1,069 results on '"authors"'
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2. Leveraging telementoring platforms to enhance PA capacity and education.
- Author
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Madhavpeddi AR, Williams E, Felix KN, and Mayer GK
- Subjects
- Humans, Arizona, Telemedicine, Palliative Medicine education, Physician Assistants education, Mentoring methods, Videoconferencing
- Abstract
Abstract: Telementoring is a valuable workforce development resource that connects subject matter experts with healthcare providers via videoconferencing. This technology can deliver training, education, and ongoing technical support to build workforce capacity. Arizona State University (ASU) has leveraged a widely used telementoring platform, Project ECHO, to disseminate best practices in palliative medicine. The model has increased clinician knowledge and confidence, and the learning network may provide protective factors for clinician wellness. The replicable and inclusive nature of telementoring platforms creates educational opportunities to align learners across the didactic and clinical years of medical training, as well as into early- and midcareer for physician associates/assistants (PAs). Telementoring programs can be used across the PA learning continuum, including in PA training programs., (Copyright © 2024 American Academy of Physician Associates.)
- Published
- 2024
- Full Text
- View/download PDF
3. PA leadership: Implementation, structure, and sustainability.
- Author
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DePalma SM, Walker CS, Simon T, and Walczyk E
- Subjects
- Humans, Delivery of Health Care organization & administration, Leadership, Physician Assistants organization & administration
- Abstract
Abstract: Physician associate/assistant (PA) leaders are essential to healthcare and critical to a healthcare organization's success. In this article, the second of a two-part series on PA leadership, we summarize methods for implementing and sustaining PA leadership opportunities and organizational structures., (Copyright © 2024 American Academy of Physician Associates.)
- Published
- 2024
- Full Text
- View/download PDF
4. Airway obstruction secondary to vocal cord polyp.
- Author
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Filarski CF, Donald CB, Mendez AP, and Lott DG
- Subjects
- Humans, Male, Hoarseness etiology, Laryngeal Diseases diagnosis, Laryngeal Diseases complications, Laryngeal Diseases etiology, Middle Aged, Dysphonia etiology, Diagnosis, Differential, Female, Polyps complications, Polyps diagnosis, Airway Obstruction etiology, Airway Obstruction diagnosis, Vocal Cords diagnostic imaging, Laryngoscopy
- Abstract
Abstract: Patients with vocal cord polyps commonly present with symptoms of hoarseness. Although rare, large polyps can cause shortness of breath and stridor and should be included in the differential for patients with airway obstruction. Dysphonia or hoarseness can be a symptom of underlying disease, such as head and neck cancer. This case illustrates the importance of prompt and accurate diagnosis in a patient with persistent symptoms and a history of smoking. Obtaining a laryngoscopy is crucial to appropriately evaluate the larynx. Proper visualization of the laryngeal structures will help direct patient care toward further diagnostic imaging and medical or surgical intervention if indicated., (Copyright © 2024 American Academy of Physician Associates.)
- Published
- 2024
- Full Text
- View/download PDF
5. Implications of breast density for breast cancer screening.
- Author
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Watkins E and Jackson T
- Subjects
- Humans, Female, Risk Factors, Mass Screening methods, Breast diagnostic imaging, United States, Middle Aged, Adult, Breast Neoplasms diagnosis, Breast Neoplasms diagnostic imaging, Early Detection of Cancer methods, Breast Density, Mammography methods
- Abstract
Abstract: Extremely dense breasts can be an independent risk factor for breast cancer. A new FDA rule requires that patients be notified of their breast density and the possible benefits of additional imaging to screen for breast cancer. Clinicians should be cognizant of the data about breast cancer risk, breast density, and recommendations to change screening techniques if patients, particularly premenopausal females, have extremely dense breasts but no other known risk factors., (Copyright © 2024 American Academy of Physician Associates.)
- Published
- 2024
- Full Text
- View/download PDF
6. Using ultrasound to identify adnexal masses.
- Author
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McConnell M and Strelow B
- Subjects
- Humans, Female, Ovarian Neoplasms diagnostic imaging, Diagnosis, Differential, Ultrasonography methods, Adnexal Diseases diagnostic imaging
- Abstract
Abstract: This article describes the use of ultrasound in the initial diagnosis of a patient with a pelvic mass. CT commonly is used to detect ovarian cancer, especially when the patient has nonspecific symptoms; ultrasound also can be used as a follow-up procedure after an abdominal ultrasound reveals suspicious findings., (Copyright © 2024 American Academy of Physician Associates.)
- Published
- 2024
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- View/download PDF
7. Vasovagal syncope with asystole.
- Author
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Middleton HT, Bachman MJ, and Strelow BA
- Subjects
- Humans, Male, Electrocardiography, Adult, Seizures etiology, Seizures diagnosis, Seizures complications, Syncope, Vasovagal diagnosis, Syncope, Vasovagal etiology, Syncope, Vasovagal therapy, Heart Arrest etiology, Heart Arrest therapy
- Abstract
Abstract: Although vasovagal episodes are a common cause of syncope, vasovagal syncope can be cardioinhibitory in nature, resulting in a severe heart block or asystole. This case report focuses on a young man with a history of seizures and frequent syncopal episodes who required an extensive clinical workup and treatment for cardioinhibitory syncope., (Copyright © 2024 American Academy of Physician Associates.)
- Published
- 2024
- Full Text
- View/download PDF
8. PAs and NPs in liver transplantation: Perceptions, implementation, and effect.
- Author
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Nargiso S, Lo M, Ramos L, Bolaños A, Lee E, and Sher L
- Subjects
- Humans, Retrospective Studies, Surveys and Questionnaires, Male, Female, Patient Care Team, Liver Transplantation, Length of Stay statistics & numerical data, Physician Assistants, Patient Readmission statistics & numerical data, Nurse Practitioners
- Abstract
Objectives: This study assessed the use and perceptions of physician associates/assistants (PAs) and NPs at liver transplant centers and sought to determine their financial effect., Methods: Leaders of liver transplant programs performing 25 or more transplants in 2020 were contacted to complete an 11-question survey about the role and effect of PAs and NPs in liver transplant. A single-center retrospective analysis compared length of stay (LOS) and readmission rates for primary liver transplants and simultaneous liver-kidney transplants before and after a dedicated PA team was established. Chi-square and t -test analyses were performed., Results: The survey achieved a 77% response rate, and 98% of institutions reported using PAs and NPs. The single-center study found the mean LOS post-transplant was significantly shorter in the post-PA cohort ( P = .0005). No significant difference was found in 30-day readmission rates., Conclusions: PAs and NPs are used broadly across the post-liver transplant care continuum. Using LOS as a surrogate financial marker suggests that a dedicated PA and NP team may contribute to cost savings., (Copyright © 2024 American Academy of Physician Associates.)
- Published
- 2024
- Full Text
- View/download PDF
9. Managing neonatal hyperbilirubinemia: An updated guideline.
- Author
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Chastain AP, Geary AL, and Bogenschutz KM
- Subjects
- Humans, Infant, Newborn, Kernicterus prevention & control, Kernicterus therapy, Kernicterus etiology, Exchange Transfusion, Whole Blood, Gestational Age, Bilirubin blood, Hyperbilirubinemia, Neonatal therapy, Phototherapy methods, Practice Guidelines as Topic
- Abstract
Abstract: More than 80% of newborn infants experience jaundice as a result of elevated bilirubin during the first few weeks after birth. In most cases, hyperbilirubinemia is physiologic, but persistent and extreme elevations can lead to serious long-term complications, such as kernicterus. To avoid these complications and help clinicians in the successful assessment, evaluation, and treatment of hyperbilirubinemia, the American Academy of Pediatrics updated its clinical practice guideline for neonatal hyperbilirubinemia. This article reviews the guideline and highlights significant updates, such as an elevation in the threshold for phototherapy and exchange transfusion, inclusion of gestational age, and removal of racially based norms., (Copyright © 2024 American Academy of Physician Associates.)
- Published
- 2024
- Full Text
- View/download PDF
10. Updated guidelines for chronic kidney disease.
- Author
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Ness B and Mosman A
- Subjects
- Humans, Disease Progression, Glomerular Filtration Rate, Renal Insufficiency, Chronic therapy, Renal Insufficiency, Chronic diagnosis, Practice Guidelines as Topic
- Abstract
Abstract: Chronic kidney disease (CKD) is an increasingly common condition worldwide that leads to substantial mortality. Research in the past decade has informed significant advances in preventing CKD or delaying its progression, mainly through new medications. This progress, however, requires adequate screening and identification of early CKD to truly transform patient outcomes. Revised guidelines from the Kidney Disease: Improving Global Outcomes consortium of experts aim to help clinicians incorporate these advances into practice. This article summarizes key updates from the guidelines regarding the evaluation and management of CKD that can lead to better patient outcomes., (Copyright © 2024 American Academy of Physician Associates.)
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- 2024
- Full Text
- View/download PDF
11. Exploring opportunities beyond clinical practice: The need for PA educators.
- Author
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Bolander S and Herrick A
- Subjects
- Humans, Burnout, Professional prevention & control, Professional Role, Physician Assistants education, Physician Assistants psychology
- Abstract
Abstract: Opportunities outside patient care are expanding for physician associates/assistants (PAs). Exploring new roles beyond clinical practice has the potential for improved career fulfillment as clinicians experience increasing levels of burnout and declining satisfaction with patient care. The decision to shift to a nonclinical role may be overwhelming without knowing what positions PAs are qualified to consider. PAs are increasingly found in the fields of healthcare consulting (as medical science liaisons), medical writing, healthcare insurance, research, and academia. With the rapid growth in PA programs, the need for educators is critical and this transition creates an interesting dynamic in which a proficient clinician becomes a novice educator. This article delves into these expectations and provides guidance on making the transition., (Copyright © 2024 American Academy of Physician Associates.)
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- 2024
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12. Silicosis: No longer exclusively a chronic disease.
- Author
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Cena AC and Cena LG
- Subjects
- Humans, Chronic Disease, Risk Factors, Silicon Dioxide adverse effects, Lung Transplantation, Occupational Exposure adverse effects, Silicosis etiology, Silicosis surgery
- Abstract
Abstract: Silicosis typically has been classified as a chronic disease that develops after at least 10 years of exposure to silica dust, and often is associated with miners and stone workers. As industries have changed over time, other types of workers (including those in artificial stonework, jewelry polishing, and denim production) have become exposed to high levels of silica, leading to the development of acute and accelerated silicosis. Acute silicosis can develop in as little as a few months, and accelerated silicosis can develop in as little as 2 years. No cure exists for any form of silicosis, and lung transplantation is the only lifesaving treatment. Primary care clinicians must understand when patients are at risk for developing silicosis and not assume that a short time of exposure precludes the development of silicosis., (Copyright © 2024 American Academy of Physician Associates.)
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- 2024
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13. Mentorship effect for PAs at an academic medical center and its healthcare system.
- Author
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Herndon JS, Louwagie VS, Strelow BA, Schenzel HA, Cumberland EA, and Oxentenko AS
- Subjects
- Humans, Male, Female, Middle Aged, Adult, Surveys and Questionnaires, Job Satisfaction, Delivery of Health Care, Physician Assistants education, Academic Medical Centers, Mentors
- Abstract
Purpose: Mentorship has many notable benefits. Research about mentorship for physician associates/assistants (PAs) is limited. This study sought to uncover more detailed information on mentorship and its effect on PAs., Methods: A survey was sent via email to all PAs and advanced practice registered nurses at our institution. Subgroup analysis was performed on PA respondents, including satisfaction and independent predictors associated with mentorship., Results: Of the 295 PAs, 63 (21.4%) identified having a mentor. Those with a mentor were statistically more likely to function as a mentor (OR 2.7 [95% CI 1.5-4.9], P = .001), have an academic rank of assistant professor or higher (OR 2.7 [95% CI 1.3-5.5], P = .007), be under age 45 years (OR 6.1 [95% CI 2.1-17.4], P = .008), be less than 10 years into their career (OR 3.1 [95% CI 1.7-5.7], P = .002), and be satisfied with mentorship (88.9% versus 23.9%, P < .001)., Conclusions: Mentorship for PAs is crucial and can boost academic promotion and career satisfaction., (Copyright © 2024 American Academy of Physician Associates.)
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- 2024
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14. Serotonin syndrome: A rare yet crucial diagnosis.
- Author
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Mungul D, Bila N, Petr G, Satterberg K, and Knueven A
- Subjects
- Female, Humans, Male, Diagnosis, Differential, Serotonin Agents adverse effects, Serotonin Syndrome chemically induced, Serotonin Syndrome diagnosis, Serotonin Syndrome therapy
- Abstract
Abstract: Serotonin syndrome is a rare, life-threatening toxidrome caused by serotonergic agents. This syndrome classically presents with a combination of mental status changes, autonomic hyperactivity, and neuromuscular abnormalities. However, diagnosing the condition is difficult because of its variable symptoms at presentation. As a result, serotonin syndrome often is underreported, making it harder to understand, recognize, and treat. Patients with this condition may present to primary or urgent care or an ED, and may become acutely symptomatic during an inpatient admission. Clinicians must be able to identify at-risk patients and intervene to prevent potentially lethal complications., (Copyright © 2024 American Academy of Physician Associates.)
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- 2024
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15. Defining competencies for PAs in healthcare administration.
- Author
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Vanderlinden S and Zimmerman R
- Subjects
- Humans, Delivery of Health Care standards, Professional Competence, Clinical Competence, Professional Role, Physician Assistants
- Published
- 2024
- Full Text
- View/download PDF
16. The importance, benefits, and contributions of PAs in healthcare leadership.
- Author
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Simon T, Walczyk E, DePalma SM, and Walker CS
- Subjects
- Humans, Professional Role, Delivery of Health Care organization & administration, Leadership, Physician Assistants
- Abstract
Abstract: Physician associate/assistant (PA) leaders are essential to healthcare and are critical to a healthcare organization's success. This article, the first of a two-part series on PA leadership, summarizes the importance of PA leaders and the benefits of PAs serving in administrative and leadership roles., (Copyright © 2024 American Academy of Physician Associates.)
- Published
- 2024
- Full Text
- View/download PDF
17. Neurocognitive changes in a patient receiving esketamine for treatment-resistant depression.
- Author
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Kundert CF, Sobule RM, and Ithman M
- Subjects
- Humans, Administration, Intranasal, Female, Middle Aged, Male, Ketamine administration & dosage, Ketamine adverse effects, Depressive Disorder, Treatment-Resistant drug therapy, Antidepressive Agents administration & dosage, Antidepressive Agents adverse effects
- Abstract
Abstract: Esketamine, the s(+) enantiomer of ketamine, was approved in 2019 as the first rapid-acting intranasal spray medication for treatment-resistant depression; the drug is given in combination with an antidepressant. The treatment is self-administered in a clinical setting under the supervision of a healthcare provider and usually is well tolerated. Many of its adverse reactions are mild, temporary, and dose-dependent, and they improve with subsequent treatments. Although the prescribing information lists difficulty remembering or thinking as possible adverse reactions, a neurocognitive evaluation is not part of the initial patient evaluation. This case report focuses on a patient whose neurocognitive symptoms worsened with esketamine treatment, necessitating treatment discontinuation., (Copyright © 2024 American Academy of Physician Associates.)
- Published
- 2024
- Full Text
- View/download PDF
18. Perceptions of telehealth use by PAs post-COVID-19.
- Author
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Raspet E and Gietzen L
- Subjects
- Humans, Male, Surveys and Questionnaires, Female, Adult, Attitude of Health Personnel, Middle Aged, Health Services Accessibility, Telemedicine, COVID-19, Physician Assistants psychology, SARS-CoV-2
- Abstract
Objective: Use of telemedicine and remote patient monitoring can provide significant cost savings through improved disease control and reduced exacerbations. This study investigated physician associates'/assistants' (PAs') perceptions of telemedicine to inform future use and expansion of these programs., Methods: The Telehealth Usability Questionnaire was completed by 30 PAs recruited via social media. Data were coded and analyzed through an electronic spreadsheet program., Results: PAs generally felt that telemedicine was a helpful tool to increase access to care (M = 4.129) but did not replace in-person visits. Variation in responses related specifically to the platform indicated PAs' varying experiences about ease of use., Conclusions: Findings demonstrated that PAs from a variety of practice settings found telemedicine to be a helpful tool to reduce barriers and improve access to care. However, PAs did not feel that telemedicine replaces in-person visits., (Copyright © 2024 American Academy of Physician Associates.)
- Published
- 2024
- Full Text
- View/download PDF
19. Imaging options for patients with abdominal aortic aneurysms.
- Author
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Gertner E and Breunig M
- Subjects
- Humans, Tomography, X-Ray Computed, Aortic Aneurysm, Abdominal diagnostic imaging
- Published
- 2024
- Full Text
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20. Corneal abrasions.
- Author
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Storts AJ and Trudeau H
- Subjects
- Humans, Corneal Injuries etiology, Corneal Injuries diagnosis
- Published
- 2024
- Full Text
- View/download PDF
21. Efficacy of intrauterine device procedural analgesics.
- Author
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Grossman K, McKown E, and Cushing R
- Subjects
- Humans, Female, Analgesics administration & dosage, Pain, Procedural prevention & control, Pain, Procedural etiology, Pregnancy, Anesthetics, Local administration & dosage, Anesthesia, Local methods, Menorrhagia therapy, Physician Assistants, Intrauterine Devices adverse effects
- Abstract
Abstract: Nearly half of all pregnancies worldwide are unintended. Intrauterine devices are an effective, long-acting form of pregnancy prevention that require minimal maintenance, and also can be used in patients with menorrhagia. However, they are underused because of pain associated with their insertion. Topical and local anesthesia are good options for reducing procedural pain in select patients. IUD placement falls within the scope of practice for physician associates/assistants (PAs) practicing in family medicine, internal medicine, and women's health. PAs should be aware of these additional analgesia options available to patients in order to increase use of effective contraception., (Copyright © 2024 American Academy of Physician Associates.)
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- 2024
- Full Text
- View/download PDF
22. Evaluation and management of febrile neutropenia in patients with cancer.
- Author
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Cossey J and Cote MCB
- Subjects
- Humans, Practice Guidelines as Topic, Risk Assessment, Fever etiology, Fever therapy, Neoplasms complications, Febrile Neutropenia diagnosis, Febrile Neutropenia etiology, Febrile Neutropenia therapy, Anti-Bacterial Agents therapeutic use, Anti-Bacterial Agents administration & dosage
- Abstract
Abstract: Febrile neutropenia is a common oncologic emergency that increases the risk for serious infection. This article reviews a joint American Society of Clinical Oncology and Infectious Diseases Society of America guideline for the evaluation and management of patients with cancer who present with fever and neutropenia. Knowledge and use of available risk assessment tools may reduce unnecessary hospitalizations, decrease inappropriate antibiotic use, and improve patient outcomes., (Copyright © 2024 American Academy of Physician Associates.)
- Published
- 2024
- Full Text
- View/download PDF
23. PA experiences in clinical trials.
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Eggleston A, Sarkodie E, and Rokser R
- Subjects
- Humans, Surveys and Questionnaires, Male, Female, Salaries and Fringe Benefits, United States, Biomedical Research, Clinical Trials as Topic, Physician Assistants
- Abstract
Objective: Physician associate/assistant (PA) experience in clinical trials is poorly documented in medical literature. This survey aimed to describe the characteristics and experiences of PAs in clinical trial research., Methods: We performed descriptive analyses of data gathered in 2022 by the American Academy of Physician Associates and published in the organization's annual Salary Report, specifically of respondents who indicated experience in traditional and/or decentralized clinical trials., Results: About 73% of PAs eligible for the clinical trials survey indicated they were either involved in clinical trials or had been involved in the past and were interested in working in clinical trials in the future. PAs often serve in subinvestigator roles and perform various clinical trial tasks regardless of previous research experience., Conclusions: PAs working in clinical trials demonstrated broad responsibilities and skills in the research setting. They leveraged benefits to working in clinical trials despite institutional barriers. Clinical research may fit into numerous PAs' practices and let them contribute to medical advancements., (Copyright © 2024 American Academy of Physician Associates.)
- Published
- 2024
- Full Text
- View/download PDF
24. Clinical officers in Uganda: Training and workforce role.
- Author
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Schaefle KJ, Habimana A, Mhoza G, and Musominali S
- Subjects
- Uganda, Humans, Professional Role, Physician Assistants education, Physician Assistants supply & distribution, Primary Health Care
- Abstract
Abstract: The clinical role of a clinical officer in Uganda is very similar to that of a physician associate/assistant in the United States. This article describes the qualifications and workforce role of clinical officers in Uganda, as well as their use in two primary care programs that provide effective, low-cost medical care to a growing population with an increasing burden of chronic disease., (Copyright © 2024 American Academy of Physician Associates.)
- Published
- 2024
- Full Text
- View/download PDF
25. Gallbladder torsion.
- Author
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Hamblin HM, Goel A, and Pennington JR
- Subjects
- Humans, Abdomen, Acute etiology, Cholecystitis surgery, Cholecystitis diagnosis, Cholecystitis etiology, Gallbladder surgery, Gallbladder diagnostic imaging, Tomography, X-Ray Computed, Gallbladder Diseases surgery, Gallbladder Diseases diagnosis, Gangrene etiology, Gangrene surgery, Torsion Abnormality surgery, Torsion Abnormality diagnosis
- Abstract
Abstract: Gallbladder torsion is a rare cause of acute surgical abdomen. Early recognition and surgical intervention are important for reducing complications and improving postoperative patient outcomes, but standard imaging and laboratory evaluation typically are indistinguishable from those of acute cholecystitis. This article describes a patient with gangrenous cholecystitis secondary to torsion and summarizes recommendations for evaluation and management., (Copyright © 2024 American Academy of Physician Associates.)
- Published
- 2024
- Full Text
- View/download PDF
26. Pharmacologic interventions for primary glenohumeral osteoarthritis.
- Author
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Garcia AV, Martini LI, and Abache AF
- Subjects
- Humans, Quality of Life, Anti-Inflammatory Agents, Non-Steroidal therapeutic use, Anti-Inflammatory Agents, Non-Steroidal administration & dosage, Osteoarthritis drug therapy, Osteoarthritis therapy, Shoulder Joint
- Abstract
Abstract: Primary glenohumeral osteoarthritis is a multifactorial condition with a complex cause that affects patients across different age groups, impairing physiologic and psychologic well-being, and substantially reducing patient quality of life and overall productivity. To effectively manage this condition, healthcare providers need to be well informed about treatment guidelines, as well as the available therapeutic options and the evidence supporting their use. Nonsurgical interventions should be regarded as the primary treatment option, particularly for patients in the initial phases of this condition. No conclusive guidelines exist for treating young and active patients, and the literature lacks high-quality data to evaluate the efficacy, safety, and long-term consequences of several interventions, regardless of patient characteristics and expectations., (Copyright © 2024 American Academy of Physician Associates.)
- Published
- 2024
- Full Text
- View/download PDF
27. PAs' perspective on leadership in medicine.
- Author
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Roberts AL, Rizzolo D, Bruza-Augatis M, Pontrelli G, Zammit C, and Banahan M
- Subjects
- Humans, Female, Male, Adult, Surveys and Questionnaires, Middle Aged, Attitude of Health Personnel, Leadership, Physician Assistants education
- Abstract
Objective: This study evaluated physician associate/assistant (PA) training and confidence in leadership and leadership skills, as well as where best to incorporate leadership training for the profession., Methods: A quantitative survey was administered to assess PAs' perceptions of leadership and degree of leadership training during their primary PA education. The study also solicited where in the career trajectory leadership training is perceived to be most effective. Of the 284 participants who responded to the survey, 207 had complete responses that were used in the analysis., Results: Nearly 92% of PAs agreed that they aspire to be leaders, and 93.2% agreed or strongly agreed that leadership training would be beneficial during PA school. Additionally, more than 50% of PAs agreed that they had no training but desired more regarding personal mastery, teaching, administration, ideals of a healthy workforce, vision and goal setting, getting results, coalitions, and system transformation., Conclusions: This study demonstrated that PAs desired supplemental training in leadership to cultivate career goals and reported that formal leadership training would be useful to cope with and overcome adversity in clinical practice., (Copyright © 2024 American Academy of Physician Associates.)
- Published
- 2024
- Full Text
- View/download PDF
28. Ovarian cancer: A review for primary care providers.
- Author
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Thull T and Kempton D
- Subjects
- Humans, Female, Risk Factors, Early Detection of Cancer, Neoplasm Staging, Ovarian Neoplasms therapy, Ovarian Neoplasms diagnosis, Primary Health Care
- Abstract
Abstract: Ovarian cancer is the second most common gynecologic cancer in the United States and the deadliest gynecologic cancer worldwide, with a 5-year survival rate of less than 50%. Because of its vague symptoms, more than half of patients present with advanced disease and metastasis. This article reviews the epidemiology, pathogenesis, risk factors, screening, presentation, and diagnosis of ovarian cancer, in addition to providing an overview of the standard approach to treatment and novel targeted biologic therapies., (Copyright © 2024 American Academy of Physician Associates.)
- Published
- 2024
- Full Text
- View/download PDF
29. The role of primary care in improving health outcomes in young foster children.
- Author
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Sitzman C and Quincy B
- Subjects
- Humans, Child, Child, Preschool, United States, Child Welfare, Child Abuse, Female, Infant, Male, Physician Assistants, Primary Health Care, Foster Home Care, Child, Foster
- Abstract
Abstract: Children removed from their biological families because of abuse, neglect, and/or violence have increased healthcare needs and are susceptible to poor health outcomes compared with children who are not in the child welfare system. Developmental delays occur in about 75% of children in foster care. Up to 80% of children entering out-of-home care have at least one physical health problem and more than 40% experience educational challenges. In most US states, newly removed children are required to have a medical evaluation shortly after placement in a foster or kinship family. The initial evaluation is important for identifying urgent concerns and developing a rapport with children who may not have had regular medical care. In addition, the child's complete social, trauma, and medical history may be unknown because of system barriers such as inconsistent medical care by biological parents, privacy laws protecting records, and unavailability of birth histories and biological parents' medical and psychosocial histories. As a result, a series of visits is required to fully evaluate the child's development and healthcare needs. This article provides guidance for physician associates/assistants who provide care to children in foster care., (Copyright © 2024 American Academy of Physician Associates.)
- Published
- 2024
- Full Text
- View/download PDF
30. Catfish spine injury to the hand with transient lymphangitis.
- Author
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Carhart P, Espinosa J, Tandra R, and Lucerna A
- Subjects
- Humans, Male, Middle Aged, Animals, Foreign Bodies complications, Hand Injuries etiology, Lymphangitis etiology, Lymphangitis diagnosis, Catfishes
- Abstract
Abstract: This case report describes a 45-year-old man whose left hand was skewered by a catfish spine while he was attempting to dehook the fish. Catfish spines can create punctures, lacerations, and foreign body injuries. The catfish spine generally is serrated, which can make removal difficult., (Copyright © 2024 American Academy of Physician Associates.)
- Published
- 2024
- Full Text
- View/download PDF
31. Benefits of dermoscopy in primary care.
- Author
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Middleton HT, Boswell CL, Strelow BA, Young PA, Sartori-Valinotti JC, and Swanson DL
- Subjects
- Humans, Algorithms, Referral and Consultation, Melanoma diagnostic imaging, Melanoma diagnosis, Melanoma pathology, Physician Assistants, United States, Biopsy methods, Dermoscopy, Primary Health Care, Skin Neoplasms diagnostic imaging, Skin Neoplasms diagnosis, Skin Neoplasms pathology
- Abstract
Abstract: Skin cancer is the most common cancer in the United States, with an estimated 9,500 new diagnoses made each day. Dermoscopy (also called dermatoscopy) is an established clinical approach to improving skin cancer evaluation. However, only 8% to 9% of primary care physicians use it, and no data are available for physician associate/assistant or NP use. This article reports a dermoscopy algorithm that primary care providers can use to increase the detection of skin cancer and reduce unnecessary referrals and biopsies., (Copyright © 2024 American Academy of Physician Associates.)
- Published
- 2024
- Full Text
- View/download PDF
32. Portal vein thrombosis associated with acute cholecystitis.
- Author
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Lehner L and Sarap M
- Subjects
- Humans, Anti-Bacterial Agents therapeutic use, Anti-Bacterial Agents administration & dosage, Female, Male, Middle Aged, Postoperative Complications etiology, Portal Vein, Venous Thrombosis etiology, Cholecystectomy, Laparoscopic, Cholecystitis, Acute complications, Cholecystitis, Acute etiology, Anticoagulants therapeutic use, Anticoagulants administration & dosage
- Abstract
Abstract: Portal venous thrombosis (PVT) is an uncommon clinical problem and is rare following cholecystectomy. This article describes a patient who developed PVT after an initially uneventful laparoscopic cholecystectomy. The patient was successfully treated with IV antibiotics and anticoagulation., (Copyright © 2024 American Academy of Physician Associates.)
- Published
- 2024
- Full Text
- View/download PDF
33. Hypertensive crisis.
- Author
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Bohensky J and Daher N
- Subjects
- Humans, Antihypertensive Agents therapeutic use, Hypertensive Crisis, Hypertension etiology
- Published
- 2024
- Full Text
- View/download PDF
34. The opportunity to lead facilitates PA professional well-being.
- Author
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Bernard KS and Bostain N
- Subjects
- Humans, Male, Female, Adult, Middle Aged, Surveys and Questionnaires, Physician Assistants psychology, Burnout, Professional prevention & control, Burnout, Professional psychology, Leadership, Job Satisfaction
- Abstract
Objective: Physician associates/assistants (PAs) with mature careers represent an important leadership resource for healthcare employers. This study sought to determine whether PA leadership task responsibility interacted with experience level to predict professional well-being., Methods: This quantitative study used an archival dataset from a national sample of PAs. The Professional Fulfillment Index was used to measure well-being and career length was used to represent experience level. PA leadership task responsibility was calculated as an aggregate score. Bivariate linear regression with mediation analysis was conducted to determine the relationship between variables., Results: An increase in PA experience level predicted higher professional fulfillment and lower burnout, and aggregate leadership task score partially mediated this relationship., Conclusions: Granting leadership task responsibility compatible with experience level may enhance PA professional fulfillment, mitigate burnout, and increase PA usefulness for healthcare employers., (Copyright © 2024 American Academy of Physician Associates.)
- Published
- 2024
- Full Text
- View/download PDF
35. Recognizing rare rashes: A case of acute generalized exanthematous pustulosis.
- Author
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Roth M and Anderson A
- Subjects
- Humans, Female, Community-Acquired Infections drug therapy, Community-Acquired Infections diagnosis, Middle Aged, Acute Generalized Exanthematous Pustulosis diagnosis, Acute Generalized Exanthematous Pustulosis etiology, Anti-Bacterial Agents adverse effects
- Abstract
Abstract: Acute generalized exanthematous pustulosis (AGEP) is a rare, pustular rash that occurs most commonly after exposure to a medication (typically antibiotics or diltiazem). This case describes a patient who developed a widespread pustular eruption shortly after beginning empiric antibiotics for community-acquired pneumonia. Diagnosis of AGEP was difficult in this scenario due to the patient's pulmonary infection and atypical skin biopsy results. However, after AGEP was correctly identified, the offending agents were discontinued and the patient had subsequent resolution of her symptoms., (Copyright © 2024 American Academy of Physician Associates.)
- Published
- 2024
- Full Text
- View/download PDF
36. Gendered racial microaggressions and stress in PAs who are Black women.
- Author
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Lotson F, Gathers QS, Gordon AC, and Litton AG
- Subjects
- Humans, Female, Adult, Stress, Psychological ethnology, Middle Aged, Surveys and Questionnaires, Racism psychology, Psychological Distress, Black or African American psychology, Physician Assistants psychology, Aggression psychology
- Abstract
Objective: This mixed-methods study explored whether physician associates/assistants (PAs) who are Black women (for brevity, called Black women PAs throughout this article) experience gendered racial microaggressions and whether these experiences correlated with psychologic distress. The phrase Black women encompasses those who identify with the sociocultural roles, behaviors, and expressions of being a Black woman., Methods: We conducted an online survey of Black women PAs using the Gendered Racial Microaggressions Scale during a 2-month period in 2019., Results: Black women PAs experienced gendered racial microaggressions in clinical settings. Gendered racial microaggressions were correlated with stress, being silenced and marginalized, and assumptions of beauty and sexual objectification. No correlations were found between stress and the angry Black woman and strong Black woman variables., Conclusions: This study revealed that Black women have interlocking forms of oppression related to their race and gender, which are associated with psychologic distress. Awareness of these occurrences can reduce the unknowing perpetuation of gendered racial microaggressions and create cultural awareness practices., (Copyright © 2024 American Academy of Physician Associates.)
- Published
- 2024
- Full Text
- View/download PDF
37. Acute liver failure.
- Author
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Beck J, Bolina JK, and Boyd LH
- Subjects
- Humans, Acute Kidney Injury therapy, Acute Kidney Injury chemically induced, Acute Kidney Injury etiology, Acute Kidney Injury diagnosis, Analgesics, Non-Narcotic adverse effects, Antidotes, Brain Edema etiology, Brain Edema therapy, Drug Overdose therapy, Acetaminophen adverse effects, Liver Failure, Acute therapy, Liver Failure, Acute chemically induced, Liver Failure, Acute diagnosis, Liver Transplantation
- Abstract
Abstract: Acute liver failure, commonly caused by acetaminophen overdose, is associated with numerous systemic complications including cerebral edema, hypotension, acute kidney injury, and infection. Management is primarily supportive, with an emphasis on excellent neurocritical care. Although some antidotes and targeted treatments exist, the only definitive treatment remains orthotopic liver transplant., (Copyright © 2024 American Academy of Physician Associates.)
- Published
- 2024
- Full Text
- View/download PDF
38. Early and aggressive treatment for Crohn disease using biologics and immunomodulators.
- Author
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Martin E and Sadowski CK
- Subjects
- Humans, Adrenal Cortex Hormones therapeutic use, Adrenal Cortex Hormones administration & dosage, Immunologic Factors therapeutic use, Mesalamine therapeutic use, Biological Products therapeutic use, Crohn Disease drug therapy, Immunomodulating Agents therapeutic use
- Abstract
Abstract: Traditionally, medical providers have used the step-up approach to manage patients with Crohn disease, starting with 5-aminosalicylic acid derivatives, progressing to corticosteroids, and eventually to immunomodulators and biologics. However, a new top-down approach focuses on early and aggressive therapy with biologics and immunomodulators to reduce the rate of mucosal and intestinal damage. This article describes early and aggressive biologic and immunomodulator therapies and new therapeutic parameters compared with traditional step-up treatment for patients with Crohn disease., (Copyright © 2024 American Academy of Physician Associates.)
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- 2024
- Full Text
- View/download PDF
39. Career flexibility for PAs: What makes switching specialties successful?
- Author
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Ward-Lev E, Kuriakose C, Navoa JJ, and Halley M
- Subjects
- Humans, Male, Female, Burnout, Professional prevention & control, Career Mobility, Adult, Personnel Selection, Interviews as Topic, Specialization, Middle Aged, Physician Assistants psychology, Job Satisfaction
- Abstract
Abstract: Switching specialties is common among physician associates/assistants (PAs) and important in combating burnout. Despite this, little is known about the PA experience with switching specialties. This study sought to identify factors associated with successfully switching specialties using semistructured interviews with PAs and hiring managers. Participants reported that switching specialties was initially challenging for managers and PAs because of insufficient onboarding and unrealistic expectations, but they also reported that they were generally satisfied with long-term outcomes. Our findings suggest that PAs hoping to switch specialties may want to focus on building a professional network, identifying areas where they can highlight relevant experience, and demonstrating their intent to remain in that role. Hiring managers could benefit from considering their hiring practices and tailoring onboarding expectations for new hires., (Copyright © 2024 American Academy of Physician Associates.)
- Published
- 2024
- Full Text
- View/download PDF
40. Glucagon-like peptide 1 agonists for type 2 diabetes, weight loss, or both?
- Author
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Keedy CA and Bland CM
- Subjects
- Humans, Liraglutide therapeutic use, Gastric Inhibitory Polypeptide therapeutic use, Gastric Inhibitory Polypeptide agonists, Exenatide therapeutic use, Exenatide administration & dosage, Peptides therapeutic use, Glycated Hemoglobin, Glucagon-Like Peptide-1 Receptor agonists, Diabetes Mellitus, Type 2 drug therapy, Weight Loss drug effects, Glucagon-Like Peptide 1 agonists, Hypoglycemic Agents therapeutic use
- Abstract
Abstract: Glucagon-like peptide 1 agonists (GLP1s) and the novel glucose-dependent insulinotropic polypeptide/glucagon-like peptide 1 agonist are effective drugs for reducing A1C and weight in patients with type 2 diabetes. However, clinicians may find it difficult to discern which drug to prescribe in specific clinical scenarios. This article discusses evidence-based clinical use of these drugs., (Copyright © 2024 American Academy of Physician Associates.)
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- 2024
- Full Text
- View/download PDF
41. Heart failure related to contemporary breast cancer treatment.
- Author
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Durkin M and DeJesus N
- Subjects
- Humans, Female, Cardiotoxicity drug therapy, Cardiotoxicity etiology, Trastuzumab pharmacology, Trastuzumab therapeutic use, Anthracyclines adverse effects, Breast Neoplasms, Heart Failure drug therapy, Ventricular Dysfunction, Left chemically induced
- Abstract
Abstract: This article addresses cardiotoxicity in patients with breast cancer who are treated with anthracyclines and/or anti-human epidermal growth factor 2 (HER2) therapy, namely doxorubicin and trastuzumab. Development of concise clinical guidelines for chemotherapy-induced heart failure is ongoing. Through identification of specific risk factors and clinical predictors of cardiotoxicity, clinicians are able to better understand and define effective monitoring strategies and optimize patient care. Close cardiac monitoring is recommended for patients throughout treatment with anthracyclines and anti-HER2 therapy. Pretreatment risk assessment with echocardiography and evaluation of cardiovascular risk factors aid in predicting the development of left ventricular (LV) dysfunction. Further clinical trials are needed to increase understanding and optimize treatment guidelines for LV dysfunction in patients taking anthracyclines or anti-HER2 therapy., (Copyright © 2024 American Academy of Physician Associates.)
- Published
- 2024
- Full Text
- View/download PDF
42. Analyzing the training of PAs in ophthalmology.
- Author
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Gutierrez LC and Ayars C
- Subjects
- Humans, United States, Education, Graduate, Ophthalmology, Physicians, Physician Assistants education
- Abstract
Objective: This study sought to determine the role of physician associates/assistants (PAs) in ophthalmology, the balance between barriers and facilitators in training, and optimal training for PAs in ophthalmology., Methods: In this explanatory qualitative case study, 17 of the 94 PAs in ophthalmology in the United States participated in qualitative, semistructured interviews. Qualitative interviews were conducted using a validated interview guide. Interpretational data analysis methods helped in the development of various themes., Results: Themes suggest that PAs play a unique role in assisting ophthalmologists in surgery, performing procedures autonomously, and evaluating and treating patients autonomously. PAs in ophthalmology reported current training programs as unfavorable, reported satisfaction in their careers, and identified formal postgraduate training programs as optimal training for PAs., Conclusions: Findings of this study suggest that formal postgraduate training programs can help PAs gain the necessary skills to successfully fulfill their roles in ophthalmology., (Copyright © 2024 American Academy of Physician Associates.)
- Published
- 2024
- Full Text
- View/download PDF
43. Spontaneous splenic rupture and a congenital splenorenal anomalous shunt.
- Author
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Popa SM and Wilke CP
- Subjects
- Humans, Splenectomy, Abdominal Pain diagnosis, Diagnosis, Differential, Rupture, Spontaneous, Splenic Rupture diagnosis, Splenic Rupture surgery
- Abstract
Abstract: Atraumatic splenic rupture is rare and not often considered in the differential diagnosis for patients with abdominal pain. This article describes a patient with atraumatic splenic rupture complicated by a congenital splenorenal anomalous shunt. The congenital anomaly increases patient risk and the degree of surgical difficulty, even if it is identified preoperatively., (Copyright © 2024 American Academy of Physician Associates.)
- Published
- 2024
- Full Text
- View/download PDF
44. PA and NP burnout in orthopedic surgery.
- Author
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Drennen AV, Heard JC, D'Antonio ND, and Kepler CK
- Subjects
- Humans, Emotional Exhaustion, Surveys and Questionnaires, Burnout, Professional epidemiology, Physicians psychology, Orthopedics, Orthopedic Procedures, Psychological Tests, Self Report
- Abstract
Objective: To quantify the burnout rate among physician associates/assistants (PAs) and NPs in a large orthopedic surgery practice affiliated with an academic institution., Methods: The Maslach Burnout Inventory (MBI) and original research questions were given to all PAs and NPs in orthopedics at the facility. Burnout was defined as a high level of emotional exhaustion or depersonalization on the MBI subscale., Results: Of the 129 PAs and NPs in orthopedics at our institution, 91 (70.5%) completed all survey items. Nearly 42% of respondents were burned out, as defined by high depersonalization or emotional exhaustion. PAs and NPs who met the burnout criteria were significantly older than those who did not (41.8 ± 10 versus 36.5 ± 7.71 years, P = .007) and spent longer in practice (12.4 ± 6.66 versus 9.35 ± 6.41 years, P = .01)., Conclusions: The prevalence of burnout is high among PAs and NPs in orthopedics who practice in an academic setting., (Copyright © 2024 American Academy of Physician Associates.)
- Published
- 2024
- Full Text
- View/download PDF
45. PAs in India: A survey report on qualifications, deployment, specialties, and job satisfaction.
- Author
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Muraleedharan M, Chandak AO, Chatterjee S, Shivakumar R, and Swapna N
- Subjects
- Humans, Adult, Job Satisfaction, Surveys and Questionnaires, Employment, Physician Assistants education, Medicine
- Abstract
Background: This report is based on a 2023 nationwide survey and literature review of physician associates/assistants (PAs) in India. The National Commission for Allied and Healthcare Professions Act, 2021, which is being implemented in India, included guidelines for PA licensing, creating a unified national curriculum, and preventing malpractice., Methods: Using a purposive sampling strategy, we surveyed 536 PAs in India between February 10 and April 30, 2023. The survey collected data on demographics, academic qualifications, specialties, salaries, job satisfaction, and future outlooks through an online questionnaire., Results: The survey showed that most PAs are below age 30 years, and most graduated PAs were involved in clinical practice in 2023. PAs work in almost all clinical specialties; most practice in private hospitals. States in southern India continued to dominate educating and employing PAs, with a nationwide representation of more than 14 states. More than 80% of practicing PAs are satisfied with their profession; however, the majority are unsatisfied with their wages., Conclusions: This first formal survey on India's PAs illustrates the challenges of PA professional practice and standardization of education and licensure in the Indian healthcare system., (Copyright © 2024 American Academy of Physician Associates.)
- Published
- 2024
- Full Text
- View/download PDF
46. A nodule on the foot.
- Author
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Thielen M, Luciew J, and Strelow B
- Subjects
- Humans, Lower Extremity, Foot, Foot Diseases
- Published
- 2024
- Full Text
- View/download PDF
47. A clinician's guide to pulmonary hypertension.
- Author
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Wilson BK, Sadowski CK, and Baeten RG
- Subjects
- Humans, Hypertension, Pulmonary diagnosis
- Abstract
Abstract: Despite advances in diagnosis and treatment, pulmonary hypertension has high morbidity and mortality. The presenting symptoms often are vague and may mimic other more common diseases, so patients can be misdiagnosed or missed early in the disease process. Early detection of pulmonary hypertension by primary care providers can play an important role in patient outcomes and survival. Identifying signs and symptoms, understanding the causes and classifications, and knowing the systematic approach to evaluating and diagnosing patients with suspected pulmonary hypertension are key to preventing premature patient decline., (Copyright © 2024 American Academy of Physician Associates.)
- Published
- 2024
- Full Text
- View/download PDF
48. Peer feedback: A tool to improve PA, NP, and physician collaboration and clinical practice.
- Author
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Gallant A, Erdman L, McBeth L, Ngov LK, and Misky G
- Subjects
- Humans, Feedback, Clinical Competence, Physicians, Nurse Practitioners education, Physician Assistants education
- Abstract
Abstract: The increasing use of physician associates/assistants (PAs) and NPs on clinical teams creates an opportunity for colleagues to provide feedback that can drive growth and improvement in PA and NP clinical skills. Through a needs assessment, month-long pilot, and buy-in from our academic hospital medicine group, we initiated a peer feedback platform that sought to highlight individual faculty strengths, facilitate thoughtful and constructive feedback, and create effective collaboration among colleagues. Three months after implementation, results indicated that the platform provided important information on clinical skills and identified areas for growth and opportunities for additional training. Peer feedback can also improve working relationships among PAs, NPs, and physicians by highlighting the clinical skill sets and value of all team members., (Copyright © 2024 American Academy of Physician Associates.)
- Published
- 2024
- Full Text
- View/download PDF
49. Postprandial facial rash in an infant.
- Author
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Hofmeister N, Ames M, and Lee A
- Subjects
- Infant, Humans, Food, Syndrome, Exanthema etiology
- Abstract
Abstract: This article describes an infant who developed a facial rash within minutes of eating certain foods. The rash resolved within 30 minutes. The patient was diagnosed with auriculotemporal syndrome or Frey syndrome, which is characterized by sweating or flushing in the preauricular area when the patient consumes certain foods, especially those that are acidic, sour, or spicy. Because most patients outgrow the syndrome, no treatment is needed., (Copyright © 2024 American Academy of Physician Associates.)
- Published
- 2024
- Full Text
- View/download PDF
50. Managing heartburn and reflux in primary care.
- Author
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Provenza D, Gillette C, Peacock B, and Rejeski J
- Subjects
- Humans, Proton Pump Inhibitors therapeutic use, Primary Health Care, Heartburn diagnosis, Heartburn etiology, Heartburn therapy, Gastroesophageal Reflux diagnosis, Gastroesophageal Reflux therapy, Gastroesophageal Reflux complications
- Abstract
Abstract: This article describes an algorithmic approach to caring for patients presenting with heartburn and reflux, including empiric treatment with acid-suppression therapy and a data-driven approach to diagnostic testing. This article also reviews the efficacy and safety profile of the widely available and commonly used proton pump inhibitors. Refining our approach to diagnostic testing can reduce time to diagnosis, better control patients' symptoms, and limit complications of longstanding disease., (Copyright © 2024 American Academy of Physician Associates.)
- Published
- 2024
- Full Text
- View/download PDF
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