A Day in the Life

A Day in the Life: LTJG Ari Doucette, PA-C, MPAS

April 11, 2012

While in Afghanistan, a Navy PA provides medical care for military personnel, prisoner of war detainees, and local citizens, while exposing British health care providers to the PA profession.
 

A Day in the Life: Jacqueline McSparron, PA-C

February 27, 2012

A woman who became a PA so she could provide health care in Africa is living her dream.
 

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.
 

Critically Appraised Topic

When does treatment of subclinical 
hypothyroidism reduce cardiovascular risk?

, Mark E. Archambault, DHSc, PA-C February 21, 2012

Patients with subclinical hypothyroidism may have a higher risk of coronary events and in some cases should be treated.
 

Is rifaximin an effective treatment option for irritable bowel syndrome?

, 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?

, 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.
 

Editorial

What could PAs become if they answer the call to leadership?

May 01, 2012

The author explores leadership as epitomized by individual PAs, arguing that their stories will help others to realize their aptitudes for leadership, demystify the path to making lasting change, and invigorate PAs to lead the profession forward.
 

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

, 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

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.
 

Genetics in Medicine

Parkinson disease

May 28, 2012

This article reviews the diagnosis and treatment of Parkinson disease and defines how genetics and genetic testing can play a role.
 

Hereditary breast and ovarian cancer

, March 26, 2012

Patients who test positive for the BRCA1/2 mutations that cause breast and ovarian cancers have options when it comes to surveillance and prevention.
 

Chromosomal microarray testing

, 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.
 

Humane Medicine

Looking through a glass darkly, then seeing face to face

April 17, 2012

How do you explain to a mother your concern that her child, whom you have seen repeatedly over years, might have an underlying genetic syndrome that will profoundly impact the rest of her life?
 

Midnight medicine: A time when difficult decisions must be made

February 28, 2012

Moral distress: when clinicians feel they cannot do the ethically appropriate thing. Midnight medicine: when difficult decisions must be made with no time for consultation and critique.
 

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.
 

Letters to the Editor

Neuraminidase inhibitors are the standard for influenza, but aren't accessible by all

The author responds to the article "Battling Influenza: Universal vaccination is the primary weapon" in the January 2012 issue of JAAPA.
 

Midnight medicine: Our moral distress and wounds may never heal

A reader shares her reaction to "Midnight medicine: A time when difficult decisions must be made," in the February 2012 issue of JAAPA.
 

Health literacy is not just about "getting patients smarter"

Hidden variables: Why patients may misunderstand written screening tools
 

PA Quandries

Should PAs assess and address the impact of implicit bias on patient care?

April 24, 2012

Implicit bias is so subtle that colleagues may not recognize it in themselves. Among the signs to watch for are loss of patient autonomy and lack of fairness in treatment.
 

Surrogate decision makers: What if a 
surrogate cannot decide?

February 29, 2012

When a surrogate feels ill-equipped to make medical decisions, the first step for clinicians is to be aware of the laws that govern surrogacy.
 

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

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.
 

Pharmacology Consult

Clostridium difficile infection: 
Managing the risks

May 11, 2012

Proton pump inhibitors can increase the risk of C difficile infection, and some types of probiotics have a role in treatment and prevention.
 

DVT prophylaxis with aspirin
in orthopedic surgery patients

April 04, 2012

The 2012 ACCP guidelines on thromboprophylaxis after orthopedic surgery contain some surprises, basing recommendations on the type of surgery and sometimes countermanding earlier versions.
 

How do dihydropyridine and nondihydropyridine CCBs differ?

March 07, 2012

All calcium channel blockers have a similar mechanism of action, but they are not interchangeable and can exert very different physiologic effects.
 

POEMs (Patient-oriented evidence that matters)

Research Corner

Workforce prediction
 requires valid data

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

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

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.
 

Sounding Board

Physician assistants and retirement

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

, 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

, 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.
 

The Surgical Patient

Individualizing revascularization 
for peripheral arterial disease

, Anvar Babaev, MD, PhD, FACC March 05, 2012

Severely occluded arteries in patients at high risk of contrast-induced nephropathy require treatment with newer, catheter-based techniques.
 

An internal hernia causes abdominal pain and small bowel obstruction

, 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

, 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.
 

What's New?

What's new in hepatology: Triple therapy for hepatitis C

February 23, 2012

Combining one of two newly approved oral agents with traditional medications offers hepatitis C patients better outcomes with shorter therapy.
 

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

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

October 20, 2011

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

When the Patient Asks

 

Is a flu shot safe after GBS?

, Bettie Coplan, MPAS, PA-C March 22, 2012

More research is needed, but current data suggest that more cases of Guillain-Barré syndrome occur after the flu or an influenzalike illness than after vaccination.
 

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.
 
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