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Overview
More than 20 million people in the United States are affected by diabetes, with 1.5 million new cases appearing each year. Of this population, nearly 65% will die from heart disease or stroke, a rate that is 4-times higher than in the non-diabetic population. Individualized and early glycemic control is critical in the prevention and management of diabetes and in reducing cardiovascular risk. This activity will expose attendees to the relationship between insulin resistance, type 2 diabetes, and the resulting cardiovascular risk in an effort to uncover effective treatment strategies and patient-based therapeutic options.
Objectives
Utilize appropriate glucose-lowering agents to reduce A1C to * 7.0%
Minimize adverse events and cardiovascular risk associated with glycemic therapy by employing appropriate glucose, blood pressure, and serum cholesterol agents
Faculty
Mark Stolar, MD
Associate Professor of Clinical Medicine
Northwestern University
The Feinberg School of Medicine
Chicago, IL
Stan Schwartz, MD, FACE, FACP
University of Pennsylvania Medical Group
Hospital of the University of Pennsylvania
Philadelphia, PA
Overview
Despite a high prevalence in the United States, insomnia remains underdiagnosed and undertreated. Extensive research has identified several factors that contribute to the inadequate treatment of insomnia, including the failure of patients to report insomnia to clinicians and clinician misperceptions about the risks associated with hypnotic medications. This program will address effective strategies for diagnosing and treating patients with insomnia.
Objectives
Identify risk factors, determine appropriate screening tools, and accurately diagnose insomnia
Evaluate current and emerging nonpharmacologic and pharmacologic therapies for acute and chronic insomnia on the basis of efficacy and safety and apply this knowledge/skill with patients
Faculty
Joseph A. Lieberman III, MD, MPH
Professor of Family Medicine
Jefferson Medical College
Thomas Jefferson University
Associate Editor, Delaware Medical Journal
Philadelphia, PA
Thomas C. Neylan, MD
University of California, San Francisco
San Francisco, CA
Overview
Atherothrombotic disease, including acute coronary syndrome, stroke/TIA and PAD (peripheral arterial disease), continues to be a world-wide challenge in terms of morbidity, premature death, and disability with tremendous costs to patients, health care systems and society. The diffuse nature of atherothrombosis (cardiovascular, cerebrovascular, or peripheral arterial) and the heightened risk of recurrence represent major challenges to the clinician. This lecture will overview current studies and treatment guidelines for PAD, ACS and Stroke and explore the role of primary care in long-term treatment of these patients.
Objectives
Identify the major risk factors for CAD (coronary artery disease), stroke, and PAD (peripheral arterial disease)
Describe 3 clinical conditions in which dual antiplatelet therapy is recommended
Faculty
Randall M. Zusman, MD
Associate Professor of Medicine
Harvard Medical School
Director, Division of Hypertension and Vascular Medicine Massachusetts General Hospital
Boston, MA
F. Wilford Germino, MD, FACP
Department of Internal Medicine
Orland Primary Care Specialists
Clinical Associate Rush Medical College
Orland Park, IL
Overview
Bipolar disorder (BD) and major depressive disorder (MDD) are two of the most prevalent psychiatric disorders in adults. These conditions are associated with overlapping disorders of mood including anxiety and depression; differentiating the two disorders can be difficult and can lead to misdiagnosis and mismanagement. This activity will focus on practical approaches to the diagnosis and management of the Òdifficult-to-treatÓ patient presenting with depression associated with MDD and BD.
Objectives
Recognize overlapping symptomatology and comorbid psychiatric disorders that can complicate the differential diagnosis of depression
Design and implement practical strategies to diagnosis and manage the difficult-to-treat patient with depression associated with major depressive disorder and bipolar disorder
Faculty
Joseph A. Lieberman III, MD, MPH
Professor of Family Medicine
Jefferson Medical College
Thomas Jefferson University
Associate Editor, Delaware Medical Journal
Philadelphia, PA
Linda Carpenter, MD
Associate Professor
Psychiatry and Human Behavior
Brown University Medical School
Butler Hospital
Providence, RI
Overview
Human papillomavirus (HPV) is the most common newly acquired sexually transmitted infection in the United States. It is a necessary cause of cervical cancer and genital warts, and is associated with other anogenital and head and neck cancers, and recurrent respiratory papillomatosis. Prevention of HPV infection through prophylactic vaccination provides a safe and effective option to reduce the health burden associated with HPV-related diseases. Two vaccines have been developed: a quadrivalent HPV (6, 11, 16, 18) vaccine, approved by the US Food and Drug Administration (FDA), and a bivalent HPV (16, 18) vaccine, currently under FDA review. Both vaccines have demonstrated lasting efficacy against HPV-associated cervical disease and are generally well tolerated. This program will review the health consequences of HPV infection; provide an update on the safety and efficacy of HPV vaccines, including recent data on efficacy in mid-adult women, duration of protection, and cross-protection against nonvaccine HPV types; and evaluate the benefits of widespread HPV vaccination in preventing HPV-related diseases.
Objectives
Describe the epidemiology, natural history and consequences of HPV infection
Evaluate the anticipated benefits of widespread HPV vaccination in preventing cervical and anogenital cancers, genital warts, and other HPV-related diseases
Faculty
Richard E. Rupp, MD
Associate Director, Division of Adolescent and Behavioral Medicine
Associate Professor of Pediatrics
University of Texas Medical Branch at Galveston
Galveston, TX
Martin C. Mahoney, MD, PhD
Director, Cancer Prevention & Detection Center
Roswell Park Cancer Institute
Associate Professor of Family Medicine
State University of New York at Buffalo
Buffalo, NY
Overview
This program is designed to provide primary care providers with information about the state of the science and evidence-based strategies for the accurate identification and comprehensive treatment of osteoporosis.
Objectives
Identify appropriate diagnostic tools & procedures that can be employed for early diagnosis of osteoporosis
Evaluate the treatment strategies, including methods of administration and MOAs of various antiresorptive agents that are currently available to prevent fractures and treat osteoporosis
Faculty
Abby Abelson, MD
Richard Pittsley, MD
Overview
An estimated 1 million cases of herpes zoster (shingles) occur annually in the United States. The incidence and severity of herpes zoster increase with advancing age to produce substantial negative effects on quality of life, activities of daily living, neuropsychological functioning, and social status, resulting in significant morbidity in older adults. While antiviral therapy reduces the incidence and severity of herpes zoster, it does not reliably prevent postherpetic neuralgia (PHN), the most common and debilitating clinical sequela of herpes zoster. Herpes zoster vaccination has been demonstrated to reduce the incidence of the disease and its complications. Clinical trial data have demonstrated significant reductions in the incidence of herpes zoster and PHN, as well as overall reductions in the burden of disease.
Objectives
Review the benefits and limitations of current treatment options for herpes zoster and postherpetic neuralgia (PHN)
Evaluate clinical trial results of the herpes zoster vaccine and discuss current recommendations of the Advisory Committee on Immunization Practices for the prevention of herpes zoster
Faculty
Katherine E. Galluzzi, DO, FACOFP
Professor and Chairperson
Department of Geriatrics
Philadelphia College of Osteopathic Medicine
Philadelphia, PA
Lawrence D. Gelb, MD
Professor of Medicine, Department of Internal Medicine
Division of Infectious Diseases
Washington University School of Medicine
St. Louis, MO
Overview
Optimal Use of Analgesics in the Management of Osteoarthritis Pain will provide an evidence-based, guideline-based review of treatment options for managing osteoarthritis pain. Video-vignette, case-based learning will be used to illustrate education from expert presentations and guidelines. Special emphasis will be placed on physician-patient communication regarding pain management.
Objectives
Implement strategies for patient communication and education for management of OA pain and utilize pharmacologic and nonpharmacologic therapies for pain management according to guideline recommendations
Describe patient risk factors which could interact with various pain relief medications
Faculty
Louis C. Almekinders, MD
Professor of Orthopaedic Surgery
Duke University
Durham, North Carolina
Mark Fendrick, MD
Professor, Internal Medicine and Health Management & Policy Codirector, Center for Value-based Insurance Design
Coeditor in Cheif, American Journal of Managed Care
University of Michigan
Ann Arbor, Michigan
Overview
The current use of lipid lowering therapy in clinical practice has fallen short of the recommendations of national guidelines. Clearly, not an easy venture when treating patients with dyslipidemia, many with multiple risk factors and many with resulting coronary events that may be preventable if patients were treated aggressively to meet the NCEP-ATP lll goals. This presentation will address the clinical challenges of goal attainment (lack of compliance, aggressive treatment by clinicians, not leaving patients 15 points from goals), and provide clinicians with the pathways and knowledge to help attain their patients to goal.
Objectives
Faculty
Ronald A. Codario, MD, FACP
Clinical Instructor in Medicine
Thomas Jefferson University Hospital
Philadelphia, PA
Muredach P. Reilly, MB
Assistant Professor of Medicine and Pharmacology
University of Pennsylvania School of Medicine
Philadelphia, PA
Overview
Gout is an ancient disease, yet it remains a modern-day dilemma for many patients and clinicians. Although substantial progress has been made in terms of evidence-based clinical diagnosis and management, the prevalence of gout continues to rise.
Gout presents a variety of obstacles for the primary care clinician. Differential diagnoses and atypical presentations of gout can complicate its accurate identification. Once a diagnosis has been confirmed, the clinician faces numerous challenges in management. Most importantly, the clinician must differentiate between acute and chronic aspects of the disease to make an appropriate choice of pharmacotherapy. Timing of dose, patient comorbidities such as kidney and cardiovascular disease, and concurrent medications are other important considerations for the clinician when managing a patient with gout.
Treatment goals include terminating acute gout attacks, rapid and safe relief of pain and inflammation, preventing future attacks, and avoiding complications (formation of tophi, kidney stones, and joint destruction). Though gout treatment is most often treated successfully and without complications, it becomes more of a challenge if other conditions exist along with gout or if there is poor patient compliance to recommended lifestyle changes or a medication regimen.
This program will outline the newest evidence-based standards for making a definitive diagnosis of gout; highlight practice recommendations to improve competence and confidence when treating gout; and discuss emerging therapies that might further contribute to improving clinical outcomes.
Objectives
Differentiate the clinical presentation of acute versus chronic gout by using up-to-date ACR and EULAR recommendations for making a diagnosis of gout, including knowing when it is appropriate to perform a presumptive diagnosis
Devise a treatment plan specific to the needs of both acute and chronic gout disease states that include individualized therapy, patient adherence, and consideration to comorbidities
Faculty
Joseph D. Croft, Jr, MD
Clinical Professor
Department of Medicine, Rheumatology
Georgetown University Medical School
Bethesda, MD
Arthur L. Weaver, MD, MS, FACP, MACR
Clinical Professor of Medicine
Rheumatology
University of Nebraska Medical Center
Omaha, NE