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In the News

Conference News Update	12/18/08
In patients with breast, lung, colon, or other solid organ cancers, occurrence of venous thromboembolism (VTE) may be significantly reduced by the use of statins. Danai Khemasuwan, MD, of Albert Einstein Medical Center...

It’s Roll-Up-Your-Sleeves Time	12/17/08
After 21 months of campaigning, incessant coast-to-coast travel, and seemingly countless promises made, our President-Elect and House and Senate representatives have finally been identified. Whether...

The Specialty Debate...PAs Have Questions; NPs Have Answers	12/17/08
NPs and PAs may be colleagues, but when it comes to licensure, certification, and regulation, the professions could not be more different. Nonetheless, practice in specialty areas...

Grand Rounds: Man, 82, With New-Onset Headaches	12/16/08
An 82-year-old man presented to his primary care provider complaining of headaches for the past week. At the time of presentation, he reported persistent, nonthrobbing pain behind...

A Clinician’s View: From Expert to Novice	12/16/08
Many of you are familiar with Patricia Benner’s book From Novice to Expert. It describes Benner’s application to nursing of the Dreyfus model of skill acquisition. The model posits that in the acquisition and development...

Risk for Sudden Cardiac Death Drops After 30 Days Post-MI	12/15/08
The risk for sudden cardiac death following a myocardial infarction (MI) appears to be greatest in the first 30 days after hospital discharge, Adabag and colleagues report in JAMA.

Teen Prescription Drug Abuse: A National Epidemic	11/20/08
Illicit drug use may be declining among US teenagers, but prescription drug abuse has risen sharply, with prescription pain relievers leading the list of misused...

My Turn: Captain of a Sinking Ship	11/20/08
This past June, the American Medical Association (AMA) proposed a number of resolutions in its House of Delegates that were generally antagonistic toward the NP and PA professions.

A Clinician’s View: Only a Thumb	11/20/08
“In the absence of any other proof, the thumb alone would convince me of God’s existence.” -Sir Isaac Newton- He was the gunner in a Humvee on patrol and woke up on the ground. He didn’t even notice...

Your Role in Oral Health Care	11/20/08
Most health care professionals recognize that, like medical care, dental care is unevenly distributed in this country, with many people receiving little or no attention. In 2000, US Surgeon...

Sidebar: The Joys of Elder Care	11/20/08
In a youth-oriented culture obsessed with Botox, plastic surgery, and age-defying cosmetic products...

Unstable Angina and NSTEMI: Are You Up to Date?	10/15/08
The latest guidelines for managing unstable angina and non-ST-segment-elevation myocardial infarction underscore the critical role emergency physicians play in prompt recognition and treatment of these ...

Intracranial Complications of Cocaine Abuse	10/15/08
Regular intranasal cocaine abuse can create a breeding ground for infection that can lead to chronic sinusitis and other serious complications. The authors present a case in point.

My Turn: The Coming Tsunami	10/15/08
The Oxford dictionary defines tsunami as "a long high sea wave caused by an earthquake or other disturbance." You'll recall the Indian Ocean tsunami in late 2004, which rose from the depths...

A Clinician's View: The Art of Medicine	10/15/08
I walked into the examination room to find a 7-year-old boy presenting with mild to moderate abdominal pain. His name was Chase. After hearing the symptoms his mother had observed...

Healing the Broken Places	10/15/08
Broken. Grossly underfunded. In crisis. That’s how psychiatric and behavioral health specialists describe the current state of mental health...

ADHD in Young Adults	09/15/08
Increasing numbers of young adults are presenting in the primary care setting with signs and symptoms of attention-deficit/hyperactivity disorder (ADHD)...

TRENDS: Learning to Live With Electronic Medical Records	09/15/08
Michele Kline, MSN, CNP, has a somewhat familiar story: As a family nurse practitioner at the Cleveland Clinic, she sees a lot of “snowbirds”...

Clinician Reviews Names NP Editor-in-Chief	09/15/08
Clinician Reviews is pleased to announce that Marie-Eileen Onieal, PhD, CPNP, FAANP, has been named Nurse Practitioner Editor-in-Chief...

How Critical Is Critical Thinking?	09/15/08
Within the competencies espoused by the PA and NP professions, critical thinking is a paramount issue. In fact, the scope...

Going the Extra Mile—Literally—to Care for the Underserved	09/15/08
Engelhard, North Carolina, is coastal country, nestled between Lake Mattamuskeet and Pamlico Sound. Every May, this commercial fishing and...

Meeting the Needs of the Underserved	09/15/08
“If every American alive today had health insurance, millions still wouldn’t be able to access the primary care that ensures better...

Grand Rounds: Man, 48, With Excruciating Leg Pain	08/15/08
A 48-year-old black man, on hemodialysis since August 2002, presented to his primary care provider (PCP) in July 2006 with excruciating...

Guidelines Recommend Early Cholesterol Screening	08/15/08
The American Academy of Pediatrics (AAP) has issued a clinical report that recommends cholesterol screening for children as...

A Clinician’s View: Rethinking Dementia	08/15/08
A report from my mother after her visit to a physician made me change the way I assess older patients who experience episodes...

Redirecting Direct-to-Consumer Advertising	08/15/08
For more than a decade, pharmaceutical companies have been pitching their drugs to the American public via so-called direct-to-consumer...

Beyond the White House: Electing More Than a President	08/15/08
Health care is always one of the top issues on the national agenda, and as the United States prepares to elect its first new president...

Is Clinical Precepting a Lost Art?	07/15/08
Over the past two decades, our changing health care environment has increased both interest in and the need for NPs and PAs...

TRENDS: Changing the Message of DTC Ads	07/15/08
Ever since direct-to-consumer (DTC) drug ads started airing on television, advanced practice nurses and physician assistants...

Supply, Demand, and the Future of Health Care	07/15/08
So, have you heard about the physician shortage—how by 2020, it is estimated that the United States will have approximately 200,000...

Vitamin D Deficiency	07/01/08
As increasing numbers of people work in windowless environments and as computer time, gaming consoles, and TV viewing keep more of them ....

Decisive Management of Undifferentiated Shock	07/01/08
The causes of undifferentiated shock are elusive, but hypotensive patients need immediate attention. The authors present a systematic approach to assessing and managing the type of shock that defies categorization.

Methadone Maintenance Therapy for Opioid Addiction	06/15/08
Treating patients in pain has challenged health care providers for centuries. Long-term use of pain medication, particularly opioids, creates a potential for physical addiction. Addiction to opiates can cause irreparable damage ...

Applying the Lessons Learned From Katrina	06/15/08
Almost three years after Hurricane Katrina, as natural disasters occur around the world with seemingly greater frequency, is the United States...

Fast Tracking PAs and NPs Into Medical School	05/15/08
I have received many positive responses to my comments regarding a pathway for PAs and NPs to become physicians ...

The Lyme Wars: Debate Rages About Treatment	04/15/08
Who knew a little tick could cause so much trouble? When Lyme disease was first described in 1977, did anyone suspect that three...

We Can—and Should—Be Partners	04/15/08
I would like to address an issue this month that is perhaps a little sensitive, yet extremely important in today's complex health...

TRENDS: On the Road to Health	11/20/08
A few months ago, a homeless woman stepped onto the mobile health clinic parked near a beach on Cape Cod. As she climbed aboard, the woman was holding her back, in pain.

TRENDS: Medical Tourism Promotes R&R (Rest and Recuperation)	05/15/08
As a lieutenant colonel in the US Army, Steve Gallegos spent his days coordinating medical care for soldiers, officers, and retired military ...

New Titles, Old Struggles: Other “Midlevel” Providers Emerging	05/15/08
The recognition that NPs and PAs--so-called (if reluctantly) midlevel providers--are enormously beneficial to the functioning of the US health care system has led to the introduction of similar practitioners ...

A Clinician's View: Showing Respect	05/02/08
My initial consultation with Dr. X was delightful. We discussed my having a first-ever screening colonoscopy. That was where my satisfaction ended...

A Clinician's View: Delivering Bad News	04/15/08
The follow-up phone call from the hematologist came early on a Saturday morning, which boded badly for me...

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