JAAPA-Journal of the American Academy of Physicians Assistants articles from June 2007

JAAPA-Journal of the American Academy of Physicians Assistants archives from June 2007

Indiana prescribing bill marks milestone for PA profession.(FROM THE AAPA)(Brief article)
June 1, 2007... PAs in Indiana achieved an historic victory in April when Gov. Mitch Daniels signed into law a bill that will allow physicians to delegate prescribing authority to PAs and change PAs to being licensed by the state, rather than certified....

Missouri PAs win compromise on on-site supervision.(FROM THE AAPA)(Brief article)
June 1, 2007... PAs in Missouri were successful in getting legislation passed that allowed them to avoid a requirement for constant on-site physician supervision in all settings, which the state Board of Healing Arts would have been forced to adopt had the...

Arkansas PAs gain flexibility in reimbursement.(FROM THE AAPA)(Brief article)
June 1, 2007... PAs practicing in Arkansas will no longer be required to have a physician on-site to be reimbursed by the state's largest insurer. Act 458, approved by the state's General Assembly in March, will take effect in June. PA employers will then be...

Building relationships--one patient at a time.(EDITORIAL)(Editorial)
June 1, 2007... "Al," I said, "we want you to take less time to complete this project and, because of your reputation as a top-notch carpenter, we feel sure that you will be able to do the high-quality work you have always done. But because we are asking you...

Product: Janumet.(New Drug Information)(Drug overview)
June 1, 2007... FROM THE EDITORS OF THE PAPR COMPANY: Merck PHARMACOLOGIC CLASS: Antihyperglycemic (dipeptidyl peptidase-4 inhibitor (DPP-4) + biguanide) ACTIVE INGREDIENTS: Sitagliptin 50mg, metformin (as HCI) 500mg; tabs. ALSO: JANUMET...

Puzzling brown area on toddler's skin.(Dermatology Digest)
June 1, 2007... [FIGURE 1 OMITTED] > CASE A 24-month-old mixed Asian Caucasian female presented with an asyrmmetrical "darkening" of the skin along the anterior trunk. The mother noticed the skin changes when the child was around 15 months old; the...

A day in the life.
June 1, 2007... [ILLUSTRATION OMITTED] I run a company called Clinical Research Consultants, Inc, which is a pharmaceutical clinical trial management organization, and I still practice as a PA in the clinic providing care for the patients who are enrolled...

Recognizing the elusive signs and symptoms of PSGN: in children, poststreptococcal glomerulonephritis usually resolves spontaneously. In adults, however, it is a serious condition and in most cases has a poor prognosis.(CME)
June 1, 2007... Poststreptococcal glomerulonephritis (PSGN) is an acute, immune complex-mediated inflammatory disorder of the glomerulus. It is an uncommon sequela of acute infection with streptococcal organisms that invade usually the throat or the skin. PSGN...

Meningitis in an infant: all that's aseptic is not viral: meningeal tuberculosis is the most common CNS manifestation of tuberculosis. Children younger than 5 years are among the groups who are most affected.(CASE REPORT)
June 1, 2007... CASE An 11-month-old African-American child was taken to a regional emergency department, where pneumonia, mild dehydration, and mild malnutrition were diagnosed. He was treated and sent home, but he returned that night with worsening...

How PAs improve access to care for the underserved.(RESEARCH REPORT)
June 1, 2007... ABSTRACT Objective: Increasing health care costs and inaccessibility to care create barriers to physicians' services. The physician assistant (PA) profession developed in part to help care for underserved populations. The objective of this...

Can emergency contraception help to reduce teen pregnancy? The authors argue that PAs cannot provide optimal care to adolescents if they aren't familiar with all pregnancy prevention options--including emergency contraception.(CME)
June 1, 2007... Teen pregnancy rates in the United States have been declining since the early 1990s--a decline primarily attributable to more effective contraceptive practice, not to a decline in sexual activity. At the same time, however, US teen pregnancy...

A walk through Never Never Land.(SOUNDING BOARD)
June 1, 2007... Your patient is a healthy woman who just turned 50. She eats right, exercises, doesn't smoke, and takes no regular medications. She goes for examinations regularly aNd without fear. She presents with a painful, coffee-bean-sized new lump in her...

Migraine treatment: 1987 and 2007.(Then and Now)
June 1, 2007... [ILLUSTRATION OMITTED] > MIGRAINE IN 1987 Janet is a 37-year-old cashier who experiences migraine headaches, hi a typical example, she develops a migraine beginning on a Sunday morning. She takes her usual doses of ergotamine-caffeine,...

Stepped approach is best for managing knee pain.(Patient-oriented evidence that matters)
June 1, 2007... Clinical question What is a reasonable approach to managing knee pain in older adults in primary care? Bottom line This guideline suggests a stepped approach to managing patients who are aged 50 years or older and have knee pain due to...

Survivors of childhood ALL are at increased cancer risk.(Patient-oriented evidence that matters)(Brief article)
June 1, 2007... Clinical question Are survivors of childhood acute lymphoblastic leukemia (ALL) at an increased risk of secondary cancers? Bottom line Survivors of childhood ALL remain at a significantly higher (13.5-fold) risk of secondary cancers than...

Higher volume is associated with lower mortality.(Patient-oriented evidence that matters)(Report)
June 1, 2007... Clinical question Are patients with abdominal aortic aneurysms (AAA) better off if they go to institutions with higher surgical volumes? Bottom line Patient survival after repair of AAA (elective or urgent) is higher when the patient is...

False-positive results have long-term effects.(Patient-oriented evidence that matters)(Clinical report)
June 1, 2007... Clinical question What are the effects of false-positive mammogram results? Bottom line Some studies found an increased level of psychological distress and breast cancer-related anxiety and apprehension. In the United States, women were...

Tadalafil is effective for BPH.(Patient-oriented evidence that matters)(Drug overview)
June 1, 2007... Clinical question Is tadalafil safe and effective in the treatment of benign prostatic hypertrophy (BPH)? Bottom line in addition to treating erectile dysfunction, tadalafil appears to have some benefit over placebo in reducing symptoms...

Atkins is equally or more effective for weight loss in premenopausal women.(Patient-oriented evidence that matters)
June 1, 2007... Clinical question Which diet is most effective for maintaining weight loss in premenopausal women at 1 year? Bottom line In this study, premenopausal overweight and obese women on the Atkins diet lost comparable or more weight than similar...

Is "reparative" therapy in the best interest of the patient?(PA QUANDARIES)(Case study)
June 1, 2007... > CASE Mr. D. is a 45-year-old man who comes to the office with a complaint of acute knee pain. This is his first visit. Mr. D. mentions to the physician that the injury occurred when he and his boyfriend were playing soccer. The physician...

Symptoms of a stroke in a 41-year-old woman.(Diagnostic Imaging Review)(Case study)
June 1, 2007... [FIGURE 1 OMITTED] > CASE A 41-year-old woman presented with complaints of severe headaches and left arm weakness that had occurred off and on for 2 months. In a visit to the emergency department 2 days previously, she underwent GT of...

PAs in orthopedic surgery.(Specialty Update: FOCUS ON PA SPECIALTY ORGANIZATIONS)
June 1, 2007... PAs in orthopedic surgery, as well as other surgical specialty groups, and AAPA exhibit at numerous physician conferences throughout the year, including the American College of Surgeons' (ACS) conference. The purpose of having a presence at...

PAs in cardiovascular surgery.(Specialty Update: FOCUS ON PA SPECIALTY ORGANIZATIONS)
June 1, 2007... PAs in cardiovascular surgery play an important role in patient safety in the clinical setting. According to the Institute of Medicine, more people die in a given year as a result of medical errors than from motor vehicle accidents, breast...

Case of the month.(Case study)
June 1, 2007... [ILLUSTRATION OMITTED] > CASE The patient is an 88-year-old white male who presented with a complaint of new-onset dizziness so severe that it caused him to limit his activity. He was spending more and more time in his independent...