Exercise might help compensate for a high genetic risk of cardiovascular disease, according to the findings of a large prospective observational cohort study.

High-risk individuals in the top cardiorespiratory fitness tertile had a 49% lower risk of coronary heart disease (hazard ratio, 0.51; 95% confidence interval, 0.38-0.69) and a 60% lower risk of atrial fibrillation (HR, 0.40; 95% CI, 0.30-0.55) compared with those in the bottom fitness tertile, reported Emmi Tikkanen, PhD, of Stanford (Calif.) University, and her associates. The study was published in Circulation.

Little is known about whether exercise offsets genetic risk for cardiovascular disease. For the study, the researchers measured grip strength, cardiorespiratory fitness (based on net oxygen consumption while riding a stationary bicycle), cardiovascular events, and mortality among 482,702 participants in the UK Biobank longitudinal cohort study. More than half of individuals were women and none had baseline evidence of heart disease. The researchers stratified cases of coronary artery disease (CHD) and atrial fibrillation (AF) by whether individuals were at high, intermediate, or low genetic risk based on genome-wide association data.

Over a median follow-up period of 6.1 years (interquartile range, 5.4 to 6.8 years), there were nearly 21,000 cardiovascular events, including more than 8,000 cases of CHD and nearly 10,000 cases of AF. For all risk groups, increased grip strength and cardiorespiratory fitness were associated with a significantly lower risk of CHD and AF (P less than .001), even after adjustment for demographic factors, diabetes, smoking, systolic blood pressure, body mass index, and use of lipid-lowering medications.

The researchers did not look closely at types or durations of exercise. “Future studies evaluating the effects of strength versus aerobic training on subclinical or clinical cardiovascular outcomes could help to tailor exercise programs for individuals with elevated genetic risk for these diseases,” they wrote.

Funders included the National Institutes of Health, Knut and Alice Wallenberg Foundation, Finnish Cultural Foundation, Finnish Foundation for Cardiovascular Research, and Emil Aaltonen Foundation. Coauthor Erik Ingelsson, MD, disclosed advisory relationships with Precision Wellness and Olink Proteomics. The other authors reported having no conflicts of interest.

SOURCE: Tikkanen E et al. Circulation. 2018 Apr 9. doi: 10.1161/CIRCULATIONAHA.117.032432.

Exercise might help compensate for a high genetic risk of cardiovascular disease, according to the findings of a large prospective observational cohort study.

High-risk individuals in the top cardiorespiratory fitness tertile had a 49% lower risk of coronary heart disease (hazard ratio, 0.51; 95% confidence interval, 0.38-0.69) and a 60% lower risk of atrial fibrillation (HR, 0.40; 95% CI, 0.30-0.55) compared with those in the bottom fitness tertile, reported Emmi Tikkanen, PhD, of Stanford (Calif.) University, and her associates. The study was published in Circulation.

Little is known about whether exercise offsets genetic risk for cardiovascular disease. For the study, the researchers measured grip strength, cardiorespiratory fitness (based on net oxygen consumption while riding a stationary bicycle), cardiovascular events, and mortality among 482,702 participants in the UK Biobank longitudinal cohort study. More than half of individuals were women and none had baseline evidence of heart disease. The researchers stratified cases of coronary artery disease (CHD) and atrial fibrillation (AF) by whether individuals were at high, intermediate, or low genetic risk based on genome-wide association data.

Over a median follow-up period of 6.1 years (interquartile range, 5.4 to 6.8 years), there were nearly 21,000 cardiovascular events, including more than 8,000 cases of CHD and nearly 10,000 cases of AF. For all risk groups, increased grip strength and cardiorespiratory fitness were associated with a significantly lower risk of CHD and AF (P less than .001), even after adjustment for demographic factors, diabetes, smoking, systolic blood pressure, body mass index, and use of lipid-lowering medications.

The researchers did not look closely at types or durations of exercise. “Future studies evaluating the effects of strength versus aerobic training on subclinical or clinical cardiovascular outcomes could help to tailor exercise programs for individuals with elevated genetic risk for these diseases,” they wrote.

Funders included the National Institutes of Health, Knut and Alice Wallenberg Foundation, Finnish Cultural Foundation, Finnish Foundation for Cardiovascular Research, and Emil Aaltonen Foundation. Coauthor Erik Ingelsson, MD, disclosed advisory relationships with Precision Wellness and Olink Proteomics. The other authors reported having no conflicts of interest.

SOURCE: Tikkanen E et al. Circulation. 2018 Apr 9. doi: 10.1161/CIRCULATIONAHA.117.032432.

Exercise might help compensate for a high genetic risk of cardiovascular disease, according to the findings of a large prospective observational cohort study.

High-risk individuals in the top cardiorespiratory fitness tertile had a 49% lower risk of coronary heart disease (hazard ratio, 0.51; 95% confidence interval, 0.38-0.69) and a 60% lower risk of atrial fibrillation (HR, 0.40; 95% CI, 0.30-0.55) compared with those in the bottom fitness tertile, reported Emmi Tikkanen, PhD, of Stanford (Calif.) University, and her associates. The study was published in Circulation.

Little is known about whether exercise offsets genetic risk for cardiovascular disease. For the study, the researchers measured grip strength, cardiorespiratory fitness (based on net oxygen consumption while riding a stationary bicycle), cardiovascular events, and mortality among 482,702 participants in the UK Biobank longitudinal cohort study. More than half of individuals were women and none had baseline evidence of heart disease. The researchers stratified cases of coronary artery disease (CHD) and atrial fibrillation (AF) by whether individuals were at high, intermediate, or low genetic risk based on genome-wide association data.

Over a median follow-up period of 6.1 years (interquartile range, 5.4 to 6.8 years), there were nearly 21,000 cardiovascular events, including more than 8,000 cases of CHD and nearly 10,000 cases of AF. For all risk groups, increased grip strength and cardiorespiratory fitness were associated with a significantly lower risk of CHD and AF (P less than .001), even after adjustment for demographic factors, diabetes, smoking, systolic blood pressure, body mass index, and use of lipid-lowering medications.

The researchers did not look closely at types or durations of exercise. “Future studies evaluating the effects of strength versus aerobic training on subclinical or clinical cardiovascular outcomes could help to tailor exercise programs for individuals with elevated genetic risk for these diseases,” they wrote.

Funders included the National Institutes of Health, Knut and Alice Wallenberg Foundation, Finnish Cultural Foundation, Finnish Foundation for Cardiovascular Research, and Emil Aaltonen Foundation. Coauthor Erik Ingelsson, MD, disclosed advisory relationships with Precision Wellness and Olink Proteomics. The other authors reported having no conflicts of interest.

SOURCE: Tikkanen E et al. Circulation. 2018 Apr 9. doi: 10.1161/CIRCULATIONAHA.117.032432.

Cancer Research Center

Single-cell analysis has revealed key genetic events in a type of T-cell acute lymphoblastic leukemia (T-ALL), according to researchers.

The team tracked the branching pattern of evolution in STIL-TAL1-positive T-ALL and identified mutations that may trigger development of the disease.

The researchers believe their findings could be used in minimal residual disease assessments as well as for the development of new targeted drugs.

Caroline Furness, MD, of Institute of Cancer Research in London, UK, and her colleagues described this research in Leukemia.

To determine the sequence of mutational events in STIL-TAL1-positive T-ALL, the researchers examined individual leukemia cells from 19 children and young adults with the disease, as well as 1 cell line with the STIL-TAL1 rearrangement (RPMI 8402).

The team found the STIL-TAL1 gene fusion and inactivation of the CDKN2A gene occurred very early in leukemia development.

The researchers said it was difficult to tell whether STIL-TAL1 fusion or CDKN2A loss are initiating events in this disease, and it isn’t clear which mutational event occurs first.

However, the team believes the STIL-TAL1 fusion is likely a founder or truncal event for this type of leukemia, so targeting the TAL1 regulatory complex could be an effective way to treat the disease.

The researchers also identified mutations in NOTCH1 and PTEN as secondary subclonal events.

Half of the samples examined had errors affecting PTEN, which suggests these events are key to maintaining leukemia growth and survival in STIL-TAL1-positive T-ALL, according to the researchers.

“We need to understand how cancers evolve and unpick which mutations are key to triggering cancer development and which are important for driving its growth and spread,” Dr Furness said.

“Our study uncovered these crucial mutations in a type of leukemia that accounts for around a quarter of cases of T-cell leukemia in children and young adults. This will help us to develop more effective treatments, especially in those children who relapse, and kinder treatments that won’t cause life-long side effects.”

Cancer Research Center

Single-cell analysis has revealed key genetic events in a type of T-cell acute lymphoblastic leukemia (T-ALL), according to researchers.

The team tracked the branching pattern of evolution in STIL-TAL1-positive T-ALL and identified mutations that may trigger development of the disease.

The researchers believe their findings could be used in minimal residual disease assessments as well as for the development of new targeted drugs.

Caroline Furness, MD, of Institute of Cancer Research in London, UK, and her colleagues described this research in Leukemia.

To determine the sequence of mutational events in STIL-TAL1-positive T-ALL, the researchers examined individual leukemia cells from 19 children and young adults with the disease, as well as 1 cell line with the STIL-TAL1 rearrangement (RPMI 8402).

The team found the STIL-TAL1 gene fusion and inactivation of the CDKN2A gene occurred very early in leukemia development.

The researchers said it was difficult to tell whether STIL-TAL1 fusion or CDKN2A loss are initiating events in this disease, and it isn’t clear which mutational event occurs first.

However, the team believes the STIL-TAL1 fusion is likely a founder or truncal event for this type of leukemia, so targeting the TAL1 regulatory complex could be an effective way to treat the disease.

The researchers also identified mutations in NOTCH1 and PTEN as secondary subclonal events.

Half of the samples examined had errors affecting PTEN, which suggests these events are key to maintaining leukemia growth and survival in STIL-TAL1-positive T-ALL, according to the researchers.

“We need to understand how cancers evolve and unpick which mutations are key to triggering cancer development and which are important for driving its growth and spread,” Dr Furness said.

“Our study uncovered these crucial mutations in a type of leukemia that accounts for around a quarter of cases of T-cell leukemia in children and young adults. This will help us to develop more effective treatments, especially in those children who relapse, and kinder treatments that won’t cause life-long side effects.”

Cancer Research Center

Single-cell analysis has revealed key genetic events in a type of T-cell acute lymphoblastic leukemia (T-ALL), according to researchers.

The team tracked the branching pattern of evolution in STIL-TAL1-positive T-ALL and identified mutations that may trigger development of the disease.

The researchers believe their findings could be used in minimal residual disease assessments as well as for the development of new targeted drugs.

Caroline Furness, MD, of Institute of Cancer Research in London, UK, and her colleagues described this research in Leukemia.

To determine the sequence of mutational events in STIL-TAL1-positive T-ALL, the researchers examined individual leukemia cells from 19 children and young adults with the disease, as well as 1 cell line with the STIL-TAL1 rearrangement (RPMI 8402).

The team found the STIL-TAL1 gene fusion and inactivation of the CDKN2A gene occurred very early in leukemia development.

The researchers said it was difficult to tell whether STIL-TAL1 fusion or CDKN2A loss are initiating events in this disease, and it isn’t clear which mutational event occurs first.

However, the team believes the STIL-TAL1 fusion is likely a founder or truncal event for this type of leukemia, so targeting the TAL1 regulatory complex could be an effective way to treat the disease.

The researchers also identified mutations in NOTCH1 and PTEN as secondary subclonal events.

Half of the samples examined had errors affecting PTEN, which suggests these events are key to maintaining leukemia growth and survival in STIL-TAL1-positive T-ALL, according to the researchers.

“We need to understand how cancers evolve and unpick which mutations are key to triggering cancer development and which are important for driving its growth and spread,” Dr Furness said.

“Our study uncovered these crucial mutations in a type of leukemia that accounts for around a quarter of cases of T-cell leukemia in children and young adults. This will help us to develop more effective treatments, especially in those children who relapse, and kinder treatments that won’t cause life-long side effects.”

Children born very preterm continue to display language difficulties compared with term controls at 13 years of age, with no evidence of developmental “catch up.”

Given the functional implications associated with language deficits, early language-based interventions should be considered for children born VP, investigators wrote in Pediatrics.

“Difficulties in language functioning in this cohort of children born VP remained stable from 2 to 13 years of age. Although generalized language deficits were observed, the VP group had marked difficulties on expressive components of language,” wrote Thi-Nhu-Ngoc Nguyen, BSc, of Monash University, Melbourne, and her associates.

©michaeljung/Thinkstock

[email protected]

Children born very preterm continue to display language difficulties compared with term controls at 13 years of age, with no evidence of developmental “catch up.”

Given the functional implications associated with language deficits, early language-based interventions should be considered for children born VP, investigators wrote in Pediatrics.

“Difficulties in language functioning in this cohort of children born VP remained stable from 2 to 13 years of age. Although generalized language deficits were observed, the VP group had marked difficulties on expressive components of language,” wrote Thi-Nhu-Ngoc Nguyen, BSc, of Monash University, Melbourne, and her associates.

©michaeljung/Thinkstock

[email protected]

Children born very preterm continue to display language difficulties compared with term controls at 13 years of age, with no evidence of developmental “catch up.”

Given the functional implications associated with language deficits, early language-based interventions should be considered for children born VP, investigators wrote in Pediatrics.

“Difficulties in language functioning in this cohort of children born VP remained stable from 2 to 13 years of age. Although generalized language deficits were observed, the VP group had marked difficulties on expressive components of language,” wrote Thi-Nhu-Ngoc Nguyen, BSc, of Monash University, Melbourne, and her associates.

©michaeljung/Thinkstock

[email protected]

ANSWER

The radiograph demonstrates no acute injury to the wrist. There is, however, a subtle nondisplaced fracture of the distal fifth metacarpal joint. The patient was given a wrist splint for symptomatic relief, and orthopedic follow-up was coordinated.

ANSWER

The radiograph demonstrates no acute injury to the wrist. There is, however, a subtle nondisplaced fracture of the distal fifth metacarpal joint. The patient was given a wrist splint for symptomatic relief, and orthopedic follow-up was coordinated.

ANSWER

The radiograph demonstrates no acute injury to the wrist. There is, however, a subtle nondisplaced fracture of the distal fifth metacarpal joint. The patient was given a wrist splint for symptomatic relief, and orthopedic follow-up was coordinated.

Clinical question: Can we use readily available data to risk stratify patients who present to the emergency department in acute heart failure (AHF)?

Background: Although cardiac biomarkers such as troponin and B-natriuretic peptide have general prognostic value in patients with AHF presenting to the emergency department, these values do not reliably aid in determining patients’ risk for unfavorable outcomes at the time of clinical decision making. Currently available published scores for risk-stratifying patients with AHF in the ED have limited applicability.

Bottom line: The MEESSI-AHF risk score may be a helpful tool in identifying the risk of 30-day mortality in patients who present to the ED with AHF, but it is currently unclear if the score can be generalized to other populations.

Citation: Miro O et al. Predicting 30-day mortality for patients with acute heart failure in the emergency department: A cohort study. Ann Intern Med. 2017 Nov 21;167(10):698-705.

Dr. Maleque is assistant professor of medicine in the division of hospital medicine, Emory University, Atlanta.

Clinical question: Can we use readily available data to risk stratify patients who present to the emergency department in acute heart failure (AHF)?

Background: Although cardiac biomarkers such as troponin and B-natriuretic peptide have general prognostic value in patients with AHF presenting to the emergency department, these values do not reliably aid in determining patients’ risk for unfavorable outcomes at the time of clinical decision making. Currently available published scores for risk-stratifying patients with AHF in the ED have limited applicability.

Bottom line: The MEESSI-AHF risk score may be a helpful tool in identifying the risk of 30-day mortality in patients who present to the ED with AHF, but it is currently unclear if the score can be generalized to other populations.

Citation: Miro O et al. Predicting 30-day mortality for patients with acute heart failure in the emergency department: A cohort study. Ann Intern Med. 2017 Nov 21;167(10):698-705.

Dr. Maleque is assistant professor of medicine in the division of hospital medicine, Emory University, Atlanta.

Clinical question: Can we use readily available data to risk stratify patients who present to the emergency department in acute heart failure (AHF)?

Background: Although cardiac biomarkers such as troponin and B-natriuretic peptide have general prognostic value in patients with AHF presenting to the emergency department, these values do not reliably aid in determining patients’ risk for unfavorable outcomes at the time of clinical decision making. Currently available published scores for risk-stratifying patients with AHF in the ED have limited applicability.

Bottom line: The MEESSI-AHF risk score may be a helpful tool in identifying the risk of 30-day mortality in patients who present to the ED with AHF, but it is currently unclear if the score can be generalized to other populations.

Citation: Miro O et al. Predicting 30-day mortality for patients with acute heart failure in the emergency department: A cohort study. Ann Intern Med. 2017 Nov 21;167(10):698-705.

Dr. Maleque is assistant professor of medicine in the division of hospital medicine, Emory University, Atlanta.

ORLANDO – In a video interview, Nasim Afsar, MD, SFHM, details the career road that led her to the “tremendous honor” of becoming president of the Society of Hospital Medicine.

Having been on the board of directors for 6 years was a profound experience, according to Dr. Afsar, and now as president she looks to take what she has learned and focus on the future of the field.

When asked about her overall vision for the coming year for the Society, Dr. Afsar said that she is committed to “an unrelenting focus on delivering value to our patients, our institutions, and society, and the way we do that is through population health management.”

ORLANDO – In a video interview, Nasim Afsar, MD, SFHM, details the career road that led her to the “tremendous honor” of becoming president of the Society of Hospital Medicine.

Having been on the board of directors for 6 years was a profound experience, according to Dr. Afsar, and now as president she looks to take what she has learned and focus on the future of the field.

When asked about her overall vision for the coming year for the Society, Dr. Afsar said that she is committed to “an unrelenting focus on delivering value to our patients, our institutions, and society, and the way we do that is through population health management.”

ORLANDO – In a video interview, Nasim Afsar, MD, SFHM, details the career road that led her to the “tremendous honor” of becoming president of the Society of Hospital Medicine.

Having been on the board of directors for 6 years was a profound experience, according to Dr. Afsar, and now as president she looks to take what she has learned and focus on the future of the field.

When asked about her overall vision for the coming year for the Society, Dr. Afsar said that she is committed to “an unrelenting focus on delivering value to our patients, our institutions, and society, and the way we do that is through population health management.”

SAN DIEGO – Both the 4Ts Score and the HIT Expert Probability (HEP) Score are useful in clinical practice for the diagnosis of heparin-induced thrombocytopenia, but the HEP score may have better operative characteristics in ICU patients, results from a “real world” analysis showed.

“The diagnosis of heparin-induced thrombocytopenia (HIT) is challenging,” Allyson M. Pishko, MD, one of the study authors, said at the biennial summit of the Thrombosis & Hemostasis Societies of North America. “The 4Ts Score is commonly used, but limitations include its low positive predictive value and significant interobserver variability.”

At the prespecified screening cut-off of 2 or more points, the HEP Score was 97.7% sensitive and 21.9% specific, with a positive predictive value of 17.7% and a negative predictive value of 98.2%. A cut-off of 5 or greater provided 90.7% sensitivity and 47.8% specificity with a positive predictive value of 23.1% and a negative predictive value of 96.8%. The mean time to calculate the HEP Score was 4.1 minutes.

The median 4Ts Score in patients with and without HIT was 5 versus 4 (P less than .0001), Dr. Pishko reported. A 4Ts Score of 4 or greater had a sensitivity of 97.7% and specificity of 32.9%, with a positive predictive value of 20.1% and a negative predictive value of 98.8%.

The area under the ROC curves for the HEP Score and 4Ts Score were similar (0.81 vs. 0.76; P = .121). Subset analysis revealed that compared with the 4Ts Score, the HEP Score had better operating characteristics in ICU patients (AUC 0.87 vs. 0.79; P= .029) and with trainee scorers (AUC 0.79 vs. 0.73; P = .032).

“Our data suggest that either the HEP Score or the 4Ts Score could be used in clinical practice,” Dr. Pishko said.

The National Institutes of Health funded the study. Dr. Pishko reported having no financial disclosures.

[email protected]

SOURCE: Pishko A et al. THSNA 2018.

SAN DIEGO – Both the 4Ts Score and the HIT Expert Probability (HEP) Score are useful in clinical practice for the diagnosis of heparin-induced thrombocytopenia, but the HEP score may have better operative characteristics in ICU patients, results from a “real world” analysis showed.

“The diagnosis of heparin-induced thrombocytopenia (HIT) is challenging,” Allyson M. Pishko, MD, one of the study authors, said at the biennial summit of the Thrombosis & Hemostasis Societies of North America. “The 4Ts Score is commonly used, but limitations include its low positive predictive value and significant interobserver variability.”

At the prespecified screening cut-off of 2 or more points, the HEP Score was 97.7% sensitive and 21.9% specific, with a positive predictive value of 17.7% and a negative predictive value of 98.2%. A cut-off of 5 or greater provided 90.7% sensitivity and 47.8% specificity with a positive predictive value of 23.1% and a negative predictive value of 96.8%. The mean time to calculate the HEP Score was 4.1 minutes.

The median 4Ts Score in patients with and without HIT was 5 versus 4 (P less than .0001), Dr. Pishko reported. A 4Ts Score of 4 or greater had a sensitivity of 97.7% and specificity of 32.9%, with a positive predictive value of 20.1% and a negative predictive value of 98.8%.

The area under the ROC curves for the HEP Score and 4Ts Score were similar (0.81 vs. 0.76; P = .121). Subset analysis revealed that compared with the 4Ts Score, the HEP Score had better operating characteristics in ICU patients (AUC 0.87 vs. 0.79; P= .029) and with trainee scorers (AUC 0.79 vs. 0.73; P = .032).

“Our data suggest that either the HEP Score or the 4Ts Score could be used in clinical practice,” Dr. Pishko said.

The National Institutes of Health funded the study. Dr. Pishko reported having no financial disclosures.

[email protected]

SOURCE: Pishko A et al. THSNA 2018.

SAN DIEGO – Both the 4Ts Score and the HIT Expert Probability (HEP) Score are useful in clinical practice for the diagnosis of heparin-induced thrombocytopenia, but the HEP score may have better operative characteristics in ICU patients, results from a “real world” analysis showed.

“The diagnosis of heparin-induced thrombocytopenia (HIT) is challenging,” Allyson M. Pishko, MD, one of the study authors, said at the biennial summit of the Thrombosis & Hemostasis Societies of North America. “The 4Ts Score is commonly used, but limitations include its low positive predictive value and significant interobserver variability.”

At the prespecified screening cut-off of 2 or more points, the HEP Score was 97.7% sensitive and 21.9% specific, with a positive predictive value of 17.7% and a negative predictive value of 98.2%. A cut-off of 5 or greater provided 90.7% sensitivity and 47.8% specificity with a positive predictive value of 23.1% and a negative predictive value of 96.8%. The mean time to calculate the HEP Score was 4.1 minutes.

The median 4Ts Score in patients with and without HIT was 5 versus 4 (P less than .0001), Dr. Pishko reported. A 4Ts Score of 4 or greater had a sensitivity of 97.7% and specificity of 32.9%, with a positive predictive value of 20.1% and a negative predictive value of 98.8%.

The area under the ROC curves for the HEP Score and 4Ts Score were similar (0.81 vs. 0.76; P = .121). Subset analysis revealed that compared with the 4Ts Score, the HEP Score had better operating characteristics in ICU patients (AUC 0.87 vs. 0.79; P= .029) and with trainee scorers (AUC 0.79 vs. 0.73; P = .032).

“Our data suggest that either the HEP Score or the 4Ts Score could be used in clinical practice,” Dr. Pishko said.

The National Institutes of Health funded the study. Dr. Pishko reported having no financial disclosures.

[email protected]

SOURCE: Pishko A et al. THSNA 2018.

A low faculty-to-learner ratio helped HM18 attendees get the most from their learning experience in the Sunday pre-conference course “Bedside Procedures for the Hospitalist.”

The pre-course blended live didactic teaching and hands-on training with simulators so participants could not only learn but also review and demonstrate techniques for many common invasive procedures hospitalists encounter in practice.

“Our goal is to make the entire bedside procedures pre-course a unique experience,” course codirector Alyssa Burk­hart, MD, of the Billings (Mont.) Clinic, said in an interview before the session.

“Our hope is that many hospitalists may once again find that spark of interest in performing more of their own procedures. The interactive sessions embedded within the pre-course are vital to the success of our program. Many other training sessions are didactics based. We strive to keep lecture time to a minimum so that small groups can learn from the expert facilitators,” Dr. Burkhart added.

“Ample hands-on practice time, interactive experience, and direct supervision separate our pre-course from other commercially available offerings,” Dr. Lenchus said.

The agenda kicked off with vascular and intraosseous access in the morning, followed by paracentesis, thoracentesis, lumbar puncture, and basic airway management, including the use of supraglottic devices.

Dr. Burkhart noted that the course included two separate practice sessions for vascular access because of the number of technical steps and potential complications. “Attendees typically wish to spend a considerable amount of time on vascular access,” she said. “The intraosseous access station and its exceptional trainers always receive very positive feedback.”

Dr. Burkhart and Dr. Lenchus had no financial conflicts to disclose.

A low faculty-to-learner ratio helped HM18 attendees get the most from their learning experience in the Sunday pre-conference course “Bedside Procedures for the Hospitalist.”

The pre-course blended live didactic teaching and hands-on training with simulators so participants could not only learn but also review and demonstrate techniques for many common invasive procedures hospitalists encounter in practice.

“Our goal is to make the entire bedside procedures pre-course a unique experience,” course codirector Alyssa Burk­hart, MD, of the Billings (Mont.) Clinic, said in an interview before the session.

“Our hope is that many hospitalists may once again find that spark of interest in performing more of their own procedures. The interactive sessions embedded within the pre-course are vital to the success of our program. Many other training sessions are didactics based. We strive to keep lecture time to a minimum so that small groups can learn from the expert facilitators,” Dr. Burkhart added.

“Ample hands-on practice time, interactive experience, and direct supervision separate our pre-course from other commercially available offerings,” Dr. Lenchus said.

The agenda kicked off with vascular and intraosseous access in the morning, followed by paracentesis, thoracentesis, lumbar puncture, and basic airway management, including the use of supraglottic devices.

Dr. Burkhart noted that the course included two separate practice sessions for vascular access because of the number of technical steps and potential complications. “Attendees typically wish to spend a considerable amount of time on vascular access,” she said. “The intraosseous access station and its exceptional trainers always receive very positive feedback.”

Dr. Burkhart and Dr. Lenchus had no financial conflicts to disclose.

A low faculty-to-learner ratio helped HM18 attendees get the most from their learning experience in the Sunday pre-conference course “Bedside Procedures for the Hospitalist.”

The pre-course blended live didactic teaching and hands-on training with simulators so participants could not only learn but also review and demonstrate techniques for many common invasive procedures hospitalists encounter in practice.

“Our goal is to make the entire bedside procedures pre-course a unique experience,” course codirector Alyssa Burk­hart, MD, of the Billings (Mont.) Clinic, said in an interview before the session.

“Our hope is that many hospitalists may once again find that spark of interest in performing more of their own procedures. The interactive sessions embedded within the pre-course are vital to the success of our program. Many other training sessions are didactics based. We strive to keep lecture time to a minimum so that small groups can learn from the expert facilitators,” Dr. Burkhart added.

“Ample hands-on practice time, interactive experience, and direct supervision separate our pre-course from other commercially available offerings,” Dr. Lenchus said.

The agenda kicked off with vascular and intraosseous access in the morning, followed by paracentesis, thoracentesis, lumbar puncture, and basic airway management, including the use of supraglottic devices.

Dr. Burkhart noted that the course included two separate practice sessions for vascular access because of the number of technical steps and potential complications. “Attendees typically wish to spend a considerable amount of time on vascular access,” she said. “The intraosseous access station and its exceptional trainers always receive very positive feedback.”

Dr. Burkhart and Dr. Lenchus had no financial conflicts to disclose.

An all-day HM18 pre-course – “Hospitalist Practice Management: How to Thrive in a Time of Intense Change” – for hospitalist leaders and practice administrators was all about practicality.

One of the goals of the session was to provide “quick, actionable interventions that attendees can implement right away, as well as alternatives for attendees to consider, which will require some work to employ,” said John Nelson, MD, MHM, a partner at Nelson Flores Hospital Medicine Consultants, La Quinta, Calif., the medical director of the Overlake Medical Center, Bellevue, Wash., and a course codirector and a faculty presenter.

The pre-course also covered effective roles for a variety of providers in a hospitalist group, including nurses, scribes, and coordinators, and delineated the benefits of providing telemedicine.

For group leaders and administrators in attendance, the session also shed light on how to interact with individual providers in their group and how to collaborate to build a healthy culture and practice, Ms. Flores said.

The day began with presentations that laid out valuable information and frameworks, including “A Tour of Survey Data: What It Does and Doesn’t Tell You” and “Defining and Measuring Value.” Sessions included six didactic lectures with a question-and-answer period, as well as what Dr. Nelson has dubbed “point/counterpoint” sessions in which faculty members debated particular issues, such as work scheduling models. During the last session, “Learning From Each Other,” participants shared with other attendees their own best practices in the areas covered.

Although there is no single best way to organize a hospitalist’s practice, the course provided lots of information and perspective to help listeners decide what is best for their practice.

“Even though we work in a stressful environment of constant change, hospitalists do have some control over their destiny, and there are things they can do to make hospitalist groups thrive in this challenging environment,” Ms. Flores concluded.

An all-day HM18 pre-course – “Hospitalist Practice Management: How to Thrive in a Time of Intense Change” – for hospitalist leaders and practice administrators was all about practicality.

One of the goals of the session was to provide “quick, actionable interventions that attendees can implement right away, as well as alternatives for attendees to consider, which will require some work to employ,” said John Nelson, MD, MHM, a partner at Nelson Flores Hospital Medicine Consultants, La Quinta, Calif., the medical director of the Overlake Medical Center, Bellevue, Wash., and a course codirector and a faculty presenter.

The pre-course also covered effective roles for a variety of providers in a hospitalist group, including nurses, scribes, and coordinators, and delineated the benefits of providing telemedicine.

For group leaders and administrators in attendance, the session also shed light on how to interact with individual providers in their group and how to collaborate to build a healthy culture and practice, Ms. Flores said.

The day began with presentations that laid out valuable information and frameworks, including “A Tour of Survey Data: What It Does and Doesn’t Tell You” and “Defining and Measuring Value.” Sessions included six didactic lectures with a question-and-answer period, as well as what Dr. Nelson has dubbed “point/counterpoint” sessions in which faculty members debated particular issues, such as work scheduling models. During the last session, “Learning From Each Other,” participants shared with other attendees their own best practices in the areas covered.

Although there is no single best way to organize a hospitalist’s practice, the course provided lots of information and perspective to help listeners decide what is best for their practice.

“Even though we work in a stressful environment of constant change, hospitalists do have some control over their destiny, and there are things they can do to make hospitalist groups thrive in this challenging environment,” Ms. Flores concluded.

An all-day HM18 pre-course – “Hospitalist Practice Management: How to Thrive in a Time of Intense Change” – for hospitalist leaders and practice administrators was all about practicality.

One of the goals of the session was to provide “quick, actionable interventions that attendees can implement right away, as well as alternatives for attendees to consider, which will require some work to employ,” said John Nelson, MD, MHM, a partner at Nelson Flores Hospital Medicine Consultants, La Quinta, Calif., the medical director of the Overlake Medical Center, Bellevue, Wash., and a course codirector and a faculty presenter.

The pre-course also covered effective roles for a variety of providers in a hospitalist group, including nurses, scribes, and coordinators, and delineated the benefits of providing telemedicine.

For group leaders and administrators in attendance, the session also shed light on how to interact with individual providers in their group and how to collaborate to build a healthy culture and practice, Ms. Flores said.

The day began with presentations that laid out valuable information and frameworks, including “A Tour of Survey Data: What It Does and Doesn’t Tell You” and “Defining and Measuring Value.” Sessions included six didactic lectures with a question-and-answer period, as well as what Dr. Nelson has dubbed “point/counterpoint” sessions in which faculty members debated particular issues, such as work scheduling models. During the last session, “Learning From Each Other,” participants shared with other attendees their own best practices in the areas covered.

Although there is no single best way to organize a hospitalist’s practice, the course provided lots of information and perspective to help listeners decide what is best for their practice.

“Even though we work in a stressful environment of constant change, hospitalists do have some control over their destiny, and there are things they can do to make hospitalist groups thrive in this challenging environment,” Ms. Flores concluded.

In this interview, Dr David Henry, the Editor-in-Chief of JCSO, and Dr Daniel Haller, of the Abramson Cancer Center, University of Pennsylvania Perelman School of Medicine in Philadelphia, discuss the findings from recent groundbreaking studies in gastrointestinal cancers.

Listen to the podcast below.

In this interview, Dr David Henry, the Editor-in-Chief of JCSO, and Dr Daniel Haller, of the Abramson Cancer Center, University of Pennsylvania Perelman School of Medicine in Philadelphia, discuss the findings from recent groundbreaking studies in gastrointestinal cancers.

Listen to the podcast below.

In this interview, Dr David Henry, the Editor-in-Chief of JCSO, and Dr Daniel Haller, of the Abramson Cancer Center, University of Pennsylvania Perelman School of Medicine in Philadelphia, discuss the findings from recent groundbreaking studies in gastrointestinal cancers.

Listen to the podcast below.