The American journal of medicine
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Approximately 4.8 million Asian Indians were documented by the US Census Bureau in 2023. Members of this population follow different religious practices, speak a multitude of languages, and belong to different socioeconomic classes. ⋯ Immigration, financial, religious, and cultural factors uniquely impact how Asian Indians interact with their healthcare providers. Asian Indians have settled throughout the country, and it is important that clinicians familiarize themselves with the specific health concerns that affect this rapidly growing population.
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Polypharmacy, commonly defined as taking ≥5 medications, is an undesirable state associated with lower quality of life. Strategies to prevent polypharmacy may be an important priority for patients. We sought to examine the association of healthy lifestyle, a modifiable risk factor, with incident polypharmacy. ⋯ Healthier lifestyle was associated with lower risk for incident polypharmacy.
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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.