JAAPA-Journal of the American Academy of Physicians Assistants articles from April 2009

JAAPA-Journal of the American Academy of Physicians Assistants archives from April 2009

Finding the place where both truth and hope reside.(Editorial)
April 1, 2009... In Greek mythology, Pandora was the first woman on earth. The gods endowed her with many talents-hence her name, Pandora, meaning "all-gifted" She received a box from Zeus that she was forbidden to open under any circumstance. Impelled by her...

Product: Acanya.(New Drug Information)(Drug overview)
April 1, 2009... PRODUCT: Acanya COMPANIES: Coria and Arcutis PHARMACOLOGIC CLASS: Lincosamide antibiotic + antibacterial/ keratolytic ACTIVE INGREDIENTS: Clindamycin (as phosphate) 1.2%, benzoyl peroxide 2.5%; gel. INDICATION: Topical...

An enlarging lesion on the knee of a teenager.(Dermatology Digest)
April 1, 2009... [FIGURE 1 OMITTED] CASE A 16-year-old boy came to the dermatology clinic seeking evaluation of a lesion on his knee. The boy's parents had first noticed skin changes in the area about 2 years before, when the boy was 14 and just...

A day in the life.(Diary entry)
April 1, 2009... [ILLUSTRATION OMITTED] In addition to practicing in emergency medicine, I am a Fellow of the Academy of Wilderness Medicine, Wilderness Medical Society, and I volunteer with a search and rescue (SAR) team that responds to incidents all...

Acute respiratory tract infections: when are antibiotics indicated? The appropriate use of antibiotics is an important tool in the battle against antibiotic resistance. PAs can educate themselves and their patients about when to use these drugs.(CME)(physicians' assistants)
April 1, 2009... [FIGURE 1 OMITTED] Inappropriate prescribing of antibiotics for acute respiratory tract infections contributes to the increasing prevalence of antibiotic resistance. In this second article of a series on antibiotic resistance, the authors...

Laparoscopic Roux-en-Y bariatric gastric bypass in an adolescent: an obese teenager's gastric bypass results not only in weight loss and a healthier lifestyle but also in resolution of her type 2 diabetes and other comorbidities.(CASE REPORT)(Case study)
April 1, 2009... CASE A 16-year-old white female with morbid obesity presented to the bariatric surgery center for an informational discussion about bariatric surgery and consultation about the laparoscopic Roux-en-Y procedure specifically. Standing 5 ft 8...

Immigrant health care in the United States: what ails our system? Current policies regarding health care for the growing immigrant population can result in delayed diagnoses, more disease in the community, and higher morbidity and mortality.
April 1, 2009... Is everyone in the United States entitled to health care? If so, how much does each person deserve? If not, how should it be allocated? And, perhaps most crucially, who pays for it? These questions have been raised in presidential debates,...

The evaluation of liver dysfunction: when to suspect portal hypertension: this condition is a life-threatening disease process. Management largely focuses on treating the complications and avoiding further injury to the liver.(CME)(Report)
April 1, 2009... A 58-year-old man presented to the emergency department in 1997 with an upper GI hemorrhage and was acutely treated for the bleeding. He was found to have esophageal varices caused by cirrhosis-related portal hypertension. Within 3 months, the...

CME posttest.
April 1, 2009... EXPIRATION DATE: APRIL 2010 All posttests must be submitted online to AAPA. The CME scoring service is provided at no charge to current Fellow members of AAPA. Others must submit a $20 scoring fee for each posttest using AAPA's secure...

Tips before you take that new job.(SOUNDING BOARD)
April 1, 2009... I have been in clinical practice for 9 years now, and along the way I have compiled some priceless pointers on how to avoid a potentially disastrous job. Of course, this means that I have accepted a couple of them in my day, but please do learn...

Is metformin beneficial for the treatment of infertility in women with PCOS?(Critically Appraised Topic)(polycystic ovary syndrome)(Report)
April 1, 2009... A 26-year-old female comes to your office complaining of an inability to conceive for the past year despite regular, unprotected intercourse. She has not been evaluated for infertility in the past. Her medical history is significant for...

Meaningful progress in therapy options.(... COLORECTAL CANCER)
April 1, 2009... Colorectal cancer (CRC) is the second most common cancer, with Americans carrying a lifetime risk of 5.29%. (1) In its most recent report, the National Cancer Institute (NCI) reveals a steady improvement in 5-year survival rates. Released in...

The physician assistant experience in Scotland.(Research Corner)
April 1, 2009... When the PA profession was established in the United States in the late 1960s and early 1970s, studies were conducted and published to document the impact of PA practice. For the most part, these studies involved small sample sizes and...

Pneumococcal polysaccharide vaccine has limited efficacy in adults.(Patient-oriented evidence that matters)(Report)
April 1, 2009... Clinical question Is the pneumococcal polysaccharide vaccine (PPV) effective for adults? Bottom line The evidence to support the efficacy of PPV in adults is limited at best. The best studies have not shown a consistent benefit,...

Oral corticosteroids not recommended for viral wheeze in younger children.(Patient-oriented evidence that matters)
April 1, 2009... Clinical question Do corticosteroids improve outcomes in young children with wheezing associated with a viral infection? Bottom line Oral corticosteroids should not be routinely used for the treatment of children aged 10 months to 5 years...

Terminating your professional relationship with a patient.(PA QUANDARIES)
April 1, 2009... How often have you dismissed a patient from your care? Why? How often have you wanted to? What are the ethical and legal issues surrounding this question? The following case includes an unexpected twist to the problem of terminating a...

Severe pain in the shoulder with no history of trauma.(Diagnostic Imaging Review)(Case study)
April 1, 2009... [FIGURE 1 OMITTED] * CASE A 37-year-old Hispanic woman was referred to our clinic for insidious severe pain in her left shoulder. During history-taking, she noted that she awoke one morning with the pain. She did not recall...

An early morning mist and the wing of a prayer.(HUMANE MEDICINE)(Column)
April 1, 2009... This morning the mist hangs heavy outside. In its wake, last night's thundershower left a detached coolness in the air, and with the coolness came the fog. Shrouded in mist, the maples in the backyard stand silhouetted in the early morning...

Case of the month.
April 1, 2009... [FIGURE 1 OMITTED] * CASE A 72-year-old white male presented with burning pain in his fight leg that had been worsening for several years. The pain radiated from his lower back, across his buttocks, and down into his posterior right...