Paroxetine versus nortriptyline in the continuation and maintenance treatment of depression in the elderly

Elderly depressed patients are vulnerable to recurrence of depression and benefit from long-term antidepressant therapy. Physicians increasingly use selective serotonin re-uptake inhibitors (SSRIs) as maintenance therapy, although in the absence of data showing that SSRIs are as efficacious as tricyclic antidepressants (TCAs) in the prevention of depression relapse and recurrence. Our objective was to evaluate, in an open trial, the efficacy of paroxetine versus nortriptyline for preventing recurrence of depression in the elderly. Elderly patients with major depression were randomly assigned in a double-blinded fashion to receive either paroxetine or nortriptyline for the acute treatment of depression. Patients who did not respond or tolerate their assigned medications were crossed over openly to the comparator agent. Patients whose depression remitted continued antidepressant medication (paroxetine n = 38; nortriptyline n = 21) during an open 18-month follow-up study. We examined the rates of and times to relapse and to termination of treatment for any reason. Paroxetine (PX) and nortriptyline (NT) patients had similar rates of relapse (16% vs. 10%, respectively) and time to relapse (60.3 weeks vs. 58.8 weeks, respectively) over 18 months. A lower burden of residual depressive symptoms and side effects during continuation and maintenance treatment was evident in nortriptyline-treated patients. Paroxetine and nortriptyline demonstrated similar efficacy in relapse and recurrence prevention in elderly depressed patients over an 18-month period.     

关于导数的三个性质及其应用

本文列举了三个易错的典型导数问题,并给出了三个避免类似错误的简单实用的结论。     

延续护理对颅脑术后合并癫痫患者出院后生活质量的影响

目的：研究延续护理对颅脑术后合并癫痫患者出院后生活质量的影响，根据影响表现探究延续护理的临床应用价值。方法随机选取某院2010年1月～2016年5月收治的60例颅脑术后合并癫痫患者，实验组40例，采用延续护理，对照组20例，采用常规护理，对比两组患者出院后生活质量评分，且根据术后随访调查及相关临床资料，分析判断延续护理的优势。结果随访调查3～6个月，实验组患者生活质量平均分（93.11±2.05）分，后遗症2例，发生率为5％，恢复情况优于对照组，生活质量平均分（82.52±5.41）分，后遗症7例，35％，差异具有统计学意义（ P＜0.05）。结论延续护理在临床针对颅脑术后合并癫痫患者护理服务方面的科学性与安全性很高，能够保证患者出院后生活质量处于较高水平，该类型护理服务模式值得推广应用。     

Adolescent Substance Use and Sensation-Seeking on Sexual Behaviors Among Young Adults from Continuation High Schools

Background: Youth from continuation high schools report greater substance use and sensation-seeking than youth from regular high schools, yet their long-term consequences on age at sexual onset and the number of sexual partners are unknown. Objective: To examine substance use, sensation-seeking and sexual behaviors by gender and race/ethnicity and the effects of substance use and sensation-seeking in adolescence on age at sexual initiation and numbers of sexual partners by young adulthood. Methods: Baseline and 4-year follow-up data on youth from 14 continuation high schools in Southern California who participated in a drug abuse prevention intervention were analyzed. Structural equation modeling assessed whether or not substance use or sensation-seeking in adolescence predicted age at sexual onset and numbers of sexual partners by young adulthood. Results: Latinos had lower sensation-seeking and frequency of substance use and a later age at sexual onset than non-Latinos. Males were more likely than females to have multiple lifetime and recent sexual partners. The effects of adolescent substance use on the number of sexual partners by young adulthood were mediated fully by their age at sexual initiation. Sensation-seeking had no direct or indirect effects on sexual behaviors. Conclusions/Importance: Factors leading to and actual sexual risk behaviors among youth from continuation high schools vary by race/ethnicity and gender. Targeting these antecedent factors by race/ethnicity and gender may improve prevention efforts.     

增刊投稿--个性化延续护理对创伤性脊髓损伤伴截瘫患者照顾者照顾负担和生活质量的影响

目的：分析个性化延续护理对创伤性脊髓损伤伴截瘫患者预后效果及患者照顾者照顾负担和生活质量的影响。方法：选择我院自2018年1月至2019年6月收治的180例创伤性脊髓损伤伴截瘫患者作为研究对象,采用随机数字表法将其分成对照组和研究组,每组90例,对照组采用常规出院指导护理干预,研究组采用个性化延续护理干预,对比两组患者护理前后的肢体疼痛评分、功能障碍评分及照顾者护理前后对疾病相关护理知识掌握度评分、照顾负担评分、生活质量评分、对护理工作的总满意率。结果：护理前,两组患者肢体疼痛评分、功能障碍评分及照顾者护理前后对疾病相关护理知识掌握度评分、照顾负担评分、生活质量评分对比均无显著差异(P＞0.05),护理后,研究组患者肢体疼痛评分、功能障碍评分及照顾者照顾负担评分均显著低于对照组,研究组患者照顾者对疾病相关护理知识掌握度评分、生活质量评分及对护理工作的总满意率均显著高于对照组,两组对比具有统计学意义(P＜0.05)。结论：对创伤性脊髓损伤伴截瘫患者实施个性化延续护理干预,不仅能有效提高患者照顾者对疾病相关护理知识的掌握度,同时还能减轻其照顾负担和提高其生活质量,并提高患者预后效果,从而有助于提高其对护理工作的满意度。     

两种含铜宫内节育器TCu380A和MLCu375s临床效果的对比研究

报告了随机放置TCu380A和MLCu315s宫内节育器共200例,一年观察结果表明,TCu380A和MLCu375s妊娠率分别为0.0%和2.2%,脱落率分别为8.4%和11.4%,因出血疼痛取出率为8.4%和2.1%,一年的继续存放率分别为84.0%和84.8%,两种节育器比较,差异无显著意义。     

Post-marketing Surveillance for Combined Oral Contraceptive Containing Desogestrel （Marvelon） in Chinese Rural Areas

To assess the side effects and the continuation rate of combined oral contraceptive （COC） containing desogestrel （Marvelon） during 12 months. Methods This was a post-marketing surveillance study on Marvelon COC among 870 healthy rural women in 5 different counties of Jiangsu Province during 12 months. Results About 24.02% of the women who used Marvelon COC experienced side effects during 12 months. Gastrointestinal disorder, bleeding/spotting and chloasma were ranked the first three in the side effects. The rate of side effects of Marvelon COC users during the first 3 months in southern area of Jiangsu was significantly higher than that of users in northern area of Jiangsu. Most of the users did not experience obvious weight changes i.e., loss or increase in weight of more than 5 kg during 12 months. Blood pressure and biochemical indicators of almost 99% among users were within the normal range. The gross cumulative continuation rate for 12 months was 83.14%; the most common medical reason for discontinuation was gastrointestinal disorder. There was an increased risk of discontinuation use among women with lower educational level. Conclusion Marvelon COC brought fewer side effects and was well accepted when applied in Chinese rural women.     

Anomalous inferior vena cava with azygos continuation in a japanese man

During an ordinary dissection by medical students at Nara Medical University in 1998, a case of anomalous inferior vena cava with azygos continuation was found in a cadaver of a 91-year-old Japanese man. The left and right inferior venae cavae were present and were joined at the height of the first lumbar vertebra. The joined inferior vena cava continued the azygos vein and the azygos vein entered the superior vena cava at the height of the fifth thoracic vertebra. Furthermore, the heart was normal.     

Not seeking yet trying long-acting reversible contraception: a 24-month randomized trial on continuation,unintended pregnancy and satisfaction

Objectives

To measure the 24-month impact on continuation, unintended pregnancy and satisfaction of trying long-acting reversible contraception (LARC) in a population seeking short-acting reversible contraception (SARC).