Needs Assessment
Rheumatoid arthritis (RA) is a common condition, with an estimated worldwide prevalence of 0.5 to 1.0% in the adult population. If left untreated, RA can be extremely disabling. Most patients require continuous treatment to retard or stop progression and to control disease flares.

In recent years, advances in diagnostic modalities and targeted therapeutics have accelerated. Experience with established therapeutics, such as the TNF inhibitors, has grown significantly, providing reassurance about the long-term safety of these agents. New drugs in this class, which potentially offer clinical advantages, such as rapid onset of action and an enduring effect, are in later stages of development.

Extended experience with additional therapeutic classes that target other key steps in the pathogenesis of RA, such as the B-cell depleting agents and costimulatory modulators, are encouraging. Novel classes of anti-RA agents are also on the horizon.

These advances have been mirrored by an evolution in imaging modalities and theories, although the clinical significance of this progress remains to be determined. In addition, advances in automation and bioinformatics have yielded insights into the pharmacogenomics and pharmacogenetics of RA, which, in turn, are translating into more targeted therapeutics and greater understanding of therapeutic failures.

As research into new product classes and combination therapies continues, there is a clear need to educate rheumatologists and nurses on the latest therapeutic and management options available in order to provide the best outcomes for their patients with RA.

Target Audience
This activity has been developed for rheumatologists, rheumatology nurses, and other allied healthcare professionals who diagnose and treat patients with RA.

Learning Objectives
Upon completion of this activity, physicians will be better able to:

• Recognize the long-term efficacy and safety of established TNF inhibitors
• Discuss the efficacy and safety implications of extended experiences with B-cell depleting agents and costimulatory modulators
• Identify emerging therapeutic approaches and agents
• Cite the potential and limitations of novel and emerging imaging concepts in RA
• Describe the potential role of pharmacogenetics and pharmacogenomics in suboptimal responses to anti-RA agents and in identifying genes that confer modest risk for RA

Accreditation
The Center for Bio-Medical Communication, Inc. (CBC) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. This CME activity was planned and produced in accordance with ACCME Essentials.

CME Credit
CBC designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Disclaimer
The opinions and recommendations expressed by faculty and other experts whose input is included in this program are their own. This enduring material is produced for educational purposes only. Use of the Center for Bio-Medical Communication, Inc. name implies review of educational format design and approach. Please review the complete prescribing information of specific drugs or combinations of drugs, including indications, contraindications, warnings, and adverse effects, before administering pharmacologic therapy to patients.

Release date: April 30, 2008
Expiration date: April 30, 2009

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Needs Assessment
According to the Consortium of Multiple Sclerosis Centers (CMSC), multiple sclerosis (MS) is an unpredictable and challenging disease to treat. The course of the disease is highly variable, but it affects patients and their families emotionally, socially, and physically. Fortunately, according to the National Multiple Sclerosis Society, hundreds of clinical trials are currently under way on therapeutic options to improve the management and outcomes of patients with MS.

The purpose of this educational activity is to address key practical issues of interest to healthcare providers who care for patients with MS. Best practices in MS management are presented by summarizing survey data collected through Volume 2 of the MS Update Series questionnaires and providing expert commentary analyzing these data. This educational report will focus on topics of importance to physicians and other healthcare providers who treat patients with MS: advances in therapy for patients with early MS, most accurate diagnostic measures, and hope for the future. Survey responses included in this issue will allow physicians to become more aware of potential gaps in their own current best practices and to learn how experts and their peers regard the same issues. The format of this activity is intended to allow rapid assimilation of the information, and to allow feedback defining additional educational needs.

Target Audience
This activity has been developed for physicians, MS nurses, and other healthcare providers who care for patients with MS.

Learning Objectives
Upon completion of this activity, clinicians will be better able to:

• Discuss the management and followup of patients with a clinically isolated syndrome (CIS) suggestive of MS
• Develop a treatment and monitoring plan for patients with relapsing-remitting MS, considering patient characteristics as well as therapeutic limitations and side effect profiles
• Discuss the role of patient age in determining aggressive versus conservative treatment of patients with probable MS
• Recommend a potential treatment algorithm for patients with probable MS and those anticipated to evolve to clinically definite MS (CDMS)

Accreditation
The Center for Bio-Medical Communication, Inc. (CBC) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. This CME activity was planned and produced in accordance with ACCME essentials.

CME Credit
CBC designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Disclaimer
The opinions and recommendations expressed by faculty and other experts whose input is included in this activity are their own. This enduring material is produced for educational purposes only. Use of the Center for Bio-Medical Communication, Inc. name implies review of educational format design and approach. Please review the complete prescribing information of specific drugs or combinations of drugs, including indications, contraindications, warnings, and adverse effects, before administering pharmacologic therapy to patients.

Note: The data presented in this issue are derived from 3 CME monographs distributed several months apart. Participation in these CME activities is ongoing; thus, the results discussed in this “Best Practices” issue represent the most current response data available.

Release date: March 21, 2008
Expiration date: March 31, 2009

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Needs Assessment
Rheumatoid arthritis (RA) is estimated to affect between 0.5% and 1.0% of the adult population worldwide. Most patients require continuous treatment to retard or stop progression and to control disease flares. In addition to direct costs, disability leads to reduced productivity and, as a result, substantial indirect costs.

It is well known that RA is characterized by a complex interplay of cellular activation through cell and cytokine networks leading to chronic synovitis and cartilage and bone destruction. Recent years have witnessed a greater understanding of these processes.

Greater insight into the pathogenesis of RA is increasingly translating into therapeutic strategies targeting various steps in the pathogenic process. Besides anti-tumor necrosis factor (TNF) and anti-interleukin (IL)-1 agents (infliximab, adalimumab, etanercept, and anakinra) whose clinical efficacy is now established, new drugs are entering the clinical treatment of RA, including blockade of B-cell activity with anti-CD20 monoclonal antibody (mAb; rituximab) and prevention of costimulatory T-cell signals (abatacept). In this respect, other targeted agents, such as the humanized TNF antagonist, certolizumab pegol, and IL-6 receptor blocker, tocilizumab, also look promising.

As research into new product classes and combination therapies continues, which in turn affects the constantly shifting treatment paradigm, there is a clear need to educate rheumatologists and nurses on the latest therapeutic and management options available in order to provide the best outcomes for their patients with RA.

Target Audience
This activity has been developed for rheumatologists, rheumatology nurses, and other allied healthcare professionals who diagnose and treat patients with RA.

Learning Objectives
Upon completion of this activity, physicians will be better able to:

• Discuss the pathophysiology of RA and the rationale for biologic therapy
• Differentiate the mechanisms of action of the biologic agents that have shown efficacy in RA
• Compare the efficacy, safety, and tolerability of conventional versus newer agents for RA
• Identify appropriate treatment options following inadequate response to methotrexate and TNF inhibitors

Accreditation
The Center for Bio-Medical Communication, Inc. (CBC) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. This CME activity was planned and produced in accordance with ACCME Essentials.

CME Credit
CBC designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Disclaimer
The opinions and recommendations expressed by faculty and other experts whose input is included in this program are their own. This enduring material is produced for educational purposes only. Use of the Center for Bio-Medical Communication, Inc. name implies review of educational format design and approach. Please review the complete prescribing information of specific drugs or combinations of drugs, including indications, contraindications, warnings, and adverse effects, before administering pharmacologic therapy to patients.

Release date: January 30, 2008
Expiration date: January 31, 2009

Click here to download the newsletter.

Needs Assessment
In the United States (US) alone, it is expected that there will be 59,940 new diagnoses of melanoma and 8110 deaths from this disease in the year 2007.1 Furthermore, the number of new diagnoses may be an underestimate since many superficial and in situ melanomas treated in the outpatient setting are not reported. Rates of melanoma are increasing more rapidly than any other tumor type in men. In women, melanoma rates are the second highest only to lung cancer. Risk factors for melanoma include family history, dysplastic nevi, and tendency to sunburn easily.

Biopsy is required to diagnose and microstage the tumor, including a measure of penetration depth (Breslow thickness) and anatomic level of skin invaded by tumor (Clark’s level). These criteria form the basis of the American Joint Committee on Cancer (AJCC) classification.² AJCC classification includes melanoma in situ (stage 0), and 5 levels of invasive disease (stages IA, IB, III, III in transit, or IV). It is estimated that between 82% and 85% of patients present with localized disease (stage I/II), 10%-13% present with regional disease (stage III), and 2%-5% present with metastatic disease (stage IV).²

Treatment for melanoma consists of excision wherever possible, with adjuvant therapy for disseminated stage IV disease and for those at high risk of recurrence.^{3, 4} Within the current AJCC staging system, there is a need to better define high-risk melanoma subgroups. Adjuvant therapy options include nodal radiation therapy, systemic therapy with interferon α2b, or a clinical trial. Several agents are being tested for patients with regionally advanced or metastatic disease (http://www.clinicaltrials.gov) including gene therapies, vaccine therapies, vascular endothelial growth factor signaling inhibitors, mammalian target of rapamycin inhibitors, multikinase inhibitors, and alkylating agents.

As researchers continue delving into new product classes and combination therapies, which in turn affect the constantly shifting treatment paradigm, there is a clear need to educate oncologists, nurses, and dermatologists on the latest therapeutic and management options available in order to provide the best outcomes for their patients with melanoma.

Target Audience
Oncologists, dermatologic oncologists, dermatologists, oncology nurses and other healthcare professionals involved in the diagnosis and treatment of patients with cutaneous melanoma.

Learning Objectives
Upon completion of this activity, physicians will be better able to:

• Identify appropriate adjuvant/systemic therapy choices based on patient characteristics, disease stage, therapeutic efficacy, and therapeutic tolerability
• Decide upon the appropriateness of immunotherapy for a given patient
• Provide details on novel agents undergoing clinical testing in melanoma
• Define the role of surgical procedures in stage III and stage IV melanoma

Accreditation
The Center for Bio-Medical Communication, Inc. (CBC) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. This CME activity was planned and produced in accordance with ACCME essentials.

CME Credit
CBC designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

This continuing nursing education activity was approved by the Oncology Nursing Society, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.

Disclaimer
The opinions and recommendations expressed by faculty and other experts whose input is included in this program are their own. This enduring material is produced for educational purposes only. Use of the Center for Bio-Medical Communication, Inc. name implies review of educational format design and approach. Please review the complete prescribing information of specific drugs or combinations of drugs, including indications, contraindications, warnings, and adverse effects, before administering pharmacologic therapy to patients.

Release date: January 2, 2008
Expiration date: January 31, 2009

Click here to download the newsletter.

Needs Assessment
The number of treatment options for patients with multiple sclerosis (MS) has expanded considerably over the last decade. Established therapies have been refined by continued clinical testing, and new medications have entered clinical practice. Despite these advances, clinicians who treat patients with relapsing-remitting MS (RRMS) still confront important challenges because some patients respond only partially to disease-modifying therapy and experience increasing physical and cognitive disability over time.

Recent clinical trials have raised issues about the importance of the timing of MS therapy in obtaining the optimal result. Evidence is emerging that early therapy may produce the best patient outcome in the long term. It is important for health care professionals who treat patients with active MS to be aware of the results of the new clinical trials, and to participate in the debates surrounding these studies.

The purpose of this activity is to provide a broad audience of US neurologists and neurology nurses with an update of clinical trial data from the 2007 ECTRIMS annual meeting on the optimal therapeutic management options for patients with MS and to explain how changes in clinical study parameters may change how and when patients initiate treatment in order to provide optimal outcomes for patients with MS.

Target Audience
This activity has been developed for physicians, MS nurses, and other healthcare providers who care for patients with MS.

Learning Objectives
Upon completion of this activity, clinicians will be better able to:

• Select patients with early evidence of MS who would benefit from therapy
• Discuss the impact of early treatment of MS on disability and quality of life
• Describe changes in the populations recruited for clinical trials on MS therapies over the last 20 years
• List key findings from recent clinical trials

Accreditation
The Center for Bio-Medical Communication, Inc. (CBC) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. This CME activity was planned and produced in accordance with ACCME essentials.

CME Credit
CBC designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Disclaimer
The opinions and recommendations expressed by faculty and other experts whose input is included in this program are their own. This enduring material is produced for educational purposes only. Use of the Center for Bio-Medical Communication, Inc. name implies review of educational format design and approach. Please review the complete prescribing information of specific drugs or combinations of drugs, including indications, contra indications, warnings, and adverse effects, before administering pharmacologic therapy to patients.

Release date: DECEMBER 31, 2007
Expiration date: DECEMBER 31, 2008

Click here to download the newsletter.

A SUMMARY OF KEY DATA PRESENTED AT:
14th European Cancer Conference
September 23-27, 2007

First World Meeting of Interdisciplinary Melanoma/Skin Cancer Centers
September 5-8 2007

Needs Assessment
In the United States (US) alone, it is expected that there will be 59,940 new diagnoses of melanoma and 8110 deaths from this disease in the year 2007.1 Furthermore, the number of new diagnoses may be an underestimate since many superficial and in situ melanomas treated in the outpatient setting are not reported. Rates of melanoma are increasing more rapidly than any other tumor type in men. In women, melanoma rates are the second highest only to lung cancer. Risk factors for melanoma include family history, dysplastic nevi, and tendency to sunburn easily. Biopsy is required to diagnose and microstage the tumor, including a measure of penetration depth (Breslow thickness) and anatomic level of skin invaded by tumor (Clark’s level). These criteria form the basis of the American Joint Committee on Cancer (AJCC) classification.2 AJCC classification includes melanoma in situ (stage 0), and 5 levels of invasive disease (stages IA, IB, III, III in transit, or IV). It is estimated that between 82%-85% of patients present with localized disease (stage I/II), 10%-13% present with regional disease (stage III), and 2%-5% present with metastatic disease (stage IV).2 Treatment for melanoma consists of excision wherever possible, with adjuvant therapy for disseminated stage IV disease and for those at high risk of recurrence.3, 4 Within the current AJCC staging system, there is a need to better define high risk melanoma subgroups. Adjuvant therapy options include nodal radiation therapy, systemic therapy with interferon alfa-2b, or a clinical trial. Several agents are being tested for patients with regionally advanced or metastatic disease (http://www.clinicaltrials.gov) including gene therapies, vaccine therapies, vascular endothelial growth factor signaling inhibitors, mammalian target of rapamycin inhibitors, multikinase inhibitors, and alkylating agents. As researchers continue delving into new product classes and combination therapies, which in turn affect the constantly shifting treatment paradigm, there is a clear need to educate oncologists, nurses, and dermatologists on the latest therapeutic and management options available in order to provide the best outcomes for their patients with melanoma.

Target Audience
This activity has been developed for oncologists, dermatologic oncologists, dermatologists, oncology nurses, and other health care professionals who diagnose and treat patients with cutaneous melanoma.

Learning Objectives
Upon completion of this activity, clinicians will be better able to:

• List recent trends in melanoma diagnosis and staging
• Provide details on prognostic biomarkers and genetic susceptibility loci
• Define the prognostic value of SLNB
• Identify changes being made to the current staging system for melanoma

Accreditation
The Center for Bio-Medical Communication, Inc. (CBC), is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. This CME activity was planned and produced in accordance with ACCME essentials.

CME Credit
CBC designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

This continuing nursing education activity was approved by the Oncology Nursing Society, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.

Disclaimer
The opinions and recommendations expressed by faculty and other experts whose input is included in this program are their own. This enduring material is produced for educational purposes only. Use of the Center for Bio-Medical Communication, Inc. name implies review of educational format design and approach. Please review the complete prescribing information of specific drugs or combinations of drugs, including indications, contraindications, warnings, and adverse effects, before administering pharmacologic therapy to patients.

Release date: October 31, 2007
Expiration date: October 31, 2008

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This CME activity is a web-based audio slide set based on an April 20, 2007 Satellite Symposium to the 21st Annual Critical Care Medicine 2007 Comprehensive Update and Board Review Course in McLean, Virginia. An addendum to the live event is also included on issues raised at the 5/10/2007 ODAC meeting.

Release date: July 30, 2007
Expiration date: July 31, 2008

Click for more information...

The purpose of this issue of the MS Update is to provide an overview of presentations at AAN 2007 on recent progress in the treatment of relapsing forms of MS. Key investigations include the outcomes of early diseasemodifying treatment and emerging options for patients with aggressive forms of RRMS.*

*All abstracts referred to in this report are available online at http://am.aan.com/scientific/abstracts.cfm

Needs Assessment
Healthcare professionals who treat patients with active MS have clinical experience with identifying symptoms and treating patients with approved immunomodulatory therapies, including interferon betas and glatiramer acetate. However, the best course of therapy to provide optimal long-term outcomes in patients with relapsing MS is yet to be confirmed. How should these relapsing patients best be managed? Is it more beneficial to treat later disease stages with aggressive therapies, or does safer, early treatment provide better outcomes? New data from the BENEFIT study support the need for identification of patients who would benefit from early treatment, and demonstrate the benefits of early treatment in these patients. Healthcare providers who treat patients with relapsing MS need to be aware of the newest data on long-term treatment of these patients in order to provide them with the best possible care. The purpose of this activity is to update a broad audience of US neurologists and neurology nurses on the newest data on treatment paradigms over time for patients with relapsing MS.

Target Audience
This activity has been developed for physicians, MS nurses, and other healthcare providers who care for patients with MS.

Learning Objectives
Upon completion of this activity, clinicians will be better able to:

• Cite new data on the benefits of early interferon beta treatment for patients at high risk of developing MS
• Describe the “therapeutic window” hypothesis on the optimal timing of therapy to minimize disability due to MS
• Identify emerging therapeutic options for patients with active RRMS despite treatment with interferon beta or glatiramer acetate
• Compare and contrast risk management strategies for emerging MS therapies associated with serious adverse events

Accreditation
The Center for Bio-Medical Communication, Inc. (CBC) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

This CME activity was planned and produced in accordance with ACCME essentials.

CME Credit
CBC designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credits^TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Disclaimer
The opinions and recommendations expressed by faculty and other experts whose input is included in this program are their own. This enduring material is produced for educational purposes only. Use of the Center for Bio-Medical Communication, Inc. name implies review of educational format design and approach. Please review the complete prescribing information of specific drugs or combinations of drugs, including indications, contraindications, warnings, and adverse effects, before administering pharmacologic therapy to patients.

Release date: June 15, 2007
Expiration date: June 30, 2008

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This report will describe strategies to improve the efficacy of established immunomodulatory therapies for the treatment of MS, discuss the rationales for these new strategies, and review the preliminary or interim data supporting these new approaches that have been presented at recent scientific congresses.

Needs Assessment
Healthcare professionals who treat patients with MS have clinical experience with existing immunomodulatory therapies for MS, including interferon betas and glatiramer acetate. However, 3 of the therapies approved for treatment of RRMS patients are in Phase III trials that, if successful, will result in a formulation change or in the availability of a higher therapeutic dose. Healthcare providers who treat patients with MS need to become familiar with the rationales for changing existing MS therapies, and to be aware of the potential advantages and disadvantages of prescribing reformulated or differently dosed therapies for their patients with MS. The purpose of this report is to describe the proposed changes to immunomodulatory therapies currently being used to treat MS, discuss the rationales for these changes, and review the preliminary or interim data presented at scientific congresses. Expert commentary assessing the potential impact of the proposed product changes will be provided.

Target Audience
This activity has been developed for physicians, MS nurses, and other healthcare providers who care for patients with MS.

Learning Objectives
Upon completion of this activity, clinicians will be better able to:

• Describe proposed changes in formulation and dosing of glatiramer acetate, interferon beta-1a subcutaneous (sc), and interferon beta-1b (sc)
• Cite the rationale for changes in formulation and dosing of existing treatments
• Summarize early data on clinical efficacy and safety of new dosing and formulations
• List the implications of changes on patient care

Accreditation
The Center for Bio-Medical Communication, Inc. (CBC) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

This CME activity was planned and produced in accordance with ACCME essentials.

CME Credit
CBC designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credits^TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Disclaimer
The opinions and recommendations expressed by faculty and other experts whose input is included in this program are their own. This enduring material is produced for educational purposes only. Use of the Center for Bio-Medical Communication, Inc. name implies review of educational format design and approach. Please review the complete prescribing information of specific drugs or combinations of drugs, including indications, contraindications, warnings, and adverse effects, before administering pharmacologic therapy to patients.

Release date: April 15, 2007
Expiration date: April 30, 2008

Click here to download the newsletter.

Providing optimum care for multiple sclerosis (MS) patients is a multifaceted process that depends on the physician’s ability to recognize and respond to changes in a patient’s condition. While academic training assists with these tasks, interaction with colleagues also provides important information. Issues of this update series, which reviewed key neurology meetings and guidelines in 2006, were read by 719 healthcare providers for patients with MS. These readers were asked about their treatment practices to create “virtual discussions” between colleagues on topics emphasized at neurology meetings in 2006 such as:

• Optimum management of first clinical events suggestive of MS
• The value of the McDonald diagnostic guidelines for clinicians
• The importance of cognitive dysfunction to MS patients
• Tactics for coping with treatment failure.

Needs Assessment
According to the Consortium of Multiple Sclerosis Centers (CMSC), MS is an unpredictable and challenging disease to treat. The course of the disease is highly variable, but it affects patients and their families emotionally, socially, and physically. Fortunately, according to the National Multiple Sclerosis Society, hundreds of experimental trials are ongoing to improve treatment for patients. The purpose of this educational activity is to address key practical issues of interest to healthcare providers who care for patients with MS by organizing and summarizing survey data on treatment of MS obtained through the MS Update Series questionnaires and to provide expert commentary analyzing these data. This educational report will focus on topics of importance to physicians and other healthcare providers who treat patients with MS: advances in therapy for patients with early MS, most accurate diagnostic measures, and hope for the future. Survey responses included in this issue will allow physicians to become more aware of their own data interpretations and to learn how experts and their peers regard the same issues. The format of this activity is intended to allow rapid assimilation of the information, and to allow feedback defining additional educational needs.

Target Audience
This activity has been developed for physicians, MS nurses, and other healthcare providers who care for patients with MS.

Learning Objectives
Upon completion of this activity, clinicians will be better able to:

• Discuss the management of patients with a clinically isolated syndrome (CIS) suggestive of MS
• Review their colleagues’ views on the McDonald guidelines
• Assess the incidence of cognitive issues in MS
• Describe the issues related to identifying and responding to treatment failure

Accreditation
The Center for Bio-Medical Communication, Inc. (CBC) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

This CME activity was planned and produced in accordance with ACCME essentials.

CME Credit
CBC designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credits^TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Disclaimer
The opinions and recommendations expressed by faculty and other experts whose input is included in this program are their own. This enduring material is produced for educational purposes only. Use of the Center for Bio-Medical Communication, Inc. name implies review of educational format design and approach. Please review the complete prescribing information of specific drugs or combinations of drugs, including indications, contraindications, warnings, and adverse effects, before administering pharmacologic therapy to patients.

Release date: January 31, 2007
Expiration date: January 31, 2008

Click here to download the newsletter.

The diagnosis of multiple sclerosis (MS), one of the major causes of neurologic-based disability in young adults, is challenging because of the heterogeneity of signs and symptoms, many of which are not specific to MS (Table 1), and because there is no single test to verify MS.1, 2 During the last 40 years, the diagnosis of MS has been aided by increasing knowledge of the natural history and pathophysiology of the disease and by technologic advances in clinical, laboratory, and radiologic testing.1, 2 This report will describe the evolution of MS diagnostic guidelines for physicians in clinical practice with a focus on guidelines for relapsing-remitting MS (RRMS), which is both the most common and the most treatable form of MS.

Needs Assessment
The diagnosis of relapsing-remitting multiple sclerosis (RRMS), the most common form of multiple sclerosis, and one of the major causes of neurologic-based disability in young adults, is challenging. The signs and symptoms are heterogeneous and similar to those for many other central nervous system (CNS) disorders, and there is no single test for detecting RRMS. During the last 40 years, the diagnosis of MS has been aided by increasing knowledge of the natural history and pathophysiology of the disease and by technologic advances in clinical, laboratory, and radiologic testing. Despite these improvements, and perhaps because of them, diagnosis of RRMS remains a complex process for many patients as it necessitates obtaining evidence of multiple attacks and multifocal white matter pathology of the CNS and ruling out conditions that mimic RRMS. The development of disease-modifying therapies has increased the importance of early diagnosis so that the risk of disease progression and development of irreversible pathology and disability may be decreased. This monograph will provide a comprehensive and up-to-date description of diagnostic guidelines for RRMS.

Target Audience
This activity has been developed for physicians, MS nurses, and other healthcare providers who care for patients with MS.

Learning Objectives
Upon completion of this activity, clinicians will be better able to:

• Review the evolution of diagnostic guidelines for MS
• Assess the new and recent information on the revised 2005 diagnostic guidelines for MS
• Cite the evidence leading to revision of the guidelines
• Utilize the new guidelines to better evaluate and diagnose patients with relapsing-remitting MS

Accreditation
The Center for Bio-Medical Communication, Inc. (CBC) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

This CME activity was planned and produced in accordance with ACCME essentials.

CME Credit
CBC designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)^TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Disclaimer
The opinions and recommendations expressed by faculty and other experts whose input is included in this program are their own. This enduring material is produced for educational purposes only. Use of the Center for Bio-Medical Communication, Inc. name implies review of educational format design and approach. Please review the complete prescribing information of specific drugs or combinations of drugs, including indications, contraindications, warnings and adverse effects before administering pharmacologic therapy to patients.

Release date: September 29, 2006
Expiration date: September 30, 2007

Click here to download the newsletter.

Multiple sclerosis (MS) is a lifelong disease that usually manifests in a patient’s early 30s.1 Current approved therapies may control but do not cure MS, and treatment may be required for decades (possibly 50 years) following diagnosis. Unfortunately, well-controlled clinical trials are not designed to study the long-term effects of therapy, so little clinical evidence is available on the long-term treatment effect of these drugs. Both physicians and patients may wonder whether an MS therapy is effective over time, and whether serious adverse events are likely to develop over time.

At the 58th American Academy of Neurology (AAN) meeting held in San Diego April 1-8, 2006, long-term data on the efficacy and safety of immunomodulatory therapies to treat MS were either newly presented or discussed in educational sessions. The purpose of this report is to review and assess the available data on long-term Immunomodulatory therapy for MS. Key presentations will be summarized, and additional viewpoints on these topics will be provided by 3 MS specialists.

Needs Assessment
Multiple sclerosis is a lifelong disease frequently affecting young adults, who may require long-term treatment to optimize or maintain their functional capabilities. Because some patients have now received immunomodulatory therapy for 16 years or more, long-term data on the efficacy and safety of MS therapies are becoming available. As these analyses are recent, much of the data is unpublished and may not be familiar to treating physicians.

Healthcare providers who treat MS patients over long periods of time can use data on the long-term consequences of Immunomodulatory therapy to help in their treatment decisions. Because not all healthcare providers who treat patients with MS were able to attend key sessions on long-term MS therapy at AAN, this educational activity is designed to further disseminate this information.

Target Audience
This activity has been developed for physicians, MS nurses, and other healthcare providers who care for patients with MS.

Learning Objectives
Upon completion of this activity, clinicians will be better able to:

• Discuss potential approaches for performing long-term studies on the efficacy of MS therapies.
• Summarize the advantages and disadvantages of registry studies and clinical trial follow-up studies.
• Review long-term data on the efficacy and safety of Immunomodulatory therapies for patients with relapsing-remitting MS (RRMS).
• Assess the strengths and weaknesses of the available long-term data on MS therapies.

Accreditation
The Center for Bio-Medical Communication, Inc. (CBC) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

This CME activity was planned and produced in accordance with ACCME essentials.

CME Credit
CBC designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)^TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Faculty
Editor-in-Chief: Barrie J. Hurwitz, MB, MRCP(UK)
Expert Commentators: Patricia Coyle, MD; Douglas R. Jeffery, MD

Disclaimer
The opinions and recommendations expressed by faculty and other experts whose input is included in this program are their own. This enduring material is produced for educational purposes only. Use of the Center for Bio-Medical Communication, Inc. name implies review of educational format design and approach. Please review the complete prescribing information of specific drugs or combinations of drugs, including indications, contraindications, warnings and adverse effects before administering pharmacologic therapy to patients.

Release date: July 28, 2006
Expiration date: August 1, 2007

Click here to download the newsletter.

Evidence-based medicine for the treatment of multiple sclerosis (MS) evaluates the balance between the efficacy and safety of individual therapies to assist physicians in optimizing patient outcome. Although efficacy is usually the central focus when analyzing clinical data, safety considerations have come to the forefront since serious adverse events and deaths have been associated with natalizumab. A recent article outlined the adverse events of disease-modifying therapies to treat MS. Furthermore, numerous presentations at the 58th meeting of the American Academy of Neurology (AAN) held in San Diego from April 1–8, 2006, focused on the safety of therapies used to treat relapsing-remitting MS (RRMS), including natalizumab.

The purpose of this report is to summarize presentations on the safety and tolerability of MS therapies from this year’s AAN meeting. Additional viewpoints on these topics will be provided by 3 MS specialists.

Needs Assessment
Multiple sclerosis is a lifelong disease most frequently affecting young adults, who may require long-term treatment to optimize their functional capabilities. Because treatment is ongoing, tolerability and safety issues are important to MS patients and their practitioners. New studies on the tolerability and safety of MS therapies were presented at the AAN in April 2006, a forum for research on neurologic diseases, including MS. This activity has been designed to disseminate the data presented at the AAN, because not all healthcare providers for MS patients were able to attend these presentations at the Congress.

Target Audience
This activity has been developed for physicians, MS nurses, and other healthcare providers who care for patients with MS.

Learning Objectives
Upon completion of this activity, clinicians will be better able to:

• Review data on the safety and tolerability of therapies for RRMS
• List strategies for managing the adverse events associated with interferon-beta therapy
• Summarize the controversy regarding the safety of natalizumab
• Discuss the need for additional clinical data on the safety and tolerability of MS therapies

Accreditation
The Center for Bio-Medical Communication, Inc. (CBC) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

This CME activity was planned and produced in accordance with ACCME essentials.

CME Credit
CBC designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)^TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Faculty
Editor-in-Chief: Barrie J. Hurwitz, MB, MRCP(UK)
Expert Commentators: Patricia Coyle, MD Douglas R. Jeffery, MD

Disclaimer
The opinions and recommendations expressed by faculty and other experts whose input is included in this program are their own. This enduring material is produced for educational purposes only. Use of the Center for Bio-Medical Communication, Inc. name implies review of educational format design and approach. Please review the complete prescribing information of specific drugs or combinations of drugs, including indications, contraindications, warnings and adverse effects before administering pharmacologic therapy to patients.

Release date: May 26, 2006
Expiration date: June 1, 2007

Click here to download the newsletter.

CME Extended through October 31, 2007

Important new data on the efficacy and tolerability of disease-modifying treatment for patients with evidence of early multiple sclerosis (MS) were recently presented at the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) meeting. The ECTRIMS meeting is the largest congress in the world that focuses entirely on MS: more than 200 talks and 600 posters on MS are presented annually. This Rapid Reporter presents selected highlights from the recent ECTRIMS meeting.

Needs Assessment
Few effective therapies are available for patients with advanced MS, but recent studies suggest that the onset of MS can be delayed by early immunomodulatory therapy. Thus, some manifestations of MS may be preventable. The data in this area are evolving rapidly, and not all of the studies have been published. For example, the BENEFIT data have only been presented at ECTRIMS 2005. Clinicians managing patients with syndromes suggestive of early MS need to be aware of the characteristics associated with development of clinically definite MS, and of recent studies examining the efficacy and tolerability of immunomodulatory therapy for patients with early MS.

Target Audience
This activity has been developed for physicians, MS nurses, and other healthcare providers who care for patients with multiple sclerosis.

Learning Objectives
Upon completion of this activity, clinicians will be better able to:

• Discuss the rationale for treating early MS patients with immunomodulatory therapy
• List diagnostic criteria for patients at high risk of MS, and for those with clinically definite MS
• Discuss the key studies on treatment of early MS
• Summarize the results of the BENEFIT trial

Accreditation
The Center for Bio-Medical Communication, Inc. (CBC) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. This CME activity was planned and produced in accordance with ACCME essentials.

CME Credit
CBC designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)^TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Disclosure
Disclosure is requested when faculty members are confirmed. This educational activity may include discussion of an unlabeled use or an investigative use not yet approved for a commercial product. Therefore, it is incumbent on individuals participating in this activity to be aware of these factors in interpreting its contents and evaluating its recommendations. Every effort has been made to encourage faculty to disclose any commercial relationships or personal benefits that may be associated with their participation in this activity. The following indicates the faculty and the nature of their commercial relationships and off-label or investigative use discussion. As part of CBC’s mechanism for resolving potential conflicts of interest, the contents of this activity have undergone peer review by an independent CME reviewer.

Barrie J. Hurwitz has received grant/research support from Berlex Laboratories. He is also a consultant for Berlex Laboratories and is on the speakers bureau for Berlex Laboratories and Serono Labs.

Patricia Coyle has received grant/research support from Berlex Laboratories and Teva. She is a consultant for Berlex, Pfizer, Serono Labs, and Teva.

Douglas Jeffery has received grant/research support from Berlex, Pelzor, Serono, and Teva. He is a consultant and scientific advisor for Berlex, Pelzor, Serono, and Teva. He is on the speakers bureau for Berlex, Pelzor, Serono, and Teva.

Fred D. Lublin has received grant/research support from Acorda, Amgen, Biogen, and Teva. He is a consultant and a scientific advisor for Bayer, Berlex, Biogen, Novartis, Pfizer, Plough, Schering, and Serono. He is on the speakers bureau for Berlex, Pfizer, Serono, and Teva.

Avertano Noronha has no commercial relationships to disclose in relation to this activity.

Off-Label Product Discussion
The following faculty members have disclosed that they will discuss unlabeled or investigative use of a commercial product: Dr. Hurwitz reports that this report discusses investigational use of interferon beta-1a (sc) and interferon beta-1b (sc) for treatment of patients with clinically isolated syndrome (CIS) suggestive of early MS.

Disclaimer
The opinions and recommendations expressed by faculty and other experts whose input is included in this program are their own. This enduring material is produced for educational purposes only. Use of the Center for Bio-Medical Communication, Inc. name implies review of educational format design and approach. Please review the complete prescribing information of specific drugs or combinations of drugs, including indications, contraindications, warnings and adverse effects before administering pharmacologic therapy to patients.

Release Date: October 19, 2005
Expiration Date: October 31, 2007

Click here to download the Newsletter.

Needs Assessment
The economic and clinical burden of candidiasis is rising due to a variety of disease- and host-related factors, including changing epidemiology of infection and emerging resistance among isolates, as well as changes in patient demographics and delays in diagnosis. Early diagnosis is an essential part of the disease management process to lessen the morbidity and mortality associated with Candida infection. Novel therapies and approaches, including echinocandins, extended-spectrum azoles, and combination regimens, are being evaluated for efficacy and safety.

Release date: February 1, 2006
Expiration date: February 28, 2007

Click here to go to this program self-study page.

This course includes five PowerPoint slide presentations from the CME-certified symposium held on the 13th November 2005 at the San Francisco Marriott.

Needs Assessment
Chronic hepatitis B (CHB) remains a global health problem, with 400 million chronically infected worldwide. Determining what constitutes best practice for patient management in chronic hepatitis B (CHB) is challenging and requires a clear understanding of current treatment strategies and the most appropriate therapeutic endpoints with which to measure clinical success. Furthermore, physicians treating patients with CHB must have a complete appreciation of the risk:benefit relationship for each therapeutic option. In recent years, the number of available treatment options for chronic hepatitis B has increased considerably. The advent of newer immune-based and/or antiviral therapies is paving the way towards improved clinical outcomes in patients with HBeAg-positive and HBeAg-negative chronic hepatitis B. However, identifying patients who will respond to therapy, rationalizing therapy choices and monitoring therapeutic endpoints for particular treatment strategies are therefore crucial for effective CHB disease management.

With new data being reported especially relating to the long-term outcomes of therapy It is important that physicians are armed with the information they need to make the best treatment choices to improve disease management and outcomes for patients with CHB.

Release date: 01 December 2005
Expiration date: 31 December 2006

Click here to go to this program self-study page.

NEEDS ASSESSMENT
In the past two decades we have seen significant strides in the management of hepatitis C. According to Centers for Disease Control and Prevention (CDC) data, during the 1980s an estimated 242,000 Americans were infected with hepatitis C (non-A, non-B hepatitis) annually. Between 1989 and 1998 the annual infection rate had dropped to 41,000 new cases. This is an 80 percent decrease in the annual infection rate. Increased public awareness of the risks and consequences of hepatitis C infection, identification of risk groups, and advances in therapy have resulted in this major impact on the prevalence of hepatitis C in the United States. The impact of improved therapy on the general HCV patient population is now bringing to light challenges in managing special patient populations. Treatment response is more difficult to obtain in some patient subpopulations than others. These include: HIV/HCV coinfected patients, African Americans, alcohol abusers, and those with genotype 1 infections. Lack of controlled HCV studies in children, women (pre- and postmenopause), and pregnancy complicate decisions on how, when, or if to treat. Added to this, most prevalence data does not include incarcerated persons, for which the HCV infection rate is extremely high (range 15 to 40 percent). The alarming prevalence in the penal system is a stark contrast to the strides made for the general population! Frequently in the Conclusions section of clinical abstracts the final line reads, “The subject needs further study.” This issue of IN-Viro™ will provide some insight into the progress made in those cases still under study.

Advisory Board:

William Carey, MD
Section Head of Hepatology
Medical Director of Liver Transplantation
Director, Cleveland Clinic Center for Continuing Education
Cleveland Clinic Center
Cleveland, Ohio

Ramsey Cheung, MD
Chief of Hepatology
VA Palo Alto Health Care System
Palo Alto, California
Associate Professor of Medicine
Stanford University
Stanford, California

Russell H.Wiesner, MD
Professor of Medicine Division of Gastroenterology and Hepatology
Mayo Clinic
Rochester, Minnesota

Target Audience: This CME study program is intended for primary care physicians, gastroenterologists, hepatologists.

CME Credit: CBC designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit(s)^TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Release Date: August 1, 2005
Expiration Date: August 31, 2006

Click here to download the Home Study Booklet.

NEEDS ASSESSMENT
Antiretroviral therapy has improved the clinical course and survival of patients with HIV infection. A variety of metabolic complications are associated with certain antiretrovirals. Insulin resistance, dyslipidemia, and fat redistribution can be major problems that predispose patients to cardiovascular disease and other complications. Clinicians who are managing patients receiving antiretroviral therapy need to recognize the potential for these metabolic derangements. Lipid-lowering therapies, insulinsensitizing agents, growth hormone, and antiretroviral regimen changes have been used to manage these disorders. This educational program will discuss how to monitor these derangements, distinguish those that cause clinically important sequelae, and prevent and manage such complications.

OBJECTIVES
Upon completion of this program, clinicians will be able to:

• Identify important metabolic abnormalities associated with antiretroviral use
• Develop a strategy to monitor antiretroviral therapy-related lipid and insulin disorders
• Understand the current therapeutic strategies available for patients with antiretroviral therapy-related metabolic disorders

TARGET AUDIENCE
Physicians who care for patients with HIV/AIDS

ACCREDITATION
The Center for Bio-Medical Communication, Inc. (CBC) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

This CME activity was planned and produced in accordance with the ACCME essentials.

CME CREDIT
CBC designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)^TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

ACKNOWLEDGEMENT
The sponsor of this program gratefully acknowledges the unrestricted educational grant received from Bristol-Myers Squibb Company in support of this activity.

Editor-in-Chief
Colleen Hadigan, MD, MPH
Harvard Medical School
Program in Nutritional Metabolism
Massachusetts General Hospital
Boston, Massachusetts

Editors
W. Michael Scheld, MD
University of Virginia
Health Sciences Center
Charlottesville, Virginia

Henry Masur, MD
George Washington University
School of Medicine
Washington, DC
Bethesda, Maryland

Richard J. Whitley, MD
University of Alabama
School of Medicine
Children’s Hospital of Alabama
Birmingham, Alabama

Release Date: 07/01/2005
Expiration date: 07/31/2006

Click here to download the Home Study Booklet.

Alzheimer disease (AD) is the most common type of dementia and one of the most devastating infirmities of old age. At present, the most successful treatment strategy for AD involves early and persistent use of cholinesterase inhibitors. Recent research, however, has led to the development of new techniques for early detection (before the onset of dementia symptoms) and the potential for earlier intervention. Of particular importance is identifying the amnestic subtype of the syndrome known as mild cognitive impairment (MCI) as a frequent precursor to AD. Increasing the recognition and monitoring of patients with MCI is likely to shorten the time from symptom onset to diagnosis and treatment of patients who progress to AD.

Recent advances offer promise for improved diagnosis and treatment of AD. Imaging technologies are now being used to visualize areas of beta-amyloid accumulation in the brain, one of the hallmarks of AD pathology, and to monitor treatment effects. Ongoing research with cholinesterase inhibitors lends support to speculation that these agents may not be purely symptomatic treatments, but may have disease-modifying properties. Finally, the burgeoning field of outcomes research is being used to identify opportunities to improve health not only for AD patients, but also for their caregivers.

This program combines clinical data and case-based learning to familiarize clinicians with the symptoms and progression of AD, techniques for screening and diagnosis, and treatment options. Areas of ongoing research and innovation are highlighted as these developments continue to advance the recognition and treatment of this common neurologic disease.

Faculty:
Howard Fillit, MD
Norman R. Relkin, MD, PhD

CME Credit: CBC designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit(s)^TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Release Date: 05/22/2005
Expiration date: 06/01/2006

Click here to download the Home Study Booklet.

This is an international, peer-reviewed journal that aims to enhance communication and discussion of the key issues affecting those active in the diagnosis, treatment, and overall care of patients with bipolar disorders. The journal seeks to inform, educate, and unify all those interested in bipolar disorder by publishing invited review-type articles that will lead to a greater appreciation and understanding of bipolar disorders, and improve patient treatment and care.

Click here to visit website (www.bipolardisorders.net).

Breast cancer is the most commonly diagnosed cancer among women and the second leading cause of cancer death. Given the prevalence and substantial pharmacoeconomic burden of this disease, there is an urgent need to improve therapeutic strategies to improve survival. A better understanding of the disease and treatment would emerge from a convergence of clinical research into potential new pharmacological agents. After listening to the audiotape and reviewing the poster panels, participants should be able to discuss the efficacy and safety of the newer endocrine agents in the treatment of early-stage breast cancer.

Faculty:
Professor Fritz Jänicke
Chairman and Head
Department of Obstetrics and Gynaecology
Universitats-Frauenklinik Eppendorf
Hamburg, Germany,

Target Audience:
Healthcare professionals who are responsible for the diagnosis and treatment of patients with breast cancer.

CME Credit:
CBC designates this activity for a maximum of 1 hour in Category 1 credit towards the AMA Physician’s Recognition Award. Each physician should claim only those hours of credit that he/she actually spent in the educational activity. The American Medical Association has determined that physicians not licensed in the United States who participate in this CME activity are eligible for AMA PRA Category 1 credit.

Release Date: October 30, 2004
Expiration Date: October 31, 2005

Supported by an unrestricted educational grant from Pfizer Inc

Click here to download the Home Study Booklet.

As a result of the findings from early clinical studies, speculation has arisen regarding the potential benefits of anticoagulant therapies including low-molecular-weight heparin (LMWH) in cancer patients with respect to their ability to prolong survival. Although patients with cancer are known to be at increased risk of developing VTE, current evidence suggests that the survival benefits seen with agents such as LMWH occur as a result of mechanisms that are independent of their antithrombotic effects. A better understanding of the suggested survival benefit with antithrombotic agents and the potential mechanisms associated with this effect are required.

After listening to the audiotape and reviewing the poster panels, participants should be able to discuss the recent evidence suggesting a survival benefit with antithrombotic agents, in particular LMWH, in cancer patients, and the potential mechanisms associated with this effect.

Faculty:
Professor Ajay Kakkar
Professor and Chairman
Centre for Surgical Sciences
Consultant Surgeon St Bartholomew’s and the London Hospitals School of Medicine
University of London
London, UK

Target Audience:
Healthcare professionals who are responsible for the diagnosis and management of cancer patients with venous thromboembolism (VTE).

CME Credit:
CBC designates this activity for a maximum of 1 hour in Category 1 credit towards the AMA Physician’s Recognition Award. Each physician should claim only those hours of credit that he/she actually spent in the educational activity. The American Medical Association has determined that physicians not licensed in the United States who participate in this CME activity are eligible for AMA PRA Category 1 credit.

Release Date: October 30, 2004
Expiration Date: October 31, 2005

Supported by an unrestricted educational grant from Pfizer Inc

Click here to download the Home Study Booklet.

With so much focus on HIV and hepatitis C infections over the past decade, hepatitis B infection (HBV) has become overshadowed as one of the world’s most dangerous and infectious diseases. It is estimated that 30 percent of the world’s population, approximately 2 billion individuals, have serologic evidence of past or present HBV infection (World Health Organization data). It is also estimated that 350 million people have chronic HBV infection and that 65 million will die of HBV-related disease. The cause of primary hepatocellular carcinoma, one of the top 10 most common cancers in the world, can be traced to HBV infection in 80 percent of cases. Only tobacco is a more potent human carcinogen!

IN-Viro™ is pleased to provide our readership with abstracts highlighting the progress to date in managing HBV infection, including conference abstracts from this year’s 55th annual AASLD meeting in Boston, Massachusetts, as well as MEDLINE abstracts.

Advisory Board:
William Carey, MD
Section Head of Hepatology
Medical Director of Liver Transplantation
Director, Cleveland Clinic Center for Continuing Education
Cleveland Clinic Center
Cleveland, Ohio

Ramsey Cheung, MD
Chief of Hepatology
VA Palo Alto Health Care System
Palo Alto, California
Associate Professor of Medicine
Stanford University
Stanford, California

Russell H.Wiesner, MD
Professor of Medicine
Division of Gastroenterology and Hepatology
Mayo Clinic
Rochester, Minnesota

Target Audience: This CME study program is intended for primary care physicians, gastroenterologists, hepatologists.

CME Credit: CBC designates this educational activity for a maximum of 1 hour in Category 1 credit towards the AMA Physician’s Recognition Award. Each physician should claim only those hours of credit that he/she actually spent in the educational activity.

Release Date: December 15, 2004
Expiration Date: December 15, 2005

CME credit cannot be awarded after the expiration date.

Click here to download the Home Study Booklet.

Neurotransmitters serve many roles and have many functions in disease etiology. This audio home study program focuses on their roles in stress urinary incontinence.

After reviewing this audio home study program, participants should be able to:

1. Explain the prevalence and impact of stress urinary incontinence
2. Define the typical patient with stress urinary incontinence
3. Understand the neurourologic component of SUI and new pharmacotherapy

Faculty:
Robert M. Guthrie, MD
Professor of Emergency Medicine, Internal Medicine, and Pharmacology
Associate Director of Clinical Pharmacology
The Ohio State University
Columbus, Ohio

Target Audience: This program is intended for primary care physicians, general practitioners, family physicians, urologists, gynecologists, and other health care providers who may treat patients with stress urinary incontinence.

CME Credit: The Center for Bio-Medical Communication, Inc. designates this educational activity for a maximum of 1.0 hour in Category 1 credit towards the AMA Physician’s Recognition Award. Each physician should claim only those hours of credit that he/she actually spent in the educational activity.

Release Date: July 28, 2004
Expiration Date: July 28, 2005

CME credit cannot be awarded after the expiration date.

Click here to download the Home Study Booklet.