Missouri medicine
-
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.
-
Diagnostic and therapeutic procedures performed outside of the operating room can necessitate the administration of sedation by non-anesthesia trained personnel. Risks associated with procedural sedation can be decreased through proper patient evaluation and selection. Understanding sedative pharmacology, dosing and delivery, monitoring and airway rescue techniques are essential to safely provide sedation. Supervision of sedation policies should occur via a carefully constructed sedation policy and ongoing sedation committee evaluation and review to ensure adequate patient care.
-
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.