JAAPA-Journal of the American Academy of Physicians Assistants articles from August 2008

JAAPA-Journal of the American Academy of Physicians Assistants archives from August 2008

VA health care gets good marks, but disparities exist.(FROM THE AAPA)(Department of Veterans Affairs)(Report)
August 1, 2008... A new "health care report card" has given the Department of Veterans Affairs (VA) health care system good marks overall for delivering high quality care to patients, but it suggested that gender and racial disparities exist in the care...

Grants available for child health-related expenses.(FROM THE AAPA)(Brief article)
August 1, 2008... The UnitedHealthcare Children's Foundation (UHCCF) has announced that new grants are available to help children who need critical health care treatment, services, or equipment not covered or not fully covered by their parents' health benefit...

It's the final countdown to HFA inhaler transition.(FROM THE AAPA)(hydrofluoroalkane)(Brief article)
August 1, 2008... By December 31, 2008, 40 million asthmatic patients must switch from using chlorofluorocarbon (CFC) propellant inhalers to hydrofluoroalkane (HFA) propellant inhalers. Because zero federal dollars have been allocated to help in this effort, the...

Potions, powders, and patients: an Rx for healing.
August 1, 2008... Like many of my contemporary colleagues, I've had the privilege of watching our profession evolve from its humble beginnings to near universal acceptance. Over the past three decades, every state has enacted legislation to enable PA practice. A...

Product: Relistor.(New Drug Information)(Drug overview)
August 1, 2008... PRODUCT: Relistor COMPANY: Wyeth PHARMACOLOGIC CLASS: Opioid antagonist (peripheral) ACTIVE INGREDIENTS: Methylnaltrexone bromide 12mg/0.6mL; soln for SC inj. INDICATION: Opioid-induced constipation. PHARMACOLOGY: The use...

Product: Treximet.(New Drug Information)(Drug overview)
August 1, 2008... PRODUCT: Treximet COMPANY: GlaxoSmithKline PHARMACOLOGIC CLASS: Antimigraine (Selective 5-HT1B/1D receptor agonist + NSAID) ACTIVE INGREDIENTS: Sumatriptan (as succinate) 85mg, naproxen sodium 500mg; tabs. INDICATION: Acute...

Product: Patanase.(New Drug Information)(Drug overview)
August 1, 2008... PRODUCT: Patanase COMPANY: Alcon PHARMACOLOGIC CLASS: Antihistamine (H1-blocker) ACTIVE INGREDIENTS: Olopatadine (as HCl) 0.6% (665mcg/spray); aqueous nasal spray; contains benzalkonium chloride. INDICATION: Seasonal allergic...

What caused discolored skin on this man's legs?(Dermatology Digest)(Case study)
August 1, 2008... [FIGURE 1 OMITTED] * CASE The patient is a 74-year-old male of Asian descent with a &week history of asymptomatic bullae and associated discoloration on his legs. He had been applying a topical neomycin ointment to the areas twice...

A day in the life.(Diary entry)
August 1, 2008... It is spring in Scotland, and we are both part of the pilot project run by the National Health Service (NHS) exploring the use of physician assistants. The project is scheduled to run from October 2006 until October 2008. Initially, 12 PAs were...

Osteoporosis in men: how to treat this condition in the atypical patient: prevention and treatment guidelines for osteoporosis frequently overlook that the disease can affect men. In fact, men fare much worse than women after a fracture.(CME)(Cover story)
August 1, 2008... Commonly considered a women's health issue, osteoporosis is increasingly being recognized as a significant cause of morbidity and mortality in men. (1,2) In 2002, more than 14 million men had osteoporosis or osteopenia, defined as low bone...

A worrisome, increasingly painful breast mass in an adolescent female: a breast mass in a young woman presents a challenge to clinicians. The differential diagnosis and diagnostic studies of choice may differ from those used for an adult patient.(CASE REPORT)(Case study)
August 1, 2008... CASE A 16-year old female presented to a family medicine clinic for evaluation of increasing right breast pain associated with a right breast mass. The patient had a 2-day history of right breast pain associated with a breast mass that had...

Mild cognitive impairment: the transition to Alzheimer's disease: cholinesterase inhibitors are the most promising agents for slowing progression to Alzheimer's disease. But for how long can this progression be delayed?(CME)(Report)
August 1, 2008... The number of people in the United States aged 65 years and older increased from 12 million to 37 million from 1950 to 2005. (1) As advancing age brings an increasing probability of memory loss, PAs in primary care, as well as those in most...

CME posttest.
August 1, 2008... EXPIRATION DATE: AUGUST 2009 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 $25 scoring fee (effective September 1, 2008) for...

Juxtaposition.(IN RETROSPECT)(Column)
August 1, 2008... It has been a long, exhausting weekend at the hospital. Monday morning arrives too soon. Standing in my office, I let my fired eyes drift down the long list of patients. Most of my morning consists of routine physical examinations and...

Compression-only CPR: bystanders can still save lives.(... EMERGENCY MEDICINE)
August 1, 2008... The American Heart Association (AHA) now supports the use of compression-only cardiopulmonary resuscitation (CPR) by untrained bystanders of witnessed cardiac arrest. The Emergency Cardiovascular Care Committee of the AHA authored a science...

Position paper: HIV prevention.(Special Article)
August 1, 2008... An estimated 40,000 new individuals are infected with HIV annually in the United States. (1) While the overall number has remained stable since the early to mid 1990s, racial and ethnic minorities, women, and youth have been disproportionately...

Do thiazolidinediones increase the risk of cardiovascular events?(CAT Clinic)(Report)
August 1, 2008... A 56-year-old woman, a nonsmoker, presents to your office seeking better control of her type 2 diabetes mellitus (DM). The diagnosis was made 6 years ago. She has been controlling her diabetes with a combination of exercise (going to the gym 3...

Combined ultrasound and mammogram for high-risk women increases cancer yield.(Patient-oriented evidence that matters)(Report)
August 1, 2008... Clinical question is mammography plus ultrasound more beneficial for breast cancer detection in high-risk women than mammography alone? Bottom line In this high-risk group of women, the combination of mammography plus ultrasound resulted in...

Accelerated care decreases length of stay in joint replacement surgery.(Patient-oriented evidence that matters)(Brief article)
August 1, 2008... Clinical question Does accelerated perioperative care decrease length of stay and affect quality of life in patients undergoing primary hip or knee arthroplasty? Bottom line In this study, a program of aggressive symptom control and...

Wait-and-see approach to AOM treatment decreases antibiotic use.(Patient-oriented evidence that matters)(acute otitis media)(Brief article)
August 1, 2008... Clinical question Does a wait-and-see approach to the treatment of acute otitis media (AOM) decrease antibiotic use when a prescription is not given? Bottom line A wait-and-see approach to acute otitis media--when a prescription for...

High random glucose level is a weak predictor of diabetes.(Patient-oriented evidence that matters)
August 1, 2008... Clinical question Does an elevated random glucose level identify patients who have diabetes? Bottom line An elevated random plasma glucose level is somewhat useful for identifying patients who will subsequently be diagnosed as having...

Hypertension treatment is effective even in patients older than 80 years.(Patient-oriented evidence that matters)
August 1, 2008... Clinical question Does the treatment of hypertension in persons older than 80 years improve clinical outcomes? Bottom line Treatment of hypertension in the very elderly reduces the risk of fatal stroke and death from any cause. Previous...

A rare disease of children appears in a young man.(Diagnostic Imaging Review)(Case study)
August 1, 2008... [FIGURE 1 OMITTED] * CASE The patient is a 22-year-old white male referred to the radiology department for an initial hip injection. He was being managed by his primary care provider for a chief complaint of chronic right hip pain,...

Case of the month.(Case study)
August 1, 2008... [FIGURE 1 OMITTED] * CASE A 16-year-old female presented to the emergency department (ED) with a 3-day history of sore throat, fever, and malaise. She had discomfort in swallowing solid foods but was able to tolerate fluids. According...