South Dakota medicine : the journal of the South Dakota State Medical Association
-
Pain is frequently reported and often undertreated in the elderly population. In light of these concerns, it is important to examine potentially ineffective or problematic pain medications. Propoxyphene is one such agent whose efficacy and safety have been questioned by researchers, clinicians and the U. ⋯ The relevance of propoxyphene use is seen by the 7.1 percent prevalence of propoxyphene prescriptions among the South Dakota Medicare beneficiaries, which is comparable to the 6.8 percent reported in the U. S. community-based Medicare population. Therefore, it is very important to consider alternatives to propoxyphene such as APAP, nonsteroidal anti-inflammatory drugs (rare use due to adverse effects) and other opioids, when managing elderly patients with pain.
-
Review
Ambulatory blood pressure monitoring: another tool for the diagnosis and management of hypertension.
Office BP measurements are unable to detect 24-hour variability in blood pressure. ABPM is a tool that can assess BP at extended intervals, aiding in the diagnosis of white coat hypertension, masked hypertension and nighttime non-dipping status. Value exists in knowing a patient's BP variability so the appropriate treatment regimen can be determined or overtreatment can be avoided, all in an effort to decrease a patient's cardiovascular risk and potential for negative outcomes.
-
The annual number of hip fractures is expected to increase dramatically in coming decades. It is, therefore, in the best interest of the health care community to maximize its efficiency in treatment of such fractures. ⋯ It found that the hospital tended to keep auxiliary cardiac testing at a minimum, treat as many patients as possible, get patients into surgery as quickly as possible and minimize both lengths of stays and mortality. However, our study found there was room for improvement in decreasing the wait time to surgery for the patient by improving physician communication and laboratory turnaround.