Opioid Use and Its Relationship to Cardiovascular Disease and Brain Health: A Presidential Advisory From the American Heart Association

Circulation. 2021 Aug 19:CIR0000000000001007. doi: 10.1161/CIR.0000000000001007. Online ahead of print.ABSTRACTThe misuse of opioids continues to be epidemic, resulting in dependency and a recent upsurge in drug overdoses that have contributed to a significant decrease in life expectancy in the United States. Moreover, recent data suggest that commonly used opioids for the management of pain may produce undesirable pharmacological actions and interfere with critical medications commonly used in cardiovascular disease and stroke; however, the impact on outcomes remains controversial. The American Heart Association developed an advisory statement for health care professionals and researchers in the setting of cardiovascular and brain health to synthesize the current literature, to provide approaches for identifying patients with opioid use disorder, and to address pain management and overdose. A literature and internet search spanning from January 1, 2012, to February 15, 2021, and limited to epidemiology studies, reviews, consensus statements, and guidelines in human subjects was conducted. Suggestions and considerations listed in this document are based primarily on published evidence from this review whenever possible, as well as expert opinion. Several federal and institutional consensus documents and clinical resources are currently available to both patients and clinicians; however, none have specifically addressed cardiovascular disease and brain health. Although strateg...
Source: Circulation - Category: Cardiology Authors: Source Type: research

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AbstractData regarding COVID-19 vaccine efficacy and adverse events  (AE) in patients with autoimmune and inflammatory rheumatic diseases (AIIRD) have been published recently although these mostly include the mRNA vaccines (Pfizer-BioNTech and Moderna) and the ChAdOx1 nCoV-19/AZD1222 (Oxford-AstraZeneca). This research aimed to study the prevalence of AE presented with six different SARS-CoV-2 vaccines {ChadOX1 nCoV-19 (AZD1222), Ad5-nCoV2, Ad26.COV2.S, mRNA-1273, BNT162b2, and CoronaVac} in Mexican patients with AIIRD. We performed a cross-sectional study about vaccine history. Two hundred and twenty five consecutive...
Source: Rheumatology International - Category: Rheumatology Source Type: research
AbstractThis case report concerns a 51-year-old woman with a 6-month history of severe right heel pain diagnosed as plantar fasciitis (PF) treated with intra-arterial infusion of imipenem/cilastatin (IPM/CS) through a 24G indwelling needle directly inserted into the posterior tibial artery (PTA). Angiography of the indwelling needle immediately before the infusion of IPM/CS demonstrated an increased number of abnormal vessels at the calcaneal attachment of theplantar fascia. Two procedures were planned: The first procedure was performed, and the second was performed 1  month after the first. A week after the first tre...
Source: CardioVascular and Interventional Radiology - Category: Radiology Source Type: research
By ETIENNE DEFFARGES According the 2019 Bloomberg Healthiest Country Index, the U.S. ranks 35th out of 169 countries. Even though we are the 11th wealthiest country in the world, we are behind pretty much all developed economies in terms of health. In the Americas, not just Canada (16th) but also Cuba (30th), Chile and Costa Rica (tied for 33rd) rank ahead of us in this Bloomberg study. To answer this layered question, we need to look at the top ranked countries in the Bloomberg Index: From first to 12th, they are Spain; Italy; Iceland; Japan; Switzerland; Sweden; Australia; Singapore; Norway; Israel; Luxe...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Economics Health disparities Health Policy American healthcare Etienne Deffarges Mediterranean Diet Opioids world health Source Type: blogs
Sandra Maddock, president &CEO of IMARC Research With new technology and groundbreaking medical device news making headlines every day, there has never been a more exciting time to be involved in clinical research. So much is changing so fast — faster than at any other time in the history of clinical research. At IMARC Research, we take pride in innovation. We’re constantly monitoring medical device trends and regulatory updates to determine how they might apply to the clinical research teams who enlist our oversight. We know this will be a transformational year, so we’re excited to kick off 2019...
Source: Mass Device - Category: Medical Devices Authors: Tags: Blog IMARC Source Type: news
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. The grayish white zippered sheet being laid on the patient stretcher was the first clue. It was the middle of a busy day at the hospital. I had been taking care of several patients for their elective surgeries in the operating room (OR) when the overhead paging system chirped: “Code Blue ER, ETA 2 minutes.” I walked over to the emergency department (ED), expecting to hear about an elderly patient who had suffered a stroke or heart attack, but instead was faced with an unresponsive overdose patient. Continue reading ...
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Physician Emergency Medicine Pain Management Source Type: blogs
Ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs) like naproxen are and have been the go-to “benign” pain medication for doctors and patients alike. Why? They aren’t addictive, and it’s not easy to overdose. Serious side effects like gastrointestinal ulcers and bleeding seemed to be limited to high doses taken for longer periods or time, or to people with significant medical problems. Even before the era of the opioid epidemic, it was raining NSAIDs, across the country. In 2004, the manufacturer of the NSAID Vioxx pulled it from the market because the drug was associated with serious...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Back Pain Drugs and Supplements Headache Health Heart Health Injuries Pain Management Source Type: blogs
Conclusion Evaluating the potential harms of a commonly used drug—especially a complex substance like marijuana—is a challenging but vital task. Fully informed awareness of both the potential and proven benefits and the potential and proven harms of marijuana are necessary in order to have rational discussions with patients, teens, and decision makers regarding marijuana use. Based on a review of the current literature, we suggest the mnemonic DDUMB (dependence, driving, underachievement, mental illness, and “bad to worse”) as a tool that captures several of the more well-supported, brain-based risk...
Source: Innovations in Clinical Neuroscience - Category: Neuroscience Authors: Tags: Behavioral and Cognitive Neurology Child Adol Mental Disorders Cognition Current Issue Medical Issues Neurologic Systems and Symptoms Psychiatry Psychopharmacology Review Substance Use Disorders Cannabis dependence drug-related har Source Type: research
By JOSEPH KRAININ, M.D. His voice had the unusual ability to convey both aggressive muscularity and profound vulnerability. Scott Weiland and Stone Temple Pilots were icons of my adolescence. Personally, my memory of Mr. Weiland will always be inextricably linked with “Plush,” that initial hit single which, upon first listen, instantly captivated me and thousands of other kids like me. During my high school days, “Plush” was elevated to the highest sonic status possible, joining Metallica’s “Enter Sandman” and Pearl Jam’s” Black” as an essential component of our f...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: THCB Pain Scott Weiland Stone Template Pilots Source Type: blogs
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