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

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

Sex in the golden years: if you don't ask, they won't tell.(Editorial)
February 1, 2009... While I was having coffee with a good friend, our conversation wandered into dose-girlfriend talk. Now that we're both in our 60s, we find that the topic of sex, once interspersed with memories of passionate days, now drifts into more winsome...

Physician assistant competencies move to front and center.(Editorial)
February 1, 2009... This year in JAAPA, you will notice a change in the way the competencies for the physician assistant profession are addressed. In 2005, all four national physician assistant organizations developed and endorsed a set of competencies for the...

New drug information.(Drug overview)
February 1, 2009... FROM THE EDITORS OF THE PAPR PRODUCT: Banzel COMPANY: Eisal PHARMACOLOGIC CLASS: Antiepileptic (triazole) ACTIVE INGREDIENTS: Rufinamide 200mg, 400mg; scored tabs. INDICATION: Adjunctive treatment of seizures in...

Does this man have genital warts?(Dermatology Digest)
February 1, 2009... [FIGURE 1 OMITTED] * CASE A 26-year-old man self-referred himself to the dermatology clinic for evaluation of "genital warts" that had not responded to OTC wart medication. The lesions had been present for several years unchanged,...

A day in the life.(Diary entry)
February 1, 2009... [ILLUSTRATION OMITTED] My deployment has me stationed at a forward operating base (FOB) near the city of Jalalabad, Afghanistan. My primary responsibilities are to mentor an Afghanistan National Army (ANA) doctor/hospital commander and his...

Ovarian cancer: the search for an accurate screening technique: few cases of ovarian cancer are diagnosed in the early stage; however, new modalities promise earlier detection and a better prognosis for patients.(CME)
February 1, 2009... Ovarian cancer is known to be an extremely aggressive and deadly disease that affects women worldwide. The disease accounts for 14,300 deaths in the United States each year and is ranked fourth in cancer deaths among women. (1) The prevalence...

What condition caused the cyclical decompensation in this child? Mitochondrial cytopathy refers to a group of disorders caused by a genetic defect that affects cell metabolism. A lack of unique symptoms makes the diagnosis difficult.(CASE REPORT)(Case study)
February 1, 2009... CASE The parents of an 8-week-old white male brought the infant to the hospital after noticing him making apparent abnormal hand movements. At birth, the infant was full term; weight, 8 lb 12 oz; length, 21 inches; Apgar scores, 7 and 9....

Using practice analysis to improve the certifying examinations for PAs.(RESEARCH REPORT)(Survey)
February 1, 2009... A practice analysis is a tool that bridges knowledge and clinical performance into a format that permits assessment. For physician assistants (PAs), this contributes to a psychometrically sound examination administered by the National...

Coil or dip? Current trends in the treatment of intracranial aneurysms: if an aneurysm bursts, the results can be devastating. Timely diagnosis and treatment can improve the quality of life for patients who survive this cerebrovascular event.(SURGICAL REVIEW)(Case study)
February 1, 2009... Subarachnoid hemorrhage (SAH) from a burst intracranial aneurysm (ICA) is an overwhelming and catastrophic event that strikes without warning during the most productive years of life. Heralded by the onset of a severe and excruciating headache,...

Otitis externa: treatment is easy, but a missed diagnosis can be fatal: acute OE rarely requires systemic antibiotic therapy. However, early indentification of the causative pathogen and expedient care are needed for effective resolution.(CME)(Report)
February 1, 2009... Otitis externa (OE) is a common ambulatory-care condition. Acute OE manifests from bacterial (90% of cases) or fungal (10% of cases) infections and affects four in 1,000 persons in the United States annually. (1) Chronic OE is often the result...

CME posttest.
February 1, 2009... EXPIRATION DATE: FEBRUARY 2010 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 server. Payment may be made using Visa,...

ACI of the knee for patients with cartilage injuries.(... ORTHOPEDICS)(Autologous chondrocyte implantation)(Report)
February 1, 2009... Articular cartilage defects in the knee present a difficult problem for orthopedic surgeons (see Figure 1). Autologous chondrocyte implantation (ACI) is a cartilage restoration technique that can provide a longer term solution for cartilage...

PAs in Australia: a new international stage.(SOUNDING BOARD)(physicians' assistants)
February 1, 2009... As physician assistants become increasingly visible and important to health care systems worldwide, more countries are showing interest in learning about the PA role and how the profession might effectively work for them. Australia is no...

Long-term erythromycin therapy decreases COPD exacerbations.(Patient-oriented evidence that matters)(chronic obstructive pulmonary disease)(Clinical report)
February 1, 2009... Clinical question Does the long-term use of erythromycin reduce exacerbations in patients with moderate to severe chronic obstructive pulmonary disease (COPD)? Bottom line In patients with moderate to severe COPD, twice daily erythromycin...

ACP guideline: new antidepressants are similarly effective.(Patient-oriented evidence that matters)(American College of Physicians)
February 1, 2009... Clinical question Of the new (noncyclic) antidepressants, which one should be used first in patients with major depressive disorder? Bottom line Citing similar effectiveness and effect on quality of life, this guideline from the American...

Ethical issues surrounding deep brain stimulation in Parkinson's disease.(PA QUANDARIES)(Case study)
February 1, 2009... Deep brain stimulation (DBS) is an elective neurosurgical treatment for patients with advanced Parkinson's disease (PD) who suffer from symptoms refractory to medication. DBS requires an invasive procedure in which, first, brain electrodes are...

Knee pain and an abnormal radiograph in a skier.(Diagnostic Imaging Review)(Case study)
February 1, 2009... [FIGURE 1 OMITTED] * CASE The patient is a 20-year-old male who fell while downhill skiing. He could not recall the exact mechanism of injury. The patient developed immediate pain and swelling in his left knee after the fall and was...

'Like a bridge over troubled water, I will lay me down".(HUMANE MEDICINE)
February 1, 2009... Passing over the bridge on my way to work under grey morning skies, I glanced out over the turbulent water. Swollen from overnight rains, raging waves the color of coffee milk danced down the wide expanse below the bridge. Only time would tame...

Case of the month.(Case study)
February 1, 2009... [FIGURE 1 OMITTED] * CASE A 21-year-old Hispanic woman, 29 weeks pregnant, presents to the emergency department (ED) with a persistent headache and subsequent seizures. Her headache began 1 week earlier with pain predominantly on the...

Primary care management of type 2 diabetes: data from a performance improvement program.(GETTING TO GOAL IN GLYCEMIC CONTROL: Practical Strategies for Improved Outcomes in Type 2 Diabetes)
February 1, 2009... NATIONAL PERFORMANCE GAPS IN DIABETES CARE Numerous reports in the medical literature support the need for practice improvements in identifying and caring for patients with type 2 diabetes. According to the Physician Consortium for...

Update on the optimal management of patients with type 2 diabetes.(GETTING TO GOAL IN GLYCEMIC CONTROL: Practical Strategies for Improved Outcomes in Type 2 Diabetes)(Disease/Disorder overview)
February 1, 2009... There is a worldwide epidemic of diabetes mellitus, affecting up to 170 million individuals; the incidence is expected to double in the next 20 years. (1,2) Diabetes is the 7th leading cause of death in the United States. Currently, more than...

Case study: long-term management of a middle-aged woman with type 2 diabetes.(GETTING TO GOAL IN GLYCEMIC CONTROL: Practical Strategies for Improved Outcomes in Type 2 Diabetes)
February 1, 2009... Edna is a 55-year-old substitute teacher. She first came to see you 4 years ago. At that time, at 5'6", she weighed 180 lb and had a body mass index (BMI) of 29. Her fasting plasma glucose (FPG) was 100 mg/dL, and her A1C level was 6.5%. Her...

CME/CE post-test.(GETTING TO GOAL IN GLYCEMIC CONTROL: Practical Strategies for Improved Outcomes in Type 2 Diabetes)
February 1, 2009... All post-tests for this monograph must be submitted online. The scoring service is provided at no charge to current Fellow members of AAPA. Others must submit a $25 scoring fee for each post-test using AAPA's secure server. Payment may be made...

8th International Symposium brings together Soy experts.(Conference news)
February 1, 2009... The International Soy Symposium held recently in Tokyo, was the eighth in a series that began in 1994. During the interim, there has been a remarkable improvement in consumer attitudes toward soyfoods and a corresponding increase in U.S. soy...

Soy and bone health.
February 1, 2009... The estrogen-like effects of isoflavones have, not surprisingly, led to considerable interest in the effects of soy on bone mineral density (BMD) in menopausal women. (1-3) The results of Italian research presented at the symposium by Francesco...

Soy and breast cancer.(Report)
February 1, 2009... For almost 20 years the relationship between soyfood intake and breast cancer risk has been rigorously investigated in the form of animal, clinical, and epidemiologic studies. (1) Much of the interest in this relationship is because the soybean...

Menopausal symptoms.(Report)
February 1, 2009... The first clinical study to examine the ability of an isoflavone-rich product to alleviate hot flashes in postmenopausal women was published in 1995. (1) Since that time more than 50 such studies have been published, but most reviews to date...

Mineral status.(Report)(Brief article)
February 1, 2009... The poorer bioavailability of iron and zinc from plant foods and the lower content of the latter in vegetarian diets have raised questions about the impact of substituting soyfoods for animal products on iron and zinc status. (1,2) Because...

Symposium post script.(Brief article)
February 1, 2009... Soyfoods, in large part because they are a rich source of isoflavones, continue to attract a remarkable amount of attention from the research community although soy protein is also of most interest. By the number of younger investigators...

Cholesterol reduction.(Report)
February 1, 2009... The first clinical study demonstrating soy protein lowers cholesterol was published in 1967, (1) but not until 1995, when a meta-analysis that included 38 trials found that soy protein lowered low-density-lipoprotein-cholesterol (LDLC) by...

Soy and reproductive health in men.
February 1, 2009... Most isoflavone-related clinical research has focused on postmenopausal women but there is also interest in understanding the effects of soy on levels of reproductive hormones, especially testosterone, in men. The reason for this interest is...