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

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

Correction.(Correction notice)
June 1, 2009... "Terminating your professional relationship with a patient," PA Quandaries, April 2009, page 57, stated the incorrect dose of alprazolam in the case presented. The correct dose is 1.0 (one) mg.

Promoting oral health care: more than just lip service.(Editorial)
June 1, 2009... If the eyes are the windows of the soul, then the mouth is certainly a place where important discoveries can be made. Routinely performing a thorough mouth examination should include evaluating your patient's teeth and gums. This is also an...

Product: Toviaz.(New Drug Information)(Drug overview)
June 1, 2009... PRODUCT: Toviaz COMPANY: Pfizer PHARMACOLOGIC CLASS: Muscarinic receptor antagonist ACTIVE INGREDIENTS: Fesoterodine fumarate 4mg, 8mg; ext-rel tabs. INDICATION: Overactive bladder (OAB) with urge urinary incontinence,...

A spreading, chronically itchy rash.(Dermatology Digest)(Case study)
June 1, 2009... [FIGURE 1 OMITTED] * CASE A 72-year-old white male presented with an "itchy rash" that had begun on his chest 2 months ago and had now spread to his upper back. No lesions were noted on the extremities. There was no generalized...

A day in the life.
June 1, 2009... [ILLUSTRATION OMITTED] I have been a full-time physician assistant for 6 years at Family Planning Associates Medical Group (FPAMG), the leading abortion provider in the state of Illinois. Located in Chicago, we provide medical and surgical...

How to perform a comprehensive examination of the knee: the knee is a complex and easily injured joint. This step-by-step guide leads the physician assistant through a thorough examination to an accurate diagnosis.(CME)
June 1, 2009... The American Academy of Orthopaedic Surgeons reports that in 2003, 19.4 million Americans visited a physician because of a knee problem. (1) An increasing older population and a greater number of persons who participate in recreational...

Sudden onset of substernal chest pare m a college student at rest: despite its name, spontaneous pneumomediastinum may be associated with a number of factors, including illicit drug use, that need to be ruled out with an appropriate history.(CASE REPORT)(Case study)
June 1, 2009... CASE A healthy 19-year-old white male presented to the student health service complaining of substernal chest pain for 1 hour. He described the pain as "achy" and rated its severity as 5 on a scale of 0 to 10. The patient denied any...

A role in trauma care for advanced practice clinicians.(RESEARCH REPORT)
June 1, 2009... ABSTRACT Advanced practice clinicians (APCs) are increasingly being utilized to care for patients on trauma services, but the quality of care provided by these alternate delivery models has been questioned. We hypothesized that APCs could...

Spinal cord astrocytomas: rare but life threatening tumors in children: though usually benign, these tumors require early surgical intervention to preserve neurologic function and quality of life for pediatric and adolescent patients.
June 1, 2009... Solid tumors of the spinal cord are a rare but serious diagnosis in pediatric patients, accounting for only 4% to 10% of all CNS tumors in that population; (1) 25% to 40% of spinal cord tumors are intramedullary, or intrinsic to the spinal...

Erythema infectiosum: recognizing the many faces of fifth disease: four patient histories are presented. Although each case is different, all of these patients have the same illness. Would you be able to recognize the common etiology?(CME)(Case study)
June 1, 2009... Fifth disease is a common childhood viral illness that poses a threat of few sequelae in the healthy child. However, the infection can masquerade as other disorders in patients of all ages, leading to misdiagnosis, failure to diagnose, and, at...

CME posttest.
June 1, 2009... EXPIRATION DATE: JUNE 2010 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 secure...

A simple new blood test for allergy triggers.(What's New in ... ALLERGY TESTING)
June 1, 2009... Virtually every guideline from allergy and asthma organizations stresses avoidance of disease triggers. (1,2) In the case of asthma and allergic rhinitis, this may mean avoiding dust mites, ragweed, or a host of other potential triggers....

Is continuity of care a victim of progress?(SOUNDING BOARD)(Column)
June 1, 2009... I know in my heart that things change and hopefully for the better. This is especially so in our profession. We are forever striving to improve the outcomes for our patients with new medications, procedures, access to care, and evidence-based...

Unequal breast cancer risk found with use of HRT progestogens.(Patient-oriented evidence that matters)(hormone replacement therapies)
June 1, 2009... Clinical question Do hormone replacement therapies (HRTs) for post-menopausal women carry different breast cancer risks? Bottom line In this large French cohort of postmenopausal women, the risk of breast cancer among those who used...

Single intra-articular injection of hyaluronic acid is equal to placebo.(Patient-oriented evidence that matters)(Report)(Brief article)
June 1, 2009... Clinical question Is a single intra-articular injection of hyaluronic acid effective in reducing pain or improving function in patients with symptomatic degenerative joint disease (DJD) of the hip? Bottom line A single intra-articular...

Early treatment is beneficial for patients with PTSD.(Patient-oriented evidence that matters)(Report)(Brief article)
June 1, 2009... Clinical question Is early treatment after a traumatic stress event beneficial? Bottom line Identification of a traumatic stress event within 3 months and treatment using trauma-focused cognitive behavioral therapy (CBT) is beneficial for...

PSA screening does not reduce mortality from prostate cancer.(Patient-oriented evidence that matters)(prostate-specific antigen)
June 1, 2009... Clinical question Does screening with prostate-specific antigen (PSA) reduce mortality? Bottom line The initial results of the Prostate Lung Cancer Ovary (PLCO) screening trial found no benefit as measured by prostate cancer-specific...

BNP testing does not lower hospitalization rate.(Patient-oriented evidence that matters)(B-type natriuretic peptide)(Brief article)
June 1, 2009... Clinical question Does B-type natriuretic peptide (BNP) testing in the emergency department improve outcomes or affect hospitalization rates? Bottom line In contrast to results from an earlier study, testing the BNP levels of patients with...

Unusual vascular structures in the chest cavity.(Diagnostic Imaging Review)(Case study)
June 1, 2009... [FIGURE 1 OMITTED] * CASE A 47-year-old female complained of shortness of breath and occasional chest pain. As part of the workup being done by the cardiology service, she was sent to the radiology department for a coronary artery CT....

Face to face: glimpsing the man behind the mask.(HUMANE MEDICINE)(Column)
June 1, 2009... What happened to this father's face?" the medical assistant asks as she hands me the chart for my next patient, a 4-year-old girl who stuck a rubber eraser up her nose. Momentarily, I'm taken aback. I glance at the name on the medical...

Case of the month.(Case study)
June 1, 2009... [FIGURE 1 OMITTED] * CASE A 53-year-old white male came to our ear, nose, and throat office with a 2-month history of a localized, partially flattened, erythematous lesion on the dorsum of his tongue (see Figure 1). Topical...