Long-acting GLP-1 receptor agonists: Findings and implications of cardiovascular outcomes trials
This article reviews CVOTs completed to date for the class of long-acting glucagon-like peptide-1 receptor agonists (GLP-1RAs; liraglutide, exenatide extended-release, albiglutide, dulaglutide, semaglutide injectable, semaglutide oral) and implications for clinical management of T2DM. All CVOTs have confirmed long-acting GLP-1RAs to be noninferior to (not worse than) placebo with regard to first occurrence of a primary outcome of three-point major adverse cardiovascular events (MACE; composite outcome of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke). Further, a number of the studies demonstrated a ...
Source: Journal of the American Academy of Physician Assistants - July 30, 2020 Category: Primary Care Tags: Long-Acting GLP-1 Receptor Agonists Source Type: research

Long-acting GLP-1RAs: An overview of efficacy, safety, and their role in type 2 diabetes management
Over recent decades, an improved understanding of the pathophysiology of type 2 diabetes mellitus (T2DM) and glucose regulation has led to innovative research and new treatment paradigms. The discovery of the gut peptide glucagon-like peptide-1 (GLP-1) and its role in glucose regulation paved the way for the class of GLP-1 receptor agonist compounds, or GLP-1RAs. The long-acting GLP-1RAs (dulaglutide, exenatide extended-release, liraglutide, semaglutide [injectable and oral]) are classified as such based on a minimum 24-hour duration of clinically relevant effects after administration. In phase 3 clinical trial programs of...
Source: Journal of the American Academy of Physician Assistants - July 30, 2020 Category: Primary Care Tags: Long-Acting GLP-1 Receptor Agonists Source Type: research

Moving forward
No abstract available (Source: Journal of the American Academy of Physician Assistants)
Source: Journal of the American Academy of Physician Assistants - July 30, 2020 Category: Primary Care Tags: Becoming a PA Source Type: research

A mother in mourning
No abstract available (Source: Journal of the American Academy of Physician Assistants)
Source: Journal of the American Academy of Physician Assistants - July 30, 2020 Category: Primary Care Tags: The Art of Medicine Source Type: research

What is the ulcerated pink nodule on this patient's scalp?
No abstract available (Source: Journal of the American Academy of Physician Assistants)
Source: Journal of the American Academy of Physician Assistants - July 30, 2020 Category: Primary Care Tags: A Difficult Diagnosis Source Type: research

Can PAs and NPs manage complex patients?
No abstract available (Source: Journal of the American Academy of Physician Assistants)
Source: Journal of the American Academy of Physician Assistants - July 30, 2020 Category: Primary Care Tags: The Science of Healthcare Delivery Source Type: research

New options for managing fecal incontinence in women
This article reviews the limited therapies for managing fecal incontinence, including a minimally invasive vaginal control device that may offer hope for managing fecal incontinence in women. (Source: Journal of the American Academy of Physician Assistants)
Source: Journal of the American Academy of Physician Assistants - July 30, 2020 Category: Primary Care Tags: Special Topics in Women's Health Source Type: research

Stevens-Johnson syndrome and toxic epidermal necrolysis
No abstract available (Source: Journal of the American Academy of Physician Assistants)
Source: Journal of the American Academy of Physician Assistants - July 30, 2020 Category: Primary Care Tags: Quick Recertification Series Source Type: research

Recognizing and limiting syphilis to prevent congenital syphilis
Syphilis is on the rise in every age and ethnicity group across the United States. The rate of congenital syphilis has started to rise as well, increasing the need for syphilis screening before pregnancy occurs. Raising awareness for syphilis screening, especially among sexually active women, is important, as the implications of this disease have lifelong effects for mother and child. (Source: Journal of the American Academy of Physician Assistants)
Source: Journal of the American Academy of Physician Assistants - July 30, 2020 Category: Primary Care Tags: Special Article Source Type: research

Opinions of supervisors of clinical associates in South African district hospitals
Conclusions: Interview results highlighted acceptance and appreciation for the introduction of clinical associates. Baseline opinions enhanced curriculum development and will inform further research on the effect of clinical associates on healthcare delivery in South Africa. (Source: Journal of the American Academy of Physician Assistants)
Source: Journal of the American Academy of Physician Assistants - July 30, 2020 Category: Primary Care Tags: Original Research Source Type: research

Intrathecal hydromorphone as an analgesia option for gynecology patients
Enhanced recovery after surgery (ERAS) is a multimodal perioperative strategy originally developed to attenuate the postsurgical stress response in patients after colorectal surgery. Patients undergoing gynecologic surgery who had ERAS had significantly shorter hospital length of stay, reduced hospital-related costs, and acceptable pain management with reduced opioid use, without compromising patient satisfaction. Intrathecal hydromorphone is an effective alternative ERAS protocol analgesia for these patients and will not compromise patient outcomes or healthcare costs. (Source: Journal of the American Academy of Physician Assistants)
Source: Journal of the American Academy of Physician Assistants - July 30, 2020 Category: Primary Care Tags: Review Article Source Type: research

ACE inhibitor-induced angioedema causing small bowel obstruction
Mucosal angioedema of the face, lips, tongue, and throat is a well-recognized adverse reaction to angiotensin-converting enzyme (ACE) inhibitors that is experienced by a minority of patients. Rarely, this angioedema can involve the small bowel, and patients commonly present with abdominal pain and small bowel obstruction. Due to the increasing number of patients being treated for hypertension, clinicians should consider the diagnosis of small bowel angioedema secondary to ACE inhibitor use in all patients with this presentation who are using this class of medications. (Source: Journal of the American Academy of Physician Assistants)
Source: Journal of the American Academy of Physician Assistants - July 30, 2020 Category: Primary Care Tags: Case Report Source Type: research

Cannabis and acute myocardial infarction
This article describes cannabis use as a contributing factor to acute myocardial infarction in a young woman with chest pain. (Source: Journal of the American Academy of Physician Assistants)
Source: Journal of the American Academy of Physician Assistants - July 30, 2020 Category: Primary Care Tags: Case Report Source Type: research

Acute abdominal pain in the first trimester of pregnancy
Pregnant women presenting to the ED with abdominal pain or vomiting are likely to be evaluated for problems with the pregnancy. Although pregnancy-related pathology is common, patients may have intra-abdominal pathology that requires prompt evaluation and possible surgical intervention. (Source: Journal of the American Academy of Physician Assistants)
Source: Journal of the American Academy of Physician Assistants - July 30, 2020 Category: Primary Care Tags: Case Report Source Type: research

Cme post-test
No abstract available (Source: Journal of the American Academy of Physician Assistants)
Source: Journal of the American Academy of Physician Assistants - July 30, 2020 Category: Primary Care Tags: Post-Test Source Type: research

Adult attention deficit/hyperactivity disorder in the ambulatory care setting
This article reviews the screening and assessment for adult ADHD along with pharmacologic and nonpharmacologic recommendations for the management of the disorder. (Source: Journal of the American Academy of Physician Assistants)
Source: Journal of the American Academy of Physician Assistants - July 30, 2020 Category: Primary Care Tags: CME: Primary Care Source Type: research

Red flags of low back pain
This article highlights the history and physical examination findings that will improve identification of red flags associated with emergency or serious causes. (Source: Journal of the American Academy of Physician Assistants)
Source: Journal of the American Academy of Physician Assistants - July 30, 2020 Category: Primary Care Tags: CME: Orthopedics Source Type: research

Diabetes self-management education and support in adults with type 2 diabetes: A consensus report of the American Diabetes Association, the Association of Diabetes Care and Education Specialists, the Academy of Nutrition and Dietetics, the American Academy of Family Physicians, the American Academy of PAs, the American Association of Nurse Practitioners, and the American Pharmacists Association
No abstract available (Source: Journal of the American Academy of Physician Assistants)
Source: Journal of the American Academy of Physician Assistants - June 26, 2020 Category: Primary Care Tags: Consensus Report Source Type: research

Nine lives
No abstract available (Source: Journal of the American Academy of Physician Assistants)
Source: Journal of the American Academy of Physician Assistants - June 26, 2020 Category: Primary Care Tags: The Art of Medicine Source Type: research

Is this patient's fistula caused by Crohn disease of the pouch?
No abstract available (Source: Journal of the American Academy of Physician Assistants)
Source: Journal of the American Academy of Physician Assistants - June 26, 2020 Category: Primary Care Tags: A Difficult Diagnosis Source Type: research

A telehealth program to perform medical screening examinations
This article describes a telemedicine program based on the provider in triage model that uses physician assistants and NPs to improve patient door-to-diagnostic evaluation times in the ED. (Source: Journal of the American Academy of Physician Assistants)
Source: Journal of the American Academy of Physician Assistants - June 26, 2020 Category: Primary Care Tags: What's New in Emergency Medicine Source Type: research

De Quervain tenosynovitis
No abstract available (Source: Journal of the American Academy of Physician Assistants)
Source: Journal of the American Academy of Physician Assistants - June 26, 2020 Category: Primary Care Tags: Quick Recertification Series Source Type: research

The effect of the COVID-19 pandemic on healthcare workers' mental health
The novel coronavirus (SARS-CoV-2) that emerged in late 2019 in Wuhan, China, commonly presents as a severe acute respiratory disease referred to as coronavirus disease-2019 (COVID-19). The rapid spread of the disease created challenges for healthcare systems and forced healthcare workers to grapple with clinical and nonclinical stressors, including shortages of personal protective equipment, mortality and morbidity associated with COVID-19, fear of bringing the virus home to family members, and the reality of losing colleagues to the disease. Evidence from previous outbreaks, along with early evidence from the COVID-19 pa...
Source: Journal of the American Academy of Physician Assistants - June 26, 2020 Category: Primary Care Tags: Special Article Source Type: research

PA job availability in primary care during 2014 and 2016
Conclusions: Our findings provide insights into which specialties have emerging high demand for PAs. The demand for PAs appears to remain much stronger for specialty jobs than for primary care jobs. (Source: Journal of the American Academy of Physician Assistants)
Source: Journal of the American Academy of Physician Assistants - June 26, 2020 Category: Primary Care Tags: Original Research Source Type: research

Nutritional considerations for the prevention and treatment of postmenopausal osteoporosis
Osteoporosis commonly affects postmenopausal women and accounts for 300,000 hip fractures in the United States each year. More women are deferring or discontinuing pharmacologic treatment because of intolerable adverse reactions or fear of long-term safety. Supplementing dietary intake of certain vitamins and minerals can have positive effects on bone parameters. Calcium is frequently recommended for osteoporotic patients but many not confer much benefit toward bone density. Certain forms of vitamins A and K have been shown to increase bone density. Isoflavones and phytates are phytochemicals found in soy foods that are co...
Source: Journal of the American Academy of Physician Assistants - June 26, 2020 Category: Primary Care Tags: Review Article Source Type: research

Hijab pin inhalation
Foreign body aspiration can be an acute life-threatening emergency and, if left untreated, can result in severe complications. Among Muslim women, the hijab pin can be accidentally aspirated. The article describes standard management with rigid bronchoscopy and a new technique involving magnets. (Source: Journal of the American Academy of Physician Assistants)
Source: Journal of the American Academy of Physician Assistants - June 26, 2020 Category: Primary Care Tags: Case Report Source Type: research

Clostridium difficile infection after antibiotic use
Every day, patients are prescribed antibiotics to treat infections, and some of these patients will subsequently develop a superinfection with Clostridium difficile. Although the use of antibiotics is a necessary part of modern medical care, clinicians must be judicious with their use and choice of antibiotics to prevent consequences for patients whenever possible. (Source: Journal of the American Academy of Physician Assistants)
Source: Journal of the American Academy of Physician Assistants - June 26, 2020 Category: Primary Care Tags: Case Report Source Type: research

Cme post-test
No abstract available (Source: Journal of the American Academy of Physician Assistants)
Source: Journal of the American Academy of Physician Assistants - June 26, 2020 Category: Primary Care Tags: Post-Test Source Type: research

Kawasaki disease: Shedding light on a mysterious diagnosis
This article reviews the pathophysiology, clinical presentation, diagnosis, and treatment of Kawasaki disease. (Source: Journal of the American Academy of Physician Assistants)
Source: Journal of the American Academy of Physician Assistants - June 26, 2020 Category: Primary Care Tags: CME: Pediatrics Source Type: research

Seeking a balanced approach to implementing sepsis guidelines
This article describes a balanced approach to sepsis guideline implementation using clinical decision tools and educates clinicians on sepsis diagnosis and management. (Source: Journal of the American Academy of Physician Assistants)
Source: Journal of the American Academy of Physician Assistants - June 26, 2020 Category: Primary Care Tags: CME: Immunology Source Type: research

Addressing PA burnout
No abstract available (Source: Journal of the American Academy of Physician Assistants)
Source: Journal of the American Academy of Physician Assistants - June 26, 2020 Category: Primary Care Tags: From the AAPA Source Type: research

Driving high-functioning clinical teams: An advanced practice registered nurse and PA optimization initiative
Conclusions: Several recommendations were presented to department leaders about NP/CNM/CNS/PA practice. Departments that implemented several of the recommendations showed positive outcomes. This was evidenced by increased financial gain (increased relative value units, increase in revenue generated), increased patient access (increased clinic densities), and overall NP/CNM/CNS/PA satisfaction. (Source: Journal of the American Academy of Physician Assistants)
Source: Journal of the American Academy of Physician Assistants - May 28, 2020 Category: Primary Care Tags: Original Research Source Type: research

A lump in the neck
No abstract available (Source: Journal of the American Academy of Physician Assistants)
Source: Journal of the American Academy of Physician Assistants - May 28, 2020 Category: Primary Care Tags: The Art of Medicine Source Type: research

What is causing this patient's severe pruritus?
No abstract available (Source: Journal of the American Academy of Physician Assistants)
Source: Journal of the American Academy of Physician Assistants - May 28, 2020 Category: Primary Care Tags: A Difficult Diagnosis Source Type: research

Medical education for primary care: Is the paradigm shifting?
No abstract available (Source: Journal of the American Academy of Physician Assistants)
Source: Journal of the American Academy of Physician Assistants - May 28, 2020 Category: Primary Care Tags: The Science of Healthcare Delivery Source Type: research

Treating asthma in the age of biologics
Many patients with severe asthma continue to have high symptom burden despite maximization of conventional therapy. As the understanding of asthma pathophysiology has evolved, however, more personalized therapy options have become available. Asthma biologics are a new class of medications that target the specific pathways that underlie a patient's disease and can reduce the frequency of asthma exacerbations and improve patient quality of life. Clinicians should refer potential candidates to a specialist for further evaluation. (Source: Journal of the American Academy of Physician Assistants)
Source: Journal of the American Academy of Physician Assistants - May 28, 2020 Category: Primary Care Tags: What'S New in Immunology Source Type: research

Schizophrenia and schizophrenia spectrum disorders
No abstract available (Source: Journal of the American Academy of Physician Assistants)
Source: Journal of the American Academy of Physician Assistants - May 28, 2020 Category: Primary Care Tags: Quick Recertification Series Source Type: research

Using interpreters for Deaf patients and patients with limited English proficiency
This article discusses the unique needs of patients who are Deaf or have limited English proficiency, and how to provide qualified interpreters to help improve patient communication and care. (Source: Journal of the American Academy of Physician Assistants)
Source: Journal of the American Academy of Physician Assistants - May 28, 2020 Category: Primary Care Tags: Special Article Source Type: research

Vitamin D, melanoma risk, and tumor thickness in PLCO cancer screening trial patients
Objective: The incidence of melanoma is increasing. Other than limiting UV exposure, few factors prevent or reduce the risk of melanoma. The aim of this study is to evaluate the relationship between vitamin D intake and melanoma risk in the Prostate, Lung, Colorectal, and Ovarian (PLCO) cancer screening trial. Methods: A secondary data analysis was performed on PLCO data. More than 1,300 participants developed melanoma. Results: Melanoma risk may be increased among men within the highest quartile of vitamin D intake (HR 1.27, 95% CI 0.99, 1.61). Women in the highest quartile of vitamin D intake had a decreased risk...
Source: Journal of the American Academy of Physician Assistants - May 28, 2020 Category: Primary Care Tags: Original Research Source Type: research

Managing acute cancer pain
This article discusses available interventions for patients with cancer pain. (Source: Journal of the American Academy of Physician Assistants)
Source: Journal of the American Academy of Physician Assistants - May 28, 2020 Category: Primary Care Tags: Review Article Source Type: research

Cervical spine subdural hematoma: A rare radiographic abnormality in a trauma patient
This article describes one approach to managing a patient with an SSDH. (Source: Journal of the American Academy of Physician Assistants)
Source: Journal of the American Academy of Physician Assistants - May 28, 2020 Category: Primary Care Tags: Case Report Source Type: research

Postoperative hemorrhage secondary to acquired hemophilia A
This article describes a patient successfully treated with recombinant factor VIIa, porcine factor VIII, plasmapheresis, rituximab, and high-dose corticosteroids. (Source: Journal of the American Academy of Physician Assistants)
Source: Journal of the American Academy of Physician Assistants - May 28, 2020 Category: Primary Care Tags: Case Report Source Type: research

Cme post-test
No abstract available (Source: Journal of the American Academy of Physician Assistants)
Source: Journal of the American Academy of Physician Assistants - May 28, 2020 Category: Primary Care Tags: Post-Test Source Type: research

The role of percutaneous coronary intervention in managing patients with stable ischemic heart disease
A major outcome of cardiology research over the last 2 decades is the finding that intensive medical management of patients with stable ischemic heart disease is as effective as revascularization procedures in preventing cardiac events and death. This finding has generated management guidelines that often are overlooked because of misplaced enthusiasm for revascularization procedures. (Source: Journal of the American Academy of Physician Assistants)
Source: Journal of the American Academy of Physician Assistants - May 28, 2020 Category: Primary Care Tags: CME: Cardiology Source Type: research

Update on HIV prevention and preexposure prophylaxis
This article provides a baseline understanding of PrEP indications, prescribing, and monitoring, including a review of previously approved medication and an update on newly approved drugs, including emtricitabine/tenofovir alafenamide (F/TAF). Sexual and gender minorities are often underrepresented in the literature about PrEP, but clinicians should address risk focused on specific behaviors rather than population-level characteristics. As one of few professions with prescriptive authority, PAs have an obligation to understand and manage PrEP. (Source: Journal of the American Academy of Physician Assistants)
Source: Journal of the American Academy of Physician Assistants - May 28, 2020 Category: Primary Care Tags: CME: Infectious Disease Source Type: research

My strange but amazing year as president
No abstract available (Source: Journal of the American Academy of Physician Assistants)
Source: Journal of the American Academy of Physician Assistants - May 28, 2020 Category: Primary Care Tags: From the AAPA Source Type: research

The machines won't save us
No abstract available (Source: Journal of the American Academy of Physician Assistants)
Source: Journal of the American Academy of Physician Assistants - May 28, 2020 Category: Primary Care Tags: Editorial Source Type: research

The overcoming
No abstract available (Source: Journal of the American Academy of Physician Assistants)
Source: Journal of the American Academy of Physician Assistants - April 29, 2020 Category: Primary Care Tags: Mindful Practice Source Type: research

Anticipating the management of Streptococcus agalactiae infective endocarditis
A patient who presented after falling out of bed had signs of right-sided stroke, which, after imaging, was suspicious for embolism with cardiac origin. Further investigation revealed a large aortic valve vegetation with mild aortic insufficiency, and the patient eventually developed heart failure requiring surgical intervention. Infective endocarditis is slowly becoming more prevalent, and clinicians should have a high index of suspicion when patients present with common complications of this disease, such as valvular dysfunction, heart failure, or stroke. Early diagnosis has been shown to reduce time to appropriate antib...
Source: Journal of the American Academy of Physician Assistants - April 29, 2020 Category: Primary Care Tags: Case Report Source Type: research

The world I'll die in
No abstract available (Source: Journal of the American Academy of Physician Assistants)
Source: Journal of the American Academy of Physician Assistants - April 29, 2020 Category: Primary Care Tags: The Art of Medicine Source Type: research