Annals of internal medicine
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Multicenter Study Observational Study
Comparative Effectiveness and Safety of Bariatric Procedures for Weight Loss: A PCORnet Cohort Study.
There has been a dramatic shift in use of bariatric procedures, but little is known about their long-term comparative effectiveness. ⋯ Patient-Centered Outcomes Research Institute.
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Falls are common among older adults. One in 3 adults aged 65 years or older and 1 in 2 adults aged 80 years or older fall each year. Interventions for prevention have been identified; however, they are often not addressed in primary care practice. ⋯ Falls and the need for care from subsequent injury increase with age. They adversely affect quality of life and are a financial burden on the health care industry. As a result, risk reduction is a key focus of prevention efforts, even among very elderly persons.
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The comparative safety and effectiveness of treatments to prevent thromboembolic complications in atrial fibrillation (AF) remain uncertain. ⋯ Patient-Centered Outcomes Research Institute. (PROSPERO: CRD42017069999).
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Gout is the most common form of inflammatory arthritis. In 2012, the American College of Rheumatology (ACR) issued a guideline, which was followed in 2017 by one from the American College of Physicians (ACP). The guidelines agree on treating acute gout with a corticosteroid, nonsteroidal anti-inflammatory drug, or colchicine and on not initiating long-term urate-lowering therapy (ULT) for most patients after a first gout attack and in those whose attacks are infrequent (<2 per year). ⋯ They also disagree on the role of a gout-specific diet. Here, a general internist and a rheumatologist discuss these guidelines; they debate how they would manage an acute attack of gout, if and when to initiate ULT, and the goals for ULT. Lastly, they offer specific advice for a patient who is uncertain about whether to begin this therapy.