MEDICAL GRAND ROUNDS 2013-2014
Medical Grand Rounds take place on Mondays at 12:30 PM in the Block Amphitheatre at the Jewish General Hospital,
3755 Cote Ste Catherine Road, Montreal:
September 16
25th ANNUAL BERTHA & NACHUM MIZNE MEMORIAL LECTURE
“A DAUNTING CHALLENGE.....WHEN LESS IS MORE”
THE HARSH CLINICAL REALITY OF EATING DISORDERS
Patricia McMillan, MD
Assistant Professor of Anesthesia
McGill University
Attending Staff, Departments of Adult Critical Care and Anesthesia
Jewish General Hospital
Educational Objectives:
1. To heighten sensitivity and awareness to eating disorders and their potential progression to severe malnutrition
2. To describe medical presentations and complications of eating disorders
3. To recognize severe malnutrition as a medical emergency. To understand starvation physiology and the refeeding
syndrome
4. To highlight the mandatory need for a coordinated multidisciplinary approach to such patients including triage; levels of
care and a continuum of care
September 23
MCGILL UNIVERSITY GLOBAL HEALTH INITIATIVE: EXPERIENCES AND FUTURE PROJECTS IN HAITI
Yen-I Chen MD
PGY-4 Gastroenterology, McGill University
Kevin Chan MD
PGY-4 Medical Oncology, McGill University
Supervisors:
Michelle Elizov MD, MHPE
Assistant Professor of Medicine, McGill University
Division of Internal Medicine, Jewish General Hospital
Jeffrey Wiseman MD, MA (Ed)
Assistant Professor of Medicine, McGill University
Division of Internal Medicine, McGill University Health Center
Educational Objectives:
1. Describe the current health care status in Haiti
2. Overview of McGill's initiative in creating a rural rotation in internal medicine in Haiti
3. Describe current projects in capacity building focusing on education
September 30
MYCOSIS FUNGOIDES AND SEZARY SYNDROME: WHAT EVERY INTERNIST SHOULD KNOW ABOUT
DIAGNOSIS AND THERAPY
Alain H. Rook, MD
Professor of Dermatology
Director, Cutaneous Lymphoma Program
Perelman School of Medicine
University of Pennsylvania
Philadelphia, PA
Educational Objectives:
1. Learn how to recognize clinically cutaneous T-cell lymphoma
2. Learn how to diagnose cutaneous T-cell lymphoma
3. Learn how to treat cutaneous T-cell lymphoma
October 7
IMPLEMENTING PERSONALIZED MEDICINE AT THE JGH-SEGAL: THE NEW MOLECULAR PATHOLOGY CENTER
Alan Spatz, MD
Professor of Pathology and Oncology, McGill University
Director, Department of Pathology, Jewish General Hospital
Canada Research Chair in Molecular Pathology
Educational Objectives:
At the end of the presentation the participants will understand:
1. What is the role of Molecular pathology in Personalized Medicine
2. What are the structure, organization and activities of the JGH Molecular Pathology Center
3. What will be the patient trajectory until the point of therapeutic decision
October 14
No Rounds - Thanksgiving
October 21
THE NOT-SO-USELESS LEFT ATRIAL APPENDAGE- POSSIBLE ROLE IN MYOCARDIAL REGENERATION
Ronen Beeri, MD, FACC
Associate Professor of Medicine (Cardiology), Hebrew University School of Medicine
Director, Cardiovascular Research Center
Heart Institute, Hadassah- Hebrew University Medical Center
Jerusalem, Israel
Educational Objectives:
1. Breaking the paradigm that myocardial remodeling involves purely hypertrophic response
2. Understand the untapped potential of the atrial appendages as progenitor cell reservoirs
3. Present the potential of the left atrial appendage to create a "complete regeneration package”
October 28
ASSOCIATION BETWEEN GAIT DISORDERS, COGNITIVE DECLINE AND VITAMIN D DEFICIENCY: WHAT HAVE
WE LEARNED? WHAT ARE THE MAIN IMPLICATIONS FOR OUR CLINICAL PRACTICE?
Pr. Olivier Beauchet, MD, PhD
Department of Neuroscience
Geriatrics Division and Memory Clinic
Angers University Hospital and School of Medicine, France
Educational Objectives:
1. To examine the interactions between gait disorders, cognitive decline and vitamin D deficiency
2. To explain the mechanism of higher-levels gait control disorders related to cognitive decline and vitamin D deficiency
3. To underscore the main clinical implications for diagnosis and treatment of higher-levels gait control disorders
November 4
CANADIAN PATIENT SAFETY WEEK
THE ROLE OF PHYSICIANS IN PREVENTING HEALTHCARE-ASSOCIATED INFECTIONS
Yves Longtin, MD
Associate Professor of Medicine, McGill University
Division of Infectious Diseases, Jewish General Hospital
Educational Objectives:
1. Review the institutional burden of healthcare-associated infections
2. Described various strategies to prevent healthcare-associated infections
3. Review the current literature on the efficacy of Chlorhexidine gluconate to prevent healthcare-associated infections
November 11
SLEEP-DISORDERED BREATHING AND CARDIOMETABOLIC INTERACTIONS: CURRENT EVIDENCE
R. John Kimoff, MD, FRCPC
Associate Professor of Medicine, McGill University
Director, Sleep Laboratory
Respiratory Division
McGill University Health Centre (Royal Victoria Hospital)
Educational Objectives:
1. Discuss recent evidence on the prevalence and management of sleep-disordered breathing
2. Describe mechanisms underlying cardiometabolic consequences of sleep-disordered breathing
3. Summarize current data linking sleep-disordered breathing to cardiometabolic complications in the general adult
population, during pregnancy and in chronic congestive heart failure
November 18
BIOLOGICS AND DERMATOLOGY IN 2013
Marc Bourcier, MD, FRCPC
Assistant Professor in Clinical Teaching
Division of Dermatology, Faculty of Medicine and Health Sciences
Sherbrooke University
Educational Objectives:
1. To better understand the systemic implications of moderate to severe psoriasis.
2. Review the current use of biological agents for psoriasis, and other dermatological conditions
3. An overview of the future in the management of moderate to severe psoriasis
November 25
A LOCAL REGISTRY FOR HEREDITARY GI CANCER SYNDROMES
Polymnia Galiatsatos, MD
Assistant Professor of Medicine, McGill University
Division of Gastroenterology, Department of Medicine
Jewish General Hospital
Educational Objectives:
1. To recognize the features of the major hereditary GI cancer syndromes
2. To understand the screening / follow-up required for the various conditions
3. To become familiar with a new local registry that is being developed, and how it could impact patient care and research
December 2
DRUGS FOR TYPE 2 DIABETES - ASSESSING CARDIOVASCULAR SAFETY
Agnieszka Majdan, MD
Assistant Professor of Medicine, McGill University
Division of Endocrinology, McGill University
Educational Objectives:
1. Appreciate the importance of CV risk reduction in diabetes
2. Review the available data on CV safety of diabetes drugs
December 9
PATIENT SAFETY: LATEST BUZZWORD OR GENUINE RESEARCH DOMAIN?
Blair Schwartz, MDCM, MHS, FRCPC
Assistant Professor of Medicine, McGill University
Division of General Internal Medicine, Department of Adult Critical Care, Jewish General Hospital
Educational Objectives:
1. To define patient safety as it applies to the care of the hospitalized patient
2. To review methodological challenges in the current patient safety literature
3. To explore past and current patient safety research at McGill University
December 16
HIGHLIGHTS OF SEGAL CANCER CENTER RESEARCH PRESENTED AT THE 2013 EUROPEAN CANCER
CONGRESS ANNUAL MEETING
Tamim Niazi, MD
Assistant Professor, Department of Oncology, McGill University
Staff, Division of Radiation Oncology, Segal Cancer Center, Jewish General Hospital
Te Vuong, MD
Associate Professor, Department of Oncology
McGill University
Staff, Division of Radiation Oncology, Segal Cancer Center, Jewish General Hospital &Young Soo Rho, MD
Research Associate, Department of Oncology and Medicine, Segal Cancer Center, Jewish General Hospital Educational
Objectives:
1. Review facts/history on treatments of Colon, rectal and prostate Cancer
2. Understand the rationale, background, results of the studies presented at the European Cancer Congress 2013
(ECCO-ESMO-ESTRO) Annual meeting
3. Discuss its implication into clinical practice
January 6
THE SHAKING PALSY: 200 YEARS OF PARKINSON'S' DISEASE
Michael Sidel, MD, CM, FRCP(C)
Assistant Professor, Neurology and Neurosurgery, McGill University
Department of Neurosciences, Jewish General Hospital
Educational Objectives:
1. To review the clinical and pathological features of Parkinson's disease
2. Update on current treatments and treatment algorithms
3. Review new and emerging treatment modalities for Parkinson's disease
January 13
VITAMINS: WHO NEEDS THEM? CURRENT KNOWLEDGE AND RECENT JGH RESEARCH
L. John Hoffer, MD PhD
Professor of Medicine, McGill University
Divisions of Internal Medicine and Endocrinology and Metabolism, Jewish General Hospital
Educational Objectives:
1. To update knowledge regarding vitamin and mineral nutrition in adults
2. To provide rational guidelines for appropriate use of vitamin supplements
Contact Person: Rubin Becker, MD, Chief, Division of Internal Medicine, Tel. 514-340-7596.
January 20
CARBAMEPENASE PRODUCING K. pneumoniae (KPC) GOES GLOBAL: EPIDEMIOLOGY, MANAGEMENT AND
PREVENTION
Deborah Ben-David, MD
Jewish General Hospital - Visiting Scientist in Infection Prevention and Control
Medical Director, Infection Control Service and Infectious Diseases
Consultant, Sheba Medical Center
Hospital Epidemiologist, National Center for Infection Control, Tel Aviv, Israel
Educational Objectives:
1. To review recent findings in the epidemiology of this organism
2. Update in the management of infections with this organism
3. Discuss infection control interventions in endemic and epidemic settings
January 27
CONTRAST ULTRASOUND: DIAGNOSTIC AND THERAPEUTIC APPLICATIONS FOR 2014 AND BEYOND
Howard Leong-Poi, MD
Associate Professor of Medicine, University of Toronto
Chief, Division of Cardiology
Scientist, Kenan Research Centre in the Li Ka Shing Knowledge Institute
St. Michael’s Hospital
Educational Objectives:
1. To review the present applications for contrast ultrasound in medical practice
2. To discuss contrast ultrasound for perfusion and molecular imaging
3. To review potential therapeutic applications for ultrasound and carrier microbubbles
February 3
EIGHTEENTH ANNUAL HUMANIZATION OF CARE AWARENESS PROGRAM
WAITER THERE'S A FLY IN MY SOUP....UNDERSTANDING AND LEARNING FROM COMPLAINTS
Rosemary Steinberg, BA, BSW, MSW
Local service quality and complaints commissioner
Jewish General Hospital
& Paul Warshawsky, MD
Assistant Professor of Medicine, McGill University
Chief, Department of Adult Critical Care
Division of Pulmonary, Department of Medicine
Jewish General Hospital
Educational Objective:
Understanding the complaint process and learning to prevent complaints
February 10
THE HEMOPHAGOCYTIC SYNDROME: A SINISTER EMERGENCY
Paraish Misra, MD, CM
Internal Medicine Second Year Resident
McGill University & Jewish General Hospital
Educational Objectives:
1. To appreciate the aggressiveness of Hemophagocytic Lymphohistiocytosis through case review
2. To understand the systemic manifestations and key diagnostic features
3. To review current treatment options
&
II. A CURIOUS CASE OF ARDS
Abdulrahman Al-Fares, MD, MRCP (UK)
Internal Medicine Second Year Resident
McGill University & Jewish General Hospital
Educational Objectives:
1. To explore an atypical cause of ARDS
2. To establish the natural history, pathophysiology and clinical manifestation of such a cause
3. To explore management strategies that could be implemented
February 17
57 YEAR OLD WOMAN ADMITTED WITH PYODERMA GANGRENOSUM
Luc Trudeau, MD
Assistant Professor of Medicine, McGill University
Division of Internal Medicine, Jewish General Hospital
Educational Objectives:
1. To recognize systemic diseases associated with pyoderma gangrenosum
2. To know potential complications associated with the treatment of rheumatoid arthritis
3. To review causes of bilateral lung infiltrates
February 24
BETA BLOCKERS AND ANGIOTENSIN RECEPTOR BLOCKERS IN BICUSPID AORTIC VALVE DISEASE
AORTOPATHY
Judith Therrien, MD
Associate Professor of Medicine, McGill University
Division of Cardiology, Jewish General Hospital
Educational Objectives:
1. To understand that BAV is associated with ascending aortopathy
2. To understand the pathogenesis of ascending aortopathy
3. To understand how BB or ARB may work to delay aortopathy progression
March 3
ADVANCES IN THE TREATMENT OF GOUT
Sabrina Fallavollita, MD
Assistant Professor of Medicine, McGill University
Division of Rheumatology, Jewish General Hospital
Educational Objectives:
1. To review the pathogenesis in gout
2. To discuss new and emerging treatments in gout
March 10
CURRENT MANAGEMENT OF LIPID DISORDERS
Morris Schweitzer PhD, M.D., FRCP(C)
Associate Professor, Faculty of Medicine
McGill University, Montreal, Quebec Canada
Director, Lipid Research and Management Clinic
Co-Director, Centre for Vascular Prevention
Staff, Division of Endocrinology
Jewish General Hospital
Educational Objectives:
1. To understand how cholesterol metabolism influences the formation of atherosclerotic disease
2. To understand the mechanism of action of lipid lowering drugs and how cholesterol reduction reduces cardiovascular
disease
March 17
DICER1 AND CANCER: MUTATIONS, miRNAS AND MECHANISMS
William D. Foulkes, MD, PhD
James McGill Professor, Departments of Medicine, Human Genetics & Oncology
McGill Program in Cancer Genetics, McGill University
Department of Medical Genetics, Jewish General Hospital
Educational Objectives:
1. To gain appreciation of the diverse presentations associated with germ-line DICER1 mutations
2. To compare and contrast DICER1 with traditional tumor suppressor genes and oncogenes
3. To be aware of the complex world of miRNAs and their regulation
March 24
THE NEW ANTICOAGULANTS - QUESTIONS - AND SOME ANSWERS
Sam Schulman, MD, PhD
Professor of Medicine, McMaster University
Thrombosis Service, McMaster Clinic, Hamilton Health Sciences - General Hospital
Educational Objectives:
1. To discuss selection of patients for the new oral anticoagulants
2. To review perioperative management related to new oral anticoagulants
3. To discuss approaches to bleeding management in patients on new oral anticoagulants
4. To highlight issues related to adherence to new oral anticoagulants
March 31
EVIDENCE BASED MEDICINE
Chantal Cassis, MD
Assistant Professor of Medicine, Division of Hematology & Department of Oncology, McGill University
Division of Hematology, Jewish General Hospital
Educational Objectives:
1. Awareness of the GRADE working group system to rate quality of evidence
2. Understanding of the limitations of evidence
3. Appreciation of shared decision making
April 7
ONCOLOGY AND AGING PROGRAM AT MCGILL: CLINICAL, RESEARCH AND TEACHING PERSPECTIVES
Doreen Wan-Chow-Wah, MD, FRCPC
Assistant Professor of Medicine, McGill University
Staff, Division of Geriatric Medicine, McGill University Health Centre and Jewish General Hospital
Medical Director, Geriatric Oncology Clinic, Segal Cancer Centre
& Associate Member, Department of Oncology, McGill University
Educational Objectives:
1. Learn about the Geriatric Oncology clinic of the Segal Cancer Centre, JGH
2. Understand the various research projects conducted by our group on cancer in older adults
3. Learn about the teaching activities and opportunities in Geriatric Oncology at McGill
April 14
NO ROUNDS - 1ST DAY PASSOVER ON APRIL 15
April 21
NO ROUNDS - EASTER MONDAY
April 28
COPD AND PULMONARY REHABILITATION: MORE THAN A TRAINING PROGRAM
Nathalie Saad, MD, MBA
Assistant Professor of Medicine, McGill University
Division of Pulmonary Medicine, Jewish General Hospital
Educational Objectives:
1. To explain the role of pulmonary rehabilitation in the management of COPD patients
2. To understand which and how patients benefit from pulmonary rehabilitation (the evidence behind pulmonary
rehabilitation).
3. To explain patients' transition from acute care to pulmonary rehabilitation
May 5
I. VITAMIN B12 DEFICIENCY IN INFLAMMATORY BOWEL DISEASE: THE PREVALENCE, RISK FACTORS,
EVALUATION AND MANAGEMENT
Robert Battat, MD
Second Year Internal Medicine Resident, McGill University & Jewish General Hospital
Educational Objectives:
1. Understanding the prevalence of and the risk factors for Vitamin B12 Deficiency in Inflammatory Bowel Disease (IBD)
2. Diagnostic and therapeutic approach for Vitamin B12 Deficiency in IBD (including screening, approach to low serum
B12 in IBD, treatment and prophylactic regimens in IBD Patients)
3. Overview of current reviews and studies analyzing this topic
II. SAFETY OF DIGESTIVE ENDOSCOPY IN THE SETTING OF RECENT ACUTE CORONARY SYNDROME
Alastair Dorreen, MD
Second Year Internal Medicine Resident, McGill University & Jewish General Hospital
Educational Objectives:
1. Understand the indications for and complications of endoscopy following ACS
2. Appreciate the role for gastroprotective agents following ACS
May 12
CLINICAL ETHICS ROUNDS
"BUT THEY SAID THEY WANT US TO DO EVERYTHING!": IS THERE STILL ROOM FOR CLINICAL JUDGEMENT IN
LEVEL OF INTERVENTION CONVERSATIONS?
Lucie Wade, MSc (Bioethics)
Clinical Ethicist
Ethics Program Office
Jewish General Hospital
Educational Objectives:
1. To use clinical ethics case review to identify and discuss the ethical challenges many clinicians experience when trying
to appropriately apply the Level of Intervention (LOI) policy
2. To review ethical principles, norms, and standards central to goals of care conversations
3. To clarify the role and limits of both clinical judgment and patient preferences in LOI conversations
May 26
BIOCHEMISTRY DETECTIVES: WHAT GOES ON BEHIND THE LABORATORY DOORS?
Elizabeth MacNamara, MD
Associate Professor of Medicine
McGill University
Chief, Division of Medical Biochemistry
& Department of Diagnostic Medicine
Jewish General Hospital
Educational Objectives:
1. To learn what happens when you let us know you think there is a problem in our laboratory
2. Using real examples of your complaints to show how we use different methods to discover what happened and learn
interesting facts
3. To understand the limitations of using near patient testing and errors that occur
4. To understand the differences between laboratories and why you should be wary of using numbers and cut off values
from the literature
June 2
LIVALYSIS: FROM FAILURE TO SUCCESS TO FAILURE
Gershon Frisch, MD
Assistant Professor of Medicine, McGill University
Division of Nephrology, Jewish General Hospital
Educational Objectives:
1. To review the historical evolution of the miraculous therapy called Dialysis
2. To understand the pitfalls of Dialysis
3. To highlight the need for drastic improvements in transplantation rates
June 9
VIRAL HEPATITIS IN IMMIGRANTS: RECOGNIZING AND DECREASING THE BURDEN
Christina Greenaway, MD
Associate Professor of Medicine, McGill University
Division of Infectious Diseases, Jewish GeneralHospital
Educational Objectives:
1. Review recent epidemiology of viral hepatitis in immigrants
2. Provide a brief update on new screening recommendations for viral hepatitis
3. Discuss rational screening and vaccination strategies for viral hepatitis in immigrants
June 16
APPROACH TO DRUG HYPERSENSITIVITY
Fanny Silviu-Dan, MD
Assistant Professor of Medicine, McGillUniversity
Division of Allergy and Immunology, Jewish General Hospital
Educational Objectives:
1. Classification of reactions
2. Diagnosis approach
3. Management - Multiple Case studies will be employed
.