JAAPA-Journal of the American Academy of Physicians Assistants articles from June 2003

JAAPA-Journal of the American Academy of Physicians Assistants archives from June 2003

Melding high-tech medicine with high-touch patient care.(Editorial)
June 1, 2003... In preparing myself to return to clinical practice after a 3 1/2-year absence, I've been pondering what skills need refreshing and which medical subjects to bone up on. Staying abreast of recent advances and maintaining technical skills are...

Leukotriene receptor antagonists less effective than steroids.(POEMs *)(Brief Article)
June 1, 2003... Clinical question In children and adults with asthma, are the leukotriene inhibitors as effective as inhaled corticosteroids? Setting Various (meta-analysis) Study design Meta-analysis (randomized controlled trials) Synopsis Two...

Vitamin D prevents fractures.(POEMs *)
June 1, 2003... Clinical question Can vitamin D, given every 4 months, prevent fractures in men and women? Setting Outpatient (primary care) Study design Randomized controlled trial (double-blinded) Synopsis The investigators enrolled 2686 men and...

Working up fever of unknown origin in adults.(POEMs *)
June 1, 2003... Clinical question What is the best approach to evaluating fever of unknown origin lasting at least 3 weeks in adults? Setting Various (meta-analysis) Study design Systematic review Synopsis Fever of unknown origin in adults is...

It is never too late: change in physical activity fosters change in cardiovascular risk factors in middle-aged women.(Cardiology)(Brief Article)
June 1, 2003... Owens JF, Matthews KA, Raikkonen K, Kuller LH. Prev Cardiol. Winter 2003;6:22-28. This study provides findings of an ongoing investigation regarding the outcomes for women who maintain of increase their physical activity as they progress...

Incidence and preventability of adverse drug events among older persons in the ambulatory setting.(Geriatric Medicine)(Brief Article)
June 1, 2003... Gurwitz JH, Field TS, Harrold LR, et al. JAMA. 2003;289:1107-1116. While more than 40% of the elderly adult population take more than five different medications per week, little systematic research has examined adverse drug events among...

Declining payments for emergency department care, 1996-1998.(Health Economics)(Brief Article)
June 1, 2003... Alexander CT, Tamayo-Sarver JH, Cydulka RK, Baker DW. Ann Emerg Med. 2003;41:299-308. Using data from 1996 and 1998, the authors described recent trends in emergency department (ED) visit charges and payments from different payer classes...

Screening men for prostate and colorectal cancer in the United States. Does practice reflect the evidence?(Oncology)(Brief Article)
June 1, 2003... Sirovich BE, Schwartz LM, Woloshin S. JAMA, 2003;289:1414-1420. Periodic colorectal cancer screening is unanimously advocated because evidence-based guidelines have shown that it substantially reduces mortality. The debate continues about...

Effectiveness of pulse oximetry screening for congenital heart disease in asymptomatic newborns.(Pediatrics)(Brief Article)
June 1, 2003... Koppel RI, Druschel CM, Carter T, et al. Pediatrics. 2003;111:451-455. Congenital heart disease is relatively common, with a prevalance of 5 to 10 per 1,000 live births, Often, these life-threatening conditions are not apparent in newborns...

Is it tension headache or migraine?(Continuing advances in headache diagnosis)
June 1, 2003... More than 14 million migraine sufferers are undiagnosed (1) 52% of all migraine sufferers in America today remain undiagnosed. (1) This is an alarming statistic, considering that migraine is more common than asthma and diabetes combined. (2)...

Assessing and managing ophthalmic emergencies.(Recertification Refresher)
June 1, 2003... First, call an ophthalmologist. Then, rapidly evaluate the patient and narrow the differential diagnosis to minimize the chance that serious, potentially permanent eye injury will occur. By definition, an ophthalmic emergency requires...

B-natriuretic peptide in the management of heart failure: although the B-natriuretic peptide assay can aid in differentiating heart failure from lung disease, the role of the recombinant form, nesiritide, in treating HF has not yet become clear.
June 1, 2003... Approximately 550,000 new cases of heart failure (HF) are added each year to an existing 4.6 million such cases in the United States. The cost of providing hospital beds supersedes all other medical expenses for these patients and continues to...

Recognizing problem gambling in primary care: the rise in legalized gambling over the past 20 years makes your ability to connect physical and metal health symptoms to pathologic gambling all the more important.
June 1, 2003... Pathologic gambling is a psychological illness generally seen in the 3rd to 6th decades of life, with a peak prevalence between ages 35 and 40 years. (1) As many as 1 million people younger than 21 years have a gambling problem. (2) The...

Weighing the risks and benefits of hormone therapy.(CSAC Special Report)
June 1, 2003... Approximately 38% of postmenopausal women the United States use hormone therapy (HT). (1) Although the FDA approved the use of estrogen alone and estrogen plus progestin combination products for relief of menopausal symptoms and prevention of...

Contemporary concepts of physician supervision.(Sounding Board)
June 1, 2003... The landscape of American medicine has changed dramatically in the past 30 years, and the practice environment for PAs has changed along with it. What remains the same, however, is our profession's unwavering commitment to practicing medicine...

CME post-test: expiration date June 2004.
June 1, 2003... Please take this CME Post-test online at www.aapa.org. Suwarno O. Assessing and managing ophthalmic emergencies. JAAPA. 2003; 16(6):18-20,23,24,27,31-33. Doehnert D. Recognizing problem gambling in primary care. JAAPA. 2003;16(6):40-44....

CME calendar.
June 1, 2003... JULY 15-19 28th Annual CME Conference Provider: Georgia Association of PAs. Location: Jekyll Island, Ga. Contact: GAPA, (888) 811-4272, (770) 640-1920. JULY 17-20 MAPA Annual Summer CME Update Provider: Missouri Academy of PAs. Location:...

Measuring autonomous provision of care.(PA Watch: brief reports on items from the medical literature relevant to PAs)
June 1, 2003... Aparasu RR, Hegge M. Autonomous ambulatory care by nurse practitioners and physician assistants in office based settings. J Allied Health Fall 2001;30:153-159. * The authors used data from the 1997 National Ambulatory Medical Care Survey...

Touching lightly on referral patterns.(PA Watch: brief reports on items from the medical literature relevant to PAs)
June 1, 2003... Fisher LW. Comparison of specially referral patterns of primary care providers. J Healthcare Management. 2002;47:197-204. * This study was prompted by the perception of difficulty among providers at 17 treatment facilities obtaining...

Anticipating a provider shortage in Indian health services.(PA Watch: brief reports on items from the medical literature relevant to PAs)(Brief Article)
June 1, 2003... Kim C. Recruitment and retention in the Navajo Area Indian Health Service. Western J Med. October 2000:173:240 244. * This cross-sectional analysis examined data from 221 questionnaires returned by physicians, NPs, and PAs who work in the...