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.

Résidence de Charles [Richard] Crane à Woods Hole (Mass.) [Massachusetts] qui sera probablement celle de Wilson [résidence d'été] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 58888

[Le podium du marathon de Boston, 19/4/20, de gauche à droite, Peter] Trivoulidas, Arthur Roth [et Carl] Linder : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 59159

Tunis's topographical and pictorial guide to Niagara : containing, also, a description of the route through Canada, and the great northern route, from Niagara Falls to Montreal, Boston, and Saratoga Springs. Also, full and accurate tables of distances on all railroads running to and from Niagara Falls. --

Cover title: Tunis's guide to Niagara and traveller's companion, illustrated.

The condition of Niagara Falls, and the measures needed to preserve them : eight letters published in the New York Evening post, the New York tribune, and the Boston daily advertiser, during the summer of 1882 /

Appendix: Extracts from Harper's weekly, New York herald, New York tribune and the Nation.

The claim of Amasa Stetson, of Massachusetts, on the United States, for money advanced, in fulfilling the orders of the Government while discharging the duties of Commissary General of Purchases, in time of the late war with Great Britain ; and for services rendered. --

Claim relating to the War of 1812.

Letter from the acting Secretary of War, transmitting information relative to the claims of the State of Massachusetts for payment of the expenses of the militia ordered out by the executive authority of the state, during the late war. --

15th Congress, 1st session, 1817-1818, House. Doc. 81.

Massachusetts militia claims : letter from the Secretary of War, transmitting, in pursuance of a resolution of the House of Representatives of the 15th Dec., 1826, a report upon the subject of the claims of the State of Masachusetts for certain services rendered during the late war.--

20th Congress, 2nd session. House Doc. no.3.

A sermon, preached in Boston, August 20, 1812, the day of humiliation and prayer, appointed by the President of the United States, in consequence of the declaration of war against Great Britain /

Published at the request of the hearers.

Ancaster Treason Trials proceedings, 1814 [photocopy]

The commission was charged with indicting those individuals who had committed acts of treason during the War of 1812. The commission appointed Thomas Scott, William Dummer Powell and William Campbell to preside over the proceedings. The grand jury met at Ancaster, Ont. over 18 days in May and June of 1814 to hear the testimony of those charged with treason as well as any pertinent witnesses. On June 21, 1814 the commission indicted 15 individuals and ordered them to be hanged and quartered. This commission came to be commonly known as the Ancaster Bloody Assize of 1814.

A Psychosocial Approach to Understanding Causality Assessment in Early Phase Oncology Clinical Trials: A Phenomenological Study

Research Question: What are the psychosocial factors that affect causality assessment in early phase oncology clinical trials? Methods: Thirty-two qualitative interviews were explicated with the aid of “Naturalistic Decision Making”. Data explication consisted of phenomenological reduction, delineating and clustering meaning units, forming themes, and creating a composite summary. Participants were members of the National Cancer Institute of Canada’s Clinical Trial Group Investigative New Drug committee. Results: The process of assigning causality is extremely subjective and full of uncertainty. Physicians had no formal training, nor a tool to assist them with this process. Physicians were apprehensive about their decisions and felt pressure from their patients, as well as the pharmaceutical companies sponsoring the trial. Conclusions: There are many problem areas when attributing causality, all of which have serious consequences, but clinicians used a variety of methods to cope with these problem areas.