Journal of the American Podiatric Medical Association
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J Am Podiatr Med Assoc · Mar 2004
ReviewPharmacologic management of foot pain in the older patient.
Foot pain, if not effectively managed, can result in significant disability and loss of function in older patients. This article reviews treatment strategies for acute and persistent pain, emphasizing new pharmacologic approaches. ⋯ Strategies for management of persistent pain using opioids, tricyclic antidepressants, gabapentin, and topical medications are reviewed. Common pain-management and prescribing errors are highlighted.
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J Am Podiatr Med Assoc · Mar 2004
ReviewPerioperative medical assessment of the podiatric surgical patient.
Patients undergoing podiatric surgery should receive a thorough perioperative evaluation. Medical "clearance" is no longer sufficient; rather, formal risk assessment should be performed and risk-reducing strategies provided. ⋯ Thus podiatric physicians should develop independent competence in perioperative evaluation in order to ensure optimal care for their patients. A general systematic approach is described that can be readily incorporated into clinical practice.
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Change in mental status is a common symptom in the older, hospitalized patient. Often referred to as delirium, it may be the first indication of a serious medical condition. If delirium is not identified and treated promptly, it may lead to severe complications. The podiatric physician can prevent many cases of delirium by maintaining a high level of suspicion, performing a thorough clinical assessment, and identifying older patients at risk in the hospital setting.