Annals of internal medicine
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Opioids are frequently prescribed for acute musculoskeletal injuries and may result in long-term use and consequent harms. ⋯ National Safety Council. (PROSPERO: CRD42018104968).
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The American College of Physicians (ACP) and American Academy of Family Physicians (AAFP) developed this guideline to provide clinical recommendations on nonpharmacologic and pharmacologic management of acute pain from non-low back, musculoskeletal injuries in adults in the outpatient setting. The guidance is based on current best available evidence about benefits and harms, taken in the context of costs and patient values and preferences. This guideline does not address noninvasive treatment of low back pain, which is covered by a separate ACP guideline that has also been endorsed by AAFP. ⋯ ACP and AAFP suggest against clinicians treating patients with acute pain from non-low back, musculoskeletal injuries with opioids, including tramadol (Grade: conditional recommendation; low-certainty evidence).
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Observational Study
Association Between Bariatric Surgery and All-Cause Mortality: A Population-Based Matched Cohort Study in a Universal Health Care System.
Mortality after bariatric surgery has been previously studied, but cohort selection bias, completeness of follow-up, and collection of confounders have limited the inference of results. ⋯ Ontario Bariatric Network.
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In their article, Sudharsanan and colleagues show the importance of adjusting for the age distribution of cases of coronavirus disease 2019 before doing cross-country comparisons of case-fatality rates. The editorialists explore the effect of age distribution on these rates and other determinants of between-country variation in the severity of this disease.
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There is wide variation in coronavirus disease 2019 (COVID-19) case-fatality rates (CFRs) across countries, leading to uncertainty about the true lethality of the disease. A large part of this variation may be due to the ages of individuals who are tested and identified. ⋯ Alexander von Humboldt Foundation.