Hepatitis C (HCV) is a systemic disease. Not only is HCV the one the most important causes of cirrhosis, liver cancer and indication for liver transplantation, it is also associated with a number of extra-hepatic manifestations. There is significant enthusiasm and genuine excitement about the possibility of eliminating hepatitis C. This is remarkable considering that this would be the first infection eliminating not by immunization but by antiviral therapy. The biggest barrier to curing and eventually HCV is not the costs of drugs but identifying who is infected. Diagnosis HCV infection is straightforward and based on laboratory tests. However, barriers occasionally exist for linkage of care.
The antinuclear antibody (ANA) test is the single most famous test in rheumatology; yet, it is frequently misused and misinterpreted. This talk will discuss the different ways the test is performed and interpreted, and how it can be properly applied to the diagnosis of lupus and other autoimmune diseases. The speaker will show how antinuclear antibodies can cause tissue damage and result in the clinical features of lupus. Then, learners will review the many non-rheumatic conditions, including healthy individuals, who may have a positive ANA and how we should sort them.
Everyone knows that exercise is important for general health. However, most of us are strapped for time. The goal of this presentation is to present current evidence for the health benefits of high intensity exercise training. Practical tips and updated resources will be covered, including ideas to assist you and your patients on integrating exercise into daily life.
Research and advancement increase the capability of medicine to provide complex care. Technology can keep patients alive in states that they might not desire. Today, clinicians are responsible for (1) anticipating future care needs and (2) guiding treatments as patients become more ill and less functional. An essential tool in the clinician armamentarium, advance care planning is a skill set that must be honed to ensure that patients receive care both consistent with their informed preferences and appropriate to their prognosis. Advance care planning includes serial discussion with patients about clinical circumstances and prognosis, incorporates specific tools, requires coordination among the team of clinicians caring for a patient across venues of care, and may be facilitated by advance care planning structures. Sometimes the process also requires setting limits and addressing maladaptive coping. Building strong relationships with patients and families, and a consistent focus on goals of care is key to high quality treatment for the complex patient and achieving optimal end of life care.
Irritable bowel syndrome (IBS) is the most common disorder seen and treated by gastroenterologists. Despite this, many physicians have difficulty making a definitive diagnosis and approximately 75% of the general population with IBS symptoms remains undiagnosed. Part of this stems from the fact that there are currently no diagnostic studies which conclusively confirm IBS. As such, it has been and continues to be considered a diagnosis of exclusion when in reality newer diagnostic criteria and minimal diagnostic testing can lead to a diagnosis with 98-99% accuracy. A better understanding of the underlying pathophysiology of this disorder has also let to more accurate treatment strategies. In this discussion we will dispel many of the myths and misconceptions surrounding this syndrome.
Experts in psychiatry and psychology have long believed that our personalities are essentially set from early childhood and remain consistent throughout life. However, new compelling evidence indicates that we can change our personalities - either on our own, with the help of a therapist, or a combination of the two - and meaningful personality change can be achieved as quickly as 30 days. The ability of someone to change their personality can have an impact on their lives. Numerous studies indicate that personality traits influence our relationships, career success, health outcomes, and even life expectancy. This presentation will review scientific evidence and practical strategies on how personality can change and impact outcomes.
When is a nosebleed not a normal nosebleed? How much menstrual bleeding is too much? Hemophilia is the best-known bleeding disorder and perhaps the most severe, but there are other milder diseases like von Willebrand disease that are much more common. What are the common myths and perceptions about children with disorders of coagulation? What does the general pediatrician need to know about bleeding disorders? The speaker will cover the basics of identifying children with abnormal bleeding and managing their conditions effectively.
This talk will update listeners on the current DSM-5 guideline-based revisions in diagnostic criteria for eating and feeding disorders. It will cover common presentations for eating disorders in children, adolescents, and young adults as well as practical tips for screening, assessing, and discussing the diagnoses with patients and their families. Participants will walk away with heightened awareness and greater confidence in identifying the possibility or probability of an eating disorder and initiating a proper referral. Because eating disorders are vastly underdiagnosed, it is important to understand that initial presentations may occur in a variety of medical settings, ranging from primary care, to the emergency department, and to the office of the subspecialist.
Vaginitis is one of the most common gynecologic problems seen in ambulatory practice. Join us in discussing the differential diagnosis, which includes not only a vaginal infection, but also cervicitis, a physiologic discharge, atrophic vaginitis, and iatrogenic vaginitis. A precise diagnosis can be achieved with a careful history, focused examination, and skilled use of the office laboratory. This talk will pave the way to an accurate diagnosis, after which, effective therapy can be prescribed.
Acute low back pain is a common reason for a patient to visit their primary care provider. Most back symptoms are usually self-limited. History and physical examination typically provide clues to the rare, but potentially serious causes of low back pain. The differential diagnosis will be explored and appropriate use of diagnostic testing, including x-rays, will be discussed. Participants will review current recommendations and treatment algorithms, and learn when it is appropriate to consider specialty referral.
Failure to prescribe anticoagulation to prevent stroke in high-risk atrial fibrillation (AF) patients is a persistent and pervasive problem. Despite a multitude of evidence-based clinical practice guidelines, and five effective oral anticoagulants for stroke prevention, at least 30% of these patients remain unprotected. This talk will focus on understanding the root causes of the failure to prevent stroke crisis. The role of antithrombotic therapy, in particular direct oral anticoagulants, will be reviewed. Strategies for implementation of best practices for stoke prevention in AF will be highlighted.
In the United States, over six million children have asthma and over 130,000 children are hospitalized yearly due to asthma exacerbations. Children with difficult-to-treat and/or severe asthma have the highest morbidity and mortality. In addition to ensuring assessment and management per existing guidelines, there is a need for more precise and personalized approaches to asthma management for these patients. This includes identification of phenotypes and tailoring medication choice based on underlying pathophysiology. This talk will address the fundamentals of identifying difficult-to-treat and severe asthma patients and outline steps to create a comprehensive asthma assessment and management plan.