ScientiaCME Free CME Courses

Activity Description / Statement of Need:

In this online, self-learning activity:

Mucopolysaccharidoses (MPS) are a group of genetic diseases characterized by a deficiency of lysosomal enzymes responsible for the hydrolysis of glycosaminoglycans (GAGs), resulting in a variety of clinical manifestations in patients presenting with MPS. MPS has several subcategories, and MPS type I (MPS I) arises from the inheritance of an alteration in the IDUA gene, which encodes for alpha-L-iduronidase. Affecting an estimated one in 100,000 live births, MPS I is categorized as either attenuated MPS I (also known as Scheie or Hurler-Scheie syndromes) or severe MPS I with cognitive impairment (also known as Hurler syndrome).

Progressive in nature, MPS I is associated with multi-organ complications and sequelae. Patients exhibit a spectrum of clinical presentations, including facial deformities, organomegaly, cognitive impairments, upper airway obstructions, skeletal deformities, and cardiomyopathy. The burden of MPS I is considerable, with reports of caregivers contributing 51 hours per week on average to help patients perform daily activities of living. Quality of life for patients and their caregivers is significantly reduced with MPS I, affecting the social, emotional, and financial well-being of a family. It is reported that parents fear for their child’s delayed language acquisition, ability to fit in amongst peers and the society, fear of the expense for the necessary care, and fear for the death of a child from obstructive sleep apnea.

This learning activity has been designed to bring HCPs’ knowledge of the strategies for treatment and management of MPS I up to date and to improve their competence and performance in treating it.

Target Audience:

The following HCPs: Pediatricians, neurologists, endocrinologists, genetic disease specialists; physician assistants, nurse practitioners, and pharmacists in the aforementioned areas of specialty; and any other HCPs with an interest in or who may clinically encounter patients with MPS I.

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.

Activity Description / Statement of Need:

In this online, self-learning activity:

Osteoporosis is a disease common among elderly patients and is increasing in frequency as senior citizens begin to represent a larger share of the US population. In the US, fragility fractures are associated with 1.7 million hospitalizations, and the number of annual of osteoporotic fractures is expected to rise to three million annually in the next few years, with annual treatment costs expected to be $25.3 billion. Despite the morbidity and mortality associated with osteoporosis, practice gaps related to suboptimal screening, risk assessment, and management practices have led to underdiagnosis and undertreatment of this condition. Osteoporosis screening may identify people at increased risk of low-trauma fracture who may benefit from interventions to minimize risk. The USPSTF recommends screening for osteoporosis with BMD testing in all women 65 years or older and in postmenopausal women younger than 65 years but at increased risk of osteoporosis. However, the literature has consistently illustrated underutilization of screening and diagnostic measures. About 60% of women for whom the USPSTF recommends screening do not receive BMD testing,  with some patient populations more likely than others to miss out on screening and care. Clinicians should be aware that prior fragility fracture is sufficient for diagnosis of osteoporosis, and yet only one-quarter of patients with a prior fragility fracture were aware they had this condition. Underdiagnosis therefore represents a compelling safety consideration, as 20% of patients become dependent on long-term care after a hip fracture, and 20% die within a year from related complications.

Target Audience:

HCPs specializing in: endocrinology, internal medicine, geriatrics, and women’s health; physician assistants, nurse practitioners, and pharmacists who practice in those areas of specialty; and those who otherwise commonly care for or clinically encounter patients with postmenopausal osteoporosis.

Activity Description / Statement of Need:

In this online, self-learning activity:

Diabetes mellitus is a group of metabolic diseases characterized by chronic hyperglycemia resulting from defects in insulin secretion, insulin action, or both. While there are many complications resulting from this disease, this CME proposal focuses on treating diabetic foot ulcers that occur in the setting of peripheral neuropathy. Diabetic foot complications are the most common cause of non-traumatic foot injuries leading to amputation, and are also the most frequent reason for hospitalization in patients with diabetes in the United States Diabetic wound care treatments are varied with mixed results, and all current methods require some degree of medium to long-term follow-up and management by an interdisciplinary team which is costly and a significant burden to both the patients and the healthcare system as a whole.

A single treatment with an ultrasonic probe has demonstrated a high rate of complete healing with low recurrence and complication rates. Using these types of devices are relatively inexpensive when compared to more extensive and complex wound care regimens and are easily learned by those experienced in managing this condition. The treatment of diabetic foot ulcers with ultrasonic probes is an evolving standard of care and is becoming an alternative to traditional treatments. This treatment involves fragmenting, emulsifying, and removing thickened scar tissue beneath the wound crater, as well as removing osseous prominences to decrease pressure on the wound bed and promote healing.

There have been recent developments in the available treatments for diabetic foot ulcers. Communicating related information to HCPs, including recent guideline updates, is a demonstrated need.

Target Audience:

The following HCPs who specialize in diabetic care: Endocrinologists, podiatrists, foot and ankle surgeons, primary care physicians, physician assistants, nurse practitioners, and wound care RNs.

Activity Description / Statement of Need:

In this online, self-learning activity:

Atopic dermatitis (AD) is a chronic, highly pruritic inflammatory skin disease that is one of the most common skin disorders in children but may develop at any age. It affects 15-30% of children and two to ten percent of adults in developed countries, and between 10-30% of children who have the condition continue to experience it in adulthood. AD is thought to arise from a complicated interplay between multiple genes and environmental triggers, with known risk factors including family history and loss of function mutations in filaggrin. Complications include food allergy, asthma, and allergic rhinitis, and aside from genetics, its pathophysiology involves T-cell mediated inflammation and epidermal dysfunction. The disease is associated with a considerable healthcare burden placed on patients and their families; pruritis aside, patients not uncommonly suffer a loss of sleep and experience secondary infections, anxiety, and depression.

Target Audience:

The following HCPs: Pediatric and adult dermatologists, allergists, and internists; physician assistants, nurse practitioners, and pharmacists who treat patients with dermatologic conditions; and any other HCPs with an interest in or who diagnose, treat, or manage patients with AD.

Activity Description / Statement of Need:

In this online, self-learning activity:

Insomnia is characterized by the dissatisfaction of sleep quality or quantity characterized by having difficulty falling asleep, staying asleep, waking too early, or a combination of these. It is the most common general complaint in medical practice, and it is designated chronic if the condition persists for three months, despite the opportunity for sleep or eradication of external stimulus.Insomnia affects people of all ages, though the likelihood of developing insomnia increases with age: one-third of the adult population reports having been affected by at least one symptom of insomnia. Several factors may contribute to the condition. Poor sleep may develop spontaneously, be influenced by genetics, occur in response to stress or other psychological triggers, arise due to endogenous neurochemical dysregulation, or a combination of any of those factors. Insomnia puts patients at a higher risk of developing mood disorders such as anxiety and depression, and cardiovascular disease. The condition is liable for patients spending $2,000 per year and the U.S. $63 billion annually, encompassing the cost of reduced productivity – including absences, work-related accidents, and health care resources.

Target Audience:

The following HCPs: neurologists, psychiatrists, sleep medicine specialists, and primary care physicians; physician assistants, nurse practitioners, and pharmacists who practice in the aforementioned areas of specialty; and those who otherwise have an interest in or commonly care for or clinically encounter patients with chronic insomnia.

Activity Description / Statement of Need:

In this online, self-learning activity:

Multiple myeloma (MM) is a hematologic malignancy of the lymphocytes, and while the true cause is unknown, associated factors are thought to include: radiation, genetics, viral infections, and the human immunodeficiency virus. Myeloma is most common of the hematologic malignancies after non-Hodgkin lymphoma, with an incidence of over 34,000 and an annual mortality rate of over 12,000. The peak incidence age of MM is at about 70 years of age, and the disease occurs twice as commonly in African Americans as it does in whites.

Goals of care in MM are prolonging survival rates and improving quality of life, and treatment begins with induction and post-induction therapy, followed by hematopoietic stem cell transplant or maintenance therapy in patients ineligible for transplant. Relapse is indicated by any of several clinical signs, including new soft tissue plasmacytomas, hypercalcemia, renal insufficiency, anemia, new bone lesions, or hyperviscosity related to serum paraprotein.

Target Audience:

Hematologists and oncologists; 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 RRMM.

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.

Each year, more than 290,000 cases of breast cancer are diagnosed, making it the leading cause of cancer among females in the United States. Although earlier screening and more effective treatment options have improved outcomes among people with breast cancer, more than 43,000 people die from this type of cancer each year. Throughout the course of breast cancer management, bone health remains an important consideration. In early breast cancer, chemotherapy-induced ovarian failure and endocrine therapy can contribute to BMD loss and subsequent osteoporosis and fracture. In advanced breast cancer, about 70% of all patients will experience bone metastases, placing patients at risk for SREs. In fact, breast cancer is associated with the highest risk of SREs among all tumor types.

Maintaining bone health in patients with breast cancer requires routine monitoring and proactive management to minimize the risk of BMD loss, osteoporosis, and SREs. Guidelines therefore recommend that patients with non-metastatic breast cancer initiating aromatase inhibitors or other treatment that causes bone loss undergo dual-energy X-ray absorptiometry (DXA) scans to assess baseline BMD. Furthermore, patients at risk for osteoporosis should receive regular follow-up DXA scans to monitor for BMD loss. This represents an opportunity for ongoing education about the need for monitoring to ensure maintenance of optimal bone health.

Acne is one of the most common skin conditions treated by physicians, affecting 40 to 50 million people in the U.S. Although the disease can affect patients at any age, acne occurs most commonly during the adolescent years, with a prevalence as high as 85%. In 20% of cases, the acne is severe, resulting in permanent physical scarring as well as a mental health burden. That burden may include increased prevalence of mood disorders, psychiatric hospitalizations, school absenteeism, unemployment, and suicidality.

Acne is a multifactorial inflammatory disease affecting the hair follicles of the skin. While an understanding of acne pathogenesis is one that is continuously evolving, key pathogenic factors include follicular hyper-keratinization, microbial colonization, sebum production, and complex immune and inflammatory mechanisms. Other research suggests that neuroendocrine regulatory mechanisms, diet, and genetic and factors all may contribute to the multifactorial process of acne pathogenesis. Professional guidelines for the treatment of acne vulgaris in adolescents and adults highlight the roles of topical and systemic pharmacotherapies as well as non-pharmacologic treatment modalities, including lasers and photodynamic therapy. However, in the time since the guidelines were published, newer medications have been approved or entered late stage clinical investigation. Communicating related information to HCPs in a timely manner is a demonstrated need.