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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
Roy K.H. Wong, MD
Chief of Gastroenterology
Walter Reed Army Medical Center
Professor of Medicine,
Director, Division of Digestive Diseases
Uniformed Services University of the Health Sciences
Washington, DC
Lin Chang, MD
Co-Director
Associate Professor of Medicine
Division of Digestive Diseases
Center for Neurovisceral Sciences & Women's Health
David Geffen School of Medicine UCLA
Los Angeles, CA
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
Stanley G. Rockson, MD
Chief of Consultative Cardiology
Stanford University School of Medicine
Stanford, CA
Lawrence E. Mieczkowski, MD
Clinical Associate Professor of Medicine
Wright State University School of Medicine
Medical Director, Center for Cardiometabolic Treatment
Dayton, OH
Overview
More than 20 million people are affected by diabetes and of this population nearly 65% will suffer early cardiovascular death. To effectively treat diabetes and reduce the risk of a cardiovascular event, glucose levels must be monitored and quickly controlled through changes in intervention, as outlined by the ADA/EASD treatment algorithm. Recent data provided by the National Health and Nutrition Examination Surveys (NHANES) revealed that there is some overall improvement in reaching the appropriate treatment standards, however, with the number of diabetes cases increasing by 1.5 million each year and the recent labeling changes affecting therapeutic options, it is more important than ever to be familiar with the pharmacologic treatment options for type 2 diabetes and the associated cardiovascular risk.
Objectives
Identify the current goals for A1C, blood pressure, and lipid levels set forth by the American Diabetes Association and apply them to the treatment strategies listed on the ADA/EASD algorithm in an effort to choose the best therapeutic option for each individual patient
Assess when patients with type 2 diabetes require cardiovascular risk reduction in addition to glycemic control and develop evidence-based approaches to treatment based on the ADA/EASD algorithm by reviewing adverse events
Faculty
Anne Peters, MD
Mark Stolar, MD
Associate Professor of Clinical Medicine
Northwestern University
The Feinberg School of Medicine
Chicago, IL
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 Neylan, MD
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 Brotzman, MD
Daron G. Ferris, MD
Professor
Department of Family Medicine
Department of Obstetrics and Gynecology
Director, Gynecologic Cancer Prevention Center
Medical College of Georgia
Augusta, GA
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
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
Lawrence D. Gelb, MD
Professor of Medicine, Department of Internal Medicine
Division of Infectious Diseases
Washington University School of Medicine
St. Louis, MO
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
Brian Koffman, MDCM
Clinical Professor, Department of Family Medicine
Keck School of Medicine, USC Family Practice
St. Jude Heritage Medical Group
Diamond Bar, CA
Steven B. Graff-Radford, DDS
Co-Director, The Pain Center
Department of Anesthesiology
Cedars-Sinai Medical Center
Los Angeles, 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
Benjamin Ansell, MD
David Leaf, MD MPH
Overview
Eyesight is a gift that most patients take for granted, until their vision becomes acutely compromised. When that happens, patients often present first to their primary care clinician. Because of the lack of formal ophthalmology training, many primary care clinicians feel uncomfortable in managing patients with eye disease. This program will help primary care clinicians recognize eye emergencies by reviewing the signs and symptoms of 10 important conditions which may restore the patientŐs eyesight and perhaps save their life.
Objectives
Identify at least 2 eye emergencies that can cause rapid blindness or threaten life if not properly diagnosed in the primary care setting
Diagnose age-related macular degeneration, diabetic retinopathy, glaucoma, and optic nerve disease in the primary care setting and refer patients at risk to ophthalmology
Faculty
Tommy Korn, MD, FACS
Attending Ophthalmologist, Sharp Memorial Hospital
Sharp Rees-Stealy Medical Group
San Diego, CA
Overview
Symptomatic treatment for menopausal women balances findings from clinical trials, guidelines, practice recommendations, and patient beliefs. Together clinicians will evaluate data and recommend initial treatment and follow up to meet a patient's needs for symptom management.
Objectives
Proactively assess and address menopausal issues with appropriate patients using clinician and patient education resources to improve communication and management of menopausal issues
Consistently apply with confidence the best evidence and up-to-date expert consensus recommendations to the clinical care and peri and menopausal patient
Faculty
Michael Policar, MD
Associate Professor of Obstetrics and Gynecology
UCSF School of Medicine
San Francisco, CA