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clinical Variants, Rates of Post-Operative Recurrence and Malignant Transformation of Sino-Nasal Inverted Papilloma

International Journal of Otolaryngology and Head & Neck Surgery 2021年第6期10卷 497-510页

作者： Israa M. Qadmi Alaa Q. Mandeel Jehad H. Hammad Reem J. Radhi Sayed Ali I. Al Mahari Department of Otorhinolaryngology Salmaniya Medical Complex Manama Kingdom of Bahrain Department of Radiology Salmaniya Medical Complex Manama Kingdom of Bahrain Department of Pathology Salmaniya Medical Complex Manama Kingdom of Bahrain

Background: Inverted Papilloma (IP) is the most common benign neoplasms arising from the mucosal lining of the of the Sino-Nasal tract with single or multifocal attachment sites. The high propensity to recur, local aggressive behavior and possibility of malignant transformation attract considerable interest. Objective: To assess the factors affecting Sino-nasal IP, malignant transformation rate, and post-operative recurrence rate. Methods: A retrospective study was carried out on all cases diagnosed as Sino-Nasal Papilloma between January 2010 and December 2020 at Salmaniya Medical Complex, Bahrain. Data gathered from medical records were analyzed using SPSS. A total of 49 Sino-Nasal Papilloma cases were recorded of which 37 were IP. factors affecting Sino-Nasal IPs are presented. Results: Sino-Nasal IP was recorded in 37 cases, composed of 28 males and 9 females with first presentation average age of 45.86 years. These involved 20 cases in the left side, 14 in the right side and 3 were bilateral. Recurrence in males and females was found to be 35.7% and 33%, respectively, with an average of 12.6 months. The symptoms include nasal blockage (97.3%), epistaxis and postnasal drip (13.5% each), headache (8.1%) and hyposmia and rhinorrhea (5.4%, each). The main recurrence was at stage T2 (60.5%), while in smokers (26.7%) and non-smokers (50%). Malignant transformation occurred in one patient only (2.6%). Conclusion: IP is the most common type of SNP with male predominance. The recurrence rate is high with an average of a year and the malignant transformation occurred in 2.6 % of the cases.

关键词： Bahrain clinical risk factors Malignant Transformation Sino-Nasal Inverted Papilloma Smoking Salmaniya Medical Complex

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Research progress of the etiology and treatment of treatment-resistant depression

Research progress of the etiology and treatment of treatment...

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中国神经科学学会第十届全国学术会议

作者： Zhi-Jun Zhang Department of Neurology Affiliated ZhongDa Hospital of Southeast University

Treatment-resistant depression(TRD) is refer to a subtype of depression that under application of two different types of antidepressants,full dose,full period of treatment(6 to 8 weeks) and compliance is good,the patient is still *** one of the important problems of the psychiatry,although the ultima pathogenic mechanism is not clear yet,TRD is considered to be associated with the abnormalities of biochemistry,heredity,endocrine,immunity,psychological social factors and anatormy,*** clinical risk factors of TRD include major depression(Hamilton depression rating scale rating > 35 points);double depressio(superimposing a depressive episode on the basis of continuous dysthymia);recurrent brief depression(lasting 2 days to 2 weeks,at least once a month,for at least 12months,not associated with menstruation and according with the symptoms of major depressive episode);other comorbidities(such as anxiety disorders,physical diseases and substance dependence etc).In view of the pathogenic mechanism and the clinical risk factors of TRD,we summarize the optimizing treatment strategies up to now.(1)Increasing the dose:Increasing doses of antidepressants currently being used,to 1 times of the maximum therapeutic doses;(2) Replacement strategies:switch to another medicine with different mechamsm of action;(3) Strengthen effect strategy:add with a certain medicine increasing the effect of antidepressant,or use anotber antidepressant with different mechamsm of action simultaneously,such as buspirone,thyroxine,nimo,propranolol,and so *** with mood stabilizer such as lithium carbonate or antiepileptic drugs can also be *** patients with low HPT axis function,adding with thyroxine will be *** there is a comorbidity of anxiety,it is better to add with buspirone;(4)Combination therapy:for a special subtype of depression such as delusional or psychotic depression,it is better to add with antipsychotic *** the perimenopausal women patients,add with e

关键词： treatment-resistant depression clinical risk factors treatment strategies synergistic agent non-pharmaceutical therapy

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