Identifying Risk Factors for Cardiovascular Events Among Active-Duty Service Members and Veterans Prescribed Nonsteroidal Anti-Inflammatory Drugs (NSAIDs).

Background: Oral NSAIDs are widely used analgesic medications for the treatment of musculoskeletal and inflammatory conditions. NSAIDs are associated with adverse effects that arise from COX enzyme inhibition including cardiovascular events. The combined role of patient and prescription factors associated with NSAID use on cardiovascular risk is not well characterized.

A review of the safety of buprenorphine in special populations.

Rates of opioid misuse and opioid use disorder have been increasing in recent years. Buprenorphine has emerged as an appealing medication for its use not only as treatment for opioid use disorder, but also as an opioid for chronic pain that has a ceiling effect on risks associated with opioid therapy. As other opioid prescribing decreases, buprenorphine prescribing continues to increase.

The Management of Substance Use Disorders: Synopsis of the 2021 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline.

Description: In August 2021, leadership within the U.S. Department of Veterans Affairs (VA) and U.

Frailty and stroke thrombectomy outcomes-an observational cohort study.

Introduction: Mechanical thrombectomy (MT) can improve outcomes following ischaemic stroke. Patient selection for MT is predominantly based on physiological and imaging parameters. We assessed whether people living with pre-stroke frailty had differing outcomes following MT.

Pain Management and Opioid Therapy: Persistent Knowledge Gaps Among Primary Care Providers.

Introduction: Given the opioid epidemic in the US, it is vital that clinicians who prescribe opioids for pain management to do so in an evidence-based manner, eg considering all pharmacologic and non-pharmacologic options, assessing risk of opioid use disorder prior to initiating opioids. Continuing education regarding the evidence-based prescribing of opioids is now required for US healthcare providers who prescribe opioids. A "blueprint" of the content to be included in continuing education programs was developed by the US Food and Drug Administration and updated in 2018.

COVID-19 in a rural health system in New York - case series and an approach to management.

Introduction: Many rural hospitals and health systems in the USA lack sufficient resources to treat COVID-19. St Lawrence Health (SLH) developed a system for managing inpatient COVID-19 hospital admissions in St Lawrence County, an underserved rural county that is the largest county in New York State.

Methods: SLH used a hub-and-spoke system to route COVID-19 patients to its flagship hospital.

Empowering Medical Students to Respond to Discriminatory Comments from Patients: A Just-in-Time Training Method.

This article was migrated. The article was marked as recommended. Physicians in training may experience harassment and discrimination from supervisors, consultants, colleagues, or patients and families.

Loss of Meaning at Work Associated with Burnout Risk in Academic Medicine.

Objectives: Meaning at work has been proposed as one of the key drivers of professional burnout in healthcare, but few studies have simultaneously measured this relation.

Methods: In this cross-sectional analysis of 1637 individuals at the University of Arkansas for Medical Sciences, burnout was measured using the Copenhagen Burnout Inventory work-related subscale.

Results: Meaningful work was measured using items adapted from the Work as Meaning Inventory.

Psychometric Properties of the Copenhagen Burnout Inventory in an Academic Healthcare Institution Sample in the U.S.

The Copenhagen Burnout Inventory (CBI) has demonstrated good psychometric properties among respondents in many different countries, but minimal research exists using the CBI in a U.S.-based sample.

Nonsteroidal Antiinflammatory Drugs for Acute and Chronic Pain.

Understanding nonsteroidal antiinflammatory drug (NSAID) use and impact on common rheumatic and arthritic conditions is critical to reconciling their appropriate use with their potentially serious adverse effects. NSAIDs have a profound impact on the treatment of connective tissue disorders because of their ability to address the underlying cause with specific benefits of decreasing stiffness and inflammation, and improving mobility. NSAID use is twice as common as opioid use, and inappropriate use of NSAIDs is widespread.

Using Didactics and Simulation to Enhance Comfort, Knowledge, and Skills of Nonsurgical Trainees Caring for Patients With Tracheostomy and Laryngectomy.

Introduction: Management of tracheostomy and laryngectomy is an important skill for physicians who often care for patients with multiple, comorbid, chronic medical conditions. There is little published literature on training for tracheostomy and laryngectomy care during nonsurgical specialty residencies. This project was designed to assess and improve comfort with, knowledge of, proficiency in tracheostomy and laryngectomy care.

Common elements in opioid use disorder guidelines for buprenorphine prescribing.

Objectives: This study sought to formulate a consolidation of guidelines representing best practices related to office-based opioid treatment (OBOT) of opioid use disorder (OUD) using buprenorphine. It also demonstrates how a set of evidence-based guidelines may be linked with claims data to leverage analytic techniques that drive cost-effective, positive health outcomes.

Study Design: Literature review of US and international guidelines for OBOT using buprenorphine for OUD.

Differences in burnout prevalence between clinical professionals and biomedical scientists in an academic medical centre: a cross-sectional survey.

Objective: To determine the prevalence and associated factors for personal, work-related and patient/client-related burnout in clinical professionals and biomedical scientists in academic medicine.

Design: Prevalence survey using the Copenhagen Burnout Inventory.

Setting: Mid-size academic health centre.

Emerging Trends in Pain Medication Management: Back to the Future: A Focus on Ketamine.

Providers face many challenges when faced with pain management. Pain is complex, difficult to understand and diagnose, and especially enigmatic to manage. The discovery of nonopioid agents for pain management has become particularly important considering the ongoing opioid epidemic.

Old Friends With New Faces: Are Sodium Channel Blockers the Future of Adjunct Pain Medication Management?

Unlabelled: Providers are being asked to decrease the emphasis and overutilization of long-term opioid therapy, but many are left without proper guidance on appropriate utilization of nonopioid therapies. Furthermore, therapeutic options are quite limited and many providers lack confidence in distinguishing available alternatives. When first-line therapy has failed in a patient, there is an apparent lack of knowledge on how to proceed with choosing subsequent therapy.

Cystic Dysplasia of the Testis in an Intraabdominal Undescended Testicle.

Cystic dysplasia of the testis is a rare, benign pathologic finding. We present two recent cases of cystic dysplasia of the testis to our practice. The first case involves an 11 month old male presenting with a non-palpable, intra-abdominal left testis.

The future of pain pharmacy: driven by need.

Background: Opioid prescribing has increased by ~400% over the past 20 years in the US and has been correlated with dramatic increases in accidental overdose-related deaths. Emerging evidence of serious dose-dependent side effects of opioid analgesics has led to recommendations from multinational pain societies and governments to decrease opioid doses and increase referrals to pain specialists. Demand for pain specialists of all types has increased; however, training programs for health care professionals struggle to satisfy this need.

Variability in Opioid Equivalence Calculations.

Objective: Equianalgesic conversion methods are commonly used to switch patients from one opioid to another due to suboptimal pain relief or adverse events. There is no universally accepted opioid conversion method, however, and there is often significant variability between conversion resources. As a result, patients are at risk for undertreated pain and serious adverse events.

Gross hematuria caused by nutcracker syndrome and segmental pseudoaneursym.

Nutcracker syndrome is a rare disorder characterized by extrinsic compression of left renal vein by the superior mesenteric artery and aorta. Prevalence of the disease is unknown, but presents most commonly with gross hematuria and flank pain. Diagnosis requires a high index of suspicion and treatment consists of a wide range of vascular surgical options with a more recent focus using an endovascular approach.

PARP-1 regulates epithelial-mesenchymal transition (EMT) in prostate tumorigenesis.

Poly (ADP-ribose) polymerase (PARP) is involved in key cellular processes such as DNA replication and repair, gene transcription, cell proliferation and apoptosis. The role of PARP-1 in prostate cancer development and progression is not fully understood. The present study investigated the function of PARP-1 in prostate growth and tumorigenesis in vivo.