Randomized controlled trials of serotonin-norepinephrine reuptake inhibitor in treating major depressive disorder in children and adolescents: a meta-analysis of efficacy and acceptability

New generation antidepressant therapies, including serotonin-norepinephrine reuptake inhibitor (SNRIs), were introduced in the late 1980s; however, few comprehensive studies have compared the benefits and risks of various contemporary treatments for major depressive disorder (MDD) in young patients. A comprehensive literature search of PubMed, Cochrane, Embase, Web of Science, and PsycINFO databases was conducted from 1970 to January 2015. Only clinical trials that randomly assigned one SNRI or placebo to patients aged 7 to 18 years who met the diagnostic criteria for major depressive disorder were included. Treatment success, dropout rate, and suicidal ideation/attempt outcomes were measured. Primary efficacy was determined by pooling the risk ratios (RRs) of treatment response and remission. Acceptability was determined by pooling the RRs of dropouts for all reasons and for adverse effects as well as suicide-risk outcomes. Five trials with a total of 973 patients were included. SNRIs were not significantly more effective than placebo for treatment response but were for remission. The comparison of patients taking SNRIs that dropped out for all reasons and those taking placebo did not reach statistical significance. Significantly more patients taking SNRIs dropped out for adverse effects than those taking placebo. No significant difference was found in suicide-related risk outcomes. SNRI therapy does not display a superior efficacy and is not better tolerated compared to placebo in these young patients. However, duloxetine has a potential beneficial effect for depression in young populations, showing a need for further research.

[The treatment of nasal adhesion after radiotherapy in the patients with nasopharyngeal carcinoma]

OBJECTIVE

In order to find a best way for treating the nasal adhesion after radiotherapy in the patients with nasopharyngeal carcinoma (NPC).

METHOD

4 cases of nasal adhesion after radiotherapy in the patients with NPC were operated by the way through palate. 32 cases were operated under endoscope, in them, 26 cases were set a tube in nasal cavity after operation, and the other 6 cases were not. And the postoperative consequences were analyzed.

RESULT

The curative effect of the reconstruction of nasal cavity with a tube through palate are favorable, but the processes are too complex and the trauma are too large for patients. Whereas the way which only sever the nasal adhesion under endoscope is simple, but the disease recur easily. The reconstruction of nasal cavity with a tube under endoscope not only predigest the operation, but also obtain the well effect.

CONCLUSION

The reconstruction of nasal cavity with a tube under endoscope is a good way to treat nasal adhesion.

[Usefulness of CT scan in secretory otitis media in patient with nasopharyngeal carcinoma]

OBJECTIVE

To explore the usefulness of CT scan in nasopharyngeal carcinoma (NPC) with secretory otitis media (SOM).

METHOD

CT of the nasopharynx and mastoid in 127 cases with NPC pro- and post-irradiation were analyzed.

RESULT

Total incidence rate of SOM was 59% before irradiation. The incidence corresponded to T stage and tumor location of NPC. In the patients without SOM before irradiation, 70 percent of the ears developed SOM, and the peak stage of the formation of SOM was in three to six month after irradiation.

CONCLUSION

CT scan for the patient with NPC is useful for the diagnosis and prognosis of SOM induced by NPC.