Free Pulmonology CME

Target Audience: Physicians specializing in Cardiology, Chest Medicine, Family Medicine, Internal Medicine.

In this online CME self-learning program: Systemic sclerosis (SSc) is a rare connective tissue disease that affects between eight and 56 people per million per year and up to 341 people per million total in the U.S., of whom around 70% will experience interstitial lung disease (ILD). The disease is characterized by a progressive course of scarring to the blood vessels underlying the skin, connective tissue, joints, and organs. The pathology of SSc remains to be fully elucidated, but different immunologic and genetic pathways have been explored as potential precipitating factors for SSc. Based on what is known, SSc-ILD may be summarized into three steps: 1) continuous injury to endothelial cells, 2) activation of innate and adaptive immunity, 3) recruitment and activation of fibroblasts. Early diagnosis is crucial for preservation and survival of major organs. Lung fibrosis is considered irreversible, and if the disease has progressed far beyond repair, lung transplantation is considered. Therefore, early detection is paramount in order for patients to preserve their lung function.

Target Audience:

The following HCPs: pulmonologists, rheumatologists, radiologists, primary care physicians, dermatologists; physician assistants, nurse practitioners, nurses, and pharmacists specializing in pulmonology; and any other HCPs who have an interest in or otherwise clinically encounter patients with SSc-ILD.

By the end of the session the participant will be able to:

• Define the clinical features of systemic sclerosis
• Discuss current understanding of the biology of systemic sclerosis
• Define clinical phenotypes of systemic sclerosis
• Explore pulmonary manifestations of systemic sclerosis
• Understand the approach to diagnosis of systemic sclerosis interstitial lung disease and other pulmonary manifestations
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Cystic Fibrosis (CF) is a genetic disease that affects nearly 70,000 people worldwide with more than 90% of patients diagnosed of Caucasian descent and a median lifetime survival remains a mere 43.6 years. CF is caused by an autosomal recessive mutation in the CF transmembrane regulator (CFTR) gene, which controls the other chloride and sodium channels at the cell surface and is found in the lungs, liver, pancreas, intestine, sweat duct, and epididymis. The primary organs in which the disease manifests clinically are the pancreas, leading to malabsorption of nutrients, and the lungs due to the accumulation of thick, sticky mucous that contributes to airway obstruction. CF causes several clinical complications, including recurrent pulmonary infections, nasal polyps, CF-related diabetes, fat-soluble vitamin deficiencies, acid reflux, and liver failure.

Target Audience:

The following HCPs: pulmonologists, pediatricians, gastroenterologists and primary care physicians; physician assistants, nurse practitioners, nurses, and pharmacists who practice in the aforementioned areas of specialty; and any other healthcare professionals with an interest in or who clinically encounter patients with CF.

By the end of the session the participant will be able to:

• Describe the pathophysiology of CF such that it might inform treatment mechanisms.
• Identify the currently available and emerging pharmacotherapeutic treatments for the management of CF and apply them to patient cases using evidence-based medicine.
• Describe newly approved and investigational therapies in development for CF.
• Evaluate an ongoing treatment plan for a specific patient with CF to optimize safety and efficacy, suggesting modifications for improvement, including the management of complications.

Alpha 1-antitrypsin deficiency (AATD), characterized by low serum levels of the serine protease inhibitor alpha-1 antitrypsin (AAT), is a genetic disorder resulting in destruction of lung structures. Reduced levels of AAT result in overactivity of neutrophil elastase, which destroys connective tissue within the lung and causes degradation of alveoli, reduced pulmonary elastic recoil, and airflow. Breakdown of the alveoli eventually manifest as emphysema or other forms of chronic lung disease, including chronic obstructive lung disease (COPD). Other complications associated with AATD include liver disease, panniculitis, and vasculitis. The most common cause of death in patients with severe AATD is respiratory failure, which accounts for 45 to 72% of deaths. Smoking, occupational hazards such as firefighting, and high levels of cumulative exposure to pollution accelerate the rate of lung function decline in people with AATD. AATD is estimated to affect one out of every 2,000 to 5,000 individuals, mainly of North European or Iberian ancestry, with a global prevalence of over 3.4 million affected individuals.

Target Audience:

The following healthcare professionals: pulmonologists and primary care physicians; physician assistants, nurse practitioners, nurses, and pharmacists who practice in pulmonology and internal medicine; and any other healthcare professionals with an interest in or who clinically encounter patients with AATD.

By the end of the session the participant will be able to:

• Summarize the present state of awareness of AATD among healthcare professionals and its attendant impact on patient care.
• Describe the best time to test a patient for AATD and whether to conduct a family screening.
• Apply best treatment practices to patients with AATD in various clinical scenarios.
• Describe the challenges associated with the optimal diagnosis and treatment of AATD.

Activity Description / Statement of Need:

In this online, self-learning activity:

Lung cancer is the leading cause of cancer-related death in the United States with over 235,000 new cases diagnosed and representing a quarter of all cancer deaths at a rate of 132,000 annually. While smoking contributes to 82% of lung cancer deaths, nonsmoking-related lung cancer deaths still fall in the top ten causes of cancer deaths and represents a growing proportion of cases. Non-small cell lung cancer (NSCLC) is the most common type of lung cancer diagnosed, accounting for approximately 80% of patients diagnosed. Despite clear guidance on surveillance for disease in individuals at high risk, late diagnosis is a fundamental obstacle to improving lung cancer outcomes. 55% of NSCLC cases are diagnosed after metastasis, at which point the two- and five-year survival rates are 20% and 6.1%, respectively, whereas patients diagnosed with local disease experience survival rates of 81% and 61.4%, respectively. Treatment decisions are influenced by disease stage, histology (squamous vs. non-), and the tumor’s molecular features (e.g., PD-L1, EGFR, ALK, BRAF, NTRK, ROS1), although patient factors like performance status and comorbidities should also inform the development, optimization, and personalizing of individual treatment plans. First-line therapy for patients with advanced-stage NSCLC who are anti-programmed-death 1 (PD-1) positive is immunotherapy with a targeted monoclonal antibody. Targeted therapies are also preferred over platinum-based doublets as first-line therapy in patients whose tumors have targetable genetic mutations. The care plan need take into account management of adverse events from therapy, which may result in treatment delays, increased morbidity, or contribute to treatment failure.

Target Audience:

HCPs specializing in: Oncology, pulmonology, and pathology; physician assistants, nurse practitioners, and pharmacists who practice in oncology; and any other healthcare professionals with an interest in or who clinically encounter patients with advanced NSCLC.