Presented by Richard D. Shih, MD To earn ACCME or ACPE credit, go online to scientiacme.org/cmecoursecontent.php?ID=301 to view the slides and complete the post-test. In this online CME self-learning program: Opioid use disorder (OUD) affects millions of individuals globally and is best defined by the Diagnostic and Statistic Manual of Mental Disorders, Fifth Edition (DSM-5) as a condition due to tolerance, manifestation of physical dependence, and loss of control leading to health hazards.The scale of the problem is staggering, and while the causes are manifold, it is fueled in part by widespread availability: the Centers for Disease Control and Prevention estimates that the distribution of prescription opioid analgesics rose over fivefold between 1997 and 2007 and that there are enough opioid equivalents presently to allow for every American to take five milligrams of hydrocodone six times a day for three weeks straight. This program is supported by an educational grant from Alkermes. Faculty Disclosure: Dr. Shih has no relevant financial relationships to disclose.  

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Opioid Use Disorder: Best Practices & Barriers To Care with Richard D. Shih, MD

Presented by Jessica Lehosit, D.O. To earn ACCME or ACPE credit, go online to scientiacme.org/cmecoursecontent.php?ID=277 to view the slides and complete the post-test. In this online CME self-learning program: Parkinson's disease (PD), a central nervous system disease of the autonomic and basal ganglia, neocortex, and spinal cord, is thought to affect about one million people in the United States. Its etiology is thought to include a confluence of factors including age, genetic predisposition, comorbid disease states (e.g., Gaucher’s disease), and environmental factor dynamics. Present in 1% of people over age 65 and 2.5% of those older than 80, its symptoms are the direct result of dopaminergic neuronal degradation along the nigrostriatal tract and include bradykinesia, resting tremor, muscle rigidity, and gait disturbance. This program is supported by an educational grant from Acorda, UCB. Faculty Disclosure: Dr. Lehosit has no relevant financial relationships to disclose.  

Parkinson's Disease: Optimizing Pharmacotherapeutic Management Strategies and Addressing Clinical Challenges

Presented by Diane M. Birnbaumer, MD, FACEP To earn ACCME or ACPE credit, go online to scientiacme.org/cmecoursecontent.php?ID=278 to view the slides and complete the post-test. In this online CME self-learning program: Influenza has been recognized as a global public health menace since at least 100 years ago with the 1918-19 pandemic, which infected an estimated one-third of the world’s population and was responsible for the deaths of one in ten, or 50 million, of those infected. While some have contended that a significant number of deaths associated with the 1918 pandemic may have actually been attributable to acid-base derangements and pulmonary edema associated with contemporary aspirin dosing in the toxic range of two to eight times what is presently the maximum recommended dose – it remains a significant public health concern, with the 2017-2018 flu season in recent decades with an estimated 80,000 deaths (typical range 12,000-56,000 per year),coming with an annual cost of $16 billion. This program is supported by an educational grant from Sanofi / Pasteur. Faculty Disclosure: Dr. Birnbaumer has no relevant financial relationships to disclose.  

Prevention and Management of Influenza

Presented by Geeta Gupta To earn ACCME or ACPE credit, go online to scientiacme.org/cmecoursecontent.php?ID=295 to view the slides and complete the post-test. In this online CME self-learning program: The development of antiretroviral therapy (ART) has had a dramatic impact on HIV-related morbidity and mortality. The use of ART in HIV-infected patients has been the core strategy to not only treat HIV but also prevent vertical HIV transmission. Antiretrovirals can be used for HIV prevention in patients who are not HIV-infected but are repeatedly exposed to HIV in a strategy termed pre-exposure prophylaxis (PrEP). Although the rationale for PrEP stems from successful HIV prevention in HIV exposed infants with the use of ART during labor, early post-partum period, and throughout breastfeeding, it has more recently applied to been applied to sexual transmission (e.g., people with multiple partners or HIV serodiscordant couples) and people who inject drugs illicitly with support from the literature. Because much of what comprises evidence and guidelines supporting PrEP has been published relatively recently and because healthcare professionals are oftentimes unable to keep up with the steady publishing of literature and evolution of clinical practice in a timely manner, continuing healthcare education activities in this area are warranted. This program is supported by an educational grant from Gilead. Faculty Disclosure: Dr. David J. Cennimo has no relevant financial relationships to disclose.  

HIV Prevention: The Role of Pre-Exposure Prophylaxis (PrEP)

Presented by David J Cennimo MD, FACP, FAAP, FIDSA To earn ACCME or ACPE credit, go online to scientiacme.org/cmecoursecontent.php?ID=281 to view the slides and complete the post-test. Universal vaccination is one of the most important public health initiatives of the last century. The rates of vaccine-preventable illnesses have dropped precipitously with each introduction of an effective vaccine. Vaccinations not only protect the public against specific infectious diseases but also reduce future consequences, sequelae, and complications of disease, such as in the cases of: human papilloma virus (HPV) vaccine and cancer; rotavirus vaccine and type 1 diabetes; and the measles vaccine and all-cause mortality. Among people born between 1994 and 2013, vaccination is responsible for the prevention of 322 million illnesses, 21 million hospitalizations, and 732,000 deaths, resulting in a savings of nearly $1.7 trillion in total costs. Extrapolating these predictions across all generations, the benefits of universal vaccination are considerable. Despite the many benefits of vaccination and the relatively low risks, vaccine hesitancy is a growing concern among health care professionals and has led to the resurgence of vaccine-preventable illnesses in pockets of the United States. This program is supported by an educational grant from Merck. Faculty Disclosure: Dr. David J. Cennimo has no relevant financial relationships to disclose.

The Problem with Vaccines: Public Hesitancy and Refusal

To earn ACCME or ACPE credit, go online to scientiacme.org/cmecoursecontent.php?ID=270 to view the slides and complete the post-test. Fabry disease is characterized by a deficiency of the glycoside hydrolase enzyme alpha galactosidase A, resulting in the accumulation of the glycolipid globotriaosylceramide throughout the body, particularly prominently in the blood vessels. A defect in the enzyme alpha galactosidase A results in glycosphingolipid accumulation, ultimately leading to multi-organ dysfunction and the patient’s premature death. Early symptoms, which occur during childhood, involve pain and may include Raynaud phenomenon, paresthesias, and arthralgia in the extremities and proximal limbs, as well as impaired gastrointestinal emptying, resulting in abdominal pain, diarrhea, early satiety, postprandial bloating, nausea, and vomiting. In adulthood, the disease’s impact spreads beyond and begins to affect the cardiac and renal systems. This program is supported by an educational grant from Sanofi / Genzyme. Faculty Disclosure: Neal J Weinreb, MD, FACP serves on Medical or Scientific Advisory Boards for Genzyme-Sanofi, Shire HGT and Pfizer for which he has received honoraria. He has consulted for Genzyme-Sanofi and for Pfizer and has received research support from Genzyme-Sanofi and from Shire HGT.

Fabry Disease - Highlights from the 15th Annual WORLD Symposium 2019 with Neal J. Weinreb

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