2024 Dietary Supplements and Bleeding
An estimated one third of United States adults use herbal supplements, often without reporting use to their physicians. These supplements can potentially alter bleeding and coagulation during surgery, and when used concomitantly with anticoagulants. Our objective is to provide a comprehensive review of the evidence of bleeding risks of the most popular herbal and dietary supplements. A PubMed search and review of the literature was performed. We found that garlic and hawthorn supplementation are strongly associated with surgical bleeding independent of anticoagulants; cordyceps sinensis, echinacea, and aloe vera are loosely associated with surgical bleeding independent of anticoagulants. In patients on anticoagulants, ginkgo biloba, chondroitin-glucosamine, melatonin, turmeric, bilberry, chamomile, fenugreek, milk thistle, and peppermint are associated with bleeding risk; no evidence was found for bleeding with these supplements independent of anticoagulants. Fish oil, ginseng, and saw palmetto are not associated with bleeding. Evidence for overall bleeding risk associated with St. John’s Wort, ginger, ginkgo biloba, or cranberry supplementation is conflicting. In conclusion, physicians must be aware of the potential anticoagulant effects of these supplements. It is imperative to report dietary and herbal supplement usage to physicians and is best to discontinue non-essential supplement use 2 weeks prior to surgery.
Category
  • BUMC Proceedings
Format
  • Journal
Credits
  • 1.00 American Board of Internal Medicine (ABIM) MOC Part 2
  • 1.00 AMA PRA Category 1 Credit
  • 1.00 Attendance
2024 Resistant gastroenteropancreatic neuroendocrine tumors: a definition and guideline to medical and surgical management
Gastroenteropancreatic neuroendocrine tumors (NETs), also historically known as carcinoids, are tumors derived of hormone-secreting enteroendocrine cells. Carcinoids may be found in the esophagus, stomach, small intestine, appendix, colon, rectum, or pancreas. The biologic behavior of carcinoids differs based on their location, with gastric and appendiceal NETs among the least aggressive and small intestinal and pancreatic NETs among the most aggressive. Ultimately, however, biologic behavior is most heavily influenced by tumor grade. The incidence of NETs has increased by 6.4 times over the past 40 years. Surgery remains the mainstay for management of most carcinoids. Medical management, however, is a useful adjunct and/or definitive therapy in patients with symptomatic functional carcinoids, in patients with unresectable or incompletely resected carcinoids, in some cases of recurrent carcinoid, and in postoperative patients to prevent recurrence. Functional tumors with persistent symptoms or progressive metastatic carcinoids despite therapy are called “resistant” tumors. In patients with unresectable disease and/or carcinoid syndrome, an array of medical therapies is available, mainly including somatostatin analogues, molecular-targeted therapy, and peptide receptor radionuclide therapy. Active research is ongoing to identify additional targeted therapies for patients with resistant carcinoids.
Category
  • BUMC Proceedings
Format
  • Journal
Credits
  • 1.00 American Board of Surgery (ABS) Accredited CME
  • 1.00 AMA PRA Category 1 Credit
  • 1.00 Attendance
2024 The efficacy and safety of botulinum toxin epicardial fat injection to prevent postoperative atrial fibrillation in patients undergoing cardiac surgery: a meta-analysis of randomized controlled trials
Postoperative atrial fibrillation (POAF) is prevalent in about 30% to 60% of patients undergoing cardiac surgery, leading to worse outcomes. Botulinum toxin type A (BTX) epicardial injection has been proposed to prevent POAF by impairing cholinergic signaling.
Category
  • BUMC Proceedings
Format
  • Journal
Credits
  • 1.00 American Board of Internal Medicine (ABIM) MOC Part 2
  • 1.00 American Board of Surgery (ABS) Accredited CME
  • 1.00 AMA PRA Category 1 Credit
  • 1.00 Attendance
2023 Baylor Scott & White Concussion Education Course [IEM-X]
Concussion treatment has largely been absent from guidelines and research. There are an estimated 1.8 to 3.6 million sport-related concussions per year, yet many youth and high school athletes get poor or no treatment. Media focus on the long term effects of concussion has created a cultu
Category
Format
  • Self-study / Enduring
Credits
  • 2.00 AMA PRA Category 1 Credit
  • 2.00 Attendance
2024 The effect of polycystic ovarian syndrome on fibrocystic breast changes in postmenopausal women
AbstractFibrocystic breast changes (FCCs) are benign lesions thought to be caused by an increased estrogen-to-progesterone ratio. One of the most common endocrinopathies that increases this ratio is polycystic ovarian syndrome (PCOS).
Category
  • BUMC Proceedings
Format
  • Journal
Credits
  • 1.00 American Board of Internal Medicine (ABIM) MOC Part 2
  • 1.00 American Board of Surgery (ABS) Accredited CME
  • 1.00 AMA PRA Category 1 Credit
  • 1.00 Attendance
2024 39th Annual Family Medicine Review
This program is designed to provide practical diagnostic and therapeutic information covering the broad scope of clinical practice. There is an emphasis on common diseases, practical therapeutics and controversial issues.
Category
Format
  • Conference / meeting
Credits
  • 21.00 AMA PRA Category 1 Credit
  • 21.00 Attendance
Event date April 3, 2024
2024 - 31st Annual Robert E. Myers, MD Lectureship in Pediatrics
This activity is designed to provide the primary care provider with practical clinical information on the recognition and evaluation of specific pediatric subspecialty disorders seen frequently in primary care office settings. 
Category
Format
  • Webinar live
  • Conference / meeting
Credits
  • 4.00 American Board of Pediatrics (ABP) MOC
  • 4.00 AMA PRA Category 1 Credit
  • 4.00 Attendance
Event date May 17, 2024
43rd Annual Internal Medicine Review 2024
This activity is designed to provide the internal medicine and primary care physician as well as the physician assistants and nurse practitioners with information directly applicable to daily patient care.
Category
Format
  • Conference / meeting
Credits
  • 24.00 AMA PRA Category 1 Credit
  • 24.00 Attendance
Event date July 15, 2024
2024 12th Management of the Complex Hospitalized Patient
This activity is designed to provide physicians, physician assistants and nurse practitioners with information and skills to improve their care of hospitalized patients.
Category
Format
  • Conference / meeting
Credits
  • 16.00 AMA PRA Category 1 Credit
  • 16.00 Attendance
Event date August 2, 2024

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