From the Director
Hi everyone!
"I am still laughing at watching VA Chief
Tony Gutierrez fight like crazy to avoid being thrown in the lake at the picnic on Saturday. Too bad he ended up in the lake anyway! A great time was had by all, with special thanks to
Randy (and Mindy) Heffelfinger, Jennifer Averitt, Lauren Dincher, and Laura Kujawski for their hard work in making the picnic fantastic. More special thanks to
Skip Burton for the use of his beautiful farm, and to interns
Marcus Ruopp, Armando Bedoya, Jeremy Halbe and Kevin Shah for working greater than 16 hours to get the pig roasted.
The rest of the week busy as well. Intern
Amanda Elliott stumped us (well, except SAR
Vaishali Patel and Intern
Anastasie Dunn-Pirio) with a case of denture cream induced hypocupremia with posterior column myelopathy at DRH morning report, and Intern
Aaron Mitchell was a fantastic presenter at Chair's conference (diffuse peritoneal mesothelioma presenting with fatigue/bloating!). His reclassification of DMPM was, well, CLASSIC!
Congratulations to Intern
Bobby Aertker and his wife
Andrea on the birth of baby
Alan! 
Looking forward to when he can play in the Turkey Bowl. Also congratulations to Intern
Meredith Edwards on her upcoming wedding this weekend!
CIMIGRO Journal Club will be meeting this week at the home of Dr. Klotman - Tuesday night, starting at 6 pm. Residents are welcome to join in. If you are planning to attend, please RSVP to Sheila Gainey.
Pubmed from the Program this week goes to SAR
Reshmi Srinath for her upcoming poster presentation "ACUTE THYROTOXIC PERIODIC PARALYSIS BEYOND THE ASIAN POPULATION: A DIAGNOSTIC CHALLENGE" at the American Association of Clinical Endocrinology meeting.
Have a great week!
Aimee
What Did I Read This Week (submitted by Dave Butterly, MD)
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Mycophenolate versus Azathioprine as Maintenance Therapy for Lupus Nephritis, Dooley et al , NEJM 365: 1886-1895, Nov 17, 2011 ( Dooley-NEJM-Lupus ) [/box]
Review: I looked at this article this past week due to a young woman we saw in renal clinic recently. She presented with 4 month history of polyarthralgias, skin rash, and alopecia. She was mildly anemic and had a serum creatinine of 1.0. ANA and ESR were elevated. Anti-DS DNA was 969 and urine protein:creatinine ratio was 1.5. Urine sediment revealed RBCs and 1 RBC cast. Biopsy was done revealing Class III Lupus Nephritis. She was commenced on MMF therapy. On follow-up this past week, serologies have improved, creatinine has dropped to 0.6 , UPC ratio has decreased to 0.5 and urine sediment has normalized.
Mary Ann Dooley, the first author on this paper, did her Rheumatology Fellowship at Duke and has published extensively in this area. The article appeared in the November 17th NEJM and reports on comparison of maintenance therapy for LN with AZA vs MMF. Renal involvement remains the single strongest predictor of morbidity and mortality in patients with Lupus. This paper follows the ALMS induction paper examining MMF vs IV Cytoxan in Lupus Nephritis. (JASN 2009).
227 patients with Class III, IV, and V Lupus nephritis were randomized to maintenance therapy with either MMF 1 gram bid or AZA 2mg/kg. Patients were followed for 36 months and followed for treatment failure (death, ESRD, doubling creatinine, renal flare or the need for rescue therapy). Baseline characteristics are shown in table 1. Outcomes are shown in Figure 2. Both treatment failure and freedom from renal flare were decreased by roughly 50% in patients treated with MMF. This article adds to the literature demonstrating the efficacy of MMF in LN and shows the superiority compared to AZA.
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From the Chief Residents
Grand Rounds
| Date |
Speaker |
| 5/25/12 |
Manesh Patel & Laura Svetkey |
| 6/1/12 |
M&M |
Noon Conference
| Date |
Topic |
Lecturer |
Time |
Vendor |
| 5/21 |
EPIC.Maestro review |
Dean Miner |
12:00 |
Saladelia |
| 5/22 |
SAR TALK |
Karen Toribio |
12:00 |
Dominos |
| 5/23 |
Maestro Care/Meaningful Use |
Adia Ross |
12:00 |
Sushi |
| 5/24 |
Ambulatory Townhall |
Bowlby/Rosenthal/Phelps |
12:00 |
Papa John's |
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From the Residency Office
Resident Research Night
The Duke Internal Medicine Residency Program and the Department of Medicine would like to invite you to present a poster on Resident Research Night June 13th, 2012 at 5 - 7 pm at the SEARLE CENTER. Please see attached instructions for abstract preparation (300 words max, no figures) and for poster printing.
POSTER INSTRUCTIONS-2012
Please email abstracts to Dr. Arcasoy by June 1st if you are planning to present your work.
For poster printing, please email Jen Averitt in the MedRes office with your poster by June 6th (see Jen's email dated 5/11). Please complete the survey monkey information in Jen's email from 5/11 if you intend to display a poster(s) so we can reserve a board for you.
We encourage you to present as posters ALL scholarly activities you have been involved in:
1- Basic, clinical and translational research projects
2- Case studies
3- QI projects
Annual Program Evaluation by Residents
Just when you thought that you had been asked to complete the last evaluation of the year - we bring you yet one more FINAL SURVEY opportunity. Residents in our program will receive a notice to complete the internal confidential evaluation of the program on Monday. We know you are "surveyed out", but PLEASE, take a few moments to complete this important survey. The results will be incorporated into the internal review that will be held on June 13, 2012. Thank You !
Dates to Add to Your Calendars /Contact Information
- June 2 - Annual SAR Dinner (invitations only)
- June 13 –Resident Research Event, 5-7pm
- June 13 - Resident Research Night, Searle Center, from 5-7 PM
Useful links
