Free CME

Activity Description / Statement of Need:
In this online, self-learning activity:

Acute hepatic porphyria (AHP) is an umbrella term for four types of acute porphyria, the most severe of which is acute intermittent porphyria (AIP). An estimated 80% of AHP cases are AIP, which is an inherited autosomal dominant condition that results from mutations of the third enzyme of heme synthesis, porphobilinogen deaminase. In the Western countries, it is estimated that approximately 1 in 2000 individuals are carriers of the relevant mutated genotype, although the majority have latent AIP and are clinically asymptomatic. Acute attacks occur in less than 10% of the at-risk population, reflecting the role of environmental factors, such as alcohol use, infections, and hormonal changes, among others. AHP symptoms are believed to be caused by ALAS1-mediated accumulation of ALA and PBG in the liver and bloodstream, leading to neurotoxicity.

Target Audience:
The following HCPs: hematologists and gastroenterologists; physician assistants, nurse practitioners, and pharmacists who practice in any of the aforementioned areas of specialties; and any other healthcare professionals with an interest in or who clinically encounter patients with AHP.

In this online, self-learning activity:

Hereditary angioedema (HAE) is a rare, debilitating, and potentially life-threatening disease due to C1-inhibitor (C1-INH) deficiency with an estimated prevalence of 5,000 people in the U.S. and over 116,000 worldwide. HAE is characterized by recurrent edema, and the cutaneous attacks can be disabling, with the skin, gastrointestinal tract, and upper airways are most commonly affected. Patients are also under persistent risk of laryngeal swelling that may prove fatal if not treated in a timely manner. The disease is classified as: HAE with normal functional C1INH protein (previously known as type III HAE) or HAE due to a deficiency of C1INH protein, with the latter further distinguished either by deficiency in both concentrations and function of C1INH (type I) or by normal levels of dysfunctional C1INH (type II). Owing to its rarity and symptomatic overlap with other conditions, patients not uncommonly experience a diagnostic delay of 8 to 10 years, putting them at a higher risk of inappropriate treatment, morbidity, and mortality.

Target Audience:
HCPs including: allergists, immunologists, emergency medicine specialists, and internists; physician assistants, nurse practitioners, and pharmacists specializing in immunology; and any other HCPs who have an interest in or otherwise clinically encounter patients with HAE.

Unintended pregnancies are a public health emergency and are associated with maternal morbidity and mortality due to complications of unsafe abortion, miscarriage, preeclampsia, obstetric bleeding, and socioeconomic inequality. Over 48% of all pregnancies in the US are unintended – either unwanted or occurring earlier or later than desired – and they are most prevalent in women and girls of lower socioeconomic status and those who cohabit. Unintended pregnancies also impose significant psychosocial and economic costs. Including expenses related to births, abortions, and miscarriages, they cost the US approximately $21 billion every year.

In this online, self-learning activity:

IgA nephropathy (IgAN) is an inflammatory kidney disease with IgA deposition in the glomerular mesangium. IgAN is the most prevalent primary chronic glomerular disease worldwide. Globally, IgAN has an estimated incidence of 25 cases per one million people annually. It is more common in children and young adults than in the elderly. Among patients of all ages, the average annual prevalence of IgAN in the United States is 329 per 1 million. The epidemiology and gender distribution of IgAN vary by country and region. In North America and Europe, the prevalence is higher in men.

Target Audience:

HCPs including: nephrologists, internists, and pediatricians; physician associates, nurse practitioners, and pharmacists who practice in those areas of specialty; and those who otherwise care for or clinically encounter patients with IgAN.

In this online, self-learning activity:

Cervical dystonia is the most common focal dystonia, characterized by involuntary muscular contractions resulting in abnormal head, neck, and shoulder movements in addition to posture that can cause tremor and pain. Early-onset dystonia can begin in infancy, childhood, or adolescence, and it generally progresses from focal to generalized. Adult-onset dystonia usually affects the upper part of the body; the origin of the dystonia determines the risk of spread. Cervical dystonia may appear as torticollis, laterocollis, anterocollis, or retrocollis. It may be distinguished from nondystonic hand tremor and essential tremor by the absence of limb tremor and the manner of neck movement. However, it is more difficult to distinguish from pseudodystonias, resulting in misdiagnosis, inappropriate treatment, and treatment delay.

Activity Description:

In this online, self-learning activity:

Pyruvate kinase (PK) is an enzyme that plays a major role in a metabolic pathway integral to the production of ATP, and a deficiency in the enzyme (PKD) is one of the most common enzyme-related glycolytic defects in a pathway integral to the production of ATP. It is transmitted as an autosomal recessive trait and is caused by mutations in the PKLR gene on chromosome 1, and over one hundred eighty of these mutations have been associated with PKD. While PKD affects approximately five people of European descent per 100,000 (data in other patient populations are lacking), it is one of the more frequent causes of chronic hemolysis. Anemia arising from the condition may range from mild and fully compensated to life-threatening in severity.

Target Audience:

HCPs including: hematology; nurse practitioners, physician assistants, and pharmacists who specialize in hematology; and those with an interest in or may clinically encounter patients with PKD.

Activity Description / Statement of Need:

In this online, self-learning activity:

Hemophilia is a genetic disease caused by mutation of one of the genes for coagulation proteins leading to dangerous, uncontrolled bleeding. In hemophilia B, a mutation in the gene for factor IX (FIX) leads to an endogenous deficiency in the clotting factor. The incidence of hemophilia B is the same across race and ethnic groups, affecting approximately 1 out of every 30,000 male births.

Target Audience:

HCPs including but not limited to: hematologists, internists, and pediatricians; physician assistants, nurse practitioners, and pharmacists who practice in hematology, and other HCPs who practice in hemophilia treatment center; and any other clinicians with an interest in or who clinically encounter patients with hemophilia B.

In this online, self-learning activity:

Dravet syndrome (DS) is a rare form of early-onset epilepsy syndrome affecting between 1:16,000 and 1:46,000 and is associated with pleomorphic seizure activity, cognitive decline, motor, and behavior abnormalities. Sudden unexpected death in epilepsy is the cause of death in nearly half of the deaths in patients with DS, with the mean age of death 8.7 years old and 73% of deaths occurring before age 10. Seizures typically begin in the first year of age, with most occurring between months 5 and 8, and it is usually a prolonged, tonic-clonic (accounting for 52% of first seizures) or hemiclonic (35%) seizure. Environmental triggers or events, such as fever, acute stress, and physical exercise may precipitate seizures, and at least 85% of those who are clinically diagnosed with DS have variations in the SCN1A gene. Unfortunately, diagnosis is not uncommonly delayed until a patient 3 years of age or older, prior to which antiseizure medication selection may be suboptimal or ineffective, which may lead to seizure exacerbation, an increased risk of status epilepticus, and worse cognitive outcomes.

Sickle cell disease (SCD) is the most common monogenic blood disorder, affecting millions of people worldwide and approximately 100,000 Americans. Although it may be found in various areas of the world, SCD predominantly affects individuals of African or Hispanic heritage. It is caused by the inheritance of b-globin alleles that code for hemoglobin S, resulting in an amino acid substitution in hemoglobin’s b chain and clinical disease. Patients with SCD have impaired circulation, and lysis of the erythrocytes contributes to a chronic inflammatory response, causing severe pain and less efficient oxygen delivery. The hallmark clinical features of SCD are hemolytic anemia and painful vaso-occlusive crises (VOCs), which may lead to emergency department visits, hospitalization, and potentially fatal complications such as acute chest syndrome, stroke, or pneumonia. In one US study, 45% of deaths among people with SCD were related to cardiopulmonary causes, and VOCs alone have been shown to increase the risk of death by 50%. SCD may disrupt employment or school and is associated with a significant reduction in quality of life. This learning activity has been designed to bring HCPs’ knowledge of rationale behind treatment of SCD up to date and to enhance their competence and performance in the condition’s management.

In this online, self-learning activity:

Prostate cancer (PC) is the most common form of malignancy among men in the U.S. with close to 314,000 new cases and over 35,000 deaths from PC annually. Over the past few decades, the death rates associated with PC have declined, likely due to changes in screening practices and improved treatment options. However, the incidence of PC overall has increased in recent years, and the incidence of mPC at the time of diagnosis is on the rise, accounting for about 8% of those diagnosed. And while patients with local or regional disease have 5-year survival rates close to 100%, that number decreases to 37% for patients with metastatic disease (mPC). Mortality aside, as mPC advances, patients often experience increasing symptom burden, such as persistent fatigue and bone pain, both of which can severely impact their overall quality of life (QoL).

CME is available in many groups including:
• Disclosure and Apology Series
• Patient Safety Series
• Improving Communications in Health Care
• Key Risk Areas
• Managing a Medical Malpractice Case

Target Audience: Physicians specializing in Risk Management

In this online, self-learning activity:

Fibrodysplasia ossificans progressiva (FOP) is an ultra-rare genetic connective tissue disorder characterized by dysregulated chondrogenesis, with heterotopic ossification (HO) being the most typical feature. The global prevalence of FOP is estimated at 1.43 per million individuals, with a U.S. prevalence of 0.88 per million. FOP develops due to a mutation in the ACVR1 gene encoding the active receptor-like kinase (ALK2), with unique presenting symptoms including great toe malformations and the development of swelling in several areas of the body within the first decade of life.

All courses are about new and current imaging modalities, with a primary focus on breast imaging.

Courses fall into these groups:
• Advanced MRI Tutorials
• Automated Breast Ultrasound
• Breast MRI
• Breast Stereotactic Biopsy
• Breast Tomosynthesis (DBT)
• Breast Ultrasound
• DXA
• Liver LI-RADS
• Prostate MRI

Target Audience: Radiologists

In this online, self-learning activity: Blepharitis is a condition characterized by inflammation of the eyelids, resulting in discomfort, redness, irritation, and the appearance of dandruff-like flakes on eyelashes. Demodex blepharitis is a specific subtype of blepharitis, where blepharitis is caused by an overgrowth of Demodex mites, which are normal facial skin flora. In other forms of blepharitis, the etiology may be bacterial colonization, allergies, or seborrheic dermatitis, whereas in Demodex blepharitis, the excessive growth of Demodex folliculorum or Demodex brevis is the driver of inflammation. Research suggests that Demodex blepharitis represents three out of five cases of blepharitis.

In this online, self-learning activity:

Polycythemia vera (PV) is an uncommon hematologic malignancy belonging to BCR-ABL1-negative myeloproliferative neoplasms (MPNs), characterized by activating mutations in JAK2 that cause the proliferation of malignant hematopoietic stem and progenitor cells. PV is characterized by erythrocytosis, thrombocytosis, leukocytosis, and splenomegaly, with approximately 50% of patients presenting symptoms such as fatigue, headache, visual disturbances, and pruritus at diagnosis. Others may be asymptomatic and diagnosed incidentally through blood tests, and as the disease progresses, individuals often experience worsening symptoms along with new ones, including early satiety and inactivity. Approximately 148,000 individuals in the United States have PV; the annual incidence of PV ranges from 0.01 to 2.61 per 100,000 individuals, while its prevalence varies from 45 to 57 per 100,000. Primarily affecting older individuals, PV has an overall median age of 61 years, with less than 10% of cases occurring in those under 40 years old.

In this online, self-learning activity:

Over 64,000 people develop and close 50,000 die each year of pancreatic cancer, and by 2030, pancreatic cancer is expected to surpass colorectal and breast cancer to become the second-leading cause of cancer death. Over 90% of whom have pancreatic ductal adenocarcinoma (PDAC), and while the 5-year survival rate for patients diagnosed with localized disease is over 44%, patients with locally advanced (LAPC) or metastatic disease have a median overall survival of 12 to 14 months. Symptoms associated with pancreatic cancer are not usually evident in the early stages of the disease and may be intermittent and nonspecific, and more than half of patients have advanced disease by the time they are diagnosed.

Primary care clinicians have many functions in emergency medicine. These include providing emergency care themselves, especially in rural areas, identifying patients who require immediate referral to an emergency department, and care coordination with emergency room physicians. Learn how to improve the care of your patients with one of the emergency medicine CME/CE courses provided by Pri-Med.

In this online, self-learning activity:

Sickle cell disease (SCD) is the most common monogenic blood disorder, affecting millions of people worldwide and approximately 100,000 Americans. Although it may be found in various areas of the world, SCD predominantly affects individuals of African or Hispanic heritage. It is caused by the inheritance of b-globin alleles that code for hemoglobin S, resulting in an amino acid substitution in hemoglobin’s b chain and clinical disease. Patients with SCD have impaired circulation, and lysis of the erythrocytes contributes to a chronic inflammatory response, causing severe pain and less efficient oxygen delivery. The hallmark clinical features of SCD are hemolytic anemia and painful vaso-occlusive crises (VOCs), which may lead to emergency department (ED) visits, hospitalization, and potentially fatal complications. In one US study, 45% of deaths among people with SCD were related to cardiopulmonary causes, and VOCs alone have been shown to increase the risk of death by 50%. SCD also imposes other significant health burdens on patients: it is associated with a significant reduction in quality of life, malnutrition, the development of mental health disorders like depression and anxiety, loss of work or school days, frequent antibiotic use leading to higher rates of antimicrobial resistance, acute chest syndrome, and stroke.