Archive for June 2013

Reflections On My Year as Chair of the American Board of Internal Medicine

Today is my last day as chair of the ABIM, and the end of my eight-year tenure on the Board. In this blog – a bookend to the one I wrote at the start of the year, which went near-viral – I’ll describe some of our accomplishments this year and a few of the challenges that I leave my talented successors to grapple with. I had two very tangible tasks to accomplish during my chairmanship. First, after a decade-long tenure as CEO and President of ABIM, Chris Cassel announced her intention to step down. (Chris is now CEO of the National Quality Forum, which is increasingly crucial in a world looking for robust measures of quality, safety, and value.) After an extensive search, we selected Richard Baron to become ABIM’s new CEO, and Rich began earlier this month. Rich is one of the most impressive people I’ve met in healthcare,…

Subsegmental PE same outcome as proximal PE

This study assessed the characteristics and outcomes of patients with subsegmental and proximal PEs, and found they were similar, including cumulative death rates of 10% and 6%, respectively. Subsegmental PEs carry the same risks as proximal PEs and should be treated as such (abstract).

Guidelines for peri-procedural use of antithrombotics in ischemic cerebrovascular disease

These guidelines provide an evidence based for the use of periprocedural antithrombotics in patients with cerebrovascular disease. They recommend continuing ASA-warfarin for dental procedures, and most other minor procedures. There is little evidence to support the use of procedural bridging with heparin, and it does increase the risk of bleeding. Cessation of therapy for 7 or more days does significantly increase the risk of stroke (guidelines).

NSAIDs reduce post-ERCP pancreatitis

This large systematic review found rectal NSAIDs significantly reduced the risk of post-ERCP pancreatitis compared to pancreatic duct stents (abstract).