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Overview
PAD is frequently unrecognized and many patients at risk are currently not identified and treated. Current estimates are that 8-12 million Americans have PAD, with the highest incidence among those over 70 years of age, regardless of health status, and people over 50 years of age with diabetes mellitus.
This lecture will overview the tremendous risk associated with PAD, discuss the major risk factors for developing PAD, and highlight the role of primary care in detecting and diagnosing the condition through increased use of ABI screening. Current therapies will be discussed including symptom improvement and prevention of future CV events with an emphasis on patient compliance issues.
Objectives
Name the two types of patients most at risk of PAD who should be screened utilizing ABI
Recognize the need and benefits of ABI, and describe what readings are considered abnormal
Faculty
Philip Altus, MD, MACP
Professor of Medicine Emeritus
University of South Florida
Tampa, FL
Randall M. Zusman, MD
Associate Professor of Medicine
Harvard Medical School
Director, Division of Hypertension and Vascular Medicine Massachusetts General Hospital
Boston, MA
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
Associate Editor, Delaware Medical Journal
Professor of Family Medicine, Jefferson Medical College
Philadelphia, PA
Thomas Neylan, MD
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
Describe at least two challenges in treating dyslipidemia to NCEP-ATP III goals, implement strategies that will help to assess CHD risk accurately, and get patients to targeted goals
Identify patients at increased risk for cardiovascular events and develop a treatment plan with at least 2 lipid lowering strategies, including the use of multiple therapies, which will help these patients achieve guideline-based targets taking into consideration current lifestyle and pharmacologic treatment options available thus reducing overall cardiovascular risk
Faculty
Peter P. Toth, MD, PhD
Clinical Associate Professor
University of Illinois School of Medicine
Chicago, IL
Larry Culpepper, MD
Professor and Chairman, Department of Family Medicine
Boston University School of Medicine
Boston, MA
Overview
Migraine is a chronic, debilitating disorder that affects approximately 28 million Americans of whom ~18% are women and ~6% are men. When compared to migraines that occur during other times of the month, menstrual migraine (MM) may last longer and be more severe, disabling, frequent, and more difficult to treat. This program will address the new advances in the understanding of MM, the role of hormones, and how to select an appropriate treatment based on individual patient characteristics.
Objectives
Recognize migraine in the differential diagnosis of headaches that impact patients ability to fully function in their daily activities and identify menstrual migraine in female patients
Identify management strategies for women with menstrual migraine including use of headache calendars, behavioral modifications and approaches to acute and preventive treatment
Faculty
Frederick Taylor, MD
Merle L. Diamond, MD
Associate Director, Diamond Headache Clinic
Clinical Assistant Professor, Dept. of Medicine
The Chicago Medical School
Rosalind Franklin University of Medicine and Science
Chicago, IL
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 epidemiology and public health burden of herpes zoster and its most common complication, postherpetic neuralgia (PHN)
Discuss the benefits and limitations of current pharmacotherapies for herpes zoster and Postherpetic neuralgia (PHN), and evaluate clinical trial data on the efficacy and safety of herpes zoster vaccination
Faculty
Kenneth E. Schmader, MD
Associate Professor of Medicine
Vice Chief, Division of Geriatrics
Duke University and Durham VA Medical Centers
Durham, NC
Lawrence D. Gelb, MD
Professor of Medicine, Department of Internal Medicine
Division of Infectious Diseases
Washington University School of Medicine
St. Louis, MO
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
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
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
Overview
This program will underscore the need for early, aggressive, combination BP treatment in order to reach JNC 7 goals, in light of the effect hypertension and diabetes has on the pathogenesis of hypertensive renal damage. It will explain the mechanisms of action of the various antihypertensive drug classes and how clinicians can use this understanding when selecting a drug regimen. Based on recent and ongoing trials, the safest and most efficacious drug combinations will be discussed.
Objectives
Develop appropriate combination therapy regimens individualized to each diabetic hypertensive patientŐs established risk and comorbid conditions
Demonstrate an understanding of the role of Renin-Aniotensin-Aldosterone System blockers in the treatment of hypertension, the prevention of new onset diabetes, and prevention of progression in diabetic nephropathy by selecting the most appropriate treatment regimen for diabetic hypertensive patients
Faculty
John R. Steinberg, MD
Volunteer Faculty
University of Maryland School of Medicine
Baltimore, MD
Raymond R. Townsend, MD
Professor of Medicine
University of Pennsylvania
Philadelphia, Pennsylvania
Overview
Chronic Constipation is a multi-symptom gastrointestinal motility disorder that negatively impacts the lives of approximately 33 million Americans. Due to the overlap in symptoms reported by patients with irritable bowel syndrome-constipation and chronic constipation, clinicians often find it challenging to differentiate between the two. With a changing landscape of therapeutic options available, it is imperative that clinicians be able to establish and accurate diagnosis so the proper foundation is provided for determining initial therapy and developing a treatment plan.
Objectives
Differentiate chronic constipation from other functional bowel disorders
Identify the therapies that can be used to treat chronic constipation and other functional bowel disorders
Faculty
William D. Chey, MD, AGAF, FACG, FACP
Associate Professor of Medicine
Director, GI Physiology Laboratory
Division of Gastroenterology
University of Michigan Health System
Ann Arbor, MI
Jay Goldstein, MD
Overview
Four million people in the United States suffer from neuropathic pain, a condition that is often difficult to diagnose. This session, Clinical Conversation: Diagnosis & Treatment of Neuropathic Pain will address practical ways primary care physicians can improve recognition and treatment of neuropathic pain.
Objectives
Recognize signs and symptoms of neuropathic pain to increase identification of patients with neuropathic pain
Evaluate available treatment options for neuropathic pain and their appropriateness for your patient population to improve outcomes in these patients
Faculty
Rebecca J. Patchin, MD
Assistant Professor of Anesthesiology
Loma Linda University
Loma Linda, CA
M. Susan Burke, MD, FACP
Clinical Assistant Professor of Medicine
Thomas Jefferson University
Philadelphia, Pennsylvania
Director, Internal Medicine Clinical Care Center
Lankenau Hospital
Wynnewood, PA
Overview
Hypogonadism affects at least 20% of US men aged 50 years and older but is both under reported and under diagnosed. This program will explore the importance of hypogonadism and its comorbidities as a major health issue, review accurate diagnosis, discuss goals of treatment, and review available treatment options.
Objectives
Recognize that low serum testosterone is far more than a sexual dysfunction issue, acknowledge its association with other serious health conditions, such as metabolic syndrome, hypertension, renal failure, diabetes, and dyslipidemia, and have the improved ability to make an accurate diagnosis, as well as, describe the goals and benefits of TRT therapy and identify common misconceptions regarding the risks
Describe the benefits and limitations of different available delivery systems for TRT and emphasize the importance of regular patient monitoring
Faculty
Chad Ritenour, MD
Assistant Professor of Urology
Director, Outpatient Services
Director, Men's Health Center
The Emory Clinic
Atlanta, GA
Overview
Rheumatoid arthritis (RA) is a complex immunologic and chronic inflammatory disease that affects more than 2 million people in the United States. Characterized by inflammation of the joints, periarticular bone resorption and cartilage destruction, RA is also an inherently aggressive, systemic disease that leaves patients vulnerable to comorbidities such as cardiovascular disease, osteoporosis, lymphoma, infection, and stroke. While primary care clinicians may not directly treat the disease long term, they are the first to come in contact with potential RA patients. Therefore it is important for all clinicians to be aware of the necessary steps in RA diagnostic and treatment modalities.
Objectives
Identify 3 early warning signs of rheumatoid arthritis (RA)
Describe current and evolving treatment options for RA, and be alert to monitoring and side effects related to these therapies
Faculty
Arthur Weaver, MD, MS, FACP, MACR
Eric Ruderman, MD
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
Frank LoVecchio, DO, MPH
Professor
Arizona College of Osteopathic Medicine
Midwestern University
Glendale, Arizona
James M. Scheiman, MD
Professor
Internal Medicine, Division of Gastroenterology
University of Michigan
Ann Arbor, Michigan