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Overview
Irritable bowel syndrome (IBS) is a highly misunderstood functional bowel disorder that is underreported and underdiagnosed. Because IBS can be challenging to diagnose and manage, it is important that clinicians stay up-to-date on current developments of diagnostic and treatment options in IBS.
Objectives
Recognize the symptoms of IBS and employ ACG guidelines and Rome III criteria to make a symptom-based diagnosis of IBS
Implement a patient-centered and evidence-based approach to the treatment of IBS, taking patientsÕ treatment goals into consideration as well as the efficacy, safety, and mechanisms of action of available treatment options
Faculty
Louis Kuritzky, MD
Clinical Assistant Professor
Dept. of Community Health & Family Medicine
University of Florida
Gainesville, FL
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
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
David Kendall, MD
Clinical Associate Professor of Medicine
Diabetes, Endocrinology and Metabolism
University of Minnesota
Minneapolis, MN
Stephen Brunton, MD
Director
Faculty Development
Cabarrus/NorthEast Medical Center
Concord, NC
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
Judith G. Regensteiner, PhD
Professor of Medicine
University of Colorado Health Science Center
Denver, CO
Lawrence E. Mieczkowski, MD
Clinical Associate Professor of Medicine
Wright State University School of Medicine
Medical Director, Center for Cardiometabolic Treatment
Dayton, OH
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
Gregory L. Brotzman, MD
Professor of Family and Community Medicine
Medical College of Wisconsin
Milwaukee, WI
J. Thomas Cox, MD
Director, The Women's Health Clinic
Student Health Services
University of California, Santa Barbara
Santa Barbara, CA
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
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
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
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
Norman Gordon, MD
Chief of the Division of Neurology, Miriam Hospital
Clinical Associate Professor of Neurology, Brown University
Medical Director, CNS Research Inc.
Providence, RI
Susan L. Hutchinson, MD
Associate Clinical Professor, Department of Family Medicine
University of California, Irvine
Director, Orange County Migraine and Headache Center
Irvine, CA
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
Muredach P. Reilly, MB
Assistant Professor of Medicine and Pharmacology
University of Pennsylvania School of Medicine
Philadelphia, PA
Ronald A. Codario, MD, FACP
Clinical Instructor in Medicine
Thomas Jefferson University Hospital
Philadelphia, PA
Overview
Thorough knowledge of current guidelines is crucial to the accurate diagnosis and effective management of Helicobacter pylori infection. Testing for H pylori should be performed before initiating treatment for the infection, as well as after therapy, to confirm eradiation. In planning and implementing the eradication regimen, clinicians should take into account antimicrobial resistance patterns in their regions as well as the importance of communicating with patients to enhance adherence.
Objectives
Identify patients in whom diagnostic testing for H pylori infection is indicated and determine the most appropriate tests for detecting infection, confirming eradication in specific situations as defined by guidelines
Describe local rates of H pylori resistance to antibiotics and create a strategy to selection of an initial eradication regimen
Faculty
Nicholas J. Talley, MD, PhD
Chair, Department of Internal Medicine
Mayo Clinic
Jacksonville, FL
Joseph A. Lieberman III, MD, MPH
Professor of Family Medicine
Jefferson Medical College
Thomas Jefferson University
Associate Editor, Delaware Medical Journal
Philadelphia, PA
Overview
Nearly half the male patients over age 50 presenting to the primary care clinician have bothersome lower urinary tract symptoms (LUTS). Identifying and treating LUTS/ benign prostatic hyperplasia (BPH) can be both simple and practical for the PCP. This presentation outlines the first evidence-based algorithm for treating male
Objectives
Identify appropriate treatment for LUTS/BPH based on a focused history and objective measures
Define a strategy to apply techniques and practices to effectively diagnose and initially assess patients with LUTS/benign prostatic hyperplasia (BPH)
Faculty
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
Arthur L. Weaver, MD, MS, FACP, MACR
Clinical Professor of Medicine
Rheumatology
University of Nebraska Medical Center
Omaha, NE
Joseph D. Croft, Jr, MD
Clinical Professor
Department of Medicine, Rheumatology
Georgetown University Medical School
Bethesda, MD