
George Auditorium, RIH
Sopkin Auditorium, TMH
Room 653, VAMC
Tuesdays at 8:00 AM
July 13, 2010
"Parkinson's Disease Update 2010"
July 20, 2010
"The quiet epidemics: Non-influenza respiratory viral infections in adults"
July 27, 2010
Morbidity & Mortality Conference
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University Medicine Embracing Concept of Patient-Centered Medical Home
The primary care offices of Drs. Basile, Bledsoe, Johnson, Oliva and Ryan and Marianne Warren NP have taken the first step toward becoming a patient-centered medical home, an advanced primary care practice that provides the resources for effective, whole-patient care. Passing the mid-point of a two year pilot program involving all major insurers in Rhode Island, the UM practice at 285 Governor St. has been certified by the National Center for Quality Assurance as a "Level 1" medical home and is applying for certification at level 3 (the highest). When certified, it will join a very few select practices in Rhode Island to be so designated.
The Patient-Centered Medical home was envisioned as a new method of both delivering and financing primary care. The goal is comprehensive care by a physician-led team that is personalized to the patient's own self-management goals developed in consultation with his or her physician. The team -- including medical assistants, diabetes educators, nutrition and pharmacy resources, mental health professionals and others -- commits to population-based care using an electronic registry and outcome tracking.
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Searching For Biomedical HIV Prevention Solutions Locally and Globally
Kenneth H. Mayer, MD
While studying infectious diseases as a fellow at Harvard Medical School in the early 80's, Dr. Kenneth Mayer saw some of the first AIDS patients in New England, and became immediately curious about the mechanism for HIV transmission. This interest has led to almost three decades of work, trying to understand the dynamics of HIV transmission, trying to develop new technologies to prevent the spread of the virus both in the US and internationally.
Early collaborations studied transmission dynamics in HIV discordant couples in order to try to understand the behavioral and biological reasons why some individuals became infected quickly with HIV and some others seemed to be more resistant to infection.
In collaboration with Dr. Charles Carpenter and other colleagues at The Miriam Hospital, he was an Investigator in the HERS cohort, which studied the natural history of HIV in women. From the start of the epidemic, The Miriam Hospital Immunology Center has focused on the care of HIV-infected women. The Miriam team was then selected as a site to conduct some of the first topical microbicide studies to evaluate different types of gels to see if they were safe and well tolerated by at-risk and HIV-infected women. Some of the studies that were conducted in Providence led to large multi-center studies that were conducted subsequently in Africa and Asia. Although some of the first generation microbicides were not found to be effective, leading to an increased interest in the use of antiretrovirals, either taken orally or used topically, to prevent HIV transmission.
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Imaging times reduced with the new SPECT Camera in the RIH Nuclear Cardiology Lab
James Arrighi, MD
Dr. James Arrighi, Director of Nuclear Cardiology at RIH, reports the acquisition of a new cardiac SPECT camera in nuclear medicine represents a major advance in cardiac imaging. This camera, a GE Discovery 530c, represents new, advanced technology in nuclear imaging, and is the first of its kind in New England, and will be used in selected patients who are referred to the RIH nuclear cardiology lab for stress testing.
The camera has several important advantages over old SPECT technology. First, imaging times are reduced by 50-75% compared to older SPECT cameras. Images of the heart can now be acquired in as short as 3 minutes. These shorter imaging times reduce the inconvenience to the patient, and improve overall patient comfort and satisfaction. Second, the high sensitivity of the camera permits protocols that decrease radiation exposure to selected patients by up to 50%. Third, the availability of this new camera technology in Nuclear Cardiology at RIH permits us to perform "patient-centric imaging". For patients in whom there is a concern about radiation exposure, reduced dose protocols can be utilized. For other patients who may have difficulty in tolerating long imaging procedures, protocols can be used that minimize imaging time. Certain cameras and protocols may be more appropriate for a particular patient. Our staff will select the most appropriate protocol and camera for each patient.
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