University of Pittsburgh School of MedicineCenter for Continuing Education in the Health Sciences

Department of Medicine

ADVANCES CHANGING PRACTICE October 10 – 11, 2019

Marriott Pittsburgh City Center

Pittsburgh, Pennsylvania

UPDATE ININTERNALMEDICINE

2019

Endorsed by:

Course DirectorsKathryn Berlacher, MD, MS

Bernard J. Bernacki, DO, MPH

Michael Donahoe, MD

Daniel Glunk, MD

Lara Groetzinger, PharmD, BCCCP

Reena A. Karnik, MD

Melissa A. McNeil, MD, MPH

Larry W. Moreland, MD

Anthony J. Pinevich, MD, MBA

Benjamin Reynolds, PA-C

Fred H. Rubin, MD

Sandra Indacochea Sobel, MD

Francis X. Solano Jr., MD

Terence W. Starz, MD

Patrick J. Strollo Jr., MD

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CME Presentations:

https://www.dom.pitt.edu/UIM19/presentations

About the Program • • •This continuing education course, held annually in October, highlights essential advances in adult medicine. Participants learn the newest approaches to patient management from a variety of general and sub-specialty areas. Expert clinician-educators and researchers use evidence-based, yet practical approaches in their presentations. All presentations focus on critical elements in the diagnosis and the management of adult medical conditions.

Objectives • • •Upon completion of this course, participants should be able to:

• Define care management pathways for common diseases encountered in primary care including dyspnea, prostate cancer, depression, chronic kidney disease, dementia, hypersomnia, obesity, and dermatology challenges.

• Synthesize current scientific evidence for managing cerebrovascular disease, motility disorders of the GI tract, atrial arrhythmias, acute pain in the hospitalized patient with substance use disorders, smoking cessation, and antibody screening in rheumatic disorders.

• Analyze the impact and outcomes of newer anticoagulation agents, medical marijuana, preventive cardiology, medication use in the elderly population, home antibiotic management, travel medicine, and sharing your DNA for analysis.

Who Should Attend • • •General internists, family practitioners, medical specialists, nurses, nurse practitioners, physician assistants, and other health care professionals who provide primary care services should attend this two-day course.

Continuing Education Credit • • •In support of improving patient care, the University of Pittsburgh School of Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME) and the Accreditation Council for Pharmacy

Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education to the health care team.

Physicians

The University of Pittsburgh School of Medicine designates this live activity for a maximum of 14.0 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity enables the participant to earn MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn ABIM MOC points equivalent to the amount of CME credits claimed for the activity.

This activity is approved for AOA Category 2 credit.

This Live activity, 2019 Update in Internal Medicine, with a beginning date of 10/10/2019, has been reviewed and is acceptable for up to 13.75 Elective credit(s) by the American Academy of Family Physicians (AAFP). Physicians should claim only the credit commensurate with the extent of their participation in this activity. AAFP members are to stop by the onsite registration desk to sign-in for the activity.

Pharmacists

This knowledge-based activity provides 14.0 contact hours of continuing pharmacy education credit.

Physician Assistants

The University of Pittsburgh has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is

designated for 14.0 AAPA Category 1 CME credits. PAs should only claim credit commensurate with the extent of their participation.

Nurses

Nurses will receive a certificate of attendance confirming the number of contact hours commensurate with the extent of participation in this activity.

Nurse Practitioners

Nurse practitioners will receive a certificate of attendance confirming the number of contact hours commensurate with the extent of participation in this activity.

* Designates pharmacotherapeutic topic in the course agenda

Other Health Care Professionals

Other health care professionals will receive a certificate of attendance confirming the number of contact hours commensurate with the extent of participation in this activity.

The Department of Medicine and the Center for Continuing Education in the Health Sciences (CCEHS) have included topics, which should meet the Patient Safety / Risk Management criteria. These topics will be highlighted in gold within the schedule.

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7:15 am Registration/Continental Breakfast: Visit Exhibitor/Vendor Booths

7:55 am Welcome/Introduction M o r n i n g S e S S i o n

8:00 am Airplane Emergencies Thomas J. Doyle, MD, MPH

8:40 am Optimal Anticoagulation: New Drugs, Indications and Reversal* Roy E. Smith, MD, MS

9:20 am The Conundrum of Medical Marijuana Antoine B. Douaihy, MD

10:00 am Medicine Made Ridiculously Simple Briana Ketterer, MD

10:10 am Break: Visit Exhibit/Vendor Booths

10:20 am Diagnosis of Occult Dyspnea Jared Chiarchiaro, MD, MS

11:00 am Advances in the Treatment of Stroke and TIA* Lawrence R. Wechsler, MD

11:50 am Lunch Break – “Grab and Go”: Visit Exhibit/Vendor Booths

12:25 pm Lunch with the Professor

A. Managing Your Risk Chatón T. Turner, JD

B. The Spondyloarthropathies and Enthesopathies — New Perspectives on Diagnosis and Management Terence W. Starz, MD

C. Medication and the Elderly: Beer’s List and More* Fred H. Rubin, MD

D. Diabetes Medications and Cardiovascular Disease* Karen Selk, DO

E. Obesity Management in Medical Disorders David A. Rometo, MD

F. Home Antibiotic Management* Kathleen R. Sheridan, DO

1:15 pm Break: Visit Exhibit/Vendor Booths

A f t e r n o o n S e S S i o n

1:30 pm Depression: How Best to Treat, When to Refer* Ellen M. Whyte, MD

2:10 pm Prostate Cancer Screening and Management Bruce L. Jacobs, MD, MPH

2:40 pm Medicine Made Ridiculously Simple Niall Prendergast, MD

2:50 pm Break: Visit Exhibit/Vendor Booths

3:10 pm Pharmaceutical Pricing: Why is this so Complicated?* C. Bernie Good, MD, MPH

3:50 pm Preparing your CKD Patient for Dialysis Christopher John Passero, MD

4:30 pm Thursday Adjournment

UPDATE IN INTERNAL MEDICINE: 2019 ScheduleADVANCES CHANGING PRACTICE

Thursday, October 10, 2019

Topics meeting Patient Safety / Risk Management criteria arehighlighted in gold-colored shading within the schedule.

*Designates pharmacotherapeutic topic

continued on page 4

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UPDATE IN INTERNAL MEDICINE: 2019 ScheduleADVANCES CHANGING PRACTICE

Friday, October 11, 2019

7:15 am Continental Breakfast: Visit Exhibitor/Vendor Booths

7:55 am Welcome/Introduction

M o r n i n g S e S S i o n

8:00 am Managing Acute Pain for Hospitalized Patients

with Substance Use Disorder* Jane M. Liebschutz, MD, MPH

8:40 am Cardiovascular Disease in Women Kathryn Berlacher, MD, MS

9:20 am Preventive Cardiology: Aspirin, Omega -3, and Lipid Therapy Aryan Narayan Aiyer, MD

10:00 am Medicine Made Ridiculously Simple Frederick Roepcke, MD

10:10 am Break: Visit Exhibit/Vendor Booths

10:30 am Breakout Session I (Repeated at 11:15 am)

G. How to Approach Antibody Screening in Rheumatic Diseases Dana Ascherman, MD

H. Assessing Cognitive Disorders in General Practice Adrian Visoiu, MD

I. Evaluating the Sleepy Patient Sanjay R. Patel, MD, MS

J. Year in Review: Endocrinology Jagdeesh Ullal, MD, MS

K. Travel Medicine: Things to Know Before You Go Carolyn Fernandes, MD

L. Driven to the Edge: Assessment of Older Drivers Michelle Rossi, MD, MPH

11:10 am Break and Room Change for Breakout Session II: Visit Exhibitor/Vendor Booths

11:15 am Breakout Session II (Repeat of 10:30 am Breakout Session I)

G. How to Approach Antibody Screening in Rheumatic Diseases Dana Ascherman, MD

H. Assessing Cognitive Disorders in General Practice Adrian Visoiu, MD

I. Evaluating the Sleepy Patient Sanjay R. Patel, MD, MS

J. Year in Review: Endocrinology Jagdeesh Ullal, MD, MS

K. Travel Medicine: Things to Know Before You Go Carolyn Fernandes, MD

L. Driven to the Edge: Assessment of Older Drivers Michelle Rossi, MD, MPH

11:55 am Lunch Break - “Grab and Go”: Visit Exhibit/Vendor Booths

12:15 pm The Risks and Benefits of Sharing Your DNA Mylynda B. Massart, MD, PhD

A f t e r n o o n S e S S i o n

1:00 pm Atrial Arrythmias: To Treat or Ablate* Samir Saba, MD

1:40 pm Functional Dyspepsia and Gastroparesis David J. Levinthal, MD, PhD

2:15 pm Break: Visit Exhibit/Vendor Booths

2:30 pm Medicine Made Ridiculously Simple Akshata Moghe, MD, PhD

2:40 pm Smoking Cessation and the Hospitalized Patient Esa Matius Davis, MD, MPH

3:10 pm The Top 10 Dermatology Challenges in Primary Care Laura Korb Ferris, MD, PhD

3:50 pm The Role of Behavioral Health Management in Chronic Medical Disorders Eva Szigethy, MD, PhD

4:20 pm Conference Adjournment

Topics meeting Patient Safety / Risk Management criteria arehighlighted in gold-colored shading within the schedule.

*Designates pharmacotherapeutic topic

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Course Directors • • •

Kathryn Berlacher, MD, MSAssistant Professor of Medicine

Bernard J. Bernacki, DO, MPHCommunity PhysicianBoard member, Pittsburgh Regional

Health Initiative

Michael Donahoe, MDExecutive Vice Chair of Clinical AffairsProfessor of Medicine

Daniel Glunk, MD, MHCDSChief Quality OfficerUPMC Susquehanna

Lara Groetzinger, PharmD, BCCCPUnit Based Clinical Pharmacist,

Medical Intensive Care UnitUPMC Presbyterian

Reena A. Karnik, MDInternal Medicine Residency

Program DirectorUPMC McKeesport

Melissa A. McNeil, MD, MPHProfessor of MedicineAssociate Chief, Division of General

Internal Medicine

Larry W. Moreland, MDMargaret J. Miller Endowed Professor

of Arthritis ResearchChief, Division of Rheumatology

and Clinical ImmunologyDepartment of Medicine

Anthony J. Pinevich, MD, MBAVice President, Medical AffairsUPMC Mercy

Benjamin Reynolds, PA-CDirectorUPMC Office of Advance

Practice Providers

Fred H. Rubin, MDProfessor of Medicine

Sandra Indacochea Sobel, MDClinical Assistant Professor of MedicineClinical Chief of EndocrinologyUPMC Mercy

Francis X. Solano Jr., MDClinical Professor of Medicine

Terence W. Starz, MDClinical Professor of Medicine

Patrick J. Strollo Jr., MDVice Chair for Veterans Affairs,

Department of MedicineVice President Medical Service Line

VA Pittsburgh Health SystemProfessor of Medicine

University of PittsburghSchool of MedicinePresenters • • •

Aryan Narayan Aiyer, MDAssistant Professor of Medicine

Dana Ascherman, MDProfessor of Medicine

Kathryn Berlacher, MD, MSAssistant Professor of Medicine

Jared Chiarchiaro, MD, MSAssistant Professor of Medicine

Esa Matius Davis, MD, MPHAssociate Professor of Medicine Director, UPMC Tobacco

Treatment Service

Antoine B. Douaihy, MDProfessor of Psychiatry and Medicine

Thomas J. Doyle, MD, MPHClinical Assistant Professor of

Emergency MedicineMedical Director, UPMC Command CenterMedical Director, Airline Services

Carolyn Fernandes, MDClinical Assistant Professor of MedicineDirector, UPMC Center for Care of

Infectious Diseases Travel Clinic

C. Bernie Good, MD, MPHProfessor of Medicine and Pharmacy,

Senior Medical Director, and Director for the Center for Value-Based Pharmacy Initiatives, UPMC Health Plan Insurance Division

Bruce L. Jacobs, MD, MPHAssistant Professor of UrologyAssociate Program Director, Urologic

Oncology Fellowship

Briana Ketterer, MDClinical Instructor of Medicine

Laura Korb Ferris, MD, PhDAssociate Professor of Dermatology

David J. Levinthal, MD, PhDAssistant Professor of MedicineDirector, Neurogastroenterology &

Motility Center

Jane M. Liebschutz, MD, MPHProfessor of Medicine Chief, Division of General

Internal MedicineUPMC Endowed Chair of Translational

Medicine and Research

Mylynda B. Massart, MD, PhDAssistant Professor of Family Medicine

Akshata Moghe, MD, PhDFellow, Gastroenterology,

Hepatology and Nutrition

Christopher John Passero, MDClinical Assistant Professor of Medicine

Sanjay R. Patel, MD, MSProfessor of Medicine and Epidemiology

Niall Prendergast, MDFellow, Pulmonary, Allergy and Critical

Care Medicine

Frederick Roepcke, MDFellow, Endocrinology and Metabolism

David A. Rometo, MDClinical Assistant Professor of Medicine

Michelle Rossi, MD, MPHAssociate Professor of Medicine

Fred H. Rubin, MDProfessor of Medicine

Samir Saba, MDProfessor of MedicineChief, Division of CardiologyCo-Director, Heart and Vascular Institute

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Marriott Garage / Chatham CenterColor Key for Floors G-1 to G-6

G-6

G-5

G-4

G-3

G-2

G-1

Entrance on Washington Place

Entrance on Fifth Avenue

Closed for Lease Holders

}

}

}

University of PittsburghSchool of MedicinePresenters • • • (continued from page 5)

Karen Selk, DOClinical Assistant Professor of Medicine

Kathleen R. Sheridan, DOClinical Associate Professor of Medicine

Roy E. Smith, MD, MSProfessor of Medicine

Terence W. Starz, MDClinical Professor of Medicine

Eva Szigethy, MD, PhDProfessor of Psychiatry, Medicine, and Pediatrics

Chatón T. Turner, JDSr. Associate Counsel/Sr. Director, Disability Services

Jagdeesh Ullal, MD, MSClinical Associate Professor of Medicine

Adrian Visoiu, MDClinical Associate Professor of Medicine

Lawrence R. Wechsler, MDHenry B. Higman Professor and Chairman

Ellen M. Whyte, MDAssistant Professor of Psychiatry

Unless otherwise noted, all conference faculty are affiliated with the University of Pittsburgh School of Medicine and are located in the Pittsburgh, PA region.

The University of Pittsburgh is an affirmative action, equal opportunity institution.

Exhibitor/Vendor Bingo Information • • •Courtesy of UPMC Centers for Rehab Services, we are raffling two iPad Pro/Apple Pencil combos. To participate and be eligible to win, Registrants need to visit a minimum of 10-vendor tables, and receive a stamp on the Bingo card. Bingo cards must be turned into the UIM onsite registration table by 4:30 pm on Friday, October 11.

Parking at Marriott Garage / Chatham Center • • •The onsite-parking rate at the Marriott parking facility is approximately $14/day. Overnight Marriott guests should ask for self-parking pass upon check-in. Registrants who pre-paid parking (at the point of registration), will receive a validation voucher from the UIM Conference Registration Table, on the 2nd floor of the Marriott.

The entrance is located on the side of the Pittsburgh Marriott City Center hotel. There are entrances located on Washington Place (Marriott side) and off Fifth Avenue. Additional parking can be found across the street from the hotel at the PPG Paints Arena.(see https://stadiumparkingguides.com/ppg-paints-arena-parking/#PARKING%20MAP).

NOTES

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Faculty Disclosure • • •

All individuals in a position to control the content of this education activity including members of the planning committee, speakers, presenters, authors, and/or content reviewers have disclosed all relevant financial relationships with any entity producing, marketing, re-selling, or distributing health care goods or services, used on, or consumed by, patients.

The following relevant relationships were disclosed:

Antoine B. Douaihy, MD receives grant/research support from Alkermes, NIMH, NIDA, NIAAA, SAMHSA, HRSA, NHLBI, and AFSP. Dr. Douaihy receives royalties from academic books published by Springer, OUP, and PESI Publishing and Media.

Bruce L. Jacobs, MD, MPH receives grant/research support from Shadyside Hospital Foundation, from the NCI, and the Henry L. Hillman Foundation.

David J. Levinthal, MD, PhD is a consultant for Takeda Pharmaceuticals.

Sanjay R. Patel, MD, MS received grant/research support from Bayer Pharmaceuticals and Philips Respironics.

Samir Saba, MD receives grant/research support from Boston Scientific.

Karen Selk, DO is involved in clinical work with funding from Regeneron Pharmaceuticals.

Roy E. Smith, MD, MS is a consultant for Alnylam Pharmaceuticals and Bioverativ, Inc.

Eva Szigethy, MD, PhD receives grant/research support from PCORI. Dr. Szigethy receives APPI Book Editor Royalties, and does behavioral work with the Steelers (NFL).

Lawrence R. Wechsler, MD is a consultant for Biogen Idec and Athersys. Dr. Wechsler is on the Scientfic Advisory Board for Silk Road, and Forest Devices.

No other planners, members of the planning committee, speakers, presenters, authors, content reviewers and/or anyone else in a position to control the content of this education activity have relevant financial relationships to disclose.

Special Needs • • •Participation by all individuals is encouraged. Advance notification of any special needs will help us provide better service. Please notify us of your needs at least two weeks in advance of the program by calling 412-586-9511.

How do I get my credits? • • •

This activity is approved for AMA PRA Category 1 Credit™, AAPA Category 1 CME and ACPE pharmacy credit.

The UPMC Center for Continuing Education in the Health Sciences (CCEHS) implemented a new continuing education portal, http://cce.upmc.com, to register, view, track, and manage your *continuing education credits. To receive credit for this activity, all participants will be required to login and complete the course evaluation and claim credit. If you are a new user, click “Register” to create a new account. The activity will be added to your Pending Activities and accessible immediately following the activity. Certificates will be available to download and stored for future reference in your Completed Activities.

*Physician AAFP members can log credits at https://secure.aafp.org/login/. Please allow three weeks for the course to be posted.

*Physician ABIM members will be given the opportunity to claim ABIM credit. Please note, ABIM members must provide date of birth and ABIM number as part of their profile, http://cce.upmc.com. In addition, you must complete a post-test with a score of at least 70%. The post-test will be provided at the time credit is claimed (as described above) and participant’s ABIM information will be automatically submitted to the ABIM.

*Nurse Practitioners pharmacotherapeutic contact hours have been designated in the course agenda. It is the responsibility of the learner to track the sessions attended. Nurse practitioners will be given the opportunity to designate these credits at the time credit is claimed (as described above).

*Pharmacists must provide date of birth and NABP number as part of their profile, http://cce.upmc.com.

The information presented at this CME program represents the views and opinions of the individual presenters, and does not constitute the opinion or endorsement of, or promotion by, the UPMC Center for Continuing Education in the Health Sciences, UPMC / University of Pittsburgh Medical Center or Affiliates and University of Pittsburgh School of Medicine. Reasonable efforts have been taken intending for educational subject matter to be presented in a balanced, unbiased fashion and in compliance with regulatory requirements. However, each program attendee must always use his/her own personal and professional judgment when considering further application of this information, particularly as it may relate to patient diagnostic or treatment decisions including, without limitation, FDA-approved uses and any off-label uses. The Center for Continuing Education and the sponsoring department do not certify that through participation in this program participants are competent to perform certain procedures or skills.

For more information, contact: dom.pitt.edu/UIM

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SAVE THE DATE: OCTOBER 22-23, 2020UPDATE IN INTERNAL MEDICINE 2020

Thank you for your support!

UPMC Health Services Division and

———

Audio-Digest

Spang Corporation

UPMC Centers for Rehab Services

UPMC Community Medicine, Inc.

UPMC – Thomas E. Starzl Transplantation Institute___________________

Please visit our exhibitors:

AbbVie (Divisions of Dermatology, Medical Affairs, Metabolics, and Rheumatology)

Amarin Pharma, Inc. • Amgen

Boehringer-Ingelheim Pharmaceuticals • Bristol-Myers Squibb

Dynavax Technologies • GlaxoSmithKline

Hikma Specialty USA Inc. • Novartis • Novo Nordisk

Otsuka America Pharmaceuticals • Pfizer • Portola Pharmaceuticals

Regeneron Healthcare Solutions • TEVA Pharmaceuticals___________________

UPMC Surgical Oncology & UPMC Medical Oncology

UPMC Wound Healing Services