Highlights of this issue • Dans ce numéro

Treating major depression in children and adolescents

Major depressive disorder can affect up to 10% of adolescents. Cheung and colleagues review the evidence on the efficacy and safety of antidepressants in pediatric patients and assess how methodologic differences between studies may have contributed to the variation in safety outcomes reported. They also make clinical recommendations based on their findings.

See page 193

Sulfonylureas and mortality in type 2 diabetes

Researchers identified almost 6000 patients starting oral anti-diabetic therapy and compared rates of death by class of drug. They found that higher daily doses of first-generation sulfonylureas and glyburide were associated with increased mortality. Metformin did not show the same dose–response relation. In a related commentary, Bell discusses these findings in the context of ongoing debate in this area and provides prescribing options for physicians.

See pages 169 and 185

Medical care and income

Most developed countries aim to ensure equitable access to health care. Researchers found that in 21 countries, the distribution of specialist care favoured the wealthy, particularly in the United States and Mexico. In a related commentary, Hurley and Grignon focus on the study's findings for Canada and their policy implications.

See pages 177 and 187

Equitable access to treatments for rare diseases

None of the new therapies for rare diseases submitted to the Canadian Common Drug Review has been recommended for reimbursement on provincial drug plans. Clarke examines the limitations of the current drug review process and suggests changes that might be made to ensure equitable access to therapy for rare diseases.

See page 189

Analysis • Practice

An update on TNM cancer staging is provided by Brierley (page 155). Katzmarzyk and Mason discuss the prevalence of class I, II and III obesity in Canada (page 156). Barnard and Friedman describe a case of stunted growth caused by a craniopharyngioma (page 159). In the second article in the series on global public health, Murray examines malaria control (page 161). Schattner and colleagues describe the steps that led them to a diagnosis of primary angiosarcoma of the spleen (page 163).