ScientiaCME Free CME Courses

Acromegaly is an endocrine disorder characterized by dysregulated hypersecretion of growth hormone (GH), usually caused by a GH-secreting, pituitary adenoma and leading to an overproduction of insulin-like growth factor 1 (IGF-1). Estimated to have a prevalence of 2.8 to 13.7 cases per 100,000, acromegaly is not as common as other endocrine disorders. However, its incidence is increasing, and it has a significant impact on patient quality of life, with clinical features that include: acral enlargement; facial feature and oral changes; headache; significant fatigue, including daytime sleepiness; hyperhidrosis; oily and thicker skin; weight gain; and arthralgia. Approximately 25 percent of people with acromegaly have elevated blood pressure, and 50 percent have evidence of insulin resistance, putting them at risk of developing type 2 diabetes in future. The mortality rates of acromegaly patients are three times higher than the general population, with most dying from respiratory or cardiac complications.

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Renal cell carcinoma (RCC) is a cancer that develops in the nephrons. It is responsible for most cancers of the kidney and renal pelvis, which occur in close to 82,000 people and account for over 14,000 deaths in the U.S. annually. The five-year survival rate is 93% for patients with early stages of the disease. However, in patients with advanced or metastatic disease, the five-year survival is 17%, representing an area of ongoing clinical need.

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Nasopharyngeal carcinoma (NPC) is a rare form of head and neck cancer, with 133,000-176,000 new cases diagnosed worldwide each year. Although relatively uncommon in the United States with an age-standardized incidence rate of 0.41 per 100,000 population, NPC is endemic to certain geographic regions, such as southern China, Southeast Asia, and North Africa. Several risk factors for NPC have been identified, including consumption of salted fish, alcohol use, wood dust exposure, and plasma Epstein–Barr virus positivity.

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.

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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.

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.

Activity Description / Statement of Need:
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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.

Activity Description:

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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.

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Over the past few decades, cultural competence has been defined in a variety of ways, including in the recent appearance of the closely related terms, cultural humility and cultural competemility. According to the Centers for Disease Control and Prevention, cultural competence is a “set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enables effective work in cross-cultural situations.” In the setting of healthcare, practicing cultural competence can improve the ability of HCPs to meet the social, cultural, and linguistic needs of patients, which may ultimately improve provider competence and health outcomes among diverse groups of patients with unique sociocultural identities, including race, ethnicity, gender, and sexual orientation.

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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.