The American journal of medicine
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Chronic noncancer pain affects about 20% of US adults and can significantly affect function and quality of life. Current guidelines recommend multimodal pain control. Despite risks associated with long-term opioid therapy, opioids are commonly prescribed. ⋯ Buprenorphine is an option for patients who use chronic daily opioids for pain. This review summarizes the literature on buprenorphine's efficacy and safety for chronic pain and provides recommendations to generalists on initiation, titration, and monitoring of buprenorphine-based pain treatment. We also discuss a communication approach when considering buprenorphine for pain.
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Comparative Study
Acute Kidney Injury and Patients Undergoing Both Right and Left Heart Catheterization with Coronary Angiography Versus Right Heart Catheterization Only.
Recent studies have challenged the reported causal association between acute kidney injury and iodinated contrast administration, ascribing some cases to changes in renal function that are independent of contrast administration. ⋯ The incidence of changes in creatinine consistent with acute kidney injury at 3 days and of nephropathy at 3 months was not significantly different in patients undergoing R&LHC compared with patients undergoing RHC only. This supports the thesis that not all changes in creatinine after procedures involving administration of contrast are caused by the contrast.
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Despite broad recognition of the physical inactivity pandemic, little to no progress has been made in the past decade in mitigating the problem. The current analysis builds upon previous research into the drivers of physical inactivity to assess the potential interactions with firearm violence in the United States. ⋯ In conclusion, the United States faces myriad health and societal challenges. Unhealthy lifestyles and gun violence are two of the leaders. The current analysis in conjunction with previous findings demonstrates that solving these challenges by interacting, create complexity to finding solutions that has not been thoroughly considered.