Missouri medicine
-
Although the occurrence of pain in hospitalized children is common, assessment and treatment of pain presents unique challenges to practitioners who care for pediatric patients. Knowledge of drug mechanisms as well as metabolic differences in infants and children compared with adults is necessary for the successful treatment of acute and chronic pain syndromes. Recent reports of adverse events in children receiving both opioid and non-opioid analgesics have prompted re-examination of some long standing pain medication regimens and prescribing practices. We review advances in diagnosis and management of pain in pediatric populations.
-
Tobacco smoking remains the highest cause of preventable deaths worldwide. Electronic cigarettes have recently become popular as nicotine alternatives. ⋯ Electronic cigarettes are safer than conventional cigarettes and at least as safe as other approved nicotine replacement therapies. Further evidence is needed as their popularity increases amidst controversy over safety and efficacy.
-
Palliative care is multidimensional care of patients with life-limiting diseases concurrent with active disease management, together with support for their caregivers. Components of primary palliative care include management of physical and psychological symptoms and discussions about goals of care and end of life wishes. Primary care physicians and all specialty physicians should provide primary palliative care for their chronically ill patients. This paper reviews the benefits of palliative care and provides resources for its implementation.