Missouri medicine
-
Recent years have seen substantial shifts in cultural attitudes towards marijuana for medical and recreational use. Potential problems with the approval, production, dispensation, route of administration, and negative health effects of medical and recreational marijuana are reviewed. Medical marijuana should be subject to the same rigorous approval process as other medications prescribed by physicians. Legalizing recreational marijuana may have negative public health effects.
-
Parkinson disease is the second most neurodegenerative disease, after Alzheimer disease, that affects up to two million Americans, the overwhelming majority of whom are aged 60 and older. The changing demographics of the country place more Americans at risk for Parkinson disease (PD) than ever before. Primary care physicians treat the majority of PD patients in the United States. Here I review diagnosis and treatment strategies for idiopathic Parkinson disease in the elderly adult.
-
In the U. S., there is a growing percentage of chronic pain patients requiring surgery. ⋯ Peri-surgical pain management often requires continuation of previously prescribed chronic pain modalities and careful selection of multimodal acute pain interventions. This article will provide a broad overview of chronic pain, definitions, and current recommendations for the treatment of perioperative pain in patients maintained on opioid therapy.
-
Acute pain is a complex process involving activation of nociceptors, chemical mediators and inflammation. Medications can be used to target each of the key elements within the pain pathway and eliminate or reduce the sensation of pain. Pain management begins, when possible, prior to the tissue trauma and continues throughout the perioperative period. When acute pain is appropriately managed, patient's clinical outcomes and satisfaction are improved.