Pain medicine : the official journal of the American Academy of Pain Medicine
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Non-steroidal anti-inflammatory drugs (NSAIDs) are some of the most commonly used medications due to their well-known analgesic, anti-inflammatory, and antipyretic actions. Due to their known benefits and inherent risks, there have been multiple guidelines from national professional societies that suggest appropriate use to provide both maximum benefit and mitigate risk of adverse events, particularly in older individuals. ⋯ Literature-based and professional society guidelines provides clinicians with means optimize efficacy and safety of NSAIDs in clinical practice. Summary recommendations are provided in this review.
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Despite a growing number of women seeking medical care in the veterans affairs (VA) system, little is known about the characteristics of their chronic pain or the pain care they receive. This study sought to determine if sex differences are present in the medical care veterans received for chronic pain. ⋯ Sex differences are present in the care female veterans receive for chronic pain. Further research is necessary to understand the etiology of the observed differences and their associations with clinical outcomes.
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Nonsteroidal anti-inflammatory drugs (NSAIDs) are principal pharmacologic agents for symptom relief in patients with arthritis and other inflammatory conditions. Cardiovascular risk is associated with all NSAIDs, excluding aspirin. Selective inhibition of cyclo-oxygenase-2 (COX)-2 could produce a relative reduction in endothelial production of prostacyclin, while leaving the platelet production of thromboxane A2 (TXA2 ) intact. It has been speculated that this imbalance of homeostatic prostanoids might increase the risk for thrombotic events. The goal of this review is to provide physicians guidelines to mitigate cardiovascular and nephrotoxicity of NSAIDs. ⋯ It is of paramount importance to consider individual health factors when choosing therapy with NSAIDs.
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Review
A systematic review of the effectiveness of CT-guided, lumbar transforaminal injection of steroids.
To determine the effectiveness and safety of computerized tomography (CT) guided, lumbar transforaminal injection of steroids in the treatment of radicular pain. ⋯ The evidence-base for CT-guided lumbar transforaminal injection of steroids is meagre. This intervention is not more effective than fluoroscopy-guided injections and is not demonstrably safer.