Medical Grand Rounds

Spring 2012

12:00 PM
Kontos Medical Sciences Building Auditorium

January | February | March | April | May | June

Podcasts on select lectures may be accessed from VCU’s iTunes University and requires download of iTunes from Apple’s website and a VCU eID to access. PowerPoint presentations also require a VCU eID to access.

January

Jan. 5

Clinicopathologic Conference: 34 year old African female presents with limb pain, acute psychosis and pancytopenia

Frank Fulco, MD, RPh, FHM
Hospitalist and Assistant Professor
Associate Program Director, VCU Internal Medicine Residency
Department of Internal Medicine
McGuire VA Medical Center and Virginia Commonwealth University

Click to Download CPC Protocol

Following this Grand Rounds presentation, participants will be able to:

  • Recognize etiologies and diagnosis from the clinicopathologic case presented
  • Observe an experienced clinician's diagnostic reasoning process

Jan. 12

Amyloidosis

Beata Holkova, MD
Assistant Professor of Medicine
Division of Hematology, Oncology, and Palliative Care
Department of Internal Medicine
VCU Medical Center

Following this Grand Rounds presentation, participants will be able to:

  • Know and recognize different subtypes of amyloidosis
  • Identify potential therapies for each subtype

Jan. 19

Expanding the Organ Donor Pool for Kidney Transplantation

Anne L. King, MD
Professor of Medicine and Surgery
Medical Director, Kidney and Pancreas Transplant Program
Hume-Lee Transplant Center
VCU Medical Center

Following this Grand Rounds presentation, participants will be able to:

  • Understand the scope of the organ donor shortage at this time
  • Recognize strategies that have been implemented to address these shortages in both deceased donor and living donor kidney transplantation
  • Discuss commercialization of donor organs for transplantation and the implications of this strategy
  • Identify unconventional approaches utilized by individuals to gain access to organ transplantation and shorten waiting times

Jan. 26

VISITING SPEAKER
Predicting and Preventing Cardiovascular Disease in Women

Eleanor B. Schwarz, MD, MS
Associate Professor of Medicine, Epidemiology,
Obstetrics, Gynecology, Reproductive Sciences,
and Clinical and Translational Research
University of Pittsburgh School of Medicine and Graduate School of Public Health

Following this Grand Rounds presentation, participants will be able to:

  • Identify aspects of women's pregnancy history that have been associated with cardiovascular disease
  • Discuss ways that premature discontinuation of lactation may affect their risk of cardiovascular disease
  • Recognize ways that clinician counseling may help women avoid cardiovascular disease

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February

Feb. 2

VISITING SPEAKER
Taking Dietary Fat Out of the Fire

William Yancy, Jr., MD, MHS
Associate Professor, General Internal Medicine,
Duke University School of Medicine 
Research Associate, Center for Health Services
Research in Primary Care, Durham VA Medical Center 

Click for Lecture Slides

Following this Grand Rounds presentation, participants will be able to:

  • Review the history and data behind the relationship between dietary fat and cardiovascular disease (CVD)
  • Recognize the weight loss and CVD risk factor benefits, and potential side effects, of low-carbohydrate diets
  • Learn innovative strategies for enhancing adherence to weight loss programs

Feb.9

VISITING SPEAKER
Health Disparities and the Racial Integration of U.S. Hospitals

P. Preston Reynolds, MD, PhD, FACP
Professor, Division of General Medicine, Geriatrics, and Palliative Care
Associate Director, Center for Health Disparities
Faculty, Center for Biomedical Ethics and Humanities
University of Virginia

Following this Grand Rounds presentation, participants will be able to:

  • Discuss patterns of racial segregation of patients and discriminatory policies against African American physicians and trainees common in hospitals throughout the country
  • Discuss strategies used by the NAACP and the federal government to reverse race discrimination in health care
  • Discuss the impact of the Medicare Hospital Certification Program on the integration of hospitals, particularly in the South
  • Discuss the legacy of race discrimination as reflected in persistent health disparities in the U.S.

Feb. 16

Pleural Effusions: Going Beyond Light's Criteria

Hans Lee, MD
Assistant Professor of Medicine
Division of Pulmonary and Critical Care Medicine
Department of Internal Medicine
VCU Medical Center

Following this Grand Rounds presentation, participants will be able to:

  • Understand Light's criteria and its limitations
  • Recognize and diagnose lung entrapment
  • Describe the fundamental evaluation of pleural effusions

Feb. 23

Hepatorenal Syndrome: Finding a Cure for a Universally Lethal Disease

Arun J. Sanyal, MBBS, MD, FACP
Charles Caravati Professor of Medicine
Chair, Division of Gastroenterology, Hepatology and Nutrition
Department of Internal Medicine
VCU Medical Center

Following this Grand Rounds presentation, participants will be able to:

  • Learn about acute kidney injury (AKI) in cirrhosis
  • Learn the pathogenesis of Hepatorenal Syndrome (HRS)
  • Learn to diagnose HRS
  • Learn how to treat and reverse HRS

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March

Mar. 1

Cardiac Amyloidosis 

Keyur B. Shah, MD, FACC
Assistant Professor of Medicine
Division of Cardiology
VCU Pauley Heart Center

Following this Grand Rounds presentation, participants will be able to:

  • Review the types of amyloidosis that affect the heart
  • Review the clinical findings that should raise the suspicion for cardiac amyloidosis
  • Review the diagnostic modalities used to confirm the presence of amyloidosis

Mar. 8

Pancreatic Cancer: "Are We Better Off Today Than 4(0) Years Ago?" 

Bhaumik B. Patel, MD
Assistant Professor of Medicine
Division of Hematology, Oncology and Palliative Care,
Massey Cancer Center and VCU Medical Center
Staff Oncologist, McGuire VA Medical Center

Following this Grand Rounds presentation, participants will be able to:

  • Learn the epidemiology and biology of pancreatic adenocarcinoma
  • Learn about the issues related to diagnosis, staging and prognosis of pancreatic adenocarcinoma
  • Understand the importance of multimodality treatment approach
  • Learn about recent advances in pancreatic cancer treatment

Mar. 15

THE GREAT DEBATE
Topic: "Escalation of Care"

Shaun Bhatty, MD
Chief Medical Resident
Department of Internal Medicine

Maria Cristina Castillo-Catoni, MD
Chief Medical Resident
Department of Internal Medicine

Daniella Muallem Schwartz, MD
Chief Medical Resident
Department of Internal Medicine

John Robert Dye, MD, PhD
Chief Medical Resident
Department of Internal Medicine

Following this Grand Rounds presentation, participants will be able to:

  • Understand the history of supervision and autonomy and how new ACGME rules have affected this
  • Identify the barriers to escalation at VCU
  • Identify the advantages and disadvantages of supervision versus autonomy

Mar. 22

Clinicopathologic Conference: 73 year old man presents with progressive mental status decline and white matter brain lesions

Owen G. Schwartz, MD
Academic Hospitalist,
McGuire VA Medical Center
Assistant Professor of Medicine,
Department of Medicine
VCU Health System 

Click to Download CPC Protocol

Following this Grand Rounds presentation, participants will be able to:

  • Recognize etiologies and diagnosis from the clinicopathologic case presented
  • Observe an experienced clinician's diagnostic reasoning process

Mar. 29

VISITING SPEAKER
"Where Does the Salt Go?"

Mitchell H. Rosner, MD, FACP
Chair, Department of Medicine
Associate Professor of Nephrology
University of Virginia School of Medicine

Following this Grand Rounds presentation, participants will be able to:

  • Understand the concept of exchangeable sodium and how this pool may be regulated
  • Understand the role of exchangeable sodium pools in the pathogenesis of hyponatremia
  • Understand the role of exchangeable sodium pools in the pathogenesis of hypertension

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April

Apr. 7

The FDA and Drug Safety: New Directions

Lenore M. Buckley, MD, MPH
Professor and Eminent Scholar
Division of Rheumatology, Allergy and Immunology
Department of Internal Medicine
VCU Medical Center

Following this Grand Rounds presentation, participants will be able to:

  • Understand the history of the development of the FDA
  • Understand the drug safety issues that led to reforms in safety systems at the FDA
  • Understand new programs in place to ensure drug safety in the FDA

Apr. 12

Palliative Care in Vietnam: Progress and Challenges

Colin P. Wozencraft, MD
Assistant Professor of Internal Medicine and Palliative Care
Department of Medicine
University of Alabama at Birmingham

Following this Grand Rounds presentation, participants will be able to:

  • Appreciate the need for palliative care in Vietnam, its development so far, and the socio-economics affecting its availability and growth
  • Understand key cultural factors for Vietnamese patients and families that inform attitudes towards palliative care, and understand the implications these factors may have when providing care for Vietnamese Americans
  • Recognize home-based palliative medicine services as a novel yet viable care delivery option for Vietnam and other resource-limited regions

Apr. 19

ANNUAL MARKHAM AWARD LECTURE
Rethinking Healthcare Teams

Alan Dow, MD, MSHA
Macy Faculty Scholar
Assistant Vice President of Health Sciences
   for Interprofessional Education and Collaborative Care
Assistant Dean of Clinical Curriculum
Associate Professor of Internal Medicine
Virginia Commonwealth University

Following this Grand Rounds presentation, participants will be able to:

  • Apply some frameworks for team functions to the care of their patients
  • Be able to articulate the leadership contract within the healthcare teams
  • Appreciate the importance of rethinking healthcare teams as healthcare evolves

Apr. 26

Care of the Woman with Inflammatory Bowel Disease

Jill K. J. Gaidos, MD
Assistant Professor of Medicine
Division of Gastroenterology, Hepatology and Nutrition
Department of Internal Medicine
VCU Medical Center

Following this Grand Rounds presentation, participants will be able to:

  • Review the risk of cervical dysplasia among women with IBD
  • Review fertility and pregnancy outcomes and mode of delivery among women with IBD
  • Review the safety of medications in pregnancy and nursing

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May

May 3

ANNUAL BLACKARD LECTURE
The Dilemma of Subclinical Hypothyroidism: Who Should Be Treated and Why?

David F. Gardner, MD
Professor of Internal Medicine
Division of Endocrinology and Metabolism
Department of Internal Medicine
VCU Medical Center

Following this Grand Rounds presentation, participants will be able to:

  • Define subclinical hypothyroidism
  • Review etiology and natural history
  • Review clinical sequelae of the disorder
  • Identify subset of patients who should be treated

May 10

An Update on MRSA Treatment 

Michael P. Stevens, MD, MPH
Assistant Professor of Internal Medicine,
Division of Infectious Diseases
Associate Hospital Epidemiologist
Director, Antimicrobial Stewardship Program
Department of Internal Medicine
VCU Medical Center

Following this Grand Rounds presentation, participants will be able to:

  • Identify first-line therapy for serious MRSA infections
  • Identify appropriate outpatient therapy for MRSA skin and soft tissue infections
  • Compare and contrast the available parenteral agents for the treatment of invasive MRSA infections
  • Describe the role of the vancomycin MIC in treating MRSA
  • Identify recently approved MRSA-active agents and discuss when their use would be appropriate

May 17

**NOTE SPECIAL LOCATION**

SANGER HALL, ROOM 1-044, 12:00 PM

VISITING SPEAKER
Emerging Treatment Options for Aortic Stenosis:
The Role for Transcatheter Aortic Valve Replacement

Zachary Gertz, MD, MBE
Interventional Cardiology Fellow
University of Pennsylvania

Following this Grand Rounds presentation, participants will be able to:

  • Understand the best methodology for determining the severity of aortic stenosis
  • Identify appropriate patients for treatment with transcatheter aortic valve replacement
  • Understand the risks and benefits of transcatheter aortic valve replacement

May 24

VISITING SPEAKER
ANCA-Associated Vasculitis

Peter A. Merkel, MD, MPH
Chief, Division of Rheumatology
Professor of Medicine and Epidemiology
University of Pennsylvania

Following this Grand Rounds presentation, participants will be able to:

  • Develop a methodology for clinically evaluating patients with ANCA-associated vasculitis granulomatosis with polyangiitis (Wegener's) and microscopic polyangiitis
  • Discuss the findings and implications of recent clinical trials for small vessel vasculitis
  • Understand the current standard of care treatment protocols for patients with ANCA-associated vasculitis
  • Discuss the current areas of clinical investigation of ANCA-associated vasculitis

May 31

VISITING SPEAKER
Restoration of CD4+ T Cell Function through IL-2 Regulation Influences Sarcoidosis Clinical Outcomes

Wonder Puryear Drake, MD
Associate Professor of Medicine
Associate Professor of Pathology,
Microbiology, and Immunology
Vanderbilt University School of Medicine

Following this Grand Rounds presentation, participants will be able to:

  • Characterize T cell function within interstitial lung diseases, such as sarcoidosis
  • Define aberrations following T cell receptor simulation that lead to T cell anergy
  • Correlate T cell function with clinical outcome in sarcoidosis

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June

June 7

Pulmonary Complications of Bone Marrow Transplant

Kristin Miller, MD
Assistant Professor of Medicine
Division of Pulmonary and Critical Care Medicine
Department of Internal Medicine
VCU Medical Center

Following this Grand Rounds presentation, participants will be able to:

  • Provide an overview of hematopoietic stem cell transplantation (HSTC)
  • Discuss pre-transplant pulmonary evaluation and its potential role in identifying those patients at risk for pulmonary complications
  • Discuss non-infectious pulmonary complications following HSTC, including pulmonary manifestations of graft versus host disease

June 14

Resident Research Presentations

The Paradox of Thrombocytopenic Thromboembolism in Acute Myelogenous Leukemia
Gary Simmons, DO
PGY-2

Following this Grand Rounds presentation, participants will be able to:

  • Recognize the incidence of venous thromboembolism in acute leukemia
  • Recognize that low-molecular weight heparin has been used safely in acute leukemia despite severe thrombocytopenia
  • Describe randomized controlled trial using low-molecular weight heparin as prophylaxis to reduce the incidence of venous thromboembolism in acute myelogenous leukemia (Non-APL)

MicroRNA-21 Mediates Cardioprotection with PKG-I a Over-Expression through Upregulation of Hydrogen Sulfide
Christopher Thomas, MD, MS
PGY-3

Following this Grand Rounds presentation, participants will be able to:

  • Describe some of the molecular processes which lead to the ischemia/reperfusion injury pathology
  • Discuss the downstream effects of upregulation of protein kinase G in regards to apoptosis and necrosis of cardiomyocytes and global cardiac function
  • Review some of the tools currently used in a basic science laboratory to measure protein function as well as markers of cellular apoptosis and necrosis

A Patient from Cameroon with Chronic Abdominal Pain
Tuyet Nguyen, MD
PGY-3

Following this Grand Rounds presentation, participants will be able to:

  • Recognize M. tuberculosis as an atypical cause of chronic abdominal pain
  • Understand the limitations of tissue culture, biopsy staining, and PCR in detection of M. tuberculosis
  • Understand the epidemiology of gynecological M. tuberculosis

Blocking an Electrical Storm
Ali Yassen, MBChB
PGY-1

    Following this Grand Rounds presentation, participants will be able to:

    • Define an electrical storm
    • Describe the ACLS recommended treatment of an electrical storm
    • Understand how a left stellate ganglion blockade works
    • Discuss evidence to support the use of a left ganglion blockade in an electrical storm

June 21

ANNUAL GALEN WAMPLER LECTURE

The Value of Palliative Care

Egidio Del Fabbro, MD
Associate Professor of Medicine
Program Director, Palliative Care
Massey Cancer Center
VCU Medical Center 

Following this Grand Rounds presentation, participants will be able to:

  • Recognize the positive outcomes of Palliative Care
  • Understand the Palliative Care Clinical Model
  • Appreciate the value of symptom assessment and management

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