Presented by Dr. J. Thomas Cox, MD
This course will take approximately 60 minutes to complete. You may bookmark and leave this course at any time and return to finish later.

Tuition
There is no fee for this activity

Course Summary and Competency Goals
Human papillomavirus (HPV) is the cause of almost all preneoplastic and neoplastic disorders of the epithelium that lines the lower genital tract. For that reason, understanding the epidemiology and natural history of HPV is critical for all obstetrician-gynecologists, family practitioners, advanced practice clinicians, and dermatologists concerned with the general welfare of their patients, as well as pathologists who supervise residents and fellows and physicians with administrative responsibility for patients. Despite the importance of this virus in the pathogenesis of common disease, many clinicians have a limited understanding of a) the basic biology of HPV and the lesions that it induces, including genital warts and preneoplastic and neoplastic disease of the entire lower genital tract; b) the costs to society, and to the individual, of HPV infections; and c) how to appropriately counsel patients as to HPV infections or lesions, or those with HPV only found on cervical cytology or on molecular HPV testing.
This evidence-based online activity was specifically designed to improve patient care, medical knowledge, practice-based learning, systems-based practice, and interpersonal and communication skills gaps.

Learning Objectives
Upon completion of the learning activity and its post-test, participants should be able to:

•  Understand the natural history and epidemiology of HPV;
• Discuss the reasons for the high prevalence of HPV and the relatively low occurrence of detectable manifestations;
• Describe the mechanism by which HPV causes cervical and other lower genital tract cancers;
• Implement appropriate management options that best reflect an understanding of the natural history of HPV and, therefore, most likely to benefit the patient; and,
• Facilitate counseling about HPV by providing answers to common questions, such as, "Where did I get it?", "How did I get it?", "Will I always have it?", and "What can I do to get rid of it?"

Intended Audience
The Online CME lecture "The Natural History and Epidemiology of HPV" will best serve those physicians and advanced practice clinicians who will be counseling and treating men and women with genital HPV infections manifest as either lesions (genital warts or intraepithelial neoplasia) or only detected cytologically or on sensitive molecular HPV testing. It was designed to meet the CME needs of the practicing obstetrician-gynecologist, family physician, gynecologic oncologist, resident in either obstetrics/gynecology or family practice, pathologist, dermatologist, nurse practitioner, certified nurse midwife, and physician assistant.

Accreditation Statement
The American Society for Colposcopy and Cervical Pathology (ASCCP) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing medical education for physicians.

Continuing Medical Education (CME) Credit
The ASCCP designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity. Accreditation valid through 11/30/2012

ONLINE CME: Immune Response to HPV and Management of Genital Warts

Presented by Dr. J. Thomas Cox, MD
This course will take approximately 60 minutes to complete. You may bookmark and leave this course at any time and return to finish later.

Tuition
There is no fee for this activity

Course Summary and Competency Goals
Most obstetrician-gynecologists and family practitioners, as well as many dermatologists and advanced practice clinicians, treat genital human papillomavirus (HPV) lesions. However, few understand the critical role that the immune system plays in treatment outcomes. An increased understanding of the role of immunity in the successful clearance of these lesions should improve clinical management of genital warts and cervical, vaginal, vulvar, penile, and anal intraepithelial neoplasia. An important aspect of successful management of men and women with genital HPV is the ability to provide education and counseling about this virus. Optimal support of patient requires full understanding of the biology, epidemiology and natural history of HPV, and of the role of the host immune response in clearing HPV lesions. A better understanding of these issues should improve communication skills with patients, colleagues, and the public about HPV and improve decision-making in the choice of options in the treatment of HPV-induced lesions, as well as provide clinicians with a better understanding of the costs to society, and to the individual, of HPV infections. The 2006 Centers for Disease Control and Prevention (CDC) guidelines for the treatment of genital warts will be discussed within the framework of this improved understanding of the role of immunity in clearing these lesions and the sensitivity to the special needs of patients who have HPV.
This evidence-based online activity was specifically designed to improve patient care, medical knowledge, practice-based learning, and systems-based practice gaps.

Learning Objectives
Upon completion of the learning activity and its post-test, participants should be able to:

• Apply of an improved understanding the natural history of HPV and the host immune response to optimal practice, particularly as it relates to success or failure in the treatment of lower genital tract HPV disease;
• Determine the best treatment option, or the best combination of options, for men and women with genital warts;
• Utilize newer options for the treatment of genital warts such as immune response modifiers and kunecatechins; and,
• Discuss the 2006 CDC STD Guidelines for the treatment of genital warts.

Intended Audience
The target audience of the Online CME lecture entitled, "Immune Response to HPV and Management of Genital Warts" are those clinicians who diagnose and treat men and women with genital HPV disease and those clinicians who treat genital warts. This activity was designed to meet the CME needs of the practicing obstetrician-gynecologist, family physician, dermatologist, gynecologic oncologist, pathologist, obstetrics/gynecology or family medicine resident, nurse practitioner, certified nurse midwife, and physician's assistant.

Accreditation Statement
The American Society for Colposcopy and Cervical Pathology (ASCCP) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing medical education for physicians. Accreditation valid through 11/30/2012

http://www.asccp.org/cme/immune_response.shtml

ONLINE CME: Targeting Cervical Cancer with the HPV Vaccines

Presented by Alan G. Waxman, MD, MPH
This course will take approximately 60 minutes to complete. You may bookmark and leave this course at any time and return to finish later.

Tuition
There is no fee for this activity

Course Summary
A quadrivalent human papillomavirus (HPV) vaccine has been available since 2006 offering protection against HPV types 6, 11, 16, and 18. In October 2009, the U.S. Food and Drug Administration approved a second, bivalent, vaccine against HPV types 16 and 18. HPV types 16 and 18 are known to be the etiologic agent in approximately two-thirds to three-quarters of cervical cancers. These viral types are also implicated in other lower genital tract cancers. An effective vaccine therefore has the potential to prevent significant suffering and mortality worldwide.
This continuing medical education activity will review those aspects of the biology, epidemiology, and natural history of HPV that have led to the development of vaccines and directed immunization guidelines. The program will help providers identify which patients are most likely to benefit from vaccination against human papillomavirus and answer questions commonly asked by patients and their family members, colleagues and the public about the HPV vaccine. This CME activity also reviews recent efficacy studies of both HPV vaccines and examines immunization-associated adverse events reported to the FDA. Cost effectiveness of HPV vaccination is also addressed as are some frequently asked questions about the vaccines.

Competencies and Objectives
The Targeting Cervical Cancer with the HPV Vaccines program has been primarily designed to improve knowledge-based competencies, as well as performance gap patterns, as to the appropriate usages and limitations HPV vaccination. Completion of this module will prepare the participant to:

1. understand the biology, epidemiology, and natural history of human papillomavirus (HPV) that have permitted the development of vaccines and have directed immunization guidelines (medical knowledge);
2. identify patients most likely to benefit from vaccination against HPV (practice-based learning, patient care);
3. discuss the efficacy, benefits and risks associated with HPV vaccination (medical knowledge, patient care, interpersonal and communication skills); and,
4. review the cost effectiveness of HPV vaccination (medical knowledge, systems-based practice, practice-based learning).

Is this educational activity right for me?
The Targeting Cervical Cancer with the HPV Vaccines CME program will best serve those licensed physicians and advanced practice clinicians who will be counseling about and prescribing HPV vaccines. These include clinicians who make gynecologic diagnosis and management decisions or who provide clinical or consultative primary care for female adolescents and women aged 21 and older, especially clinicians in the fields of family medicine, obstetrics and gynecology, and pediatrics. Consequently, this activity has been developed for the gynecologist, family physician, gynecologic oncologist, advanced practice clinician (e.g., NP, CNM, PA-C), pathologist, pediatrician, and resident working with women and adolescents and counseling them about and prescribing HPV vaccines.

ACCME Accreditation
The American Society for Colposcopy and Cervical Pathology (ASCCP) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Continuing Medical Education Credits
The American Society for Colposcopy and Cervical Pathology designates this educational activity for a maximum of 1 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity. Accreditation valid through 12/31/2012

http://www.asccp.org/cme/hpv_vaccines.shtml

Online CME: Exploring the Spectrum of HPV-Related Disease

Target Audience: Primary care physicians, family physicians, internists, gynecologists, nurse practitioners and physician assistantsFunding Disclosure

There is no fee for this activity which is sponsored by PRIME® through an independent educational grant from QIAGEN
The Consensus Guidelines for the Management of Women with Abnormal Cervical Cancer Screening Tests were published in the American Journal of Obstetrics and Gynecology in 2007, with recent updates recommending that women age 30 and over receive an HPV test along with their routine Pap smear. Results from a study in the New England Journal of Medicine found that HPV testing has greater sensitivity for the detection of precancer and an improved reduction in the incidence of cancer than the Pap alone. This supports long-term data from a study published in the International Journal of Cancer that found women screened only with an HPV test were half as likely to develop moderate to severe cervical disease over the next six years than those who only receive conventional cytology. With the advent of new evidence and techniques for HPV testing and HPV diagnostics, practitioners can benefit from CME education that offers both case-based and application-based interactive learning on screening for HPV related disease and cancer.

Physician Accreditation Statement

Prime Education, Inc. (PRIME®) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
PRIME® designates this educational activity for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Physician Assistant Continuing Education

AAPA accepts AMA Category 1 CME CreditTM for the PRA from organizations accredited by ACCME.

Family Physician Accreditation Statement

This activity has been reviewed and is acceptable for up to 1.0 Prescribed credit(s) by the American Academy of Family Physicians. Of these credit(s) 0.5 conforms to AAFP criteria for evidence-based CME clinical content. CME credit has been increased to reflect 2 for 1 credit for only the EB CME portion. AAFP accreditation begins June 22, 2009. Term of approval is for two years from this date with option for yearly renewal. When reporting AAFP credit, report total Prescribed and Elective credit earned for this activity. It is not necessary to label credit as evidence-based CME for reporting purposes. Accreditation valid through 6/21/2011

The EB CME credit awarded for this activity was based on practice recommendations that were the most current with the strongest level of evidence available at the time this activity was approved. Since clinical research is ongoing, AAFP recommends that learners verify sources and review these and other recommendations prior to implementation into practice.

Nurse Practitioner Accreditation Statement

PRIME Education, Inc. (PRIME®) is accredited by the American Academy of Nurse Practitioners as an approved provider of nurse practitioner continuing education. Provider number: 060815. This program is accredited for 0.5 contact hour(s). Program ID# 41WB091.
This program was planned in accordance with AANP CE Standards and Policies and AANP Commercial Support Standards.

 

Online CME: FDA Approvals: Gardasil, Cervarix

News Author: Yael Waknine and Michael O'Riordan
CME Author: Yael Waknine
CME/CE Released: 10/22/2009; Valid for credit through 10/22/2010

Target Audience
This article is intended for primary care clinicians, pediatricians, obstetrician and gynecologists, cardiologists, and other specialists who care for young men and women at risk for infection with human papillomavirus, and patients aged 55 years and older at high risk for cardiovascular events who cannot tolerate treatment with angiotensin-converting enzyme inhibitors.

Goal
The goal of this activity is to provide medical news to primary care clinicians and other healthcare professionals in order to enhance patient care.
Authors and Disclosures
Learning Objectives

Upon completion of this activity, participants will be able to:

• Describe the potential benefits of a human papillomavirus quadrivalent vaccine in males aged 9-26 years.
  • Describe the potential benefits of a bivalent human papillomavirus vaccine in females aged 10-25 years.

Credits Available

Physicians - maximum of 0.25 AMA PRA Category 1 Credit(s)™
Family Physicians - maximum of 0.25 AAFP Prescribed credit(s)
Pharmacists - 0.25 knowledge-based ACPE (0.025 CEUs)
All other healthcare professionals completing continuing education credit for this activity will be issued a certificate of participation.
Physicians should only claim credit commensurate with the extent of their participation in the activity.

http://cme.medscape.com/viewarticle/711143?src=cmenews&uac=113202DR

 

Clinical Controversies and Challenges in HPV Vaccination

Now available online

Course Chair
Kenneth A. Alexander, MD, PhD
Associate Professor of Pediatrics
Chief, Pediatric Infectious Diseases
University of Chicago

Faculty
Amanda Frisch Dempsey, MD, PhD, MPH
Assistant Professor
Department of Pediatrics and Communicable Diseases
University of Michigan

Overview
Human papillomavirus (HPV) is responsible for nearly 100% of cervical cancers, a large proportion of genital warts, and a variety of other cancers. Two vaccines for HPV are available, each with exceptional efficacy and safety profiles. This monograph reviews available vaccines, their Food and Drug Administration-approved indications, and the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices recommendations regarding vaccine administration. The rationale for immunizing males against HPV will be presented. The vaccine efficacy in males and the cost-effectiveness for immunizing males will be evaluated. Finally, barriers to achieving optimal HPV immunization rates in adolescents and strategies for overcoming these barriers will be discussed.

Target Audience
The target audience for this activity is pediatricians, pediatric nurse practitioners, and other health care professionals involved in the treatment of pediatric patients.

Learning Objectives
After reviewing the materials, participants should be able to:

• Describe the compositions and indications of the 2 available HPV vaccines.
• Evaluate current clinical data regarding HPV vaccination of males and the controversy surrounding HPV immunization of this population.
• Discuss the risks and benefits of immunizing pre-teens vs. older teenagers.
• Implement office-based strategies to optimize HPV immunization rates.

Disclaimer
This continuing medical education activity is jointly sponsored by Infectious Diseases in Children and Vindico Medical Education. This activity is supported by an educational grant from Merck.
This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Vindico Medical Education and Infectious Diseases in Children. Vindico Medical Education is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
Vindico Medical Education designates this educational activity for a maximum of 1.25 AMA PRA Category 1 Credits™,  Physicians should only claim credit commensurate with the extent of their participation in the activity.

This enduring material is approved for 1 year from the date of original release. March 2010 to March
2011

http://www.pediatricsupersite.com/cmecenter/pedss/payment/rid/63293/
 

HPV Disease Burden It’s Not Just About the Cervix

Now available online

Course Chair
Kenneth A. Alexander, MD, PhD

Tuition:
There is no course fee for this activity.

Human papillomaviruses (HPVs) are associated with a significant disease burden in both males and females. Prevention of HPV-associated cancers through screening for precancers helps to reduce the burden of HPV-associated malignancies. However, for many HPV-associated cancers, there are no established screening programs. Prevention of HPV infection through vaccination may also help to reduce the burden. This monograph will review the disease burden associated with HPV and issues surrounding screening for some of these diseases. The efficacy, safety, and cost effectiveness of the 2 available HPV vaccines will be discussed, along with effective strategies for communicating with parents and adolescents who are reluctant to receive the HPV vaccine.

Learning Objectives
After reviewing the material, the participant should be able to:

• Describe the epidemiology of HPV infection in the head, neck, and anogenital tract, and the implications for cancer risk.
• Discuss the public health implications of HPV vaccination of both males and females, including predicted cost-effectiveness and disease burden.
• Plan communication strategies to anticipate and dispel myths about HPV vaccination and influence parents and patients to improve vaccination rates.
• Summarize current evidence concerning the safety and efficacy of HPV vaccination in both males and females.

Target Audience:
This activity was developed for pediatricians, pediatric nurse practitioners, and other healthcare professionals involved in the treatment, management, and prevention of HPV in the adolescent patient.

Disclaimer
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Vindico Medical Education and Infectious Diseases in Children. Vindico Medical Education is accredited by the ACCME to provide continuing medical education for physicians. Vindico Medical Education takes responsibility for the content, quality and scientific integrity of this CME activity.
Vindico Medical Education designates this educational activity for a maximum of 1.50 AMA PRA Category 1 Credits(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
This enduring material is approved for 1 year from the date of original release. August  2010

http://cme.medscape.com/viewarticle/723161