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October 20, 2017 | LOGIN | REGISTER | HELP | 

According to the late night television host Stephen Colbert, Americans should relax and try not to get high blood pressure from the political environment because now we won’t be able to afford the treatment. If only it were so simple.

There are many barriers to adequate blood pressure control. Some people are simply not firmly diagnosed. Others fail to keep up with regular treatment for the condition. Still others do not adhere to medication guidelines. A lack of insurance and high out of pocket costs play into these barriers to seeking care for hypertension.

Politicians tend not to listen to health care providers about health care issues, at least not until it personally affects them, so meanwhile what can we offer our patients with high blood pressure?

Some answers can be found in our current Cyberounds®. Please join Aditya Khetan, M.B.B.S., Cardiology Fellow, Harrington Heart & Vascular Institute; Richard A Josephson, M.S., M.D., Professor of Medicine, Case Western Reserve University School of Medicine and Director Cardiac Intensive Care and Director Cardiovascular and Pulmonary Rehabilitation, Harrington Heart & Vascular Institute; and Sri Krishna Madan Mohan M.B.B.S., Chief Quality Officer, Harrington Heart & Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, as they present Current Management of Hypertension

This activity has been approved for 1.0 AMA PRA Category 1 CreditTM.

It's non-invasive. It's cost-effective. It provides real-time information that can immediately impact decision-making.

Focused ultrasound (US) is the medical technique du jour, now employed in over 92% of academic emergency medicine departments in the United States.

What can it do for you and for many of your patients?

You'll be surprised.

Please join Ashish R. Panchal, M.D., Ph.D., R.D.M.S., Assistant Professor of Emergency Medicine and Director of the Center for EMS; Creagh Boulger, M.D., Assistant Professor of Emergency Medicine and Associate Director of Ultrasound; Amar Vira, M.D., Ultrasound Fellow; and David Bahner M.D., R.D.M.S., Professor of Emergency Medicine and Director of Ultrasound, Ohio State University Wexner Medical Center, Columbus, OH, as they present Focused Ultrasound in Emergency Medicine. This activity has been approved for 1.0 AMA PRA Category 1 CreditTM.

You know what acromegaly looks like — just picture Jaws, James Bond’s nemesis in the movies The Spy Who Loved Me and Moonraker.

The actor who played Jaws, Richard Kiel, suffered from acromegaly, an endocrine disorder caused by growth hormone excess in adult life.

While transsphenoidal pituitary surgery (TSS) remains the mainstay of therapy in most patients, it is not for everyone. There are emerging new medical therapies that offer hope to those who are unlikely to be cured by surgery, who decline surgery or are unfit for surgery because of poor health.

Please join Nicholas A. Tritos, M.D., D.Sc., Assistant Professor of Medicine, Neuroendocrine Unit / Neuroendocrine and Pituitary Tumor Clinical Center, Massachusetts General Hospital and Harvard Medical School, as he discusses Current and Emerging Approaches to the Management of Patients With Acromegaly.

This FREE activity has been approved for 1.0 AMA PRA Category 1 CreditTM

Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related death worldwide. And despite improvements in treatment, patients continue to have a dismal prognosis, with 5-year survival rates of only 18%.

Though hepatitis B and cirrhosis are known risk factors, some of the awful HCC statistics are related to under-recognition of at-risk patients, as well as underuse of available treatments. But with new therapies on the horizon, the opportunity to customize clinical management offers more than a glimmer of hope for HCC patients.

Please join Brian C. Davis, M.D., Resident Physician, and Amit G. Singal, M.D., M.S., Associate Professor, Medical Director of Liver Tumor Program, Department of Internal Medicine, Division of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, Dallas, TX, as they discuss the Treatment of Hepatocellular Carcinoma.

This activity has been approved for 1.0 AMA PRA Category 1 Credit™.

Sexual activity and interest may decline with age, but they are a key part of the quality of life for many seniors.

In fact, a majority of older adults still consider sex important, and many older people remain regularly sexually active even into their 80s and 90s.

Medical professionals need to keep in mind that older adults are not a homogenous group — their needs and issues are diverse and often quite individual. Relationship dynamics and awkwardness in discussing sex can also complicate the process.

If you know the basic issues sex poses for seniors, you can do a better job helping them remain as sexually active and satisfied as possible.

Please join Barbara L.Marshall, Ph.D., Professor of Sociology, Trent University, Peterborough, ON, Canada, as she discusses Aging, Sexual Diversity and Sexual Health:

This activity has been approved for 1.0 AMA PRA Category 1 CreditTM.

Companies proudly offer wellness programs to their employees, which always sounds like a great benefit. The guiding belief is that a physically and mentally fit employee will not only be healthier but will also be more productive. But the reality, however, is somewhat more problematic.

Especially concerning in the Age of Obamacare is who really pays for the program — the employer or the employees?

Do wellness programs compromise employee privacy and the confidentiality of medical information? Do they disrupt the doctor-patient relationship of trust?

And do they unfairly penalize those with conditions — weight loss is one example — that most people cannot substantially change even with the best of intentions?

Please join Maxwell J. Mehlman, J.D., Distinguished University Professor, Arthur E. Petersilge Professor of Law and Director of the Law-Medicine Center, Case Western Reserve University School of Law, and Professor of Bioethics, Case Western Reserve University School of Medicine, as he discusses Corporate Wellness Programs: Pros and Cons.

This activity has been approved for 1.0 AMA PRA Category 1 CreditTM.

They are a self-sustaining source of energy. They are autonomous and omnipresent.

Unlike most energy producers, they don't use fossil fuels or uranium. So, in no way, do they contribute to global warming.

Every eukaryotic organism, from amoeba to human beings, depends on their continued efficient performance. But they are not perfect. Indeed, their dysfunction is the source of the largest group of metabolic diseases.

Please join Claus Desler, Ph.D., Assistant Professor, and Lene Juel Rasmussen, Ph.D., Professor and Managing Director, Center for Healthy Aging, Department of Molecular and Cellular Medicine, University of Copenhagen, Denmark, as they discuss Mitochondria in Health and Disease.

This activity has been approved for 1.0 AMA PRA Category 1 CreditTM.

Finally, some seriously good news on cancer treatment — specifically, acute myelocytic leukemia or AML.

Two drug candidates for AML are expected to gain FDA approval in 2017. In randomized phase 3 trials both have offered significant overall survival time (OS) benefit. They will be the first drugs approved for AML in over a decade.

Please join Mary-Elizabeth Percival, M.D., M.S., Assistant Professor of Medicine, University of Washington School of Medicine, and Assistant Member, Fred Hutchinson Cancer Research Center, and Roland B. Walter, M.D., Ph.D., M.S., Associate Professor of Medicine and Associate Member, Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA., as they present Emerging Treatments In Acute Myeloid Leukemia (AML).

This activity has been approved for 1.0 AMA PRA Category 1 CreditTM.

It was discovered at the beginning of the twentieth century and was immediately hailed as a miracle drug. Named “D” because it was the fourth vitamin discovered, all these years later we’re still finding out what Vitamin D does and does not do.

Please join Malcolm D. Kearns, M.D., Medical Resident, and Vin Tangpricha, M.D., Ph.D., Associate Professor of Medicine, Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine, as they present Vitamin D in Health and Disease.

This activity has been approved for 1.0 AMA PRA Category 1 CreditTM.

It's more likely to affect women and African Americans. And, globally, it's the second leading cause of blindness, afflicting more than 60 million people.

We don't know for certain what causes open angle glaucoma (OAG), but luckily, there are some promising new treatments on the horizon.

Please join Yang Sun, M.D., Ph.D., Associate Professor of Ophthalmology, Stanford University School of Medicine, Palo Alto, CA, and Enoch Kassa, M.D., Resident in Ophthalmology, Eugene and Marilyn Glick Eye Institute, Indiana University School of Medicine, Indianapolis, IN, as they discuss emerging treatments and procedures which may dramatically reduce the disease burden of Open Angle Glaucoma. This activity has been approved for 1.0 AMA PRA Category 1 Credit.TM

While schizophrenia’s positive symptoms such as hallucinations and delusions are largely responsive to antipsychotic medication, negative symptoms like anhedonia and cognitive symptoms (memory and attentional deficits) are challenging, constituting a major unmet therapeutic need.

Cognitive symptoms, in particular, have been the focus of substantial on-going clinical and preclinical research because they are highly predictive of long-term functional outcome in patients.

And now emerging research suggests that cholinergic and dopaminergic modulation of the prefrontal cortex may usher in the development of new therapeutics.

Please join Sarah Canetta, Ph.D., Associate Research Scientist, and Christoph Kellendronk, Ph.D., Assistant Professor of Pharmacology (in Psychiatry), Departments of Psychiatry & Pharmacology, Columbia University, and the Division of Molecular Therapeutics, New York State Psychiatric Institute, New York, as they discuss the Molecular Mechanisms of Cognitive Deficits in Schizophrenia

This eCME activity has been approved for 1.0 AMA PRA Category 1 CreditTM

Population health promises to refocus healthcare from fighting disease to maximizing wellness. It says it will do this with the help of Big Data and, eventually, individualized genomic data.

But what about a chronic medical/social condition where Congress doesn’t allow anyone to collect and study the data? And where, in one state, Florida, legislators passed a law that says doctors can't even talk to the patient about the problem?

The second and third leading causes of death among 15- to 34-year-olds are homicide and suicide. Firearms cause many of these deaths, yet the CDC, the NIH, the Surgeon General are under a permanent gag rule on gun violence.

Can population health techniques finesse this political blockade?

Please join David B. Nash, M.D., M.B.A., The Raymond C. and Doris N. Grandon Professor of Health Policy and Founding Dean, Jefferson School of Population Health, Thomas Jefferson University, Philadelphia, PA., as he discusses Population Health: Transforming Healthcare in the 21st Century.

This FREE activity has been approved for 1.0 AMA PRA Category 1 CreditTM.

It's amazing, but true, that in the USA alone 24 million people, 7.6% of adults and 9.6% of children, have been diagnosed with asthma.

But what really takes your breath away, pun intended, is that, according to a recent research survey, one-third of providers are unfamiliar with the asthma treatment guidelines, and of those who know about the guidelines only 46% follow them!

Isn't about time that we all try a little harder to change these percentages in a positive direction?

Authors Cathy G. Benninger, R.N., M.S., C.N.P., and Jennifer W. McCallister, M.D., Assistant Professor of Internal Medicine, Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, present Asthma Management: A Multi-Faceted Approach.

This FREE activity has been approved for 1.0 AMA PRA Category 1 CreditTM.

They have unique signs and symptoms, some with weird names such as Shawl, Mechanic’s Hands and V.

They affect females more than males and though, fortunately, they have a low incidence, they can be devastating.

We look at three main types of idiopathic inflammatory myopathies (dermatomyositis, polymyositis and inclusion body myositis), as well as the new kid on the block -- immune mediated necrotizing myopathy.

Please join Julie J. Paix, M.D., M.H.S., Assistant Professor of Medicine, and Lisa Christopher-Stine, M.D., M.P.H., Associate Professor of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, as they present Idiopathic Inflammatory Myopathies: A 2016 Update. This activity has been approved for 1.0 AMA PRA Category 1 Credit.TM

Reproductive rights are a contentious subject. Regardless of your personal beliefs, there are things you need to know as a healthcare professional about a woman’s right to be in charge of her own body in order to fully inform your patients.

Nada L. Stotland, M.D., M.P.H., is Professor of Psychiatry at Rush Medical College, a past president of the American Psychiatric Association, and the author of several peer-reviewed books on reproductive rights. Please join her for this special Cyberounds® Women’s Health, Caring for Women and Their Families: The Essential Role of Reproductive Rights.

This activity has been approved for 1.0 AMA PRA Category 1 CreditTM.

Myocardial infarction (MI) remains a leading cause of morbidity and death. Progress has been made in both primary and secondary prevention, but care of the post-MI patient is fraught with challenges.

Patients are often very anxious about their chances of another MI. They are more aware of chest symptoms, and may be depressed and afraid to resume their daily activities, including having sex.

What should the clinician do and recommend for their patients post-MI?

Authors Richard Josephson, M.S., M.D., Professor of Medicine, Case Western Reserve University School of Medicine. Director Cardiac Intensive Care Unit and Director Cardiovascular & Pulmonary Rehabilitation at Harrington Heart & Vascular Institute, and Sri K. Madan Mohan, M.D., Assistant Professor of Medicine, Chief Quality Officer and Program Director, Harrington Heart & Vascular Institute, Case Western University School of Medicine, Cleveland, OH., present Management of the Post-Myocardial Infarction Patient.

This activity has been approved for 1.0 AMA PRA Category 1 CreditTM



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