A lot of people are fibbing. And most of them aren't even politicians.
Atrial fibrillation (AF) is the most common clinically-significant arrhythmia; and though there are medicines and other techniques available to control AF, no available drug or strategy is fully effective in maintaining sinus rhythm. The drugs can have serious side effects, and many AF patients are considered unsuitable for rhythm control simply because their sinus rate cannot be restored and maintained.
Enter selective cardiac vagal neurostimulation.
Please join leading heart researchers
Youhua Zhang, M.D., Ph.D., Project Staff, and
Todor N. Mazgalev, Ph.D., Full Staff, Department of Molecular Cardiology and Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, as they present
Cardiac Vagal Neurostimulation for Ventricular Rate Control During Atrial Fibrillation. This activity has been approved for
1.0 AMA PRA Category 1 CreditTM.
Blunt abdominal trauma (BAT) remains a diagnostic challenge to emergency physicians. Despite advances in motor vehicle and occupational safety measures over the past three decades, BAT resulting in intra-abdominal injury represents a substantial cause of mortality and morbidity in the United States and worldwide
Even though treating physicians have many new and effective diagnostic techniques (e.g., FAST), here is a surprisingly large group of patients (pediatric, obese, pregnant) who continue to pose additional risks and difficulties for the clinician.
Please join
John R. Richards, M.D., F.A.A.E.M., Professor of Emergency Medicine, University of California, Davis Medical Center, Sacramento, California, as he discusses the diagnosis and management of six prototypical and intriguing cases in
Blunt Abdominal Trauma: Current Concepts. This activity has been approved for
1.0 AMA PRA Category 1 CreditTM.
Toxic sugar sounds like it could be the name of a girl group, but, unfortunately, it is the apt descriptor for glucose's effects on diabetics' bodies over time.
It is estimated that 60-70 percent of people with diabetes will develop some form of neuropathy during the course of their illness. While not precise, the presentation of neuropathy appears to occur after five years and reaches a peak after 25 years of hyperglycemia.
But what exactly does the high level of glucose do? Why is it so injurious?
Please join
John W. Wiley, M.D., Professor, Internal Medicine and Director, Michigan Clinical Research Unit, and
Dr. Roberto Towns, Research Assistant Professor, Department of Internal Medicine, Division of Gastroenterology, University of Michigan Medical School, Ann Arbor, MI, as they look at the enzymatic and metabolic consequences of too much glucose in
Neuropathic Complications of Diabetes. This activity has been approved for
1.0 AMA PRA Category 1 CreditTM.
You may or may not know that more than 10,000 different kinds of microbes live happily in our GI tract.
And this is a very good thing. These 10,000 are not mere freeloaders looking to take advantage of a congenial environment. Rather, they help maintain an elaborate homeostasis that insures health. Think of them as excellent dinner companions.
When this "microbiota" is disturbed, it now appears that many serious chronic diseases -- ulcerative colitis, irritable bowel, Crohn's -- may result. With this new understanding of GI disease, researchers are starting to identify effective therapies to help the bacteria cope with various insults.
Please join eminent researchers
John Y. Kao, M. D., Assistant Professor and
Nirmal Kaur, M.D., Fellow, Department of Internal Medicine, Division of Gastroenterology, and
Vincent B. Young, M.D., Ph.D., Assistant Professor, Department of Medicine, Infectious Diseases Division, and Department of Microbiology & Immunology, University of Michigan Medical School, Ann Arbor, Michigan, as they take us on a tour of
The Indigenous Gastrointestinal Microbiota in Health and Disease. This activity has been approved for
1.0 AMA PRA Category 1 CreditTM.
What do Okinawans, California's Seventh Day Adventists and men in Sardinia have in common?
Answer: they live longer than other human beings. Much longer.
Why? Is it the dietary mantra of "hara haci bu," religious practices or genetics? Or all of the above?
We're not totally sure but we do know that the number of centenarians has doubled each decade between 1950 and 1990. And that over the course of human history the likelihood of living from birth to age 100 has risen from 1 in 20 million to 1 in 50 for females in low-mortality nations. In Japan, for example, female life expectancy has risen for the last 160 years at a steady pace of almost 3 months/year.
Please join
Robert J. Pignolo, M.D., Ph.D., Assistant Professor and Director, Ralston-Penn Clinic for Osteoporosis & Related Bone Disorders, Department of Medicine, Division of Geriatric Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA. as he presents the exceptional medical story of
Exceptional Human Longevity. This activity has been approved for
1.0 AMA PRA Category 1 CreditTM.
Recently television executives announced that they were canceling As The World Turns, the last remaining daytime drama, after 54 years.
Who needs soaps when we have our own, long-running, 60-year-old soap opera, Will We Ever Have Health Care Reform? It features a cast of legislative characters who will say or do anything to get their names in the news.
Please join
Max J. Mehlman, J.D.,
Arthur E. Petersilge Professor of Law and Director of the Law-Medicine Center, Case Western Reserve University School of Law, as he makes sense of all the drama in
Containing Health Care Costs. This activity has been approved for
1.0 AMA PRA Category 1 CreditTM.
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The treatment of brain tumors changed during the past five years, largely as a result of a large prospective European and Canadian research study. But despite the revised standard, brain cancer for most patients will inevitably progress.
Now, thanks to emerging research highlighting the pathways important in gliomagenesis, new targeted therapies may soon be available to act upon brain tumor cells.
Please join
Nicole A. Shonka, M.D., Fellow, and
Mark R. Gilbert, M.D., Deputy Chair and Professor, the Department of Neuro-Oncology, the University of Texas M.D. Anderson Cancer Center, Houston, TX, as they look at the molecular pathways and the therapeutic possibilities in
Molecularly Targeted Therapies for Malignant Brain Tumors. This activity has been approved for
1.0 AMA PRA Category 1 CreditTM.
There's a lot we know, much we don't know and much information that's incorrect about the genetics of breast and other associated cancers.
For example:
Even though its rate decreased by 3.5% per year between 2001 and 2004, breast cancer remains the most common cancer and the second leading cause of cancer death among women.
Its incidence is higher among whites than African Americans but it is more lethal for African Americans.
It is a misconception that breast cancer can only be inherited from the maternal lineage. On the contrary, half of all inherited breast cancer cases are inherited from the father's side of the family.
Male breast cancer is more commonly associated with BRCA2 mutations when compared to BRCA1 mutations.
Please join
Jennifer Barrick, M.S., C.G.C., Genetic Counselor, Division of Hematology and Oncology,
Nancie Petrucelli, M.S., C.G.C., Clinical Assistant Professor, Senior Genetic Counselor/Coordinator, Division of Hematology and Oncology and Population Studies and Prevention Program and
Michael S. Simon, M.D., M.P.H., Professor of Medicine and Oncology, Division of Hematology and Oncology and Population Studies and Prevention Program; all at the Karmanos Cancer Institute at Wayne State University, Detroit, MI., as they present
The Genetics of Breast and Associated Cancers. This activity has been approved for
1.0 AMA PRA Category 1 CreditTM.
Gadolinium? Does it ring any bells?
Clue: It's a rare earth element and a member of the lanthanide series in the Periodic Table of elements.
And it's also used in magnetic resonance angiograms where it is causing serious problems for patients.
Please join
Frieda Wolf, M.D., Attending Physician in Nephrology and Internal Medicine at Rambam Health Care Campus, Haifa, Israel, as she reviews the etiology of
Nephrogenic Systemic Fibrosis and what to do about it. This activity has been approved for
1.0 AMA PRA Category 1 CreditTM.
Apple-shaped bodies have central (visceral) deposition of fat which increases the risk for serious medical conditions (e.g. stroke, diabetes, coronary artery disease). And central obesity can exist even in the absence of overall obesity.
If current trends continue, nearly all American adults will be overweight or obese by 2030. Even developing nations are seeing an increase in obesity and obesity-related complications.
What's especially alarming is that we have yet to find a "cure" or a consistent treatment that successfully addresses more than a minority of obese patients.
Should you give up and just tell your patients to eat what they like or is there something you can advise?
Please join
Lawrence J. Cheskin, M.D., Director of the Johns Hopkins Weight Management Center and Associate Professor of Medicine and Public Health at Johns Hopkins University, and
Scott Kahan, M.D., M.P.H., Associate Director of the Johns Hopkins Weight Management Center and Faculty Member, the Johns Hopkins University Preventive Medicine Residency Program, Baltiomore, MD, as they present
Current Management of Obesity. This activity has been approved for
1.0 AMA PRA Category 1 CreditTM.
The fascination with quantification, AKA demographics, continues.
If we told you that:
- More than 9 million Americans have it.
- It primarily affects whites, especially cigarette smokers.
- And mostly those over 55.
What would you think we're talking about?
Not politics, we can assure you.
Age-related macular degeneration (AMD), also known as age-related maculopathy, is a potentially progressive macular disease that is the leading cause of adult visual impairment and blindness in industrialized nations.
Please join
Joshua L. Dunaief, M.D., Ph.D, Assistant Professor of Ophthalmology, and
Leon Charkoudian, M.D., Resident, F.M. Kirby Center for Molecular Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA, as they present
Age-related Macular Degeneration (AMD). This activity has been approved for
1.0 AMA PRA Category 1 CreditTM.
For people over 65 Parkinson's disease (PD) is the second most common neurodegenerative disease after Alzheimer's disease in the U.S. and is rapidly increasing in developing countries.
But younger adults get PD too. Three to ten percent of PD cases have an age-at-onset of 40 or younger. They are characterized as Early-onset Parkinson's Disease (EOPD).
While there are many similarities between EOPD and late-onset PD, EOPD has its own unique features, yet the presentation can be quite variable and is easily confused with other diseases.
Please join
Roy N. Alcalay, M.D., M.Sc., Assistant Professor of Neurology, and
Karen Marder, M.D., M.P.H., Professor of Neurology (in the Sergievsky Center, Taub Institute and Psychiatry), Columbia University College of Physicians and Surgeons, New York, as they present
Early-onset Parkinson's Disease. This activity has been approved for
1.0 AMA PRA Category 1 CreditTM.
Six Sigma.
It sounds like the name of a Greek fraternity. Or a sequel to Star Trek.
Six Sigma is a statistical, problem-solving management philosophy that was used to expand Fortune 500 companies, most notably General Electric. Now one of its leading advocates, Don Berwick, M.D., who President Obama recently appointed to head the Centers for Medicare and Medicaid, promises to bring the gospel to healthcare.
What is Six Sigma and how will you and your patients be affected?
Please join
Wendy M. Novicoff, Ph.D., Assistant Professor, Departments of Public Health Sciences and Orthopaedic Surgery, University of Virginia School of Medicine, Charlottesville, VA, and
Khaled J. Saleh, M.D., M.Sc., M.H.C.M., Professor and Chair, Division of Orthopaedic & Rehabilitation Surgery, Southern Illinois University School of Medicine, Springfield, IL, as they present
Six Sigma in Healthcare.This activity has been approved for
1.0 AMA PRA Category 1 CreditTM.
Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death in the United States. Currently, more than 24 million Americans have COPD. As the population ages and a new generation of smokers matures, it is certain that this disease will impact patients and the medical establishment for years to come.
New research demonstrates that chronic exposure to cigarette smoke results in a marked increase in matrix metalloproteinases (MMPs), zinc-dependent enzymes, within the lung. And it is the presence of these proteases which is a critical factor in the development of COPD.
Is there anything we can do to reduce the effects of MMPs?
Please join
Robert Foronjy, M.D., Assistant Professor of Medicine, and
Jeanine D'Armiento, M.D., Ph.D.,
Associate Professor of Medicine, Columbia University, Department of Medicine, Division of Molecular and Pulmonary Medicine, New York, as they discuss,
The Role of Matrix Metalloproteinases (MMPs) in COPD. This activity has been approved for
1.0 AMA PRA Category 1 CreditTM.
Here's a really tough question. Give yourself a gold star if you know the answer:
What do syphilis, melioidosis (Nightcliff gardener's disease), Lyme Disease, Creutzfeldt-Jakob, ileocecal valve syndrome, neuroretinitis and cutaneous actinomycosis have in common?
Give yourself a silver star if you even know what all of them are. We didn't.
Answer: Over the years, each of the above diseases has been characterized as The Great Mimicker.
If you want to be the star of the next medical cocktail party, where we guarantee you'll be the only person who can update the Great Mimicker list, please join
Peguy Saad, M.D., Medical Resident at Staten Island University Hospital, NY and
Peter Barland, M.D., Professor Emeritus of Medicine and Pathology, the Albert Einstein College of Medicine, Bronx, NY, as they present
Immunoglobulin G4-related Sclerosing Syndrome. This activity has been approved for
1.0 AMA PRA Category 1 CreditTM.
Should she or shouldn't she?
We are talking about estrogen replacement, not hair coloring. It's an issue/question of great importance to menopausal women.
In 1998, the Heart and Estrogen/Progestin Replacement Study (HERS) concluded that the combination of estrogen and progestin increased the rate of cardiovascular disease. Then, in 2002, the largest randomized clinical trial of HRT ever conducted, the Women's Health Initiative trial, concluded that the overall risks outweigh the benefits associated with HRT.
These studies essentially marked the end of hormone replacement therapy as an accepted protocol.
But in recent years, significant new research, including re-evaluation of the original data from the two landmark studies, has shown the estrogen therapy (as opposed to HRT), if initiated at the right time following the onset of menopause significantly "decreases cognitive decline in aging women," though other risks remain.
So the question once again is, What should you tell your patients about supplemental hormones?
Please join
Istvan Merchenthaler, M.D., Ph.D., D.Sc., Professor, Department of Epidemiology & Preventive Medicine and Anatomy & Neurobiology, University of Maryland, School of Medicine, Baltimore, MD, and
Laszlo Prokai, Ph.D., D.Sc., Robert A. Welch Professor, Department of Molecular Biology & Immunology, University of North Texas Health Science Center, Fort Worth, TX, as they present
Central Nervous System-selective Estrogens: A Safe Estrogen Therapy. This activity has been approved for
1.0 AMA PRA Category 1 CreditTM.
While they may have a certain Indiana Jones-like allure, snakebites are deadly serious.
And the fact is that if much of what you know about treating snakebites is based on films and adventure stories, it is likely to be wrong. For example, sucking out the venom is DEFINITELY not recommended. Tourniquets? Not effective.
But with recent advances in antivenom production techniques and the worldwide recognition of snakebite as a neglected tropical disease, it has become important for physicians to have a working knowledge of the epidemiology, pathophysiology and emergent medical management of this disease.
Please join
Thomas C. Arnold, M.D., Professor and Chairman, Department of Emergency Medicine, and
Robert A. Barish, M.D., M.B.A., Chancellor, the LSU Health Sciences Center, Shreveport, LA, as they present
Snakebite Management in the United States. This activity has been approved for
1.0 AMA PRA Category 1 CreditTM.
