The natural course of anxiety symptoms in early adolescence: factors related to persistence

Background and objectives: Anxiety disorders are the most common mental health problems during childhood and adolescence. This study examined the course of anxiety symptoms in early adolescents from the general population over three phases.

Design: Prospective cohort study.

Methods: Two hundred and forty-two participants (mean-age of 13.52) from a baseline sample of 1514 (mean-age of 10.23) were followed up three times. Of the 1514 children, those with emotional risk and controls without risk constituted the second-phase sample (n?=?562; mean-age of 11.25). The Screen for Child Anxiety Related Emotional Disorders-SCARED was administered in all three phases.

Results: Fifty-six percent and 32% of respondents showed total scores above the SCARED cutoff point at one and three years follow-up, respectively. Eight percent showed fluctuating symptoms. Fifty-five percent of respondents showed high scores for any subtype of anxiety over three years. Social phobia and generalized anxiety symptoms were the most prevalent and persistent. Participants with persistent separation anxiety showed the highest co-occurrence with symptoms of other psychopathological disorders. Participants with persistent anxiety showed lower academic performance. Being male was a protective factor against persistence.

Conclusions: The data support anxiety maintenance during early adolescence. Early adolescence is a critical period which may involve other serious academic, social, and family problems.     

老年结直肠癌的治疗

老年患者占结直肠癌患者的70%,因此老年人是结直肠癌的主要患病人群。为了提高结直肠癌治疗的总体疗效,我们应当特别关注老年性结直肠癌的治疗。以往,手术治疗和化疗的应用随着年龄的增高而明显减少。我们一直以为老年人手术和化疗的效果不令人满意。近期的研究改变了这一认识。证据表明辅助化疗和姑息性化疗对一般情况良好的老年人是有效而安全的。即使存在一些与年龄相关的基础疾病的老年结直肠癌患者仍然能从合理的治疗方案中获益。所以我们尚有许多工作需做,以提高老年性结直肠癌患者的疗效。腹腔镜下结肠癌根治术是对老年人安全有效的手术技术。我们期待随着经腔道的内窥镜手术技术的发展,将来会使老年性结直肠癌患者受益。     

大肠癌常见诊疗误区解析

大肠癌是最常见的恶性肿瘤之一。尽管近年诊疗水平不断提高,但在临床诊疗工作中,仍存在一些误区。本文主要针对肠镜检查的必要性、肝转移是否能手术治疗、术后辅助化疗的适应证、靶向药物的适应证以及K-RAS基因检测的必要性等5方面进行分析。逐步规范大肠癌的诊断和治疗,提高大肠癌综合治疗水平。     

姑息医学在大肠癌治疗中的地位和应用策略

大肠癌的治疗应采用一种无缝的连接方式将姑息治疗与抗肿瘤治疗整合在一起。姑息医学的采用应贯穿肿瘤治疗的始终,以期更好地提高生命质量,尊重生命价值,体现医学本质和人文关怀。     

乳腺癌手术患者术前心理危机的原因剖析与应对策略

乳腺癌手术患者术前严重的心理危机对其极为不利,笔者从多方面剖析了患者术前心理危机产生的原因,同时针对乳腺癌手术患者术前心理危机如何有效应对提出了诸多策略,最后就目前临床工作中存在的一些不足进行了必要的思考。     

对宫颈癌中前哨淋巴结检测的认识

广泛子宫切除+盆腔淋巴结清扫是治疗早期宫颈癌的标准术式。但对无盆腔淋巴结转移患者,淋巴结清扫并无治疗意义,且伴随多种并发症。前哨淋巴结检测有望解决这一问题,其在宫颈癌中的应用有较大可行性,亦存在局限性。只有正确认识并应用之,才能造福患者。     

非小细胞肺癌术后化疗循证医学证据引发的思考

肺癌是目前对人类生命威胁最大的恶性肿瘤之一.对非小细胞肺癌术后化疗的循证医学证据及由此引发的思考:对循证医学的局限性及认识真理的曲折性进行了阐述.     

循证医学在眼科临床实践中的应用

循证医学是在Internet蓬勃发展并极大推动社会信息化和网络化的大背景下,将临床流行病学、现代信息学与临床医学相互交叉融合的新兴边缘学科。它的出现使临床医学面临巨大的挑战,已使得行医模式由理论知识加以个人经验为指导的传统经验医学转向现代循证医学。这将是传统医学模式向循证医学模式转变的一场深刻变革,也是本世纪临床医学发展的必然趋势。     

与癌共存安享欢乐生活

癌症是现代社会人群意外死亡的致命杀手,目前医学科学还没有完美预防和治疗它的措施和办法,恐惧、悲观、失望、焦虑是有害的,过度治疗也不可取,与癌共存,安享生活是值得提倡的理念。