"Weekly Updates" February 20, 2012

From the Director

Hey Everyone! Hard to believe it's almost March! The hospitals remain extremely busy, and being on gen med this week I have been getting a great opportunity to see the outstanding care you all provide on a daily basis! Lots of compliments have been coming to me – shout outs to intern Sarah Wingfield for her above-and-beyond care for a family (a gold star is on its way!), as well as to JAR Jon Menachem from his colleagues at the VA for excellent care in an emergent situation, Intern Matt Summers from Lynn Bowlby for great work at the DOC and night JARS Blake Cameron and Kathleen Kiernan for fantastic work. I'm sure there is more....this is just what I have heard this week! Pubmed from the program this week goes to SAR Ryan Schulties for his work with Dr. Ralph Corey "carotid-cavernous fistulas: not a diagnosis of exclusion" The NC ACP meeting is this week - congratulations to our residents who are presenting posters (see table below). Have a great week - we will keep you posted on where to meet us to watch the Duke -Carolina game ! Aimee

	Author		Title
Resident	Amanda	Elliott		A Common, Inherited Genomic Deletion At Negr1 Is Associated With Body Mass Index And Highlights A Neuronal Influence On Body Mass
Resident	Samuel	Horr		A ''Deep Seeded'' Problem
Resident	Brian	Miller	Tian Zhang, Daniel Kaplan	Non-infectious mimics of infectious diseases: A case presentation of new onset Crohn?s disease
Resident	John	Roberts	Arthur Greenberg MD	Multi-Focal Fibromuscular Dysplasia causing Renovascular Hypertension and Chronic Mesenteric Ischemia
Resident	John	Stanifer	Uptal Patel, MD; Nathan Thielman, MD	Chronic Kidney Disease in Sub-Saharan Africa
Resident	Sima	Pendharkr	Sundhar Ramalingam, Ambika Tumkur, Mitch Black, Thomas Ortel	Cramping My Style: A Case of Quinine Induced TTP – HUS
Resident	Richard	Wu		Noncirrhotic Hyperammonemic Encephalopathy from an unusual ammonia cleaving bacteria
Resident	Joel	Boggan		Shift changes for the hospital team:  standardizing and evaluating transitions of care in the era of duty-hour reform
Resident	Krish	Patel	George Cheely MD, Amanda George MD, Saumil Chudgar MD	A "mass" to remember
Resident	Jennifer	Rymer	Tian Zhang, MD;  Daniel Kaplan, MD	Expanding the Differential of Vesiculobullous Disease: A Case of Vancomycin-Induced Linear IgA Bullous Dermatosis
Med Student	Christina	Behrend	Nicole Greyshock MD, Daniel Ong MD, Alyssa Stephany MD	A curious case of caffeine-induced hypokalemic paralysis
Med Student	Jonathan	O''Donnell	John Posenau, MD, Kristen Dicks, MD, and Saumil Chudgar, MD	A Rheumatologic Riddle

What Did I Read This Week (by Anne Phelps, MD)

[box] Calcium supplements with or without vitamin D and risk of cardiovascular events: reanalysis of the Women’s Health Initiative limited access dataset and meta-analysis. BMJ. 2011;342:d2040) complete article [/box] This meta analysis raises questions about the safety of calcium and vitamin D use. Many patients have stopped their supplements due to their concern about an increased risk of cardiovascular events. Articles: 1. Review New Insights about Vitamin D and Cardiovascular Disease. Annals of Internal Medicine December 20,2011. Volume 155, Number 12, pages 820-824. Conclusions: Vitamin D deficiency has been implicated in the development of artherosclerosis and endothelial dysfunction. While there are studies linking low Vitamin D levels and an increased risk for myocardial infarction, there is no clear evidence demonstrating that vitamin D supplementation prevents cardiovascular events. 2. Vitamin D With or Without Calcium Supplementation for Prevention of Cancer and Fractures: An updated Meta-analysis from the U.S. Preventive Services Task Force. Annals of Internal Medicine. December 20th, 2011. Volume 155, Number 12 pages 827-837. Conclusions: Vitamin D plus calcium supplementation decrease fracture risks in older persons. There is insufficient data to link calcium and vitamin D supplement with increased or decreased risk of cancer. Summary: Looking at multiple studies, there is a large body of evidence showing that calcium and vitamin D use decreases a postmenopausal women’s risk of fracture. There are multiple studies showing no benefit or harm from calcium and vitamin D supplementation on cardiovascular events.  (References 1,2.) At this point, women should not stop their calcium and vitamin D supplement after this one meta-analysis from the WHI study. More data is needed before I would recommend stopping calcium plus vitamin D supplements. References: 1. Hsia J, Heiss G, Ren H, et al; Women’s Health Initiative Investigators. Calcium/vitamin D supplementation and cardiovascular events. Circulation. 2007;115:846-54. [PubMed ID: 17309935] 2. Wang L, Manson JE, Song Y, Sesso HD. Systematic review: vitamin D and calcium supplementation in prevention of cardiovascular events. Ann Intern Med. 2010;152:315-23. [PubMed ID: 20194238]   [hr] [divider]

From the Chief Residents

Grand Rounds

Date	Speaker	Division	Topic
2/24/12	Dr. Ferranti	CMIO/VP CI	Maestro Care

Noon Conference

Day	Date	Topic	Lecturer	Time	Vendor
Monday	2/20	Dr. Dinge - combined Med, Med-Psych	Dr. Dinge	12:00	Jersey Mike's
Tuesday	2/21	Med Peds SAR Talk     Ketan Shah/ Olivia Granillo Johnson	Ketan Shah/ Olivia Granillo Johnson	12:00	Dominos
Wednesday	2/22	Gallops	ACRs	12:00	Saladelia
Thursday	2/23	SAR TALK	Lauran Gratian/April Barnado	12:00	Chick-fil-A
Friday	2/24	Chair's Conference	Chiefs	11:00	Meelos

Duke Cardiology Fellowship - Meet and Greet

Cardiology will host a casual meeting between interns, residents considering applying for cardiology fellowship and current fellows on Tuesday, February 28, 2012, 6:30 at the indoor patio,  Geer St Pub.  If you are planning to attend, please RSVP to Zubin Eapen? Andrew Wang, MD Director, Cardiovascular Disease Fellowship Program

Charity Auction

Friday March 23rd at 7pm, at the Durham Arts Council Building. If you would like to support our cause, please contact Tian at tian.zhang2@duke.edu." 12th annual Charity Auction save the date

Picker Institute Challenge Grant (tian.zhang2@duke.edu)

The Picker Institute RFP is now open.  Check out the following attachment regarding this opportunity - Picker Institute

Humanism in Medicine - May 5, 2012

Please contact Chris Hostler if you're interested in either helping to organize this wonderful tradition or if you'd like to participate in the night's festivities. [divider]

From the Residency Office

MLSP and Survival Guides

We are offering a 2nd opportunity this year for Rising SAR's to submit a request for MKSAP.  How?  Complete the following online request. We also are considering placing an order for more Survival Guides due to the demand that we have seen to replace those that have been lost.  If you lost yours and need a replacement, you can use the following link as well to submit your name. When?  complete the survey no later than Monday, February 27, 2012. https://www.surveymonkey.com/s/MKSAP_SURVIVAL_GUIDE_REQUESTS

BLS BLITZ

Reminder to check your expiration dates.    The following link takes you to registration:  Blitz registration April 2012

February - Month to Celebrate GME

Please join Duke GME Leadership and staff in celebrating our GME community and the contributions made towards making this a terrific year of GME.  The month of February has many events scheduled.  We encourage you to take advantage of some of these opportunities during the month.  GME Month 2012 - Calendar of Events<https://gme.duke.edu/sites/medicine.duke.edumedicine.duke.edudefault/files/files/GME%20Month%20Calendar%20of%20Events%201-18-12_0.pdf

Opportunities

Dates to Add to Your Calendars

March 23 - Charity Auction May 5 - Humanism in Medicine June 2 - Annual SAR Dinner (invitations only) June 13 –Resident Research Event, 5-7pm

Useful links

• Main Internal Medicine Residency website
• Main Curriculum website
• Ambulatory curriculum wiki
• Confidential Comment Line Note: ALL submissions are strictly confidential unless you chose to complete the optional section requesting a response.
• Department of Medicine