CME MULTIMEDIA ACTIVITIES

January 2012
CaseBook Consults: Improving Outcomes in Gout
(iPad compatible)
Presenters: Paul P. Doghramji, MD, FAAFP, Brian F. Mandell, MD, PhD, FACR, MACP, and Rick S. Pope, MPAS, PA-C, DFAAPA

Despite the fact that gout can be diagnosed with relative certainty and that effective therapies have been available for a long time, gout is underdiagnosed and undertreated, management is less than optimal, and poor clinical outcomes are not uncommon. It is the aim of this CE activity to provide information that will assist primary care providers to improve management and clinical outcomes for their patients with gout. Specifically, the program will convey the key factors needed to confidently make a presumptive diagnosis of gout, explore the rationale, timing and duration of pharmacologic treatment of gout and hyperuricemia, discuss the importance of achieving a target SUA level of ≤6.0 mg/dL with urate lowering therapy (ULT), and provide examples of how to educate and communicate with patients to improve adherence to urate-lowering therapy and overall outcomes.

Commercial Support: This activity is supported by an educational grant from Takeda Pharmaceuticals North America, Inc.
Review and Sponsorship: This multimedia activity was peer reviewed by The American Journal of Medicine and The Journal for Nurse Practitioners and is jointly sponsored by Beth Israel Medical Center & St. Luke's and Roosevelt Hospitals and Health Education Alliance, Inc.
 

November 2011
Multispecialty Approaches to Patients with Comorbid:
Chronic Kidney Disease and Cardiovascular Disease

The US Centers for Disease Control (CDC) analysis of the 1999-2004 National Health and Nutrition Examination Survey (NHANES) data found that almost 17% of the US population aged >20 years had chronic kidney disease (CKD), and 12% of noninstitutionalized US adults have diagnosed cardiovascular disease (CVD). Although unfortunately underappreciated and malcomprehended by the general healthcare system, these 2 disease often present as comorbidities. As a result, and for many reasons, patients who present with any degree of CKD and/or CVD are often not seen by the most appropriate medical carer, are not treated intensively enough by the carers they do see, and/or are not referred rapidly enough to the appropriate level of medical care. This means that for many patients who present with earlier forms of renal disease (stages 1 – 3 renal disease) and who often have concomitant CVD, they are not treated rapidly and intensively enough to prevent either their progression on to more serious renal disease (stages 3 -5 CKD or even end-stage renal disease [ESRD]) or, more likely, to worsening CVD morbidity and even death. This registers the clear need for physicians from the different relevant specialties to interact with each other in this educational forum in order to present a comprehensive review of how each specialty should recognize, respond to, and refer for these comorbid conditions.

Commercial Support: This activity is supported by an educational grant from Merck.
Review and Sponsorship: The content posted on this online activity has been reviewed and approved by the The American Journal of Medicine.
 

August 2011
Invasive Mycoses:
Evolving Challenges and Opportunities in Antifungal Therapy
A Case-based Discussion
Presenters: Michael A. Pfaller, MD, Luis Ostrosky-Zeichner, MD, FACP, FIDSA, Dimitrios P. Kontoyiannis, MD, ScD, FACP, FIDSA, John R. Perfect, MD

The diagnosis and management of invasive fungal infections remain a clinical challenge. Both the frequency of infections and resistance to antifungal agents continue to increase despite the introduction of new antifungal agents. While early diagnosis and intervention are essential for favorable outcomes, diagnoses of invasive mycoses is often difficult as current diagnostic methods are not sensitive or specific enough and may not be readily available to clinicians. In addition, the underlying disease of the host is a major contributor to the final clinical outcome and often may complicate the effective management of the mycosis.

The improvements in antifungal susceptibility testing methods to detect emerging resistance patterns coupled with molecular characterization of resistance mechanisms provide useful adjuncts to optimize the efficacy of antifungal therapy. The clinician’s familiarity with the latest diagnostic markers and techniques along with emerging data and safety and efficacy of antifungal agents will help guide clinical decisions.

Commercial Support: This activity is supported by an educational grant from Merck.
Review and Sponsorship: This multimedia activity was peer reviewed by The American Journal of Medicine and is jointly sponsored by Post Graduate Institute for Medicine and Global Education Exchange.
 

August 2011
Managing Chronic Pain with Nonopioid Analgesics: A Multidisciplinary Consult
Presenters: Daniel Clauw, MD, and Bill H. McCarberg, MD

Determining pain mechanism is important in selecting treatment for chronic musculoskeletal pain states. While broad classifications (nociceptive, neuropathic, etc.) provide a framework, any combination of mechanisms may be present in a chronic pain patient. Growing evidence shows that pain states traditionally considered to be nociceptive (osteoarthritis, low back pain), may also involve elements of augmented central nervous system pain processing, and certain nonopioid analgesics, specifically certain SNRIs, can be effective in treating these conditions. Besides identification of biological pain mechanisms, chronic pain management also requires assessment of psychological and sociocultural factors that influence pain chronicity and patient prognosis. A multimodal/multidisciplinary approach incorporating pharmacologic and nonpharmacologic therapy is important to improve outcomes in chronic pain patients.

Commercial Support: This activity is supported by an educational grant from Lilly USA, LLC. For further information concerning Lilly grant funding visit www.lillygrantoffice.com.
Review and Sponsorship: This multimedia activity was peer reviewed by The American Journal of Medicine and jointly sponsored by Purdue University College of Pharmacy and Health Education Alliance, Inc.
 

July 2011
Comprehensive Chronic Pain Management: Improving Physical and Psychological Function
Presenters: Bill H. McCarberg, MD, Steven Stanos, DO, and David A. Williams, PhD

Using a unique, highly interactive, video patient case teaching format, this activity is intended to provide clinicians who manage patients with chronic pain with new insights and expand their understanding to achieve the goals of effective pain management -- reduction of pain, improvement in function, and restoration of psychological health-- utilizing a multidisciplinary (pharmacological and nonpharmacological) approach. Participants will have multiple "interactive" opportunities to reinforce their own best practices or recognize potential gaps in their clinical practice and will receive information to help them accurately assess the severity of pain, evaluate biopsychosocial factors that impact treatment, and develop strategies to meet the goals of therapy and improve patient outcomes.

Commercial Support: This activity is supported by an educational grant from PriCara, Division of Ortho-McNeil-Janssen Pharmaceuticals, Inc., administered by Ortho-McNeil Janssen Scientific Affairs, LLC.
Review and Sponsorship: This multimedia activity was peer reviewed by The American Journal of Medicine and Journal of Pain and Symptom Management and is jointly sponsored by Beth Israel Medical Center & St. Luke’s and Roosevelt Hospitals and Health Education Alliance, Inc.
 

November 2010
CME Recognizing and Assessing Key Symptom Domains in Chronic Widespread Pain: Focus on Fibromyalgia
Presenters: Lesley M. Arnold, MD, Laurence A. Bradley, PhD, and Bill H. McCarberg, MD

While pain relief is a primary objective of fibromyalgia treatment, it is clear that multidimensional symptoms/comorbidities (such as pain, fatigue, nonrestorative sleep, depressed mood, cognitive difficulties, and others) affect social and physical functioning, and negatively affect well-being. It is critical for clinicians to comprehend and treat both the biological and behavioral aspects of fibromyalgia to optimize outcomes. It is the aim of this program, using case-based patient scenarios, to provide guidance on the diagnosis and management of patients with fibromyalgia, giving clinicians a better understanding of the mechanisms of pain and other symptom domains in fibromyalgia, resulting in multidisciplinary management programs, tailored to the needs of the individual patient.

Commercial Support: Forest Laboratories, Inc.
Review and Sponsorship: This multimedia activity was peer reviewed by The American Journal of Medicine and jointly sponsored by Purdue University College of Pharmacy and Health Education Alliance, Inc.
 

July 2010
Preventing Stroke in Atrial Fibrillation: Bridging the treatment gap
Presenters: Joseph S Alpert, MD, Elaine M. Hylek, MD, MPH, Stephen E. Kimmel, MD, MSCE and Gregory Y. H. Lip, MD

Commercial Support: OrthoMcNeil, a division of Ortho-McNeil-Janssen Pharmaceuticals, Inc.
Review and Sponsorship: This multimedia activity was peer reviewed by The American Journal of Medicine and jointly sponsored by The University of Cincinnati and The Exeter Group.