CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne
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The dramatic increase over the past 10 years in the amount of available clinical research on the use of antidepressants to treat major depression in children and adolescents has substantially improved our knowledge of the safety and efficacy of these medications in the pediatric population. Many questions remain, however, that highlight the need to continue research in this patient population rather than relying on the extrapolation of data from trials involving adults. In this article, we review the current state of research into antidepressant therapy for major depression in children and adolescents. In addition, we discuss methodologic issues and clinical implications specific to the pediatric population.
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Clinical Trial
Shelter-based managed alcohol administration to chronically homeless people addicted to alcohol.
People who are homeless and chronically alcoholic have increased health problems, use of emergency services and police contact, with a low likelihood of rehabilitation. Harm reduction is a policy to decrease the adverse consequences of substance use without requiring abstinence. The shelter-based Managed Alcohol Project (MAP) was created to deliver health care to homeless adults with alcoholism and to minimize harm; its effect upon consumption of alcohol and use of crisis services is described as proof of principle. ⋯ A managed alcohol program for homeless people with chronic alcoholism can stabilize alcohol intake and significantly decrease ED visits and police encounters.
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Randomized Controlled Trial
Efficacy of intensive multitherapy for patients with type 2 diabetes mellitus: a randomized controlled trial.
National guidelines for managing diabetes set standards for care. We sought to determine whether a 1-year intensive multitherapy program resulted in greater goal attainment than usual care among patients with poorly controlled type 2 diabetes mellitus. ⋯ Intensive multitherapy for patients with poorly controlled type 2 diabetes is successful in helping patients meet most of the goals set by a national diabetes association. However, 6 months after intensive therapy stopped and patients returned to usual care, the benefits had vanished.