From the Director
Hi everyone!
T-1 day until the last day of recruiting! You all have been fantastic ambassadors of the program, even despite the perennial low point of late January! Looking forward to our end of recruitment party at
Piazza Italia this Friday. Please don't forget to RSVP so we can get a reasonable count of who can make it.
Kudos this week go to
Aaron Mitchell for a fantastic chair's conference on a complicated case of cryoglobulinemia and hyper viscosity syndrome presenting as "falling out". Many people remarked that they finally understood the differences between paraproteins, cryoglobulins and cold agglutinins after Aaron's talk! Also kudos from
Peter Kussin to Mandar Aras for great care of a patient on Duke nights, to
Erin Boehm from Bimal Shah for fantastic work on CAD, and also to
Wendy Zhang from Kevin Harrison for spectacular work on CAD. Also thanks to everyone for being good sports while on the pull list — here's hoping the norovirus and flu start to calm down!
This week's
pubmed from the program goes to our many residents who will be presenting at the upcoming NC ACP meeting!
Carolyn Avery, Wassim Shatilla, Andrea Shaw, Ben Heyman, Brian Miller, Lauren Prats, Mandar Aras, Matt Chung, Jim Gentry and Jenn Rymer. Wonderful job – we look forward to seeing your posters!
Also congrats to medical students
Bill McManigle and Matthew Foglia on their upcoming presentations as well.
Have a great week!
Aimee
QI Corner (submitted by Jon Bae, MD)
Time to Get your Phil of Quality at our next Quality Improvement and Patient Safety Noon Conference!
When: Wednesday, January 30th, Noon Conference
Who: Dr. E. Philip Lehman IV
What: The Fiscal Cliff and Healthcare
Also Featuring: Ryan & George with QI Updates
But wait, there's more! Will also provide a Sharepoint Diabetic Foot Exam Update!
What Did I Read This Week (by Suzanne Woods, MD)
[box]Limited options left to treat N. gonorhoeae; Infectious Disease News Jan 2013, Vol 26, No 1 [/box]
Why did I read this article: This is one of a few ID publications that arrive in our home mail (for the other Dr. Woods) and I find it is always informative. The topic is of interest to me given the amount of time we spend in Med-Peds clinic on STI (sexually transmitted infection) evaluation, treatment and counseling.
Summary: The CDC issued new treatment guidelines for Neisseria gonorrhoeae in Aug 2012 based on evidence that resistance to cefixime was emerging. The current recommendations for patients who test positive for GC are: use a combination of ceftriaxone 250mg IM and either azithromycin 1 gram po x1 or doxycycline 100 mg po x7 days. Azithro is preferable due to convenience and compliance with dosing and lower resistance compared with the tetracyclines. The concern is that following ceftriaxone there are no highly effective and well-studied options for treating this infection. It is estimated >700,000 people are infected each year with GC in the US.
History: GC was first treated with sulfa drugs but resistance developed very rapidly. Penicillin was then introduced in the 1940s and remained the drug of choice for decades. By the early 1980s though it could no longer be used and fluoroquinolones were the next choice. In 2007 due to additional resistance the CDC recommended oral cephalosporins as the first line of therapy. In just the last five years resistance has again developed and now injectable cephalosporins are the last remaining drugs to use. Patterns of resistance are detected through a CDC national surveillance system (GISP). Each month isolates are collected from the first 25 men who present with GC to some STD clinics. Antimicrobial susceptibility testing is performed on these isolates to determine the MIC’s.
Challenges:
- Tests of cure are not universally recommended, unless pt. receives therapy other than the recommended one above.
- Expedited partner therapy (EPT) is allowed in some states, but complicated by recommendation to use IM ceftriaxone. Should encourage infected patients to have all sexual partners in the last 60 days seek evaluation and treatment for STI’s.
- Antimicrobial susceptibility testing is done on isolates from culture and most practices no longer routine perform cultures.
- ? future treatments………gentamicin, carbapenams…..
Take home points:
- Remember to screen, especially since many patients are asymptomatic!
- Follow treatment recommendations as above.
- If allergic to cephalosporins, use 2g po azithro x1 and do test of cure in 7 days.
[divider]
From the Chief Residents
Grand Rounds
| Date |
Department |
Speaker |
Title |
| Feb 1, 2013 |
Medicine / Psychiatry |
Xavier Preud'homme |
Sleep and Physician Fatigue |
Noon Conference
| Day |
Date |
Topic |
Lecturer |
Vendor |
| Monday |
1/28 |
INTERVIEW |
|
Nosh |
| Tuesday |
1/29 |
Renal Transplant |
Matt Ellis |
The Picnic Basket |
| Wednesday |
1/30 |
QI/Patient Safety Conference |
Jon Bae |
Bullock's BBQ |
| Thursday |
1/31 |
SAR talks |
Blake Cameron, Natasha Cunningham |
Chick-fil-A |
| Friday |
2/1 |
Chair's Conference |
Chiefs |
Jimmy John's |
Annual Charity Auction - Tickets on Sale NOW!!!
2013 Charity Auction
benefiting Durham Senior PharmAssist
& The DOC Clinic Fund
Friday – February 15, 2013
Durham Arts Council Building
120 Morris Street, Durham, NC
Tickets - On sale in the Med Res Office and at Grand Rounds
[divider]
From the Residency Office
Global Health Fellowship
The University of Miami is starting a Global Health-Hospitalist Fellowship in July 2013, and we are currently seeking qualified applicants for the positions. We would greatly appreciate if you would forward the flyer (attached) to any internal medicine residents who will complete their training in June and might be interested in a two year global health fellowship. The deadline for applications is February 8th. Please contact me with any questions. Thank you.
Vincent DeGennaro, MD, MPH
Medical Director, Global Health Hospitalist Fellowship
University of Miami
USA
305-984-6249; Haiti 509-3822-4796
Applications for 2013 Dr. Charles A. Sanders/Project HOPE International Residency Scholarship Now Being Accepted
Applications are now being accepted for the 2013 Dr.
Charles A. Sanders/Project HOPE International Residency Scholarship funded by the North Carolina GlaxoSmithKline Foundation. The scholarship program enables current medical residents from the state of North Carolina to participate in a one- to two-month supervised global health elective at one of Project HOPE’s program sites in the developing world.
http://www.projecthope.org/news-blogs/press-releases/applications-for-2013-dr.html
MLPR - RECEPTION MONDAY, JANUARY 28
The Management and Leadership Pathway for Residents (MLPR ) will hold an information session for interested residents on Monday, January 28
from 5:30 – 6:30 in the Faculty Center (in the Library, just off the walkway between the Hospital and Clinics). Dr. William Fulkerson, Chief Executive Officer, Duke University Hospital and MLPR Program Director, and current residents and faculty will be available to answer questions about the program.
The Duke Science Review
Want to get connected with medical, graduate and undergraduate students across campus who love science as much as you do?
Come to The Duke Science Review information session on January 22nd at 7 pm in the Social Sciences Center 136 to learn more about how to get involved.
DSR is the new premiere campus wide science review journal created by medical students for the Duke scientific community. The publication will give clinical physicians and researchers the opportunity to publish review articles on scientific subjects. These review articles can be about personal work or about any topic you are interested in!
We will provide dinner (pizza, soda), so please let us know if you're coming! RSVP to
https://docs.google.com/spreadsheet/viewform?formkey=dFNkOEZZQmlFNll4R1N3SmR6bm5LTGc6MQ
Who: The Duke Science Review
What: Information Session
When: January 22nd at 7 pm
Where: Social Sciences Center 136
Why: To learn about the opportunity to publish review articles in DSR!
Contact Information/Opportunities
Raleigh Medical Group MD position 2013
Raleigh Medical Group MD position 2013 letter
Upcoming Dates and Events
January 28: MLPR Reception/Information SessionFebruary 1, 5:30 in the Faculty Lounge
February 1: CELEBRATE THE END OF RECRUITMENT!! (by invitation)
February 8: ACP Meeting /Poster Session, Washington Duke
February 13: Duke/ UNC Game at Motorco
February 15: Annual Charity Auction, 7 PM at the Durham Arts Center
March 15: MATCH DAY CELEBRATION at Dr. Klotman’s!
April 28: 2nd Annual Stead Tread
June 4: Resident Research Conference, Searle Center
June 8: SAR Dinner, Hope Valley Country Club
Useful links
