Medicine Grand Rounds, Rumey Ishizawar "Autoimmunity Induced by Cancer Immunotherapy"
2017-12-14 12:00 - 13:00 (America/New_York)
Immune-related adverse events are an unintentional side effect of immune checkpoint inhibitors used for cancer immunotherapy. Immune checkpoint inhibitors upregulate the immune system to prevent tumor evasion and promote destruction of tumor cells. These immune checkpoint inhibitors are effective as noted by the expanding number of FDA-approved drugs in this class and number of indications. In upregulating the immune system to target tumor cells, these immune checkpoint inhibitors can tip the balance of the immune system to overreact against normal cells, leading to presentations similar to autoimmune diseases. Emergence of immune-related adverse events can provide insight to rare autoimmune diseases.
Rumey Ishizawar is an assistant professor of Medicine and the medical director of the Rheumatology Specialty Clinic. She is developing an autoimmunity database, studying oncology patients that develop immune-related adverse events. The immune-oncology patient registry will promote clinical, translational and basic research.

Medicine Grand Rounds Cancelled Due to Adverse Weather
2018-01-04 12:00 - 13:00, 2018-01-18 12:00 - 13:00

McAllister Heart Institute Seminar Series: Nenad Bursac, PhD, “Engineering Excitable Tissues for Experimental Studies and Regenerative Therapy”
2018-01-09 14:00 - 15:00
Speaker: Nenad Bursac, PhD, Professor of Biomedical Engineering, Duke UniversityTopic: Engineering Excitable Tissues for Experimental Studies and Regenerative Therapy
Presentation Preview: In this talk, I will present our recent progress on engineering of human excitable tissues using primary, stem cell-derived, and genetically engineered cell sources. I will first describe scalable methodology for engineering of functional human cardiac tissues for use in medium-throughput in vitro studies and treatment of cardiac injury. Then I will describe how building on our work with rat cells, we for the first time engineered electrically and chemically responsive, contractile human skeletal muscle tissues made of primary cells isolated from standard muscle biopsies and induced pluripotent stem cells. Finally, I will describe methods to convert human unexcitable fibroblasts into an autonomous source of electrically excitable and actively conducting cells using forced expression of prokaryotic and mammalian ion channels. Together, these results open doors to new studies of human excitable tissue function, disease, and regeneration, and provide preclinical assays for testing of novel therapeutics.

Medicine Grand Rounds, Balfour Sartor and Edward Barnes, "Post-Operative Crohn’s Disease: Current and Future Management"
2018-01-11 12:00 - 13:00
Rescheduled from January 4 — In this lecture, Drs. Sartor and Barnes will summarize an evidence-based approach to the management of post-operative Crohn’s disease, and describe the future landscape based on novel molecular and microbial predictors of risk of recurrence. This topic is clinically important because the majority of patients with Crohn’s disease eventually undergo surgical resection for refractory disease or complications (obstruction or abscess/fistulae), and experience recurrent disease after resection. There are important advances in the field, but the goal of preventing recurrence after surgery has not yet been achieved; this goal will require innovative approaches.
Balfour Sartor is a gastroenterologist and mucosal immunologist with a long-standing interest in mechanisms by which commensal microbiota induce chronic intestinal inflammation vs. mucosal homeostasis. He specializes in inflammatory bowel diseases (IBD) and co-directs the UNC Multidisciplinary IBD Center.
Edward Barnes is assistant professor of Medicine in the Division of Gastroenterology and Hepatology. Dr. Barnes’ interests include evaluation of clinical outcomes related to differing treatment strategies among patients with Inflammatory Bowel Disease, as well as the effects that these strategies have on cost and resource utilization.

McAllister Heart Institute Seminar Series: Didier Stainier, PhD, “Cardiovascular development and regeneration in zebrafish”
2018-01-18 14:00 - 15:00
Speaker: Didier Stainier, PhD, Director of the Max Planck Institute for Heart & Lung Research in Bad Nauheim, GermanyTopic: Cardiovascular development and regeneration in zebrafish

McAllister Heart Institute Seminar Series: Wolfgang Bergmeier, PhD, “Platelets at the vascular interface: finding the right balance between too little and too much activation”
2018-01-23 14:00 - 15:00
Speaker: Wolfgang Bergmeier, PhD, Associate Professor of Biochemistry & Biophysics, UNCTopic: Platelets at the vascular interface: finding the right balance between too little and too much activation
Presentation Preview: Platelets are small anucleated cells that constantly patrol the cardiovascular system to preserve its integrity and prevent excessive blood loss where the vessel lining is breached. Their key challenge is to form a hemostatic plug under conditions of high shear forces. To do so, platelets have evolved a molecular machinery that enables them to sense trace amounts of signals at the site of damage and to rapidly shift from a non-adhesive to a pro-adhesive state. However, this highly efficient molecular machinery can also lead to unintended platelet activation and cause clinical complications such as thrombocytopenia and thrombosis. Thus, several checkpoints are in place to tightly control platelet activation and adhesiveness in space and time. In this talk I will discuss the major molecular mechanisms controlling platelet activation in circulation and at sites of vascular injury, with a particular focus on signaling by the small GTPase Rap1.

Medicine Grand Rounds, Amy Shaheen "Quality Improvement -- Value of Learners in a Clinic Setting"
2018-01-25 12:00 - 13:00
The LCME and ACGME require that learners participate and demonstrate competency in quality improvement activities. However, learners are not always welcome to do these activities in clinical settings due to perceived burdens on productivity, time, and resources. Dr. Shaeen will demonstrate the learner activities as beneficial to the practice and health system.
Amy W. Shaheen is an Associate Professor of Medicine in the Division of General Medicine and Clinical Epidemiology. Her clinical expertise is in general internal medicine, and quality improvement in the care of people with acute and chronic illness. She is co-director of the Community Based Longitudinal Care Course that places medical students in primary care practices. She helps design the curriculum around primary care, quality and safety, and end of life issues. She also works as subject matter expert, developing tools to improve the care of patients with COPD.

Cardiovascular Grand Rounds: Dr. Shivanshu Madan, Cardiac MRI in the Modern Era
2018-01-29 12:00 - 13:00
Speaker: Shivanshu Madan, MD, UNC Cardiology FellowTopic: Cardiac MRI in the Modern Era

McAllister Heart Institute Seminar Series: Hossein Ardehali, MD, PhD, "Role of Iron in Cardiovascular Disease"
2018-01-30 14:00 - 15:00
Speaker: Hossein Ardehali, MD, PhD, Director of the Center for Molecular Cardiology & the Medical Scientists Program at Northwestern UniversityTopic: Role of Iron in Cardiovascular Disease

Medicine Grand Rounds, Eric Juengst and Greg Copenhaver, "The Biology and Ethics of CRISPR"
2018-02-01 12:00 - 13:00
CRISPR technology is a simple yet powerful tool for editing genomes. It allows researchers to easily alter DNA sequences and modify gene function. Its many potential applications include correcting genetic defects, treating and preventing the spread of diseases and improving crops. However, its promise also raises ethical concerns. Drs. Juengst and Copenhaver will explore the biological basis of CRISPR technology and its potential biomedical applications.
Eric Juengst is Professor in the Department of Social Medicine and the Department of Genetics. He also serves as Director of the UNC Center for Bioethics. Dr. Juengst’s research interests and publications have focused on the conceptual and ethical issues raised by new advances in human genetics and biotechnology. Since 1997 he has been the principal investigator of a series of N.I.H. funded research projects examining the ethical and social policy issues that will be raised by the availability of genetic and genomic technologies. His current R01 project examines ethical and social implications of “Personalized Genomic Medicine”as a paradigm for health care.
Greg Copenhaver is a professor in the UNC Biology Department. He serves as the Director of Graduate Studies (Biology – MCDB) at UNC and as Editor-in-Chief for the peer-reviewed scientific journal PLoS Genetics. In addition, he co-founded the biotechnology company Chromatin Inc. He has also authored or co-authored numerous research papers including publications in Science, Nature, PLoS Genetics, eLife, Proceedings of the National Academy of Sciences, and Nature Genetics.

McAllister Heart Institute Seminar Series: Brian Jensen, MD, Novel roles for the nuclear receptor ROR-alpha in regulating cardiac hypertrophy
2018-02-06 14:00 - 15:00
Speaker: Brian Jensen, MD, Associate Professor of Medicine & Pharmacology, UNCTopic: Novel roles for the nuclear receptor ROR-alpha in regulating cardiac hypertrophy

Medicine Grand Rounds, Matthew Cavender "Coronary Artery Disease in Patients with Diabetes Mellitus"
2018-02-08 12:00 - 13:00
Diabetes mellitus is a common medical problem and a significant risk factor for the development of atherosclerotic coronary artery disease. Coronary artery disease is highly prevalent and is the major cause of morbidity and mortality in diabetic patients. Dr. Cavender will discuss the link between diabetes and heart disease, strategies to reduce cardiovascular risk in this population, and insights from observational data on the effectiveness of therapies.
Dr. Cavender is an active interventional cardiologist with a focus on catheter-based interventions for coronary artery disease, aortic and mitral valve disease, peripheral vascular disease, and cardiogenic shock. In addition to his clinical interests, he has an active research program with an emphasis on improving the quality of health care delivery and understanding the clinical effectiveness of pharmacological and device based therapies for patients with coronary artery disease, diabetes, peripheral arterial disease, and valvular heart disease.
In 2017, he was selected by Cardiology Today as one of its Next Gen Innovators, “a bright group of early career cardiologists identified as innovators in the field.” Dr. Cavender joined UNC’s interventional cardiology team in 2016, and since then has been a valued faculty member, performing procedures, seeing patients in clinic, and pursuing a research program.

Cardiovascular Grand Rounds: Dr. Gregory Means, Drug Eluting Balloon Technology: History, Pharmacokinetics, Current & Future Use
2018-02-12 12:00 - 13:00
Speaker: Gregory Means, MD, UNC Cardiology FellowTopic: Drug Eluting Balloon Technology: History, Pharmacokinetics, Current & Future Use

McAllister Heart Institute Seminar Series: Christopher L. Holley, MD, PhD. Non-coding RNA, RNA modifications, and Oxidative Stress in the Heart
2018-02-13 14:00 - 15:00
Speaker: Christopher L. Holley, MD, PhD, Assistant Professor of Medicine, Department of Cardiology, Duke UniversityTopic: Non-coding RNA, RNA modifications, and Oxidative Stress in the Heart

Lydia Chang and Arun Kannappan, "Sepsis Management: Beyond the Bundle"
2018-02-15 12:00 - 13:00
Sepsis remains a life-threatening disease in the setting of infection that causes significant morbidity and mortality. The new Sepsis Definitions and updated Surviving Sepsis Guidelines released in the past two years herald a time of change in the assessment and treatment of sepsis. This lecture aims to address many questions that remain unanswered in treating this illness by reviewing the latest information on epidemiology in the age of sepsis bundle implementation, methods to predict fluid responsiveness in patients with sepsis and hypotension, as well as new diagnostics and therapies recently approved and on the horizon.
Lydia Chang is Assistant Professor of Medicine in the division of Pulmonary Diseases and Critical Care Medicine. She specializes in critical care medicine, respiratory failure, ARDS, sepsis, medical emergency teams, asthma, and COPD.

Arun Kannappan is Chief Fellow, Pulmonology and Critical Care. His interests include ICU outcomes, quality improvement, and academic education.

4th Annual Women's Heart Symposium
2018-02-17 08:00 - 16:00
Register by February 5! Call Barbara at 919-843-5205 or email breid@med.unc.edu with first & last name, contact number, & t-shirt size (S, M, L, XL). Lunch will be provided.
TOPICS AT THE SYMPOSIUM INCLUDE• An overview of heart disease in women• Heart failure in women• Device therapy in women: cardiac electrophysiology, pacemakers, defibrillators, and more• Cardiovascular disease and exercise• Cardiovascular disease and nutrition• Cardiovascular disease and stress• Stretching for Health
Hosted by Paula Miller, MD, Clinical Associate Professor, Medical Director of Cardiac Rehabilitation, and Director of the Women’s Heart Program at UNC School of Medicine. She will be hosting the event and giving an overview of heart disease in women.

McAllister Heart Institute Seminar Series: Deepak Voora, MD, “Genotype-informed Statin Therapy”
2018-02-20 14:00 - 15:00
Speaker: Dr. Deepak Voora, MD, Associate Professor of Medicine, Department of Cardiology, Center for Applied Genomics and Precision Medicine at Duke University Topic: “Genotype-informed Statin Therapy”
Seminar Synopsis: Statins are among the most commonly prescribed medications to lower cholesterol and to prevent cardiovascular disease. Although well tolerated by most patients, a significant proportion of patients develop musculoskeletal symptoms associated with statin therapy that can lead to premature statin discontinuation, elevated cholesterol, and increased risk for cardiovascular events. Our group was among the first to discover a reduced function genetic variant in the SLCO1B1 gene that predisposes to higher statin concentrations and statin-associated musculoskeletal symptoms (SAMS). We have extended this finding to higher cholesterol levels in patients with cardiovascular disease treated with statins and tested for effects on cardiovascular events. The statin-specific nature of SLCO1B1 associations with SAMS that we and others have identified laid the foundation to translate our findings into the clinic. We have developed a genotype-informed statin therapy (GIST) intervention based on communicating SLCO1B1 genotype based risk for SAMS and tailored prescriptions to reduce the risk of SAMS. In two prospective studies, including a randomized clinical trial, GIST improves perceptions of statin therapy, increased statin re-initiation, and lowered cholesterol levels in patients with statin-intolerance.

Medicine Grand Rounds, Nancy Allbritton "Organs-on-Chips"
2018-02-22 12:00 - 13:00
Organ-on-chips are miniaturized devices that arrange living cells to simulate functional subunits of tissues and organs. These microdevices provide exquisite control of tissue microenviroment for the investigation of organ-level physiology and disease. Human organ-on-chips are expected to transform biomedical research providing platforms that accurately replicate human tissues, enable a better understanding of human-to-human physiologic variations and even permit patient-specific organ mimics. These human organ facsimiles will fundamentally alter drug discovery and development by providing human constructs for screening assays, toxicity measurements and investigation of molecular-level drug actions.
Nancy L. Allbritton is the Kenan Professor and Chair of the Joint Department of Biomedical Engineering at UNC and NC State, and Kenan Professor in the UNC Department of Chemistry. Her research focuses on the development of novel technologies for applications in single-cell analysis, micro-arrays and fluidics, and organ-on-chip. It has resulted in over 180 full-length journal publications and patents and led to 15 commercial products. Her research program has been well funded by the National Institutes of Health with nearly $60 million in grants since 1994.

Cardiovascular Grand Rounds: Dr. Faisal Syed, “Sudden Death in Mitral Valve Prolapse”
2018-02-26 12:00 - 13:00
Speaker: Faisal Syed, MBChB, Assistant Professor of Medicine, UNC CardiologyTopic: “Sudden Death in Mitral Valve Prolapse”

McAllister Heart Institute Seminar Series: Douglas A. Marchuk, PhD, “Cerebral Cavernous Malformations: The Path from Gene Discovery to Therapy”
2018-02-27 14:00 - 15:00
Speaker: Dr. Douglas A. Marchuk, PhD, James B. Duke Professor, Dept. of Molecular Genetics and Microbiology at Duke University Topic: “Cerebral Cavernous Malformations: The Path from Gene Discovery to Therapy”

Medicine Grand Rounds, Ana Felix "A Rational Approach to the Painful Back"
2018-03-01 12:00 - 13:00
Busy clinicians need a focused clinical approach to both the diagnostic and imaging challenges of diagnosis in patients presenting with back pain and neurological symptoms.
Ana Felix is an Assistant Professor of Medicine in the Division of General Medicine and Clinical Epidemiology. She is an expert neurologist, seeing patients who have MS and a variety of other neurological conditions. Dr. Felix is particularly interested in stroke, TIA in adults and children, vascular neurology, vascular ultrasound, stroke in the young and in women, and hypercoagulable disorders associated with stroke.

McAllister Heart Institute Seminar Series: James F. Martin, MD, PhD, "Hippo Signaling in Heart Regeneration"
2018-03-06 14:00 - 15:00
Speaker: James F. Martin, MD, PhD, Vivian L. Smith Professor in Regenerative Medicine, Baylor College of Medicine; Director, Cardiomyocyte Renewal Lab, Texas Heart InstituteTopic: “Hippo Signaling in Heart Regeneration”
Seminar Synopsis: Dr. Martin is an internationally recognized developmental and regenerative biologist who has made fundamental contributions to our understanding of development, disease, and regeneration. He has authored more than 135 peer-reviewed papers in top journals such as Nature, Science, Cell, Developmental Cell, Plos Genetics, Development, and PNAS. His recent groundbreaking work on the Hippo pathway in heart size regulation is a landmark study that led to the insight that the Hippo pathway is an inhibitor of adult heart muscle regeneration. Dr. Martin’s insights revealed new avenues for treatment of human heart failure. Dr. Martin has made fundamental insights into the role of the transcription factor Pitx2 in atrial fibrillation, the most common sustained arrhythmia in the human population. He made use of the mouse model to investigate Pitx2 in atrial homeostasis but also in left right asymmetric morphogenesis that is essential for human development. Dr. Martin’s studies investigating Pitx2 function in craniofacial development provided insight into the molecular basis of Rieger syndrome. He uncovered a pivotal function for Bmp signaling in endothelial-mesenchymal transition and cardiac valve development. Dr. Martin’s studies uncovered a novel role for canonical Wnt signaling in cardiac progenitor cell diversification. He found the first microRNA implicated in orofacial clefting. Dr. Martin’s studies are highly cited and also reported on by the lay media.

42nd Annual Internal Medicine Conference
2018-03-07 00:00 - 2018-03-09 00:00

Medicine Grand Rounds, Anne Peery "Diverticulitis -- A Medical Perspective"
2018-03-08 12:00 - 13:00
Dr. Peery focuses on benign conditions of the colon, including diverticular disease and hemorrhoids. Despite the extremely common nature of these conditions, there is little scientifically-based evidence to guide the care of patients with these commonly-encountered conditions. Indeed, most of the algorithms of care for these diseases are governed by opinions and best guesses as to good practice rather than hard evidence. Dr. Peery’s research has challenged long-held beliefs about risk factors for uncomplicated diverticulosis and raised new questions about a long neglected disease. She recently served as a content expert and co-authored the guideline for the management of acute diverticulitis for the American Gastroenterological Association. She also co-authored a commentary that addressed a controversial recommendation generated by the guideline.
Dr. Peery recently received a career development award by the National Institutes of Health to study the effectiveness, benefits, and harms of antibiotics for acute diverticulitis. In addition, this award will allow her to develop a novel patient-reported outcome measure for acute diverticulitis. Her group is also studying the utilization of surgery for non-malignant colorectal diseases.

Integrated Care of Patients with Atrial Fibrillation: A Satellite Symposium
2018-03-10 07:00 - 12:15
Course Description – Integrated Care of Patients with Atrial Fibrillation: A Satellite Symposium – March 10, 2018 (7:00am – 12:15pm)Atrial Fibrillation is best managed by treating it as a “chronic disease” with episodic symptoms which can be successfully managed through a coordinated multidisciplinary model. This symposium will provide education to primary care providers and cardiologists on the importance of an integrated model of care for AF and strategies for implementing such an approach. This event will be held at the The Friday Center in Chapel Hill on March 10, 2018.
Agenda Highlights:
•Patient perspective: My life with Atrial Fibrillation – Marcia Van Riper, RN, PhD
•Integrated care of Atrial Fibrillation: What is it and how do we get there? Anil Gehi, MD
•The importance of shared decision-making in discussions about anticoagulation and stroke prophylaxis – Zack Deyo, PharmD
•Addressing obesity/physical inactivity – Sriram Machineni, MD

2018 McAllister Heart Institute/Integrative Vascular Biology Research Symposium
2018-03-13 09:00 - 17:00
UNC’s Integrative Vascular Biology (IVB) Training Program and the McAllister Heart Institute (MHI) jointly announce their Annual Research Symposium on Tuesday, March 13, 2018. This year’s event will be held from 9AM – 5PM at the George Watts Hill Alumni Center on the UNC campus (150 Stadium Drive, Chapel Hill, NC 27514). The symposium highlights research from graduate students, postdocs, and medical fellows within the cardiovascular community at UNC and the greater Chapel Hill area and promotes multi-disciplinary collaborative research in this important field. This year’s keynote speakers will be Caroline and Geoffrey Burns (Harvard University) who will jointly present a talk entitled “New insights into zebrafish cardiovascular development and regeneration” and Karen Hirschi (Yale University) who will present a talk entitled “Regulation of endothelial cell specification”.
Abstract submission – For those who wish to present data at the symposium, the abstract submission deadline is Monday, February 26th. Abstracts should include a title and all authors and are limited to 250 words (not including the title, etc). Note that you will need to have your abstract on hand during the registration process, and please indicate whether you wish to be considered for a limited number of oral presentations. Poster board dimensions are 3ft high by 4ft wide. For more information please contact Hannah Perrin (hjperrin@email.unc.edu).
The registration deadline for those not presenting is March 8th.

Medicine Grand Rounds, Brad Drummond "Chronic Obstructive Pulmonary Disease -- Where We Are in 2018"
2018-03-15 12:00 - 13:00
Chronic obstructive pulmonary disease (COPD) is the umbrella term for the group of tobacco-related lung diseases including emphysema and chronic bronchitis. COPD is the third leading cause of death in the United States, with an estimated 650,000 North Carolinians living with COPD. Recent guidelines have proposed a multidimensional assessment to define disease control and inform appropriate inhaler selection. With more than 18 FDA-approved maintenance inhalers available for COPD, including multiple delivery devices, selection of appropriate inhaler and device can be complex. Dr. Drummond will review the recent updates to the COPD management guidelines, as well as discuss emerging evidence regarding the role of peak inspiratory flow measurements to inform optimal inhaler selection for COPD patients.
Dr. Drummond is an Associate Professor of Medicine in the Division of Pulmonary Diseases and Critical Care Medicine. He is the Director of the UNC Obstructive Lung Diseases Clinical and Translational Research Center located at the Meadowmont Facility. Dr. Drummond’s research interests include characterizing the mechanisms for development of chronic lung disease in individuals at-risk or with COPD, with a focus on high-risk populations including persons living with HIV or those in rural residences.

Cardiovascular Grand Rounds: Dr. Joshua Vega, “UNC Project Health for Leon: A Joint Mission for Global Health”
2018-03-19 12:00 - 13:00
Speaker: Joshua Vega, UNC Cardiology FellowTopic: “UNC Project Health for Leon: A Joint Mission for Global Health”

McAllister Heart Institute Seminar Series: James F. Martin, MD, PhD, “Hippo Signaling in Heart Regeneration”
2018-03-20 14:00 - 15:00
Speaker: Joan Taylor, PhD, Professor and Vice Chair for Research in Pathology and Lab Medicine, UNC School of MedicineTopic: “GRAFs mind the GAP between muscle fate and function”
Seminar Synopsis: The overall goal of our research is to characterize the intracellular signaling pathways that govern normal and aberrant growth responses in the cardiovascular and musculoskeletal system. For this seminar, I will focus on the role of GRAF family member RhoGAPs in muscle fate and function. We originally identified GRAF1 (GTPase-regulator for RhoA associated with FAK) in an un-biased screen for Focal Adhesion Kinase binding partners and over the past several years we have shown that GRAF1 (Arhgap26) and it’s family members GRAF2 (Arhgap10) and -3 (Arhgap42) are critical for limiting RhoA activity in muscle (cardiac, skeletal and smooth) wherein they play unique roles in co-regulating actin and membrane dynamics. In this seminar, I will highlight our latest studies on GRAF3 which indicate a critical role for this protein in the development and pathogenesis of human hypertension. Moreover, I will present new evidence to suggest that GRAF1 and GRAF2 may be equally as important for maintaining cardiac and skeletal muscle homeostasis respectively by novel mechanisms that involve mitochondrial quality control. Collectively, our findings support the possibility that targeting GRAFs might provide promising therapeutic strategies to limit hypertension and striated muscle degeneration.
