Weekly Updates - June 18, 2012

By admin2

From the Director

New interns arrive in one week! And it's the last week for our amazing Chief residents.  VA Chief Tony Guiterrez capped off his year with a tour de force grand rounds. This week also featured our Resident Research Night - what an impressive showing by so many of you. A full list of poster presenters is included on this program. Many thanks to our mentors as well. A special recognition to our Califf Award winners (and this week's Pubmed from the Program!):

First place - Stephen Sumner, MD (mentor Nathan Theilman, MD, MPH)  Association between Earthquake Events and Cholera Outbreaks:   A Cross-Country 15-year Longitudinal Analysis

Second place - Joel Boggan, MD, MPH (mentor Ravi Jhaveri, MD)  Pediatric-specific Antimicrobial Susceptibility Data Improve Empiric Antibiotic Selection

Third place - John Roberts, MD, MS (mentor, Uptal Patel, MD, MHS) Comparative Efficacy of Revascularization Procedures for Severe CAD in Patients with Chronic Kidney Disease

Also, congratulations to our other reward winners and nominees from this year, announced at Tony's grand rounds.

The Eugene A. Stead, Jr. M. D. Award:  Louis Diehl,  Chet Patel

VA Faculty Teaching Award:   Schuyler Jones       

Lecocq Award for Outstanding Senior Resident Talk:  1st Jared Chiarchiaro,  2nd Priyesh Patel, 3rd David lofthus

Finally, many many thanks to our Stead attendings from this year - and note that a picture of Stead rounds with Manesh Patel made the New York Times this week!  It's not always easy to fit in "extra" teaching time on a busy service, and your efforts to teach and mentor us are much appreciated.  So, thanks to Chet Patel, Manesh Patel, Claude Piantadosi, Lou Diehl, Anna Mae Diehl, Vance Fowler, John Perfect, Diana McNeill, Kevin Schulman, Tom Owens, David Zaas, Murat Arcasoy, Mike Felker, Joel Morganlander, Bill Fulkerson, Joe Govert, Mitch Heflin, Cathleen Colon Emeric, David Simel, Heather Whitson, Matt Ellis, Susanna Naggie, Peter Kussin, Gene Oddone, Joe Govert, James Tulsky, Andy Alspaugh, Brice Weinberg, Larry Moss, Tony Huang, Rudy Lehrich, Cary Ward, Andrew Muir, Steve Crowley, Ben Powers, Bob Harrington, Ralph Corey, and Peter Ubel. See you at Eileen's Grand Rounds! Aimee

What Did I Read This Week (Daniella Zipkin, MD)

[box]       Efficacy and Safety of Exenatide Once Weekly Versus Metformin, Pioglitazone, and Sitagliptin Used as Monotherapy in Drug-Naïve Patients With Type 2 Diabetes (DURATION-4): A 26-week double blind study. Diabetes Care 35:252-258, 2012       [/box] Why did I read this? When the incretin mimetic class of drugs first emerged, animal models showed beta cell preservation and diabetes prevention. I’ve been waiting to see more studies which employed these agents as first line and compared to current standards. (Incretin mimetics include GLP-1 analogues like exenatide which stimulate glucose dependent insulin secretion, and DPP-IV inhibitors like sitagliptin inhibit the enzyme which degrades GLP-1 and indirectly lead to similar effects) What were the main results? The design was set-up to look for non-inferiority. A1c reduction was -1.53% in the exenatide weekly (IM) group, -1.48% in metformin, -1.63% in pioglitazone, and -1.15% in sitagliptin. Exenatide was non-inferior to metformin but not non-inferior to pioglitazone. Exenatide was superior to sitagliptin. The power (ability to find a difference if one is really there) was not quite met – they needed 740 patients and only 696 completed the 26 weeks. How will I use these results? The study was short and may have missed other meaningful differences. It’s good to know that our current standard of starting with metformin is not worse than exenatide for first line therapy, at least in terms of A1c lowering. The paper supports current practice – it’s not time to use the more expensive GLP-1 agonists first line. [Disclaimer – this summary is intentionally brief – if you want to dig in to the details, let me know! Daniella] [hr]

From the Chief Residents

Grand Rounds

Duke Chief Resident Grand Rounds - Eileen Maziarz

Noon Conference

Day Date Topic Lecturer Time Vendor
Monday 6/18 Gallops/ACR goodbye ACRs 12:00 Saladelia
Tuesday 6/19 Colorectal Cancer Screening Ziad Gellad 12:00 Bullock's
Wednesday 6/20 QI Wrap up Jon Bae/Buhr 12:00 Picnic Basket
Thursday 6/21 Clin Pharm -Management of Delirium -- dn2003 Andrew Muzyk 12:00 Papa John's
Friday 6/22 Chairs Conference 12:00 Pita Pit
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From the Residency Office

The countdown to Maestro continues!!    31 days until go live July 18!!

Tips –
  1. Inbasket will be our friend! That will be where labs, messages, pts calls will be routed to you..check it once a day, can send message on to staff to help with task
  2. Med refills will be much better! It is now a 2 way street, refill requests will come thru Maestro, no more paper refill requests..
  3. Click reviewed! Many items like PMH, tobacco use don’t need to be reentered every visit, but you do need to click “reviewed”
  4. The countdown until my birthday (LB) is 4 days, but then that isn’t Maestro related is it?

Annual Housestaff Survey (from Duke GME)

The time for the annual survey is here again. Please use the link in the email you received for the Annual Housestaff Survey to complete the survey. There are 33 questions in the survey and it should take about 10 minutes to complete. Survey closes June 30, 2012.

Dates to Add to Your Calendars /Contact Information

  • Duke Chief Resident Grand Rounds - Friday, June 22, 2012
  • Interns start GME orientation - June 25, 2012
  • Departmental orientation starts - June 28, 2012
  • Change over date - June 30, 2012
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