JAAPA-Journal of the American Academy of Physicians Assistants articles from June 2006

JAAPA-Journal of the American Academy of Physicians Assistants archives from June 2006

AAPA members elect Bennett, Fichandler, Delaney, Pagels.(FROM THE AAPA: News of current interest)(American Association of Surgical Physician Assistants)(Brief article)
June 1, 2006... AAPA members have elected Gregor Bennett as AAPA president elect for 2006-2007. A past AAPA director at large (2001-2005) and chair of the Board of Directors (2004-2005), Bennett ran against Robert L. Wooten, current secretary of the board, and...

AAPA to fight Medicare consultation policy change.(American Academy of Physician Assistants)
June 1, 2006... On December 20, 2005, the Centers for Medicare and Medicaid Services (CMS) issued Transmittal 788, which clarified the agency's coverage policy on consultations. The transmittal clearly reaffirmed that PAs are covered for either requesting or...

PA ranked fifth best job in America.(American Academy of Physician Assistants)(Brief article)
June 1, 2006... Money magazine and Salary.com, a leading provider of employee compensation data and software, recently ranked the best jobs in America. Physician assistant ranked fifth on the list and first among health professions. One attractive aspect...

Correction.(Correction notice)
June 1, 2006... The January 2006 article on nonsurgical management of osteo-arthritis of the knee stated that when obtaining the AP view, the technician should place the patient in a standing (or lying) position with knees bent at a 45-degree angle. The...

I (still) want to be a PA!(physician assistants)(Editorial)
June 1, 2006... There was an interesting confluence of news items in the March 30th issue of AAPA News. Perhaps you noticed it too. One headline announced the passing of Malcolm Beinfield, MD, (1) and another highlighted the opening of the Eugene A. Stead, Jr....

A day in the life: how PAs live and work.(physician assistants)(Chronology)
June 1, 2006... I began my career as a PA in 2004, and my first job was in emergency medicine. I stayed for about 6 months, until I realized that I wanted to pursue a career in surgery. I'm also a paramedic and I enjoy taking care of the prehospital...

Paying for performance: an American PA in Britain and the NHS quality outcome framework.(physician assistants, United Kingdom National Health Service )(Column)
June 1, 2006... AAPA has published a policy paper on quality incentive programs, also known as pay-for-performance programs. (1) The Quality Care Committee has outlined necessary and preferred aspects of these programs and has advised of skills that PAs will...

Benign anorectal disease: an update on diagnosis and management: when a patient comes to your office with anorectal complaints, chances are that they have progressed to the point of extreme discomfort. this article will help you prepare for just such a visit.(Disease/Disorder overview)
June 1, 2006... For any anorectal problem, performing a complete history and physical examination is essential. Ask the patient about bleeding, pain, discharge, swelling, changes in bowel habits, pruritus, prolapse, fever, incontinence, prior sexual contacts,...

Evaluating eosinophilia in the primary care setting: don't rely on specialists to do the tests that you should do before your patient is referred. Eosinophilia can accompany many and varied signs and symptoms, but assessment always begins with basic testing.(physician assistants)
June 1, 2006... Approximately 30 diseases are capable of causing an eosinophilia of greater than 600/[micro]L of blood. Some of these diseases are relatively common and within the realm of primary care evaluation, while others are rare and difficult to...

CME post-test.
June 1, 2006... EXPIRATION DATE JUNE 2007 AAPA members: Please take this CME post-test online at www.aapa.org. Gavin J, Cuffy M, Abir F, Longo WE. Benign anorectal disease: an update on diagnosis and management. JAAPA. 2006;19(6):28-33. Ridings...

Implementing a continuous insulin infusion protocol on a cardiac surgical service APA's perspective: the author describes how one rural hospital used aggressive glucose control with continuous IV insulin to reduce complications and death among surgical patients, whether they had diabetes or not.
June 1, 2006... Among patients undergoing cardiac surgery, 25% to 29% have diabetes, making it the fourth most common comorbid condition in this group. (12) In some cardiac surgery practices, almost half of all patients have diabetes. (1) Moreover,...

In defense of full disclosure.(SOUNDING BOARD: JAAPA's op-ed department)
June 1, 2006... I was struck by an article in The Wall Street Journal announcing that the Journal of Thoracic and Cardiovascular Surgery had prohibited some authors from publishing in it because they did not fully disclose their affiliations with the companies...

Difficult-to-diagnose pelvic pain.
June 1, 2006... CASE The patient is a 34-year-old woman who has been seeing you about chronic pelvic pain for some time now. You have performed a thorough workup. You have ruled out fibroids, endometriosis, and inflammation, but you cannot seem to find a...

A common cause of photodistributed rash.(DERMATOLOGY DIGEST: A derm photo quiz)
June 1, 2006... A 57-year-old woman is referred to the dermatology clinic by her primary care provider for evaluation of an itchy rash that has been present on her chest, upper back, and the lower halves of her arms for the past 2 months. The rash, which...

Natalizumab reduces relapse and disability in MS.(Patient-oriented evidence that matters)(Drug overview)
June 1, 2006... Clinical question Is natalizumab safe and effective for the treatment of relapsing multiple sclerosis (MS)? Bottom line Natalizumab reduces the likelihood of relapse and progression of disability in patients with relapsing MS (RMS)....

Glucosamine/chondroitin has mixed benefits for OA.(Patient-oriented evidence that matters)
June 1, 2006... Clinical question Is glucosamine or chondroitin (or both) effective for osteoarthritis (CA) of the knee? Bottom line Glucosamine/chondroitin provides modest if any symptomatic benefit for patients with mild CA of the knee. This study was...

FOBT screening does not reduce all-cause mortality.(Patient-oriented evidence that matters)(fecal occult blood testing )
June 1, 2006... Clinical question Does fecal occult blood testing (FOBT) reduce all-cause mortality? Bottom line Screening for colorectal cancer using FOBT does not reduce all-cause mortality. We have to remember this--and the similar controversial...

Dexamethasone reduces nausea after laparoscopic cholecystectomy.(Patient-oriented evidence that matters)(Brief article)
June 1, 2006... Clinical question Does preoperative dexamethasone reduce nausea in patients undergoing elective laparoscopic cholecystectomy? Bottom line Preoperative dexamethasone appears to reduce postoperative nausea in patients undergoing elective...

Aspirin and statins cost-effective only for those at high risk.(Patient-oriented evidence that matters)
June 1, 2006... Clinical question In men without a history of cardiovascular disease, is low-dose aspirin, a statin, or both cost-effective in preventing cardiovascular events? Bottom line From the viewpoint of cost to a third-party payer, the costs of...

100% humidity no better than other options for croup.(Patient-oriented evidence that matters)
June 1, 2006... Clinical question is the use of high humidity or low humidity best for treating moderate to severe croup? Bottom line In children with moderate to severe croup, the use of controlled delivery of 100% humidity results in no greater...

CME Calendar.(Calendar)
June 1, 2006... CONNECTICUT September 16 Connecticut Dermatology Physician Assistant Society Second Regional CME Symposium. Where: Mashantucket. Provider: Connecticut Dermatology Physician Assistant Society. Information: www.ctdermpa.com. ...

Should I be tested for breast cancer genes?(WHEN THE PATIENT ASK: Brief reviews for you and your patients)
June 1, 2006... News reports of medical advances in genetics are appearing in the lay press almost daily. These reports, coupled with women's fear of breast cancer, mean that more women are asking about screening for mutations in the breast cancer...

Should I be tested for breast cancer genes?
June 1, 2006... BRCA1 and BRCA2 are shorthand for BReast CAncer gene 1 and BReast CAncer gene 2. These are genes that everyone has. Genes are the blueprint for life. They determine what your body will look like and how it will work. They also determine whether...

PAs in surgery.(SPECIALTY UPDATE: Focus on PA specialty organizations)(Brief article)
June 1, 2006... PAs in surgery have already been part of a national effort to address the issue of patient safety, which will be the focus of the 2006-2007 Host City Prevention Campaign. AAPA and representatives from PA surgical specialty organizations have...

American Association of Surgical Physician Assistants (AASPA).(SPECIALTY UPDATE: Focus on PA specialty organizations)(Brief article)
June 1, 2006... On October 5-8, 2006, AASPA will take up temporary residence at the Renaissance Chicago North Shore, about 20 miles north of the Windy City. AASPA will again offer PAs, medical and surgical, the opportunity to hear about surgical disease and...

PAs in otorhinolaryngology.(SPECIALTY UPDATE: Focus on PA specialty organizations)(Brief article)
June 1, 2006... PAs in otorhinolaryngology practice with physicians in settings varying from general otolaryngology to head and neck surgery, allergy, facial reconstructive surgery, neurotology, and pediatric ENT. The organization for PAs in this specialty is...

Society of Physician Assistants in Otorhinolaryngology--Head & Neck Surgery (SPAO-HNS).(SPECIALTY UPDATE: Focus on PA specialty organizations)(Brief article)
June 1, 2006... SPAO-HNS was founded in 1991 to provide CME and opportunities to form collegial relationships for PAs in this specialty. Since then, the society has evolved to clarify and promote the role of PAs in the ENT team, collect performance and...

Case of the month: diagnostic challenges from your case files).(Case of the month: diagnostic challenges from your case files)
June 1, 2006... The patient is a 67-year-old white man presenting with a 3-day history of difficulty moving his right wrist to full extension; he also cannot extend his fingers of the same hand. He admits no other neurologic deficits. He denies any significant...