Medicine Grand Rounds, Ann Bailey and Elizabeth Dreesen, "NPO Guidelines for Procedural Sedation: What Are They and Why Do We Have Them?"
2017-10-05 12:00 - 13:00 (America/New_York) | NC
Anyone who uses sedation to accomplish procedures or surgery must adhere to NPO guidelines. UNC Hospital recently approved contemporary NPO guidelines for all procedural sedation. This lecture will detail what those are and why we have them.
Ann Bailey is Professor of Anesthesiology and Pediatrics. She also serves at Associate Chief Medical Officer of UNC Hospitals. She has a particular interest in studying infants at risk for autism.
Elizabeth Dreesen is Chief of General and Acute Care Surgery, and Associate Professor of Surgery.

Cardiovascular Grand Rounds: Dr. Adam Caldwell, “Genetics of Dilated Cardiomyopathy”
2017-10-09 12:00 - 13:00
Speaker: Adam Caldwell, MD, Chief Fellow, UNC CardiologyTopic: Genetics of Dilated Cardiomyopathy

MHI Seminar Series: Kari North, PhD, Genetic Diversity Turns a New PAGE in Our Understanding of Complex Traits
2017-10-10 14:00 - 15:00
Speaker: Kari North, PhDTopic: Genetic Diversity Turns a New PAGE in Our Understanding of Complex Traits
Presentation Preview: Genome-wide association studies (GWAS) have laid the foundation for many downstream investigations, including the biology of complex traits, drug development, and clinical guidelines. However, the dominance of European-ancestry populations in GWAS creates a biased view of human variation and hinders the translation of genetic associations into clinical and public health applications. To demonstrate the benefit of studying underrepresented populations, the Population Architecture using Genomics and Epidemiology (PAGE) study conducted a GWAS of 26 clinical and behavioral phenotypes in 49,839 non-European individuals. Using novel strategies for multi-ethnic analysis of admixed populations, we confirm 574 GWAS catalog variants across these traits, and find 28 novel loci and 42 residual signals in known loci. Our data show strong evidence of effect-size heterogeneity across ancestries for published GWAS associations, which substantially restricts genetically-guided precision medicine. We advocate for new, large genome-wide efforts in diverse populations to reduce health disparities.

Medicine Grand Rounds, Jonathan Juliano and Steve Meshnick, "Evolving Concepts in Malaria Control and Treatment"
2017-10-12 12:00 - 13:00
In 2015, there were 212 million malaria cases worldwide, with the majority of deaths occurring in sub-Saharan Africa. In addition to the human burden of malaria, the economic burden is vast. It is thought to cost African countries more than $12 billion every year in direct losses. For more than a decade, Drs. Juliano and Meshnick have worked together to develop tools to control this epidemic.
Dr. Steve Meshnick is Professor and Associate Chair of the Department of Epidemiology. He has worked on tropical infectious diseases, especially malaria, for over 30 years and has published more than 340 scientific papers. He has a long-standing commitment to training and capacity-building and has been the primary mentor for 40 doctoral students and for ten post-docs, including many from developing countries.
One of his former trainees, Dr. Juliano, and he are now co-leader of the Infectious Disease Epidemiology and Ecology Lab (IDEEL@UNC). In addition to malaria, the group has studied African Sleeping Sickness, tick-borne diseases, hepatitis, and Pneumocystis carinii. The goal is to integrate laboratory and field research to develop better tools for infectious disease prevention and control.
Jonathan Juliano, MD, is an Associate Professor in the Department of Medicine’s Division of Infectious Diseases. He is the Medical Director of the UNC Hospital Antimicrobial Stewardship Program. He is also adjunct faculty in the Department of Epidemiology at the Gillings School of Global Public Health and a preceptor in UNC’s Curriculum in Genetics and Molecular Biology. Dr. Juliano also acts as the Associate Program Director of research and professional development for the UNC Infectious Disease Fellowship program.

McAllister Heart Institute Seminar Series: Timothy Haystead, PhD, Defining Novel Therapeutic Targets for Cardiovascular Disease through Chemical Biology
2017-10-17 14:00 - 15:00
Speaker: Timothy Haystead, PhD, Professor of Pharmacology and Cancer Biology, Duke University School of MedicineTopic: Defining Novel Therapeutic Targets for Cardiovascular Disease through Chemical Biology

Medicine Grand Rounds, William Fischer and David Wohl, "Ebola and Lassa Fever: New Concepts of Epidemiology and Therapy"
2017-10-19 12:00 - 13:00
Severe acute viral infections are one of the world’s most common causes of hospitalization and mortality with worse outcomes disproportionately affecting resource-constrained countries. In the past 15 years we have witnessed the emergence or re-emergence of several viral pathogens that threaten global public health including SARS, pandemic H1N1 Influenza, MERS-CoV, and most recently Ebola.

Fischer, assistant professor in the Division of Pulmonary and Critical Care Medicine, was among the first physicians on the ground in Guinea, West Africa, caring for patients during that country’s Ebola outbreak. He later teamed up with David Wohl, MD, professor of medicine in the Division of Infectious Diseases, in Liberia. In collaboration with health care providers from Liberia and a clinical research organization called Clinical RM, they launched the first clinical trial of a therapeutic intervention in an Ebola outbreak, in which plasma from survivors of Ebola virus disease is given to patients who are battling the disease.
“Our model has always been to couple direct service with clinical research, with the idea being that if our freezers went down and we lost all of our research samples we were still providing an incredibly important service to patients” said Fischer.

Cardiovascular Grand Rounds: Dr. Szymon Wiernek, Coronary Artery Disease in Patients with End-stage Renal Disease
2017-10-23 12:00 - 13:00
Speaker: Szymon Wiernek, MD, PhD, Fellow, UNC CardiologyTopic: Coronary Artery Disease in Patients with End-stage Renal Disease

McAllister Heart Institute Seminar Series: Ming C. Gong, MD, PhD, Disrupted Circadian Rhythms of Blood Pressure and Vascular Function in Diabetes
2017-10-24 14:00 - 15:00
Speaker: Ming Cui Gong, PhD, MD Professor of Physiology and Cardiovascular Research Center, University of Kentucky College of MedicineTopic: Disrupted Circadian Rhythms of Blood Pressure and Vascular Function in Diabetes

Medicine Grand Rounds, David Rubinow "Reproductive Mood Disorders: This Is Your Brain on Steroids"
2017-10-26 12:00 - 13:00
Both basic and clinical studies suggest that reproductive steroids regulate virtually every element of neural signaling and do so in a highly context dependent fashion, with contexts including cell type, metabolic profiles, developmental stage/age, sex, environment, past experience, and genotype. Reproductive endocrine-related mood disorders in women (premenstrual dysphoric disorder, perinatal depression, and perimenopausal depression) offer an unparalleled opportunity to understand critical and distinct processes in disorders characterized by affective state dysregulation, namely how they are triggered and what renders some individuals susceptible to the disorders. This presentation will describe how manipulations of the reproductive endocrine system can reveal the role of reproductive steroids in the regulation of affect and suggest the means by which differential sensitivity to reproductive steroids translates into the precipitation of negative affective states.
Dr. David Rubinow is the Assad Meymandi Professor and Chair of the Department of Psychiatry. Prior to joining UNC, he was the Clinical Director of the National Institute of Mental Health (NIMH) and Chief of the Behavioral Endocrinology Branch. His research interests focus on neurobehavioral effects of gonadal steroids and how genetic variation contributes to differential behavioral response to changes in steroid signaling. Additionally, the UNC Women’s Mood Disorders Program, which he directs, has the first and only NIH training fellowship in Women’s Mood Disorders. On the basis of his research, he was inducted into the Institute of Medicine of the National Academies in 2012. Dr. Rubinow is also the Director of the UNC Center for Innovation and Health Care System Transformation, which promotes the development of patient-centered innovations designed to address the current challenges facing our nation’s health care delivery system.

Medicine Grand Rounds, Maya Styner "Is Fat in the Marrow Harmful to Bone Health?"
2017-11-02 12:00 - 13:00
Dr. Styner conducts translational experiments applying running exercise in obese as well as calorie-restricted mice to understand the relationship between bone fat and bone quantity. Her background in Endocrinology and skeletal biology, combined with an interest in exercise physiology, makes this an exciting venue for research into diet and exercise, which may be the most challenging issues facing the modern world.
Dr. Styner is Assistant Professor of Medicine in the Division of Endocrinology & Metabolism. She is an expert in the relationship of bone fat, or marrow fat, and bone health. It is this topic that she has published substantially on in the journals Endocrinology, Journal of Bone and Mineral Research and Bone.

Cardiovascular Grand Rounds: Craig R. Lee, PharmD, PhD, Clinical outcomes and sustainability of using CYP2C19 genotype-guided antiplatelet therapy after percutaneous coronary intervention
2017-11-06 12:00 - 13:00
Speaker: Craig R. Lee, Pharm.D., Ph.D., FCCP, FAHA. Associate Professor of Pharmacy, Division of Pharmacotherapy and Experimental Therapeutics, UNC Eshelman School of PharmacyTopic: Clinical outcomes and sustainability of using CYP2C19 genotype-guided antiplatelet therapy after percutaneous coronary intervention

McAllister Heart Institute Seminar Series: Hong Chen, PhD, Molecular Mechanisms Regulating VEGF Receptor Trafficking
2017-11-07 14:00 - 15:00
Speaker: Hong Chen, PhD, Associate Professor Dept. of Surgery, Harvard Medical School, Boston Children’s HospitalTopic: Molecular Mechanisms Regulating VEGF Receptor Trafficking

Medicine Grand Rounds, Roy Williams, "Leadership"
2017-11-09 12:00 - 13:00
Roy Williams is entering his 15th season as head coach of the Tar Heels. He has achieved great success on the court, winning his third NCAA title in 2017, appearing in nine Final Fours (five with UNC) and earning eight Atlantic Coast Conference regular-season titles. Even greater is the impact he makes on the lives of the young men he coaches.
Roy Williams received the Nell and John Wooden Leadership in Coaching Award on October 12, 2017. This award, named after legendary UCLA basketball coach John Wooden and his wife, Nell, was created in 2012 to recognize coaches who exemplify Wooden’s “Pyramid of Success” teachings both on and off the court.
The numbers and list of Williams’ accomplishments unquestionably place him among the finest coaches in basketball history. Williams is one of six coaches to win three or more national championships with John Wooden, Mike Krzyzewski, Jim Calhoun, Bob Knight and Adolph Rupp; fourth in Final Fours (9) behind only Wooden, Krzyzewski and Dean Smith; second in NCAA Tournament wins (76) and games (100); second in NCAA Tournament history in No. 1 seeds (12); third in NCAA Tournament winning percentage (.760) among coaches with at least 50 games; first to win three national championships at his alma mater; eighth all-time in Division I wins (816) and reached 800 wins in fewer seasons and the second-fewest games in NCAA history; and sixth all-time in career winning percentage (.791)

McAllister Heart Institute Seminar Series: Jeffery Holmes, MD, PhD, Scar Formation after Myocardial Infarction
2017-11-14 14:00 - 15:00
Speaker: Jeff Holmes, M.D., Ph.D.Professor of Biomedical Engineering & Medicine, University of VirginiaTopic: Scar Formation After Myocardial Infarction: What Happens, Why does it Matter, and What Can We Do about It?”

Medicine Grand Rounds, Stacy Wood "Medicine + Marketing: The New Role of Consumer Theory in Patient-Centric Care"
2017-11-16 12:00 - 13:00
As the healthcare environment changes, patients increasingly see more personal control in their choice of doctors, therapies, and systems of care. From new models of tele-health to the ubiquitous direct-to-consumer pharmaceutical ads on TV, patients are shifting to a “customer mind-set” when they make health decisions and this has sweeping ramifications for healthcare providers.
In this lecture, internationally-recognized scholar in consumer theory and President-Elect of the Association for Consumer Research, Dr. Stacy Wood (the Langdon Distinguished University Professor of Marketing and Executive Director of the Consumer Innovation Collaborative, NC State University) will give a practical introduction into how consumer theory can be used by medical practitioners to improve patient choice environments, patient adherence, and patient satisfaction. Based on her research with physicians, she will discuss common pitfalls to avoid and exciting new arenas that combine the best of medicine with the best of marketing to promote patient well-being.

McAllister Heart Institute Seminar Series: Francis Miller, MD, Role of Smooth Muscle Cell NADPH Oxidase in Vascular Disease
2017-11-21 14:00 - 15:00
Speaker: Francis J. Miller, MD, Professor of Medicine, Dept. of Internal Medicine, Division of Cardiology, Duke University School of MedicineTopic: Role of Smooth Muscle Cell NADPH Oxidase in Vascular Disease
Information from Dr. Miller on his lecture:The primary goal of my research program is to understand the molecular and cellular mechanisms that contribute to the generation of reactive oxygen species and pathophysiology of vascular disease. The objectives of my seminar are:1) Describe the role of inflammation and oxidative stress in the development of vascular disease.2) Describe the structure and function of the vascular NADPH oxidases in the blood vessel.3) Discuss the role of phosphorylation and endocytosis in activation of the Nox1 NAPDH oxidase.4) Discuss the regulation of Nox4 NADPH oxidase by miRNA and its role in smooth muscle cell differentiation.Describe novel approaches for targeting smooth muscle cell Nox1 in vascular disease.

Medicine Grand Rounds, Joseph Rossi and William Powers, "PFO Closure to Reduce Stroke Risk -- How Compelling Is the Evidence?"
2017-11-30 12:00 - 13:00
Recent clinical trials have investigated the efficacy of mechanical closure of patent foramen ovale (PFO) for prevention of recurrent stroke. We will review the epidemiological evidence linking PFO and stroke, the methodology and results of clinical trials of secondary stroke prevention in patients with PFO, and the techniques for mechanical closure of PFO.
William J. Powers, MD, is an expert on cerebral blood flow and metabolism, as well as stroke treatment and prevention. Powers has dedicated his career to improving the outcome of patients with stroke and cerebrovascular disease. His early work helped establish concepts of blood pressure auto-regulation and acute blood pressure management in stroke, influential on the choice and timing of anti-hypertensive therapies and the consideration of acute vs. chronic blood pressure control. He later identified patterns of blood pressure control in intracerebral hemorrhage and noted that the tissue surrounding the hemorrhage is not ischemic. Powers spearheaded studies suggesting chronic hemodynamic impairment from occlusive cerebrovascular disease. He is the H. Houston Merritt Distinguished Professor and chair of the Department of Neurology.
Joseph Rossi, MD, MSCI, FACC, FSCAI, is director of the Cardiac Catheterization Lab and Program Director of the Interventional Cardiology Fellowship. He specializes in interventional cardiology.

Cardiovascular Grand Rounds: Dr. Chaitanya Madamanchi, Myocardial Strain Imaging
2017-12-04 12:00 - 13:00
Speaker: Chaitanya Madamanchi, MD, UNC Cardiology FellowTopic: Myocardial Strain Imaging

McAllister Heart Institute Seminar Series: Kristina I. Boström, MD, PhD
2017-12-05 14:00 - 15:00

Medicine Grand Rounds, Eric Klett, "Dietary Fat -- Impact on the Development of Chronic Metabolic Diseases"
2017-12-07 12:00 - 13:00
Consumption of dietary fat has been the focus of debate for more than 50 years. Ancel Keys’ diet-heart hypothesis changed the way Americans eat and as a result has left us with significant unintended consequences. Dr. Klett will review the history of the diet-heart hypothesis, the recently discovered unpublished data refuting the diet-heart hypothesis, and how changes in the type of dietary fatty acids consumed might be contributing to the development of diabetes.
Eric Klett practices General Endocrinology with clinical interests in thyroid disease, lipid disorders and transgender medicine. He is Assistant Professor of Medicine and Nutrition and serves as the Associate Endocrinology Fellowship Director.

McAllister Heart Institute Seminar Series: Kristy Red-Horse, PhD. Coronary Artery Development
2017-12-11 12:00 - 13:00
Speaker: Kristy Red-Horse, PhD, Assistant Professor, Department of Biology, Stanford UniversityTopic: Coronary Artery Development: Transcriptional Regulation of Blood Flow Guided Behaviors

Medicine Grand Rounds, Rumey Ishizawar "Autoimmunity Induced by Cancer Immunotherapy"
2017-12-14 12:00 - 13:00
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
