JAAPA-Journal of the American Academy of Physicians Assistants articles from May 2005

JAAPA-Journal of the American Academy of Physicians Assistants archives from May 2005

Governor signs New Jersey controlled drug prescribing legislation.(FROM THE AAPA: News of current interest)(Brief Article)
May 1, 2005... New Jersey Gov. Richard Codey (D) signed legislation in March authorizing physicians to delegate prescriptive authority for controlled medications (Schedules II-V)to PAs. The law takes effect 180 days after the governor's signature. The new law...

CMS announces quality care initiative.(FROM THE AAPA: News of current interest)
May 1, 2005... The Centers for Medicare and Medicaid Services (CMS) has launched a new initiative that pays Medicare providers, including PAs, based on the quality of care they deliver. CMS announced in February that 10 large physician groups around the...

Winners of PAragon publishing awards announced.(FROM THE AAPA: News of current interest)
May 1, 2005... The American Academy of Physician Assistants announced the 2005 winners of its annual publishing award competition. The awards will be presented on May 27, in Orlando, Florida, during the AAPA's 33rd Annual Physician Assistant Conference. ...

Health care illiteracy: your chance to make a difference.(GUEST EDITORIAL)(Editorial)
May 1, 2005... Yolanda has been a patient in our clinic for about 20 years now. In addition to other chronic problems, Yolanda has diabetes and hypertension. When I * started to care for Yolanda, I was frustrated. All of her numbers were off. Her...

The right DNA.(GUEST EDITORIAL)(career directions of physicians assistants)(Editorial)
May 1, 2005... As I travel around the country as AAPA executive vice president/CEO, I marvel at how the PA profession has progressed and thrived since I first became involved with it in the early 1970s. Despite the many changes in health care over the years,...

The case of Mr. S.(PAQ--PA QUANDARIES: Ethics in everyday practice)(ethics of physician assistant's treatment of a man with atrial fibrillation)
May 1, 2005... In previous columns, using the Jonsen four-box approach to clinical bioethics, (1) we focused on the issues of medical indications and contextual features. In this case, we will explore patient preference. I would like to thank my student...

Gestational diabetes is your patient at risk? Screening most pregnant women between 24 and 28 weeks of gestation is the standard of care. It is important for clinicians to identify and treat gestational diabetes early to improve perinatal outcomes.(Gestational diabetes)
May 1, 2005... Gestational diabetes mellitus (GDM) is defined as "carbohydrate intolerance of varying severity with onset or first recognition during pregnancy. This definition applies whether insulin is used for treatment or the condition persists after...

Nine key questions to address polypharmacy in the elderly: elderly patients take more medications, both prescription and OTC, than any other segment of the population, and they're at great risk for suffering the consequences of polypharmacy.(Polypharmacy)
May 1, 2005... Persons aged 65 and older comprise approximately 12% of the population of the United States, yet they consume one third of all prescription medications and more than half of OTC medications. (1,2) Data from the Third National Health and...

CME post-test: expiration date May 2006.(continuing medical education)
May 1, 2005... Gestational diabetes 1. Gestational diabetes mellitus (GDM) is more likely to develop in women who are a. Alcoholic b. Multiparous c. Caucasian d. Obese 2. If the practitioner does not diagnose GDM at the initial...

Heath care illiteracy implications for providers: approximately 90 million adults in the United States are illiterate, a condition that frequently underlies low health literacy. Risk factors include poverty, incarceration, lack of education, immigration status, age, and race.(Illiteracy)
May 1, 2005... One quarter of adults in the United States are functionally illiterate. (1) Although the US Department of Education conducted the National Adult Literacy Survey (NALS) in 1992, the problem of how this high rate of illiteracy affects health care...

How to make the "difficult" patient encounter less difficult: this article reviews four types of difficult patient encounters that might well end badly. Each scenario is followed by communication techniques that PAs can use to improve the outcome.(The difficult patient)
May 1, 2005... Clinicians label one sixth of all outpatient encounters with patients "difficult." (1) Typically, these encounters challenge both the patient and the provider. (2) Common scenarios involve patients who are angry, silent, or confrontational;...

Thoracic outlet syndrome.(WHEN THE PATIENT ASKS)
May 1, 2005... The thoracic outlet is bordered on two sides by the anterior and middle scalene muscles of the neck, which help move the head. (1) In most patients, the bottom of the outlet is formed by the first rib; however, some people have a naturally...

Thoracic outlet syndrome.(PATIENT INFORMATION: From your physician assistant)
May 1, 2005... Thoracic outlet syndrome (TOS) is a condition that can cause pain and discomfort in your shoulder, arm, and hand. What is the thoracic outlet? It is a space in your upper body between your neck and armpit. Think of the outlet as a box. Two...

A persistent "fungal infection" on the face.(DERMATOLOGY DIGEST: A derm photo quiz)
May 1, 2005... A 52-year-old African American woman was seen in the dermatology clinic for evaluation of a "fungal infection" of facial skin that had persisted despite the use of several OTC and prescription antifungal creams. Oral terbinafine, 250 mg daily...

Screening for HIV in general population not cost-effective.(POEMs: Patient-oriented evidence that matters)
May 1, 2005... Clinical question Should criteria for human immunodeficiency virus screening be expanded? Bottom line Current recommendations for screening populations with a risk of human immunodeficiency virus of at least 1% are appropriate based on...

Outpatient = inpatient for many with pneumonia.(POEMs: Patient-oriented evidence that matters)
May 1, 2005... Clinical question In low-risk patients, is outpatient treatment of pneumonia as effective as inpatient therapy? Bottom line This study provides good support for 2 theories in the treatment of community-acquired pneumonia: (1) emergency...

Three days of Cipro better for uncomplicated UTI.(POEMs: Patient-oriented evidence that matters)(comparison of Cipro versus Augmentin for urinary tract infections)(Brief Article)
May 1, 2005... Clinical question Are amoxicillin-clavulanate (Augmentin) and ciprofloxacin (Cipro) equivalent as a 3-day treatment for uncomplicated cystitis in women? Bottom line Three days of ciprofloxacin is superior to 3 days of...

CME Calendar.(Calendar)
May 1, 2005... CALIFORNIA September 21-24 15th Annual Certification/Recertification Review. Where: Atlanta. Provider: Emory University PA program. Information: (404) 727-7827; cwilson@learnlink.emory.edu. September 30-October 2 29th Annual CAPA...

Case of the month: diagnostic challenges from your case files.
May 1, 2005... John Bradford, MPAS, PA-C CASE The patient is a 72-year-old man who was referred for a preoperative evaluation before surgery to remove a melanoma on his back. An ECG performed at the surgeon's office showed nonspecific ST-segment...