2013 UC Davis Update in Gastroenterology and Hepatology


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2013 UC Davis Update in Gastroenterology and Hepatology

  1. 1. MONTEREYPLAZAHOTEL & SPASponsored by:UC DAVIS HEALTH SYSTEMOffice of Continuing Medical Educationand Division of Gastroenterology & HepatologyDepartment of Internal Medicine2013 UPDATE INGASTROENTEROLOGY & HEPATOLOGYfor the Primary Care PractitionerAugust 24–25, 2013Saturday - SundaySCAN FOR ONLINEREGISTRATION
  2. 2. 2013 UPDATE IN GASTROENTEROLOGY & HEPATOLOGY FOR THE PRIMARY CARE PRACTITIONERSaturday, August 24, 20137:00 am Registration, Continental Breakfast, Visit Exhibits7:55 Welcome and Course ObjectivesChristopher Bowlus, MD8:00 Update on Clostridium difficile InfectionClostridium difficile infection (CDI) is the mostcommon hospital acquired infection in the UnitedStates. This lecture will review current issues in thediagnosis and management of CDI.Stuart Cohen, MD8:30 Q & A8:40 Gluten-free Diets and Celiac DiseaseCeliac disease is now recognized as beingrelatively common and gluten-free diets havebecome popular among the general public. Learnhow to properly diagnosis celiac disease andthe potential benefits of a gluten-free diet in yourpatients.Sooraj Tejaswi, MD9:10 Q & A9:20 Colon Cancer ScreeningColon cancer incidence and mortality are droppingand believed to be due in part in increasedscreening, yet the uptake of screening andsurveillance remains suboptimal. We will reviewthe latest data supporting current screening andsurveillance guidelines for colon cancer screening.Mary Pat Pauly, MD9:50 Q & A10:00 Refreshment Break, Visit Exhibits10:20 Chronic ConstipationChronic constipation is often an overlooked, yetdebilitating cause for abdominal pain. Learn aboutthe approach to this condition as well as whento refer to a specialist for further evaluation andmanagement.Amar Al-Juburi, MD10:50 Q & A11:00 Surgical and Non-surgical Treatments of DiverticulitisOur knowledge of the pathophysiology andmanagement of diverticulitis has changed.Understand the medical and surgical managementof diverticulitis.Kathrin Troppmann, MD11:30 Q & A11:40 Irritable Bowel SyndromeIrritable Bowel Syndrome (IBS) continues to be acommon condition encountered by health careprofessionals. Learn how to recognize IBS aswell as the various steps in managing this chroniccondition.Michael Lawson, MD12:10 pm Q & A12:20 Adjourn12:30-1:30 OPTIONAL LUNCH SESSIONSAdditional fee of $50Informal discussion with faculty, limited seating,pre-registration required, 1 hour of credit1. Management of Liver Disease for Mid-LevelsLaura Lester, RNAn informal discussion for mid-levels to discussmanagement issues in patients with chronicliver disease from treatment of hepatitis C tocomplications of cirrhosis.2. Hepatitis CLorenzo Rossaro, MDNucleotide Polymerase Inhibitor Sofosbuvir plusRibavirin for Hepatitis CN Engl J Med. 2013;368:34-44Exploratory Study of Oral Combination AntiviralTherapy for Hepatitis CN Engl J Med. 2013;368:45-533. Procedural Safety in CirrhosisValentina Medici, MDEltrombopag before Procedures in Patients withCirrhosis and Thrombocytopenia. N Engl J Med2012; 367:716-7244. Management of Acute GI BleedingAnne Thai, MDTransfusion Strategies for Acute UpperGastrointestinal Bleeding.N Engl J Med 2013; 368:11-215. New Treatment for GERDKaveh Hoda, MDEsophageal Sphincter Device forGastroesophageal Reflux Disease.N Engl J Med 2013;368:719-7276. Abdominal Wall PainGeorge Meyer, MDChronic abdominal wall pain: a frequentlyoverlooked problem. Practical approach todiagnosis and management.Am J Gastroenterology 2002 Apr;97(4):824-30.
  3. 3. Sunday, August 25, 20136:45 am Registration, Continental Breakfast, Visit Exhibits6:50-7:50 OPTIONAL BREAKFAST ROUNDTABLESInformal discussion with faculty, limited seating,pre-registration not required, 1 hour of credit7. Clinical Trials in GI and Liver DiseasesLaura Lester, RNDiscuss issues related to management of clinicaltrials including issues related to IRB approval,budgeting, recruitment, and others.8. Clostridium difficile ColitisStuart Cohen, MDDuodenal Infusion of Donor Feces for RecurrentClostridium difficile.N Engl J Med 2013;368:407-4159. IBSMichael Lawson, MDRifaximin Therapy for Patients with IrritableBowel Syndrome Without Constipation.N Engl J Med 2011; 364:22-3210. GastroparesisAmar Al-Juburi, MDRecent Advances in the Pathophysiology andTreatment of Gastroparesis.J Neurogastroenterol Motil. 2013 January;19(1): 18–24.11. Colon Cancer ScreeningMary Pat Pauly, MDColonoscopy versus Fecal ImmunochemicalTesting for Colon Cancer Screening.N Engl J Med 2012; 366:697-70612. Colon Cancer ScreeningSooraj Tejaswi, MDColonoscopic Polypectomy and Long-termPrevention of Colorectal-cancer Deaths.N Engl J Med 2012; 366:687-69613. Diverticular DiseaseKathrin Troppmann, MDDiverticular disease in younger patients - is itclinically more complicated and relate to obesity?Colorectal Disease. 2013 Mar 26.14. Vomiting SyndromesGeorge Meyer, MDCyclic vomiting syndrome: what aGastroenterology needs to know.Am J Gastroenterology 2007Dec;102(12):2832-407:55 Welcome and Course ObjectivesDrew Ingram, MD8:00 Screening for Liver Disease in Primary CareChronic liver diseases are common and oftenasymptomatic. New guidelines from the Center forDisease Control and Prevention and other agencies willbe reviewed to update practitioners on which patients toscreen for viral hepatitis and other common liver diseases.Christopher Bowlus, MD8:30 Q & A8:40 Baby Boomers Hopes and Promises: InterferonFree for Hepatitis C CureTreatment of hepatitis C is evolving. It is likely that withinseveral years, treatment regimens without interferon willbe common. This lecture will review the current state ofthe art in staging and managing patients with hepatitisC with an eye to future treatment strategies.Lorenzo Rossaro, MD9:10 Q & A9:20 Managing Cirrhosis in the Primary Care SettingPatients with cirrhosis present a complex medicalsituation requiring management of ascites,encephalopathy, varices and risk of hepatocellularcarcinoma. Learn the basics of managing theseissues as well as determining the appropriate settingfor liver transplant referral.Valentina Medici, MD9:50 Q & A10:00 Refreshment Break, Visit Exhibits10:20 Updated Guidelines for the Diagnosis andManagement of GERDReview and understand recently published guidelinesfor this common condition managed in the primarycare setting including long-term use of PPIs, refer forendoscopy, and surgical treatment options.Kaveh Hoda, MD10:50 Q & A11:00 Barrett’s EsophagusBarrett’s esophagus is an asymptomatic, pre-malignant condition. We will review the risk factorsfor Barrett’s esophagus, its natural history and currentrecommendations for screening and surveillance.Anne Thai, MD11:30 Q & A11:40 Helicobacter pylori. New Approaches to TreatmentInfection with H. pylori is endemic in manypopulations and is a known carcinogen. However,eradication of the infection can be difficult. Learnabout the newest regimens and their effectiveness.Drew Ingram, MD12:10 pm Q & A12:20 Adjourn2013 UPDATE IN GASTROENTEROLOGY & HEPATOLOGY FOR THE PRIMARY CARE PRACTITIONER
  4. 4. TARGET AUDIENCEThis activity is designed for primary care physicians, nursepractitioners, physician assistants and nurses who are often thefirst source of information for patients with gastroenterologyand hepatology diseases. These professionals must have currentinformation to appropriately diagnose, treat, refer, and counseltheir patients.EDUCATIONAL NEEDThis conference is knowledge based and designed to changephysician competence. We have identified opportunitiesfor education about a broad range of gastroenterology andhepatology digestive disease topics based on feedback from pastparticipants and physician needs assessment surveys. Topicsidentified included the diagnosis and management of chronichepatitis C, cirrhosis, IBS, chronic constipation, Diverticulitis,Celiac Disease, Clostridium difficile infection, Barrett’s Esophagus,GERD and Helicobacter Pylori. This symposium is part of astrategy to address these educational needs and improve thehealth of all patients with digestive diseases.This year’s 2 day conference will specifically address theseidentified educational needs and provide practitioners withstate-of-the-art tools to improve treatment options for theirpatients. Faculty presenting and interacting with participantsat this activity have been selected on the basis of theircomprehensive clinical experience and academic excellence.Our physicians routinely provide consultation and educationto primary caregivers based on the direct experience of thegastroenterology faculty at UC Davis Medical Center.EDUCATIONAL OBJECTIVESAt the end of the activity, participants should be able to:• Define the issues regarding the epidemiology of Clostridiumdifficile and identify the prevention and treatment options forthis disease to improve patient outcomes• Explain how to diagnose Celiac Disease and become familiarwith gluten-free diets• Describe the latest screening and surveillance guidelines forcolon cancer• Evaluate and treat the patient who presents with chronicconstipation• Evaluate and treat the patient who presents with IBS• Describe the operative and non-operative approach todiverticulitis; recall the risks and benefits of dietary fiber,nuts, seeds, and popcorn• Discuss the workup and treatment plan for patientspresenting with different liver diseases• Discuss the approach to diagnosis and treatment of hepatitisC in view of the new medications that have recently becomeavailable• Evaluate the causes of chronic liver disease; discuss how toevaluate and treat the complications of cirrhosis• Discuss the workup and treatment plan for patients with GERD• Define Barrett’s Esophagus and when to refer for surveillanceand/or treatment of this disease• Identify the appropriate diagnostic test for different clinicalpresentations of Helicobacter pylori as well as the limitations oftreatmentFacultyCOURSE CO-CHAIRSChristopher L. Bowlus, MDProfessor of MedicineDirector, GI FellowshipTraining ProgramDivision of Gastroenterologyand HepatologyDepartment of Internal MedicineUniversity of California, Davis,Health SystemDrew C. Ingram, MDFellow, Division ofGastroenterology andHepataologyGastroenterology MedicalClinic, FolsomUniversity of California, Davis,Health SystemDIVISION OF GASTROENTEROLOGY& HEPATOLOGY FACULTYAmar Al-Juburi, MDAssociate Clinical ProfessorLaura Lester, MSN, FNP-C, CCRCGI/Hepatology Clinical Trials UnitValentina Medici, MDAssistant Clinical ProfessorGeorge W. Meyer, MD, FACP,MACGClinical Professor of MedicineLorenzo Rossaro, MDProfessor and ChiefSooraj Tejaswi, MD, MPHAssistant Clinical ProfessorCecilia R. Terrado, MDAssociate Clinical ProfessorINFECTIOUS DISEASESStuart H. Cohen, MDProfessor of MedicineDivision of Infectious DiseasesDepartment of Internal MedicineCONFERENCE COORDINATORPamela SchneiderCME SpecialistOffice of Continuing Medical EducationUC Davis Health Systempamela.schneider@ucdmc.ucdavis.eduGUEST FACULTYKaveh Hoda, MDDepartment of Gastroenterologyand HepatologyKaiser Permanente Medical GroupSan Francisco, CAMichael J. Lawson, MDClinical Professor of MedicineDepartment of Gastroenterologyand HepatologyKaiser Permanente Medical GroupSacramento, CAMary Pat Pauly, MD, FACPClinical Professor of MedicineDepartment of Gastroenterologyand HepatologyKaiser Permanente Medical GroupSacramento, CAAnne Thai, MDGastroenterology and HepatologySan Mateo, CAFOR FURTHER INFORMATIONUC Davis Health System (866) CME4EDU (263–4338)Office of Continuing Medical Education (916) 734–53903560 Business Drive, Suite 130 Fax (916) 734–0742Sacramento, CA 95820–2161 http://cme.ucdavis.eduBROCHURE ART CREDITBrochure images courtesy of Accreditation Council for ContinuingMedical Education, UC Davis Public Affairs, Monterey Plaza Hotel &Spa, and iStockphoto.com.DEPARTMENT OF SURGERYKathrin M. Troppmann, MDClinical ProfessorDivision of Gastrointestinal andMinimally Invasive Surgery
  5. 5. ACCREDITATIONThe University of California, Davis, Health System isaccredited by the Accreditation Council for ContinuingMedical Education (ACCME) to provide continuingmedical education for physicians.CREDIT DESIGNATIONPHYSICIAN CREDIT: The University of California, Davis, Health Systemdesignates this live activity for a maximum of 10 AMA PRA Category 1Credits™. Physicians should claim only the credit commensurate withthe extent of their participation in the activity.AAFP: Application for CME credit has been filed with the AmericanAcademy of Family Physicians. Determination of credit is pending.AMA PRA Category 1 Credits™ acceptable for interprofessional team membersNURSE: For the purpose of recertification, the American NursesCredentialing Center accepts AMA PRA Category 1 Credits™ issued byorganizations accredited by the ACCME. For the purpose of relicensure,the California Board of Registered Nursing accepts AMA PRA Category 1Credits™ (report up to 10 hours of credit and fill in “CME Category 1”for the provider number).PHYSICIAN ASSISTANT: The National Commission on Certification ofPhysician Assistants (NCCPA) states that AMA PRA Category 1 Credits™are acceptable for continuing medical education requirements forrecertification.CULTURAL AND LINGUISTICCOMPETENCY REQUIREMENTAll continuing medical education (CME) courses with patient carecomponents are required by California State statute to includecurriculum on cultural and linguistic competency in the practice ofmedicine (California Business and Professions Code, Section 2190.1).Those who have developed this UC Davis CME activity have beenencouraged to address cultural and linguistic differences for a diversepatient population related to this topic. A variety of resources areavailable that address these competencies. Additional resources andinformation can be found on our website, http://cme.ucdavis.edu.REGISTRATIONPlease register early – space is limited.Tuition is $340 for physicians and $295 for all others. Confirmation ofregistration will be sent within two weeks after receipt of registrationform. The fees will increase after July 25, 2013.Tuition includes continental breakfasts, refreshment breaks, electronicsyllabus, and an online certificate of attendance. Tuition may be paid bycheck, American Express, Discover, MasterCard or VISA. Cash is notaccepted. Program materials cannot be guaranteed unless registrationis received by August 12, 2013. The Office of Continuing MedicalEducation reserves the right to cancel this program. In such a case, a fullrefund will be given.Registration forms received without payments will not be processeduntil payment is received, and payment must follow within 10 days.Early discount rates are honored if payment is received by the datenoted on the registration form. After that date, the late fee is applied.On-site Fees: At door registrations will be charged at a higher rate.Please see registration form for details.CANCELLATION AND REFUND POLICY: A refund of tuition, less $75administrative fee, will be allowed if requested in writing by August 12,2013. No refunds will be provided after this date.CREDIT | AMA PRA Category 1 Credits™GENERAL SESSIONUp to 8 AMA PRA Category 1 Credits™OPTIONAL ROUNDTABLE SESSIONSUp to 2 AMA PRA Category 1 Credits™ (1 each session)ELECTRONIC EVALUATION AND CREDITThe link to your electronic syllabus, evaluation andcertificate of credit will available for 30 days after thelast day of the conference. Once you have completed theevaluation process your certificate will be available.ELECTRONIC SYLLABUSThe electronic syllabus will be available to pre-registeredattendees online prior to the conference for downloadingand printing. A flash drive will be distributed at theconference. If you prefer to have a printed syllabus, wewill be happy to accommodate you for an additional feeof $30 if ordered by August 12, 2013.
  6. 6. LOCATION400 Cannery Row, Monterey, CA 93940(831) 646-1700(831) 646-0285 Fax(800) 334-3999 Reservationswww.montereyplazahotel.comPerched dramatically over the Monterey Bay, the Monterey Plaza Hotel& Spa combines elegant European architecture, sweeping coastal viewsand sophisticated style to create the perfect vantage point from whichto enjoy the gentle sounds of the surf, the fresh scent of sea air and thesight of otters, seals and dolphins at play.The Monterey Plaza’s central location on Cannery Row makes it easyto enjoy the area’s many attractions and activities, including the world-renowned Monterey Bay Aquarium just three blocks away. The range ofactivities and attractions nearby is nearly limitless. Launch a kayak fromthe hotel’s beach, play a round of golf at one of 19 local championshipcourses, go sailing, whale watch or scuba dive in the protected marinesanctuary of Monterey Bay. Walk to Fisherman’s Wharf, Old TownMonterey or the Maritime Museum, or take a scenic drive to Carmel,Pebble Beach, 17-Mile Drive or Big Sur.The Monterey Plaza Hotel & Spa is proud to have been named by thereviewers of TripAdvisor one of the Top 25 Hotels in the entire UnitedStates, and is a recipient of the 2012 Forbes Four-Star Award. Only160 hotels in the Unites States and Canada have been honored withthis distinction, establishing our waterfront resort as one of the finestin the country. The Forbes Travel Guide inspections are regarded as themost rigorous and comprehensive in the industry, ensuring that yourhigh expectations will be met. We invite you to visit the Monterey PlazaHotel & Spa, the premier resort on the Monterey Peninsula.Layered clothing is recommended as the meeting room temperaturemay be uncomfortable for some, depending on personal preferences.If you have any special needs due to a disability as specified in theAmericans with Disabilities Act, please call the Office of ContinuingMedical Education at (916) 734-5390 so we may make the necessaryaccommodations for you.By staying at the host hotel, you help the University of California,Davis, meet its contractual obligations with the Monterey Plaza Hoteland keep future registration fees reasonable. Please consider thatwhen making your accommodation decisions. We encourage you tostay at the host hotel.MONTEREYPLAZAHOTEL & SPAAIR TRAVELMonterey Regional Airport (MRY)San Jose International Airport (SJC)San Francisco International Airport (SFO)The Office of Continuing Medical Education has arranged group rateswith United. Please read and follow the directions carefully to obtainthese special rates for your travel to our conference.UNITED AIRLINES ONLINE RESERVATIONSTo obtain Groups and Meetings discount prices go to http://www.united.com and enter offer code: ZNNT235740GROUND TRANSPORTATIONHertz Car Rental: To obtain discount prices go to http://www.hertz.com and enter Convention Number 04H70004 for discounted rates.National Car Rental: 1 (800) CAR-RENT and request ID #5282865for discounted rates.OFFICE OF CME MISSION STATEMENTTo educate health care providers through evidence-based activitiesthat emphasizes advances in medicine, new medical technology,biomedical research, and changes in health care delivery to improveclinical outcomes.OFFICE OF CME VISIONProviding medical education for health care professionals to improvepatient care.DISCLOSURE OF RELEVANT FINANCIAL RELATIONSHIPSAs a provider accredited by the Accreditation Council for ContinuingMedical Education, the University of California, Davis Health SystemOffice of Continuing Medical Education must ensure balance,independence, and objectivity in all CME activities to promoteimprovements in health care and not proprietary interests of acommercial interest. The provider controls all decisions related toidentification of CME needs, determination of educational objectives,selection and presentation of content, selection of all personsand organizations that will be in a position to control the content,selection of educational methods, and evaluation of the activity.Course directors, planning committee members, presenters, authors,moderators, panel members, and others in a position to control thecontent of this activity are required to disclose relevant financialrelationships with commercial interests related to the subject matter ofthis educational activity. Learners are able to assess the potential forcommercial bias when complete disclosure, resolution of conflicts ofinterest, and acknowledgment of commercial support are providedprior to the activity. Informed learners are the final safeguards inassuring that a CME activity is independent from the influence orcontrol of commercial interests. We believe these mechanismscontribute to the transparency and accountability of CME.A block of rooms is being held for conference participants at rates of:INLAND VIEW: $229PARTIAL OCEAN VIEW: $279OCEAN VIEW: $329OCEAN VIEW/BALCONY: $379Plus hotel and sales tax (extension dates may be available). After July24, 2013, reservations will be on a space and rate available basis.Reservations should be made directly with the hotel.
  7. 7. For OfficeUse OnlyGASTR146184TELEPHONE: (916) 734-5390FAX APPLICATION: (916) 734-0742REGISTER ONLINE AT: https://chtapps-prod.ucdmc.ucdavis.edu/cme/CmeSignIn?ccode=GASTR14Registration FormGASTROENTEROLOGY AND HEPATOLOGY FOR THE PRIMARY CARE PROVIDER · AUGUST 24-25, 2013________________________________________________________________________________________________________________________________________________________________________First Name M.I. Last NameMD DO PA NP RN Lic. #_________________________________________________________ Other:_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Institution/Employer (as you would like it to appear on your badge) Profession/Occupation________________________________________________________________________________________________________________________________________________________________________Address (where you would like your receipt mailed)________________________________________________________________________________________________________________________________________________________________________City State Zip Code________________________________________________________________________________________________________________________________________________________________________Day Phone Fax NumberIf you need disability accommodations at the meeting, please let us know by August 12th and our representative will contact you.Please note special dietary/food allergy requirements: ___________________________________________________________________________________________Please check your payment method: Registration forms received without check, credit card number or purchase order number will not be processed until payment is received.Check enclosed payable to: UC Regents AMEX Discover MasterCard VISA___________________________________________________________________________________________________________________________________________Account Number Expiration Date___________________________________________________________________________________________________________________________________________Authorized Signature (name on card) 3 Digit Security CodePhysician information required for CME credit and name badge.Please indicate primary medical specialty:FP GP IM GI Other (specify)_________________________________________________________Social Security Number (last 4 digits required for transcript purposes)Please copy the mail code from the address side of the brochure(above your name, e.g. PPGI, MMSGI, CRDGI)____________________________________________________If you did not receive a brochure in the mail, how did you hear about this conference?(Example: PT&MG, UCD website, web search, magazine, friend)?____________________________________Have you attended this conference in the past? Yes NoPlease use ONE of these methods to register (Do not mail if previously faxed or telephoned):MAIL APPLICATION AND PAYMENT TO:Office of Continuing Medical Education,c/o UC Davis Cashier’s OfficePO Box 989062, West Sacramento, CA 95798-9062( ) ( )E-mail for link to electronic syllabus. UC Davis CME will not use your email for any purpose other than corresponding with you.REGISTRATION FEES (Receipt/Confirmation will be mailed within two weeks) Early Discount After July 25 On SitePhysician $340 $400 $425Other Health-care Professional $295 $345 $3957 Digit Acct. # Authorized Signature and Phone # DepartmentELECTRONIC SYLLABUSThe electronic syllabus will be availableto pre-registered attendees online prior tothe meeting for downloading and printing.A USB flash drive will be distributedat conference. If you prefer to have aprinted syllabus, we will be happy toaccommodate you for an additional $30if ordered by August 12, 2013. Pleasemake your choice of syllabus on theenrollment form.Flash Drive (included in tuition)Printed (additional $30)OPTIONAL LUNCH SESSIONSSATURDAY 12:15 – 1:15 PMADDITIONAL $50 Limited to nine participantsper subject. Includes lunch and 1 hour of credit.Circle your session preference1 2 3 4 5Web
  8. 8. University of California, DavisOffice of Continuing Medical Education3560 Business Drive, Suite 130Sacramento, CA 95820-2161Non-profit Org.U.S. PostagePAIDSacramento, CAPermit No. 3405This program is self-supporting and receives no state funding.2013 UPDATE INGASTROENTEROLOGY& HEPATOLOGYfor the Primary Care PractitionerMonterey Plaza HotelSATURDAY - SUNDAYAugust 24-25, 2013HIGHLIGHTS:• Interferon-free Treatment of Hepatitis C• Gluten-free Diets and Celiac Disease• GI Conditions Faced in Primary Care• Small Group Sessions on Digestive Disease Topics• Diverticulitis Treatments• Managing Cirrhosis in Primary Care• Updated Guidelines for GERD• 20% Spa DiscountMONTEREYPLAZAHOTEL & SPA