JAAPA JAAPA is the peer-reviewed clinical journal of the American Academy of Physician Assistants (AAPA). www.jaapa.com
JAAPA is the peer-reviewed clinical journal of the American Academy of Physician Assistants. Its mission is to support the ongoing education and advancement of PAs by publishing current information and research on clinical, health policy, and professional issues. Some features of JAAPA include: -Monthly publication -Clinical review articles -Original health services research -Articles on the PA profession -Blinded peer review by outside experts -Category I CME Credit for selected articles -Award-winning editorial In addition, JAAPA.com features: -Weekly blogs, including: Musings: The JAAPA Editorial Board Blog; Health Disparities Blog; Health Information Technology Blog; and Atrial Kick, a blog written by a cardiothoracic PA. -Online-only columns, including Ask a Librarian and Inside the AAPA Policy Manual -Web-exclusive articles such as Case Reports and Interpreting ECGs JAAPA also actively uses Twitter to provide up-to-the-minute PA news, updates about our latest content and contests, and more! Stay Connected With Us on Twitter: @JAAPAcom
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With the expanded use of DNA analyses, the number of patients with an identified hereditary risk for ovarian cancer is i...
02/27/2020

With the expanded use of DNA analyses, the number of patients with an identified hereditary risk for ovarian cancer is increasing. This article describes birth control options for women with no history of cancer, but with an identified hereditary ovarian cancer risk, who decline bilateral salpingo-oophorectomy. http://bit.ly/2T0PNWI

JAAPA is currently seeking a leader in the PA profession to be the journal’s new Editor-in-Chief. This position is a par...
02/27/2020

JAAPA is currently seeking a leader in the PA profession to be the journal’s new Editor-in-Chief. This position is a part-time, independent-contractor position with an honorarium. http://bit.ly/2TflpqJ

02/24/2020

Have you listened to the February episode of the JAAPA Podcast yet? In this month’s episode, our co-hosts cover everything from point-of-care ultrasound of long bone fractures to CME articles on multiple sclerosis and complementary feeding for infants. Don’t miss it! https://apple.co/2UVHo8F

February is American Heart Month, so make sure to check out the latest guidelines from the American Diabetes Association...
02/22/2020

February is American Heart Month, so make sure to check out the latest guidelines from the American Diabetes Association which include new information on hypertension, lipid management, heart failure, and coronary heart disease. http://bit.ly/2LeOwqd

How can clinicians respectfully address religious objections to vaccination while honoring patient autonomy? This articl...
02/21/2020

How can clinicians respectfully address religious objections to vaccination while honoring patient autonomy? This article introduces a four-step framework for exploring and responding to a patient's stated religious objections to vaccination. http://bit.ly/2HxO4BO

This month’s original research surveyed PA attitudes about electronic-assisted documentation in the outpatient setting a...
02/20/2020

This month’s original research surveyed PA attitudes about electronic-assisted documentation in the outpatient setting and its disadvantages. Learn more from the study: http://bit.ly/2vNrUZS

This article explains why drugs can have a proarrhythmic propensity, discusses the origins and nature of the regulatory ...
02/19/2020

This article explains why drugs can have a proarrhythmic propensity, discusses the origins and nature of the regulatory landscape that governs current premarketing assessments, provides examples of resulting prescribing information warnings, and presents a scenario illustrating clinical practice implications for PAs and NPs. http://bit.ly/2V1PTPm

Should we treat other providers’ rude behavior as a threat to patient safety? Harrison Reed, MMSc, PA-C, shares why pati...
02/18/2020

Should we treat other providers’ rude behavior as a threat to patient safety? Harrison Reed, MMSc, PA-C, shares why patient safety may suffer due to destructive interpersonal behavior in this month’s Editorial. http://bit.ly/2P4ugKu

02/14/2020

Kick off your weekend with the February episode of the JAAPA Podcast! This month, our co-hosts discuss CME articles on multiple sclerosis and complementary feeding for infants, a Quick Recertification Series article on skin cancer, and much more. https://apple.co/2UVHo8F

Multiple sclerosis affects more than 900,000 Americans and patient presentations vary widely; therefore, symptom recogni...
02/11/2020

Multiple sclerosis affects more than 900,000 Americans and patient presentations vary widely; therefore, symptom recognition and an understanding of diagnostic criteria are critical in providing timely patient referrals. http://bit.ly/3brUArG

A local dentist called the primary care clinic concerned about a lytic lesion in the anterior right lower jaw of a 28-ye...
02/10/2020

A local dentist called the primary care clinic concerned about a lytic lesion in the anterior right lower jaw of a 28-year-old female patient. Find out the diagnosis in this month's Diagnostic Imaging Review. http://bit.ly/2SJ8bCr

AAPA President David Mittman, PA, DFAAPA, writes about direct payment for PAs in this month’s issue - read how current p...
02/07/2020

AAPA President David Mittman, PA, DFAAPA, writes about direct payment for PAs in this month’s issue - read how current payment arrangements are disadvantaging PAs in the healthcare marketplace and why advocacy efforts on this front are vital. http://bit.ly/3bfFK7u

Safe and timesaving, ultrasound can be used in the ED as a screening tool for suspected long bone fractures and can dete...
02/06/2020

Safe and timesaving, ultrasound can be used in the ED as a screening tool for suspected long bone fractures and can detect associated musculoskeletal injuries. Studies have found that clinicians using ultrasound can detect long bone fractures with an average 90% sensitivity and specificity after an average of 1 to 4 hours total of didactic and practical training. http://bit.ly/388xJiQ

Clinicians can find it difficult to navigate the recommendations and research to give practical, evidence-based advice t...
02/05/2020

Clinicians can find it difficult to navigate the recommendations and research to give practical, evidence-based advice to parents about optimal feeding practices for infants. This article brings the current recommendations and recent research together and organizes them for clinicians in pediatrics to enable them to understand and convey this information to parents of infants. http://bit.ly/2S0SCqf

Ibrutinib is a new first-line drug for treating chronic lymphocytic leukemia (CLL). Learn more about this oral drug that...
02/02/2020

Ibrutinib is a new first-line drug for treating chronic lymphocytic leukemia (CLL). Learn more about this oral drug that could change frontline treatment of CLL from traditional IV chemotherapy to oral targeted therapy. http://bit.ly/2REqb1m

A man who presented with a 2-week history of atraumatic, unilateral, retro-orbital cranio-facial pain, ipsilateral diaph...
02/01/2020

A man who presented with a 2-week history of atraumatic, unilateral, retro-orbital cranio-facial pain, ipsilateral diaphoresis, and facial flushing was diagnosed with cluster headaches after a positive response to oxygen therapy. Learn more in this case report: http://bit.ly/2U5MPkV

Foreign body aspiration is the fifth most common cause of mortality due to unintentional injury in the US. Children who ...
01/31/2020

Foreign body aspiration is the fifth most common cause of mortality due to unintentional injury in the US. Children who have aspirated a foreign body may present with a variety of symptoms, from mild irritation and cough to respiratory failure. Clinicians must have a high degree of suspicion to ensure a foreign body aspiration is not missed on initial presentation. http://bit.ly/2S0WsPe

Take a look at this month's Difficult Diagnosis to learn an unexpected cause of wheezing and shortness of breath. http:/...
01/30/2020

Take a look at this month's Difficult Diagnosis to learn an unexpected cause of wheezing and shortness of breath. http://bit.ly/36EJEDs

Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of morbidity and mortality for patients with diabete...
01/29/2020

Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of morbidity and mortality for patients with diabetes. The latest guidelines from the American Diabetes Association include new information on hypertension, lipid management, heart failure, and coronary heart disease. http://bit.ly/2LeOwqd

Over the past 15 years, policy reports and news headlines have predicted dire physician shortages. But if workforce proj...
01/27/2020

Over the past 15 years, policy reports and news headlines have predicted dire physician shortages. But if workforce projections included a realistic assessment of the roles of PAs and NPs, these concerns might seem considerably less dramatic. http://bit.ly/2otnuDQ

The US opioid epidemic has resulted in legislative actions to make treatment more accessible to patients. This article d...
01/27/2020

The US opioid epidemic has resulted in legislative actions to make treatment more accessible to patients. This article describes opioid use disorder in the US, treatment gaps, safe treatment with buprenorphine, and PA prescriptive authority. http://bit.ly/2IntWTS

Kick off your weekend with the January episode of the JAAPA Podcast! Co-hosts Kris Maday, PA-C and Adrian Banning, PA-C ...
01/24/2020

Kick off your weekend with the January episode of the JAAPA Podcast! Co-hosts Kris Maday, PA-C and Adrian Banning, PA-C review CME articles on peripheral neuropathy and pericarditis. They also discuss an article on helping survivors of sexual assault and an original research article on improving health disparities in PA practices. https://apple.co/2GqCCHr

Athletes and parents often believe that initiating specialized & intensive training at an early age is necessary in orde...
01/23/2020

Athletes and parents often believe that initiating specialized & intensive training at an early age is necessary in order to optimize development of sport-specific skills. However, evidence suggests that this early specialization counteracts many of the physical, psychologic, and social benefits of sport participation, and does not produce the desired result. Clinicians need to know how to counsel families about participation patterns in youth sports. http://bit.ly/2TTmVAC

Bariatric surgery is largely known for its role as a weight loss tool but is gaining notoriety as a successful treatment...
01/21/2020

Bariatric surgery is largely known for its role as a weight loss tool but is gaining notoriety as a successful treatment for patients with refractory type 2 diabetes. As bariatric surgery gains more prominence in diabetes, clinicians must understand these procedures, which patients are appropriate candidates, and how to manage patients postoperatively. http://bit.ly/2TQo1gJ

American Academy of PAs
01/20/2020

American Academy of PAs

Today we honor the life and legacy of Dr. Martin Luther King, Jr. Thank you Dr. King, for dedicating your life to equality, justice, and peace for all Americans.

According to the CDC, about 20,000 deaths each year are attributed to viral hepatitis, and 5 million people are chronica...
01/19/2020

According to the CDC, about 20,000 deaths each year are attributed to viral hepatitis, and 5 million people are chronically infected and at risk for serious liver disease and hepatocellular cancer. This article reviews the three most common causes of viral hepatitis, screening guidelines, and more. http://bit.ly/34qCLoD

Pericarditis is the most common form of pericardial disease and may be associated with significant morbidity and mortali...
01/16/2020

Pericarditis is the most common form of pericardial disease and may be associated with significant morbidity and mortality. This CME article discusses the management of acute and recurrent idiopathic pericarditis. http://bit.ly/30sM8mA

January is Thyroid Awareness Month - check out this case report on recognizing thyrotoxic hypokalemic periodic paralysis...
01/15/2020

January is Thyroid Awareness Month - check out this case report on recognizing thyrotoxic hypokalemic periodic paralysis, a rare but potentially serious complication of thyrotoxicosis. http://bit.ly/2CKjLWQ

The histologic overlap between chronic idiopathic IBD and SCAD creates the potential for misdiagnosing SCAD as IBD, whic...
01/14/2020

The histologic overlap between chronic idiopathic IBD and SCAD creates the potential for misdiagnosing SCAD as IBD, which can be problematic because the natural history and prognosis of the two conditions vary significantly. http://bit.ly/2Nk5Lbi

Sepsis affects more than 31.5 million people worldwide every year, potentially resulting in 5 million deaths. Up to one-...
01/11/2020

Sepsis affects more than 31.5 million people worldwide every year, potentially resulting in 5 million deaths. Up to one-third of patients with sepsis also develop sepsis-associated acute kidney injury. This article describes the need for restraint in fluid resuscitation in patients with sepsis, in order to mitigate end-organ damage and ultimately to save lives. http://bit.ly/36HgsMV

Simply advising a patient with type 2 diabetes to lose weight and increase physical exercise ignores the complex interpl...
01/10/2020

Simply advising a patient with type 2 diabetes to lose weight and increase physical exercise ignores the complex interplay of many levels of influences throughout a patient's life. This article describes type 2 diabetes from a multilevel life course perspective that can help clinicians find areas of possible intervention and understand the challenges patients face. http://bit.ly/2NcmYTS

In an era of less-frequent routine gynecologic examinations, cervical infections, especially if asymptomatic, may be mis...
01/09/2020

In an era of less-frequent routine gynecologic examinations, cervical infections, especially if asymptomatic, may be missed. Annual wellness examinations and other patient visits outside routine gynecologic cancer screening visits should include brief evaluation with sexual risk assessment and a gynecologic examination if indicated. http://bit.ly/2sgZXUZ #CervicalHealthMonth

The ideal environment necessary for health equity requires the removal of a broad range of barriers that reduce patients...
01/07/2020

The ideal environment necessary for health equity requires the removal of a broad range of barriers that reduce patients' access to the opportunities and resources needed to be healthy. This study assessed a quality improvement initiative designed to highlight awareness of health disparities and improve healthcare practices. http://bit.ly/2tBjlQI

Sexual assault is a widespread problem in US communities, affecting about one in every three women and one in every eigh...
01/05/2020

Sexual assault is a widespread problem in US communities, affecting about one in every three women and one in every eight men. These assaults reverberate through the lives of survivors and their loved ones, often for decades or even a lifetime. Healthcare providers must be empowered and equipped to contribute to the medical and mental health of survivors. http://bit.ly/39EKjHz

After serving JAAPA for nine years as Editor-in-Chief, Reamer L. Bushardt, PharmD, PA-C, DFAAPA, will retire from the JA...
01/03/2020

After serving JAAPA for nine years as Editor-in-Chief, Reamer L. Bushardt, PharmD, PA-C, DFAAPA, will retire from the JAAPA board next June. In his farewell letter, he shares some of what he’s learned through his tenure, his gratitude to his peers, and his appreciation for the experience: http://bit.ly/2QH798K

Peripheral neuropathy is a common condition that can be encountered in a multitude of clinical settings, and treatment m...
01/02/2020

Peripheral neuropathy is a common condition that can be encountered in a multitude of clinical settings, and treatment must be tailored to the underlying cause. Review the various causes of peripheral neuropathy and recommendations for evaluating patients to determine the cause of peripheral neuropathy: http://bit.ly/2MR148F

American Academy of PAs
01/01/2020

American Academy of PAs

Wishing everyone a Happy New Year! 🎆

It's not quite yet the new year, but the new issue of JAAPA is now available online! Check out the January issue to lear...
12/31/2019

It's not quite yet the new year, but the new issue of JAAPA is now available online! Check out the January issue to learn about a curious case of colitis, bariatric surgery and type 2 diabetes, helping survivors of sexual assault, and more. http://bit.ly/2Vr44Lt

Hepatocellular carcinoma is the fifth most common cancer worldwide. Advanced hepatocellular carcinoma with tumor thrombu...
12/30/2019

Hepatocellular carcinoma is the fifth most common cancer worldwide. Advanced hepatocellular carcinoma with tumor thrombus metastasis to the right atrium is rare, generally considered inoperable, and has a poor prognosis. This article describes the management of two patients with hepatocellular carcinoma and incidental findings of tumor thrombus invasion into the right atrium. http://bit.ly/2tfuhQr

Leber congenital amaurosis is a rare congenital disorder caused by a mutation in any of several different genes that cau...
12/30/2019

Leber congenital amaurosis is a rare congenital disorder caused by a mutation in any of several different genes that causes rod-cone dystrophy and may eventually lead to blindness. Characteristic findings on fundoscopic examination include retinal pigment migration and macular atrophy. Confirmation can be obtained using electroretinograms and the specific gene can be identified with genetic testing. http://bit.ly/39mZ6q5

Patients with Down syndrome are known to produce excess interferon gamma, a major culprit of psoriasis formation and sev...
12/26/2019

Patients with Down syndrome are known to produce excess interferon gamma, a major culprit of psoriasis formation and severity. Both conditions increase patient risk for major cardiovascular events; however, a potential association between Down syndrome and severe psoriasis has not been well studied. This article discusses a patient with Down syndrome and worsening plaque psoriasis. http://bit.ly/2t38VsQ

Happy Holidays from JAAPA! May your holidays be filled with cheer.
12/22/2019

Happy Holidays from JAAPA! May your holidays be filled with cheer.

After serving the Journal of the American Academy of PAs for nine years as Editor-in-Chief, Reamer L. Bushardt, PharmD, ...
12/21/2019
Editor-in-Chief Bushardt to Retire from JAAPA Board - AAPA

After serving the Journal of the American Academy of PAs for nine years as Editor-in-Chief, Reamer L. Bushardt, PharmD, PA-C, DFAAPA, will retire from the JAAPA board. Harrison Reed will serve as the Acting Editor-in-Chief as the search for a new Editor-in-Chief begins.

After serving the Journal of the American Academy of PAs for nine years as Editor-in-Chief, Reamer L. Bushardt, PharmD, PA-C, DFAAPA, will retire from the JAAPA board next June. Bushardt is professor and senior associate dean at GW School of Medicine and Health Sciences.

Acetaminophen-induced hepatotoxicity is the most common cause of acute liver failure in adults and a major cause of acut...
12/20/2019

Acetaminophen-induced hepatotoxicity is the most common cause of acute liver failure in adults and a major cause of acute liver failure in children. Prompt treatment with N-acetylcysteine can mitigate hepatotoxicity and progression to liver failure. This article describes a 16-year-old girl who ingested a large dose of extra-strength acetaminophen, and how the 150 rule was used in her management. http://bit.ly/36KO8bR

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Journal of the American Academy of PAs (JAAPA)

About JAAPA

JAAPA is the peer-reviewed clinical journal of the American Academy of PAs (AAPA). Its mission is to support the ongoing education and advancement of physician assistants (PAs) by publishing current information and research on clinical, health policy, and professional issues.

About AAPA

Founded in 1968, the American Academy of PAs is the national professional society for PAs. It represents a profession of more than 123,000 PAs across all medical and surgical specialties in all 50 states, the District of Columbia, U.S. territories, and the uniformed services.

AAPA advocates and educates on behalf of the profession and the patients PAs serve. We work to ensure the professional growth, personal excellence and recognition of PAs. We also enhance their ability to improve the quality, accessibility and cost-effectiveness of patient-centered healthcare.

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