A Day in the Life

A Day in the Life of Gina Brown, MPAS, PA-C

Gina Brown, MPAS, PA-C June 25, 2010

A PA working at a family practice clinic in Kabul, Afghanistan, describes her day as a Mother-Child Health Coordinator.
 

A day in the life of Major Shawn T. Buller, APA-C, MPH

Major Shawn T. Buller, APA-C, MPH April 13, 2010

The author narrates the activities of a day while deployed as a aeromedical physician assistant in Iraq.
 

A day in the life of Alexandra Braunstein Scott, MS, PA-C, MPH

Alexandra Scott, MS, PA-C, MPH February 11, 2010

A PA who works in the Michigan Clinical Research Unit at the University of Michigan Hospital describes an average day in the unit.
 

Critically Appraised Topic

MMR vaccine and autism: Is there a link?

Melissa L. Kemp, MPAS, PA-C; M. Beth Hart, MD, FAAP June 15, 2010

A focused search identifies three studies that disprove the theory of a causal relationship between autism and vaccines.
 

Should patients at low-to-moderate cardiac risk receive beta-blockers before undergoing noncardiac surgery?

Jennifer S. Williams, MMS, PA-C; Kristen K. Will, MHPE, PA-C; Zachary C. Hartsell, MPAS, PA-C; Adriane I. Budavari, MD March 29, 2010

A search of the literature does not support using beta-blocker therapy in patients at lower risks for cardiac events prior to noncardiac surgery.
 

Is black cohosh a safe and effective substitute for hormone replacement therapy?

Elizabeth Becker; Tanya Letham; James D. Stoehr, PhD September 29, 2009

A search of the literature found that patients who wish to avoid hormone replacement therapy are not likely to find relief of their symptoms with this alternative.
 

Editorial

Lessons learned: Writing editorials in the age of the Internet

Sarah Zarbock, PA-C May 05, 2010

After reading the online comments on one of her editorials, the author wonders: What has happened to our ability to converse with each other respectfully on topics about which we disagree?
 

Charlotte's Web: Lessons learned from a pig and a spider

Sarah Zarbock, PA-C April 07, 2010

Skilled communication is especially critical during conversations with children and their families about life-threatening and terminal conditions. How can E.B. White's classic children tale make you a better communicator?
 

Yes, I'm his daughter—and I'm also a physician assistant

Sarah Zarbock, PA-C March 04, 2010

The author explores what happens as the roles of medical professional and daughter coincide when her elderly father is hospitalized with pneumonia.
 

Genetics in Medicine

The Genetic Information Nondiscrimination Act (GINA): How PAs can protect patients and their families

Constance Goldgar, MS, PA-C July 14, 2010

A new law protects against the misuse of genetic information that may reduce health care benefits for patients and their families.
 

Moving beyond the basics: Teaching the genetics of complex traits

Michael J. Dougherty, PhD May 21, 2010

Genetic testing has rapidly expanded to include screening for thousands of genetic variants associated with common complex diseases.
 

The genetics encounter: Not the typical clinic visit

Gary S. Gottesman, MD, FAAP, FACMG March 18, 2010

The author explains the detail-oriented work of a pediatric geneticist working at a genetics clinic to help children and families dealing with rare disorders.
 

Humane Medicine

House calls, homebodies: Remembering that you came

Brian T. Maurer, PA-C June 16, 2010

The comfort of a clinician's home visit is immeasurable to patients who wish to live their last days in their own home.
 

Telling it slant: Using poetry 
as a venue for healing

Brian T. Maurer, PA-C April 27, 2010

When the author is invited to speak to a local boy scout troop, he uses poetry to find a pathway in to a difficult subject.
 

A grief observed: A belated bill must finally be paid

Brian T. Maurer, PA-C February 25, 2010

An encounter with a patient last seen 6 years previously reminds the author that there's no escaping grief. It always catches up with us.
 

Letters to the Editor

Urinary antigen test cannot be effective in patients with renal failure

QRS: Community-acquired pneumonia (CAP) in adults
 

Lyme disease rash is not always a bull's eye

On target with Lyme disease: Understanding vector-borne infections
 

Lyme disease: More than a controversy

On target with Lyme disease: Understanding vector-borne infections
 

PA Quandries

Is it ethically permissible to mandate influenza vaccination for health care workers?

Ralph Rice, MPAS, PA-C June 09, 2010

Patient autonomy does not always transcend to health care workers. The author makes a case for patient safety to be an overruling factor.
 

Eyes wide shut: Can casual use of medical evidence cause harm and erode bioethical values?

Jim Anderson, PA-C, ATC, Diane Bruessow, RPA-C; F.J. Gianola, PA, DFAAPA April 23, 2010

A complex patient case illustrates a range of societal and clinical biases and the impact these biases can have on patient care.
 

Why physician assistants should consider joining the hospital ethics committee

Jim Anderson, PA-C, ATC February 18, 2010

Service on an ethics committee allows PAs to learn how to apply bioethical principles, and it allows their colleagues to learn more about PAs.
 

Pharmacology Consult

Dosage adjustments in renal disease and steroid tapers

Larissa DeDea, PharmD, BCPS, PA-C July 08, 2010

This month's questions: What formula is best for calculating dosage adjustments in renal disease? When and how should oral steroids be tapered?
 

ACE inhibitor therapy and prescribing schedule II drugs

Larissa DeDea, PharmD, BCPS, PA-C June 03, 2010

This month's questions: How much can the serum creatinine rise when starting an ACE inhibitor? What controlled substance prescriptions can be called into a pharmacy?
 

POEMs (Patient-oriented evidence that matters)

Prophylaxis is not effective for tension-type headache

July 29, 2010

Clinical question: Are antidepressants, muscle relaxants, benzodiazepines, or vasodilators effective as prophylaxis for patients with frequent tension-type headache (TTH)?
 

Mood stabilizers can improve acute bipolar depression symptoms in some patients

July 29, 2010

Clinical question: In adults with acute bipolar depression, does treatment with a mood stabilizer improve symptoms or induce remission?
 

Metoclompramide is better than promethazine for hyperemesis

July 29, 2010

Clinical question: Is promethazine or metoclopramide more effective and/ or better tolerated for the treatment of hyperemesis gravidarum?
 

Research Corner

Physician assistants in hospital-based specialty practice

Richard W. Dehn, MPA, PA-C July 16, 2010

Four articles that review the impact and roles for physician assistants in hospital-based practice settings are reviewed.
 

The relative value and risks of nonphysician health care providers

Richard W. Dehn, MPA, PA-C April 14, 2010

The increasing number of nonphysician health care providers is prompting researchers to study their impact on the health care workforce.
 

The development of varying physician assistant roles in the United States

Richard W. Dehn, MPA, PA-C January 13, 2010

The studies discussed in this installment of Research Corner illustrate the growing demand for PAs in the American health care workforce across a variety of settings.
 

Sounding Board

PA profession in South Australia: One year later

Dawanda R. Pesicka, PA-C January 12, 2010

A PA participating in a South Australian trial reflects on her experience and the future of the PA profession in Australia.
 

Piecing together confusing symptoms

Kay Christian, MS, PC-C December 08, 2009

The author reflects on the pain and confusion her family experienced watching her sister struggle with frontotemporal dementia.
 

The art and science of defensive medicine

Denise Rizzolo, PA-C, PhD November 10, 2009

The art and science of medicine that serves patients' best interest is defended against the overwhelming need to avoid malpractice lawsuits.
 

The Surgical Patient

Collis-Nissen fundoplication for a symptomatic paraesophageal hernia

Ashley L. Racette, PA-C, MPAS; Richard T. Miller, MD July 12, 2010

A laparoscopic approach leads to relief of the patient's gastroesophageal reflux, uneventful surgery, and a smooth recovery.
 

A practical guide for mechanical ventilation in adult patients who require respiratory assistance

Richard G. Winters, MSPAS, PA-C; Donald A. Reiff, MD May 10, 2010

Providing care for postoperative, acutely ill, or traumatically injured patients requires an understanding of mechanical ventilation.
 

Drain placement with antibiotics provides effective therapy for appendicitis in pregnancy

Megan Bales Fulton, PA-C; Bennett Fontenot, MD; Stuart M. Leon, MD, FACS March 15, 2010

Conservative management is used effectively to treat a woman with a ruptured appendix at 32 weeks' gestation.
 

What's New?

What's new in military medicine: The ancient art of acupuncture is new again

Captain Trevor Ambron, MPAS, PA-C, USAF June 17, 2010

The modern-day equivalent of an ancient pain-relieving technique is helping injured troops without the side effects of narcotics.
 

What's new in breast oncology

Kathleen L. Connery, PA-C, MPAS April 16, 2010

Genetic profiling with the 21-gene RT-PCR assay improves predictions for risk of 10-year recurrence and response to chemotherapy.
 

What's new in diabetes: A1C assay emerges as a diagnostic test for diabetes

Karen A. Beer, PA-C, RD, CDE February 19, 2010

A committee of international experts recommends use of the A1C assay as the new standard diagnostic test for diabetes.
 

When the Patient Asks

What is hypertension?

Mary L. Hewett, PA-C, MS July 14, 2010

Hypertension is defined and how it is diagnosed is explained, including the severity levels for BP measurements.
 

What is an implantable cardioverter-defibrillator?

Mary L. Hewett, PA-C, MS May 17, 2010

Your patients with arrhythmias will want to know all there is to know about these lifesaving devices.
 

What do I do about treatment-resistant depression?

Mary L. Hewitt, PA-C, MS March 25, 2010

Patients who don't respond to their antidepressant should be evaluated carefully for compliance, substance abuse, bipolar disorder, and social stressors. Switching drugs or combination therapy may be warranted.
 
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