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

Cervicofacial non-tuberculous mycobacterial infection should be a part of the differential diagnosis for immunocompetent children ages 1 to 5 years who present with painless submandibular or preauricular lymphadenopathy. Although a benign and self-limiting disease, patients can develop a chronically draining fistula if not diagnosed and treated promptly. The diagnostic process can be managed with a combination of microbiological studies, cytology, laboratory tests, and imaging studies. Surgical excision is the most definitive curative measure. Incision and curettage, medical management with antibiotic therapy, or observation are other treatment strategies that may be considered. Frontline clinicians play a pivotal role in identifying which children may have this condition and can facilitate prompt diagnosis and treatment of this uncommon disease.

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.

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.

This article reviews the reasons to take a prebiopsy photograph and the consequences that can ensue when one is not taken. Electronic medical record systems compatible with mobile devices can record clinical photographs that comply with patient privacy regulations, making them the method of choice for dermatologic photo documentation. Correct photographic documentation technique also is critical and is reviewed with examples.

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.

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.

This article describes a framework for the development, implementation, and effect of advanced practice provider (APP) grand rounds. A team of certified registered nurse anesthetists (CRNAs), NPs, and physician associates/assistants (PAs) developed and operationalized a grand rounds initiative in 2019. Since January 2020, 34 live monthly learning sessions have been held in person and virtually. Surveys using Likert-scale questions were provided postattendance to attendees to assess educational growth and opportunities for improvement in future programming. Attendees also were offered an opportunity to give open-ended feedback. Recordings of each presentation were analyzed to identify content alignment with stated academic medical center system goals. Most attendees reported increased projected medical competence, performance, and perceived projected effect on patient outcomes after attending grand rounds. Grand rounds are a novel model for increasing PA, NP, certified nurse-midwife, and CRNA engagement; enhancing evidence-based medical knowledge; and advancing stated academic medical center system goals.

Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is the most common type of autoimmune encephalitis. The initial presentation can vary from subtle mental status changes to more severe symptoms such as seizures, coma, or death. This case report outlines the interdisciplinary and collaborative approach to diagnosing and treating a patient with anti-NMDAR autoimmune encephalitis.

A 72-year-old man with progressive memory loss and confusion presented to a neurology clinic for evaluation. He initially had difficulty remembering names and misplaced objects; however, his memory deficits had progressed, and more recently he had numerous car accidents and difficulty managing his own medications and finances. Cognitive testing revealed significant memory deficits reflecting moderate-stage dementia, and his brain MRI showed several cortical microbleeds and an area of siderosis consistent with the diagnosis of cerebral amyloid angiopathy (CAA). This case report provides an overview of a classic case of CAA and its potential treatment options.

Expert guidelines, meta-analyses, and multiple randomized controlled trials have demonstrated the effectiveness of long-acting inhaled antimuscarinic agents (LAMAs) as an additive medication for patients with poorly controlled moderate or severe persistent asthma. LAMAs play an essential role in blocking acetylcholine binding to muscarinic receptors and reducing bronchoconstriction and mucus production. By adding this medication to other combination inhalers, patients can use a triple inhaler to improve FEV1 values and reduce exacerbations.

State-level physician associate/assistant (PA) practice regulations have evolved since the profession's inception. The conditions that influence states' adoption of PA regulatory reforms are not fully understood. As some states begin to adopt components of optimal team practice, PAs in other states continue to face significant legal and regulatory practice restrictions. This article describes state economic, demographic, and workforce characteristics and highlights important differences across states that may affect future reform adoption and shape reform outcomes.