Congenital CMV infection presenting with massive intracerebral hemorrhage.

INTRODUCTION: Cytomegalovirus (CMV) is a common intrauterine infection and the developing nervous system is a frequent target, suffering a range of injuries from subclinical to catastrophic. CASE PRESENTATION: A 20-week gestational age fetus was found to have a large echogenic focus in one cerebral hemisphere. Congenital CMV infection was identified by amniocentesis and maternal serology. Postmortem examination of the brain revealed massive intracerebral hemorrhage as the correlate for the sonographic finding. The microscopic examination of the brain was also striking for extensive polymicrogyria, a high burden of CMV, and abundant angiocentric CMV pathology. DISCUSSION AND CONCLUSION: Catastrophic intracerebral hemorrhage has not been previously reported in association with congenital CMV infection. The present case expands the range of potential injuries to the developing brain in congenital CMV infection and raises the possibility of a direct vascular injury.

Analysis of 2011 physician assistant education debt load.

This study seeks to investigate how physician assistants (PAs) finance their education and to characterize the educational debt of PA students. Data from the 2011 American Academy of PAs (AAPA)-Physician Assistant Education Association Graduating Student Survey were used to explore the educational debt of PA students. The median total educational debt of a PA student graduating in 2011 was $80,000. Little financial assistance, other than student loans, is available to PA students. Eighty-five percent of PA students report owing some PA education debt amount, with 23% owing at least $100,000. This study provides a baseline look at PA student debt loads as a starting point for more detailed and robust research into new graduate specialty choices and PA career migration into other specialties. Further research is needed to explore the effect of student debt on students' specialty choices.

Health Information Exchange in Emergency Medicine.

Emergency physicians often must make critical, time-sensitive decisions with a paucity of information with the realization that additional unavailable health information may exist. Health information exchange enables clinician access to patient health information from multiple sources across the spectrum of care. This can provide a more complete longitudinal record, which more accurately reflects the way most patients obtain care: across multiple providers and provider organizations. This information article explores various aspects of health information exchange that are relevant to emergency medicine and offers guidance to emergency physicians and to organized medicine for the use and promotion of this emerging technology. This article makes 5 primary emergency medicine-focused recommendations, as well as 7 additional secondary generalized recommendations, to health information exchanges, policymakers, and professional groups, which are crafted to facilitate health information exchange's purpose and demonstrate its value.

Physician assistant education: an analysis of the Journal of Physician Assistant Education.

PURPOSE: The literature of a profession reflects its vitality, activity, and intellectual temperature. A thorough review of literature can reveal areas of growth and improvement as well as serve as a means to share relevant research accomplishments. As the physician assistant (PA) education profession continues to thrive and expand, it is important for the literature that reflects the profession to also develop and expand its audience. METHODS: A retrospective, systematic analysis of published research articles in the Journal of Physician Assistant Education (JPAE) and its predecessor publication, Perspective on Physician Assistant Education, from 2001-2011 (N = 145) was conducted. Articles were organized by study topic, cohort of interest, and methodology and further analyzed to determine respective response rates and frequency of topics. RESULTS: Nearly one-fourth of all articles considered were dedicated to studying various PA curricula. Methodological approaches used in these studies tended toward Internet-based surveys, but telephone-based surveys retained the highest response rate (97%). Among study subjects (cohorts) examined, the most frequently studied cohort consisted of PA students, who displayed high response rates (74.4%). CONCLUSION: The total number of articles published in JPAE increased annually; study methodology reflects a predominance of survey research approaches. Analysis from this review of 10 years of JPAE content suggests that studies using effective methodology to gain high response rates, those that have more sophisticated designs and use appropriate statistical measures, and those that aim to reach a more diverse pool of cohorts may be future goals.