment of early melanoma. NIH Consensus Development Conference. January 27-29, 1992.

The National Institutes of Health Consensus Development Conference on Diagnosis and Treatment of Early Melanoma brought together experts in dermatology, pathology, epidemiology, public education, surveillance techniques, and potential new technologies as well as other health care professionals and the public to address (1) the clinical and histological characteristics of early melanoma; (2) the appropriate diagnosis, management, and followup of patients with early melanoma; (3) the role of dysplastic nevi and their significance; and (4) the role of education and screening in preventing melanoma morbidity and mortality. Following 2 days of presentations by experts and discussion by the audience, a consensus panel weighted the scientific evidence and prepared their consensus statement. Among their findings, the panel recommended that (1) melanoma in situ is a distinct entity effectively treated surgically with 0.5 centimeter margins; (2) thin invasive melanoma, less than 1 millimeter thick has the potential for long-term survival in more than 90 percent of patients after surgical excision with a 1 centimeter margin; (3) elective lymph node dissections and extensive staging evaluations are not recommended in early melanoma; (4) patients with early melanoma are at low risk for relapse but may be at high risk for development of subsequent melanomas and should be followed closely; (5) some family members of patients with melanoma are at increased risk for melanoma and should be enrolled in surveillance programs; and (6) education and screening programs have the potential to decrease morbidity and mortality from melanoma. The full text of the consensus panel's statement follows.

Dysplastic Nevus Syndrome

Diagnosis and treatment of depression in late life. NIH Consensus Development Conference. November 4-6, 1991.

The National Institutes of Health Consensus Development Conference on Diagnosis and Treatment of Depression in Late Life brought together biomedical and behavioral scientists, surgeons, and other health care professionals as well as the public to address the epidemiology, pathogenesis, pathophysiology, prevention, and treatment of depression in the elderly and to alert both the professional and lay public to the seriousness of depression in late life, to its manifestations and useful treatments, and to areas needing further study. Following 2 days of scientific presentations by experts and discussion by the audience, a consensus panel weighed the evidence and prepared their consensus statement. Among their findings, the panel concluded that (1) depression in late life occurs in the context of numerous social and physical problems that often obscure or complicate diagnosis and impede management of the illness; (2) because there is no specific diagnostic test for depression, an attentive and focused clinical assessment is essential for diagnosis; (3) depressed elderly people should be treated vigorously with sufficient doses of antidepressants and for a sufficient length of time to maximize the likelihood of recovery; (4) electroconvulsive therapy and psychosocial treatments also can be effective in the treatment of elderly depressed patients; and (5) estimates of the prevalence of depression vary widely, but the highest rates are in nursing homes and other residential settings, and staff in many of these facilities are not equipped to recognize or treat depressed patients. The full text of the consensus panel's statement follows.

Aged

The impact of implants on dental practice. A review of the 1988 NIH Consensus Development Conference.

The Consensus Development Conference process for the second time in ten years has come to grips with the dynamic field of oral implantology and has given it unquestioned scientific legitimacy and clear future clinical and research direction. Hopefully, for the millions of patients who could benefit from implant therapies, practitioners, hospitals, academic institutions, government agencies, health care insurance carriers, etc. will not wait to be forced to confront the reality of the success of implants, but they will begin or continue to restructure their practices, curricula, health care policies and benefits to provide the quality of life reasonably desired by our citizens.

Dental Implantation