OVERVIEW
This free activity, entitled “CMV Infection in Transplant Recipients: Clinical Cases and Expert Opinion,” consists of four brief presentations and panel discussion, a Learning Assessment, and an Evaluation form. The content of this virtual lecture is derived from a symposium presented on October 26, 2008, during the 2008 ICAAC/IDSA Joint Meeting.

MEDIUM: Virtual Lecture and Podcast
LIVE RELEASE DATE: October 26, 2008
INTERNET RELEASE DATE: December 1, 2008
(Continuing education credit is no longer available for this activity.)

Estimated time to complete this activity: 2 hours and 45 minutes

TARGET AUDIENCE
This virtual lecture is designed to meet the educational needs of physicians, pharmacists, and nurses involved in the care of patients with cytomegalovirus (CMV).

ACTIVITY PURPOSE
This activity is intended to assist physicians, pharmacists, nurses, and other infectious disease specialists in understanding how to manage patients with CMV.

STATEMENT OF NEED
Cytomegalovirus (CMV) infection is an important cause of morbidity and mortality in recipients of hematopoietic stem cell transplant (HSCT) and solid organ transplant (SOT). Immunosuppression following transplantation is an important risk factor for the development of CMV infection. In turn, CMV disease is associated with an increased risk of graft loss, development of bacterial or fungal opportunistic infections, and increased mortality in this patient population. Several strategies exist to prevent CMV infection and disease in transplant recipients. Because each strategy has inherent advantages and limitations, controversy exists regarding the best method for CMV prevention. Despite significant progress in elucidating the pathophysiology of CMV infection and the spectrum of disease in transplant recipients, diagnostic and therapeutic challenges remain. Thus, a clear need exists for additional research into and improved therapies for patients who have this persistently ominous pathogen.

EDUCATIONAL OBJECTIVES
After completing this activity, the participant should be better able to:

• Cite challenges associated with cytomegalovirus (CMV) infection in solid organ transplant (SOT) recipients and hematopoietic stem cell transplant (HSCT) recipients
• Describe strategies for preventing CMV disease in transplant recipients
• Identify diagnostic methods for CMV in transplant recipients
• Review factors that contribute to late-onset CMV disease in SOT recipients
• Outline treatment options for CMV disease in transplant recipients

METHOD OF PARTICIPATION
There are no fees for participating and receiving CE credit for this activity. During the period October 26, 2008, through December 1, 2009, participants must 1) read the learning objectives and faculty disclosures; 2) study the educational activity; 3) complete the Learning Assessment by recording the best answer to each question in the “Learning Assessment Answers” box on the Evaluation form; 4) complete the Evaluation form; and 5) mail or fax the Evaluation form with the Learning Assessment answers to Postgraduate Institute for Medicine. You may also complete the Learning Assessment online at www.cmeuniversity.com. Click on “Find Post-Test/Evaluation by Course” on the navigation menu, and search by Project ID 5738.

Participants must receive a score of at least 70% on the Learning Assessment and must complete and submit the Evaluation form to successfully complete this activity. Participants who successfully complete the Learning Assessment and Evaluation form via www.cmeuniversity.com will have a statement of credit made available immediately. Participants who successfully complete this activity and submit the Learning Assessment and Evaluation form via fax or mail will be issued a statement of credit via US mail in 4 to 6 weeks.

PHYSICIAN CONTINUING EDUCATION
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 Postgraduate Institute for Medicine (PIM) and Robert Michael Educational Institute LLC (RMEI). PIM is accredited by the ACCME to provide continuing medical education for physicians.

CREDIT DESIGNATION
Postgraduate Institute for Medicine designates this educational activity for a maximum of 2.75 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

PHARMACIST CONTINUING EDUCATION
ACCREDITATION STATEMENT
Postgraduate Institute for Medicine is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

CREDIT DESIGNATION
Postgraduate Institute for Medicine designates this educational activity for a maximum of 2.7 contact hours (0.27 CEUs) of the Accreditation Council for Pharmacy Education. (Universal Program Number - 809-999-08-240-H01-P)

A statement of credit will be issued only upon receipt of the completed activity Evaluation form and will be mailed to you within 4 to 6 weeks. If you received credit for UPN 809-999-08-074-L01-P, you are not eligible for this activity.

NURSING CONTINUING EDUCATION
CNA/ANCC
This educational activity for 2.7 contact hours is provided by Postgraduate Institute for Medicine (PIM).

PIM is an approved provider of continuing education by the Colorado Nurses Association, an accredited approver by the American Nurses Credentialing Center's Commission on Accreditation.

CALIFORNIA BOARD OF REGISTERED NURSING
Postgraduate Institute for Medicine (PIM) is approved by the California Board of Registered Nursing, Provider Number 13485 for 3.3 contact hours.

FACULTY
Michael J. Boeckh, MD
Associate Member
Fred Hutchinson Cancer Research Center
Associate Professor
University of Washington School of Medicine
Seattle, Washington

John R. Wingard, MD
Professor and Price Chair of Medicine
Professor, Department of Pediatrics
Director, Blood and Bone Marrow Transplant Program
University of Florida Shands Cancer Center
Gainesville, Florida

Raymund R. Razonable, MD
Associate Professor of Medicine
Mayo Clinic College of Medicine
Rochester, Minnesota

Ajit P. Limaye, MD
Associate Professor
Laboratory Medicine
Co-Director
Clinical Microbiology Laboratory
Director, Organ Transplant Infectious Diseases Program
University of Washington Medical Center
Seattle, Washington

DISCLAIMER
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. 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.

DISCLOSURE OF UNLABELED USE
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. Postgraduate Institute for Medicine (PIM), Robert Michael Educational Institute LLC (RMEI) and ViroPharma Incorporated do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of PIM, RMEI, or ViroPharma Incorporated. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications and warnings.

DISCLOSURE OF CONFLICTS OF INTEREST
Postgraduate Institute for Medicine (PIM) assesses conflict of interest with its instructors, planners, managers and other individuals who are in a position to control the content of CME activities. All relevant conflicts of interest that are identified are thoroughly vetted by PIM for fair balance, scientific objectivity of studies utilized in this activity, and patient care recommendations. PIM is committed to providing its learners with high-quality CME activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.

The faculty reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CE activity:

• Dr. Michael J. Boeckh has an affiliation with ViroPharma Incorporated, Roche, Novartis, and AlphaVax (Consulting Fees); ViroPharma Incorporated, Roche, and Vical Inc. (Contracted Research); and Baxter (Other).
• Dr. John R. Wingard has an affiliation with Merck & Co., Inc., and Pfizer Inc. (Consulting Fees); and Astellas, Merck & Co., Inc., and Pfizer Inc. (Fees for Non-CME Services Received Directly from a Commercial Interest or their agents, e.g., speakers’ bureaus).
• Dr. Raymund R. Razonable has an affiliation with Roche (Contracted Research).
• Dr. Ajit P. Limaye has an affiliation with Roche (Consulting Fees, Contracted Research) and ViroPharma Incorporated (Contracted Research).

The following planners and managers have the following to disclose:

Robert Michael Educational Institute LLC

• Sherri Kramer, MD, has no affiliations with commercial interests to disclose.

Postgraduate Institute for Medicine

• Jan Hixon, RN, BSN, MA, has no affiliations with commercial interests to disclose.
• Linda Graham, RN, has no affiliations with commercial interests to disclose.
• Trace Hutchison, PharmD, has no affiliations with commercial interests to disclose.

FEE INFORMATION
There is no fee for this educational activity.

QUESTIONS & TECHNICAL ASSISTANCE
For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity: jjones@pimed.com. For technical assistance, contact jungsen@rmcom.net.

SYSTEM REQUIREMENTS
Hardware/Software requirements include:
• Windows 95, 98se, ME, XP, NT 4.0, 2000   
  - Internet Explorer 4.0+
  - Netscape Navigator 6.2+
  - AOL 8
  - Mozilla Firefox 1.0+
• Macintosh 9.2, OS X 10.1+
  - Safari 1.1+
  - Netscape Navigator 6.2+
  - Internet Explorer 5.2+
  - Mozilla Firefox 1.0+
• Additional Requirements
  - Macromedia Flash Player 7
  - Internal/external speakers
  - Broadband connection (DSL/cable) recommended

To see additional educational programming available from Robert Michael Educational Institute LLC,
visit www.RMEI.com.

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