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

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

To risk prescribing this drug, or not to risk: that is the question.(Editorial)
March 1, 2009... Patients and families usually see life in the numerator when they experience unfortunate events, not considering the denominator. The numerator is the child who suffers a reaction to penicillin or the spouse who is killed in a car accident. The...

Product: Trilipix.(New Drug Information)(Drug overview)
March 1, 2009... PRODUCT: Trilipix COMPANY: Abbott PHARMACOLOGIC CLASS: Fibrate ACTIVE INGREDIENTS: Fcnofibric acid (as choline fenofibrate) 45mg, 135mg; del-rel caps. INDICATIONS: Adjunct to diet: In combination with a statin, to reduce...

What caused the total hair loss in this young boy?(Dermatology Digest)(Case study)
March 1, 2009... [FIGURE 1 OMITTED] CASE Hair loss is devastating at any age, even for older persons with hereditary predisposition. But it is especially troubling for children, in whom alopecia is surprisingly common. But losing all of one's hair at...

The 2009 vaccine schedules.(ADULT IMMUNIZATION)
March 1, 2009... WHO SHOULD READ THIS? Any PA who provides care for adult patients (older than 18 years). WHY IS THIS IMPORTANT? Every year, more than 40,000 adults in the United States die from influenza, and additional deaths can be directly...

Antibiotic resistance: the ongoing challenge for effective drug therapy: the abilities to evolve and exchange DNA are unique survival tactics used by bacteria. Overcoming these mechanisms is a clinical challenge for the 21st century.(CME)(Cover story)
March 1, 2009... Antibiotic resistance is an increasingly common problem that complicates the treatment of both community-acquired and nosocomial infections. A series of three articles reviews this serious health threat, explains why the challenge is...

Infrapatellar contracture syndrome following ACL reconstruction.(The Surgical Patient)(anterior cruciate ligament)(Case study)
March 1, 2009... CASE A 29-year-old woman with no known medical problems sustained a complete anterior cruciate ligament (ACL) tear and partial lateral meniscus tear while snow skiing. At 22 days postinjury, she had no effusion and full range of motion...

Treatment of restless legs syndrome with iron infusion therapy: this 52-year-old woman's case reaffirms the importance of a careful history and appropriate diagnostic studies in evaluating a patient with symptoms of RLS.(CASE REPORT)(Case study)
March 1, 2009... CASE A 52-year-old female presented to the clinic with symptoms of daytime somnolence and nocturnal leg discomfort. She described the leg discomfort as an "urge to move" and "tingly." The sensation disappeared with walking or activity. The...

Expanded criteria donors offer hope for patients needing kidney transplant: when should patients with end-stage renal disease consider expanded criteria kidney donation, and how can you help them understand their options?(Report)
March 1, 2009... The National Kidney Foundation says that "rates of chronic kidney disease (CKD) in the United States have increased by more than 20% over the [p]ast decade, causing dramatic loss of life and sky-rocketing health care costs, according to the...

How to recognize depressive disorders in children and adolescents: mental health disorders are difficult to diagnose in the nonadult patient. Complications range from limited language and communications skills to a struggle for autonomy.(CME)(Report)
March 1, 2009... [ILLUSTRATION OMITTED] Depression was once thought to affect only adults. Clinical evidence has revealed that children and adolescents experience both depressive symptoms and depressive disorders. (1,2) However, the limited language skills...

CME posttest.
March 1, 2009... EXPIRATION DATE: MARCH 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...

Why the attitude?(SOUNDING BOARD)(treatment and prevention of obesity to avoid further complications)(Conference news)
March 1, 2009... Recently I attended a CME presentation on hypercholesterolemia, diabetes, and cardiac disease. One speaker pointed out that successful treatment of those diseases often involves getting patients to lose weight and suggested that we clinicians...

Gstroesophageal reflux disease (GERD).(Quick Recertification Series)(Disease/Disorder overview)
March 1, 2009... Preparing to recertify (or certify for the first time) is an arduous process for which there is never enough time to practice and test one's knowledge. The Quick Recertification Series is one way PAs who are preparing to take the exam can meet...

Eczema.(Quick Recertification Series)(Disease/Disorder overview)
March 1, 2009... Colomb-Lippa, Dawn GENERAL FEATURES * Eczema is a group of skin disorders that are related to a hypersensitivity reaction of the skin resulting in chronic relapsing dermatitis. * Eczema can affect any age-group but is most likely...

Generic and brand-name drugs are equally effective for cardiovascular disease.(Patient-oriented evidence that matters)(Report)
March 1, 2009... Clinical question Are generic and brand-name drugs equally effective in the treatment of adults with cardiovascular disease (CVD)? Bottom line In the management of adult CVD, current evidence firmly demonstrates that generic equivalents are...

Infliximab, adalimumab are effective for moderate to severe plaque psoriasis.(Patient-oriented evidence that matters)(Report)
March 1, 2009... Clinical question How effective are pharmacologic treatments for moderate to severe plaque psoriasis? Bottom line Infliximab and adalimumab appear to be the most effective treatments for moderate to severe plaque psoriasis, although safety...

Procalcitonin may distinguish bacterial from viral meningitis in kids.(Patient-oriented evidence that matters)(Brief article)
March 1, 2009... Clinical question Are biologic markers such as procalcitonin helpful in distinguishing bacterial meningitis from viral meningitis in children? Bottom line In this study--with biases that tend to inflate the estimates of sensitivity and...

Dexamethasone may prevent headache recurrence after treatment of acute migraine.(Patient-oriented evidence that matters)(Report)
March 1, 2009... Clinical question Does the addition of dexamethasone to standard therapy for acute migraine headache decrease the incidence of recurrent headache in adults? Bottom line This review found a significant benefit to adding dexamethasone to...

Vitamins E and C and selenium do not reduce risk of prostate or total cancer in men.(Patient-oriented evidence that matters)(Report)(Brief article)
March 1, 2009... Clinical question Do vitamins E and C or selenium, alone or in combination, reduce the risk of prostate cancer or total cancer in men? Bottom line In this large, well-designed, randomized trial, vitamins E and C and selenium, alone or in...

Q: How do I control my heart failure?(When the Patient Asks)
March 1, 2009... A National Institutes of Health study reported that hospitalizations for heart failure (HF) have increased significantly since 1980; study findings show an increase of 131% between 1980 and 2006. (1) Considering that 5 million people in the...

Q: How do I control my heart failure?(Patient Information)
March 1, 2009... Heart failure (HF) is a common problem. HF is when your heart is not pumping blood properly. Your heart may not be pumping blood hard enough to reach the rest of your body and return to the heart. HF may also mean your heart does not relax and...

Eclampsia causes a reversible condition in a young woman.(Diagnostic Imaging Review)
March 1, 2009... [FIGURE 1 OMITTED] >CASE A 19-year-old woman presented to the emergency department with a history of seizures at home. She also had a seizure in the ambulance on the way to the hospital. At the time of presentation, she had an...

A genome's home: genomics and health care reform.(GENETICS IN MEDICINE)
March 1, 2009... [ILLUSTRATION OMITTED] The coming year promises to usher in important reforms to the delivery of health care in the United States. Rising costs, questions about health care quality, and a business community rendered uncompetitive at least...

Case of the month.(Case study)
March 1, 2009... [FIGURE 1 OMITTED] * CASE A 59-year-old white woman, with a history of small cell lung cancer presented to her oncologist complaining of a drooping left eyelid for two days. She denied any vision abnormalities, fatal weakness, or...

The IBS Practice Circles Program: promoting practice improvements for better patient outcomes.(Improving Clinical Proficiency: ENHANCING CARE FOR YOUR IBS PATIENTS)(irritable bowel syndrome)
March 1, 2009... Participation in continuing education (CE) is standard for all health care professionals and helps them to maintain, develop, or increase the knowledge and skills needed for their practice. In fact, most states and specialty boards require that...

Improving clinical proficiency: enhancing care for your IBS patients.(Improving Clinical Proficiency: ENHANCING CARE FOR YOUR IBS PATIENTSd)(Disease/Disorder overview)
March 1, 2009... INTRODUCTION Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders but remains an incompletely understood syndrome with significant unmet medical needs. While not life-threatening, IBS is a chronic...

Dr. Frissora's diet for the sensitive stomach.(Brief article)
March 1, 2009... "What Can I Eat, Doctor?" This s meant to be a general guideline and will vary with each patient. * If you have CELIAC DISEASE or SPRUE, avoid wheat, barley, rye, and their derivatives. * Usually Tolerated (in moderation) Soluble fiber...

CME post-test.(Improving Clinical Proficiency: ENHANCING CARE FOR YOUR IBS PATIENTS)
March 1, 2009... All post-tests for this monograph must be submitted online. The scoring service is provided at no charge to current Fellow members of the AAPA. Others must submit a $25 scoring fee for each post-test using the AAPA's secure server. Payment may...