Dear Residents, Please join us for our Endocrinology Interest Group on Thursday 11/12 from 5:30pm-6:30pm via Zoom (information below). Thank you to Sophie Cannon and Dr. Santos for setting this up! Sincerely, Your Chiefs
If you’d like to participate in the research block elective next year, now is your chance! We are planning a session to set you up for success with regards to helping find a mentor, writing a proposal and submitting an application to secure this coveted protected research time during your senior residency years.
This session is open to those interested in pursuing fellowship, Hospital Medicine or Primary Care! Many residents who are looking for careers in hospital medicine and primary care have participated in this research block. The world is your oyster! Furthermore, if you are a 2nd year and have not yet applied to this block, there is still the opportunity to participate during your 3rd year!
“How to choose a research mentor and write a research proposal.”
– 10/23: AFTER Friday school (5:10-6:10pm) via Zoom (link below)
This morning we had the pleasure of hearing from two of our outstanding residents, Ibrahim Selevany and Susan Seav, who presented their research findings as part of the research elective.
Dr. Selevany presented findings from his research, titled “Stroke Volume Reserve Index (SVRI) is an Independent Predictor of Survival and Need for Advanced Therapies in Systolic Heart Failure Patients.” Dr. Selevany informed us of some of the indices currently used via Cardiopulmonary Exercise Testing (CPET) in order to help stratify the need for advanced therapies in patients with systolic heart failure, including peak VO2, which attempts to estimate peak cardiac output, however is limited by a number of physiologic factors including gender, age, deconditioning, obesity and anemia. SVRI, however, is an innovative measure, definted as the ratio of the calculated stroke volume at anaerobic threshold compared to rest. He explained that SVRI accounts for inotropic reserve and is less dependent on other patient factors. Dr. Selevany presented data from a retrospective study of 104 patients and demonstrated that abnormal SVRI in these patients was highly predictive of mortality at 1 year, compared to those individuals with normal SVRI. Furthermore, he demonstrated that SVRI is better than traditional CPET measures (Peak VO2, AT VO2, PCWP) via Receiver Operating Curve (ROC-AUC). Thus, SVRI is a novel parameter that provides additional insight into exercise physiology and may have a role in the evaluation of heart failure patients.
Next, Dr. Susan Seav presented her research, titled “Hyperoxia Kills: Overuse of Oxygen Therapy on the Medicine Wards.” Dr. Seav sought to conduct an observational study to identify the use/misuse of oxygen therapy in the inpatient setting, and better understand the disparities between prescription and delivery of inpatient oxygen protocols. She presented data from a systematic review of 25 RCTs comparing liberal vs conservative oxygen therapy in acute illness (IOTA), which demonstrated that in-hospital mortality and 30-d mortality was significantly higher in those receiving liberal O2. She also reviewed the 2018 BMJ Rapid Recommendations for oxygen use based on O2 saturation, and then presented data from a retrospective study from a UCSD experience of 1501 patients, and showed that only 12% of those patients who met inclusion criteria were meeting the standard of BMJ guidelines. She then outlined the reasons for hyperoxia of these patients, which appeared to be due to a variety of reasons including patient comfort, frequent desaturations, lack of time, or oxygen given during procedures. She then outlined potential changes to the order-set protocol in order help counteract the degree of hyperoxia, as well as proposed further nursing and physician education regarding updated BMJ guidelines on oxygen use in acutely ill patients.
Thank you to Dr. Selevany and Dr. Seav for these interesting and important research projects. Congratulations to you both for being winners of the Annual Research Symposium. For their full abstracts and video-poster presentations, please see https://www.ucsdimrrs20.org.
Dr. Susan Seav will be a third-year resident for the 2020-2021 academic year, and is slated to be a future Chief Medical Resident thereafter. Dr. Selevany will completing his Residency in Internal Medicine and will be a Cardiology Fellow at Montefiore Medical Center starting this summer.
Please join us for our Annual Resident Research Symposium coming up on Tuesday, May 5 at 5PM. This year, due to the COVID-19 pandemic, we have made significant adaptations to our traditional in-person poster presentations. We have transitioned to an entirely web-based virtual symposium. We have collected abstracts, posters, and recorded oral poster presentations and will be hosting them in a virtual environment for all to view.
We have 30 residents who will be showcasing the results of work performed during their research electives. Topics of study include Cardiology, Gastroenterology, Hospital Medicine, Quality Improvement, Hematology/Oncology, Pulmonary & Critical Care, and Nephrology.
The California Society of Addiction Medicine’s annual conference will be held in San Diego from August 26-29th, 2020. Scholarships are offered to cover the entire cost of registration. Please contact Stacy Charat (firstname.lastname@example.org) if you are interested in attending with local faculty members. The scholarship application requires very little preparation but the deadline is April 24th so please express interest ASAP!
Last week, Mitra Jamshidian and Lauren Haggerty presented their research at the 17th Annual Nephrology Young Investigators Forum, organized by UC San Diego School of Medicine Continuing Medical Education. Mitra presented an abstracted, titled “Effect of lanthanum carbonate on blood pressure in CKD.” Lauren presented “Estimates of ESKD risk and timely renal replacement therapy education.” Congratulations to our two future Nephrologists!
This morning, the inaugural Stephen Wasserman Lecture was given by Dr. Frank Austen. Dr. Austen began by recounting his experiences in the Stephen Wasserman lab where a cohort of post-docs and trainees then went to began their own prolific laboratories replicating the dynamic nature of the Wasserman lab.
Today’s presentation focused on highlighting the work that has led to the understanding of mast cell diversity and heterogeneity–work that has spanned several decades. Dr. Frank Austen highlighted several key studies that underscored differences in lineage development, variety of localization of mast cell progenitors and differences in granulation patterns of mature mast cells. Dr. Austen also highlighted that the hematopoietic lineage development of tissue mast cells is unique compared to other myeloid-derived cells because its early lineage progenitors have been found to leave the bone marrow to enter the circulation. These immature lineage mast cells immediately undergo transendothelial recruitment into peripheral tissues wherein the appearance of secretory granules with a particular protease phenotype is regulated by the peripheral tissue. Altogether these findings suggest dual roles of connective tissue mast cells (CTMCs) and mucosal mast cell (MMC) populations, based on distributions of where these populations reside within a tissue, dependence on T-cells, and lifespan.
Thank you to Dr. Austen for providing a fantastic overview of generations of work in this field and for a fantastic Grand Rounds presentation!
Congratulations to Dr. Jack Temple, outgoing QI chief, and his team on winning 1st place at the VA Performance Improvement Fair! They won the System Redesign Award!! Most impressive! Congratulations again, Jack! We will miss you!
Today we had the privilege of hearing from two of our own residents Dr. William Stendardi and Dr. Allison Brann. These two residents were selected from among their peers for their accomplishments in research at our annual symposium. Dr. Stendardi started us off by presenting his research on social media in medicine. He started by giving examples of social media mishaps in medicine leading to serious consequences including loss of position in residency. He then highlighted evidence showing the frequency of violations and who is reporting these and what the medical board does about these events. The AMA recommends using privacy settings and never posting patient identifiable information, this can include findings that may be linked with publicly known events. One option would be to have two separate accounts, one private, one public. And if you see something, say something! Report anyone violating these policies. Dr. Stendardi then discussed the study he did on our own residents, some results are