Buprenorphine Therapy for Opioid Use Disorder.

Buprenorphine Therapy for Opioid Use Disorder. Am Fam Physician. 2018 Mar 01;97(5):313-320 Authors: Zoorob R, Kowalchuk A, Mejia de Grubb M Abstract Opioid misuse, including the use of heroin and the overprescribing, misuse, and diversion of opioid pain medications, has reached epidemic proportions in the United States. As a result, there has been a dramatic increase in opioid use disorder and associated overdoses and deaths. Addiction is a chronic brain disease with a genetic component that affects motivation, inhibition, and cognition. Patient characteristics associated with successful buprenorphine maintenance treatment include stable or controlled medical or psychiatric comorbidities and a safe, substance-free environment. As a partial opioid agonist, buprenorphine has a ceiling effect that limits respiratory depression and adds to its safety in accidental or intentional overdose. Buprenorphine and combinations of buprenorphine and naloxone are generally well tolerated; adverse effects include anxiety, constipation, dizziness, drowsiness, headache, nausea, and sedation. Family physicians who meet specific requirements can obtain a Drug Addiction Treatment Act of 2000 waiver by notifying the Substance Abuse and Mental Health Services Administration of their intent to begin dispensing and/or prescribing buprenorphine. Medication-assisted treatment with buprenorphine is as effective as methadone in terms of treatment retention and decreased opioid use w...
Source: American Family Physician - Category: Primary Care Authors: Tags: Am Fam Physician Source Type: research

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Pulsed RF of left superior cluneal nerves Do you guys think the contrast outlines branches of the nerves, or just muscle fibers of the glutes? I am not sure either way. Patient did have strongly concordant stimulation at the lateral most 3 branches with 50hz stimulation. This guy weighs around 400lbs so U/s was not a good option.
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Pain Medicine Source Type: forums
I have a patient with several months of coccyx pain. Worse with sitting, TTP over coccyx. Otherwise normal exam. No trauma, but she has an anteriorly displaced coccyx. Failed NSAIDs and no one around me does good pelvic floor PT. I scheduled her for ganglion impar injection, but her insurance won't pay for it. They wouldn't even let me to a peer-to-peer... they just straight up said they won't cover it. Any other treatment options? I don't want to send her to a surgeon. Thanks.
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Pain Medicine Source Type: forums
Publication date: Available online 12 September 2019Source: Social Science &MedicineAuthor(s): Mengyun Lin, Qing WangAbstractGrandparents, especially grandmothers, are highly involved in childcare globally. There is a rising interest in studying the relationship between providing care and grandmothers' economic well-being in social science and health literature. However, little is known about how grandmothers' behavior responds to a government's family policy. This paper examines the effects of a large government-led formal childcare expansion on the well-being of working-age grandparents living with their adult childr...
Source: Social Science and Medicine - Category: Psychiatry & Psychology Source Type: research
Publication date: Available online 12 September 2019Source: Joint Bone SpineAuthor(s): Shoji Baba, Goro Motomura, Satoshi Ikemura, Yusuke Kubo, Takeshi Utsunomiya, Hiroyuki Hatanaka, Koichiro Kawano, Yasuharu NakashimaAbstractObjectives: To quantify the volume of bone-resorptive lesions in post-collapse osteonecrosis of the femoral head (ONFH) using micro-computed tomography (micro-CT) and assess their characteristics in post-collapse ONFH.Methods: We investigated 35 femoral heads resected from 35 patients with ONFH (20 men and 15 women; mean age, 47.2 years). On each of seven coronal high-resolution micro-CT slices of the...
Source: Joint Bone Spine - Category: Orthopaedics Source Type: research
Publication date: October 2019Source: Epilepsy &Behavior, Volume 99Author(s): Zilin Wang, Zhiwen Luo, Shunhua Li, Zhiwen Luo, Zilin WangAbstractObjectiveAnxiety is a common neurological condition often comorbid with epilepsy, with approximately 20% of patients with epilepsy exhibiting symptoms of anxiety. Despite this prevalence, accurate and efficacious tools designed to screen for anxiety specifically in patients with epilepsy have not yet been developed. The purpose of this study is to systematically review the literature and better understand this relationship.MethodsOvid MEDLINE, EMBASE, and PsyclNFO were searched...
Source: Epilepsy and Behavior - Category: Neurology Source Type: research
Source: BMJ News - Category: General Medicine Source Type: research
Source: BMJ Comments - Category: General Medicine Source Type: forums
Source: BMJ Comments - Category: General Medicine Source Type: forums
Source: BMJ Comments - Category: General Medicine Source Type: forums
Publication date: 14–20 September 2019Source: The Lancet, Volume 394, Issue 10202Author(s): Desmond O'Neill
Source: The Lancet - Category: General Medicine Source Type: research
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