From the Director
Hey everyone! Welcome back from the holiday break! First, a big thanks to you all - with the influenza epidemic and the other winter ills, the pull list has been put to maximal use. Even if it doesn't feel like it, part of professionalism is staying home if you are sick (protect the patients and each other) and we all really appreciate the ease at which people step up when called in to cover. And a reminder, we reached 100% in the flu shot or online opt out....now is still a good time to get your shot if you opted out and can safely get a vaccination.
Kudos this week go to three residents who received gold stars...
Yvonne "four star general" Mowery, Denise Duan-Porter and Lindsey Boole. Great work, all. Plus, two great SAR talks by
Bonike Oloruntoba and Jason Rose!
Also congratulations to two of our senior residents and their fiancés! Both
Megan Diehl and Rebecca Sadun got engaged in December.
Winter social events....recruitment dinners continue on Sundays and Thursdays, the chiefs are planning a joint EM-IM happy hour, we will celebrate the end of recruitment in late January and have the Match Party at Dr. Klotman's on March 15! Plus, the Spectacular Charity Auction is coming up soon!!
This week's pubmed from the program goes to
Phil Lehman for his op-Ed piece in the Washington Times.
http://www.washingtontimes.com/news/2012/dec/28/obamas-student-loan-repayment-racket-program-hurts/
Have a great week!
Aimee
What Did I Read This Week (by, Saumil Chudgar, MD )
[box] Oral Rivaroxaban for the Treatment of Symptomatic Pulmonary Embolism, The EINSTEIN-PE Investigators, N Engl J Med 2012; 366:1287-97 [/box]
Why I read this?
I recently had a patient admitted to my service that had been discharged from an OSH on rivaroxaban for acute DVT and PE. I had seen rivaroxaban used for Afib and for VTE prophylaxis after orthopedic surgery, but this is the first use I had seen for treatment of PE, so I wanted to read more about the data behind it.
What they found?
This was a randomized, open-label, noninferiority trial that compared rivaroxaban at 15 mg q12h x 3 weeks followed by 20 mg daily with enoxaparin + warfarin for the treatment of PE. Nearly 5,000 patients were enrolled from multiple sites in 38 countries. The primary efficacy endpoint was recurrent PE or DVT while on therapy. This occurred in 2.1% in the rivaroxaban group and 1.8% in the warfarin group (HR 1.12, 95% CI 0.75 – 1.68). No difference was found in primary safety endpoint was major or clinically relevant nonmajor bleeding (HR 0.90, 95% CI 0.76 – 1.07). Major bleeding was less likely in the rivaroxaban group (1.1% vs. 2.2%, HR 0.49, 95% CI 0.31 – 0.79). Mortality was also similar between the two groups.
What I learned?
The authors draw the conclusion based on this data that rivaroxaban is noninferior to enoxaparin + warfarin for treatment of symptomatic PE with a lower risk of major bleeding. It seems that the new oral anticoagulants (both the oral Xa inhibitors like rivaroxaban and the direct thrombin inhibitors like dabigatran) will be something that we will be seeing more and more commonly.
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From the Chief Residents
Grand Rounds
| Date |
Division |
Speaker |
| 11-Jan-13 |
General Medicine |
Dr. James Tulsky |
Noon Conference
| Day |
Date |
Topic |
Lecturer |
Time |
Vendor |
Room |
| Monday |
1/7 |
INTERVIEW |
|
12:00 |
Pipers |
2002 |
| Tuesday |
1/8 |
MED PEDS INTERVIEW |
|
12:00 |
Saladelia |
2002 |
| Wednesday |
1/9 |
Improving Communication--PWIM Conference |
|
12:00 |
Moe's |
2002 |
| Thursday |
1/10 |
SAR talks |
John Stanifer, Tara Weiselberg |
12:00 |
Domino's |
2002 |
Updates from the Ambulatory Chief (and PICTURES)
Kristin DeHaven Greyshock was born on 12/26/12 at 9:34 pm. She was 7 pounds 9 ounces & 20 inches of beautiful perfection. We're at home & doing well. Dave & I appreciate everyone's support!
In my absence, please contact Kathleen Kiernan for issues related to Durham Regional Hospital, DRH morning report, or pre-clinic conferences. Please contact Lynn Bowlby regarding the DOC. For questions regarding your ambulatory schedules, contact Lauren Dincher. For other concerns, please contact Jeff or Jason.
Thank you all for the hard work you do! Congratulations on finishing half of the year! I'll look forward to seeing you all in a few weeks! Happy New Year!
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From the Residency Office
Teaching the Outpatient Teachers - A Half Day Workshop Sponsored by The Duke Primary Care Leadership Track
Date: Friday, January 11, 2013 (AM and PM sessions)
Topics to be covered include Giving Streamlined Feedback, Using an iPad, Staying on time in a busy practice, Improve your Musculoskeletal Exam, and Review of Compliance issues
To Enroll contact Blake Wiggins at
blake.wiggins@duke.edu
teaching outpt teachers 3 0 docx (2)
ACLS/BLS Certification Dates
Refer to the following schedule for additional information and training dates:
2013 Life Support Offerings - January - June
Recruiting Dinners and Tour Guide
If you haven't done so already, PLEASE sign up for a Recruitment Dinner and/or to be a Tour Guide on a Recruitment day! The links to sign up for both are below!
http://www.signupgenius.com/go/60B084FAEAE2CA13-december
http://www.signupgenius.com/go/60B084FAEAE2CA13-december1
Contact Information/Opportunities
North Carolina Internal Medicine
Upcoming Dates and Events
March 15 Match Day - Celebration at Dr. Klotman's
Useful links
