LIJ Medical Grand Rounds Update in Internal Medicine:
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New Concept
in Neurology Expires
12/12
RONALD KANNER, MD
ABSTRACT
Advances in neurology in the last thirty-five years have revolutionized the outcomes of devastating illnesses. Strokes, multiple sclerosis, neurodegenerative illness, pain, and movement disorders have become issues now with tolerable and effective treatments in many situations. This has occurred through the clinical application of scientific advances of an ever expanding knowledge of neurobiology.
Treatments not even thought of as recently as the 1970’s are now widely available and accepted.
MARC L. GORDON, MD
RECENT RETREATS AND ADVANCES IN ALZHEIMER’S DISEASE
ABSTRACT
Currently available symptomatic
therapies for Alzheimer’s Disease target transmitter
abnormalities resulting from neuronal degeneration.
The future goal is to develop therapies that target
the underlying pathogenesis of disease and offer the
potential for slowing or arresting the course of the
disease further upstream. Putative hypotheses about
the pathogenesis of Alzheimer’s disease include
abnormal aggregation of beta-amyloid peptide,
abnormal aggregation of hyperphosphorylated tau
protein, inflammation, neuronal energy failure, and
abnormal entry of post-mitotic neurons into the cell
cycle. Recent large scale clinical trials of
erstwhile promising drugs for Alzheimer’s disease,
including several amyloid vaccines have proven to be
problematic. However, there are ongoing clinical
trials of passive immunization with monoclonal anti
–amyloid antibodies. New data from animal models
suggest that passive monoclonal anti-tau antibodies
may also be a feasible therapeutic strategy.
JEFFREY M. KATZ, MD
ABSTRACT
Classically, acute stroke therapy involves vessel recanalization by intravenous thrombolysis, and in certain cases, endovascular techniques. Neuroprotection in stroke is an evolving area of interest, but to date there is no proven modality to preserve the brain while recanalization is occurring. This talk focuses on therapeutic hypothermia, the most promising option for neuroprotection in stroke patients. Some of the data supporting its use in stroke comes from animal models of stroke and its suggested benefit in comatose survivors of cardiac arrest and post neonatal asphyxiation. Some of the Challenges to the use of hypothermia in stroke patients are then discussed, including the body’s own mechanisms of temperature control. Finally, our new IRB protocol studying therapeutic hypothermia in acute stroke patients is detailed.
OBJECTIVES:
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To be able to describe changes in neuro-imaging capabilities
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To identify at least two recent therapeutic advances in neurology
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To describe the current hypotheses of Alzheimer’s disease in pathogenesis
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To understand the rationale for future Alzheimer’s disease drug development
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To describe current data on the use of hypothermia as neuroprotection for stroke
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To understand the challenges of hypothermia in awake stroke patients
Mission of Continuing Medical Education.
The Committee For Innovations In Medical Education is committed to providing outstanding
patient care and promoting physician innovations through excellence in medical education.
To achieve this mission, the Committee affirms its support of the medical staff by
endorsing and providing a comprehensive program of continuing medical education (CME)
designed to address the identified needs of physicians and other health care professionals.
To keep physicians in the forefront of current knowledge, the CME program shall be broad
and diverse enough to provide a wide array of presentations by leading experts.
Programs will be designed to improve scientific knowledge, clinical skills and professional
concern for the interests and rights of patients.
The Committee For Innovations In Medical Education , recognizes its responsibility to utilize its
resources to contribute to the education of the profession regionally, nationally and internationally
to enhance physicians ability to practice the highest level of medicine. The CME program accomplishes
this goal by supporting departments and faculty who undertake the design and development of
CME activities that enrich the arena of professional continuing medical education. The Committee,
through its CME program, is committed to keeping abreast of, and developing, new methods of delivering
CME, as techniques for accomplishing this become available to the scientific community.
Copyright © 2007 The Committee for Innovations in Medical Education . All Rights Reserved. Designed by Summa Consulting.
Statement of Need:
This is an online version of selected live Medical Grand Rounds lectures, including the special series “Updates in Internal Medicine”. For those physicians, physician assistants and nursing staff who are unable to attend the live presentation, this presentation allows access to this lecture information for CME credit at a convenient time and in a location of their choosing. The expected outcome of this educational activity is improved knowledge and improved clinical practice for optimal clinical management of patients.
CME Course Director:
Howard Kerpen, MD, FACP
Lorber Professor of Medical Education
Albert Einstein College of Medicine
Director
Bette & Jerome Lorber Center for the Advancement of Medical Education
Long Island Jewish Medical Center
CME Content Reviewer:
Harry Steinberg, MD, FACP
Executive Vice Chairman of Medicine –Dept of Medicine
Edward Meilman Professor of Clinical Medicine
Albert Einstein College of Medicine
Target Audience:
This activity has been developed for physicians, physician assistants and nursing staff in the community who cannot attend the weekly live Medical Grand Rounds regularly scheduled series.
Educational Goal:
The goal of this activity is to provide physicians in the community with the most up-to-date information based on the latest research and practices available for the purpose of improving the diagnosis and treament of their patients. The ultimate goal is to improve clinical practice of the participating physicians, physician assistants and nursing staff to insure optimal patient management and outcomes.
Learning Objectives:
These CME activiites are designed to improve patient care. After participating in these activities, the participant should be able to:
1. Improve awareness of certain disease states so that timely dianoses can be made, and appropriate therapies/interventions can be initiated in order to improve quality of life.
2. Improve knowledge of latest techniques, emerging therapies, and the underlying basic science in order to determine the best course of treatment for patients.
3. Improve management of diseases so that patients can have resolution of signs and symptoms of their disease with improved clinical outcomes.
Accreditation:
North Shore-Long Island Jewish Health System is accredited by the Accreditation Council for Continuing Medical Education to provide Continuing Medical Education to physicians.
Credit Designation:
The North Shore-Long Island Jewish Health System designates the Continuing Medical Education activity for a maximum of 1 AMA PRA™ Category 1 credit. Physicians, physician assistants and nursing staff should only claim credit commensurate with the extent of their participation in the activity.
Method of Physician Participation
After participants complete the presentation, they are asked to take post-test and demonstrate that they participated in the program. A passing grade is required in order to received CME credit for each lecture session. If participants fail the test, they will have the opportunity to retake the test until a passing grade is achieved. The post-test and evaluation of the program will be the mechanism by which participants receive CME credit. Each session is reviewed by a faculty presenter who will provide and/or review the objectives and post-test for each session. The software program automatically grades the tests. After passing the test, participants will be able to pring a page verifying the successful completion of the lecture session.
This online erion of the RSS will benefit the following:
11. Physicians, physician assistants and nursing staff who were unable to attend the live RSS to gain the same educational experience.
2. Physicians, physician assistants and nursing staff who attended the live RSS will be given the opportunity to hear the presentation again in order to reinforce the information as needed (for informational purposes only)
To receive credit, the articpant must:
1. Access the designated website ((www.medfoundation.org)
2. Review the required text and information specific to the lecture session
3. Complete the presentation, in the order in which it was presented
4. Complete the post-test for the session
5. Complete a program evaluation for the session
6. Print a successful completion page
Estimated Time to Complete Activity:
The activity will take place during the academic year 2010-2011 and should take approximately 1 hour per lecture to complete.
System Requirements:
The hardware requirement for this program is any computer with internet access
The software requirement is Windows Media Player (or similar)
Disclosure Policy:
North Shore-Long Island Jewish Health System adheres to the ACCME’s New Standards for Commercial Support. Any individuals in a position to control the content of a CME activity, including faculty, planners and managers, are required to disclose all financial relationships with commercial interests. All identified potential conflicts of interest are thoroughly vetted by North Shore-Long Island Jewish for fair balance and scientific objectivity and to ensure appropriateness of patient care recommendations.
Disclosures:
Faculty:
• Howard Kerpen, MD has nothing to disclose
• Harry Steinberg, MD has nothing to disclose
Planners and Managers:
• Betty Kerpen has nothing to disclose
Provider Contact Information:
If there are any questions with respect to this activity, please contact North Shore-Long Island Jewish Health Sytem Office of Continuing Medical Education, 175 Community Drive, Great Neck, NY 11021. Phone: 516-465-2500; Fax: 516-465-8204
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