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Little is known about the combined use of benzodiazepines and antidepressants in older psychiatric patients. This study examined the prescription pattern of concurrent benzodiazepines in older adults treated with antidepressants in Asia, and explored its demographic and clinical correlates.
The data of 955 older adults with any type of psychiatric disorders were extracted from the database of the Research on Asian Psychotropic Prescription Patterns for Antidepressants (REAP-AD) project. Demographic and clinical characteristics were recorded using a standardized protocol and data collection procedure. Both univariate and multiple logistic regression analyses were performed.
The proportion of benzodiazepine and antidepressant combination in this cohort was 44.3%. Multiple logistic regression analysis revealed that higher doses of antidepressants, younger age (<65 years), inpatients, public hospital, major comorbid medical conditions, antidepressant types, and country/territory were significantly associated with more frequent co-prescription of benzodiazepines and antidepressants.
Nearly, half of the older adults treated with antidepressants in Asia are prescribed concurrent benzodiazepines. Given the potentially adverse effects of benzodiazepines, the rationale of benzodiazepines and antidepressants co-prescription needs to be revisited.
Subjective memory impairment (SMI) is common among older adults. Increasing evidence suggests that SMI is a risk factor for future cognitive decline, as well as for mild cognitive impairment and dementia. Medial temporal lobe structures, including the hippocampus and entorhinal cortex, are affected in the early stages of Alzheimer's disease. The current study examined the gray matter (GM) volume and microstructural changes of hippocampal and entorhinal regions in individuals with SMI, compared with elderly control participants without memory complaints.
A total of 45 participants (mean age: 70.31 ± 6.07 years) took part in the study, including 18 participants with SMI and 27 elderly controls without memory complaints. We compared the GM volume and diffusion tensor imaging (DTI) measures in the hippocampal and entorhinal regions between SMI and control groups.
Individuals with SMI had lower entorhinal cortical volumes than control participants, but no differences in hippocampal volume were found between groups. In addition, SMI patients exhibited DTI changes (lower fractional anisotropy (FA) and higher mean diffusivity in SMI) in the hippocampal body and entorhinal white matter compared with controls. Combining entorhinal cortical volume and FA in the hippocampal body improved the accuracy of classification between SMI and control groups.
These findings suggest that the entorhinal region exhibits macrostructural as well as microstructural changes in individuals with SMI, whereas the hippocampus exhibits only microstructural alterations.
Primitive neuroectodermal tumour/extraskeletal Ewing’s sarcoma (PNET/EES) is a rare disease of the head and neck region. We report a case of a 74-year-old man with a laryngeal Ewing’s sarcoma. This is the first reported case of extraskeletal Ewing’s sarcoma of the larynx in an elderly male patient. The patient was successfully treated with surgical resection and post-operative radiotherapy.
Sialolithiasis is a major cause of salivary gland dysfunction. The submandibular gland is the most common site followed by the parotid gland. The sublingual gland and minor glands are very rare sites for stone formation. This paper describes a case of multiple sialoliths arising in the sublingual gland. They presented on the right floor of the mouth. The sublingual gland and sialoliths were completely removed with careful preservation of the lingual nerve and Wharton’s duct. This was an uncommon sialolithiasis of the sublingual gland in a 14-year-old female.
Hypoplasia or absence of the epiglottis in an adult is a rarely reported congenital anomaly that usually occurs in association with congenital anomalies of other organ systems. Most epiglottic anomalies usually present in infancy and early childhood with respiratory and feeding problems and the affected individual dies shortly after birth due to multiple congenital anomalies. We present a case of congenital absence of the epiglottis and false vocal folds with hypoplastic maxillae in an adult.
The degradation behavior of integrated Pt/SrBi2Ta2O9/Pt capacitors caused by hydrogen impregnation during the spin-on glass (SOG)-based intermetal dielectric (IMD) process was investigated. SOG was tested as an IMD since it offers better planarity for multilevel metallization processes compared to other SiO2 deposition methods. It was found that the SOG itself does not degrade the ferroelectric performance. Deposition of an under-layer of SiOxNy by plasma-enhanced chemical vapor deposition (PECVD) using SiH4 + N2O + N2 source gases and a SiO2?x capping layer by another PECVD process using SiH4 + N2O source gases produced hydrogen as a reaction by-product. The hydrogen diffused into the SBT layer and degraded the ferroelectric performance during subsequent annealing cycles. A very thin (10 nm) Al2O3 layer grown by atomic layer deposition before the IMD process successfully blocked the impregnation of the hydrogen. Therefore, excellent ferroelectric performance of the SBT capacitors were maintained after the multilevel metallization process as well as passivation. The adoption of SOG in the IMD process greatly improved the surface flatness of the wafer resulting in a higher capacitor yield with very good uniformity in ferroelectric properties over the 8-in.-diameter wafer.
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