1. 1. MKSAP 15Medical knowledge self-Assessment program
2. 2. Cardiovascular Medicine Contributors Please note that a "1" following a contributor's name indicates that he or she has no relationships to disclose. A "2" indicates that the contributor has disclosed relationships. Please scroll down to view all disclosures. Catherine M. Otto, MD, FACP, Book Editor1 J. Ward Kennedy-Hamilton Endowed Professor of Cardiology Professor of Medicine Director, Cardiology Fellowship Programs University of Washington School of Medicine Seattle, Washington Howard H. Weitz, MD, FACP, Associate Editor2 Professor of Medicine Director, Division of Cardiology Vice-Chairman, Department of Medicine Jefferson Medical College, Thomas Jefferson University Philadelphia, Pennsylvania R. Michael Benitez, MD1 Associate Professor of Medicine Fellowship Program Director Division of Cardiology University of Maryland School of Medicine Baltimore, Maryland Heidi M. Connolly, MD1 Professor of Medicine Mayo Clinic College of Medicine Rochester, Minnesota Rosario V. Freeman, MD, MS2 Associate Professor Division of Cardiology University of Washington Seattle, Washington Kristen K. Patton, MD2 Assistant Professor Division of Cardiology University of Washington Seattle, Washington David M. Shavelle, MD2 Associate Clinical Professor David Geffen School of Medicine at UCLA Division of Cardiology Director, Interventional Cardiology Director, Interventional Cardiology Fellowship
3. 3. Los Angeles County/Harbor-UCLA Medical Center Torrance, California Marcus F. Stoddard, MD1 Professor of Medicine Clinical Chief Division of Cardiovascular Medicine Department of Medicine The University of Louisville Louisville, Kentucky Andrew Wang, MD2 Associate Professor of Medicine Director, Fellowship Training Program Division of Cardiovascular Medicine Duke University Medical Center Durham, North Carolina Audrey H. Wu, MD, MPH1 Clinical Assistant Professor Division of Cardiovascular Medicine University of Michigan Health System Ann Arbor, Michigan Editor-in-Chief Patrick C. Alguire, MD, FACP1 Director, Education and Career Development American College of Physicians Philadelphia, Pennsylvania Cardiovascular Medicine Reviewers Philip Altus, MD, MACP2 Gloria Fioravanti, DO, FACP1 John D. Goldman, MD, FACP2 Jose A. Joglar, MD1 Warren J. Manning, MD, FACP1 Michael W. Peterson, MD, FACP1 Ileana L. Pia, MD2 Mark D. Siegel, MD1 Cardiovascular Medicine ACP Editorial Staff Becky Krumm, Senior Staff Editor Sean McKinney, Director, Self-Assessment Programs Margaret Wells, Managing Editor Charles Rossi, Senior Associate of Clinical Content Development John Murray, Editorial Coordinator
4. 4. ACP Principal Staff Steven E. Weinberger, MD, FACP2 Deputy Executive Vice President Senior Vice President, Medical Education and Publishing D. Theresa Kanya, MBA1 Vice President, Medical Education and Publishing Sean McKinney1 Director, Self-Assessment Programs Margaret Wells1 Managing Editor Charles Rossi1 Senior Associate of Clinical Content Development Becky Krumm1 Senior Staff Editor Ellen McDonald, PhD1 Senior Staff Editor Amanda Neiley1 Staff Editor Katie Idell1 Production Administrator/Editor Valerie Dangovetsky1 Program Administrator John Murray1 Editorial Coordinator Shannon O'Sullivan1 Editorial Coordinator Developed by the American College of Physicians 1. Has no relationships with any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. 2. Has disclosed relationships with entities producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. See below.
5. 5. Conflicts of Interest The following contributors and ACP staff members have disclosed relationships with commercial companies: Philip Altus, MD, MACP Consultantship: King Pharmaceuticals, Sanofi-Aventis Speakers Bureau: Bristol-Myers Squibb, King Pharmaceuticals, Sanofi-Aventis Rosario V. Freeman, MD, MS Employment (Spouse): Philips Medical Systems John D. Goldman, MD, FACP Employment: Pinnacle Health Kristen K. Patton, MD Research Grants/Contracts: Boston Scientific (includes Guidant products), Medtronic, Inc. Ileana L. Pia, MD Speakers Bureau: AstraZeneca, GlaxoSmithKline, Novartis, Sanofi-Aventis David M. Shavelle, MD Research Grants/Contracts: Takeda, GlaxoSmithKline, eV3, Inc., Boston Scientific, Abbott Vascular, Atritech, Inc., St. Jude, Inc., Possis, Inc., Cordis, Inc., Boehringer Ingelheim, AstraZeneca, Cardiomems Andrew Wang, MD Research Grants/Contracts: Evalve, Inc., Radiant Medical, Medtronic, Inc. Steven E. Weinberger, MD, FACP Stock Options/Holdings: Abbott, GlaxoSmithKline Howard H. Weitz, MD, FACP Other: GlaxoSmithKline (member of adverse events review committee of a clinical research trial) Dermatology Contributors Please note that a "1" following a contributor's name indicates that he or she has no relationships to disclose. A "2" indicates that the contributor has disclosed relationships. Please scroll down to view all disclosures.
6. 6. Kathryn Schwarzenberger, MD, Book Editor2 Associate Professor of Medicine (Dermatology) Associate Chief and Residency Program Director Division of Dermatology University of Vermont College of Medicine Burlington, Vermont Jack Ende, MD, MACP, Associate Editor1 Professor of Medicine University of Pennsylvania Chief, Department of Medicine Penn Presbyterian Medical Center Philadelphia, Pennsylvania Jeffrey P. Callen, MD, FACP2 Professor of Medicine (Dermatology) Chief, Division of Dermatology University of Louisville School of Medicine Louisville, Kentucky Dirk Elston, MD2 Director, Department of Dermatology Geisinger Medical Center Danville, Pennsylvania Lindy P. Fox, MD2 Assistant Professor of Clinical Dermatology Director, Hospital Consultation Service Department of Dermatology University of California, San Francisco San Francisco, California William D. James, MD1 Paul R. Gross Professor and Vice Chair Department of Dermatology University of Pennsylvania Philadelphia, Pennsylvania Editor-in-Chief Patrick C. Alguire, MD, FACP1 Director, Education and Career Development American College of Physicians Philadelphia, Pennsylvania Dermatology Reviewers Richard Fatica, MD1 Lisa Inouye, MD, MPH, FACP1 Khalid J. Qazi, MD, MACP1 Steven F. Reichert, MD, FACP1
7. 7. Leonard H. Sigal, MD, FACP2 Laura J. Zakowski, MD1 Dermatology ACP Editorial Staff Katie Idell, Production Administrator/Editor Sean McKinney, Director, Self-Assessment Programs Margaret Wells, Managing Editor Charles Rossi, Senior Associate of Clinical Content Development Shannon O'Sullivan, Editorial Coordinator ACP Principal Staff Steven E. Weinberger, MD, FACP2 Deputy Executive Vice President Senior Vice President, Medical Education and Publishing D. Theresa Kanya, MBA1 Vice President, Medical Education and Publishing Sean McKinney1 Director, Self-Assessment Programs Margaret Wells1 Managing Editor Charles Rossi1 Senior Associate of Clinical Content Development Becky Krumm1 Senior Staff Editor Ellen McDonald, PhD1 Senior Staff Editor Amanda Neiley1 Staff Editor Katie Idell1 Production Administrator/Editor Valerie Dangovetsky1 Program Administrator John Murray1 Editorial Coordinator
8. 8. Shannon O'Sullivan1 Editorial Coordinator Developed by the American College of Physicians 1. Has no relationships with any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. 2. Has disclosed relationships with entities producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. See below. Conflicts of Interest The following contributors and ACP staff members have disclosed relationships with commercial companies: Jeffrey P. Callen, MD, FACP Honoraria: Stiefel Laboratories Consultantship: Amgen, Centocor, Abbott, EOS, Genentech, Medicis, VSLT Royalties: Elsevier Speakers Bureau: Amgen Other: Genmab (Safety Monitoring Committee) Dirk Elston, MD Consultantship: Abbott, Medicis Lindy P. Fox, MD Honoraria: Bristol-Myers Squibb, Galderma, Elsevier Kathryn Schwarzenberger, MD Research Grants/Contracts: Galderma, Genentech, Amgen Honoraria: Abbott Leonard H. Sigal, MD, FACP Employment: Bristol-Myers Squibb Steven E. Weinberger, MD, FACP Stock Options/Holdings: Abbott, GlaxoSmithKline Endocrinology and Metabolism Contributors
9. 9. Please note that a "1" following a contributor's name indicates that he or she has no relationships to disclose. A "2" indicates that the contributor has disclosed relationships. Please scroll down to view all disclosures. Henry B. Burch, MD, Book Editor1 Chief, Endocrinology Walter Reed Army Medical Center Professor of Medicine and Chair, Endocrinology Division Uniformed Services University of the Health Sciences Bethesda, Maryland Howard H. Weitz, MD, FACP, Associate Editor2 Professor of Medicine Director, Division of Cardiology Vice-Chairman, Department of Medicine Jefferson Medical College, Thomas Jefferson University Philadelphia, Pennsylvania Baha M. Arafah, MD2 Professor of Medicine Director, Clinical Program & Fellowship Training Program Division of Endocrinology Case Western Reserve University and University Hospitals Case Medical Center Cleveland, Ohio Richard J. Auchus, MD, PhD2 The Charles A. and Elizabeth Ann Sanders Chair in Translational Research Professor of Internal Medicine Division of Endocrinology and Metabolism University of Texas Southwestern Medical Center at Dallas Dallas, Texas Victor J. Bernet, MD, FACP1 Director, National Capital Consortium Endocrinology Fellowship Program Walter Reed Army Medical Center-Bethesda Naval Medical Center Associate Professor Uniformed Services University of the Health Sciences Bethesda, Maryland Silvio E. Inzucchi, MD2 Professor of Medicine Clinical Director, Section of Endocrinology Director, Yale Diabetes Center Yale University School of Medicine New Haven, Connecticut Mark E. Molitch, MD, FACP2 Professor of Medicine Division of Endocrinology, Metabolism and Molecular Medicine Northwestern University Feinberg School of Medicine Chicago, Illinois
10. 10. Meeta Sharma, MD2 Assistant Chief Division of Endocrinology Director, Diabetes Team Washington Hospital Center Washington, DC Editor-in-Chief Patrick C. Alguire, MD, FACP1 Director, Education and Career Development American College of Physicians Philadelphia, Pennsylvania Endocrinology and Metabolism Reviewers Amindra S. Arora, MD1 Arnold A. Asp, MD, FACP1 Dawn E. DeWitt, MD, MSc, FACP2 Cheryl A. Fassler, MD, FACP2 Jason L. Gaglia, MD1 William James Howard, MD, MACP2 Steven Ricanati, MD1 Ingram Roberts, MD, FACP2 Cynthia M. Tracy, MD2 Endocrinology and Metabolism ACP Editorial Staff Ellen McDonald, PhD, Senior Staff Editor Sean McKinney, Director, Self-Assessment Programs Margaret Wells, Managing Editor Charles Rossi, Senior Associate of Clinical Content Development Shannon O'Sullivan, Editorial Coordinator ACP Principal Staff Steven E. Weinberger, MD, FACP2 Deputy Executive Vice President Senior Vice President, Medical Education and Publishing D. Theresa Kanya, MBA1 Vice President, Medical Education and Publishing Sean McKinney1 Director, Self-Assessment Programs
11. 11. Margaret Wells1 Managing Editor Charles Rossi1 Senior Associate of Clinical Content Development Becky Krumm1 Senior Staff Editor Ellen McDonald, PhD1 Senior Staff Editor Amanda Neiley1 Staff Editor Katie Idell1 Production Administrator/Editor Valerie Dangovetsky1 Program Administrator John Murray1 Editorial Coordinator Shannon O'Sullivan1 Editorial Coordinator Developed by the American College of Physicians 1. Has no relationships with any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. 2. Has disclosed relationships with entities producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. See below. Conflicts of Interest The following contributors and ACP staff members have disclosed relationships with commercial companies: Baha M. Arafah, MD Consultantship: Novartis Richard J. Auchus, MD, PhD Consultantship: Cougar Biotechnology, Takeda Stock Options/Holdings: Merck, Bristol-Myers Squibb Research Grants/Contracts: Novartis
12. 12. Dawn E. DeWitt, MD, MSc, FACP Honoraria: Sanofi-Aventis Consultantship: Sanofi-Aventis Other: Sanofi-Aventis Cheryl A. Fassler, MD, FACP Stock Options/Holdings: Amgen Research Grants/Contracts: Eli Lilly Speakers Bureau: Tercica, Sanofi-Aventis William James Howard, MD, MACP Research Grants/Contracts: Pfizer, AstraZeneca Honoraria: Pfizer, AstraZeneca, Merck, Schering-Plough, Abbott, Sankyo Consultantship: Merck, Schering-Plough Speakers Bureau: Pfizer, AstraZeneca, Merck, Schering-Plough, Abbott, Sankyo Silvio E. Inzucchi, MD Research Grants/Contracts: Eli Lilly Honoraria: Pfizer, Takeda, Novartis, Merck, NovoNordisk Consultantship: Takeda, Novartis, Merck, Daiichi-Sankyo, Amylin Speakers Bureau: Takeda, Merck Mark E. Molitch, MD, FACP Research Grants/Contracts: Amgen, Tercica, Ardana, Lilly Consultantship: Sanofi-Aventis, Abbott, Tercica, Novartis Speakers Bureau: Sanofi-Aventis, Abbott, Merck Stock Options/Holdings: Amgen, Abbott, Pfizer Ingram Roberts, MD, FACP Royalties: UpToDate Meeta Sharma, MD Honoraria: Procter & Gamble, Takeda, Merck, Sanofi-Aventis Speakers Bureau: Procter & Gamble, Takeda, Merck, Sanofi-Aventis Cynthia M. Tracy, MD Honoraria: Medtronic Steven E. Weinberger, MD, FACP Stock Options/Holdings: Abbott, GlaxoSmithKline Howard H. Weitz, MD, FACP Other: GlaxoSmithKline (member of adverse events review committee of a clinical research trial)
13. 13. Gastroenterology and Hepatology Contributors Please note that a "1" following a contributor's name indicates that he or she has no relationships to disclose. A "2" indicates that the contributor has disclosed relationships. Please scroll down to view all disclosures. Steven K. Herrine, MD, FACP, Book Editor2 Professor of Medicine Division of Gastroenterology and Hepatology Thomas Jefferson University Philadelphia, Pennsylvania Thomas Fekete, MD, FACP, Associate Editor1 Professor of Medicine Associate Professor of Microbiology Temple University Medical School Philadelphia, Pennsylvania Brian P. Bosworth, MD2 Assistant Professor of Medicine Weill Medical College of Cornell University New York, New York Patricia Kozuch, MD2 Assistant Professor of Medicine Division of Gastroenterology and Hepatology Thomas Jefferson University Philadelphia, Pennsylvania David E. Loren, MD2 Assistant Professor of Medicine Division of Gastroenterology and Hepatology Thomas Jefferson University Philadelphia, Pennsylvania Victor J. Navarro, MD2 Professor of Medicine, Pharmacology and Experimental Therapeutics Hepatology and Liver Transplantation Thomas Jefferson University Philadelphia, Pennsylvania Amy S. Oxentenko, MD, FACP2 Assistant Professor of Medicine College of Medicine, Mayo Clinic Rochester, Minnesota Patrick R. Pfau, MD1 Associate Professor of Medicine University of Wisconsin Madison, Wisconsin
14. 14. Simona Rossi, MD2 Assistant Professor of Medicine Division of Gastroenterology and Hepatology Thomas Jefferson University Philadelphia, Pennsylvania Editor-in-Chief Patrick C. Alguire, MD, FACP1 Director, Education and Career Development American College of Physicians Philadelphia, Pennsylvania Gastroenterology and Hepatology Reviewers Amindra S. Arora, MD1 Raymond F. Bianchi, MD, FACP1 Douglas Einstadter, MD, MPH, FACP2 Asad Khan Mohmand, MD1 Darrell S. Pardi, MD2 Amir Qaseem, MD, PhD, MHA, FACP 2 Darius A. Rastegar, MD, FACP1 Joel E. Richter, MD, FACP2 Ingram M. Roberts, MD, FACP1 Suzanne Rose, MD, MSEd, FACP2 Gastroenterology and Hepatology ACP Editorial Staff Charles Rossi, Senior Associate of Clinical Content Development Sean McKinney, Director, Self-Assessment Programs Margaret Wells, Managing Editor Katie Idell, Production Administrator/Editor ACP Principal Staff Steven E. Weinberger, MD, FACP2 Deputy Executive Vice President Senior Vice President, Medical Education and Publishing D. Theresa Kanya, MBA1 Vice President, Medical Education and Publishing Sean McKinney1 Director, Self-Assessment Programs
15. 15. Margaret Wells1 Managing Editor Charles Rossi1 Senior Associate of Clinical Content Development Becky Krumm1 Senior Staff Editor Ellen McDonald, PhD1 Senior Staff Editor Amanda Neiley1 Staff Editor Katie Idell1 Production Administrator/Editor Valerie Dangovetsky1 Program Administrator John Murray1 Editorial Coordinator Shannon O'Sullivan1 Editorial Coordinator Developed by the American College of Physicians 1. Has no relationships with any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. 2. Has disclosed relationships with entities producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. See below. Conflicts of Interest The following contributors and ACP staff members have disclosed relationships with commercial companies: Brian P. Bosworth, MD Stock Options/Holdings: Schering-Plough Research Grants/Contracts: Abbott, Centocor, Cerimon, PDL Biopharma, Salix, UCB, Procter & Gamble Douglas Einstadter, MD, MPH, FACP Consultantship: Medical Mutual of Ohio
16. 16. Steven K. Herrine, MD, FACP Research Grants/Contracts: Human Genome Sciences, Roche, Schering-Plough, Bristol-Myers Squibb, McNeil Consumer Products, Sanofi-Aventis Speakers Bureau: Roche, Schering-Plough Patricia Kozuch, MD Consultantship: UCB, Abbott Speakers Bureau: Scientific American Frontiers Research Grants/Contracts: Sub investigator for Abbott, Ocera, Celltech, Berlex, Otsuka, Prometheus, Given Imaging, Alba Therapeutics, AstraZeneca, Salix, PDL Biopharma; Primary investigator for Abbott, Centocor Other (Educational Speaking, Ad Board): UCB, Centocor, Abbott, Elan David E. Loren, MD Speakers Bureau: Olympus America, Boston Scientific Research Grants/Contracts: Boston Scientific, Protherics Victor J. Navarro, MD Consultantship: Merck, Alza, Amgen, Bristol-Myers Squibb, Theravance, Metabasis, Janssen, Viropharma, Johnson & Johnson Research Grants/Contracts: Alza, Biotrin, Bristol-Myers Squibb, Janssen, McNeil Consumer Products, Madaus Pharma, Merck, Metabasis, Roche, Sanofi-Aventis, Theravance Amy S. Oxentenko, MD, FACP Research Grants/Contracts: PDL Biopharma Darrell S. Pardi, MD Research Grants/Contracts: Salix, AstraZeneca, Procter & Gamble Consultantship: Biobalance Corporation, Lonza, Salix, Elan Amir Qaseem, MD, PhD, MHA, FACP Employment: American College of Physicians Honoraria: NovoNordisk Joel E. Richter, MD, FACP Honoraria: AstraZeneca, TAP Speakers Bureau: AstraZeneca, TAP Suzanne Rose, MD, MSEd, FACP Royalties: Hayes-Barton Press Consultantship: Takeda, Novartis Speakers Bureau: Takeda, TAP Simona Rossi, MD Research Grants/Contracts: Bristol-Myers Squibb, Human Genome Sciences, McNeil Consumer Products, Novartis Pharmaceuticals, Roche, Sanofi-Aventis, Schering-Plough, Gilead Sciences,
17. 17. Inc. Honoraria: Gilead Steven E. Weinberger, MD, FACP Stock Options/Holdings: Abbott, GlaxoSmithKline General Internal Medicine ed directly to the syllabus content by clicking on the tabs. Contributors Please note that a "1" following a contributor's name indicates that he or she has no relationships to disclose. A "2" indicates that the contributor has disclosed relationships. Please scroll down to view all disclosures. Kurt Kroenke, MD, MACP, Book Editor2 Professor of Medicine Indiana University School of Medicine Research Scientist, Regenstrief Institute Indianapolis, Indiana Jack Ende, MD, MACP, Associate Editor1 Professor of Medicine University of Pennsylvania Chief, Department of Medicine Penn Presbyterian Medical Center Philadelphia, Pennsylvania Brent W. Beasley, MD, FACP1 Associate Professor of Medicine University of Missouri-Kansas City Program Director, Internal Medicine Residency Kansas City, Missouri Steven L. Cohn, MD, FACP2 Director, Medical Consultation Service Kings County Hospital Center Clinical Professor of Medicine SUNY Downstate Brooklyn, New York Paul A. Hemmer, MD, MPH, FACP1* Bethesda, Maryland John T. Philbrick, MD, FACP1 Professor of Medicine Division of General Medicine, Geriatrics, and Palliative Medicine
18. 18. University of Virginia School of Medicine Charlottesville, Virginia Michael J. Roy, MD, MPH, FACP1* Colonel, Medical Corps, US Army Professor of Medicine Uniformed Services University of the Health Sciences Bethesda, Maryland Stephen M. Salerno, MD, MPH, FACP1* Associate Professor of Medicine, USUHS Director of Medical Education Madigan Army Medical Center Tacoma, Washington Gary H. Tabas, MD, FACP1 Professor of Medicine Division of General Internal Medicine University of Pittsburgh School of Medicine Pittsburgh, Pennsylvania Editor-in-Chief Patrick C. Alguire, MD, FACP1 Director, Education and Career Development American College of Physicians Philadelphia, Pennsylvania General Internal Medicine Reviewers Raymond F. Bianchi, MD, FACP1 John K. Chamberlain, MD, MACP1 John H. Holbrook, MD, FACP1 Robert T. Means, Jr., MD, FACP2 Patrick G. O'Malley, MD, MPH, FACP1 Amir Qaseem, MD, PhD, MHA, FACP1 Darius A. Rastegar, MD, FACP1 Robert E. Wright, MD, FACP1 General Internal Medicine ACP Editorial Staff Becky Krumm, Senior Staff Editor Sean McKinney, Director, Self-Assessment Programs Margaret Wells, Managing Editor Charles Rossi, Senior Associate of Clinical Content Development Shannon O'Sullivan, Editorial Coordinator ACP Principal Staff
19. 19. Steven E. Weinberger, MD, FACP2 Deputy Executive Vice President Senior Vice President, Medical Education and Publishing D. Theresa Kanya, MBA1 Vice President, Medical Education and Publishing Sean McKinney1 Director, Self-Assessment Programs Margaret Wells1 Managing Editor Charles Rossi1 Senior Associate of Clinical Content Development Becky Krumm1 Senior Staff Editor Ellen McDonald, PhD1 Senior Staff Editor Amanda Neiley1 Staff Editor Katie Idell1 Production Administrator/Editor Valerie Dangovetsky1 Program Administrator John Murray1 Editorial Coordinator Shannon O'Sullivan1 Editorial Coordinator Developed by the American College of Physicians 1. Has no relationships with any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. 2. Has disclosed relationships with entities producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. See below. * The views expressed here are those of the authors only and are not to be construed as those of the Department of Army, Department of Air Force, or Department of Defense.
20. 20. Conflicts of Interest The following contributors and ACP staff members have disclosed relationships with commercial companies: Steven L. Cohn, MD, FACP Stock Options/Holdings: Pfizer, GlaxoSmithKline, Merck, AstraZeneca Speakers Bureau: Sanofi-Aventis, Pfizer Kurt Kroenke, MD, MACP Research Grants/Contracts: Eli Lilly Consultantship: Eli Lilly, Pfizer, Forest Robert T. Means, Jr., MD, FACP Honoraria: Beckman Coulter Steven E. Weinberger, MD, FACP Stock Options/Holdings: Abbott, GlaxoSmithKline Hematology and Oncology Contributors Please note that a "1" following a contributor's name indicates that he or she has no relationships to disclose. A "2" indicates that the contributor has disclosed relationships. Please scroll down to view all disclosures. Hematology Jack E. Ansell, MD, FACP, Book Editor2 Chairman, Department of Medicine Lenox Hill Hospital New York, New York Marc J. Kahn, MD, FACP1 Professor of Medicine Hematology/Medical Oncology Senior Associate Dean for Admissions and Student Affairs Tulane University School of Medicine New Orleans, Louisiana Randy L. Levine, MD, FACP1 Director of Research for Hematology and Oncology Fellowship Director of Blood Bank and Transfusion Services
21. 21. Lenox Hill Hospital New York, New York Karen Quillen, MD2 Associate Professor of Medicine Director, Blood Bank Boston University School of Medicine Boston, Massachusetts Vaishali Sanchorawala, MD2 Associate Professor of Medicine Boston University School of Medicine Director, Stem Cell Transplant Program Boston Medical Center Boston, Massachusetts Oncology Bernard A. Mason, MD, FACP, Book Editor1 University of Pennsylvania School of Medicine Clinical Professor of Medicine Pennsylvania Hospital Philadelphia, Pennsylvania Mary E. Cianfrocca, DO2 Assistant Professor Division of Hematology/Oncology Feinberg School of Medicine Northwestern University Chicago, Illinois Nancy L. Lewis, MD2 Director, Phase I Clinical Trial Program Cooper Cancer Institute Voorhees, New Jersey Jyoti D. Patel, MD2 Assistant Professor Division of Hematology/Oncology Feinberg School of Medicine Northwestern University Chicago, Illinois Russell J. Schilder, MD2 Senior Member Director, Graduate Medical Education Fox Chase Cancer Center Philadelphia, Pennsylvania Associate Editor
22. 22. Richard S. Eisenstaedt, MD, FACP2 Clinical Professor of Medicine Temple University School of Medicine Chair, Department of Medicine Abington Memorial Hospital Abington, Pennsylvania Editor-in-Chief Patrick C. Alguire, MD, FACP1 Director, Education and Career Development American College of Physicians Philadelphia, Pennsylvania Hematology and Oncology Reviewers John E. Bennett, MD, MACP1 Lee Berkowitz, MD, FACP1 Duane R. Hospenthal, MD, PhD, COL, MC, FACP2 Dan L. Longo, MD, FACP1 Robert T. Means, Jr., MD, FACP2 Richard H. Moseley, MD, FACP1 Steven Ricanati, MD1 Barbara L. Schuster, MD, MACP2 Hematology and Oncology Editorial Staff Margaret Wells, Managing Editor Sean McKinney, Director, Self-Assessment Programs Charles Rossi, Senior Associate of Clinical Content Development John Murray, Editorial Coordinator ACP Principal Staff Steven E. Weinberger, MD, FACP2 Deputy Executive Vice President Senior Vice President, Medical Education and Publishing D. Theresa Kanya, MBA1 Vice President, Medical Education and Publishing Sean McKinney1 Director, Self-Assessment Programs Margaret Wells1 Managing Editor
23. 23. Charles Rossi1 Senior Associate of Clinical Content Development Becky Krumm1 Senior Staff Editor Ellen McDonald, PhD1 Senior Staff Editor Amanda Neiley1 Staff Editor Katie Idell1 Production Administrator/Editor Valerie Dangovetsky1 Program Administrator John Murray1 Editorial Coordinator Shannon O'Sullivan1 Editorial Coordinator Developed by the American College of Physicians 1. Has no relationships with any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. 2. Has disclosed relationships with entities producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. See below. Conflicts of Interest The following contributors and ACP staff members have disclosed relationships with commercial companies: Jack E. Ansell, MD, FACP Consultantship: Bristol-Myers Squibb, Bayer/Scios, Sanofi-Aventis, St. Jude Medical, Roche Diagnostics, HemoSense, Aryx Pharma, Aton Pharma, Instrumentation Labs, Regado Biosciences, ITC, Inc. Mary E. Cianfrocca, DO Research Grants/Contracts: GlaxoSmithKline Speakers Bureau: GlaxoSmithKline, Genentech, Genomic Health
24. 24. Richard S. Eisenstaedt, MD, FACP Speakers Bureau: Ortho Biotech Duane R. Hospenthal, MD, PhD, COL, MC, FACP Research Grants/Contracts: Schering-Plough, Merck Speakers Bureau: Merck, Pfizer Nancy L. Lewis, MD Research Grants/Contracts: Pfizer, Raven, Boehringer-Ingelheim, Wyeth, Incyte, PharmaMar USA Inc., Merck, Novartis, Sonus, EMD Pharmaceuticals, AstraZeneca, PharmaMar, Amgen, Lilly, BiPar Sciences, Bristol-Myers Squibb Robert T. Means, Jr., MD, FACP Honoraria: Beckman Coulter Jyoti D. Patel, MD Speakers Bureau: Genentech Research Grants/Contracts: Lilly Pharmaceuticals, Genentech Karen Quillen, MD Research Grants/Contracts: Novo Nordisk Vaishali Sanchorawala, MD Research Grants/Contracts: Celgene, Millenium Pharmaceuticals Speakers Bureau: Ortho Biotech, LLP Russell J. Schilder, MD Research Grants/Contracts: Bristol-Myers Squibb Consultantship: Biogen Idec Speakers Bureau: Biogen Idec, Ortho Biotech, Lilly Barbara L. Schuster, MD, MACP Honoraria: American Journal of Medicine (Editorial Board) Steven E. Weinberger, MD, FACP Stock Options/Holdings: Abbott, GlaxoSmithKline Infectious Disease Contributors Please note that a "1" following a contributor's name indicates that he or she has no relationships to disclose. A "2" indicates that the contributor has disclosed relationships. Please scroll down to view all disclosures.
25. 25. John N. Goldman, MD, Book Editor1 Professor Emeritus Pennsylvania State University College of Medicine Hershey, Pennsylvania Thomas Fekete, MD, FACP, Associate Editor1 Professor of Medicine Associate Professor of Microbiology Temple University Medical School Philadelphia, Pennsylvania Emily J. Erbelding, MD, MPH2 Associate Professor of Medicine Division of Infectious Diseases Johns Hopkins Bayview Medical Center Baltimore, Maryland Stephen Gluckman, MD, FACP1 Professor of Medicine University of Pennsylvania School of Medicine Chief Infectious Disease Clinical Services Hospital of the University of Pennsylvania Philadelphia, Pennsylvania Visiting Professor of Infectious Diseases University of Botswana Joseph A. Hassey, MD1 Clinical Assistant Professor of Medicine Drexel University College of Medicine Department of Medicine Division of Infectious Diseases Abington Memorial Hospital Abington, Pennsylvania Fred A. Lopez, MD, FACP2 Richard Vial Professor of Medicine Professor and Vice Chair Louisiana State University Department of Medicine Assistant Dean Louisiana State University School of Medicine New Orleans, Louisiana Carlene A. Muto, MD, MS1 Medical Director of Infection Control and Hospital Epidemiology University of Pittsburgh Medical Center (UPMC) Presbyterian Center for Quality Improvement and Innovation, UPMC Health System Associate Professor of Medicine and Epidemiology Division of Infectious Diseases University of Pittsburgh School of Medicine Pittsburgh, Pennsylvania Judith A. O'Donnell, MD2 Associate Professor of Clinical Medicine
26. 26. Division of Infectious Diseases University of Pennsylvania School of Medicine Hospital Epidemiologist and Director Department of Infection Prevention and Control Penn Presbyterian Medical Center Philadelphia, Pennsylvania William R. Short, MD, MPH2 Assistant Professor of Medicine Division of Infectious Diseases Jefferson Medical College of Thomas Jefferson University Philadelphia, Pennsylvania Allan R. Tunkel, MD, PhD, MACP1 Professor of Medicine Drexel University College of Medicine Chair, Department of Medicine Monmouth Medical Center Long Branch, New Jersey Editor-in-Chief Patrick C. Alguire, MD, FACP1 Director, Education and Career Development American College of Physicians Philadelphia, Pennsylvania Infectious Disease Reviewers Robert D. Arbeit, MD, FACP2 Rabeh Elzuway, MD1 Thomas E. Finucane, MD, FACP1 John D. Goldman, MD, FACP1 Duane R. Hospenthal, MD, PhD, FACP2 Leigh K. Hunter, MD, FACP2 Jeffrey L. Jackson, MD, FACP1 Richard H. Moseley, MD, FACP1 Michael W. Peterson, MD, FACP1 Peter H. Wiernik, MD, FACP2 John Zurlo, MD2 Infectious Disease ACP Editorial Staff Margaret Wells, Managing Editor Sean McKinney, Director, Self-Assessment Programs Charles Rossi, Senior Associate of Clinical Content Development John Murray, Editorial Coordinator
27. 27. ACP Principal Staff Steven E. Weinberger, MD, FACP2 Deputy Executive Vice President Senior Vice President, Medical Education and Publishing D. Theresa Kanya, MBA1 Vice President, Medical Education and Publishing Sean McKinney1 Director, Self-Assessment Programs Margaret Wells1 Managing Editor Charles Rossi1 Senior Associate of Clinical Content Development Becky Krumm1 Senior Staff Editor Ellen McDonald, PhD1 Senior Staff Editor Amanda Neiley1 Staff Editor Katie Idell1 Production Administrator/Editor Valerie Dangovetsky1 Program Administrator John Murray1 Editorial Coordinator Shannon O'Sullivan1 Editorial Coordinator Developed by the American College of Physicians 1. Has no relationships with any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. 2. Has disclosed relationships with entities producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. See below.
28. 28. Conflicts of Interest The following contributors and ACP staff members have disclosed relationships with commercial companies: Robert D. Arbeit, MD, FACP Employment: Paratek Pharmaceuticals Stock Options/Holdings: Paratek Pharmaceuticals Emily J. Erbelding, MD, MPH Employment: Johns Hopkins University Research Grants/Contracts: Health Services Resource Administration, King Pharmaceuticals Consultantship: Accordia Global Health Foundation (formerly known as the Academic Alliance for Care and Prevention of AIDS in Africa) Duane R. Hospenthal, MD, PhD, FACP Speakers Bureau: Merck, Pfizer Leigh K. Hunter, MD, FACP Employment: Methodist Health Systems Speakers Bureau: Cubist Fred A. Lopez, MD, FACP Royalties: UpToDate Judith A. O'Donnell, MD Employment: Spouse works for Viropharma William R. Short, MD, MPH Consultantship: Abbott, Tibotec, Gilead Speakers Bureau: Tibotec, Gilead, Merck Steven E. Weinberger, MD, FACP Stock Options/Holdings: Abbott, GlaxoSmithKline Peter H. Wiernik, MD, FACP Research Grants/Contracts: Favrille, Celgene Honoraria: Celgene John Zurlo, MD Research Grants/Contracts: Tibotec, Gilead Nephrology
29. 29. Contributors Please note that a "1" following a contributor's name indicates that he or she has no relationships to disclose. A "2" indicates that the contributor has disclosed relationships. Please scroll down to view all disclosures. Phyllis August, MD, MPH, Book Editor2 Ralph A. Baer Professor of Medical Research Professor of Medicine and Public Health Professor of Medicine in Obstetrics and Gynecology Division of Nephrology and Hypertension Weill Medical College of Cornell University New York, New York Virginia U. Collier, MD, FACP, Associate Editor2 Hugh R. Sharp, Jr. Chair of Medicine Christiana Care Health System Newark, Delaware Professor of Medicine Jefferson Medical College of Thomas Jefferson University Philadelphia, Pennsylvania Arlene Chapman, MD2 Professor of Medicine Department of Medicine, Renal Division Emory University School of Medicine Atlanta, Georgia Gerald A. Hladik, MD1 Associate Professor of Medicine Division of Nephrology and Hypertension University of North Carolina Kidney Center The University of North Carolina at Chapel Hill Chapel Hill, North Carolina Michelle A. Josephson, MD, FACP2 Professor of Medicine Section of Nephrology University of Chicago Hospitals Chicago, Illinois Michelle Whittier Krause, MD, MPH1 Associate Professor of Medicine Division of Nephrology University of Arkansas for Medical Sciences Little Rock, Arkansas Biff F. Palmer, MD, FACP, FASN2 Professor of Internal Medicine Department of Internal Medicine Nephrology Fellowship Program Director Division of Nephrology
30. 30. University of Texas Southwestern Medical Center Dallas, Texas Editor-in-Chief Patrick C. Alguire, MD, FACP1 Director, Education and Career Development American College of Physicians Philadelphia, Pennsylvania Nephrology Reviewers Sharon Adler, MD, FACP2 Robert J. Anderson, MD, MACP1 Lee Berkowitz, MD, FACP1 Frantz Duffoo, MD, FACP1 Kent A. Kirchner, MD, FACP1 Richard I. Kopelman, MD, FACP1 Dan L. Longo, MD, FACP1 Mark E. Pasanen, MD, FACP1 Barbara L. Schuster, MD, MACP1 Jerry L. Spivak, MD, FACP2 Nephrology ACP Editorial Staff Amanda Neiley, Staff Editor Sean McKinney, Director, Self-Assessment Programs Margaret Wells, Managing Editor Charles Rossi, Senior Associate of Clinical Content Development John Murray, Editorial Coordinator ACP Principal Staff Steven E. Weinberger, MD, FACP2 Deputy Executive Vice President Senior Vice President, Medical Education and Publishing D. Theresa Kanya, MBA1 Vice President, Medical Education and Publishing Sean McKinney1 Director, Self-Assessment Programs Margaret Wells1 Managing Editor
31. 31. Charles Rossi1 Senior Associate of Clinical Content Development Becky Krumm1 Senior Staff Editor Ellen McDonald, PhD1 Senior Staff Editor Amanda Neiley1 Staff Editor Katie Idell1 Production Administrator/Editor Valerie Dangovetsky1 Program Administrator John Murray1 Editorial Coordinator Shannon O'Sullivan1 Editorial Coordinator Developed by the American College of Physicians 1. Has no relationships with any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. 2. Has disclosed relationships with entities producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. See below. Conflicts of Interest The following contributors and ACP staff members have disclosed relationships with commercial companies: Sharon Adler, MD, FACP Research Grants/Contracts: Asprevia, Genzyme, Genentech, Novartis Consultantship: Genentech Phyllis August, MD, MPH Stock Options/Holdings: Pfizer, Merck Arlene Chapman, MD Research Grants/Contracts: HALT Trial/NIH, Otsuka America Pharmaceuticals
32. 32. Virginia U. Collier, MD, FACP Stock Options/Holdings: Celgene, Pfizer, Merck, Schering-Plough, Abbott, Johnson & Johnson, Medtronic, McKesson, Amgen Michelle A. Josephson, MD, FACP Speakers Bureau: Roche Pharmaceuticals Research Grants/Contracts: Astellas, Wyeth, Roche Pharmaceuticals Biff F. Palmer, MD, FACP, FASN Speakers Bureau: Novartis Jerry L. Spivak, MD, FACP Consultantship: Ortho, Roche, Novartis, Pfizer Steven E. Weinberger, MD, FACP Stock Options/Holdings: Abbott, GlaxoSmithKline Neurology Contributors Please note that a "1" following a contributor's name indicates that he or she has no relationships to disclose. A "2" indicates that the contributor has disclosed relationships. Please scroll down to view all disclosures. David W. Dodick, MD, Book Editor2 Professor of Neurology Neurology Residency Program Director Mayo Clinic Arizona Phoenix, Arizona Jack Ende, MD, MACP, Associate Editor1 Professor of Medicine University of Pennsylvania Chief, Department of Medicine Penn Presbyterian Medical Center Philadelphia, Pennsylvania Patrick C. Alguire, MD, FACP, Editor-in-Chief1 Director, Education and Career Development American College of Physicians Philadelphia, Pennsylvania Richard J. Caselli, MD1 Professor and Chair Department of Neurology
33. 33. Mayo Clinic Arizona Scottsdale, Arizona Bart M. Demaerschalk, MD, MSc, FRCP(C) 2 Director, Cerebrovascular Diseases Center Associate Professor of Neurology Division of Cerebrovascular Diseases Division of Critical Care Neurology Department of Neurology Mayo Clinic Arizona Phoenix, Arizona Brent P. Goodman, MD1 Assistant Professor of Neurology Department of Neurology Mayo Clinic Arizona Scottsdale, Arizona Katherine H. Noe, MD, PhD1 Assistant Professor of Neurology Department of Neurology Mayo Clinic Arizona Phoenix, Arizona Dean M. Wingerchuk, MD, MSc, FRCP(C) 2 Professor of Neurology Multiple Sclerosis Clinic Division of Demyelinating Diseases Mayo Clinic Arizona Scottsdale, Arizona Editor-in-Chief Patrick C. Alguire, MD, FACP1 Director, Education and Career Development American College of Physicians Philadelphia, Pennsylvania Neurology Reviewers Dawn E. DeWitt, MD, MSc, FACP, FRACP2 Richard A. Fatica, MD1 Thomas E. Finucane, MD, FACP1 Faith T. Fitzgerald, MD, MACP1 Jeffrey L. Jackson, MD, MPH, FACP1 Kevin A. Kahn, MD2 Bashar Katirji, MD, FACP1 Steven L. Lewis, MD1 Mark E. Pasanen, MD, FACP1 Steven F. Reichert, MD, FACP1
34. 34. Neurology ACP Editorial Staff Ellen McDonald, PhD, Senior Staff Editor Sean McKinney, Director, Self-Assessment Programs Margaret Wells, Managing Editor Charles Rossi, Senior Associate of Clinical Content Development Shannon O'Sullivan, Editorial Coordinator ACP Principal Staff Steven E. Weinberger, MD, FACP2 Deputy Executive Vice President Senior Vice President, Medical Education and Publishing D. Theresa Kanya, MBA1 Vice President, Medical Education and Publishing Sean McKinney1 Director, Self-Assessment Programs Margaret Wells1 Managing Editor Charles Rossi1 Senior Associate of Clinical Content Development Becky Krumm1 Senior Staff Editor Ellen McDonald, PhD1 Senior Staff Editor Amanda Neiley1 Staff Editor Katie Idell1 Production Administrator/Editor Valerie Dangovetsky1 Program Administrator John Murray1 Editorial Coordinator Shannon O'Sullivan1 Editorial Coordinator
35. 35. Developed by the American College of Physicians 1. Has no relationships with any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. 2. Has disclosed relationships with entities producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. See below. Conflicts of Interest The following contributors and ACP staff members have disclosed relationships with commercial companies: Bart M. Demaerschalk, MD, MSc, FRCP(C) Research Grants/Contracts: Abbott (CHOICE, ACT I), Vernalis UK, Neurobiological Technologies, AGA, St. Jude Medical Honoraria: Genentech, Hoffman Roche Consultantship: Genentech Other: Neurobiological Technologies, Neuralieve Dawn DeWitt, MD, MSc, FACP, FRACP Consultantship: Sanofi-Aventis David W. Dodick, MD Research Grants/Contracts: Abbott (CHOICE, ACT I), Allergan, AstraZeneca, Advanced Bionics, Advanced Neurostimulation Systems, Medtronic, Alexza Honoraria: Merck, GlaxoSmithKline, Neuralieve, Solvay, Ortho-McNeil, Coherex, MAP, Eli Lilly, Endo, Minster Consultantship: Merck, GlaxoSmithKline, Neuralieve, Eli Lilly, St. Jude Medical, Ortho- McNeil, Solvay, Coherex, MAP, Endo, Minster Kevin A. Kahn, MD Employment: UNC Hospitals, Dept. of Neurology Research Grants/Contracts: UCB Pharmaceuticals Honoraria: Pfizer, Ortho-McNeil Speakers Bureau: Pfizer, Ortho-McNeil Steven E. Weinberger, MD, FACP Stock Options/Holdings: Abbott, GlaxoSmithKline Dean M. Wingerchuk, MD, MSc, FRCP(C) Research Grants/Contracts: Genentech, Genzyme Consultantship: Genentech Pulmonary and Critical Care Medicine
36. 36. Contributors Please note that a "1" following a contributor's name indicates that he or she has no relationships to disclose. A "2" indicates that the contributor has disclosed relationships. Please scroll down to view all disclosures. Scott F. Davies, MD, FACP, Book Editor1 Professor of Medicine University of Minnesota Chief of Medicine Hennepin County Medical Center Minneapolis, Minnesota Richard S. Eisenstaedt, MD, FACP, Associate Editor2 Clinical Professor of Medicine Temple University School of Medicine Chair, Department of Medicine Abington Memorial Hospital Abington, Pennsylvania Marie R. Baldisseri, MD, FCCM2 Associate Professor of Critical Care Medicine Department of Critical Care Medicine University of Pittsburgh School of Medicine Pittsburgh, Pennsylvania Craig E. Daniels, MD2 Assistant Professor of Medicine Section Head, Critical Care Medicine Division of Pulmonary & Critical Care Medicine Mayo Clinic Rochester, Minnesota E. Wesley Ely, MD, MPH, FACP2 Professor of Medicine Allergy, Pulmonary and Critical Care Health Services Research Center Associate Director of Aging Research, VA GRECC Vanderbilt University School of Medicine Health Services Research Center Nashville, Tennessee Stanley B. Fiel, MD, FACP, FCCP2 Professor of Medicine Mt. Sinai School of Medicine Regional Chairman, Department of Medicine/Atlantic Health The deNeufville Professor and Chairman Department of Medicine Morristown Memorial Hospital Morristown, New Jersey
37. 37. Nizar N. Jarjour, MD, FACP, FCCP2 Professor and Head Section of Allergy, Pulmonary and Critical Care Department of Medicine University of Wisconsin School of Medicine and Public Health Madison, Wisconsin Robert Kempainen, MD2 Associate Professor of Medicine University of Minnesota Hennepin County Medical Center Minneapolis, Minnesota David E. Midthun, MD, FACP2 Professor of Medicine Consultant, Division of Pulmonary and Critical Care Medicine Mayo Clinic Rochester, Minnesota Timothy Morris, MD2 Professor of Medicine Clinical Service Chief Division of Pulmonary and Critical Care Medicine University of California, San Diego San Diego, California Consulting Authors E. Brigitte Gottschall, MD, MSPH1 Assistant Professor Division of Environmental and Occupational Health Sciences National Jewish Health University of Colorado Denver School of Medicine Denver, Colorado Teofilo Lee-Chiong, MD2 Head, Division of Sleep Medicine Department of Medicine Associate Professor of Medicine National Jewish Health University of Colorado Denver School of Medicine Denver, Colorado Steven A. Sahn, MD, FACP2 Professor of Medicine and Director Division of Pulmonary, Critical Care, Allergy and Sleep Medicine Medical University of South Carolina Charleston, South Carolina Editor-in-Chief
38. 38. Patrick C. Alguire, MD, FACP1 Director, Education and Career Development American College of Physicians Philadelphia, Pennsylvania Pulmonary and Critical Care Medicine Reviewers Donna D. Carstens, MD2 John R. Cohn, MD2 Lois J. Geist, MD, FACP1 Nora Goldschlager, MD, MACP2 Joseph John Padinjarayveetil, MD1 Trish M. Perl, MD2 Ileana L. Pia, MD2 Mark D. Siegel, MD1 Jean-Louis Vincent, MD2 Steven E. Weinberger, MD, FACP2 Pulmonary and Critical Care Medicine ACP Editorial Staff Charles Rossi, Senior Associate of Clinical Content Development Sean McKinney, Director, Self-Assessment Programs Margaret Wells, Managing Editor Katie Idell, Production Administrator/Editor John Murray, Editorial Coordinator ACP Principal Staff Steven E. Weinberger, MD, FACP2 Deputy Executive Vice President Senior Vice President, Medical Education and Publishing D. Theresa Kanya, MBA1 Vice President, Medical Education and Publishing Sean McKinney1 Director, Self-Assessment Programs Margaret Wells1 Managing Editor Charles Rossi1 Senior Associate of Clinical Content Development Becky Krumm1 Senior Staff Editor
39. 39. Ellen McDonald, PhD1 Senior Staff Editor Amanda Neiley1 Staff Editor Katie Idell1 Production Administrator/Editor Valerie Dangovetsky1 Program Administrator John Murray1 Editorial Coordinator Shannon O'Sullivan1 Editorial Coordinator Developed by the American College of Physicians 1. Has no relationships with any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. 2. Has disclosed relationships with entities producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. See below. Conflicts of Interest The following contributors and ACP staff members have disclosed relationships with commercial companies: Marie R. Baldisseri, MD, FCCM Royalties: UpToDate Donna D. Carstens, MD Speakers Bureau: GlaxoSmithKline John R. Cohn, MD Employment: Asthma, Allergy & Pulmonary Associates Research Grants/Contracts: GlaxoSmithKline, Dyax, Novartis, Genentech, Allergan, Schering- Plough Speakers Bureau: Schering-Plough, Novartis, GlaxoSmithKline, AstraZeneca Craig E. Daniels, MD Research Grants/Contracts: Novartis, Genzyme, Cambridge Antibody Technology
40. 40. Richard S. Eisenstaedt, MD, FACP Speakers Bureau: Ortho Biotech E. Wesley Ely, MD, MPH, FACP Research Grants/Contracts: Pfizer, Lilly, Hospira, Aspect Honoraria: Lilly, Hospira, Pfizer Speakers Bureau: Lilly, Hospira, Pfizer Stanley B. Fiel, MD, FACP, FCCP Research Grants/Contracts: Novartis, Genetech, Gilead, Transave, Cystic Fibrosis Foundation Speakers Bureau: GlaxoSmithKline, Boehringer Ingelheim, Novartis, Pfizer Consultantship: Novartis, GlaxoSmithKline Nora Goldschlager, MD, MACP Honoraria: St. Jude Medical Nizar N. Jarjour, MD, FACP, FCCP Research Grants/Contracts: GlaxoSmithKline, Dey, Genentech, Merck Consultantship: Genentech, GlaxoSmithKline, Asthmatx Honoraria: Merck, Novartis Robert Kempainen, MD Research Grants/Contracts: Hill-Rom, Inc. Teofilo Lee-Chiong, MD Research Grants/Contracts: Respironics, Restore, Cephalon, Takeda, Saunders, Wiley, Elsevier, Oxford University Press, Lippincott Williams and Wilkins Consultantship: Saunders, Elsevier, Covidien Speakers Bureau: GlaxoSmithKline David E. Midthun, MD, FACP Royalties: UpToDate Honoraria: ACP (PIER) Timothy Morris, MD Research Grants/Contracts: Agen Biomedical, Ltd. Trish M. Perl, MD Research Grants/Contracts: 3M, Sage, Astellas Honoraria: Merck, GlaxoSmithKline, 3M, Baxter Consultantship: IHI Ileana L. Pia, MD Speakers Bureau: AstraZeneca, Sanofi-Aventis, Innovia, Merck, Solvay, Novartis
41. 41. Steven A. Sahn, MD, FACP Research Grants/Contracts: Novartis, AstraZeneca, Intermune, Boehringer Ingelheim, Actelion, Gilead, Centocor, NIH IPFnet Royalties: UpToDate Honoraria: ACCP (PCCU) Consultantship: Intermune, Pilot, LAM Foundation Speakers Bureau: Intermune, Boehringer Ingelheim, Pilot Jean-Louis Vincent, MD Research Grants/Contracts: Abbott, AM Pharma, Apex, Artisan-Asahi, AstraZeneca, Biosite, Biotest, BioMerieux, Brahms, Covidien, DaiichiSanyo, Discovery, Drager, Edwards Lifesciences, Eli Lilly, Esai, Ferring, GlasxoSmithKline, Hutchinson, Intercell, Merck, Novartis, NovaLung, Novo Nordisk, Organon, Pfizer, Philips, PICIS, Roche Diagnostics, Spectral, Takeda, Teva, Tyco, Vasamed, Wyeth Lederle, Zeneus Honoraria: Eli Lilly, Edwards Lifesciences, Esai, GlaxoSmithKline, Novartis, Novo Nordisk, Pfizer Consultantship: AM Pharma, Apex, Artisan-Asahi, AstraZeneca, Biosite, BioMerieux, Covidien, Edwards Lifesciences, Eli Lilly, Esai, Ferring, GlaxoSmithKline, Instrumentation Labs, Intercell, Merck, Novartis, Novo Nordisk, Organon, Pfizer, Philips, Roche Diagnostics, Spacelabs, Spectral, Takeda, Wyeth Lederle Speakers Bureau: Eli Lilly, Edwards Lifesciences, Esai, GlaxoSmithKline, Novartis, Novo Nordisk, Pfizer Steven E. Weinberger, MD, FACP Stock Options/Holdings: Abbott, GlaxoSmithKline Rheumatology Contributors Please note that a "1" following a contributor's name indicates that he or she has no relationships to disclose. A "2" indicates that the contributor has disclosed relationships. Please scroll down to view all disclosures. Marcy B. Bolster, MD, FACP, Book Editor2 Professor of Medicine Director, Rheumatology Training Program Medical University of South Carolina Charleston, South Carolina Virginia U. Collier, MD, FACP, Associate Editor2 Hugh R. Sharp, Jr. Chair of Medicine Christiana Care Health System Newark, Delaware Professor of Medicine Jefferson Medical College of Thomas Jefferson University Philadelphia, Pennsylvania
42. 42. Anne R. Bass, MD, FACP2 Associate Professor of Clinical Medicine Weill Cornell Medical College Rheumatology Fellowship Program Director Hospital for Special Surgery New York, New York Richard D. Brasington, Jr., MD, FACP2 Professor of Medicine Director, Rheumatology Training Program Division of Rheumatology Washington University School of Medicine St. Louis, Missouri Alan N. Brown, MD, FACP2 Associate Professor of Medicine Medical University of South Carolina Charleston, South Carolina Beth Jonas, MD2 Director, Rheumatology Training Program Assistant Professor of Medicine Division of Rheumatology University of North Carolina School of Medicine Chapel Hill, North Carolina Leslie S. Staudt, MD1 Assistant Professor of Medicine Director, Rheumatology Training Program University of Oklahoma Health Sciences Center Oklahoma City, Oklahoma Editor-in-Chief Patrick C. Alguire, MD, FACP1 Director, Education and Career Development American College of Physicians Philadelphia, Pennsylvania Rheumatology Reviewers Robert D. Arbeit, MD, FACP2 Stewart Babbott, MD, FACP1 Frantz Duffoo, MD, FACP1 Barri J. Fessler, MD, FACP2 Lois J. Geist, MD, FACP1 Kent A. Kirchner, MD, FACP1 Carlos J. Lozada, MD, FACP2 Joseph J. Padinjarayveetil, MD1 Trish M. Perl, MD, MSc2
43. 43. Rheumatology ACP Editorial Staff Amanda Neiley, Staff Editor Sean McKinney, Director, Self-Assessment Programs Margaret Wells, Managing Editor Charles Rossi, Senior Associate of Clinical Content Development Shannon O'Sullivan, Editorial Coordinator ACP Principal Staff Steven E. Weinberger, MD, FACP2 Deputy Executive Vice President Senior Vice President, Medical Education and Publishing D. Theresa Kanya, MBA1 Vice President, Medical Education and Publishing Sean McKinney1 Director, Self-Assessment Programs Margaret Wells1 Managing Editor Charles Rossi1 Senior Associate of Clinical Content Development Becky Krumm1 Senior Staff Editor Ellen McDonald, PhD1 Senior Staff Editor Amanda Neiley1 Staff Editor Katie Idell1 Production Administrator/Editor Valerie Dangovetsky1 Program Administrator John Murray1 Editorial Coordinator Shannon O'Sullivan1 Editorial Coordinator
44. 44. Developed by the American College of Physicians 1. Has no relationships with any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. 2. Has disclosed relationships with entities producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. See below. Conflicts of Interest The following contributors and ACP staff members have disclosed relationships with commercial companies: Robert D. Arbeit, MD, FACP Employment: Paratek Pharmaceuticals Anne R. Bass, MD, FACP Research Grants/Contracts: Centocor Marcy B. Bolster, MD, FACP Research Grants/Contracts: Procter & Gamble Speakers Bureau: Genentech, Merck, Novartis Other: Abbott, UCB Richard D. Brasington, Jr., MD, FACP Speakers Bureau: Centocor, Genentech, Bristol-Myers Squibb, Biogen Idec, Abbott Alan N. Brown, MD, FACP Speakers Bureau: Abbott Other: UCB, Genentech Virginia U. Collier, MD, FACP Stock Options/Holdings: Celgene, Pfizer, Merck, Schering-Plough, Abbott, Johnson & Johnson, Medtronic, McKesson, Amgen Barri J. Fessler, MD, FACP Research Grants/Contracts: Actelion Consultantship: Gilead, Abbott Immunology Speakers Bureau: Actelion, Gilead, Encysive Pharmaceuticals Beth Jonas, MD Research Grants/Contracts: Stryker Biotech, Roche, Pfizer Other: Abbott Carlos J. Lozada, MD, FACP Honoraria: Wyeth, Amgen, Abbott, Bristol-Myers Squibb Speakers Bureau: Wyeth, Amgen, Abbott, Bristol-Myers Squibb
45. 45. Trish M. Perl, MD, MSc Stock Options/Holdings: Visicu Research Grants/Contracts: 3M, Sage Honoraria: Pfizer, Ortho-McNeil Consultantship: VHA, IHI, Theradoc Steven E. Weinberger, MD, FACP Stock Options/Holdings: Abbott, GlaxoSmithKline
46. 46. Epidemiology of Cardiovascular Disease Overview Women and Cardiovascular Disease Ethnicity and Cardiovascular Disease Diabetes Mellitus and Cardiovascular Disease Metabolic Syndrome and Cardiovascular Disease Cancer and Cardiovascular Disease Systemic Inflammatory Conditions and Cardiovascular Disease Lifestyle Factors and Cardiovascular Disease Key Points Cardiovascular disease is the leading cause of death in the United States, and among persons 75 years and older, more than twice as many die from cardiovascular disease than from cancer-related causes. More women than men die of cardiovascular disease each year, and the number of women dying of cardiovascular disease has not decreased over time. The prevalence of cardiovascular disease and the death rate due to cardiovascular disease are 2 to 4 times higher among persons with diabetes than those without diabetes. Microalbuminuria in persons with diabetes is strongly associated with cardiovascular disease and poorer cardiovascular disease outcomes. Patients treated with radiation therapy have higher than expected rates of valvular and coronary artery disease. Cardiomyopathy occurs in approximately 2% of patients treated with anthracyclines; it is directly related to the cumulative dose and is associated with a mortality rate of nearly 50%. Trastuzumab is associated with a high risk of cardiotoxicity, and cardiac function should be closely monitored during and after treatment. PreviousNext Overview More than 80 million adult Americans (1 in 3) have cardiovascular disease, with approximately 47% of these persons older than 60 years. If high blood pressure is excluded, approximately 10% of the adult U.S. population has cardiovascular disease (coronary artery disease, heart failure, stroke). The incidence of a first cardiovascular event increases directly with age, occurring in 10 per 1000 men between ages 45 and 54 years and increasing to 59 per 1000 men for ages 75 to 84
47. 47. years (Figure 1). The incidence of a first cardiovascular event for women also increases substantially with age, with a delay of approximately one decade in rates compared with men. Cardiovascular disease is the most common cause of death in the United States; although cancer- related deaths slightly exceed deaths related to cardiovascular disease for persons ages 45 to 74 years, deaths due to cardiovascular disease are more than twice as frequent as cancer-related deaths for persons older than 74 years. Figure 1. Incidence of Cardiovascular Disease by Age and Sex. Cardiovascular disease consists of coronary artery disease, heart failure, cerebrovascular accident, or intermittent claudication. Framingham Heart Study 1980-2003. Data from National Heart, Lung, and Blood Institute. Incidence and Prevalence: 2006 Chartbook on Cardiovascular and Lung Diseases. www.nhlbi.nih.gov/resources/docs/cht-book_ip.htm. Published May, 2006. Accessed February 2, 2009. Chart 2-1. PreviousNext Women and Cardiovascular Disease
48. 48. Women develop cardiovascular disease at later ages than men, but the prevalence of cardiovascular disease is similar for both sexes. The average lifetime risk for a woman to develop cardiovascular disease is approximately 1 in 2. Cardiovascular disease is the leading cause of death among women; 1 of 3 women die of cardiovascular disease, compared with 1 of 5 women dying from cancer-related causes. More women than men in the United States die of cardiovascular disease each year. Over the past 25 years, the number of cardiovascular deaths among men has declined significantly, but the number among women has remained essentially unchanged. PreviousNext Ethnicity and Cardiovascular Disease In 2005 in the United States, the prevalence of myocardial infarction or coronary heart disease/angina was approximately 5% for Asians, 6% for whites and blacks, 7% for Hispanics, and 11% for American Indian/Alaskan natives. This variable prevalence is largely attributable to the presence of risk factors in these ethnic groups: two or more risk factors for heart disease and stroke are found in nearly 50% of blacks and American Indian/Alaskan natives but in 25% of Asian adults. The prevalence of hypertension and stroke also has significant ethnic variability. Approximately 30% of the adult American population have high blood pressure: 16% of Asians, 19% of Hispanics or Latinos, 32% of whites, and 41% of blacks. The prevalence in American blacks is among the highest in the world. Compared with whites, blacks develop high blood pressure at a younger age, have higher average blood pressure measurements, and carry a much greater risk of end-organ complications such as stroke and end-stage kidney disease. PreviousNext Diabetes Mellitus and Cardiovascular Disease Approximately 10% of the U.S. adult population has diabetes mellitus, 95% of whom have type 2 diabetes. Since 1990, the prevalence of diabetes has increased 61%. The prevalence is approximately 1.5- to 2-fold higher in blacks, Hispanic Americans, and American Indian/native Alaskan adults than in whites. Diabetes is a risk factor for coronary artery disease, heart failure, and stroke, and adults with diabetes are 2 to 4 times more likely to have heart disease or experience a stroke than persons without diabetes. In 2000, the prevalence of any self-reported cardiovascular condition among persons with diabetes older than 35 years was greater than 30%. At least 65% of people with diabetes eventually die of cardiovascular disease, which is the leading cause of premature death among patients with diabetes. Although the cardiovascular disease mortality rate has declined in the United States, the relative reduction in mortality is much lower in persons with diabetes than in those without. Among persons with diabetes, the presence of microalbuminuria is strongly associated with coronary artery disease, left ventricular hypertrophy, and peripheral vascular disease.
49. 49. Microalbuminuria is an adverse prognostic indicator for cardiovascular disease outcomes and all- cause mortality in persons with diabetes. PreviousNext Metabolic Syndrome and Cardiovascular Disease The term metabolic syndrome refers to the clustering of risk factors for cardiovascular disease and type 2 diabetes. The most commonly utilized definition in the United States is the presence of at least three of the following five risk factors: 1. Fasting plasma glucose level 110 mg/dL (6.11 mmol/L) 2. HDL cholesterol level