Opioid drugs, including prescription as well as heroin, have come to the national spotlight due to the unprecedented rate of overdose and addiction. The Centers for Disease Control and Prevention (CDC) has termed this problem as an "epidemic" that has reached record numbers of deaths in 2014. Approximately half of these deaths are the result from prescribed opioids. Also on the rise are the numbers of individuals who are diagnosed with chronic pain and are treated with opioids, methadone and buprenorphine. Individuals currently taking opioids for chronic pain confound the treatment of acute pain after traumatic injury. Goals of treatment include effective pain relief, prevention of opioid withdrawal, and managing the associated behavioral and psychological factors with drug addiction and dependence. The CDC has put forth guidelines on how to treat chronic pain but has yet to provide recommendations on how to treat acute pain in this unique population. The purpose of this literature review is to provide resources to treat pain, given a tolerant opioid-dependent patient.
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http://dx.doi.org/10.1097/JTN.0000000000000309 | DOI Listing |
Am Fam Physician
January 2025
Western University Schulich School of Medicine and Dentistry, London, Ontario, Canada.
Vision loss affects more than 7 million Americans and impacts quality of life, independence, social functioning, and overall health. Common and dangerous conditions causing sudden vision loss include acute angle-closure glaucoma, retinal detachment, retinal artery occlusion, giant cell arteritis, and optic neuritis. Acute angle-closure glaucoma features ocular pain, headache, and nausea; treatment includes pilocarpine eye drops, oral or intravenous acetazolamide, and intravenous mannitol.
View Article and Find Full Text PDFAm Fam Physician
January 2025
University of Kansas Medical Center, Kansas City.
Acute rhinosinusitis causes more than 30 million patients to seek health care per year in the United States. Respiratory tract infections, including bronchitis and sinusitis, account for 75% of outpatient antibiotic prescriptions in primary care. Sinusitis is a clinical diagnosis; the challenge lies in distinguishing between the symptoms of bacterial and viral sinusitis.
View Article and Find Full Text PDFJACC Case Rep
December 2024
Department of Cardiology, Division of Heart and Lungs, University Medical Centre Utrecht, Utrecht, the Netherlands.
This case highlights the prompt use of cardiac computer tomography angiography in a patient with intracardiac localization of diffuse large B-cell lymphoma and chest pain in the acute setting. Information on anatomical associations of the metastases with the coronaries serves as the foundation for subsequent therapeutic and diagnostic strategies.
View Article and Find Full Text PDFCureus
December 2024
Conservative Dentistry and Endodontics, SRM Kattankulathur Dental College and Hospital, SRM Institute of Science and Technology (SRMIST), Chengalpattu, IND.
With over two millennia of history, traditional Chinese acupuncture ranks among the most renowned forms of supplementary and other healthcare. The use of acupuncture releases endorphins and serotonin, two naturally occurring painkillers, into the nervous system and stimulates it. It also modifies how pain signals are processed and perceived.
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December 2024
Division of Pulmonary Critical Care Medicine, Charleston Area Medical Center, Charleston, USA.
Abdominal pain is a common presenting symptom among patients visiting the hospital. A wide range of differential diagnoses are associated with this presentation, some of which are more uncommon than others, and require a higher degree of clinical suspicion and radiological excellence to diagnose. Although clinicians rely on physical assessment, examining a patient who is agitated and non-cooperative sometimes limits the physical exam findings, making these diagnoses even more challenging.
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