Dysfunctional uterine bleeding from the primary care perspective

, Daniel Cervonka, DHSc, PA-C April 23, 2012

PAs need to be informed about the diagnosis and management of excessive uterine 
bleeding, which is one of the most common reasons women seek gynecologic care.
 

An anti-inflammatory diet: The next frontier in preventive medicine

February 06, 2012

Although a healthy diet has long been encouraged for many reasons, research now shows 
a correlation between the foods we eat and biomarkers of inflammation.
 

Chikungunya virus: An emerging condition in the industrialized world

, Paul P. Rega, MD, FACEP; Christopher E. Bork, PhD, EMT-B, FASAHP January 23, 2012

Once found only in developing tropical nations, CHIKV has spread to the world at large. 
With proper management and close communication with authorities, it can be contained.
 

Interactions between supplements and drugs: Deciphering the evidence

December 12, 2011

Make sure you know what dietary supplements your patient uses because the potential for interaction with a medication you prescribe is significant.
 

The use of NIPPV therapy to treat 
patients with acute respiratory failure

November 09, 2011

Appropriate use of noninvasive positive pressure ventilation can decrease the morbidity and mortality rates associated with standard treatment for ARF.
 

The use of corticosteroids for spinal cord injuries: Where are we now?

October 17, 2011

Clinicians have long been confused about how to best treat SCIs. Research on the topic is limited, and existing study designs remain flawed. This article reviews the literature.
 

Hidden variables: Why patients may misunderstand written screening tools

, Jennifer DeLong, PA-C; Viraj A. Master, MD, PhD, FACS September 19, 2011

Low health literacy and education level adversely affect patients' understanding of written screening tools. Strategies are available to prevent confusion and improve outcomes.
 

Animal-assisted therapy: Do patients experience a medical benefit?

August 01, 2011

Statistically significant changes are not often seen in studies, but patients report feeling better after interaction with an animal and that alone should justify the use of animal-assisted therapy.
 

Serum anion gap: An important tool in patients with acid-base disorders

, Divya Rajan, MD; Alluru S. Reddi, MD, PhD July 01, 2011

Calculation of serum anion gap produces a useful tool for classifying metabolic acidosis, even though no actual gap exists in the normal physiologic state.
 

An effective tool in establishing the diagnosis of sport-related concussion

Jonathan Thomas Baird, MPAS, PA-C, ATC June 20, 2011

An objective assessment of concussion will benefit the athlete as well as aid clinicians in 
accurately describing the injury to parents, coaches, and the athletes themselves.
 

Current options in the management of opioid dependence: A review

, Kenneth W. Faistl, MD, FAAFP; Joseph L. Monaco, PA-C, MSJ May 16, 2011

All PAs may encounter opioid-addicted patients and should understand the essentials of drug abuse to expand their role in providing care.
 

Dengue fever: Potentially fatal, and now emerging in the United States

March 28, 2011

Long thought to be endemic only in other parts of the world, dengue is the focus of an 
investigation in Key West, Florida, site of a recent outbreak.
 

SLAP lesions: How to recognize and treat this debilitating shoulder injury

March 14, 2011

Many orthopedic clinicians have sharpened their focus on this condition, concentrating on how to best recognize this injury to the glenoid labrum in athletes and nonathletes alike.
 

Deep brain stimulation: A review of the procedure and the complications

, February 14, 2011

DBS is no longer experimental, and this treatment is becoming more common. PAs should be prepared to care for these implant patients.
 

Educating patients about the value 
of umbilical cord blood donation

, Brenda McGadney-Douglas, MSW, PhD; James Hampton, PhD October 22, 2010

PAs can help to expand knowledge of UCB banking, donation, and uses, thus increasing the opportunities for UCB to assist patients.
 

Buprenorphine: A more accessible treatment for opioid dependence

September 10, 2010

Buprenorphine-naloxone holds the key to opening primary care clinics to a greater number of patients suffering from opioid addiction.
 

Rapid sequence intubation: Stay up to date on this important procedure

August 13, 2010

The ability to perform intubation is increasingly required by emergency room physicians, internists, PAs, and paramedics.
 

Does the right to bear children guarantee access to treatment for infertility?

June 21, 2010

The law protects the right of all patients to procreate, but clinicians should consider the welfare of the child born as a result.
 

Remitting seronegative symmetrical synovitis with pitting edema

February 22, 2010

RS3PE must be distinguished from other forms of arthritis and PMR to avoid exposing the patient to inappropriate therapy.
 

Have the latest CPR guidelines improved cardiac arrest outcomes?

David J. Klocko, MPAS, PA-C November 16, 2009

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

Identifying and managing physeal injuries in the upper extremity

Jason R. Smith, PA-C; Scott H. Kozin, MD September 21, 2009

Understanding bone growth in young patients and knowing what to look for on imaging are key to managing upper-extremity injuries.
 

Overwhelming postsplenectomy infection: Managing patients at risk

Sandra L. Moffett, PA-C July 27, 2009

Asplenia can be triggered by conditions that decrease splenic function, leaving patients susceptible to life-threatening infection.
 

Spinal cord astrocytomas: Rare but life-threatening tumors in children

Johanna L. Chelcun, MHS, PA-C; Richard S. Pope, MPAS, PA-C June 15, 2009

These usually benign tumors require early surgical intervention to preserve neurologic function.
 

Put a PDA in your practice for easy access to current medical information

May 15, 2009

Educators and students must be familiar with the latest equipment and software programs.
 

Immigrant health care in the United States: What ails our system?

Katherine G. Footracer, MS, PA-C, CMT April 13, 2009

Current policies regarding health care for the growing immigrant population can result in a number of serious problems.
 

Hypothermia: A cool intervention for hypoxic-ischemic encephalopathy

March 24, 2009

The window of time for diagnosis of hypoxic-ischemic insult is short. Quick recognition and fastreferral ensure the best possible outcome for affected infants.
 

Expanded criteria donors offer hope for patients needing kidney transplant

Lisa Vieira, PA-C, MS March 23, 2009

When should patients with end-stage renal disease consider expanded criteria kidney donation, and how can you help them understand their options?
 

The effects of polyunsaturated fatty acids on coronary disease

March 17, 2009

The cardioprotective properties of PUFAs can reduce the risk of heart disease. Fatty fish and fish oils are the best sources for these essential fatty acids.
 

Understanding the idiopathic inflammatory myopathies

March 17, 2009

Polymyositis and dermatomyositis can manifest with similar signs and symptoms. Look for the diagnostic markers that can help you make the correct diagnosis.
 

Using yoga to treat disease: An evidence-based review

March 17, 2009

As researchers continue to increase our understanding of what yoga can do for patients with chronic conditions, we very well may be writing prescriptions for yoga poses.
 

A fresh look at continuous subcutaneous insulin infusion

Richard Jones, MS, PA-C; Nadia Mustafa, MD February 19, 2009

Advances in technology have allowed persons with diabetes to choose an insulin-delivery method.
 

Disaster response: Physician assistant skills are an important asset

John S. Lynch, MS (Biosecurity), MPAS, PA-C January 01, 2009

PAs can help fill the inevitable shortfall of providers during the aftermath of major disasters.
 

Increasing obesity in children and adolescents: An alarming epidemic

Kimberly M. Wilkinson, MPAS, PA-C December 01, 2008

Without better prevention and intervention, the health consequences are likely to be severe as the current generation of overweight children reaches adulthood.
 

Examining the most popular weight loss diets: How effective are they?

Erin L. Sherer, MPAS, PA-C, RD; James A. Sherer, JD November 01, 2008

Patients may swear by a particular diet, but the medical evidence gathered so far indicates that for most, keeping lost weight off for at least a year is an elusive goal.
 

Human papillomavirus infection and the HPV vaccine: What are the facts?

Melissa Renee Conner, MPAS; Miranda Merandi Collins, MEd, MPAS, PA-C October 01, 2008

Review Article - If administered before sexual activity has begun, the HPV vaccine can prevent an estimated 7 of 10 cases of cervical cancer. Why, then, has it caused so much controversy?
 

A review of the unique injuries sustained by musicians

April 01, 2008

Musculoskeletal injuries in musicians range from common repetitive stress injuries to unusual,sometimes career-ending disorders. Here's how to help the patient return to making music.
 

Cross-cultural perspectives on intimate partner violence

, , Mufiyda Abraham, PA-C; Robert David Coleman, MPAS, PA-C; Kelly C. McCarthy, BS; Trisha Harris-Odimgbe, MS, PA-C; Cindy K. Tong, MS, PA-C April 01, 2008

Addressing intimate partner violence through an ecological model and viewing it as amatter of public health can improve identification, treatment, and prevention.
 

Acute appendicitis: Pregnancy complicates this diagnosis

Alicia Borst December 01, 2007

In pregnant women, the clinical signs and test results that typically are used to diagnose appendicitis become unreliable. What do you rely on instead?
 

Common skin pathology in LE prosthesis users

James T. Highsmith, MPAS, PA-C; M. Jason Highsmith, November 01, 2007

The nature of state-of-the-art skin-prosthesis interface puts amputees who use prostheses at increased risk for these common dermatologic conditions.
 

Improving care of the dying: What do the experts say?

, Joan Malespina, PA-C, MS November 01, 2007

This article reviews nine key points that experts at an NIH conference said characterize the challenges associated with improving end-of-life care.
 

Should patients with diabetes follow a low-carb diet?

Michael J. Chandler, RD, CNSD, MS; Leslie A. Hildebrandt, PhD, RD October 01, 2007

Before you recommend a low-carbohydrate diet for weight loss, read this review of the effect these diets can have on a patient with type 2 diabetes.
 

Mind-body-spirit medicine: Interventions and resources

Leslie Freels Lloyd, RhD, CRC, LPC; Laurie R. Dunn, MPAS, PA-C October 01, 2007

MBS techniques can help patients who are afflicted with a wide variety of chronic conditions.This concise review helps you decide which to recommend.
 

Capsule endoscopy: What role for this new technology?

Christina Beard, PA-C, MPAS; John E. Poulos, MD, MSci, September 01, 2007

During this noninvasive procedure, the patient swallows a pill-sized camera and clinicians can visualize the fine mucosal detail of the small intestine.
 

What are the best screening instruments for PPD?

Athena Pogany, PA-C; Martha Petersen, MPH, CHES, PA-C July 01, 2007

An accurate and prompt diagnosis is essential to minimizing suffering from postpartum depression. These three instruments can help identify women at risk.
 

Can cellular cardiomyoplasty cure heart failure?

Melinda Jean Johnson, MCMS, PA-C; Doreen C. Parkhurst, PA, MD, FACEP May 01, 2007

Heart failure (HF) affects approximately 5 million people in the United States, with 550,000 new cases diagnosed each year. From 30% to 40% of patients with HF are hospitalized every year, and it is the leading cause of hospitalization in adults older than 65 years.
 

Care of patients with diabetes who are undergoing surgery

April 01, 2007

Management includes careful preoperative evaluation of risk, meticulous attention to glucose control during surgery, and a seamless transition to a stable regimen postoperatively.
 

Factors to consider before referring patients for major cancer surgery

March 01, 2007

Hospital and surgical volumes are correlated with better outcomes for patients undergoing complex surgical procedures. Staffing of ICUs and a high nurse-to-patient ratio also influence the quality of hospital care.
 

Male neonatal circumcision: An evidence-based review

Herb Ridings, MA, PA-C; Michelle Amaya, MD, MPH February 01, 2007

Controversy and confusing study results confound parents and clinicians alike. Despite some proven medical benefits of circumcision, cultural and religious beliefs still usually determine whether this procedure will be performed.
 

Rapid diagnosis of ectopic pregnancy using emergency bedside ultrasonography

January 01, 2007

Is your patient's abdominal pain a pregnancy gone wrong? Using bedside ultrasonography can improve your diagnostic proficiency and provide expedient care for your patients.
 

Pandemic influenza: A brief history and primer

January 01, 2007

The avian flu, a virulent strain of type A influenza, threatens to cause the next pandemic. Although antivirals are effective, the most appropriate dosage has yet to be determined—and creating a large enough supply could be another stumbling block.
 

High-altitude illnesses: From the limited to the potentially lethal

January 01, 2007

If you have skiers or other high-altitude travelers in your practice, awareness of high-altitude illnesses is a must. Acute mountain sickness is the most common and most benign form.
 

Distinguishing ADHD from juvenile bipolar disorder: A guide for primary care PAs

, Lloyd Taylor, PhD; Noelle Carlozzi, MA; Beverly Fortson, MA December 01, 2006

Pediatric clinicians should know how to distinguish juvenile-onset bipolar disorder from ADHD, since arriving at the right diagnosis is essential to providing the most effective treatment.
 

Botulism: Rare, but deadly

Kristin Foulke, MPH, PA-C November 01, 2006

An outbreak of botulism would be a medical and public health emergency requiring immediate government intervention. Up-to-date knowledge of diagnosis and treatment is essential.
 

The patient with cold hands: Understanding Raynaud's disease

November 01, 2006

Acute attacks are predictable and manifest in classic ways, but be sure to look beyond the obvious to rule out possible underlying diseases, including those that can mimic the signs and symptoms of Raynaud's.
 

Depression—An independent risk factor for cardiovascular disease

September 01, 2006

The author describes how to screen for depression in patients with CVD and summarizes what studies say about why it is essential that you do so.
 

Predicting UTI in symptomatic postmenopausal women: A review of the literature

August 01, 2006

Evidence-based medicine techniques can help clinicians to accurately predict the presence of UTI in postmenopausal women with atypical symptoms and risk factors.
 

Understanding Ecstasy

July 01, 2006

Evidence of the dangerous effects of MDMA is mounting, but knowledge of these dangers remains limited. Learning about MDMA can help you educate patients and help to reduce its use.
 

The subcutaneous abscess: Beyond simple management

Meredith F. Thompson, PA-C, MMSc; Michael Kramer, PA-C, MMSc May 01, 2006

The incidence of community-acquired methicillin-resistant Staphylococcusaureus is rising—only one fact that PAs must consider as they re-evaluate their approach to the patient with a subcutaneous abscess.
 

Oral health in children: Overlooked and undertreated

Pilar Berg; David Coniglio, MPA, PA-C April 01, 2006

Tooth decay is epidemic among young children in this country, yet millions do not receive proper care—or even attention. The authors explain what you can do to help.
 

Community-acquired MRSA infection: An update

Patti Ragan, PhD, MPH, PA-C April 01, 2006

Infection often begins on the skin—where it may be mistaken for a spider bite—but MRSA can quickly cause deadly systemic illnesses such as toxic shock syndrome and necrotizing pneumonia.
 

SARS: Are we still at risk?

Frank A. Acevedo, MS, PA-C; Salvatore Barese, MS, EdD, PA-C March 01, 2006

After emerging as the first new pathogen of the 21st century, the SARS virus rapidly caused a worldwide pandemic. The risk it poses to health care workers should make all providers exceedingly vigilant.
 

Understanding diastolic dysfunction

March 01, 2006

The primary therapeutic goal in treating diastolic heart failure is to restore physiologic balance using symptom-mediated therapy. Pharmaceutical therapy used for systolic dysfunction may actually be harmful.
 

Avian influenza: What PAs need to know

Patricia R Jennings, DrPH, PA-C; Charles DiMaggio, PhD, PA-C; John W. Baddley, MD February 01, 2006

In the News
 

A clinician’s guide to condoms, spermicides, microbicides, and lubricants

Patricia R. Jennings, DrPH, PA-C; Laura Bachmann, MD, MPH December 01, 2005

Apart from abstinence, the proper use of a new latex condom during every act of sexual intercourse is currently the most effective method of preventing sexually transmitted infections, including HIV.
 

Advances in treating early breast cancer

Katherine Y. Hanley, PA-C, MA; Alan Beckman, MD; Marta Hayne, MD November 01, 2005

A new, alternative approach to breast conservation treatment involves accelerated partial breast irradiation utilizing a high-dose rate balloon catheter system.
 

Endoscopic vessel harvesting in coronary artery bypass graft surgery

November 01, 2005

Since its inception in 1997, EVH has considerably reduced the morbidity associated with vessel conduit harvesting and has virtually eliminated patients postoperative leg pain.
 

Laryngopharyngeal reflux—It's not GERD

August 01, 2005

Laryngopharyngeal reflux--It's not GERD - Before you can alleviate symptoms in patients with LPR and ensure healing of the laryngopharynx, you must understand the differences between LPR and GERD.
 

Vision screening of young children: Taking a second look

August 01, 2005

There is controversy over the best ways to detect and treat amblyopia. Considering evidence from the latest research could be the first step in decreasing the preventable loss of vision.
 

Leishmaniasis: Early diagnosis is key

July 01, 2005

A patient presents with nasal congestion, a history of nosebleed, and painful lesions on his body and in his mouth. What questions should you ask to ensure that you make an accurate diagnosis?
 

Hypothermia—potentially deadly all year round

June 01, 2005

When the body loses more heat than it develops, hypothermia is the result. Quick thinking and knowledge of the different rewarming techniques are key to managing this potentially deadly condition.
 

Health care illiteracy: Implications for providers

May 01, 2005

Approximately 90 million adults in the United States are illiterate, a condition that frequently underlies low health literacy. Risk factors include poverty, incarceration, lack of education, immigration status, age, and race.
 

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