Archives of internal medicine
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Comparative Study
The comparative safety of analgesics in older adults with arthritis.
The safety of alternative analgesics is unclear. We examined the comparative safety of nonselective NSAIDs (nsNSAIDs), selective cyclooxygenase 2 inhibitors (coxibs), and opioids. ⋯ The comparative safety of analgesics varies depending on the safety event studied. Opioid use exhibits an increased relative risk of many safety events compared with nsNSAIDs.
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Adrenal incidentalomas are adrenal masses discovered inadvertently. We undertook this study to review the clinical characteristics of patients with adrenal incidentalomas who presented to a tertiary endocrine center in Hong Kong. ⋯ Adrenal incidentaloma is a commonly encountered clinical problem. Functional or primary malignant adrenal incidentalomas can be detected at an earlier stage during hormonal and radiological evaluations, which provides an opportunity for further management.
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Comparative Study
The comparative safety of opioids for nonmalignant pain in older adults.
Severe nonmalignant pain affects a large proportion of adults. Optimal treatment is not clear, and opioids are an important option for analgesia. However, there is relatively little information about the comparative safety of opioids. Therefore, we sought to compare the safety of opioids commonly used for nonmalignant pain. ⋯ The rates of safety events among older adults using opioids for nonmalignant pain vary significantly by agent. Causal inference requires experimental designs, but these results should prompt caution and further study.
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Sugar-sweetened beverage (SSB) taxes are increasingly being considered as a strategy for addressing the obesity epidemic. We sought to investigate the differential impact of targeted beverage taxes on higher- and lower-income households. ⋯ Large taxes on SSBs have the potential to positively influence weight outcomes, especially for middle-income households. These taxes would also generate substantial revenue that could be used to fund obesity prevention programs or for other causes.
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Shared management of surgical patients between surgeons and hospitalists (comanagement) is increasingly common, yet few studies have described its effects. ⋯ Implementation of a hospitalist comanagement service had little effect on patient outcomes or satisfaction but appeared to reduce hospital costs and improve health care professionals' perceptions of care quality. As comanagement models are adopted, more emphasis should be placed on developing systems that improve patient outcomes.