样式: 排序: IF: - GO 导出 标记为已读
-
An overview of myelodysplastic syndromes J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-05-10 Gina Pontrelli, Carina Loscalzo, Mark L'Eplattenier
Myelodysplastic syndromes (MDS) can present as a cytopenia—often as unexplained anemia. Because MDS can progress to acute myelogenous leukemia, primary care providers should be aware of the signs and symptoms, which are associated with the corresponding cytopenia that patients experience and may include fatigue, infection, easy bruising, and bleeding. Treatment options center on managing related cytopenias
-
Suicide and homicide deaths of PAs: Analysis of the National Violent Death Reporting System J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-05-10 William N. Robiner, Collin A. Dorzinski
Objective: This study describes physician associate/assistant (PA) deaths in the US CDC's National Violent Death Reporting System (NVDRS) from 2003 to 2020. Methods: PAs' violent deaths were analyzed and summarized in terms of decedents' numbers and demographics, methods of death, locations of death, and relationships with assailants. Results: The NVDRS identified 93 suicides and 9 homicides in
-
An update on treatments for autosomal dominant polycystic kidney disease J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-05-10 Suhani Janak Patel, Catherine K. Sadowski
Autosomal dominant polycystic kidney disease (ADPKD) is less common than primary hypertension or diabetes but should be considered as a possible cause of end-stage renal disease, especially in young patients without comorbidities. Because of ADPKD's nonspecific symptoms, the diagnosis, treatment, and pertinent patient education may be delayed. This article describes ADPKD and its management, including
-
Drugs in primary care that may alter COVID-19 risk and severity J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-05-01 Brent Luu, Sampath Wijesinghe, Tarek Kassem, Justin Lien, Darrick Luu, Rynee Wijesinghe, Leianna Luu, Gerald Kayingo
This article describes drugs used in primary care that could alter patients' risk for and severity of COVID-19. The risks and benefits of each drug class were differentiated according to the strength of evidence from 58 selected randomized controlled trials, systematic reviews, and meta-analyses. Most of the studies reported on drugs affecting the renin-angiotensin-aldosterone system. Other classes
-
What is the analgesic ceiling dose of ketorolac for treating acute pain in the ED? J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-05-01 Reynold Jaglal, Eric C. II Nemec
Recent research has suggested that ketorolac has an analgesic ceiling effect, meaning that despite increased dosages, the patient obtains no additional pain relief and is more likely to suffer adverse drug reactions. This article describes the outcomes of these studies and the recommendation to use the lowest possible dose for the shortest time when treating patients with acute pain.
-
Diagnosing and managing adrenal incidentalomas J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-05-01 Justine Herndon, Irina Bancos
Adrenal incidentalomas are commonly encountered because of the widespread use of high-resolution cross-sectional imaging. Adrenal incidentalomas may be benign or malignant, and also may demonstrate hormonal hypersecretion, so all patients with adrenal masses should undergo further assessment. Clinicians should have a basic understanding of adrenal incidentalomas, their workup, and when follow-up and
-
Fecal impaction in adults J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-05-01 Victoria Louwagie, Mark D. Steinman, Ming-Hsi Wang
Fecal impaction is a common digestive disorder and is considered an acute complication of chronic and untreated constipation. Generally, the factors responsible for fecal impaction are similar to those associated with constipation. Early identification and treatment minimize complications and patient discomfort. Common treatment options to address fecal impaction of the rectum include manual disimpaction
-
Skin lesions in a man with end-stage renal disease J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-05-01 Chelsea Makowicz
Calciphylaxis is an uncommon condition most often seen in patients with end-stage renal disease. It is easily mistaken for other more common conditions and requires a high level of suspicion to make a timely diagnosis. Although various treatments such as IV sodium thiosulfate and bisphosphonates have been used for management, calciphylaxis remains a condition with a high mortality that requires an
-
Paired analysis of ED efficiency for low-acuity children treated by PAs and pediatricians J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-05-01 Kenneth W. McKinley, Jennifer Q. Tran, James M. Chamberlain, Deena D. Berkowitz
Objective: To determine if there was a clinically important difference (15 minutes or more) in length of stay (LOS) for low-acuity pediatric ED patients treated by PAs compared with those treated by pediatricians. Methods: Between July 2017 and February 2020, shifts were identified that had shared PA and pediatrician staffing in the low-acuity care area for a large, urban ED. LOS was collected for
-
Understanding arrhythmogenic right ventricular cardiomyopathy J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-05-01 Regina Welkie
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited cardiac disease characterized by fibrofatty replacement of myocardial tissue and is an important cause of ventricular dysrhythmias, ventricular dysfunction, and sudden cardiac death. The clinical course and genetics of this condition are highly variable, and definitive diagnosis can be challenging, despite published diagnostic criteria
-
Stronger together: PA and APRN shared governance council drives transformational change J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-05-01 Rebecca K. Swanson, Theresa A. Diederich, Samantha Jordan-Schaulis, Brandon L. Reicks, Risa Zimmerman
Physician associates/assistants (PAs) and advanced practice RNs (APRNs) are a vital part of the healthcare team. As the PA and APRN workforce continues to grow, collaborations can move beyond the bedside. With organizational support, a shared APRN/PA Council allows these clinicians to raise a collective voice on issues that are unique to their practice and to implement meaningful solutions, thus improving
-
Racism: Eroding the health of Black communities J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-05-01 James Anderson, Patricia J. Devine, Quanté Greenlee, Deanna Bridge Najera, Delilah Dominguez
Even in the context of major advances in medicine, racial minorities continue to suffer worse medical outcomes. Although race is defined as a social, nonscientific construct, researchers have continued to use it as proxy to explain genetic and evolutionary differences among patients. Poorer health outcomes among Black Americans are known to be related to the psychosocial and physiological stress of
-
PAs as principal investigators of FDA-regulated clinical trials J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-04-06 Colleen Elizabeth Gosa Nalepinski
A misconception exists that only physicians can be principal investigators for FDA-regulated human clinical trials such as interventional studies. This article reviews existing guidelines and dispels the notion that physician associates/assistants (PAs) cannot be principal investigators for clinical trials. Additionally, this article describes an implementation plan to correct the misconception and
-
Acknowledging the risk of suicidal ideation, depression, and anxiety in PAs J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-04-01 Noël E. Smith, Talia Sierra, Heidi Brown
The prevalence of suicidal ideation is unknown and limited information exists about depression and anxiety among physician associates/assistants (PAs). We set out to understand the degree of depression, anxiety, and suicidal ideation in PAs and PA students. In total, 728 PAs and 322 PA students took an online survey. Risk of depression and anxiety were present at higher levels in PA students compared
-
The roles of neuroinflammation and glutamatergic excitotoxicity in treatment-resistant depression J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-04-01 Ryan Candee, Rachel Wilkenson, Molly Schreiber, Megan DeCenzo
Major depressive disorder affects nearly 20% of people during their lifetime. A growing body of evidence supports the theory that neuroinflammation plays a prominent role in the neurobiology of depression, which implicates glutamate and gamma aminobutyric acid as key factors in the pathophysiology of the disease process. This article reviews the pathologic pathways of glutamate excess in the central
-
Recognizing and managing hydrocephalus in children J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-04-01 Corinne I. Alois, Allison Luntz
Hydrocephalus is one of the most common indications for pediatric neurosurgical intervention and is associated with the need for lifelong monitoring. All clinicians should be familiar with the complications that may arise throughout life in these patients so that they can provide timely intervention. This article focuses on the assessment of hydrocephalus, the appropriate diagnostic workup and differential
-
Precision oncology comes of age J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-04-01 Steven Sorscher
Each cancer has a unique fingerprint, and precision oncology can be used to more effectively fight malignancies. The identified genes, expressed RNA, and proteins expressed in patients' cancers are now used routinely to predict prognosis and inform treatment recommendations. This article describes how malignancies develop and some of the targeted drugs that can be used against them.
-
Botulinum neurotoxin: A therapeutic powerhouse with broad clinical implications J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-04-01 Jamie H. R. Aldridge
Clostridium botulinum is a Gram-positive bacterium that produces one of the most deadly chemodenervating toxins in the world. To date, six distinct neurotoxins are available for prescription use in the United States. Decades of data across aesthetic therapeutic areas and therapeutic disease states support the safety and efficacy of C. botulinum, providing good symptom management and improved quality
-
Rent-a-MEDEX: An early PA prototype J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-04-01 Donald Pedersen, Roderick S. Hooker
In the 1970s, busy physicians knew little about the capabilities of a new member of the healthcare team—the physician associate/assistant (PA). Internal studies by the University of Utah and University of Washington educational programs demonstrated that the MEDEX/PA could increase access to care by providing quality, cost-effective care in rural primary care practices. Marketing this concept was essential
-
High-pressure injection hand injury: What lies beneath? J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-04-01 Paul A. Willette, Emily Barker
High-pressure injection injuries are true emergencies that require prompt treatment to avoid devastating complications. This article describes the presentation and management of these injuries and provides clear and concise recommendations for intervention by the ED clinician.
-
Oral iron replacement vs. IV iron treatment in bariatric surgery patients with anemia J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-04-01 Angelyn Connors, Elyse J. Watkins
Bariatric surgery has become a recognized tool to reduce weight and resolve or improve comorbid conditions associated with obesity. Patients with obesity are at risk for nutritional deficiencies because of poor-quality diets and the chronic inflammatory state of obesity. Iron deficiency is common in these patients, with incidence rates as high as 21.5% preoperatively and 49% postoperatively. Iron deficiency
-
Are beta-blockers safe and effective after myocardial infarction in patients with COPD? J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-03-01 Lindsay E. Davis, Elizabeth K. Pogge, Rajeev Garg
Clinicians may be hesitant to prescribe beta-blockers in patients with chronic obstructive pulmonary disease (COPD) who have a comorbid compelling cardiovascular indication for beta-blocker therapy. This article summarizes the available data on the safety and efficacy of beta-blockers in patients with COPD and recent myocardial infarction.
-
An outpatient pain plan and ED pain pathway for adults with sickle cell disease J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-03-01 Stephanie Harris Mercado
Sickle cell disease (SCD), one of the most common inherited diseases, is associated with lifetime morbidity and reduced life expectancy. In the United States, SCD primarily affects Black patients and, to a lesser degree, those of Hispanic descent. These populations are known to have healthcare disparities related to lower socioeconomic status, limited access to healthcare, and racial bias. The quality-adjusted
-
A patient with untreated preeclampsia and peripartum cardiomyopathy J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-03-01 Mara A. Prickett, Christopher M. Howell
The pathophysiologic process of peripartum cardiomyopathy, a rare and potentially life-threatening condition, is not completely understood. One theory is a possible link between the development of preeclampsia and peripartum cardiomyopathy. These two conditions have been linked to significant mortality in peripartum or postpartum patients. Clinicians must be able to identify the two, their differences
-
Mindfulness for depression management in men with prostate cancer J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-03-01 Amber Teigen
Increasing incidence and survival rates of prostate cancer are leaving more men to suffer the sequelae of their diagnosis and treatment, like depression. Depression and other negative psychosocial factors significantly affect this population but often go undiagnosed and/or ineffectively managed. This case report focuses on the negative effects of prostate cancer diagnosis and treatment, the importance
-
Genicular nerve radiofrequency ablation: An option for knee osteoarthritis pain J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-03-01 Jennifer L. Swanson
Genicular nerve radiofrequency ablation is an option to treat osteoarthritic knee pain unresponsive to conservative and minimally invasive measures. This article reviews genicular nerve radiofrequency ablation, neuroanatomy of the knee, patient selection, results, and risks and complications of the procedure.
-
Characteristics of highly prolific PA authors who contributed research to JAAPA and JPAE J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-03-01 Marcia Bouton, Michael Halasy
Objective: Highly published physician associate/assistant (PA) researchers were surveyed to quantify experienced support patterns that may inform increased support of PA-led research. Methods: Publication volume of authors of research articles published in JAAPA and the Journal of Physician Assistant Education (JPAE) between 2011 and 2020 was recorded. PAs in the upper quartile were emailed surveys
-
PAs in the Republic of Ireland J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-03-01 Pauline Joyce, Sean T. Robinson, Lisa Mustone Alexander
The physician associate/assistant (PA) profession was introduced into the Republic of Ireland following a 2-year pilot project with the Irish Department of Health between 2015 and 2017. Four PAs from North America were recruited into four designated surgical services at a large teaching hospital in Dublin. To date, the PA numbers are small in Ireland, with one university, in Dublin, running the program
-
PAs and NPs in employee health during the COVID-19 pandemic J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-03-01 Pauline O'Bryan, James Cutrell, John D. Gonzalez, Azadeh Namiranian
COVID-19 created unprecedented occupational health challenges for hospitals. To meet these demands at a large county safety-net hospital, a COVID-19 employee response team led by PAs and NPs was created. From April 2020 through February 2022, this team managed more than 14,000 discrete employee contacts related to COVID-19 employee concerns. This article describes our experience in creating this team
-
A review of organizing pneumonia J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-03-01 Kimberlee Ketchersid
Organizing pneumonia is a clinical and pathological syndrome that describes a lung injury caused by an inflammatory reaction in the alveolar connective tissue. Classified as an interstitial lung disease, it can be secondary to infection, drug toxicity, connective tissue disorders, inhalation injuries (cocaine), organ transplant, or radiotherapy, and also can be idiopathic. Although organizing pneumonia
-
Whither the PA doctorate? J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-02-01 James F. Cawley, Gerald Kayingo, Violet Kulo
New perspectives have been brought to bear in the discussion of the topic of the physician associate/assistant (PA) doctoral degree in general and the entry-level PA doctorate in particular. Both the Physician Assistant Education Association (PAEA) and the American Academy of Physician Associates (AAPA) have sought and supported formal research investigations into the question. Evidence from studies
-
Which patient factors increase the risk of fluoroquinolone-associated reactions? J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-02-01 Letitia N. Warunek, Susan M. Smith
Fluoroquinolones commonly are used to treat a variety of infections in the urinary, gastrointestinal, and respiratory tracts. Clinicians should evaluate patients to ensure that a fluoroquinolone is a safe and effective therapy to treat the infection. This article discusses patient factors that increase the risk for serious adverse drug reactions that can occur with fluoroquinolone use.
-
An update on expanding HIV preexposure prophylaxis J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-02-01 Jonathan Baker, Joanne Rolls
HIV continues to affect certain populations disproportionately, including sexual and gender minorities, racial/ethnic minorities, and populations with limited resources in southern US states. New CDC guidelines include a recommendation to discuss HIV preexposure prophylaxis (PrEP) with all sexually active patients, which is likely to expand use. The guidelines also include important changes in PrEP
-
Wellens syndrome: An important consideration in patients with chest pain J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-02-01 Joshua Alexander, Denise Rizzolo
Coronary artery disease (CAD) is the number one cause of death in the United States, and it is estimated that every 40 seconds one person experiences a heart attack. Among patients with chronic CAD, many will experience a potentially fatal complication known as acute coronary syndrome (ACS). Wellens syndrome is a rare form of ACS that indicates critical left anterior descending coronary artery occlusion
-
The art of shared decision making J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-02-01 Luke Bingaman
Now more than ever, we know that there is uncertainty in medicine. Over the past 2 years, we have witnessed the evolution of knowledge that occurs in medicine and how this informs medical recommendations. Similarly, we have learned that patients have varying levels of risk tolerance, goals, and values. Although this is not a new reality, the COVID-19 pandemic has put it on display. Shared decision
-
Well-being and the early-career PA: Influence of the collaborative physician relationship J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-02-01 Kari Sue Bernard
Objective: Recent updates to physician associate/assistant (PA) laws reflect less mandated supervision. Although greater autonomy may inspire experienced PAs, newer PAs may struggle with less required oversight. This study examined the influence of autonomy, career length, and the quality of the collaborative physician (CP) relationship on PA well-being. Methods: A secondary analysis of data gathered
-
PA and NP onboarding in primary care: The participant perspective J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-02-01 Nathalie Ortiz Pate, Hilary Barnes, Heather R. Batchelder, Lorraine Anglin, Mara Sanchez, Christine Everett, Perri Morgan
Objective: To describe new graduate physician associate/assistant (PA) and NP perspectives of onboarding programs in their first primary care position. Methods: Thirteen semistructured interviews were conducted with new graduate PAs and NPs who participated in onboarding programs. Interviews were transcribed and then analyzed using an inductive coding methodology. Results: Analyses revealed nine
-
Sudden anisocoria in a healing pediatric multitrauma patient J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-02-01 David Shane Harper, Sarah Bayless
This article describes a teenager who developed anisocoria with no obvious neurologic deficits or decline after a motor vehicle accident. The condition resolved over several hours before reappearing in the opposite eye 2 days later. Again no clinical neurologic deficits were noted and the condition resolved after several hours. The patient's asymptomatic anisocoria was finally determined to be secondary
-
Treating pain using acupuncture for nonacupuncturists J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-01-01 Bernard Jr. Toney
Battlefield acupuncture is a specific auricular acupuncture protocol that can be performed by nonacupuncturists in military and civilian clinical settings. Battlefield acupuncture is purported to be efficacious in controlling pain, is quickly administered, and requires minimal postadministration observation. With very low risk and a negligible adverse reaction profile, this technique can be used as
-
Endometrial cancer and obesity: Addressing the awkward silence J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-01-01 Lacey King, Shilpa Gajarawala, Melissa D. McCrary
Endometrial cancer is the most common malignancy of the female reproductive system diagnosed in the United States. The most commonly cited cause is unopposed endogenous estrogen produced by excess adipose tissue. Endometrial cancer typically is diagnosed in postmenopausal women with a body mass index (BMI) of 25 kg/m2 or more. This article reviews how clinicians can use a systematic approach to fill
-
Which four medication classes have important pharmacogenetic considerations? J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-01-01 Susan M. Smith
Medications often are prescribed without knowledge of a patient's pharmacogenetic profile. Initial therapy may require subsequent modification due to adverse reactions or lack of efficacy. Although many variables, including changes in pharmacokinetics, pharmacodynamics, or patient nonadherence, may account for these outcomes, information about a patient's ability to metabolize or transport drugs across
-
Lung cancer screening in primary care J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-01-01 Ashley Peterson
This article reviews the evidence supporting low-dose CT to screen for lung cancer, and the risks, costs, and challenges of implementing broad-based screening for eligible patients. Increased familiarity with lung cancer screening guidelines by primary care and specialty clinicians presents an opportunity to improve lung cancer screening rates and to save lives from the most common cause of cancer
-
Early identification of Lyme disease complications J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-01-01 Kristin Eckenrode
Complications of Lyme disease including Lyme arthritis, Lyme carditis, and Lyme neuroborreliosis, typically occur during the early disseminated and late phases of the disease. Clinicians must maintain a high index of suspicion so they can recognize and treat complications promptly. Early treatment with appropriate antibiotics often leads to improved clinical outcomes.
-
A curious case of a blue finger J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-01-01 Kristine Trotter, James Espinosa, Alan Lucerna
This article describes an unusual presentation of a blue finger in a middle-aged woman with no significant past medical history. The patient was diagnosed with Achenbach syndrome, a rare condition that is generally considered transient and benign. The underlying pathophysiology of this condition is unclear, but may be related to transient subcutaneous ecchymosis, possibly from microtrauma. If the condition
-
When is caring sharing? Primary care provider interdependence and continuity of care J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-01-01 Christine M. Everett, Jacob Christy, Perri A. Morgan, Sharron L. Docherty, Valerie A. Smith, John B. Jr. Anderson, Anthony Viera, George L. Jackson
Efforts to improve access to high-quality, efficient primary care have highlighted the need for team-based care. Most primary care teams are designed to maintain continuity of care between patients and primary care providers (PCPs), because continuity of care can improve some patient outcomes. However, PCPs are interdependent because they care for, or share, patients. PCP interdependence, and its association
-
New Zealand PA profession gains momentum with regulation in sight J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2023-01-01 Lisa Fitzgerald deWolfe
This article offers an update on physician associate (PA) growth and development in the New Zealand healthcare system. New Zealand has a shortage of healthcare workers and PAs offer a solution. Regulation is in process and will allow a full scope of practice for PAs. A New Zealand-based PA training program also is being considered when regulation has progressed.
-
Complicated appendicitis in a patient with myelodysplastic syndrome and pancytopenia J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2022-12-01 Samantha Gaffney, William Dunson
Patients with immunocompromise presenting with abdominal pain can present a diagnostic challenge, because they may have atypical or vague symptoms. This case report discusses nonoperative management of a patient with immunocompromise, complicated appendicitis, and intra-abdominal infection.
-
Bruising, hair loss, and stretch marks in a 23-year-old woman J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2022-12-01 Sonya M. Peters
This article describes a 23-year-old woman with bruising, hair loss, and stretch marks, which was found to be due to Cushing syndrome. Because of its nonspecific symptoms, this disease of hypercortisolism can be mistaken for other conditions.
-
A review of slipped capital femoral epiphysis J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2022-12-01 Emma V. Cotton, Samuel C. Fowler, Kristopher R. Maday
Hip pain in children is common, with causes ranging from the benign to destructive. This article reviews slipped capital femoral epiphysis (SCFE), one of the most common hip pathologies in preadolescents and adolescents, which often is missed or delayed in diagnosis because of its vague, atypical presentation.
-
Using teledermatology to prevent and diagnose skin cancer in the rural United States J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2022-12-01 Veronica Benedit, Mallory M. Aycock
In the United States, skin cancer is a prevalent and sometimes preventable form of cancer that causes a significant disease burden in rural and urban communities. Studies have shown, however, that rural residents are less likely to engage in primary prevention behaviors against skin cancer, and rural populations have higher skin cancer incidence and mortality than urban residents. Teledermatology can
-
PAs in Myanmar: Courage and humanitarianism required J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2022-12-01 Gina R. Brown, Zu Zae Nar Blue
Myanmar might be the most recent country to graduate its first class of physician assistants (PAs). The country has a history of medics serving in underserved areas, but graduated its first six PAs in 2020, after a 5-year training program. These clinicians will care for a largely rural population, who live in areas of unreliable infrastructure and security. The PA profession in Myanmar aims to reduce
-
Neuropathic upper extremity pain: A double-crush scenario J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2022-12-01 Elizabeth Worthley
Neuropathic upper extremity pain has many causes. Cubital tunnel syndrome is the second most common compressive peripheral neuropathy after carpal tunnel syndrome. Entrapment, or compression, of the ulnar nerve at the elbow classically presents with elbow pain, numbness in the ulnar nerve distribution, and weakness in the hand. C8 radiculopathy and various brachial plexopathies can mimic cubital and
-
Herpes zoster: A primary care approach to diagnosis and treatment J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2022-12-01 Angela Kelley
Herpes zoster, or shingles, caused by a reactivation of the chickenpox virus, can occur in patients of any age, but is more common in older adults. Patient history is critical in reaching a diagnosis, not only to manage the outbreak effectively, but also to prevent severe complications such as dissemination of the virus into the central nervous system. This article describes recent changes in diagnostic
-
Understanding carpal tunnel syndrome J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2022-12-01 Jose Omar Garcia, Derek Scott, Parth Parikh, Kara L. Curley, Ali Turkmani
Carpal tunnel syndrome (CTS) is an entrapment neuropathy affecting the median nerve. Prevalence is estimated at 4% to 5% of the population. A solid understanding of the anatomy, presentation, and diagnostics is key to efficient diagnosis and appropriate referral. Both surgical and nonsurgical interventions have led to improved clinical outcomes. Clinicians who have an in-depth knowledge of CTS symptoms
-
Dual antiplatelet therapy for minor ischemic stroke and transient ischemic attack J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2022-12-01 Blake Miller, Kayce M. Shealy
Traditional preventive management of patients suffering from a minor ischemic stroke and/or transient ischemic attack indicated dual antiplatelet agents for 90 days. Newer clinical trial data suggest that therapeutic effectiveness is reached much sooner than previous guideline recommendations. Continued use of dual antiplatelet therapy beyond newly studied durations of efficacy has shown an increased
-
A cross-sectional survey of German PA employment and workforce entry J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2022-12-01 Peter Heistermann, Hans-Joachim Günther, Claudia Heilmann, Tanja Meyer-Treschan, Stefan Sesselmann, Andre Schneke, Lorenz Mihatsch, Tamika Lang, Walter Mihatsch
Objective: The contribution of physician assistants (PAs) to the German healthcare workforce has increased significantly since their introduction in 2005. From five training programs, the number has increased to the current 18, with 560 PAs awarded the PA bachelor of science degree as of 2020. Despite the growth, researchers lack systemic and reliable empirical data that provide insight into the German
-
A curious case of ovarian cysts J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2022-12-01 Rebecca Hodges, Elyse Watkins
Benign mature cystic teratomas are a form of ovarian germ cell tumor that originates from primordial germ cells in the ovaries. Of the three types of teratoma neoplasms, benign mature cystic teratomas (also called dermoid cysts) are the most common. Patients may present with intermittent abdominal or pelvic pain, abdominal enlargement, dysmenorrhea, dyspareunia, or may be asymptomatic. Clinicians should
-
The PA profession in Israel: A half-decade perspective J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2022-11-01 Roi Ozer
Implementation of physician assistants (PAs) in EDs throughout Israel began in May 2016. The profession is now showing some progress but at a relatively slow rate. This article provides an overview of Israel and its healthcare system, and describes the implementation, deployment, education, training, and scope of practice of PAs in Israel, plus recent developments and suggestions for advancing the
-
Assessing and benchmarking equity, diversity, and inclusion in healthcare professions J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2022-11-01 Gerald Kayingo, Carolyn Bradley-Guidry, Nicole Burwell, Sumihiro Suzuki, Ramona Dorough, Vanessa Bester
Healthcare professions are among the fastest growing careers in the United States, but the issues of equity, diversity, and inclusion remain a challenge. The percentage of underrepresented minority groups is disproportionately small despite many efforts to increase workforce diversity over the past several decades. As the demographics in our nation are rapidly changing, increasing racial, ethnic, and
-
What is rilonacept's role in treating recurrent pericarditis? J. Am. Acad. Physician Assist. (IF 1.1) Pub Date : 2022-11-01 Nicholas C. Schwier
The interleukin (IL)-1 antagonist rilonacept is approved by the FDA to treat recurrent pericarditis. In adults and adolescents with multiple recurrences of pericarditis, compared with placebo, rilonacept is associated with a lower risk of recurrent pericarditis, more persistent clinical response, normalized C-reactive protein within 7 days, and a higher number of days with no or minimal pericarditis