Canadian family physician Médecin de famille canadien
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To help obstetric care providers, including family physicians, nurse practitioners, midwives, and obstetricians, educate patients on the risks of cannabis use in pregnancy and postpartum and its relationship to nausea and vomiting in pregnancy. ⋯ There is no known safe level of cannabis use during pregnancy or lactation. Pregnant women should be counseled regarding the risks of in utero exposure and encouraged to abstain from use in pregnancy and while breastfeeding.
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To systematically review the literature for studies comparing the efficacy of opioid analgesics for older adults (≥ 65 years) presenting to the emergency department (ED) with acute pain. ⋯ The lack of published research in this area demonstrates a considerable gap in knowledge of the comparative efficacy of opioid analgesics in the growing older adult patient population. Physicians are often uncertain in their choice of analgesia, potentially contributing to the undertreatment of pain. It is clear that well designed RCTs are urgently needed.
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To define pregnancy-related cardiovascular risk indicators and their association with developing future cardiovascular disease (CVD), and to provide guidance on how primary care providers can help lower future CVD risk through early identification and intervention. ⋯ Women with 1 or more of these pregnancy complications should be identified at the time of delivery and have formalized postpartum follow-up, including a thorough history, a physical examination, biochemical screening, counseling around lifestyle modification, and possible therapeutic intervention. The link between pregnancy complications and future CVD affords the earliest opportunity for CVD risk assessment for health preservation and disease prevention.
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To summarize information on the effects of opioid use in pregnancy on subsequent pediatric development and behaviour. ⋯ The effect of maternal opioid use on pediatric development is unclear and the evidence is inconsistent. However, opioid exposure in pregnancy does define these children as a population at risk. They might experience developmental delays compared with their peers, yet remain within population norms in cognition, fine-motor skills, hand-eye coordination, executive function, and attention and impulsivity levels.