Commentary and Observations from
the Medical Front Lines
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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.
Impact of Prenatal and Early-life Pollution Exposure on Development of Asthma in Children
Posted By: 
Amanda Michaud, MMS, PA-C
December 07, 2021
Research suggests an association of early-life pollution exposure and the development of asthma in childhood. Perinatal exposure to a variety of pollutants such as nitric oxide, ozone, and particulate matter has been reported to increase the likelihood of developing allergic disease and asthma.
A recent cohort study by Zhang et al shows that prenatal and early-life exposure to particulate matter less than 10 μm in diameter was associated with increased risk of development of asthm... Continue Reading
Filed under: Allergy/Immunology, Public Health
Prenatal Vitamin D Supplementation and the Development of Allergic Disease
Posted By: Amanda Michaud, MMS, PA-C
December 03, 2021
It is suggested that the increasing prevalence of vitamin D insufficiency worldwide could be a factor in the rising rates of allergic rhinitis, atopic diseas... Continue Reading
Filed under: Allergy/Immunology, Women's Health
Attitude: Reframing a Bad Diagnosis
Posted By: 
Richard S. Pope, PA-C, MPAS
November 30, 2021
As medical practitioners it can be our job to inform patients of serious illness. Any diagnosis that is new to the patient and implies changing one's li... Continue Reading
Filed under: Miscellaneous
Scary Words in Rheumatology
Posted By: Richard S. Pope, PA-C, MPAS
November 23, 2021
There are many rheumatology words that are difficult to pronounce, poorly understood, and that can generate fear in both practitioners and patients. As such,... Continue Reading
Filed under: Rheumatology
New and First Ever Chest Pain Guidelines Released
Posted By: 
Daniel Thibodeau, MHP, PA-C
November 19, 2021
There's exciting news in the world of cardiovascular medicine! A multi-joint medical society (2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR) has published the "Guide... Continue Reading
Filed under: Cardiometabolic
Wearable Technology Is Helpful, But Not Perfect
Posted By: Daniel Thibodeau, MHP, PA-C
November 16, 2021
We have all seen this scenario before: A patient comes in and tells you that they've seen a concerning reading on their smartphone or smartwatch regarding so... Continue Reading
Filed under: Miscellaneous
A Veteran, A Legacy
Posted By: 
Debra A. Danforth, DNP, APRN, FAANP
November 12, 2021
Loretta C. Ford, EdD, RN, PNP, NP-C, CRNP, FAAN, FAANP—an icon in the nurse practitioner (NP) world—turned 100 on December 28, 2020. Loretta, who is know... Continue Reading
Filed under: NPs & PAs
Happy Nurse Practitioner Week
Posted By: Debra A. Danforth, DNP, APRN, FAANP
November 09, 2021
National Nurse Practitioner (NP) Week is celebrated this year from November 7-13. The theme for 2021 is "NPs going the extra mile." The American Association... Continue Reading
Filed under: NPs & PAs
Non-radiographic Axial Spondyloarthropathy—Often Not Recognized and Commonly Misdiagnosed
Posted By: Shannon Ghizzoni, PA-C
November 05, 2021
Non-radiographic axial spondyloarthropathy (nr-axSpA) is an autoimmune, inflammatory disease affecting the spine, sacroiliac joints, and hips. Unlike its mor... Continue Reading
Filed under: Rheumatology
IV Tocilizumab Shortage for Rheumatology Patients: A Result of the COVID-19 Pandemic
Posted By: Shannon Ghizzoni, PA-C
November 02, 2021
The COVID-19 pandemic has brought many challenges to our daily rheumatology practices: From the initial switch to mostly telemedicine appointments in early 2... Continue Reading
Filed under: Miscellaneous, Rheumatology