Buprenorphine for Pain: A Narrative Review and Practical Applications
Chronic non-cancer pain affects about 20% of US adults and can significantly affect function and quality of life. Current guidelines recommend multimodal pain control. Despite risks associated with long-term opioid therapy, opioids are commonly prescribed. Buprenorphine is a partial opioid agonist with an improved safety profile compared to full agonists. Some formulations are approved for chronic pain and others for opioid use disorder. Buprenorphine is an option for patients who use chronic daily opioids for pain. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - February 8, 2024 Category: General Medicine Authors: Sara Spinella, Rebecca McCarthy Tags: Review Source Type: research
Do We Need Fasting Prior to Coronary Angiography? The CORO-NF Randomized Pragmatic Study
Similar to procedures requiring general anesthesia, current guidelines recommend fasting for 6 hours for solids and for 2 hours for liquids prior to coronary angiography, but without data supporting such recommendation. The CORO-NF study aimed at assessing whether a shorter fasting period prior to elective coronary angiography associates with improved patient satisfaction without more complications compared with the standard fasting approach. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - February 7, 2024 Category: General Medicine Authors: Pietro Paolo Tamborrino, Laura Papi, Laura Michelotti, Carlo Vitale, Paolo Caravelli, Anna Sonia Petronio, Emilia Terlizzi, Ludovica Della Volpe, Mihaela Virlan, Annamaria Sardanelli, Riccardo Morganti, Raffaele De Caterina Tags: Clinical Research Study Source Type: research
Negative Secular Trends in Medicine: Part XI: The Salaries of Physicians Compared with Professional Athletes
Over the last 8 years, I have had 10 Commentaries in this Journal on trends I thought would make it less likely that the smartest kids in the class, the ones to whom we entrust our lives, would choose a career in Medicine. The astronomical salaries of professional athletes in comparison with physicians allows me to make a variety of points. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - February 7, 2024 Category: General Medicine Authors: Robert M. Doroghazi Tags: Commentary Source Type: research
Do we need fasting before coronary angiography? The CORO-NF randomized pragmatic study
Contrast-enhanced procedures are increasingly used in radiology and cardiology, with coronary angiography as the first diagnostic approach in coronary syndromes and other cardiological conditions1-3. This procedure is minimally invasive and usually requires no sedation. The now universal implementation of iso-osmolar or hypo-osmolar non-ionic contrast agents has now reduced serious acute systemic side effects, making these agents better tolerated than previous ones for a number of side effects, including nausea, vomiting and the consequent risk of gastric aspiration4. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - February 7, 2024 Category: General Medicine Authors: Pietro Paolo Tamborrino, Laura Papi, Laura Michelotti, Carlo Vitale, Paolo Caravelli, Anna Sonia Petronio, Emilia Terlizzi, Ludovica Della Volpe, Mihaela Virlan, Annamaria Sardanelli, Riccardo Morganti, Raffaele De Caterina Tags: Clinical Research Study Source Type: research
“Negative Secular Trends in Medicine: Part XI: The Salaries of Physicians Compared to Professional Athletes”.
Over the last 8 years, I have had 10 Commentaries in this Journal on trends I thought would make it less likely that the smartest kids in the class, the ones to whom we entrust our lives, would choose a career in Medicine. The astronomical salaries of professional athletes in comparison to physicians allows me to make a variety of points. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - February 7, 2024 Category: General Medicine Authors: Robert M. Doroghazi Tags: Commentary Source Type: research
Making Medical Treatment Decisions for Unrepresented Hospitalized Patients
A 2020 joint statement by the American Thoracic Society/American Geriatrics Society (ATS/AGS) helpfully offers guidance on designing policies governing decision making for unrepresented patients who lack capacity to make their own decisions and have no identified surrogate decision maker.1 However, the statement is limited in two respects. First, it focuses on only patients in Intensive Care Units (ICU). Second, it focuses on withdrawing life-sustaining treatments. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - February 7, 2024 Category: General Medicine Authors: Ryan Marshall Felder, Kate Luenprakansit, Thaddeus Mason Pope, David Magnus Tags: Commentary Source Type: research
The Potential Influence of Firearm Violence on Physical Inactivity in the United States
Despite broad recognition of the physical inactivity pandemic, little to no progress has been made in the past decade in mitigating the problem. The current analysis builds upon previous research into the drivers of physical inactivity to assess the potential interactions with firearm violence in the United States (U.S.). (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - February 7, 2024 Category: General Medicine Authors: Thomas E. Kottke, Nicolaas P. Pronk, Colin Woodard, Ross Arena Tags: Clinical Research Study Source Type: research
Factors associated with cognitive impairment in patients with persisting sequelae of Covid-19
Quantify cognitive deficits in patients with post-acute sequelae of Covid-19 (PASC) and identify key variables related to cognitive impairment in PASC. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - February 6, 2024 Category: General Medicine Authors: Aaron Bonner-Jackson, Rohun Vangal, Yadi Li, Nicolas Thompson, Shinjon Chakrabarti, Kamini Krishnan Source Type: research
Re-analyses of 8 Historical Trials in Cardiovascular Medicine Assessing Multimorbidity Burden and its Association with Treatment Response
To examine the multimorbidity burden of clinical trial participants and assess its association with treatment response. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - February 6, 2024 Category: General Medicine Authors: Andrew J. Foy, Eric W. Schaefer, Mohammed Ruzieh, Matthew Nudy, Omaima Ali, Vernon M. Chinchilli, Gerald V. Naccarelli Source Type: research
Clinical and Laboratory Characteristics of Fatigue-dominant Long-COVID subjects: A Cross-Sectional Study
Long-COVID is defined by persistent symptoms following COVID-19 infection. Approximately 71% of individuals with long-COVID experience ongoing fatigue, post-exertional malaise, and cognitive impairments, which share pathological similarities with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). This similarity has prompted studies to explore the characteristics of long-COVID to gain a better understanding of ME/CFS. To gain insights, we investigated the clinical and laboratory characteristics of individuals with fatigue-dominant long-COVID. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - February 6, 2024 Category: General Medicine Authors: Jin-Seok Lee, Yujin Choi, Jin-Yong Joung, Chang-Gue Son Tags: Clinical Research Study Source Type: research
Endometrial Carcinoma Diagnosed in a patient with Pasteurella Bacteremia
Pasteurella multocida is a gram-negative coccobacillus classically associated with zoonotic infection. It is commonly found in the normal oropharyngeal flora of many mammals, especially cats and dogs. While most human infections with P. multocida are caused by dog or cat bites or scratches, other modes of transmission are possible1. Direct contact with pet saliva through licking of nonintact skin, kissing, or sharing food may lead to infection or even colonization. In rare instances, colonization of individuals can result in horizontal or vertical human-to-human transmission. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - February 4, 2024 Category: General Medicine Authors: Kelly Szymanski, Cody Wu, Ryan Kovacik, Dhara Patel, Shadi Memar, David Cohen Tags: Clinical Communications to the Editor Source Type: research
Painful left bundle branch block
A 76-year-old man with long-standing hypertension treated with perindopril/amlodipine combination presented with a one-month history of angina on exertion accompanied by dyspnea and pain in the left arm. A few months before, propafenone at 2 × 300 mg daily was prescribed for frequent symptomatic supraventricular extrasystoles (Figure 1). Physical examination revealed no abnormality, his blood pressure was 120/70 mmHg, and his heart rate was 60 bpm. Apart from mild hypercholesterolemia, laboratory examination showed no other abnorm ality. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - February 4, 2024 Category: General Medicine Authors: J ános Tomcsányi, Kristóf Tomcsányi Tags: ECG image of the month Source Type: research
Aerococcus urinae: an emerging, gram-positive pathogen causing urinary tract infection
Many urinary tract infections (UTIs) are caused by gram-negative rods. However, gram-positive cocci (GPC) can also cause UTIs, particularly in the elderly. Aerococcus urinae is a gram-positive coccus that forms colony clusters. Here, we present a case of an elderly woman who developed a complicated UTI caused by A. urinae. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - February 3, 2024 Category: General Medicine Authors: Yosuke Maezawa, Kazuya Nagasaki Tags: Clinical Communication to the Editor Source Type: research
Restorative Justice: The Life and Death of Jean Cowsert, MD
As the sun rose on January 30, 1967, Jean Cowsert, MD's body lay crumpled by her front steps in Mobile, Alabama. She had been working late, at the kitchen table, when a rock crashed through the window. Armed with her revolver, she went to investigate. The Mobile coroner concluded that the cause of death was a single bullet to the chest, and lacking witnesses, classified the death as an “accident.” His report and that of the police investigation disappeared. Only in 2023 did that death emerge as key to a larger story of the struggle to end segregated hospital care. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - January 30, 2024 Category: General Medicine Authors: David Barton Smith Tags: Commentary Source Type: research
Acute Kidney Injury in Patients Undergoing Both Right and Left Heart Catheterization with Coronary Angiography Vs Right Heart Catheterization Only
Recent studies have challenged the reported causal association between acute kidney injury and iodinated contrast administration, ascribing some cases to changes in renal function that are independent of contrast administration. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - January 30, 2024 Category: General Medicine Authors: Annette Min, Sumon Roy, Abhishek Chaturvedi, Ravi Choxi, Melissa Wasilewski, Pradeep Arora, Robert A. Perera, Ion S. Jovin Tags: Clinical Research Study Source Type: research
