JAAPA-Journal of the American Academy of Physicians Assistants articles from August 2004

JAAPA-Journal of the American Academy of Physicians Assistants archives from August 2004

CMS agrees--no change to assistant-at-surgery policies.(From the AAPA: news of current interest)(Centers for Medicare and Medicaid Services)(Brief Article)
August 1, 2004... In response to a letter of concern from the AAPA concerning a General Accounting Office (GAO) report on payment policies for first assistants-at-surgery, the director of the Centers for Medicare Management (CMM) responded that the Centers for...

State reimbursement information available on AAPA Web site.(From the AAPA: news of current interest)(American Academy of Physician Assistants)(Brief Article)
August 1, 2004... AAPA members can now find state billing and coverage policies of third-party payers in one place. The AAPA has recently made its database of information on public and private payers available on the "Members Only" section of the AAPA Web site,...

Second mailing of 2004 AAPA Census Survey.(From the AAPA: news of current interest)
August 1, 2004... The second mailing of the 2004 AAPA Annual Census Survey was recently sent to PAs from whom a completed survey has not been received. If you did not fill out the survey earlier in the year, now is your chance. Policy makers use census survey...

AAPA moves to a 12-month membership cycle.(From the AAPA: news of current interest)
August 1, 2004... Graduate PAs and PA students who join the Academy or renew their AAPA membership will now receive a full, 12-month membership. In the past, the Academy operated on a "fixed membership cycle," meaning that no matter when a person joined, his or...

Resistant infections increase in patients with leg ulcers.(Journal club: the bottom line on new research)(Brief Article)
August 1, 2004... Valencia IC, Kirsner RS, Kerdel FA. Microbiologic evaluation of skin wounds: alarming trend toward antibiotic resistance in an inpatient dermatology service during a 10-year period. J Am Acad Dermatol. 2004;50:845-849. * The rate of...

Symptoms of ovarian cancer common in primary care.(Journal club: the bottom line on new research)(Brief Article)
August 1, 2004... Goff BA, Mandel LS, Melancon CH, Muntz HG. Frequency of symptoms of ovarian cancer in women presenting to primary care clinics. JAMA. 2004;291:2705-2712. * Ovarian cancer is often called the "silent killer," as symptoms do not generally...

Computer use aids development in preschoolers.(Journal club: the bottom line on new research)(Brief Article)
August 1, 2004... Li X, Atkins MS. Early childhood computer experience and cognitive and motor development. Pediatrics. 2004;113:1715-1722. * This study explored the association between access to and frequency of early computer use and cognitive and...

Look for the metabolic syndrome in obese children.(Journal club: the bottom line on new research)(Brief Article)
August 1, 2004... Weiss R, Dziura J, Burgert TS, et al. Obesity and the metabolic syndrome in children and adolescents. N Engl J Med. 2004;350: 2362-2374. * This study examined the relationship between varying degrees of obesity and the metabolic syndrome in...

The case of Ms. R.(PAQ--PA quandaries: ethics in everyday practice)
August 1, 2004... In our first case, presented in the June 2004 issue of JAAPA, we focused on the medical indications portion of the four-box approach to clinical bioethics. In this our second case, we will examine the contextual features portion. Thanks to my...

Screening for lung cancer with computed tomography: an examination of the evidence: smokers and others who are at high risk for lung cancer could benefit from a screening test that would find the cancer at an early stage, when the most effective treatments are available. How far are we from such a test?
August 1, 2004... KEY POINTS in this article * Chest radiography and sputum cytology were once considered acceptable lung cancer screening tools, until five randomized controlled studies of both showed that they produced no survival benefit. * Five...

Minimizing recurrences of genital herpes--a role for suppressive antiviral therapy: stress may contribute to recurrent episodes of genital herpes, which themselves cause more stress. Minimizing the frequency of recurrences--or eliminating them altogether--may help to break the cycle.
August 1, 2004... KEY POINTS in this article * Recurrent episodes of genital herpes can cause patients considerable psychological distress, which may itself help to provoke further episodes. * Daily suppressive antiviral therapy may be considered early...

CME post-test.
August 1, 2004... EXPIRATION DATE AUGUST 2005 AAPA members: Please take this CME Post-test online at www.aapa.org. Weber M. Screening for lung cancer with computed tomography: An examination of the evidence. JAAPA. 2004; 17(8): 14-18. Remington M....

Anthrax exposure--stay alert, act swiftly: initiating appropriate antibiotic therapy as soon as anthrax infection is suspected is not only acceptable but is also justified by the outcomes of the 2001 anthrax cases.
August 1, 2004... KEY POINTS in this article * Among the four forms of anthrax--inhalational, cutaneous, gastrointestinal, and oropharyngeal--the inhalational form is the deadliest and the cutaneous form is the most common, typically resulting from...

Preventing a fatal outcome in Addison's disease: low serum sodium levels combined with decreased extracellular volume are your key to recognizing this potentially lethal but very treatable disease.(Case Report)
August 1, 2004... KEY POINTS in this article * Addison's disease will often go undetected until the patient is subjected to physiologic stress, infection, illness, or overexertion. Symptoms usually do not appear until approximately 90% of the adrenocortical...

Steroid injections effective for knee osteoarthritis.(Poems: patient-oriented evidence that matters)(Brief Article)
August 1, 2004... Clinical question Are intra-articular corticosteroids effective for symptoms of osteoarthritis of the knee? Bottom line Intra-articular steroids produced some measure of improvement greater than placebo, with approximately 2 to 4 patients...

Topiramate prevents migraines better than placebo.(Poems: patient-oriented evidence that matters)
August 1, 2004... Clinical question Is topiramate effective in preventing migraine headaches? Bottom line Topiramate (Topamax), 100 mg or 200 mg daily, is more effective than placebo in preventing migraine headaches in patients who did not have severe...

Breast cancer screening results in overdiagnosis.(Poems: patient-oriented evidence that matters)
August 1, 2004... Clinical question Does screening identify breast cancers that would not otherwise have affected patients' mortality? Bottom line Misdiagnosis is a common risk with breast cancer screening (or any disease screening). But there is a second...

CME calendar.(Calendar)
August 1, 2004... CALIFORNIA October 22-24 28th Annual Conference. Where: Palm Springs. Provider: California Academy of PAs. Information: www.capanet.org. FLORIDA November 10-14 Second Annual Fall CME Conference. Where: Orlando. Provider:...

Case of the month: diagnostics challenges from your case files.(rheumatoid arthritis)
August 1, 2004... CASE In July 2000, Mr. F., a 57-year-old computer programmer, presented with bilateral ankle pain aggravated by weight bearing and exercise, as well as some morning stiffness. On physical exam, he had ankle joint and subtalar joint...