Commentary and Observations from
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Welcome to PCE's The Exchange—Stay Current on Issues That Matter Most to You and Your NP/PA Colleagues
PCE is excited to announce the launch of The Exchange, a collection of short commentaries from your NP/PA colleagues on a broad range of topics relevant to your practice. The Exchange will bring you reflections on trends in medicine, observations about new treatments and guidelines, and advice related to career decisions and practicing in today's changing healthcare environment.
Non-Infectious Complications of Common Variable Immunodeficiency
Posted By: 
Amanda Michaud, MMS, PA-C
September 21, 2021
Common variable immunodeficiency (CVID) is the most common type of symptomatic primary immune deficiency disorder, affecting approximately 1 out of every 25,000 persons. The most recent guidelines suggest CVID in the presence of the following: low immunoglobulin (Ig) G levels, based on age; either low IgM or IgA; poor antibody response after vaccination; older than 4 years of age; and no secondary causes of hypogammaglobulinemia. Secondary causes of hypogammaglobulinemia can include liver dis... Continue Reading
Filed under: Allergy/Immunology
Diagnosis and Management of Hereditary Angioedema
Posted By: Amanda Michaud, MMS, PA-C
September 17, 2021
Hereditary angioedema (HAE) is an autosomal-dominant disorder caused by deficiency of C1 esterase inhibitor (C1-INH). It is estimated that HAE affects 1 out... Continue Reading
Filed under: Allergy/Immunology
Not All Moisturizers Are the Same
Posted By: 
Kristine Kucera, PA-C, MPAS, DHS
September 14, 2021
With summer coming to an end, the temperature will decrease, the humidity will lower, heaters will be turned on, and dry, cracked skin will appear. The term... Continue Reading
Filed under: Dermatology
Controversies in Sunscreen – An Update
Posted By: Kristine Kucera, PA-C, MPAS, DHS
September 10, 2021
It is well established that too much ultraviolet radiation from the sun can damage the DNA in your skin cells, which can lead to premature aging and skin can... Continue Reading
Filed under: Dermatology
Periprosthetic Fractures: The New Osteoporotic Fragility Epidemic
Posted By: 
Richard S. Pope, PA-C, MPAS
September 07, 2021
Periprosthetic fracture, defined as a post-operative fracture around or near a prosthesis, has become increasingly common. This was shown in a study publishe... Continue Reading
Filed under: Orthopedics, Rheumatology
Prime Time for Osteoanabolic Therapy
Posted By: Richard S. Pope, PA-C, MPAS
September 03, 2021
We now have fracture risk reduction evidence from 2 separate trials comparing oral bisphosphonates with osteoanabolic medications. These well controlled phas... Continue Reading
Filed under: Orthopedics, Rheumatology
Advanced Practice Clinicians in Rheumatology, Part 2
Posted By: 
Jennifer Simpson, DNP
August 31, 2021
As I alluded to in my previous po... Continue Reading
Advanced Practice Clinicians in Rheumatology, Part 1
Posted By: Jennifer Simpson, DNP
August 27, 2021
I have been practicing as an NP in rheumatology for 7 years and I love it. I got lucky, really: A recruiter reached out to a fellow student who was not inter... Continue Reading
Filed under: NPs & PAs, Practice Management/Career, Rheumatology
STEMI Mimics: Part 2, Left Bundle Branch Block
Posted By: 
Ben Taylor, PA-C, PhD, DFAAPA
August 20, 2021
Left bundle branch block (LBBB) is the second most common STEMI mimic. The ECG pattern includes an elevated ST segment at baseline, making it impossible to u... Continue Reading
Filed under: Cardiometabolic
STEMI Mimics: Part 1, Left Ventricular Hypertrophy
Posted By: Ben Taylor, PA-C, PhD, DFAAPA
August 18, 2021
As advanced practice providers, we are expected to be able to discern dangerous rhythms on the ECG—such as the dreaded ST-segment elevation myocardial infa... Continue Reading
Filed under: Cardiometabolic