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

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.

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.

Abstract: Febrile seizures are the most common seizure disorder in childhood. Most febrile seizures have a benign course and children have a good prognosis. However, febrile seizures are traumatizing events for a child's family or caregiver to witness. Appropriate caregiver education is crucial to ease anxiety. This article reviews the risk factors, clinical presentation, diagnostics, treatment, and prevention of febrile seizures in addition to providing a guideline for effective caregiver education and support.

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.

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.

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.