2024 Management dilemmas in restarting anticoagulation after gastrointestinal bleeding
Systemic anticoagulants are widely prescribed to prevent and treat thromboembolism, among other indications. A common com-plication of using these agents is gastrointestinal bleeding. While early resumption of anticoagulants after the bleeding has resolved can increase the risk of rebleeding, delayed resumption puts the patient at increased risk of thromboembolic events and mortality. There is limited data on this topic to guide clinicians on resuming anticoagulation after hospitalization for gastrointestinal bleeding and to educate patients regarding the subsequent risks of recurrent gastrointestinal bleeding, thromboembolism, and mortality. The optimal time to resume anticoagulation is also unknown. This review summarizes the existing literature and available data on the commonly encountered dilemma of restarting anticoagulation therapy after hospitalization for gastrointestinal bleeding.
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 Alopecia syphilitica, from diagnosis to treatment
Alopecia syphilitica (AS) is an uncommon manifestation of secondary syphilis, with a prevalence that ranges from 3% to 7%. It is a nonscarring alopecia that can present in a diffuse pattern, a moth-eaten pattern, or a mixed subtype. Due to its low prevalenceand similar presentation to other forms of alopecia such as alopecia areata, telogen effluvium, and tinea capitis, dermatologistsmust maintain a high degree of suspicion for prompt diagnosis. The diagnosis of AS is made by eliciting the patient’s history,obtaining serologic tests, and examining histopathologic or dermatoscopic findings. First-line treatment includes benzathine peni-cillin G injection, which leads to hair regrowth weeks to months after administration. In this article, we present a focused reviewon the diagnosis of AS and discuss evidence-based therapeutic approaches for the management and treatment of this condition.
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 A Concerning Trend in Geriatric Pharmacy Merits Evidence-Based Intervention
The effects of polypharmacy on geriatric populations are an emerging concern that merits more exploration. The primary goal of this review was to evaluate the current body of knowledge on polypharmacy and explore the preventive and corrective measures to avoid negative outcomes. Even if a medication has an appropriate indication, polypharmacy in the geriatric population is associated with an increased risk of drug-drug or drug-condition interactions. Recent efforts to prevent polypharmacy include the development of interprofessional teams in clinics dedicated to medication review and reconciliation, deprescription plans aimed to safely discontinue potentially inappropriate medications, and inpatient screening tools that provide prescribing recommendations. In conclusion, polypharmacy affects a high percentage of the geriatric population. Current efforts to address and prevent polypharmacy are ongoing but have not been widely adopted.
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 Optimal Cardiovascular Medical Therapy: Current Guidelines and New Developments
Coronary artery disease is a leading cause of mortality worldwide, and patients with obstructive coronary artery disease require optimal cardiovascular medical therapy along with lifestyle modification for secondary prevention of future cardiac events. Optimal medical therapy includes antiplatelet agents, high-intensity statins, beta-blockers, angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers, aldosterone antagonists, and calcium channel blockers. There are differences in the medical therapy guidelines of the American Heart Association/American College of Cardiology and the European Society of Cardiology. In addition, there are emerging medical therapies that may be added to future guidelines with additional cardiovascular outcome benefits.
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 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 Obstetrics and Critical Care Course 20240213
There is an ongoing need for knowledge & clinical judgement for caring of critical OB patients in the OB department and/or in ICU. There is a need for advanced understanding, skills & clinical judgement for the critically ill high risk obstetric patient. 
Category
Format
  • Conference / meeting
Credits
  • 7.00 AMA PRA Category 1 Credit
  • 8.00 ANCC
  • 7.00 Attendance
Event date February 13, 2024
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
2024 McLane Children's School Nurse Conference
More information to come!For questions please contact: Taylor Williamstaylor.williams1@bswhealth.org
Category
Format
  • Conference / meeting
Credits
Event date July 9, 2024

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