Nutraceuticals: potential roles and potential risks for pain management.

Over the past 2 decades, the world health market has been flooded with over the counter herbal products, also known as nutraceuticals. Although many of these products are neither recommended nor prescribed by conventional medical practitioners, an increasing number of people are taking these products on a daily basis. A recent survey at Texas Tech University School of Medicine in Lubbock, Texas concluded that 32% of patients scheduled for elective surgery or pain procedures were taking one or more herbal supplements; however, 70% did not disclose these during a routine anesthetic assessment.

Perioperative anesthesia clinical considerations of alternative medicines.

The presence of nutraceutical agents in the United States health care system dictates the need for a general understanding of these agents by all physicians and health care providers. Increasing trend toward reimbursement of herbal medicines by the insurance companies and managed care organizations have further encouraged their use. Because herbs are listed under the "supplement" category by the Food and Drug Administration, the Dietary Supplement and Health Education Act establishes no protocol for standardization of the products labeled as "supplements" thereby increasing the risk for adverse effects associated with the use of these products.

Progressive systemic sclerosis: clinical manifestations and anesthetic considerations.

Progressive systemic sclerosis is a complex disease that involves multiple organ systems. Patients with progressive systemic sclerosis can pose a significant challenge for the anesthesiologist. As the disease progresses, profound musculoskeletal, gastrointestinal, pulmonary, renal, and cardiac system changes occur.

Progressive systemic sclerosis-clinical manifestations and anesthetic considerations.

Progressive systemic sclerosis (PSS), also known as scleroderma, is a complex disease that involves multiple organ systems. Patients with PSS can pose significant challenge for an anesthesiologist. As the disease progresses, profound pulmonary, gastrointestinal, renal, cardiac, and musculoskeletal system changes occur.