JAAPA-Journal of the American Academy of Physicians Assistants articles from November 2008

JAAPA-Journal of the American Academy of Physicians Assistants archives from November 2008

AAPA objects to proposed HHS "conscience" role.(FROM THE AAPA)(American Academy of Physician Assistants)(Department of Health and Human Services )
November 1, 2008... The Department of Health and Human Services (HHS) is proposing a role to expand the ability of health care providers to refuse to perform health care services because of religious, ethical, or other convictions. In a letter to HHS Secretary...

AARP coalition seeks health care affordability.(FROM THE AAPA)(Divided We Fail )(Brief article)
November 1, 2008... Divided We Fail is a nonpartisan movement committed to amplifying the voices of those who believe that health care and long-term financial security are the most pressing issues facing the nation. The effort is being led by AARP, the Business...

DEA drafts e-prescribing rule for controlled substances.(FROM THE AAPA)(Drug Enforcement Administration)(Brief article)
November 1, 2008... On June 27, 2008, the Drug Enforcement Administration (DEA) issued a notice of a proposed rule to allow practitioners to write electronic prescriptions for controlled medications. The proposed regulations would also permit pharmacies to...

Pale sunlight through a dusty lens: physician assistant research.(Editorial)
November 1, 2008... By many standards, a remarkable achievement in health care delivery has occurred. The number of graduating physician assistants (PAs) has reached approximately one-third of the number of US medical school graduates. (1) PAs and nurse...

Product: Cleviprex.(New Drug Information)(Drug overview)
November 1, 2008... PRODUCT: Cleviprex COMPANY: The Medicines Company PHARMACOLOGIC CLASS: Calcium channel blocker (dihydropyridine) ACTIVE INGREDIENTS: Clevidipine butyrate emulsion 0.5mg/mL; soln for IV infusion; contains lipids 0.2g/mL (soybean...

Too much attention makes this problem worse.(Dermatology Digest)(Case study)
November 1, 2008... [FIGURE 1 OMITTED] * CASE The patient is a 33-year-old woman who was referred to the dermatology clinic for evaluation of a rash on the periorbital skin of both eyes that had been present off and on for months. The patient reported...

Update your vaccination protocol.(INFLUENZA 2008-2009)
November 1, 2008... * WHO SHOULD READ THIS? Any physician assistant involved in patient care should be familiar with the latest information about influenza. Two important features of this disease are its epidemic nature and the mortality rate from pulmonary...

Multiple myeloma: vague symptoms can challenge diagnostic skills: PAs should include this disease in the differential diagnosis for patients who present with nonspecific symptoms such as bone pain, fatigue, and recurrent infections.(CME)(Disease/Disorder overview)
November 1, 2008... Multiple myeloma is a hematologic malignancy characterized by a clonal proliferation of plasma cells that secrete a monoclonal protein. Infiltration of malignant cells into the bone marrow results in bone destruction. Bone pain, fatigue, and...

Hidradenitis suppurativa: a disease of apocrine gland physiology.(The Surgical Patient)(Disease/Disorder overview)
November 1, 2008... Hidradenitis suppurativa is a disease affecting the apocrine sweat glands that often results in chronically draining sinus tracks and wounds. Over time, the affected areas become scarred and can be afflicted by contracture or tissue immobility....

Severe stress in an elderly woman causes a temporary "broken" heart: this novel cardiac syndrome has clinical features that mimic those of acute myocardial infarction. The typical patient is a postmenopausal woman.(CASE REPORT)(Case study)
November 1, 2008... CASE A 71-year-old white female presented to the emergency department (ED) for evaluation of chest pain. She reported that while she was sitting in church 2 hours earlier, she felt the sudden onset of crushing substernal chest pain, rated...

Examining the most popular weight loss diets: how effective are they? Patients may swear by a particular diet, but the medical evidence gathered so far indicates that for most, keeping lost weight off for at least a year is an elusive goal.
November 1, 2008... Overweight and obese are more than just descriptors--these health conditions, in which a person has an excess amount of body fat in relation to lean body mass, are indicators for numerous potential health problems. Whether a person is...

Scoliosis: a straightforward approach to diagnosis and management: scoliosis should be no more intimidating to manage than acute otitis media. This article reviews how to treat patients with the condition before and after referral to a specialist.(CME)(Disease/Disorder overview)
November 1, 2008... Scoliosis management is a fundamental component of pediatric evaluation and care. All PAs who treat pediatric patients should feel comfortable approaching this condition, just as one would treating otitis media or strep throat. The essential...

CME posttest.
November 1, 2008... EXPIRATION DATE: NOVEMBER 2009 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...

The title search: not just for real estate.(SOUNDING BOARD)
November 1, 2008... After more than 3 decades as a proud member of the PA profession, and as one who has focused on patient care exclusively during that entire time, I feel able to speak with some clarity about what has always been the most sensitive of subjects:...

Premenstrual dysphoric disorder (PMDD).(Quick Recertification Series)(Disease/Disorder overview)
November 1, 2008... * GENERAL FEATURES ** PMDD involves physical and behavioral symptoms that occur regularly in women in the luteal phase (days 14-28 of the menstrual cycle) and interfere with normal activities. ** PMDD is thought to be the most severe...

Psoriasis.(Quick Recertification Series)(Disease/Disorder overview)
November 1, 2008... [ILLUSTRATION OMITTED] * GENERAL FEATURES ** This chronic skin disorder is characterized by rapid epidermal cell turnover and proliferation of keratinocytes, resulting in formation of scaly plaques, pruritus, and inflammation. **...

Hematopoietic agents and methylphenidate are helpful in cancer-related fatigue.(Patient-oriented evidence that matters)(Brief article)
November 1, 2008... Clinical question What treatments are helpful in improving fatigue associated with cancer and its treatment? Bottom line In patients with cancer-related fatigue, methylphenidate may be helpful. Erythropoiefin is effective in improving...

Common smoking cessation methods are all effective.(Patient-oriented evidence that matters)(Brief article)
November 1, 2008... Clinical question What is the most effective pharmacotherapy for smoking cessation? Bottom line The commonly used methods of pharmacotherapy to improve smoking cessation rates--varenicline, bupropion, and nicotine replacement--are all...

Probiotics decrease antibiotic-associated diarrhea in children.(Patient-oriented evidence that matters)
November 1, 2008... Clinical question Can concurrent treatment with a probiotic decrease diarrhea associated with antibiotic use in children? Bottom line A probiotic consisting of several strains of a Lactobacillus species is effective in preventing prolonged...

Q: how can I quit smoking?(When the Patient Asks)
November 1, 2008... Cigarette smoking is extremely common: in the United States, about 18% of women and 24% of men smoke cigarettes. (1) Smoking increases the risk for various cancers, coronary artery disease, stroke, abdominal aortic aneurysms, upper and lower...

Q: how can I quit smoking?(Patient Information)
November 1, 2008... * HOW CAN I QUIT SMOKING? Cigarette smoking is a common habit. In the United States, about 18% of women and 24% of men smoke cigarettes. Smoking increases the risk of many diseases. Some of them are cancers, heart and blood vessel disease,...

A common cause of knee pain in athletic children.(Diagnostic Imaging Review)(Case study)
November 1, 2008... [FIGURE 1 OMITTED] * CASE A 13-year-old female presented with a 4-day history of left knee pain. The pain had come on suddenly. The patient stated that after she walked home from school, she had some moderate knee discomfort; then,...

Case of the month.(Case study)
November 1, 2008... [FIGURE 1 OMITTED] * CASE The patient is a spry, 79-year-old retired dentist who presented to the emergency department (ED) via emergency medical services (EMS) with an unwitnessed episode of passing out at home. The patient took...