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A Day in the Life

A Day in the Life: Kaatje van der Gaarden, PA-C

December 13, 2011

A PA specializing in rehabilitation medicine finds reward in caring for patients with debilitating injuries.

A Day in the Life: Zehra Ahmed, PA-C, MBBS

Zehra Ahmed, PA-C, MBBS October 25, 2011

A PA describes her time in Oworobong, a rural village in Ghana, treating patients at a government clinic and adjusting to the cultural challenges such an immersion can bring.

A Day in the Life: Terri Peischl, MS, PA-C

Terri Peischl, MS, PA-C August 23, 2011

The author describes a typical day working for a PA pilot project at a major hospital in South Australia.

Is rifaximin an effective treatment option for irritable bowel syndrome?

Rachel E. Smith, BSN, Wilson Crone, MD, PhD December 22, 2011

Research suggests that rifaximin could offer symptom relief to IBS patients who have not had success with traditional medications and lifestyle modifications.

Can an ACE inhibitor reduce the risk of  developing progressive renal disease?

Lauren Jewett, MMS, PA-C, Mark E. Archambault, DHSc, PA-C September 15, 2011

Using CCBs to treat hypertension in African Americans based on the perception that they have increased efficacy may do little to prevent ESRD.

Do drospirenone-containing oral  contraceptives have a higher risk of VTE?

Jennifer Hofmann Ribowsky, MS, RPA-C August 11, 2011

Because these products are among the top-selling OCs in the United States, awareness of the evidence regarding their safety is essential.

A parent's death: Helping a  child after devastating trauma

Reamer L. Bushardt, PharmD, PA-C, Lloyd "Chip" Taylor, PhD December 06, 2011

PAs are ideally situated to intervene in situations of parental loss. We can do much to help these children, such as providing practical strategies that help create environments that support healing and normal development.

AAPA's new president: Learn more about a man on a mission

Reamer L. Bushardt, PharmD, PA-C September 06, 2011

Robert Wooten believes that PAs can provide the leadership needed to solve our health care challenges—leadership that he says begins the moment you volunteer and get involved.

Tales of the unexpected—and  the lessons therein for us all

Reamer L. Bushardt, PharmD, PA-C August 02, 2011

As a PA, you know how to make a team successful, and you have a deep understanding of why teams sometimes fail.

Chromosomal microarray testing

W. Andrew Faucett, MS, CGC, Melissa Savage, MS, CGC January 30, 2012

CMA testing of children with autism, intellectual impairment, or multiple congenital anomalies detects clinically significant chromosomal deletions and duplications that are not visible by routine chromosome studies.

Preimplantation genetic diagnosis

R. Lynn Holt, MS, CGC September 22, 2011

This article reviews the use of preimplantation genetic diagnosis (PGD), an assisted reproductive technology that has been used to evaluate embryos for genetic conditions prior to implantation.

Lynch syndrome

Ed Michaud, PhD July 29, 2011

Lynch syndrome, an autosomal dominant disorder that carries a high risk for colorectal and endometrial cancers, can be best detected by obtaining a family cancer history, screening colorectal and endometrial cancers for LS, and genetic testing of at-risk patients and family members.

An unlikely afternoon hero: When being there is good enough

December 20, 2011

In the middle of a humdrum afternoon at the office, in between sobbing febrile toddlers and heartbroken adolescents, those patients whose suffering I can do little to alleviate, momentarily I become a hero to one family.

Transitional medicine: Patients  who are just passing through

Brian T. Maurer, PA-C October 13, 2011

I watch them go—a new family I will most likely never see again. They've played by the rules, but got burned by the system. Lose your job, lose your health insurance, lose your doctor.

Growth and development: In  pediatrics, everything starts small

Brian T. Maurer, PA-C August 24, 2011

Some things grow more quickly than others, and sometimes we have the chance to weed the garden before it's too late.

Health literacy is not just about "getting patients smarter"

Hidden variables: Why patients may misunderstand written screening tools

Correction: PAs CAN prescribe buprenorphine

Current options in the management of opioid dependence: a review

Headache specialists enable a quicker diagnosis and less testing

Intermittent headaches relieved by lying down

After the error, then what? The emotional impact of errors on clinicians

Jim Anderson, PA-C, ATC December 22, 2011

Empathy seems to be on the side of the patient and family, but clinicians also need help in dealing with their feelings after they make a mistake.

The ethics of coding:  Are we committing fraud?

Helene Hill, MPAS, RPA-C, Matthew Hill, MDiv October 19, 2011

What are the ethical obligations of health care providers? Since auditors look to the medical record to validate billing, providers are expected to document thoroughly and completely on every case.

Physician assistants for sale:  Will prescribe for food

Jim Anderson, PA-C, ATC August 19, 2011

The evidence is consistent: Clinicians believe that their colleagues' prescribing behaviors are impacted by interactions with drug representatives but that their own practices are not. Unfortunately, they are wrong.

Prescribing opioids safely in  patients with an opiate allergy

Larissa DeDea, PharmD, BCPS, PA-C January 09, 2012

IgE-mediated allergy to opioids is rare but life-threatening, so distinguishing between a true allergic reaction and side effects to a previously prescribed opioid is crucial.

How should extravasation  injuries be treated?

Larissa DeDea, PharmD, BCPS, PA-C December 07, 2011

Most extravasation injuries do not result in significant harm, but prompt recognition and early treatment are crucial.

Understanding the appropriate and effective use of vancomycin

Elizabeth duPreez, PharmD November 09, 2011

Vancomycin should be dosed aggressively early on, with a loading dose given that is sufficient for rapid achievement of target concentrations.

Daily probiotic reduces upper RTI duration in elderly

January 13, 2012

Clinical question: Does a fermented probiotic (Lactobacillus casei) reduce the incidence or duration of common acute infections in the elderly?

Adjuvant increase efficacy of influenza vaccine in infants and children

January 13, 2012

Clinical question: Does an adjuvant improve efficacy of influenza vaccine in young children?

Oral care with chlorhexidine reduces the risk of VAP in intubated patients

January 13, 2012

Clinical question: Does oral care with chlorhexidine or povidone-iodine decrease the risk of ventilator-associated pneumonia in intubated patients?

Workforce prediction  requires valid data

Richard Dehn, MPA, PA-C, DFAAPA July 21, 2011

The methodology for predicting medical workforce supply and demand consists of estimating the future medical provider workforce as well as modeling future demand for medical services.

PAs in specialty care: The current trends

Richard Dehn, MPA, PA-C, DFAAPA April 26, 2011

The PA profession continues to shift away from primary care toward specialty care. Demand for PAs is increasing in relatively new specialties in the United States, creating new employment opportunities in these areas of practice.

Substitution of PAs and NPs for doctors in ED settings

Richard Dehn, MPA, PA-C, DFAAPA January 27, 2011

This installment reviews a quality of care comparison study, a novel study of patient willingness to see a PA or NP rather than a physician prior to the visit, and an article that disagrees with the second article's conclusions.

Physician assistants and retirement

Roderick S. Hooker, PhD, PA-C November 08, 2011

PAs may practice longer than expected and need to bridge their retirement in unprecedented ways. Who, what, and why remain challenging questions.

Ways to celebrate PA Week

Joshua N. Butler, MMS, PA-C, Katie E. Butler, MPAS, PA-C September 21, 2011

The PA profession is undeniably critical to the future of medicine, and we all have a responsibility to represent PAs the best we can.

Ovarian cancer: Breaking the silence

Kelly Donkers, MPA, PA-C, Heidi M. Felix, MPAS, PA-C September 16, 2011

More than 90% of women survive when ovarian cancer is caught early. The key is awareness, for both the patient and the PA.

An internal hernia causes abdominal pain and small bowel obstruction

Lisa Vieira, DHS, PA-C, Sona James, RN, MA, ACNP-BC, CCRN January 09, 2012

This case of a woman with an internal hernia caused by a small bowel obstruction illustrates a relatively rare condition. Clinician awareness and suspicion are key to a good outcome—left untreated, bowel strangulation is fatal more than 50% of the time.

Intrathoracic hemorrhage after placement of a subpleural catheter

Kylee Sondergaard, PA-C, Daniel J. Boffa, MD; Frank C. Detterbeck, MD; Anthony W. Kim, MD November 07, 2011

An already uncommon postoperative complication affects two patients in unusual locations and via different mechanisms.

Reduced lung function and bullae  resulting from illicit drug use

Amy L. Jay, PA-C July 25, 2011

A male patient was transferred for evaluation of large left bullae at risk for rupture. CT and history confirmed an interesting cause for the air pockets: marijuana, tobacco, and cocaine use.

What's new in lung cancer:  Screening, staging, targeted therapies

Michele Taffaro-Neskey, PA-C December 09, 2011

Chemotherapy damages both normal cells and tumor cells, but newer agents target specific biomarkers to inhibit cancer growth and progression.

What's new in emergency medicine : The utility of bedside ultrasonography

Clare Scott, PA-C October 20, 2011

Bedside ultrasonography has advanced the practice of emergency medicine, allowing physicians to establish prompt diagnoses and even improve patient outcomes.

What's new in multiple sclerosis treatment:  First oral drug, new antibody therapies

Teresa Frohman, PA-C, Megan Orchard, PA-C; Paula Hardeman, PA-C; Daniel L. O’Donoghue, PA-C, PhD August 18, 2011

A number of revolutionary new treatments for multiple sclerosis—including the first oral treatment, antibody therapies, and agents that may be able to regulate immune function—are currently being developed.

Does my child need fluoride supplements?

January 26, 2012

Fluoride has proven benefits in the prevention of cavities, but children may be exposed to too much fluoride. Parents should know how to monitor exposure to prevent dental fluorosis.