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Online Textbook: Allergic and Non-Allergic Sinusitis for the Primary Care Physician: Pathophysiology, Evaluation and Treatment

This online book is provided free to web users concerned with sinonasal disorders. IT IS ALSO NOW AVAILABLE FOR CME CREDITS for physicians as outlined below. Links for access, testing and payment ($50), and more are below. Chapters are presented in Adobe .pdf format and contain diagrams and much more information.

This book is not published in bookstores and cannot be copied, reproduced nor sent without express written authorization by at least one of the authors.

CME CREDIT OPPORTUNITIES

Primary Care Physicians can obtain CME credits by using this online book, through Medical Education Resources, Inc.(MER).

Following is pertinent information regarding requirements, timeframes, contacts and procedures to obtain 11 AMA PRA Category 1 creditsTM> between September 2010 and September 1 2012. Note that that the book is presented in Adobe .pdf format and contains discussion questions, diagrams and much more information that, again, cannot be copied, reproduced nor sent without express written authorization of the authors, Daniel G. Becker MD and Samuel S. Becker, MD of Becker Nose & Sinus Center, LLC.

  • Title of activity: Allergic and Non-Allergic Sinusitis for Primary Care Physicians: Pathophysiology, Evaluation and Treatment
  • Release date: September 1, 2010; Expiration date: September 1, 2012
  • Estimated time to complete activity: 11 hours
  • Required hardware/software: A computer capable of reading, printing and sending Adobe Acrobat documents, an Internet service provider (ISP), a browser (e.g., Internet Explorer, Firefox) and a consistently used email address. A scanner or FAX machine for answering test questions.
  • For questions regarding this activity, please contact MER at 1-800-421-3756.

Target Audience:
This activity has been designed provide primary care physicians with the most up-to-date information about allergic and non-allergic sinusitis and its treatment.

Statement of Need:

Sinusitis is one of the most common health care complaints in the United States. (1-8) An estimated 32.3 million people in the United States have chronic sinusitis. Furthermore, 10% of the population suffers from allergic sinus disease. The cost of treating sinus disease runs into the billions of dollars, without taking into account loss of work.

Until recently, sinusitis has been an undertreated disease. In the past and unfortunately even today, many patients are told they will just have to "live with it." Since the introduction of endoscopic techniques for diagnosis of sinus disease in the United States in 1985, (9) increased attention has been directed to this problem.

Fortunately, there have been significant advances in the diagnosis and treatment of this problem. This CME activity responds to the continuing need of practicing physicians to update their knowledge. It is designed to provide primary care physicians with the most up-to-date information about allergic and non-allergic sinusitis and its treatment.

Primary care physicians would benefit from a detailed update and overview of the:

  • Causes of allergic and non-allergic sinusitis,
  • Components of a thorough evaluation
  • The roles of various medical treatments and surgical treatments in achieving symptom relief, and the indications for referral to a specialist.
MER's Privacy Policy can be found below..

This activity is jointly sponsored by Medical Education Resources, Inc. (MER) and Becker Nose & Sinus Center, LLC. It is supported by an educational grant from Kennedy University Hospital.

Learning Objectives:
After completing this activity, the participant should be better able to:

  • Discuss the anatomy and physiology of the paranasal sinuses
  • Define the pathophysiologic bases of rhinitis and sinusitis
  • Discuss the health impact of sinusitis on the individual patient and on society
  • Assess the various signs and symptoms associated with sinusitis
  • Recognize the factors involved in making a diagnosis of sinusitis
  • Define the proper role of nasal endoscopy, nasopharyngoloryngoscopy and radiologic studies such as CT scans
  • Define the pathophysiology and proper evaluation of chronic allergic sinusitis
  • Describe the introductory concepts of food allergies
  • Discuss the concept of the Unified Airway and the effect of chronic sinusitis on asthma
  • Differentiate between the common symptoms of acid reflux and laryngopharyngeal reflux
  • Discuss how the symptoms of gastoesophageal reflux can mimic those of sinusitis
  • Discuss the anatomical and physiological causes of snoring and the impact of snoring on the patient's health and quality of life
  • Describe various diagnostic methods and treatment options for patients with snoring
  • Recognize the spectrum of sinusitis in children and various uncommon diseases that may present as sinusitis
  • Discuss the role of antibiotic and non-antibiotic treatments in the management of sinusitis
  • Describe the indications and risks associated with sinus surgery and the underlying philosophy of Functional Endoscopic Sinus Surgery (FESS)
  • Recognize the various anatomical and physiological causes of nasal obstruction and the role of associated surgical management

Faculty:

    Daniel G. Becker, MD
    Clinical Associate Professor,
    Department of Otolaryngology-Head and Neck Surgery
    University of Pennsylvania, Philadelphia, Pennsylvania

    Samuel S. Becker, MD
    Clinical Instructor
    Vanderbilt University and
    Clinical Assistant Professor,
    Department of Otolaryngology-Head and Neck Surgery
    University of Pennsylvania, Philadelphia, Pennsylvania

Program Agenda:
The agenda includes:

  • Introduction
  • Anatomy and Physiology with Sinusitis Overview
  • Sinus Signs and Symptoms
  • Making the Diagnosis
  • Allergic Rhinitis
  • Asthma and Sinusitis
  • Acid Reflux and Sinusitis
  • Snoring
  • Unusual Causes of Sinusitis
  • Sinusitis in Patients Who Have Had Surgery
  • Medical Treatment of Sinusitis
  • Surgical Treatment of Sinusitis
  • Surgery of the Septum, the Turbinates, and Other "Non-Sinus" Causes of Nasal Blockage

Accreditation Statement:
This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Medical Education Resources (MER) and the Becker Nose & Sinus Center, LLC. MER is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation:
Medical Education Resources designates this educational activity for a maximum of 11 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Disclosure of Conflicts of Interest:
Medical Education Resources (MER) insures balance, independence, objectivity, and scientific rigor in all our educational programs. In accordance with this policy, MER identifies conflicts of interest with its instructors, content managers, and other individuals who are in a position to control the content of an activity. Conflicts are resolved by MER to ensure that all scientific research referred to, reported, or used in a CME activity conforms to the generally accepted standards of experimental design, data collection, and analysis. MER is committed to providing its learners with high-quality CME activities that promote improvements or quality in health care and not the business interest of a commercial interest.

The faculty/authors reported the following financial relationships with commercial interests whose products or services may be mentioned in this CME activity:

Reported Financial Relationship:

Name of Authors/Content ManagersReported Financial Relationship
Daniel G. Becker, MDNo financial relationships to disclose
Samuel S. Becker, MDNo financial relationships to disclose

The content managers reported the following financial relationships with commercial interests whose products or services may be mentioned in this CME activity:

Name of Content ManagerReported Financial Relationship
Victoria Smith, MD (MER)No financial relationships to disclose

Media Format Internet

Method of Participation and Payment:

  • Reading the online book and associated questions, (CLICK HERE).
  • CLICKING HERE to begin the process.
  • Filling out the contact information and making the $50 processing fee online from the above link, by clicking "NEXT" button when prompted. All major credit cards are taken.
  • Completing the Answer Sheet and Post-test Evaluation form (these will be sent to you).
  • FAXing the completed answer key and evaluation form to 720-449-0217.
  • Your answers will be rated and a grade of 70% or better will qualify you for credits specified below.
  • If you do not receive confirmation within that time frame, call MER at 1-800-421-3756.
The Adenda (Table of Contents) is itemized above.

A statement of credit will be issued only upon receipt of a completed activity evaluation form and a completed test answer sheet with a 70% or better. Statements of credit will be issued within 6 weeks of submission.

Disclaimer:
The content and views presented in this educational activity are those of the authors and do not necessarily reflect those of Medical Education Resources, the Becker Nose & Sinus Center, LLC, and/or Kennedy University Hospital. The authors have disclosed if there is any discussion of published and/or investigational uses of agents that are not indicated by the FDA in their presentations. The opinions expressed in this educational activity are those of the faculty and do not necessarily represent the views of Medical Education Resources, Becker Nose & Sinus Center, LLC, and/or Kennedy University Hospital.

Before prescribing any medicine, primary references and full prescribing information should be consulted. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient?s conditions and possible contraindications on dangers in use, review of any applicable manufacturer?s product information, and comparison with recommendations of other authorities.

The information presented in this activity is not meant to serve as a guideline for patient management.

Fee Information:
There is a $50.00 processing fee this educational activity.

MER Privacy Policy:
Medical Education Resources and Becker Nose & Sinus Center, LLC maintain high standards for the protection of privacy over the Internet. The purpose of this statement is to explain what information we obtain, how it is used, and how visitors can restrict its use or disclosure. The only information MER obtains is information supplied voluntarily by the visitor.

We do not sell or disclose individually identifiable information obtained online unless it is required by law or disclosure is necessary to protect the safety of customers, employees, or property. We use the information to grade your post-test and to send you a certificate of completion of the CME activity. If we use a third-party company to grade your post-test and issue certificates of completion, we will give the information to that company for that purpose only.

For each CME activity that you take, you MUST complete an evaluation questionnaire. That questionnaire asks if you are willing to participate in a follow-up survey. If you answer yes, we will use your name and contact information to send you the survey. We may use the information to invite you to participate in other CME activities that we may offer.

On occasion, the commercial supporter of a CME activity will ask us for a list of the people who participated in that activity in order to document the first level of outcomes-based evaluation in CME (eg, who attended, which medical specialties/practices were represented, how this compares to the target audience, and whether the activity needs to be repeated because significant numbers of the target audience did not attend). In that event, we will request in writing that the supporter not contact you directly for any purpose.

Medical Education Resources is committed to safeguarding customer privacy, and we require our employees to protect the privacy of information about our customers. Should you wish to delete your information from our files or discuss our privacy policy, please contact us at 1-800-421-3756.

Thank you for your participation; we know this information will be of use to you. Your access to the online book will include printing, and updates will stand until September 1, 2012 unless otherwise specified

*Medical Education Resources (MER) address: 1500 W. Canal Court, Bldg. B, Littleton, CO 80120-6404
FAX: 720-449-0127; phone: 303-798-9682

REFERENCES

    1. Melen I. Chronic sinusitis: clinical and pathophysiological aspects. Acta Otolaryngol Suppl (Stockh) 1994; 515:45-48.

    2. Gliklich RE, Metson R. The health impact of chronic sinusitis in patients seeking otolaryngologic care. Otolaryngol Head Neck Surg 1995; 113:104?109.

    3. Gliklich RE, Hilinski JM. Longitudinal sensitivity of generic and specific health measures in chronic sinusitis. Qual Life Res 1995: 4:27?32.

    4. Gliklich, RE, Metson R. The health impact of chronic sinusitis in patients seeking otolaryngologic care. Otolaryngol Head Neck Surg 1995; 113:104?109.

    5. Ray NF, Baraniuk JN, Thamer M. Direct expenditures for the treatment of allergic rhinoconjunctivitis in 1996, including the contributions of related airway illnesses. J Allergy Clin Immunol 1999; 103: 401?407.

    6. Ray NF, Baraniuk JN, Thamer M. Healthcare expenditures for sinusitis in 1996; contributions of asthma, rhinitis, and other airway disorders. J Allergy Clin Immunol 1999; 103: 408?414.

    7. Pankey GA, Gross CW, Mendelsohn MG. Contemporary Diagnosis and Management of Sinusitis.Newtown PA: Handbooks in Health Care, 2000.

    8. Dereberry J, Meltzer E, Nathan RA, Stang PE, Campbell UB, Corrao M, Stanford R. Otolaryngol Head Neck Surg, 2008 Aug;139(2):198-205. Rhinitis symptoms and comorbidities in the United States: burden of rhinitis in America survey

    9. Kennedy DW, Bolger WE, Zinreich SJ. Diseases of the Sinuses: Diagnosis and Managemet, London:BC Decker, 2001
 
 
 
 
 
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