Missouri medicine最新文献

Lifestyle medicine focuses on evidence-based practices to help individuals adopt healthy behaviors. It is supported by six foundational pillars: a plant-predominant diet, regular exercise, restorative sleep, effective stress management, avoidance of risky substances, and positive social connections. These pillars offer both therapeutic and preventive benefits against chronic diseases. This article will focus on the how a plant-predominant diet, physical activity and sleep impact cardiovascular health, type 2 diabetes mellitus, weight management, and cancer. Lifestyle changes can significantly impact each patient's individual health and make a large financial impact on healthcare spending.

Medical school graduates must complete extensive supervised residency training before practicing independently. In contrast, many states allow nurse practitioners (NPs) and physician assistants (PAs) to engage in the unsupervised practice of medicine (UPM) with significantly less clinical experience. Despite decades of such legislation, data on safety, quality, and outcomes remain limited. This article reviews current evidence evaluating nonphysician UPM, finding that most studies used to support UPM legislation involve physician oversight, low-risk patients, or measure minor outcomes. Recent data suggest higher costs, increased resource use, and potential safety concerns when NPs and PAs practice independently. Malpractice trends further underscore the need for caution. Robust, high-quality research is urgently needed to assess the safety and effectiveness of nonphysician UPM.

Substance Use Disorder (SUD) is a growing public health crisis, with rising rates of morbidity and mortality, particularly due to opioids and alcohol. Despite the increasing need for treatment, access remains inadequate, highlighting the critical role of primary care physicians (PCPs) in addressing this gap. By integrating evidence-based screening, pharmacologic and non-pharmacologic treatment approaches, and stigma-reducing language, PCPs can serve as a frontline defense against the devastating impacts of SUD. Special considerations for maternal health, adolescent risk, and co-occurring mental health conditions further underscore the need for comprehensive, patient-centered care.

This retrospective study compares postoperative visual outcomes among 150 eyes treated with Light-Adjustable Lenses (LAL), toric monofocal lenses, and spherical monofocal lenses at Discover Vision Centers in Missouri and Kansas. The study included individuals with an average age of 68.9 years (25-82 years) who had cataract extraction (CE) within the past five years. Patients with prior corneal refractive procedures, including Radial Keratotomy (RK), Photorefractive Keratectomy (PRK), Laser-Assisted In Situ Keratomileusis (LASIK) or Small Incision Lenticule Extraction (SMILE) were excluded. Sixty-four percent of eyes with LALs achieved uncorrected distance visual acuity (UCDVA) better than 20/20 after the final lock-in, 46.0% with toric monofocal lenses, and 32.0% with spherical monofocal lenses. LAL-treated eyes also showed lowest residual refractive error, with a final mean spherical equivalent of 0.0 ± 0.353D, outperforming toric (0.08 ± 0.386D) and spherical monofocal lenses (0.20 ± 0.631D). These results suggest that LALs offer superior outcomes, though further research is warranted.