From the Director
Hello!
This week was capped off by one of the best days of the year.....intern day off! Thanks to the chiefs for an awesome and hilarious jeopardy grand rounds, and to the JARs and SARs who covered so the interns could have a great day. And, of course, thanks to the interns for their hard work this year...you are really close to being JARs!
The Stead trivia night was a huge success....see below from Matt Crowley...
Also congrats this week goes to
Ragnar Palsson for his gold star and from
Mike Durheim to Aparna Swaminathan and Nijhu Bhowmik for outstanding work on 7800. Also to
Newton Wiggins and Jon Menachem for our cardiology themed SAR talks, complete with some
Tom Holland worthy jokes.
We had our first fellowship info meeting this week - if you couldn't attend, there is another chance this week. See you there! The info is for anyone planning to apply to fellowships this summer or any interns who are wondering what this is all about.
Get ready for
"MiniCex Madness!" Is it as cool as March Madness? No, but, direct observation of your work is a huge part of learning how to be the best physician you can be. Details to come this week.
This week's pubmed from the program goes to
Adia Ross for her article in The Hospitalist about residency leadership.
http://www.acphospitalist.org/archives/2013/02/residents.htm
Have a great week
Aimee
(pictures from Intern Day Off)
QI Corner (Submitted by Jon Bae, MD)
Quality Improvement and Patient Safety Conference
Please join us for our next Quality Improvement and Patient Safety Noon Conference!
- When: Wednesday, February 28th
- Who: Mamata Yanamadala discussing Patient Safety and Medical Error. Also Ryan & George w/QI updates
Don't make the ERROR of missing this one!
Medicine Patient Safety and Quality Council Updates
2 projects ongoing, from residents, by residents
- 1) Outside Hospital Transfer Process Review and Improvement
- 2) DOC Discharge Follow-up Clinic
If interested, get involved today!
[box]
What did I read this week (submitted by Dave Butterly, MD)
Cytomegalovirus Exposure and Cardiovascular Disease in Kidney Transplant Recipients Cecile Courivaud et al Journal of Infectious Diseases 2013
[/box]
I saw this article this week on the ASN's web site. It was published online 2/15 in the
Journal of Infectious Diseases and will appear in print later in the year. I found the topic and the results very interesting and clinically relevant.
With modern immunosuppressant regimens, 1 year outcomes for kidney transplantation have continued to improve and now are greater than 90%. Recipients of a successful transplant experience a tremendous impovement in quality of life as well as a mortality benefit. The risk of death for transplant recipients is less than half that of age matched controls maintained on dialysis. However, the number one cause of mortality after the first year in kidney transplant recipients is cardiovascular and the number one reason for allograft loss is death with a functioning transplant due to cardiovascular mortality. Clearly, better understanding the causes of this excess mortality could have a tremendous impact on our patients.
This study looks at the results in a cohort of 570 consecutive renal transplant recipients. Follow-up was 87 months. Immunosuppressant protocols were similar to the Duke regimen and included : MMF, Tacrolimus, Prednisone, and induction with either ATG, Thymo, or anti-CD-25 Aby. Patients transplanted prior to the release of Tacrolimus were treated with Cyclosporine. 357 patients were CMV exposed and 213 were CMV negative. All CMV positive patients were given CMV prophylaxis post transplant. Of the 357 patients with CMV exposure, 225 had no evidence of CMV replication (CMV-DNA remained neg on monitoring) while 132 of the group did (CMV-DNA positive on surveillance). These 3 groups: CMV neg, CMV pos with no viral replication, and CMV + with viral replication make up the 3 groups reported in the remainder of the study.
Atherosclerotic events (AE) occured in 8.5%, 13.2%, and 18.2% of the cohort. Highest event rate was in the group with CMV replication, those with exposure but no replication were in the middle and the CMV negative group experienced the best outcomes. CMV exposure carried a RR of 1.8 of Atherosclerotic event. The group with CMV replication had a RR of 2.06 of atherosclerotic event and an increased (1.76) risk of death. These survival curves are shown in Figure 1, pages 21, 22, and 23.
The potential pathophysiologic mechanisms for this association along with the potential for impacting this positively by better surveillance and CMV prophylaxis are discussed.
JID-CMV&CVMortality.full
[divider]
From the Chief Residents
Grand Rounds
| Date |
Division |
Speaker |
| 1-Mar-13 |
Pulmonology |
Dr. Scott Palmer |
Noon Conference
| Date |
Topic |
Lecturer |
Vendor |
Room |
| 2/25 |
SAR talks |
Lisa Vann, Shereen Katrak |
Jersey Mike's |
2002 |
| 2/26 |
Hypopituitarism |
Jennifer Perkins |
Bullock's BBQ |
2002 |
| 2/27 |
QI/Patient Safety Conference |
Jon Bae |
Moe's |
2002 |
| 2/28 |
Board Review |
ACRs |
Saladelia |
2002 |
| 3/1 |
Chair's Conference |
Chiefs |
Pita Pit |
2002 |
Informational session on Fellowship Programs
Dr. Aimee Zaas and
Dr. Bill Hargett will be leading the final informational session on Fellowship Programs and the application process this week. Important information and insights will be shared and it is a great opportunity for anyone who is interested in applying for Fellowship!
Tuesday, Feb. 26
th 5:30 - 6:30 p.m., in the MedRes Library
Results of the Carolina Ale House Trivia Contest (submitted by Matt Crowley, MD)
“Let it be known that on the 20th night of February 2013, a valiant group of
Kempners entered into trivia battle in the arena known as the Carolina Ale House. Riding upon steeds of knowledge,
Sam Horr, Zach Healy, Joel Boggan, Eileen Maziarz, Dave Simel, Schuyler Jones, and company aimed to strike down any foe who dared cross their path.
Despite dire circumstances (i.e., a few misfires that left us just a couple spots from last place with 5 questions remaining), these gallant trivia warriors never lost hope. Displaying massive fortitude, Kempner coolly submitted the most improbable series of correct answers in the history of trivia (Italy? Hamburger Helper?? Joe Versus the Volcano??? Butterflies?!?!?), and not only defeated the other Stead Societies (much to the chagrin of
Susanna Naggie’s Smith Society, who had been leading throughout the night), but also emerged victorious overall (out of 19 teams!).
It was a truly epic performance, and one that will live on in Kempner lore for eternity. As a result of the Kempner victory, Rankin Society made a
$200 donation to Stead Tread 2013 to benefit Lincoln Community Health Center. Thanks to Steve
Crowley and Rankin Society for hosting trivia night and for their donation!”
[divider]
From the Residency Office
Maestro Training
We are continuing to work out the details of the Maestro training schedule, and it is likely that you will receive an email generated by the training system as slots are filled. Please retain this for your records, but in addition, your training dates will be added in to Amion/MedHub as well.
Access to Survey Tools (submitted by Tom LeBlanc, MD)
Duke provides free access to a phenomenal survey design system called
Qualtrics. It’s free, AND it has much better reporting, tracking, and statistical components. You just go to duke.qualtrics.com, and sign in with your NetID.
For any residents who want to do survey research, or even surveys for their SAR talks, I’d highly recommend Qualtrics. It’s very easy to use, is more powerful than SurveyMonkey, and it’s free
Do You Have Something to Sell (or Need)??
Check out the following site hosted by Duke if you have something you want to post for sale, or search for items that are offered by other Duke employees (homes, electronics, rentals, etc.)
http://dukelist.duke.edu/
Cardiovascular Young Investigators Competition - Poster Session (submited by Paul Rosenburg, MD)
Announcing an opportunity to participate in the poster session at the 2013 Cardiovascular Symposium, Tuesday May 14 in Searle Lecture Hall, highlighting the work of our talented students, post-doctoral fellows, and housestaff. If you are interested in presenting your work as a poster, please email your PDF abstract to
amberly.adams@duke.edu by April 15, 2013. Abstracts should be 1 page or less with 1 figure and sections for intro, materials and methods, results and discussion, and conclusion. Abstracts should also include your name, your professional title and abstract title in the header. All who submit abstracts will be given space to display their poster and will have an opportunity to discuss their work with symposium attendees. If you plan to display a poster please include the size in the email. Abstracts previously submitted to national meetings (i.e. AHA, ACC) are acceptable.
In addition, after reviewing the abstracts three finalists will be chosen to participate in a Young Investigators Competition and will present their work orally on the day of the symposium (they will be notified by April 29th in order to have time to prepare). The three finalists must display a poster along with their talk. A winner will be announced at the end of the day. Prizes will be awarded to the finalists: first place - Ipad, gift certificates for 2nd and 3rd place.
Contact Information/Opportunities
CMS Letterhead Geriatriac
Knoxville, TN IM
Upcoming Dates and Events
- March 12 & 19: Duke Medical Oncology fellowship discussions, 4:00, Med Res Library
- March 15: MATCH DAY CELEBRATION at Dr. Klotman’s!
- March 25-28: BLS Blitz (registration: blsblitz )
- March 29: Faculty Resident Research Grant Application Deadline
- April 19: Residency Program Pictures (rain date April 26)
- April 28: 2nd Annual Stead Tread
- June 4: Resident Research Conference, Searle Center
- June 8: SAR Dinner, Hope Valley Country Club
Useful links
