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

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

What is a physician assistant? Looking for the right answer.(Editorial)
December 1, 2008... I will soon celebrate my 30th year as a certified physician assistant. I hope that by then, or not long thereafter, people will know what that means. I look forward to the time when someone asks what I do for a living; I say, "I'm a PA"; and...

Product: Xyntha.(New Drug Information)(Drug overview)
December 1, 2008... PRODUCT: Xyntha COMPANY: Wyeth PHARMACOLOGIC CLASS: Clotting factor ACTIVE INGREDIENTS: Antihemophilic Factor (recombinant): nominally 250 IU, 500 IU, 1000 IU, or 2000 IU per vial; pwd for IV infusion after reconstitution;...

Painless growths felt like stones in her shoes.(Dermatology Digest)(Case study)
December 1, 2008... [FIGURE 1 OMITTED] * CASE A 24-year-old white female presented to the dermatology clinic with a 2-year history of growths on the soles of her feet. The growths were not painful when walking, but felt like "a bunch of stones in her...

A day in the life.(Diary entry)
December 1, 2008... [ILLUSTRATION OMITTED] Gilroy, California, is a town of about 50,000 people halfway between the urban sophistication of the Bay Area and the agricultural backdrop of several Steinbeck novels. I work at Saint Louise Regional Hospital in a...

Can you recognize a patient at risk for a hypercoagulable state? A disrupted clotting system can lead to life-threatening thrombosis. PAs can use a simple mnemonic to remember the differential diagnosis for hypercoagulable states.(CME)
December 1, 2008... Thrombotic stroke is the third leading cause of death in the United States; (1) approximately 2 million cases of venous thromboembolism (VTE) occur annually and result in up to 60,000 deaths from pulmonary embolism (PE) each year. (2) These...

Measuring the optic nerve sheath diameter in a head-injured man: measuring optic nerve sheath diameter does not involve radiation exposure and can be done quickly at the bedside during the evaluation of a patient with head injuries.(CASE REPORT)(Case study)
December 1, 2008... CASE Emergency medical services (EMS) was activated for an assault at a private residence. A basic life support ambulance was promptly dispatched to the scene, where the crew found a 44-year-old male lying supine in bed. Bystanders stated...

Increasing obesity in children and adolescents: an alarming epidemic: without better prevention and intervention, the health consequences are likely to be severe as the current generation of overweight children reaches adulthood.(Disease/Disorder overview)
December 1, 2008... Childhood obesity has become an important public health issue. Today, obesity is the most common nutritional disorder among American adults and children. (1) Over the past 30 years, the number of children with a body mass index (BMI) greater...

Patellofemoral syndrome: how to perform a basic knee evaluation: the complexity of this joint makes it more susceptible to injury. An understanding of the biomechanics of the knee is instrumental when assessing patients' injuries.(CME)(Disease/Disorder overview)
December 1, 2008... Patellofemoral syndrome (PFS), also known as anterior knee pain, is one of the most common knee disorders encountered in primary care. PFS also comprises 25% of the injuries treated in sports medicine clinics. (1,2) The knee joint is affected...

CME posttest.
December 1, 2008... EXPIRATION DATE: DECEMBER 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 $20 scoring fee for each posttest using AAPA's...

Lifestyle changes do make a difference.(SOUNDING BOARD)
December 1, 2008... We've heard a lot of talk this year about needing change in our political system. It's also time to change the model of our health care system--from a disease model to a wellness model. By many estimates, close to our entire population will be...

Caregiver use of pictograms reduces dosing errors and improves adherence.(Patient-oriented evidence that matters)
December 1, 2008... Clinical question Do pictograms help reduce medication dosing errors by caregivers of children? Bottom line Compared with usual care, caregivers of children who use pictogram-based instructions have better knowledge about the prescribed...

Prognosis of bicuspid aortic valve depends on age and severity of valve dysfunction.(Patient-oriented evidence that matters)(Brief article)
December 1, 2008... Clinical question What is the prognosis of adults with a bicuspid aortic valve? Bottom line Primary cardiac events, including surgery for valve and aortic complications, occurred in 25% of adults with newly diagnosed bicuspid aortic valves...

Lactobacilli after antibiotic treatment is effective for BV.(Patient-oriented evidence that matters)(bacterial vaginosis)(Brief article)
December 1, 2008... Clinical question Does vaginal administration of lactobacilli after antibiotic treatment for bacterial vaginosis (BV) enhance restoration of vaginal flora? Bottom line Vaginal administration of exogenous lactobacilli restores vaginal flora...

Risk of cardiovascular event in COPD is increased with inhaled anticholinergic use.(Patient-oriented evidence that matters)(chronic obstructive pulmonary disease)(Report)
December 1, 2008... Clinical question Do adults with chronic obstructive pulmonary disease (COPD) who use inhaled anticholinergics have an increased risk of a major cardiovascular event? Bottom line Adults with COPD treated with inhaled anticholinergics,...

Alexander technique reduces low back pain disability.(Patient-oriented evidence that matters)
December 1, 2008... Clinical question Can the Alexander technique reduce disability and pain in patients with chronic or recurrent low back pain? Bottom line The Alexander technique, a system of teaching self-awareness of body posture and movement, was more...

Pleural disease manifests years after asbestos exposure.(Diagnostic Imaging Review)(Case study)
December 1, 2008... [FIGURE 1 OMITTED] * CASE An 82-year-old African-American male presented to the emergency department (ED) with a complaint of fever for 3 days and a history of previous abnormal findings on chest radiograph. As part Of the patient's...

Treating vitiligo and psoriasis with the excimer laser.(... DERMATOLOGY)
December 1, 2008... Effective... Long-lasting... Quick... Easy... Painless... Covered by insurance. These words are not typically associated with most treatment options for patients with psoriasis. However, the XTRAC excimer laser, introduced in 2000,...

The art of medicine: using your heart and your head.(HUMANE MEDICINE)(Column)
December 1, 2008... When I was a PA student, I distinctly remember a comment that one of our more erudite instructors made during an afternoon lecture. This internist was discussing standard medical treatments for rheumatoid arthritis. Classmates fired back...

Case of the month.(Case study)
December 1, 2008... [FIGURE 1 OMITTED] * CASE The patient is a 74-year-old white woman who presented with complaints of longstanding anterior pelvic pain over the symphysis pubis. She reported a baseline dull and aching pain but experienced sharp,...