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November 2009 Issue of JAAPA

Editorial

The challenging economics of US health care reform

The current health care reform bills focus on expanding coverage without adequately addressing out-of-control health care costs.

Letters

Health costs reform versus health care reform

Editorial: The challenging economics of US health care reform

It's just a new name for an old concept

Clinical Watch: The PCMH: A model for primary care

An alternative perspective on how to treat Achilles' tendon injuries

How to diagnose and manage an acute Achilles tendon rupture

Dermatology Digest

Is this skin diseased, or is it just dirty?

Two brothers are brought to clinic with a mysterious dirty appearance to their skin that did not resolve with routine cleaning.

Clinical Watch

Major depression: Screening and treatment

Depression is under-diagnosed in primary care and other settings, but screening is as simple as asking the patient two brief questions.

CME

The role of human papillomavirus testing in cervical cancer screening

HPV infection can progress to cervical cancer. Updated screening guidelines identify those at high risk for more serious disease.

Managing the adverse effects of bisphosphonate therapy on the jaw

Despite its undisputed benefits, bisphosphonate therapy can lead to jaw osteonecrosis, a devastating oral condition.

CME Posttests

CME Posttest: The role of HPV testing; Osteonecrosis of the jaws

November 2009

The Surgical Patient

An uncommon cause of mechanical small bowel obstruction

An otherwise active and healthy, older man experiences a recurrence of GI symptoms that occur after eating.

Review Articles

Have the latest CPR guidelines improved cardiac arrest outcomes?

Do CPR and ACLS protocols make a difference for cardiac arrest victims? Outcome data are finally available to answer this question.

Surgical Review

Surgical treatments for patients with an infected total knee arthroplasty

Two-stage revision arthroplasty is the usual treatment for an infected knee replacement, but less invasive procedures may also work.

Quick Recertification Series

Lipid disorders

Hyperlipidemia is a major risk factor for coronary artery and heart diseases. This article reviews screening and the most effective approach to disease management in ...

Sounding Board

The art and science of defensive medicine

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

POEMs

Highly sensitive troponin I is a more accurate test for AMI

Clinical question: Are the new, highly sensitive cardiac troponin tests more accurate for early diagnosis of acute MI (AMI) than older assays?

Antivirals have a small benefit in children

Clinical question: Do antivirals hasten symptom resolution or prevent influenza in children?

Corticosteroids hasten resolution of sore throat symptoms in adults

Clinical question: Do systemic corticosteroids reduce symptoms in adults and children with sore throat?

Aspirin use after diagnosis of colon cancer reduces mortality

Clinical question: Does aspirin use after the diagnosis and treatment of nonmetastatic colon cancer reduce mortality?

Mediterranean diet delays need for diabetes treatment

Clinical question: In overweight patients with newly diagnosed type 2 diabetes, does a Mediterranean-style diet delay the need for antihyperglycemic treatment?

Denosumab reduces fracture risk better than placebo

Clinical question: Is denosumab safe and effective for the prevention of fractures in women with osteoporosis?

When the Patient Asks

How can I reduce the risk of SIDS?

This brief review helps you to make sure that expectant parents in your practice know all the current ways to reduce the risk of SIDS.

Diagnostic Imaging Review

Foot pain for 5 years, and an abnormal radiograph

Learn to recognize the clinical manifestations and radiographic appearance of a condition you may never have heard of.

Genomics in PA Practice

Helping your patients to deal with a predisposition to genetic disease

PAs who understand both the medical and psychological implications of genetic information can help to integrate this new area of medical practice into the lives ...

Case of the Month

A 2-week history of painful urination

An otherwise healthy 6-year-old boy presents with nonspecific abdominal pain. Recent voiding behaviors were the most definitive clues to this diagnosis.

Ask a Librarian

Ask a Librarian!—November 2009

Which is better—Medline or Google Scholar? How can community-based PAs search the medical literature most easily and economically? This month's installment answers these questions.

Eliminating Health Disparities: What Works?

Eliminating health disparities: What works?—November 2009

This column examines recent literature on health disparities, emphasizing tools that can help clinicians to assess and address disparities in their own practices. This month's ...