Missouri medicine
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Brachial plexus injuries can be difficult to diagnose and manage. A combination of injury history, as well as radiology, electrodiagnostics, and physical exam skills can aid in this diagnosis. While some patients will regain function spontaneously, many require surgical reconstruction. Surgical options have changed with technological advances in microsurgery, and the availability of long-term outcome data following plexus reconstruction.
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Comprehensive geriatric assessment (CGA) consists of medical history taking, medication review, physical examination with special attention to sensory and neurological evaluation, and use of assessment instruments to measure cognitive, affective, functional, social, and economic status. CGA is most often beneficial when applied to frail elders at risk of functional decline. Beneficial outcomes may include decreased risks of falls, cognitive decline, and nursing home placement--in addition to improved sense of well-being and satisfaction with care.
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Despite the widespread knowledge that tobacco use causes death and debilitating disease, tobacco control efforts in Missouri remain inadequate. No other health issue combines the prevalence, lethality, and neglect of tobacco addiction. ⋯ Successful tobacco control efforts change society by creating an environment in which nonsmoking is the norm and quitting smoking is supported. This paper concludes that it is time for medicine and public health professionals to communicate, collaborate, and assume leadership in reducing the health burden of tobacco use in Missouri.