From the Director
It's been a busy week, and getting busier! We ended Doctoberfest with cider and donuts, and welcomed in Movember, the first time the residency program has officially participated in this campaign to enhance awareness of men's health issues. So, if you see members of the house staff looking a bit scruffy, ask them why! It's not too late to go to
Movember.com and join team modukemed! Or come to the office and make a small donation and get to draw a mustache on your favorite program leadership (our pictures, that is).
Get ready also for
RECRUITING! We're excited for the future Duke residents to be visiting...sign up for dinners and tours! Lunch on Mondays and Fridays are a social lunch with med applicants, and Tuesdays with med peds. Looking forward to seeing you there. If you haven't seen our movie, check out the medicine blog.
Kudos this week to many.......first, congrats to SARS
Kathleen Kiernan and Ivan Harnden on the birth of
Savannah Renee! The family is doing well! Also kudos to intern
Nick Rohrhoff for the gold star he received from his time on Duke gen med. Other compliments came from
Tracy Wang regarding Intern
Nick Turner's work on CAD, to intern
Monica Tang for an awesome intern report presentation, and to SAR
Dustin Norton for his team leadership on Duke Gen Med. Keep sending kudos - lots of excellent care by you all should get recognized.
Our SAR talks kicked off with three fantastic presentations. Thanks
AnnMarie Navar Boggan, Joel Boggan and Kevin Parrott - the bar has been set high!
This week's pubmed from the program goes to
Joel Boggan and Ann Marie Navar Boggan for their article in Pediatrics!
Pediatrics. 2012 Sep;130(3):e615-22. Pediatric-specific antimicrobial susceptibility data and empiric antibiotic selection,
We are planning some ways to help show support for these affected by Sandy. Be on the lookout for a blood drive, and more, but if you can donate now, the Red Cross is in need of blood donations due to all the injuries and issues with the hospital moves and shut downs:
Durham American Red Cross Blood Donation Center, 4737 University Place, Durham, NC 27707
Happy Recruiting!
Aimee
QI Corner (by Jon Bae, MD)
GME Incentive Program Update
The most recent numbers have been posted to Sharepoint.
We are maintaining our performance of meeting targets for 2 of the 4 measures (CMS Evidence Based Care Score and HCAHPS Patient Satisfaction). And there has been a little downward movement in 30 day readmissions. Not sure if that is real or not, but time will tell.
If the program were to end today, all GME trainees would receive an additional $400!
Thanks for your hard work and if interested in getting involved, please touch base with Jon Bae or George Cheely. Our most recent balanced scorecard is now posted to Sharepoint.
Three Good Things (3GT) Follow-up
We are 2 weeks post our program resiliency building exercise which overall was a smashing success.
For those who participated, you may have noticed a follow-up survey in your inbox (Sender: Bryan Sexton) which we implore you to complete. In <12 hrs, we already have 41 respondents! I did it myself and it took <5 min.
Thank you again for your engagement. And if you haven't seen it, here is the "Wordle" that was generated from the GME Leadership 3GT.
'Tis the season for pumpkin, apparently!
Thanks all!
What Did I Read This Week (by Jon Bae, MD)
[box] Weir, E, “The hazards of Halloween.” CMAJ, 2000; 163(8): 1046. [/box]
In the “spirit” of the season, I thought I would turn to pubmed to see what everyone’s favorite one-stop literature search engine (other then Dr. Google, of course) could offer up on “All Hallows Eve”. Searching “Halloween” in pubmed brings up some interesting articles including a lovely piece from the “hallowed” halls of Yale on how the negative symbolism of Halloween confers a 5.3% decrease in spontaneous births (contrasted with Valentine’s Day which confers a 3.6% increase)
1. You can also find a fair bit on the “Halloween genes” Spook and Phantom (no joke), which transcribe a particularly important step in the ecdysteroid biosynthetic pathway in Dropophila and a form of desert locust
2. Suffice it to say that I haven’t the slightest notion what this means, other then that entomologists need to “scare” up some new hobbies. I really wanted to “dig up” a good read for this weeks WIRTW and saw a “spooky” little piece that was tantalizingly entitled “Trick or treat? Enjoying Halloween when you have diabetes”. Unfortunately, it was unavailable to review (even in abstract form) and I had to draw some of my own conclusions (alluded to below). Thus I settled upon the above editorial. To be honest, it’s a simple one page that took all but 5 minutes to read while recovering from this past weekend’s Halloween festivities. It details some of the known and lesser-known risks associated with this nation’s most-werewolf associated holiday (other then Flag Day). I would have guessed “zombie bites” (or at least apple bobbing injuries) to be the biggest danger on “All Hallows”, but according to the CDC, the main risk is that of motor vehicle injuries, specifically those of pedestrian origin. This is of specific risk to children, who are 4 times more likely to be struck by cars on Halloween then any other night. The reasons for this are obvious including the increased volume of pedestrians out seeking candy or playing jokes (also known as “Trick or Treating”), the relative increase in dark clothing (AKA costumes), and the use of masks which decrease peripheral vision and hearing. Add to this the general excitement of going house-to-house collecting sugary confections, which leads to perilous road crossings and distraction, and you have a recipe for pedestrian motor vehicle collisions. I cannot tell you whether these motor vehicle accidents are more common in diabetics but can only assume so in absence of reading the aforementioned article. The most interesting aspect of this editorial was actually the references that brought to my attention some previously unknown conditions and facts:
1) Halloween diarrhea: osmotic diarrhea resulting from ingestion of excessive amounts of sorbitol-containing candy or food products. The abstract title says it all
3; please see my references. Only in America.
2) Halloween appendicitis: perforation of the appendix related to ingestion of needles hidden within candy products
4. Despite the publicity this problem received in the late 80s-early 90s, it is actually a relatively infrequent occurrence. That being said, the debate still rages as to whether all candy should undergo Roentograms (i.e. x-ray) to evaluate for hidden objects. I personally am for this practice, but mainly because I hope the extra radiation exposure my candy receives will, upon cumulative ingestion, finally grant me super powers. Hoping for the laser vision!
3) Egg Eye: blunt ocular trauma resulting from thrown eggs, apparently more common around Halloween. A prospective study from the UK evaluated all patients with eye injuries related to thrown eggs
6. Turns out, this was serious stuff. Most victims (12 of 13) were men in their 20s (average age 27.9) and raw egg was the weapon of choice. For some reason, the left eye was targeted more often (9/13). 4 of the 13 patients had permanent injury from the assaults, one with resulting permanent visual loss. As a result, UK public safety began a campaign to promote EggBeaters
TM Egg Whites as their prank egg substitute of choice.
4) Garlic and Vampires: this article out of Norway is my personal favorite. Only the abstract was available and because there is no way I could do it justice, I have included it here in its entirety. I have highlighted my favorite parts with
italics:
“Does garlic protect against vampires? An experimental study.
Vampires are feared everywhere, but the Balkan region has been especially haunted. Garlic has been regarded as an effective prophylactic against vampires. We wanted to explore this alleged effect experimentally.
Owing to the lack of vampires, we used leeches instead. In strictly standardized research surroundings, the leeches were to attach themselves to either a hand smeared with garlic or to a clean hand. The garlic-smeared hand was preferred in two out of three cases (95% confidence interval 50.4% to 80.4%). When they preferred the garlic the leeches used only 14.9 seconds to attach themselves, compared with 44.9 seconds when going to the non-garlic hand (p < 0.05). The traditional belief that garlic has prophylactic properties is probably wrong. The reverse may in fact be true.
This study indicates that garlic possibly attracts vampires. Therefore to avoid a Balkan-like development in Norway, restrictions on the use of garlic should be considered.
5”
What do I take away from all of this? Avoid sorbitol candy, x-ray your candy, wear eye protection, and don’t count of the prophylactic vampiric effects of garlic on Halloween. Also, make sure you (or your children) are wearing a reflective device and look both ways before crossing the street this Halloween, especially if you are a diabetic.
References:
1) Levy, BR. “Influence of Valentine’s Day and Halloween on birth timing.”
Soc Sci Med, 2011; 73(8): 1246.
2) Marchal, E. “Role of the Halloween genes, Spook and Phantom in ecdysteroidogenesis in the desert locust, Schistocerca gregaria.”
Jour Insect Physi, 2011; 57 (9): 1240.
3) Breitenbach, R. “’Halloween diarrhea.’ An unexpected trick of sorbitol containing candy.”
Postgrad Med. 1992; 92 (5): 63.
4) Conforti, F. “Halloween appendicitis: pin perforation of the appendix.”
Conn Med. 1987; 51 (8) :507.
5) Sandvik, H. “Does garlic protect against vampires? An experimental study.”
Tidsskr Nor Laegeforen. 1994; 114 (30): 3583.
6) Stewart, R. “Here’s egg in your eye”: a prospective study of blunt ocular trauma resulting from thrown eggs.”
Emerg Med J. 2006; 23 (10): 756.
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From the Chief Residents
Grand Rounds
| Date |
Division |
Speaker |
| 9-Nov-12 |
Cellular Therapy |
Dr. Cristina Gasparetto |
Noon Conference
| Day |
Date |
Topic |
Lecturer |
Time |
Vendor |
Room |
| Monday |
11/5 |
INTERVIEW |
|
12:00 |
Pipers in the Park |
2002 |
| Tuesday |
11/6 |
MED PEDS INTERVIEW |
|
12:00 |
Saladelia |
2002 |
| Wednesday |
11/7 |
Non-invasive stress testing |
Zainab Samad |
12:00 |
Sushi |
2002 |
| Thursday |
11/8 |
SAR talks |
Dustin Norton, Zach Healy |
12:00 |
Papa John's |
2001 |
| Friday |
11/9 |
INTERVIEW |
|
12:00 |
Nosh |
2002 |
Additions to "Our Family" (sent by Kathleen and Ivan)
Kathleen gave birth to baby
Savannah Renee on Friday! She was 7lb 11oz, 21 inches. She is doing great and so is Kathleen. We came home this afternoon and are settling in.
Picture of the HAPPY family:
Movember - Yes, it Has Started!
Stop by the office to see what Lauren has created this week to have some fun with Movember.
As a reminder, this is a fantastic opportunity and easy way for all of us to help raise awareness of men's health issues, including prostate and testicular cancers. By growing a mustache during Movember, men can essentially become a walking billboard for these important health issues that affect all of our patients. Also, by seeking sponsors for growing your mustache from family, friends, and colleagues, we can all help raise money for a great cause!
How it works:
Register at
www.movember.com with Team – MoDukeMed. Men start November 1
st clean shaven, then grow a mustache throughout Movember.
Raise funds for charity by getting sponsorship for growing your mustache and take pictures along the way.
This is not just for men! Women too can help by raising awareness, seeking out donations, and helping to encourage the men!
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From the Residency Office
BLS Blitz - November 12 - 15
This happens only twice a year. If your BLS is expiring before the March, 2013, this is your chance to recert - with out any cost to you. If you miss this opportunity and your certification expires you risk being pulled from your rotation and will have to pay out of pocket to be recertified. The following attachment has all of the details. You must pre-register, and our office will be providing BLS manuals on a 1st come/first served basis.
BLS_Blitz_registration[1]
Dinner and Tour Sign -ups: Keep checking the boards in the main office to sign up for upcoming dinners and tours. If you can't stop by to sign up, call the office to add your name to the list. This is your chance to help recruit the next class of interns, AND get a great dinner to boot.
Resp Fit Test Schedule:
Check out the following attachment to find out when/where you can get this done.
Resp Fit Testing-T-Dap-TB Skin Testing Flyer Nov 2012.pdf
Internal Medicine Certification Dates - 2013
SAR's - not too early to start planning ahead. The following flyer has the details regarding 2013 ABIM Certification Examinations.
Summer 2013 IM Certification Exam Dates
Dates to Add to Your Calendars /Contact Information/Opportunities
November 12-15 BLS Blitz
November 22 Turkey Bowl
December 1 DoM Holiday Party
Opportunities
Savannah GA
Useful links
Kathleen gave birth to baby Savannah Renee on Friday! She was 7lb 11oz, 21 inches. She is doing great and so is Kathleen. We came home this afternoon and are settling in.
Picture of the HAPPY family:
Movember - Yes, it Has Started!
Stop by the office to see what Lauren has created this week to have some fun with Movember.
As a reminder, this is a fantastic opportunity and easy way for all of us to help raise awareness of men's health issues, including prostate and testicular cancers. By growing a mustache during Movember, men can essentially become a walking billboard for these important health issues that affect all of our patients. Also, by seeking sponsors for growing your mustache from family, friends, and colleagues, we can all help raise money for a great cause!
How it works:
Register at www.movember.com with Team – MoDukeMed. Men start November 1st clean shaven, then grow a mustache throughout Movember.
Raise funds for charity by getting sponsorship for growing your mustache and take pictures along the way.
This is not just for men! Women too can help by raising awareness, seeking out donations, and helping to encourage the men!
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