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Overview
Atherothrombosis is the leading cause of death worldwide and the underlying process in the etiology of acute coronary syndrome (ACS), stroke and vascular death. Cardiovascular risk factors such as obesity, the metabolic syndrome, diabetes mellitus, hypertension, smoking and other "lifestyle" risks contribute to this pandemic of atherothrombotic disease. Patients with ACS, stroke/TIA and PAD (peripheral arterial disease), present major challenges to the primary care clinician in terms of managing CV risk factors and prevention of a second event. 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
Describe 3 clinical conditions in which dual antiplatelet therapy is recommended
Name 5 treatment recommendations for reduction of global CV risk
Faculty
Randall M. Zusman, MD, FACC
Associate Professor of Medicine
Harvard Medical School
Director, Division of Hypertension and Vascular Medicine Massachusetts General Hospital
Boston, MA
Theodore G. Ganiats, MD
Professor and Interim Chair,
Department of Family and Preventive Medicine,
University of California San Diego,
Executive Director UCSD Health Outcomes Assessment Program
San Diego, CA
Overview
Insomnia, defined as complaints of disturbed sleep in the presence of adequate opportunity and circumstance for sleep, is the most common adult sleep pathology. Besides cognition, other pathologic processes have been deleteriously associated with insomnia, including cardiovascular morbidity and glycemic control. The latest evidence about sleep pathology will be presented, including spectral analysis that indicates sleep patterns, including slow wave sleep, are important, rather than just total sleep time. Nonpharmacologic approaches, as well as current and developing pharmacotherapies used to address these sleep pathologies will be described.
Objectives
Identify the underlying causes and comorbid conditions of insomnia for increased confidence in treatment
Assess the current and developing nonpharmacologic and pharmacologic approaches to the management of primary and co- morbid insomnia
Faculty
David Neubauer, MD
Assistant Professor, Department of Psychiatry,
Johns Hopkins University School of Medicine
Medical Director, Psychiatry Mobile Treatment Services,
Johns Hopkins Bayview Medical Center
Associate Director, Johns Hopkins Sleep Disorders Center
Paul P. Doghramji, MD, FAAFP
Family Physician
Collegeville Family Practice
Medical Director of Health Services, Ursinus College
Collegeville, PA
Overview
This presentation will address early and aggressive LDL-C management and the clinical challenges of goal attainment. Clinicians will be provided with pathways and knowledge to help them improve their patient outcomes by goal attainment of the healthy lipid profile.
Discussion will be applicable to clinicians' practice including lifestyle changes of diet and exercise, along with pharmacologic treatment options available for lipid management in order to give the appropriate tools to get patients to their true LDL goals.
Objectives
Understand the key tenets of assessing and managing dyslipidemia in clinical practice and the current evidence regarding the safety and efficacy of available LDL-C lowering therapies
Identify at least 2 lipid lowering strategies to initiate and tailor comprehensive management treatment plans for patients with high LDL-C in order to reach and maintain targeted goals
Faculty
Emma Meagher, MD
Associate Professor
University of Pennsylvania, School of Medicine
Philadelphia, PA
John Russell, MD
Clinical Associate Professor of Family and Community Medicine
Temple University School of Medicine
Philadelphia, PA
Overview
Smoking is the single most important preventable cause of death in the United States. This session, "Do Ask, Do Tell: Successful Smoking Interventions", will address practical ways primary care clinicians can help their patients quit smoking.
Objectives
Screen all patients for smoking status and design individualized cessation interventions for patients who smoke
Commit to active follow-up with patients along the smoking cessation path
Faculty
Katherine Galluzzi, DO, CMD
Professor and Chairperson
Department of Geriatrics
Philadelphia College of Osteopathic Medicine
Philadelphia, PA
Overview
Allergic rhinitis and chronic idiopathic urticaria, chronic histamine-induced conditions, negatively and significantly impact patient health and quality of life. However, current treatment options are only modestly successful, and obstacles remain to improving outcomes. Diagnostic Work-up and Management of Histamine-induced Disorders: Allergic Rhinitis and Chronic Urticaria will provide primary care clinicians with practical, evidence-based solutions for managing the challenges of these conditions, with an emphasis on finding effective treatments, managing side effects, and ensuring patient compliance.
Objectives
Identify strategies to overcome barriers for adequate control of allergic rhinitis symptoms
Create treatment strategies to improve outcomes for patients with chronic idiopathic urticaria
Faculty
Bradley E. Chipps, MD
Medical Director, Cystic Fibrosis Center and Respiratory Therapy
Capital Allergy and Respiratory Disease Center
Associate Medical Director, Sleep Laboratory
Sutter Medical Hospitals
Sacramento, CA
Myron Zitt, MD
Clinical Associate Professor of Medicine
Division of Allergy and Immunology
State University of New York at Stony Brook
Stony Brook, NY
Director, Adult Allergy Clinic
Division of Allergy and Immunology
Nassau University Medical Center
East Meadow, NY
Overview
This educational initiative will provide primary care practitioners insight regarding assessment of chronic musculoskeletal pain with a focus on fibromyalgia and common overlapping diagnoses. This program will also provide primary care practitioners with new information about evidenced based therapies used to manage fibromyalgia.
Objectives
Identify the differential diagnosis of chronic musculoskeletal pain and clinical characteristics that suggest a diagnosis of fibromyalgia
Identify evidence based treatment strategies for fibromyalgia including two nonpharmacologic and two pharmacologic strategies
Faculty
Edgar Ross, MD
Director, Pain Management Center
Brigham and Women's Hospital Pain Clinic
Boston, MA
Mathew M. Clark, MD, MA
Associate Clinical Professor, Family and Community Medicine
Temple University School of Medicine
Philadelphia, PA
Overview
This educational activity will describe and reinforce tools that enable clinicians to efficiently recognize and diagnose migraine that may have been previously undiagnosed and untreated, or who may have lapsed from treatment, and to communicate realistic treatment goals to reach the goal of improved patient outcomes.
Objectives
Identify the symptoms and patterns of headache for accurate assessment of migraine, including associated risks for progression to chronic migraine, and utilize simple screening tools to overcome diagnostic challenges
Create a migraine management strategy tailored to individual patient needs that incorporates a stratified approach to pharmacological and nonpharmacological therapies and communication of realistic treatment goals to help improve patient outcomes
Faculty
Frederick R. Taylor, MD, FAHS
Adjunct Professor of Neurology
University of Minnesota School of Medicine
Director, Park Nicollet Headache Clinic and Research Center
Minneapolis, MN
M. Susan Burke, MD, FACP
Clinical Assistant Professor of Medicine
Thomas Jefferson University
Philadelphia, PA
Director, Internal Medicine Clinical Care Center
Lankenau Hospital
Wynnewood, PA
Overview
Updated American College of Chest Physicians guidelines acknowledge the pace with which medical therapies for pulmonary arterial hypertension (PAH) are evolving. This educational session will address the new guidelines, diagnostic and functional assessment, and options for lifestyle and pharmacologic therapy. The discussion will be applicable to primary care practitioners and provide them with the awareness, information and evidence based therapies used to manage PAH.
Objectives
Differentiate the hemodynamic abnormalities of pulmonary arterial hypertension including its etiology and pathogenesis in order to decrease morbidity and mortality of the patient population at risk
Apply clinical practice guidelines in the early detection and effective management of PAH by selecting appropriate therapeutic interventions to attain therapeutic goals for patients with PAH
Faculty
Harrison W. Farber, MD
Professor of Medicine
Boston University/Boston Medical Center
Boston, MA
Ronald A. Codario, MD, FACP
Clinical Instructor in Medicine
Thomas Jefferson University Hospital
University of Pennsylvania Health System
Philadelphia, PA
Overview
The National Heart Lung Blood Institute (NHLBI) reports that there are 12 million Americans with obstructive sleep apnea (OSA). Despite the prevalence of this common condition, studies show that 80 -90% of people with OSA remain undiagnosed. Patients who suffer silently with undiagnosed OSA face significant quality of life and associated health issues. Identifying patients with OSA can be a challenge in the busy office setting, and requires the clinician to maintain a high level of suspicion based on sometimes subtle patient complaints, physical exam findings, and OSA risk factors. Once diagnosed and treatment is initiated, successful management is the cornerstone to better patient outcomes. As the first medical contact for most patients with OSA primary care clinicians are crucial for both recognition and management of patients with OSA. This educational activity will provide both the science and the skills that can make significant improvements in the lives of patients with OSA.
Objectives
Recognize the signs and symptoms of OSA and utilize simple assessment questions to identify the possibility of OSA
Identify strategies to assess and monitor patient adherence to treatment for OSA
Faculty
Paul P. Doghramji, MD, FAAFP
Family Physician
Collegeville Family Practice
Medical Director of Health Services, Ursinus College
Collegeville, PA
David Neubauer, MD
Assistant Professor, Department of Psychiatry,
Johns Hopkins University School of Medicine
Medical Director, Psychiatry Mobile Treatment Services,
Johns Hopkins Bayview Medical Center
Associate Director, Johns Hopkins Sleep Disorders Center
Overview
This program will address the key "must-know" points in gout management. The provision of case-based presentations will provide primary care clinicians with a clear step-by-step comprehension of how to manage gout and establish effective, supportive patient interaction to optimize life-long adherence to life-style and therapeutic regimens. There will be opportunities to interact with the faculty and obtain their expert opinions on clinical issues faced in managing patients with gout.
Objectives
Identify that the long-term goal of gout treatment is to reduce serum urate to <6.0 mg/dL and to define the key steps in selecting and individualizing urate lowering therapy according to the disease stage; together with recognizing the importance of monitoring serum urate levels
Educate patients that an important factor in successful management includes their long-term commitment to adherence with the recommended life-style and drug interventions
Faculty
Brian Mandell, MD, PhD, FACP, FACR
Professor and Chairman of Medicine
CCF Lerner College of Medicine of CWRU
Center for Vasculitis Care and Research
Editor in Chief, Cleveland Clinic of Medicine
The Cleveland Clinic
Cleveland, OH
M. Susan Burke, MD, FACP
Clinical Assistant Professor of Medicine
Thomas Jefferson University
Philadelphia, PA
Director, Internal Medicine Clinical Care Center
Lankenau Hospital
Wynnewood, PA
Overview
Despite the great advances in medical care represented by adult immunization, the challenges continue to be numerous and varied. This activity will explore the barriers, clarify the "myths," and provide the most updated information on adult vaccines to increase immunization rates.
Objectives
Identify the Advisory Committee on Immunization Practices (ACIP) recommended adult vaccines and the recommended immunization schedules for each ACIP recommended adult vaccine
Increase knowledge and confidence regarding safety, risks, benefits, and side effects of adult immunizations and create a strategy to increase patient immunization rates, including the use of a health maintenance form or other tool for immunization review
Faculty
Brian P. McDonough, MD, FAAFP
Chairman
Department of Family Medicine
St. Francis Hospital
Wilmington, DE
Clinical Professor of Family Medicine
Temple University School of Medicine
Philadelphia, PA
Overview
Opioids provide effective pain management for acute and cancer pain and are useful in treating patients with chronic non-cancer pain who have not responded to other pain management therapies. Because of potential opioid abuse, patients and physicians may be reluctant to initiate opioid therapy for pain relief. This program will examine clinical strategies and recently published guidelines to balance effective opioid therapy against the risk of opioid misuse, abuse, and diversion.
Objectives
Implement clinical strategies designed to provide safe and effective use of opioid therapy while addressing the issues of opioid abuse, misuse, and diversion
Utilize recommendations from the American Pain Society/American Academy of Pain Medicine's Clinical Guidelines for the Use of Chronic Opioid Therapy in Chronic Noncancer Pain in clinical practice
Faculty
Howard Heit, MD
Board Certified in Internal Medicine and
Gastroenterology/Hepatology
Diplomat in Addiction Medicine
Certified Medical Review Officer
Chronic Pain Specialist
Assistant Clinical Professor
Georgetown University
Washington, DC