June 15, 2016

When considering chronic opioid therapy, physicians should weigh the risks against any possible benefits and should assess for the risks of opioid misuse, opioid use disorder, and overdose. When initiating opioid therapy, physicians should consider buprenorphine for patients at…

The evaluation of eye pain includes an assessment of visual acuity and a systematic evaluation of the conjunctiva, eyelids, sclera, cornea, pupil, anterior chamber, and anterior uvea. Further examination with fluorescein staining and tonometry is often necessary. Because pain…

An occupational disorder is an event or exposure that occurs in the workplace that causes or contributes to a condition or worsens a preexisting condition. An occupational history is important for diagnosing these conditions. Treatment of occupational disorders is generally the…

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The new CDC guideline is intended to help clinicians decide whether and how to prescribe opioids for chronic pain; offer safer, more effective care for patients with chronic pain; improve clinician-patient communication; and prevent opioid use disorder and opioid-related…

The opioid epidemic that is afflicting our nation resulted in nearly 30,000 deaths last year. Those of us responsible for health care and policy are looking at ways to stop these needless deaths. It is our professional and ethical responsibility as physicians to help bring this…

Cardiac troponin T and I are released into the bloodstream when cardiac muscle is damaged. Cardiac troponin tests have been available for decades and are the preferred biomarkers for the diagnosis of acute myocardial infarction (AMI). However, until recently, they lacked…

Suvorexant effectively increases total sleep time and decreases time to sleep onset. Because of its risk of abuse, significant incidence of next-day impairment, and high cost, it should be reserved for use in patients for whom other insomnia therapies, such as cognitive…

A man presented with unsteadiness, fever, chills, and lower extremity rash after returning from a trip to South Africa.

M.A. is a 43-year-old woman with a seven pack-year smoking history. She has no health concerns and has not visited a physician in four years. Her blood pressure and pulse are normal, and her body mass index (BMI) is 27 kg per m2. She does not have a family history of diabetes…

or patients with painful knee osteoarthritis, a high-dose combination of glucosamine hydrochloride (1,500 mg) and chondroitin (1,200 mg) was as effective in lessening pain and stiffness and improving function as celecoxib (200 mg). Other studies have not found benefit.

Letter

Patients with hypertension who are treated intensively are less likely to have major cardiovascular events, stroke, or progression of albuminuria or retinopathy than those treated less intensively, but intensive lowering had no meaningful effect on myocardial infarctions, heart…

Requiring clinicians to justify antibiotic prescribing in the permanent electronic health record and to undergo periodic peer comparisons of prescribing rates are effective interventions for reducing inappropriate antibiotic prescribing for acute respiratory tract infections…

A recently released guideline aims to establish patient-centered approaches to initiating, managing, and discontinuing opioid use. The recommendations from the Centers for Disease Control and Prevention (CDC) emphasize the serious risks and harms associated with opioids.

The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for impaired visual acuity in older adults.

Opioids (OH-pee-oyds) are medicines used to treat pain. They're also called narcotics. When you take them for more than a few days, they may cause serious problems.