Multiple Sclerosis Patient Visits—Carin Visit 2: A Young Female with a History of Clinically Isolated Syndrome: Delayed 3-month Follow-up

Learning Objectives

Upon completion of the activity, participants should be able to:

1. Implement guidelines, recommendations, and practice standards of care to accurately diagnose and classify level of disease among patients with multiple sclerosis (MS)
2. Evaluate the role of immunomodulators and immunosuppressants in specific MS management scenarios
3. Explain the role of standard and advanced imaging results in showing the impact of MS therapy on brain atrophy and neuronal preservation
4. Apply knowledge gained on safe and effective MS management options to optimize patient quality of life and reduce disability

Faculty

Howard L. Zwibel, MD
Neurologic Consultants Comprehensive
Multiple Sclerosis Center
Founding Medical Director Emeritus
Coral Gables, Florida

Howard L. Zwibel, MDHoward L. Zwibel, MD, is Founding Medical Director, Emeritus of Neuroscience Consultants Comprehensive Multiple Sclerosis Center in affiliation with the National Multiple Sclerosis Society (NMSS) in Coral Gables, Florida. He is also the past Medical Director of the Multiple Sclerosis Center at Doctors Hospital in Coral Gables, Florida. He earned an MD from Hahnemann Medical College in Philadelphia, Pennsylvania and completed a residency in neurology at Jackson Memorial Hospital at the University of Miami. Dr. Zwibel serves on the board of trustees of the South Florida Chapter of the NMSS and is Past Chairman and present member of the chapter's professional advisory committee. Dr. Zwibel currently serves on several committees with the NMSS, including the Clinic and Practice Committee, the Chapter Center Affiliation Committee, the Emerging Therapy Committee, and the Medical Advisory Board. Dr. Zwibel has received the HOPE Award from the NMSS. A scholarship in his name was given by the NMSS for medical students at the University of Miami School of Medicine to develop an interest in MS.

Dr. Zwibel has previously served as Chairman of the Practice Committee of the Multiple Sclerosis Section of the American Academy of Neurology, member of the board of governors of the Consortium of Multiple Sclerosis Centers, and voluntary Professor of Neurology at the University of Miami, Miller School of Medicine. He is a Diplomate of the American Board of Neurology.

Kathleen Costello, MS, ANP-BC, MSCN
Research Associate/Nurse Practitioner
Johns Hopkins MS Center
Johns Hopkins Medicine
Department of Neuroimmunology
Baltimore, Maryland

Kathleen Costello, MS, ANP-BC, MSCNKathleen Costello, MS, ANP-BC, MSCN, is an Adult Nurse Practitioner and Research Associate for the Johns Hopkins MS Center at Johns Hopkins Medicine in Baltimore, MD. She is also the Executive Director for Project Restore, a project designed to advance research in MS and transverse myelitis. In addition, she is the Director of the MS Specialist Certification Project for the Consortium of Multiple Sclerosis Centers. She is certified as an Adult Nurse Practitioner, Multiple Sclerosis Nurse, and a Multiple Sclerosis Specialist. In 1979, she earned her diploma in Nursing from St. Joseph Hospital in Baltimore. She earned both her BS in Nursing and MS as an Adult Nurse Practitioner from the University of Maryland in 1980 and 1998, respectively. She was among the founders of the International Organization of Multiple Sclerosis Nurses and served as the President of that organization from 2002-2004. She is extremely active in the education of MS nursing professionals through extensive lecturing and peer development programs and was instrumental in the development of the certification exam for MS specialists. She is a member of the Nurse Practitioner Association of Maryland and the International Organization of MS Nurses. She is published in numerous peer reviewed journals including American Journal of Rehabilitation Nurses, American Journal of Nurse Practitioners, and the International Journal of MS Care. She is an editor of the text, Nursing Practices in Multiple Sclerosis: A Core Curriculum, and has authored numerous book chapters.

Sponsored by North American Center for Continuing Medical Education, LLC

Activity Overview

CME Accreditation (Accepted for Physician Assistants)
North American Center for Continuing Medical Education, LLC (NACCME) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

NACCME designates this educational activity for a maximum of 0.5 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

The National Commission on Certification of Physician Assistants accepts AMA PRA Category 1 Credit™ from organizations accredited by the ACCME.

AANP Accreditation
This program has been approved for 0.5 contact hour of continuing education by the American Academy of Nurse Practitioners. Program ID 1005148.

This program was planned in accordance with AANP CE Standards and Policies and AANP Commercial Support Standards.

CNE Accreditation
North American Center for Continuing Medical Education, LLC (NACCME) is an approved provider of continuing nursing education by the Pennsylvania State Nurses Association, an accredited approver by the American Nurses Credentialing Center's Commission on Accreditation.

This continuing nursing education activity was approved for 0.5 contact hour.

Provider approved by the California Board of Registered Nursing, Provider #13255 for 0.5 contact hour.

CPE Accreditation
North American Center for Continuing Medical Education, LLC (NACCME) is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. This activity is approved for 0.5 contact hour (0.05 CEU) of continuing pharmacy education (UAN 276-000-10-030-H01-P)

Any participant wanting to file a grievance with respect to any aspect of a continuing pharmacy education activity accredited by NACCME may contact John Savage, Director, Medical Education, NACCME, in writing at 300 Rike Drive, Suite A, Millstone Township, NJ 08535, or by e-mail at jsavage@naccme.com. The Director of Medical Education will review the grievance and respond within 30 days of receiving the written statement. If the participant is unsatisfied with the response, an appeal to the Vice President, Medical Education, NACCME, may be made for a second level of review.

Independent Clinical Reviewer: Darin T. Okuda, MD, Assistant Clinical Professor of Neurology, UCSF Multiple Sclerosis Center, San Francisco, California

Planning Committee
The planning committee comprises Kathleen Costello, MS, ANP-BC, MSCN, Darin T. Okuda, MD, Howard L. Zwibel, MD; Kristin Ciszeski, Mary Johnson, Mike Kearney, Nick Lombardi, Randy Robbin, and John Savage, NACCME.

Financial Disclosure and Conflicts of Interest
According to the disclosure policy of NACCME, faculty, editors, managers, and other individuals who are in a position to control content are required to disclose any relevant financial relationships with relevant commercial companies related to this activity. All relevant conflicts of interest that are identified are reviewed for potential conflicts of interest. If a conflict is identified, it is the responsibility of NACCME to initiate a mechanism to resolve the conflict(s). The existence of these interests or relationships is not viewed as implying bias or decreasing the value of the presentation.

All educational materials are reviewed for fair balance, scientific objectivity of studies reported, and levels of evidence.

The faculty has reported the following:
Ms. Costello: Consultant—Acorda Therapeutics, Biogen Idec, EMD Serono, Inc, Novartis; Promotional speakers bureau—Biogen Idec, EMD Serono, Inc, Teva Neuroscience
Dr. Okuda: Grant/research support—Pfizer, Inc, EMD Serono, Inc
Dr. Zwibel: Consultant—Acorda Therapeutics, Teva Neuroscience; Promotional speakers bureau—Acorda Therapeutics, Teva Neuroscience

Ms. Ciszeski, Ms. Johnson, Mr. Kearney, Mr. Robbin, and Mr. Savage have disclosed no relevant financial relationships with any commercial interests.

Mr. Lombardi: Stock shareholder—Inspire Pharmaceuticals, Inc, Vertex Pharmaceuticals, ViroPharma, Inc

NACCME requires faculty to inform participants whenever off-label/unapproved uses of drugs and/or devices are discussed in their presentations.

The faculty has disclosed that no off-label/unapproved use(s) of drugs and/or devices will be discussed.

Privacy Policy
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NACCME maintains physical, electronic, and procedural safeguards that comply with federal regulations to guard your nonpublic personal information.

Copyright © 2010 by North American Center for Continuing Medical Education, LLC. All rights reserved. No part of this accredited continuing education activity may be reproduced or transmitted in any form or by any means, electronic or mechanical, without first obtaining permission from North American Center for Continuing Medical Education.

Grant Support