The University of Virginia Department of Medicine presents

The 38th Annual

Edward W. Hook, Jr., M.D.

Recent Advances in Clinical Medicine

October 26 - 28, 2011
Sponsored by the Office of Continuing Medical Education University of Virginia School of Medicine Omni Charlottesville Hotel Charlottesville, Virginia

Dear Colleague:

n behalf of the Department of Medicine at the University of Virginia, we would like to invite you to attend the 38th annual Recent Advances in Clinical Medicine Conference. The Planning Committee has assembled a broad array of stimulating lectures addressing current issues relevant to the care of patients in both the outpatient and inpatient settings. Reflecting the increasing complexity of medical practice, the conference will continue to feature interdisciplinary sessions, this year focusing on sleep disorders and on medical issues that arise in joint replacement and in care of the pregnant patient. The lectures are designed to provide practical take-home points that you can put into practice upon your return to the office and hospital. Ample time is allotted at the end of each session to have your questions addressed by the speakers, and many attendees confer informally with lecturers during the breaks. We have continued our popular Meet the Professor sessions over breakfast and lunch to provide you with opportunities to broaden your medical knowledge and skills through challenging case discussions, workshops and interactive presentations. Again we are offering a dinner symposium in the University of Virginias historic Rotunda, designed by Thomas Jefferson, where you can participate in a provocative discussion of how physicians deal with adversity. The course will be particularly useful to generalists physicians, nurse practitioners and physician assistants -- practicing in a variety of settings, but specialists also attend this conference to stay abreast of important advances in medical care. All meeting materials will be available for download at the RACM website for registered participants one week prior to the conference. A printed syllabus is available for a small additional charge. Late October is one of the most spectacular times of the year to visit Charlottesville. The foliage in the nearby Blue Ridge Mountains will be at its peak, Thomas Jeffersons University of Virginia and Monticello are within minutes of the conference hotel and there are many activities available for families. The meeting takes place on the historic Downtown Mall, which boasts charming shops, fine restaurants, art galleries, the historic Paramount Theatre (performing arts), and a movie theatre. You may also wish to stay for the weekend to attend athletic and cultural events at the University. We look forward to seeing you in October!

Andrew M.D. Wolf, M.D. Associate Professor of Medicine Course Director

Mitchell H. Rosner, M.D. Associate Professor of Medicine Interim Chair, Department of Medicine

Course Director

Andrew M.D. Wolf, M.D.

Planning Committee Members

Andrew M. D. Wolf, MD B. Gail Macik, MD Michael Mangrum, MD Bryan Sauer, MD Kambiz Kalantarinia, MD Cynthia D. Brown, MD Sue A. Brown, MD John G. Leiner, MD Tamara W. Eberly, PhD, RN General Medicine Hematology/Oncology Cardiology Gastroenterology Nephrology Pulmonary Endocrinology General Medicine Continuing Education

Faculty
Emaad Abdel-Rahman, MD Alan P. Alfano, MD Laurie Archbald-Pannone, MD Robert W. Battle, MD Daniel Becker, MD Larry Borish, MD Cynthia D. Brown, MD James A. Browne, MD Scott P. Commins, MD Alan Dalkin, MD Patrick M. Dillon, MD Kyle Enfield, MD Uta Erdbrugger Matthew J. Goodman, MD William W. Grosh, MD Nephrology Physical Medicine & Rehabilitation Geriatrics Cardiology General Medicine Allergy & Immunology Pulmonary Orthopaedic Surgery Allergy & Immunology Endocrinology Hematology/Oncology Pulmonary Nephrology General Medicine Hematology/Oncology Donald L. Kimpel, MD Susan E. Kirk, MD Susan L. Lashley, MD David Ling, MD Zhenqi Liu, MD B. Gail Macik, MD John M. MacKnight, MD James Mann, MD Anthony McCall, MD Christopher C. Moore, MD Patrick Northup, MD Margaret L. Plews-Ogan, MD Robert D. Powers, MD Mark Quigg, MD Michael Ragosta, MD Rheumatology & Immunology Endocrinology OB/GYN General Medicine Endocrinology Hematology/Oncology General Medicine Gasteroenterology Endocrinology Infectious Diseases Gasteroenterology General Medicine General Medicine Neurology Cardiology Michael F. Rein, MD Christopher Rembold, MD Preston Reynolds, MD C. Edward Rose, MD Scott Sanoff, MD Bryan Sauer, MD Michael Scheld, MD Costi D. Sifri, MD Paul Suratt, MD Brian Uthlaut, MD Mary Lee Vance, MD George M. Verghese, MD Max M. Weder, MD Mark E. Williams, MD Andrew M. D. Wolf, MD Infectious Diseases Cardiology General Medicine Pulmonary Nephrology Gasteroenterology Infectious Diseases Infectious Diseases Pulmonary General Medicine Endocrinology Pulmonary Pulmonary Geriatrics General Medicine

Srikant Nannapaneni, MD, MPH General Medicine

Eric Gunderson, MD General Medicine & Psychiatry & Neurobiological Sciences

Educational Objectives

By the end of the Recent Advances conference, attendees should be able to: n Better manage congestive heart failure in patients with chronic kidney disease n Select appropriate vitamin d therapy to prevent and manage renal bone disease n More comfortably co-manage renal transplant patients n Describe how to better integrate the new oral anticoagulants into prevention and management of thromboembolic disease n Better identify and address adverse effects of commonly used chemotherapeutic agents n Assist in the management of bone metastases n Discuss appropriate indications for joint replacement n Recognize and initiate evaluation of prosthetic joint infection n Institute appropriate venous thromboembolism prophylaxis in patients undergoing joint replacement surgery n Understand key aspects of rehabilitation following joint replacement surgery n Evaluate and manage challenging cases of constipation n Discuss new management options for Hepatitis C n Co-manage patients with Barretts esophagus n Recognize, diagnose, and treat Lyme disease in its different stages n Recognize emerging patterns of colonization with resistant organisms n Integrate recent updates into the diagnosis and management of selected sexually transmitted diseases. n Employ strategies to manage the difficult-to-control asthmatic n Evaluate patients for and initiate treatment of sarcoidosis n Recognize important clinical problems that arise in the post-lung transplant patient. n Institute appropriate preventive and management measures in C. diffiicile enterocolitis n Manage common problems that arise in providing palliative care to hospitalized patients. n Address challenging issues that arise in the pre- and perioperative setting. n Discuss the role of antioxidants in coronary artery disease prevention n Perform an appropriately targeted cardiovascular evaluation of the athlete n Adopt an evidence-based approach to managing stable angina n Better manage diabetes, hypertension, and asthma in pregnancy n Discuss options for home evaluation of suspected sleep apnea n Improve detection of sleep apnea in patients undergoing surgery n Recognize causes and potential management options for patients with hypersomnia n Initiate evaluation and management of male hypogonadism n Become more comfortable prescribing long-acting GLP-1 agonists for diabetic patients n More expertly manage dyslipidemia in diabetic patients n Institute an evidence-based strategy for dealing with medication allergies n Discuss the connection between deer tick bites and the development of red meat allergy n Better handle challenging situations involving anticoagulation n Incorporate advanced physical exam techniques into clinical practice n Reflect on how certain clinical scenarios challenge our humanism and professionalism n Better appraise patients risks of heritable disorders n Discuss the current status of health care reform n Practice mindfulness as a professionally renewing exercise n Handle challenging rheumatology cases n Handle challenging sports medicine patient scenarios n Appreciate how dealing with adversity can help physicians develop wisdom.

Agenda
Wednesday, OctOber 26, 2011 aM sessiOns
Registration and Continental Breakfast Welcoming Remarks: Steven T. DeKosky, MD Dean, UVA School of Medicine Mitchell H. Rosner, MD, Interim Chair, Department of Medicine Andrew M. D. Wolf, MD, Course Director 8:15-9:55 NEPHROLOGY 8:15 Introduction Mark Okusa, MD 8:20 Management of Heart Failure in Patients with Kidney Disease Emaad Abdel-Rahman, MD 8:45 Vitamin D for Treatment of Renal Bone Disease: Which Form and Which Patient? Uta Erdbrugger, MD 9:10 Chronic Care of Kidney Transplant Patients Scott Sanoff, MD 9:35 Panel Discussion 9:55 Morning Break 10:15-11:20 HEMATOLOGY-ONCOLOGY 10:15 Introduction Geoffrey Weiss, MD 10:20 Are the New Oral Anticoagulants Ready for Prime Time? B. Gail Macik, MD 10:45 New Oncology Medications: Common Toxicities & Their Solutions William Grosh, MD 11:10 Bone Metastases: How to Treat and Avoid Complications Patrick Dillon, MD 11:35 Panel Discussion 11:55-1:00 LUNCH - On Your Own - OR 12:05-12:55 Meet the Professor Lunch Session Pre-registration Required L1 - Challenging Anticoagulation Cases B. Gail Macik, MD L2 - Genetics in Clinical Practice Preston Reynolds, MD 7:00 8:00 3:30 3:55 4:20 4:45 5:05 6:00-9:00 New Movements in Constipation James Mann, MD Management Updates in Hepatitis C Patrick Northup, MD Barretts Esophagus: Who to Screen and When to Treat Bryan Sauer, MD Panel Discussion Adjourn Rotunda SYMPOSIUM DINNER Separate Sign-up Required Choosing Wisdom: The Path Through Adversity Margaret Plews-Ogan, MD

thursday, OctOber 27, 2011 aM sessiOn

7:15-8:15

Wednesday, OctOber 26, 2011 PM sessiOns

1:00 - 3:05 INTERDISCIPLINARY: MEDICAL ISSUES IN JOINT REPLACEMENT 1:00 Introduction Andrew Wolf, MD 1:05 Joint Replacement 2011: Whats New, Whats True, and for Whom? James Browne, MD 1:30 Prosthetics and Pus: a Perplexing Problem Christopher Moore, MD 1:55 VTE Prophylaxis in Joint Replacement Surgery Srikant Nannapaneeni, MD 2:20 Rehabilitation Issues in Joint Replacement Surgery Alan Alfano, MD 2:45 Panel Discussion 3:05 - 3:25 Afternoon Break 3:25 - 5:05 GASTEROENTEROLOGY 3:25 Introduction Carl Berg, MD

Meet the Professor Breakfast Session Pre-registration Required B1 - Humanism, Professionalism, and Wheaties: Breakfast of Champions Daniel Becker, MD 8:00 Registration and Continental Breakfast 8:30-10:30 INFECTIOUS DISEASES 8:30 Introduction Michael Rein, MD 8:35 Updates in Lyme Disease Michael Scheld, MD 9:00 Emerging Issues in Colonization with Drug-Resistant Organisms Costi Sifri, MD 9:25 Update in Sexually Transmitted Infections: Did the December 2010 CDC Guidelines Get it Right? Michael Rein, MD 9:50 Panel Discussion 10:10 Morning Break 10:30 - 12:10 PULMONARY 10:30 Introduction C. Edward Rose, MD 10:35 The Difficult-to-Control Asthmatic C. Edward Rose, MD 11:00 Sarcoidosis Update George Verghese, MD 11:25 Lung Transplant for the Primary Care Physician Max Weder, MD 11:50 Panel Discussion 12:10-1:10 LUNCH - On Your Own - OR 12:15-1:05 Meet the Professor Pre-registration Required L3 - Advanced Pearls on the Physical Examination Mark Williams, MD L4 - Health Care Reform: Where Are We Now? Robert Powers, MD

thursday, OctOber 27, 2011 PM sessiOn

1:10-2:50 1:10 1:15

GENERAL MEDICINE, GERIATRICS & PALLATIVE CARE Introduction Margaret Plews-Ogan, MD C. Diff in the Hospital & Long-term Care Setting Laurie Archbald, MD

1:40

Practical Issues in Palliative Care of the Hospitalized Patient David Ling, MD 2:05 Challenging Medical Issues in Perioperative Care Brian Uthlaut, MD 2:30 Panel Discussion 2:50 Afternoon Break 3:10-4:50 CARDIOLOGY 3:10 Introduction Brian Annex, MD 3:15 Antioxidants & Coronary Artery Disease Christopher Rembold, MD 3:40 Cardiovascular Care of the Athlete Robert Battle, MD 4:05 Approach & Management of Stable Angina Michael Ragosta, MD 4:30 Panel Discussion 4:50 Adjourn

10:30-12:10 UPDATES IN SLEEP MEDICINE 10:30 Introduction Cynthia Brown, MD 10:35 Home Evaluation of Apnea Cynthia Brown, MD 11:00 Sleep Apnea in the Perioperative Period Paul Suratt, MD 11:25 When Sleep Attacks: Neurological Causes of Hypersomnia Mark Quigg, MD 11:50 Panel Discussion 12:10 - 1:10 LUNCH - On Your Own - OR 12:15 - 1:05 Meet the Professor Pre-registration Required L5 - Challenging Cases in Sports Medicine John MacKnight, MD L6 - Challenging Rheumatology Cases Donald Kimpel, MD

Friday, OctOber 28, 2011 PM sessiOn

Friday, OctOber 28, 2011 aM sessiOn

7:15-8:15 Meet the Professor Breakfast Session Pre-registration Required B2 - Mindfulness for Physicians Matthew Goodman, MD B3 - Challenging Cases in Pain & Addiction Erik Gunderson, MD 8:00 Registration and Continental Breakfast 8:30-10:10 INTERDISCIPLINARY: MEDICAL ISSUES IN PREGNANCY 8:30 Introduction Andrew Wolf, MD 8:35 Diabetes Mellitus in Pregnancy Susan Kirk, MD 9:00 Hypertension in Pregnancy Susan Lashley, MD 9:25 Asthma in Pregnancy Kyle Enfield, MD 9:50 Panel Discussion 10:10 Morning Break

1:10-2:50 ENDOCRINOLOGY 1:10 Introduction Alan Dalkin, MD 1:15 A Clinical Approach to Male Hypogonadism Mary Lee Vance, MD 1:40 Update on the GLP-1 Agonists in Diabetes Management Zhenqi Liu, MD 2:05 Lipid Management in Diabetes Anthony McCall, MD, PhD 2:30 Panel Discussion 2:50 ALLERGY 2:50 Introduction Larry Borish, MD 2:55 Drug Allergies: What To Do When There Are No Alternatives Larry Borish, MD 3:20 Tick Bites & Red Meat Allergy: The Tip of an Iceberg? Scott Commins, MD 3:45 Panel Discussion 4:00 Wrap-up & Adjourn

Disclosure of faculty financial affiliations

The University of Virginia School of Medicine, as an ACCME accredited provider, endorses and strives to comply with the Accreditation Council for Continuing Medical Education (ACCME) Standards of Commercial Support, Commonwealth of Virginia statutes, University of Virginia policies and procedures, and associated federal and private regulations and guidelines on the need for disclosure and monitoring of proprietary and financial interests that may affect the scientific integrity and balance of content delivered in continuing medical education activities under our auspices. The University of Virginia School of Medicine requires that all CME activities accredited through this institution be developed independently and be scientifically rigorous, balanced and objective in the presentation/discussion of its content, theories and practices. All faculty presenters participating in an accredited CME activity are expected to disclose relevant financial relationships with commercial entities occurring within the past 12 months (such as grants or research support, employee, consultant, stock holder, member of speakers bureau, etc.). The University of Virginia School of Medicine will employ appropriate mechanisms to resolve potential conflicts of interest to maintain the standards of fair and balanced education to the reader. Questions about specific strategies can be directed to the Office of Continuing Medical Education, University of Virginia School of Medicine, Charlottesville, Virginia. The faculty and staff of the University of Virginia Office of Continuing Medical Education have no financial affiliations to disclose.

Disclosure of discussion of non-FDA approved uses for pharmaceutical products and/or medical devices The University of Virginia School of Medicine, as an ACCME provider, requires that all faculty presenters identify and disclose any off-label uses for pharmaceutical and medical device products. The University of Virginia School of Medicine recommends that each physician fully review all the available data on new products or procedures prior to clinical use. Disclosure for attendance records and certificate distribution The University of Virginia Office of Continuing Medical Education requires that all participants at live CME activities sign attendance sheets daily to confirm participation in the CME activity for that day. Participants are responsible for accurately tracking their actual participation at live events.

Special Needs
The Americans with Disabilities Act of 1990 requires that all individuals, regardless of their disabilities, have equal access. The Office of Continuing Medical Education at the University of Virginia School of Medicine is pleased to assist participants with special needs. Written requests must be received 30 days prior to the conference date. These should be mailed to UVA Office of Continuing Medical Education, Box 800711, Charlottesville, VA 22908 or to uvacme@virginia.edu. Some of the conference venues used by the University of Virginia Office of Continuing Medical Education are registered historic properties and may not be fully ADA accessible. Please feel free to contact the facility if you have specific questions.

LOcatiOn This conference will be held at the Omni Charlottesville Hotel, 235 West Main Street, Charlottesville, Virginia. **NOTE: If the Omni lot is full, do not park across the street in the private lot without first checking in with the Omni parking lot attendant. The owner of that lot will tow cars without an Omni pass.** accOMMOdatiOns A block of rooms has been reserved for course participants at the conference site. Please identify yourself as a participant in the Recent Advances In Clinical Medicine conference. Omni Charlottesville Hotel 235 West Main Street Charlottesville, Virginia 22902 (434-971-5500 or 1-800-THE-OMNI) Single occupancy: $159 plus tax Double occupancy: $174 plus tax cOurse descriPtiOn Now in its 38th year, this course is designed for primary care and emergency room physicians and subspecialists who want to update their knowledge of internal medicine and related disciplines. The course will provide current information on specific topics that will also benefit housestaff, nurse practitioners, physician assistants, and other healthcare professionals. accreditatiOn The University of Virginia School of Medicine designates this live activity for a maximum of 19.0 AMA PRA Category 1 Credit(s) for the main program and an additional 1.0 credit for each breakout session and the Dinner Symposium. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Application has been made to the American Academy of Family Physicians for a maximum of 25 Prescribed Credits. cOnFerence Fees The fee for the course in $510 and includes a downloadable online syllabus, continental breakfasts and breaks. If you would like a printed syllabus in addition to the online syllabus, the cost is $25 and it MUST be ordered in advance of the conference. Each Meet the Professor session is an additional $25 and includes a deluxe hot breakfast or box lunch. A daily fee of $225, which includes access to the online syllabus, is available for those attendees unable to attend the entire conference. registratiOn Registration is available on-line at www.cmevillage.com or can be completed by fax or mail using the registration form found in this brochure. Pre-registration for this conference will close three business days prior to the conference date. Please call to confirm that onsite registration will be available. Registration is limited to 250 participants. Please register early to ensure a place. cOnFirMatiOn and canceLLatiOn POLicy Upon receipt of registration and payment, you will receive an email confirmation. Registration fees will be refunded (less a $50 administration fee) for written cancellations (emails and faxed requests are acceptable) received a minimum of 14 days prior to the activity date (October 12, 2011). No refunds will be granted for cancellations made within 13 days of the activity. You are encouraged to send a substitute if you are unable to attend. The University of Virginia School of Medicine reserves the right to cancel CME activities if necessary. In this case, reimbursement of registration fees will not be assessed the $50 administrative fee. All other expenses associated with this CME activity are the sole responsibility of the participant. inFOrMatiOn/registratiOn For more information about this course or its logistics, please contact Tammy Eberly in the Office of Continuing Medical Education at 434-924-1657, or teberly@ virginia.edu. Physicians may also call toll free by using the Medical Information and Referral Service line at 1-800-552-3723 or at www.cmevillage.com. aiM PrecePtOrs You may be eligible for partial reimbursement of the RACM registration fee if you are scheduled to precept a 3rd year AIM Student in the 2011-2012 academic year. The AIM Preceptors Dinner is Thursday, October 27, 2011 from 6:30-9:00PM at the Omni. Please contact the AIM Office 434-982-2516 for details.

Dinner Symposium
CHOOSING WISDOM: THE PATH THROUGH ADVERSITY
OCTOBER 26, 2011 6:30PM 9:00PM
In the Historic Rotunda Dome Room
Featured Speaker: Margaret Plews-Ogan, MD Associate Professor of Medicine
Plus: A sneak preview of Dr. Plews-Ogans PBS documentary!

Advance Registration Required No on-site Registration Available

The University of Virginia School of Medicine designates this live activity for a maximum of 1.0 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

RegistrationRecent Advances in Clinical Medicine Form

REGISTRATION FORM The 38th Annual Edward W. Hook, Jr., MD Recent Advances in Clinical Medicine October 26-28, 2011 Omni Hotel Charlottesville Please PRINT legibly to ensure accuracy. *** Please visit our website, www.cmevillage.com, to see if online registration is available for this conference.*** Pre-registration for this conference will close two business days (three days for online registrations) prior to the conference date. Please call to confirm that onsite registration will be available. q Mr. q Mrs. q Ms. q Dr. First Name: ______________________M.I.: ____ Last Name: ______________________________ Credentials: (MD, PhD, RN, etc.): _____________________Specialty: ________________________________________________ Affiliation/Business./Organization:______________________________________________________________________________ Primary Address: This is: q home q work Street: _____________________________________________________________________________________________________ City: ____________________________________________State/Province: ______________________ Zip: ___________________ Country: _____________________________________Phone: ______________________ Fax: __________________________ Email: _______________________________________ Please print clearly for successful email delivery of your confirmation letter. Are you an employee of the University of Virginia? q Yes q No Are you a resident physician? q Yes q No Are you a fellow? q Yes q No Do you require special assistance because of a disability, or have any dietary restrictions? If so, please describe: _________ ____________________________________________________________________________________________________________ Birth date (required for tracking CME credits/CEU): _________/________/_________ REGISTRATION FEES q Main Conference (Includes Continental Breakfast, Breaks and Online Syllabus Only) $510 or q Daily Registration Fee $225/day (Please select day(s) q Wed q Thu q Fri ) q Plus Printed Syllabus in addition to Online Syllabus $25 q Meet the Professor Session $25 X ________ Sessions = $__________ (Select Sessions Below) q Dinner Symposium $65 /person X ________ Persons = $__________ Only advanced registration for the Dinner Symposium No onsite registration) Total Fees = $__________ MEET THE PROFESSOR SESSIONS Check desired sessions and insert total fee above. $25/Session includes Deluxe Breakfast or Box Lunch Wednesday Lunch Sessions q L1 Challenging Anticoagulation Cases (Limit 40 participants) q L2 Genetics in Clinical Practice (Limit 40 participants) Thursday Breakfast Session q B1 Humanism, Professionalism and Wheaties: Breakfast of Champions (Limit 60 participants) Thursday Lunch Sessions q L3 Advanced Pearls on the Physical Examination (Limit 60 participants) q L4 Health Care Reform Where Are We Now? (Limit 60 participants) Friday Breakfast Sessions q B2 Mindfulness for Physicians (Limit 40 participants) q B3 Challenging Cases in Pain & Addiction (Limit 60 participants) Friday Lunch Sessions q L5 Challenging Cases in Sports Medicine (Limit 60 participants) q L6 Challenging Rheumatology Cases (Limit 40 participants) Payment is required with registration. An exception is made for institutional checks; however, these must be received at least 4 days prior to the scheduled CME activity. If payment is not received by the deadline, you will NOT be registered for the conference. You will receive written confirmation (by email) upon receipt of your payment. PAYMENT OPTIONS q Check or money order made payable to UVA-CME. Please indicate the name of the conference on your check. q Charge payment to: q Visa q MasterCard q Discover q American Express Your credit card number:__________________________________________________ Expiration date_____/_______ Signature:_______________________________________________________________________________________ SEND REGISTRATIONS TO: Bebe Moore, Registrar *** RACM 2011*** Office of Continuing Medical Education, P.O. Box 800711 University of Virginia School of Medicine, McKim Hall Charlottesville, VA 22908 Tel: (434) 924-5310, Fax: (434) 243-6393, MIRS Tel: 1-800-552-3723

University of Virgina Hospital School of Medicine The Office of Continuing Medical Education P.O. Box 800711, Charlottesville, Virginia 22908-0711

The 38th Annual

Edward W. Hook, Jr., M.D.

Recent Advances in Clinical Medicine

The 38th Annual

Edward W. Hook, Jr., M.D.

Recent Advances in Clinical Medicine

"This was a great conference!! Much practical information that I can use in my everyday practice. Wow! I'm glad I came back." -- Prior Course Participant