TCA Induced Cardiotoxicity

Thank you Dr. Daniel Jimenez for an excellent presentation on TCA induced cardiotoxicity

Teaching Points

  • Clinical presentation: anticholinergic sx (urinary retention, constipation), CNS (seizures, coma), acidosis, arrythmias
  • ECG: prolonged QRS/PR/QT –> predisposes for ventricular arrhythmias)
  • Management: supportive care, benzos for seizures, activated charcoal if 2 hours of ingestion, sodium bicarb if QRS>100msec (goal ph 7.5-7.55), aggressive IVF/pressor support if hypotensive

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Unable to Access Email at Home? Set up Multifactor Authentication

Setup Multifactor Authentication for Microsoft Office 365 with the following steps to enable off-site email access.

  1. Go to https://365enroll.lacounty.gov from work,
    Or go to https://sslvpn.lacounty.gov/mfa from off campus.

  2. Enter county email address (XXX@dhs.lacounty.gov), and
    Enter county email password

  3. Complete the form, including specifying 3 security Q&A’s

  4. Click the “Accept” button to complete

  5. Click the link to go back to Office 365.  You will need to log in again if you want to access email.

  6. From a remote computer, the old email link will take you to the log-in page.  After entering your password, you will be asked your security answer.

NEW Collaborative Care Round

Howdy, residents! We are rolling out our new Collaborative Care Round (CCR)! See roll out date and schedule below:

 

Teams Location Rounding Time Roll out Date
C & D 4D127 Team D: 10:00am

Team C: 10:15am

 March 7th,2017
A & B 4D107 Team B: 10:00am

Team A: 10:15am

 March 13th, 2017
E & F 5C106 Team F: 10:30am

 

Team E: 10:45am

 March 20th, 2017
G & H 5D107 Team H: 10:30am

 

Team G: 10:45 am

 March 27th, 2017

 

 

BRIDGE TRIAL

Thank you Thomas Vu for your excellent overview of the BRIDGE trial (Perioperative Bridging Anticoagulation in Patients with Atrial Fibrillation)

Conclusions of the study:

  • In patients with atrial fibrillation who had warfarin treatment interrupted for an elective operation or other elective invasive procedure, forgoing bridging anticoagulation was noninferior to perioperative bridging with low molecular weight heparin for the prevention of arterial thromboembolism and decreased the risk of major bleeding.

Main Points: BRIDGE PowerPoint

Read Full Article: BRIDGE Trial

 

STOPAH TRIAL

Thank you Quynh Vu for your excellent overview of the STOPAH trial (Prednisolone or Pentoxifylline for Alcoholic Hepatitis)

Conclusions of the study:

  • Pentoxifylline did not improve survival in patients with alcoholic hepatitis
  • Prednisolone was associated with a reduction in 28-day mortality that did not reach significance and with no improvement in outcomes at 90 days or 1 year

Main points: STOPAH PowerPoint

Read Full Article: STOPAH Trial

Block 8 Ambulatory Week: Academic Half Day

All Intern Didactics have been rescheduled to Wednesday on Ambulatory week to pilot Academic Half Day. SBP is still on Friday.

 

Fri 
Location: Clinic A
7:30-8:00am: SBP (Dr. Soleymani)

Wed
Location: 6D103
7:30-8:00am: COPD (Dr. Gold)
8:00-8:30am: URI (Dr. Rotblatt)
8:30-8:45am: Break
8:45-9:15am: Asthma (Dr. Suthar/Dr. Barot)
9:15-9:45am: Wellness 101 (Dr. Nafisi/Chiefs)
9:45-10:00am: Break
10:00-12:00pm: Profession of Medicine (POM) – Geriatrics (Drs. Kim/Schickedanz)

Disseminated Histoplasmosis

histo-microscopy

Thank you Dr. Brendan Cerk for an excellent presentation on neurocysticercosis presenting with new onset seizure

Teaching Points

  • Histoplasmosis is a common endemic mycosis, usually asymptomatic but occasionally results in severe illness
  • Hematogenous dissemination occurs during the acute infection before cellular immunity develops
  • Diagnosis: serum and urine antigen
  • Treatment: itraconazole for 12 months, if CNS then liposomal amphotericin B for 4-6 weeks then itrazonazole for an additional 12 months

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