Lectures and Discussions

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by topic ALLERGY ALTERNATIVE MEDICINE    CARDIOLOGY   DERMATOLOGY ENDOCRINE GI GERIATRICS HEME/ONC ID RENAL/UROLOGY  NEURO    ortho   PEDS PRACTICE MANAGEMENT PREVENTION PSYCH PULMONARY RHEUMATOLOGY WOMEN'S HEALTH  TEACHING OTHER ..........Cardiovascular DVT an Evidenced Based Approach D-dimer may be useful in low risk patient to decide if lower extremity dopplers need to be done (LOE 1-B) Lower Extremity US is the test of choice in most circumstances (LOE 1-A) Initial treatment with Heparin, LMWH or Factor Xa inhibitors are equally safe and efficacious (LOE 1-A) Long term treatment with LMWH is recommended in patients with Cancer (LOE 1-B) Long term treatment with Coumadin should be instituted for 3 months in provoked DVT’s (LOE 1-A) Possibly indefinitely for unprovoked DVT’s (at least 2 years) (LOE 1-B) Thrombotic workup does not change outcomes for most individuals with 1 VTE (LOE 2-B) Would consider Antiphospholipid antibodies in individuals with unprovoked VTE who wish to go off anticoagulation (LOE 2-B) Mike Mazzone November 2005           ..........Neurology Headache     70% of headaches are tension-type Nausea is the most helpful in patient with a history of Acute migraine Most effective treatment is NSAIDs, then tryptans Avoid narcotics and butalbital For Chronic migraine: TCAs or ß-blockers Image if: HA awakes from sleep abnormal neuro exam Consider analgesic-rebound David Fay November 2005           ..........Other Time Management: Mastering Self and Time l wDiscuss the basic principles of time management wBe able to create an effective “To Do” List wUnderstand the concept of the whole person docto Mike Mazzone February 2006         Disaster Medicine     l w Discuss disaster medicine Patrick Ginn August 2006         Nasolaryngoscopy: An introduction     l w Reviews the indications/contraindications for nasolaryngoscopy Looks at the typical findings found on nasolaryngoscopic exams David Fay August 2005         Internet use for Physicians     l w Understand some of the many ways physicians can use the web to better care for patients Be able to set up a RSS feed to receive journal summaries and medical information directly Be able to list some of the resources available for those wanting to set up their own website Michael F. Mazzone, MD October 2006         Suicide Prevention in Primary Care     l Why should family doctors care? Two clinical strategies for suicide prevention. Bruce Ambuel , Ph. D July 2007         Supporting Suicide Survivors     l Stigma's Common survivor responses What helps and heals CENTRE FOR SUICIDE PREVENTION November 1999         Depression Management Tool Kit     l Recognition & Diagnosis Patient Education Treatment Monitoring THE MACARTHUR INITIATIVE June 2004         ..........Rheumatology Antiphospholipid Antibodies: What the heck are they and whay do I do about them? lNo recommendations for or against screening the general population for APL (SOR 5-Expert opinion without explicit critical appraisal) lAll women with greater than 3 miscarriages should be screened for APL (SOR 2B based on small-randomized control trials) ) lNo current recommendations for screening for APL those with an idiopathic VTE (SOR 5-Expert opinion without explicit critical appraisal) lWomen with greater than 3 miscarriages should be treated with LMWH and Aspirin from time of positive pregnancy test until delivery or 34 weeks gestation ( SOR 2A  Systematic Review  (with homogeneity* ) of low quality randomized controlled trials) lThose with APL and a VTE should consider indefinite anticoagulation with coumadin or similar medication  (SOR 2B based on small-randomized control trials) ) lModerate Intensity (INR 2-3) coumadin therapy as good as High Intensity (INR 3-4) for patients with known APL  (SOR 2B based on small-randomized control trials) Mike Mazzone February 2006         ..........Women's Health FP's who do OB: Myth and Reality     Looks at the statistics about FP's in the US and their role in delivering obstetrical care David Fay November 2005         Active Management of the Third Stage of Labor     Routine active management is superior to expectant management in terms of blood loss, PPH, and severe PPH Active management should be routine for women expecting a vaginal delivery in a maternity hospital Give oxytocin immediately upon delivery of ant shoulder 10 IU IM or 20 IU/L IV wide open Clamp/cut cord within 2-3 minutes Gentle, controlled traction of cord accompanied by gentle fundal distraction David Fay August 2006         Prenatal Care     Discusses the role of a family physician caring for a pregnant patient Outlines the tasks that need to be completed as well as discussing educational objectives throughout pregnancy David Fay November 2005         The Elective Induction Controversy     In nulliparous women between 37-41 weeks, elective induction of labor increases the risk of cesarean section (NNH=10-14). (LOE 2B) There is insufficient evidence regarding the impact of elective inductions on neonatal outcomes. (LOE 2B) In this group of women risks of elective induction likely outweigh the benefits. (LOR B) Potential risks and benefits of elective inductions should be discussed with all patients desiring elective induction. (LOR D) David Fay, Joi Davis May 2006         Contraception Failure Contraception failure is VERY common and Physicians deal with it often Emergency Contraception is useful if patients know about it Medical and surgical abortions are both safe and available in Wisconsin Adoption laws differ from state to state so local knowledge is important Michael F. Mazzone, MD April 2007