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

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

Diagnosis: sinus headache or migraine?(Continuing advances in headache diagnosis)
March 1, 2003... Millions of migraine sufferers are undiagnosed 52% of all migraine sufferers remain undiagnosed despite significant advances in migraine research. (2) This means that millions of people are not benefiting from specific treatments that help...

POEMs for PAs.(Editorial)(patient-oriented evidence that matters)(physicians' assistants)(Editorial)
March 1, 2003... Overwhelmed." "Flooded." "Buried." "Snowed under." "Inundated." These are words I frequently hear to describe how PAs feel about their struggle to keep up with the seemingly ever more rapid advances in medicine. No wonder they feel this way....

Harms outweigh benefits of COX-2 for many patients.(POEM *)
March 1, 2003... Clinical question How safe are COX-2 inhibitors? Setting Other Study design Other Synopsis This is an excellent (although non-systematic) review of the benefits and harms of COX-2 inhibitors. It is non-systematic, because we...

Prediction of the risk of myocardial infarction from polymorphisms in candidate genes.(Cardiology)(Author Abstract)
March 1, 2003... Yamada Y, Izawa H, Ichihara S, et al. N Engl J Med. 2002.347: 1916-1923. * MI is a complex polygenic disorder. While genotype clearly predisposes some to defined risk factors for MI, such as hypertension, diabetes mellitus, and...

Screening for prostate cancer: recommendations and rationale.(Oncology)(Brief Article)
March 1, 2003... U.S. Preventive Services Task Force. Available at: http://www.ahrq. gov/clinic/3rduspstf/prostatescr/prostaterr.htm. Accessed February 5, 2003. * Although prostate cancer is the second leading cause of cancer-related death among men in the...

Trends in care by nonphysician clinicians in the United States.(Professional Issues)(Author Abstract)
March 1, 2003... Druss BG, Marcus SC, Olfson M, et al. N Engl J Med. 2003;348: 130-137. * The 1990s saw rising numbers of nonphysician clinicians (NPCs). To evaluate trends in outpatient care provided by physicians and NPCs, two nationally representative...

Years of life lost due to obesity.(Public Health)(Author Abstract)
March 1, 2003... Fontaine KR, Redden DT, Wang C, et al. JAMA. 2003;289:187-193. * The health messages disseminated regarding the dangers of obesity appear to have fallen on deaf ears. This study estimates the expected number of years of life lost (YLL) due...

National Kidney Foundation develops practice guidelines for chronic kidney disease.(Specialty Update)
March 1, 2003... According to the National Kidney Foundation, more than 20 million Americans have chronic kidney disease (CKD), which is defined either as a glomerular filtration rate (GFR) of less than 60 mL/min/1.73 [m.sub.2] or as kidney damage for 3 or more...

Recognition and management of gout and hyperuricemia: key clinical findings help you make the diagnosis. Management centers on identifying the stage of gout and using effective--but often toxic--drug therapy.(Recertification Refresher)
March 1, 2003... One of the most common forms of inflammatory joint disease, gout has been associated with suffering since the time of Hippocrates. Acute gout is characterized by severe pain and tenderness, swelling, erythema, and warmth in one or two joints,...

Pharmacotherapeutic approaches to treatment-resistant depression: first, rule out complicating factors and nonadherence to prescribed antidepressant drugs. Then, consider these options for improving the response to treatment.
March 1, 2003... Depression is a serious medical condition that carries significant morbidity and mortality. The socioeconomic cost of depression is similar to the costs of coronary artery disease (CAD), cancer, and AIDS. (1) In fact, major depressive disorder...

Medical abortion with mifepristone: an update: mifepristone, formerly called RU-486, has been available to induce medical abortion for 2 1/2 years, but little information has gone out to PAs regarding its use.
March 1, 2003... Since being approved by the FDA in September 2000, mifepristone--the drug formerly known as RU-486 and marketed as Mifeprex--has been used to safely induce abortion in pregnancies of 49 days' duration or less (as dated from the first day of the...

Clubbing and hip pain in a long-term smoker.(Diagnostic Imaging Review)(cancer diagnosis)
March 1, 2003... A 54-year-old man with a history of hypertension, alcohol dependence, and peripheral vascular disease arrived at the clinic complaining of intermittent "crampy" low back pain that radiated down the left buttock to the back of the left thigh and...

CME post-test: expiration date March 2004.(continuing medical education)
March 1, 2003... EXPIRATION DATE MARCH 2004 Please take this CME Post-test online at www.aapa.org. Yennie RH. Recognition and management of gout and hyperuricemia. JAAPA. 2003;16(3):21,22,24,27.28,31. St. John D. Pharmacotherapeutic approaches to...

Expanding our concept of the medical literature: the value of the humanities in medicine.(Sound Board)
March 1, 2003... The PA covering the ER has called me. A patient in our practice is in the ER with such bad ascites that she can't breathe. She needs a paracentesis. Her last one was last week. She has ovarian cancer. She's net sure she wants to be admitted....

CME calendar.(continuing medical education)(Calendar)
March 1, 2003... MARCH 28-29 Comprehensive Diabetes Review Provider: New Jersey State Society of PAs. Location: Newark, N J. Contact: Ellen Mandel, (908) 771-0030, ellen@ameded.org MARCH 30-APRIL 4 16th Annual Charter Oak Conference ...

Introducing the PA profession to Britain.(PA Watch)(Physician assistants )(Author Abstract)
March 1, 2003... Mittman DE, Cawley JF, Fenn WH. Physician assistants in the United States. BMJ. 2002;325:485-487. * Since the 1960s, the United States has developed a cadre of PAs to work in primary care. They mainly work semi-autonomously in association...

Liver biopsy performed by a PA.(PA Watch)(physician assistant)(Author Abstract)
March 1, 2003... Gunneson TJ, Menon KV, Wiesner RH, et al. Ultrasound-assisted percutaneous liver biopsy performed by a physician assistant. Am J Gastroenterol. 2002;97:1472-1475. * Diagnostic percutaneous liver biopsy is generally performed by physicians...

Erroneous workforce study results, and PAs.(PA Watch)(Author Abstract)
March 1, 2003... Sheldon GF. Great expectations: the 21st century health workforce. Am J Surg. January 2003;185:35-41. * Most health workforce studies have predicted an oversupply of physicians, a shortage of primary care doctors, and an excess of...