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Credits: 1.0 CME / 1.0 CNE
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Expired
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Few guidelines exist for the management of surgery in hemophilia patients. In this case-based learning activity, Louis M. Aledort, MD, MACP, and Johanna McCarthy, RN, examine 3 clinical cases in which hemophilia patients undergo surgical procedures, and provide clinical discussion on the perioperative management of hemophilia A patients with no inhibitors, perioperative management of patients with inhibitors, and dosing strategies for bypassing agents.
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Credits: 0.5 CME / 0.5 CNE
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Expired
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Prophylaxis is currently considered the optimal treatment for hemophilia management. However, the treatment poses a risk for inhibitor formation, with the highest risk being present during the first 20 exposure days. In this learning activity, Leonard A. Valentino, MD, reviews emerging trends and issues relevant to the treatment of hemophilia patients without inhibitors, and the impact of prophylaxis on inhibitor development.
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Credits: 0.75 CME / 0.75 CNE
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Expired
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Pediatric hematologist Donald L. Yee, MD, offers his expert opinion on the role of prophylaxis in the management of hemophilia patients, with a focus on inhibitor risk. In explicating data from clinical studies comparing prophylaxis with on-demand treatment, Dr. Yee draws on current danger signal theories that advance the argument that low-dose prophylaxis may reduce the incidence of inhibitors. Dr. Yee also addresses the role of pharmacokinetics and the impact of factor VIII trough levels on prophylaxis efficacy, as well as dose tailoring as a cost-effective treatment strategy when designing a prophylaxis regimen.
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Credits: 1.0 CME / 1.0 CNE
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Expired
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Clinicians at hemophilia treatment centers (HTCs) need to be aware of the latest developments in hemophilia; however, HTC staff are not always able to attend congresses where current trends in treatment are discussed. In this eMonograph, several noted experts in hemophilia have collaborated to present recent evidence and findings in such areas as inhibitor development, treatment strategies, and hemophilia B.
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Credits: 0.5 CME / 0.5 CNE
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Expired
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Inhibitor development in hemophilia patients can be a multifactorial process, involving both patient- and treatment-related risk factors. A patient’s immune system also plays a key role in response to exogenous factor exposure. In this learning activity, hemophilia expert Donald L. Yee, MD, examines how the risk for inhibitor development may be decreased through early and regular factor exposure in the absence of immunologic “danger signals.”
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Credits: 1.0 CME / 1.1 CNE
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Expired
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Blood in the joint can have direct and indirect effects on joint health in hemophilia patients, with chronic synovitis and cartilage damage leading to joint destruction. In this learning activity, Angela Forsyth, PT, DPT, and Nick Zourikian, PT, discuss the importance of early intervention in hemophilia patients experiencing joint bleeding, and how, if bleeding is left unchecked, symptoms can lead to early hemophilic arthropathy.
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Credits: 0.5 CME / 0.5 CNE
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Expired
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Radiosynovectomy has been in use for the treatment of hemophilic synovitis for more than 20 years in the United States. In this learning activity, hemophilia experts James V. Luck, Jr, MD, and Mauricio Silva, MD, offer their clinical perspectives on the safe use of radiosynovectomy in hemophilia patients, including the possible causal relationship between malignancy and radiation exposure, and safe protocols for using the procedure.
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Credits: 0.75 CME / 1.0 CNE
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Expired
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Hemophilia B is the second most common form of hemophilia. In this vodcast learning activity, Meera Chitlur, MD, explains the history and prevalence of FIX deficiency and the various treatment modalities available. She also explores the possible causes for the co-manifestation of inhibitor development and allergic reactions, and the usefulness of registries in monitoring the occurrence of inhibitors in patients with hemophilia B.
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Credits: 1.0 CME / 1.0 CNE
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Expired
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Listen to expert commentary derived from the “CME NetWorkShops: Clinical Challenges in Your Hemophilia Center” Webinar series. In this CME activity, Ralph A. Gruppo, MD; Steven W. Pipe, MD; Michael Recht, MD, PhD; and Guy Young, MD, offer their insights on how hemophilia treatment center specialists can use the latest information on current research and trends to improve patient outcomes.
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Credits: 0.75 CME / 1.0 CNE
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Expired
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The advent of registry databases to aid in the collection of information on hemophilia B has helped further the understanding of FIX deficiency and inhibitors within the scientific community. In this learning activity, Meera Chitlur, MD, discusses the importance of the ISTH-SSC International FIX Inhibitor Registry, in addition to the etiology of severe reactions associated with the appearance of inhibitors in hemophilia B.
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Credits: 0.5 CME / 0.5 CNE
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Expired
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Listen to hemophilia experts James V. Luck, Jr, MD, and Mauricio Silva, MD, share their clinical perspectives on radiosynovectomy as a potentially effective and minimally invasive option for hemophilia patients with recurrent hemarthroses and synovitis. In this learning activity, Drs. Luck and Silva offer their insights on radiosynovectomy procedure, including proper technique, and the pathogenesis of hemophilic synovitis.
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Credits: 0.75 CME
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Expired
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Listen to Michael J. Paidas, MD, an expert in blood disorders, discuss the clinical challenges of managing acquired or congenital bleeding disorders during pregnancy and childbirth. As part of this activity, Dr. Paidas addresses the use of plasma fibrinogen to reduce postoperative bleeding, and presents data concerning the latest advances in point-of-care testing for early diagnosis and treatment.
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Credits: 0.5 CME / 0.7 CNE
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Expired
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The nurse coordinator serves as the link that connects hemophilia patients to other members of the hemophilia care team and extended medical community, including the patient’s primary care provider. In this learning activity, nurse coordinator Jim Munn explains the nurse coordinator’s role within the care team, addressing such issues as predicting and preventing inhibitor development when preparing patients for immune tolerance induction and surgery.
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Listen to expert commentary derived from the symposium titled “Perspectives in Hemophilia: Clinical Challenges and Current Issues in Managing Patients With Inhibitors,” which was held at the American Society of Pediatric Hematology/Oncology (ASPHO) Annual Meeting on April 8, 2010. In this CME activity, Victor S. Blanchette, MD, FRCP, Manuel D. Carcao, MD, MSc, and Amy D. Shapiro, MD, offer their insights on the clinical challenges of inhibitor development, prophylaxis with bypassing agents, the presence of stable and long-lasting venous access, and frequent infusion of factor concentrates. This presentation also addresses short- and long-term treatment objectives for hemophilia patients with inhibitors.
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Credits: 0.5 CME / 0.5 CNE
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Expired
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Physical therapy has been shown to ameliorate the orthopedic morbidity associated with hemophilia. In this vodcast learning activity, physical therapist Angela Forsyth explains how an exercise regimen can help break the cycle of acute hemarthroses in patients with hemophilia and describes the role and responsibilities of this integral member of the hemophilia care team.
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Hemophilia experts Michael Recht, MD, PhD, and Guy Young, MD, team up to provide a comprehensive overview of the use of prophylactic bypassing therapy in hemophilia patients with inhibitors. In this learning activity, Drs. Recht and Young examine the natural history of hemophilia A with inhibitors, available clotting factor products for hemophilia patients with inhibitors, recent data considering use of prophylaxis therapy for inhibitor patients, and pertinent issues to consider before initiating prophylactic bypassing therapy .
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In this podcast, we interview hemophilia experts Michael Recht, Associate Professor of Pediatrics and Medicine and Director of The Hemophilia Center at Oregon Health & Science University in Portland, Oregon, and Guy Young, Director of the Hemostasis and Thrombosis Center Children’s Hospital and Associate Professor of Pediatrics at USC Keck School of Medicine in Los Angeles, California. Drs. Recht and Young provide expert commentary on issues such as the role of prophylaxis therapy in hemophilia treatment; the benefits of prophylaxis with bypassing agents in patients with inhibitors; and an effective treatment algorithm for the initiation of prophylactic bypassing therapy.
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Credits: 0.5 CME / 0.5 CNE
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Expired
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Listen to expert commentary derived from the symposium titled “Multidisciplinary Team Care in Hemophilia: Elective Orthopedic Surgery in Patients With Inhibitors,” which was held at the National Hemophilia Foundation (NHF) Annual Meeting on October 31, 2009. In this CME activity, Prasad Mathew, MD, FAAP, and James V. Luck, Jr, MD, offer their perspective as team members of hemophilia treatment center (HTC) programs. Each clinician addresses the specific needs of hemophilia A patients with inhibitors who elect to undergo orthopedic surgery and the challenges faced by the HTC team as a result of that decision.
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