Jaapa-Journal of the American Academy of Physician Assistants最新文献

Objective: To explore if a physician associate/assistant (PA)-led advance care planning (ACP) intervention would be successful and if patients and caregivers are comfortable having these discussions with PAs.

Methods: We conducted a randomized controlled trial with optional open-label crossover to assess the feasibility, acceptability, and effect on ACP engagement of a PA-led telemedicine-facilitated ACP (tele-ACP) intervention in a Huntington disease (HD) clinic.

Results: All participants felt they could effectively express themselves to the PA during the tele-ACP visit, and 95.8% felt comfortable communicating with the PA about ACP. The PA-led tele-ACP intervention significantly increased ACP engagement.

Conclusions: Our PA-led tele-ACP intervention was feasible, acceptable, and it increased ACP engagement.

Abstract: Prader-Willi syndrome is a rare and complex genetic disorder with multiple physical and behavioral characteristics, affecting endocrine, metabolic, and neurologic systems and producing a plethora of medical complications. Early identification and diagnosis are paramount to providing timely and appropriate interventions to improve patient outcomes. Treatment should focus on neonatal feeding and growth, followed by hormonal therapy for hypothalamic dysfunction, and should then be directed at the prevention and treatment of obesity and obesity-related complications. Effective treatment requires a comprehensive multidisciplinary approach.

Abstract: The incidence of coccidioidomycosis has been rising in the past decade. This case report focuses on a man with a history of persistent migraine who presented to the ED with altered mental status. After cerebrospinal fluid testing, the patient was diagnosed with coccidioidal meningitis and treated with lifelong antifungal therapy. Clinician awareness and early identification of this disease can lead to reduced patient morbidity and mortality.

Abstract: This article reviews practice guidelines, diagnosis, and treatment for synovial chondromatosis, a rare, benign condition that involves the synovium of the joints, most commonly the knee. The condition also can affect the hip, ankle, shoulder, elbow, and temporomandibular joint.

Abstract: Chimeric antigen receptor (CAR) T-cell therapy has led to significant advances in the treatment of blood cancers such as leukemia, lymphoma, and multiple myeloma, and now shows promise for solid tumors. This type of immunotherapy can achieve high response rates in patients with hematologic malignancies, but carries serious adverse reactions, including cytokine release syndrome and immune-effector cell-associated neurotoxicity syndrome. This article describes CAR T-cell therapy, guidance for primary care providers caring for patients undergoing therapy, and the ongoing need for research to enhance CAR T-cell therapy's safety and effectiveness.

Objective: To describe Kentucky's physician associate/assistant (PA) leadership pathway and provide advice for individual leadership trajectories.

Methods: A qualitative study using semistructured interviews and inductive coding methodology to identify themes of PA leaders.

Results: Participants were primarily female (76.2%), ages 35 to 44 years (52.4%), and White (90.5%). They were primarily nonclinical (38.1%), described achieving their current leadership role by pursuing opportunities (42.9%), showed emotional intelligence (61.9%), had grit (61.9%), and did not feel that academic success correlates to leadership (42.9%). Leaders also gave advice consisting of form connections, prioritize personal growth, develop an entrepreneurial mindset, and play to your strengths .

Conclusions: Leadership is needed in healthcare and PAs are primed to serve in this role. Previous leadership experience is not a requirement, but organization, emotional intelligence, and grit are required. Future PA leaders should follow the playbook laid out by these leaders and begin today with investing in personal leadership development.