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New Departmental Research PublicationsGreene NH, Attix DK, Weldon BC, Smith PJ, McDonagh DL, Monk TG. Measures of executive function and depression identify patients at risk for postoperative delirium. Anesthesiology. 2009; 110 (4): 788-795.

Smith PJ, Attix DK, Weldon BC, Greene NH, Monk TG. Executive function and

depression as independent risk factors for delirium. Anesthesiology. 2009; 110: 781-787.

Call for Artwork - Academic Evening 2009Cathleen Peterson-Layne, MD

To continue to the tradition of highlighting various talents in the department, you are invited (and encouraged) to submit your artwork for display at our Seventeenth Annual Academic Evening on Tuesday, May 12th. Everyone is welcome to participate. Last year, several folks revealed their talent in photography, sketching, painting, bead work, and weaving.

Please let me know the type and size of each item you would like to display so that we can plan for easels - tabletop and floor.

If you would like your artwork to be considered for the program cover, please send an electronic copy to me ([email protected]) by April 10th.

If you have any questions about Academic Evening, please do not hesitate to ask.

Announcing: June Resident Evaluation Committee MeetingThomas Pafford

Mark your calendars for Monday, June 15th from 4:00-6:00 pm, for the final Resident Evaluation Committee meeting of this academic year. We will need to discuss every resident for promotion and those who are up for graduation. The location will be Conference Room 6686 in the HAFS building (on the sixth floor, directly above Dr. Borel’s office).

Committee members, please RSVP to me at [email protected]

http://anesthesiology.duke.edu 1

Anesthesiology ExcellenceRichard Moon, MD

Congratulations to Rob Lobato, MD, who has been elected to Alpha Omega Alpha!

ASA Hotel Room Block InformationMark F. Newman, MD

In order to maximize our impact while minimizing the overall departmental cost, we will again have a hotel arrangement this year that will allow us to consolidate and take advantage of group purchase

to reduce our food and room rental expenses. In order to accomplish this we have a room block at the Renaissance Hotel in New Orleans. You will need to book your room by visiting the site listed below. The link includes our reservation code for our room rate. I expect that we will fully reserve in our block first before using any outside hotels. If you have any questions or concerns please see me.

http://www.marriott.com/hotels/travel/msydt?groupCode=dukduka&app=resvlink&fromDate=10/15/09&toDate=10/22/09

NewsMonday, April 13, 2009 • Volume 11, Issue 13

Department of Anesthesiology Research ConferenceMonday’s from 5-6 pm in 5685-HAFS Monday, April 13th“Patent Basics”Speaker: Mr. Bryan Shang

This is an introduction for individuals who may have little or no exposure to the basic tenants of Patent Law. Some of the items that will be covered include: • The Basis of US Patent Law, • What rights are conferred when a patent issues, • What rights are not conferred when a patent

issues, • The three different types of patent applications

• Provisional Patent • Utility Patent • Design Patent

• The components of a Utility patent application, • Domestic filing process • International filing process • Q&A’s

Upcoming Meetings:May 12: Academic Evening October 12June 8 November 9September 14 December 14

THIS MoNTH IN THE DEPARTMENT of ANESTHESIology


April 2009MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY13 14 15 16 17

7:15-8:00 a.m., RM203-Pain Clinic MRC Pain Conference

2-3 p.m., VAMCVA Echocardiography Conference

5-6 p.m., 5685-HAFSDepartment of Anesthesiology Research Conference: “Patient Basics” - Mr. Bryan Shang

5-6 p.m., 5685-HAFSCT Conference: “Alpha 2 Agonists for ICU Sedation” - Charles Brud-ney, MD

5-6 p.m., 6686-HAFSGVTCCM Conference: “Nitrous Oxide: Friend or Foe?” - John Nardiello, MD

IRB Deadline: Submit 1 original and 3 copies to Dr. Gan’s office by 5 p.m.

6:15-7:15 a.m., 5685-HAFSCT Anesthesia Fellow/Faculty Preceptor Seminar: “Prosthetic Valve Assessment” - Joseph Mathew, MD

6:30 a.m., 2001DNResident Conference Lectures: “Pediatric Regional Anesthesia” - Allison Ross, MD

7:15 a.m., 2001DNGrand Rounds: “Molecular Basis of Postoperative Delirium” - Madan Kwatra, PhD

7:15-8:00 a.m., RM203-Pain ClinicMRC Pain Journal Club

12:00-12:45 p.m., 2001DNCritical Care Conference

4-5 p.m., 5680A-HAFSPediatric Conference: “Deep Extubation: How Deep is Deep & How Deep is the Data?” - Sean Selig, MD

5 p.m., Location TBAEducation Executive Committee Meeting

20 21 22 23 24



4-5:30 p.m., 5685-HAFSExecutive Team Meeting

5-6 p.m., 5685-HAFSCT Conference: NO CONFERENCE

5-6 p.m., 6686-HAFSGVTCCM Conference: “The Uganda Experience” - Tony Roche, MD

6:15-7:15 a.m., 5685-HAFSCT Anesthesia Fellow/Faculty Preceptor Seminar: NO CONFERENCE

6:30 a.m., 2001DNResident Conference Lectures: “Pediatric Anesthesia Review“ - John Eck, MD

7:15 a.m., 2001DNGrand Rounds: “The Duke Enter-prise Data Warehouse” - Jeffrey Ferranti, MD

5 p.m., Chen Conference RoomNeuroradiology Conference


12:00-12:45 p.m., 2001DNCritical Care Grand Rounds

4-5 p.m., 5680A-HAFSPediatric Conference

5-6 p.m., 5685-HAFSResident Education Sessions: “Topic TBA” - Warwick Ames, MD

5-6 p.m., 5685-HAFSDepartment Fellow/Faculty Fellow/Faculty Preceptor Seminar:“Industry, Academics, Money, & Ethics” - Joseph Mathew, MD

27 28 29 30 May 1, 2009



4-5 p.m., 5420B-DNPerioperative Leadership Group Meeting

5-6 p.m., 5685-HAFSCT Conference

5-6 p.m., 6686-HAFSGVTCCM Conference: “NICOM (Non Invasive Cardiac Output Monitor)” - Cheetah Medical Rep-resentative [Non-CME]


6:15-7:15 a.m., 5685-HAFSCT Anesthesia Fellow/Faculty Preceptor Seminar

6:30 a.m., 2001DNResident Conference Lectures: “Common Pediatric Problems& their Anesthetic Implications” - Heather Frederick, MD

7:15 a.m., 2001DNGrand Rounds: “Anesthesia Reim-bursement” - Andrea Styron, MD


12:00-12:45 p.m., 2001DNCritical Care Conference


4 5 6 7 8



4-5 p.m., 5685-HAFSExecutive Team Meeting

5-6 p.m., 5685-HAFSFaculty Meeting

5-6 p.m., 5685-HAFSCT Conference

5-6 p.m., 6686-HAFSGVTCCM Conference


6:15-7:15 a.m., 5685-HAFSCT Anesthesia Fellow/Faculty Preceptor Seminar

6:30 a.m., 2001DNResident Conference Lectures

7:15 a.m., 2001DNGrand Rounds


12:00-12:45 p.m., 2001DNCritical Care Grand Rounds


5-6 p.m., 5685-HAFSResident Education Sessions: “Towards Rational Perioperative Fluid Management: Dispelling the Concept of a “Third Space” and Other Myths” - Mark Stafford Smith, MD

Upcoming Events:2009 Academic Evening: May 12, 2009 | 5:45 p.m. | Millennium Hotel, Durham, NCResident Practice oral Exams: Monday, May 18, 2009 | 4 - 6 p.m.2009 Resident graduation Banquet: May 30, 20092009 ASA: October 17-21, 2009 | New Orleans, LA21st Annual Alumni Reception: October 18, 2009 | 7-10 p.m. | New Orleans, LA


ANESTHESIology NEWS

Study is More Than Just ‘The Bends’Kelly Malcom, Inside Duke Medicine

Clad in swim trunks and neoprene slippers, Jason, a medical student, climbed out of the chamber, dripping wet. Careful not to disturb the catheters put into his arms to measure his blood pressure and pulmonary arterial pressures, he walked into an adjacent room to recuperate from his underwater exercise.

Jason had answered the call for fit volunteers to assist in a clinical study to understand immersion pulmonary edema, a condition that causes some scuba divers’ lungs to suddenly fill with fluid.

“The condition is life-threatening and has caused some swimmers and divers to die,” said principle investigator Richard Moon, M.D., professor of anesthesiology and medical director of the Duke Center for Hyperbaric Medicine and Environmental Physiology. “We’re still unclear as to what causes pulmonary edema but it could be related to high pressures in the pulmonary artery or deficiencies in the way some people clear their lungs of fluid.”

This Navy-funded study is just one example of the ongoing basic and translational research projects at the Center.

The facility, located in Duke South, contains an impressive series of chambers, the largest of which can hold up to 12 patients plus staff, as well as water tanks for physiological studies. In an area resembling the control room of a submarine, physicians and technicians constantly monitor oxygen levels, pressure, and patient condition in each chamber. Hyperbaric oxygen is administered for a variety of medical conditions, including most famously, decompression illness, colloquially known as “the bends.”

Scuba divers and people who work in pressurized environments who return to normal atmospheric pressure and aviators and astronauts who rapidly transition to low pressure environments can develop bubbles of nitrogen gas in their tissues. Symptoms can include skin rashes, joint pain, and more serious symptoms such as blurred vision and disorientation. Severe decompression sickness can be life threatening.

Treatment requires the administration of 100 percent oxygen in a pressurized hyperbaric chamber, usually for one or more periods of around 4-6 hours. Duke University Medical Center is also where the Divers Alert Network (DAN), a network that provides educational and emergency information for recreational divers internationally, got its start. Duke physicians routinely consult for DAN and Duke’s hyperbaric facility is open for emergencies 24 hours a day, seven days a week and Duke’s chamber is the largest civilian facility in the world.

“Duke’s facility is not just another hyperbaric chamber,” said John Freiberger, M.D., MPH, assistant professor of anesthesiology. It is a unique facility where investigators can readily research the effects of extreme environmental conditions on human physiology. Current projects deal with topics ranging from the molecular biology of the laboratory bench to the ill patient’s bedside and all strive for an in depth understanding of the biology of oxygen and other metabolic gases and their clinical applications. He is currently investigating the use of hyperbaric oxygen for the treatment of jaw necrosis in patients who have received certain drugs for chemotherapy that inhibit bone cell growth.

In addition, he has a pilot study to diagnose chronic carbon monoxide (CO) exposure and examine possible prevention efforts in medically underserved populations.

Hyperbaric oxygen is often prescribed for victims of house fires or suicide attempts who are acutely exposed to elevated CO, because in addition to its known immediate toxic effects, CO can have devastating long term neurological consequences if not treated immediately. This has important public health implications because CO even low levels of chronic intoxication may lead to subtle but significant changes in neurological function if exposure were to persist over time. Epidemiologic research has shown that certain populations, especially recent Hispanic immigrants, may be more likely than other ethnic groups to be exposed to chronic, low-level CO exposure through the use of generators or cooking grills indoors. This study seeks to document CO exposure and develop strategies for prevention in all populations vulnerable to this disease.

Although CO is a known toxin, it is also a normal product of metabolism and may have important roles in cell signaling. Researchers at Dukes Hyperbaric Chamber are utilizing the facility to examine the effects of carbon monoxide and oxygen on mitochondria, the powerhouse of the cell.

“CO at high levels inflicts damage through oxidative stress,” says Hagir B.Suliman, Ph.D., assistant professor of anesthesiology. At low doses, though, CO has an important role in cell signaling. Certain chemotherapy drugs, such as doxorubicin, can cause mitochondrial damage and cardiac cell death. Suliman and her colleagues have found that exposure to low levels of carbon monoxide can promote the biogenesis of mitochondria, a process that may be intimately involved with the underlying mechanisms of wound healing and aging.

“Duke’s hyperbaric facility is special because of its commitment to both quality clinical care and to high caliber research,” said Freiberger. We have the clinical and scientific depth to figure out how to make people better in a rational and reproducible way.”

get Involved

The Duke Hyperbaric and Physiology Lab is actively recruiting volunteers for clinical trials. For more information, visit http://clincaltrials.gov or call the Duke Center for Hyperbaric Medicine and Environmental Physiology at 919-684-6726.

Comings and goingsPlease welcome Jaime Atwell to the Anesthesiology family as a permanent employee. Jaime is working in the Cardiothoracic Division as a Staff Assistant to Drs. Steven Hill, Willem Lombard, Madhav Swaminathan and Ian Welsby. Jaime started permanent today, Monday, April 13, 2009.

We wish a fond farewell and good luck to the following employees who will be leaving the department on March 30, 2009.

• Judith Margolis, MD, Assistant Professor• Chan-Hong Park, MD, PhD, Research Associate

Seventeenth Annual Academic Evening

Tuesday, May 12, 2009 at 5:45 pmMillennium Hotel

Durham, NC

CALL FOR ABSTRACTS

ACAD

EMIC

EVE

NING

Medical Students, CRNAs, Residents, Fellows, and Junior Faculty are invited to submit abstracts for presentation.

Abstracts may represent original clinical, laboratory scientific or case reports. Submission to other scientific organizations (e.g. ASA, Gulf Atlantic Residents’ Conference) is allowed. In fact, we encourage those of you who have ASA abstracts in preparation to submit them for the Academic Evening. All

submissions will be accepted for poster presentation.

Abstracts must be no longer than one full page (8.5” x 11”) including diagrams and tables.

Entries are due Wednesday, April 15th at 5 pm. Please submit electronically in MS Word to June Santa. Please submit one

unblinded copy and one blinded copy of each abstract, as well as the completed abstract cover sheet.*

*PLEASE NOTE: THE ABSTACT COVER SHEET CAN BE DOWNLOADED FROM THE STAFF INTRANET AT

HTTP://ANESTHESIOLOGY.DUKE.EDU

Questions? Contact June Santa at [email protected],684-6252 or Cathleen Peterson-Layne, MD at

[email protected], 970-6408.http://anesthesiology.duke.edu 4


ANESTHESIology NEWS

Magic Kingdom® Park©Disney

2nd Annual Emerging Technologies in the OR

June 7-10, 2009Disney’s Yacht and Beach Club ResortLake Buena Vista, Florida

For registration questions please contact Katherine Siler at 919-681-6437 or email at [email protected]

anesthesiology.duke.edu

Sponsored by the Duke University School of Medicine

DUKE CME: TRANSFORMING KNOWLEDGE

Duke University School of Medicine and The Department of AnesthesiologyPRESENTS


Duke University School of Medicine and The Department of AnesthesiologyPRESENTS

SAV

E TH

E D

ATE

Sponsored

by the Duke

University

School of

Medicine.

Mark your calendars for another year of cutting-edge research and updated information designed for medical personnel of all skill levels.

http://anesthesiology.duke.edu

12th Annual Duke Cardiothoracic Update and TEE Review Course

June 18-21, 2009Crowne Plaza ResortHilton Head Island, South Carolina

NEW!Featuring

Heartworks™TEE Simulator

Pre-ASA Symposium/Workshop 6th Annual Ultrasound for Every AnesthesiologistFriday, October 16, 2009Renaissance Arts HotelNew Orleans, Louisiana

SAVE THE DATE


Duke University School of Medicine and The Department of AnesthesiologyPRESENT

Sponsored by the Duke University School of Medicine.

anesthesiology.duke.eduImage Credit: Jean-Paul Gisclair

ClassifiedsReal Estate & Rentals

Huge, beautiful apartment in great lo-cation for rent. Ideal for Visiting Duke Faculty or Fellows. Recently renovated top floor of 203 Watts Street. 1920’s Arts & Crafts style duplex. 2 full bedrooms, 1 bath plus office/den. All new bath-room. High ceilings, great light. Eat-in kitchen and formal dining room. Large living room. Completely and tastefully

furnished and fully equipped with cookware, utensils, dish ware and linens. Washer/Dryer in unit. Lease terms negotiable. Owner lives in first floor unit, providing quick and friendly service and repairs. Electric-ity, Internet, Cable TV, and Water/Sewer included. Tenant pays for gas-fired heat (new more efficient furnace just installed). $1900/month. Pets require additional damage deposit. Non-Smokers only, please. Contact Adam by phone at 919-452-3751 or [email protected] for more details.

1301 Antler Point Dr. Durham NC 27713. Year Built: 2006, 3020 sq. ft., 4 bedroom(s), 3 full bath(s), 15 min. to Duke, UNC, or RTP, 2 minutes to South-point Mall, Backyard backs to American Tobacco Trail, Lots of upgrades, see MLS for details, $385,000 - MLS ID #1652795. If interested please email lrostami@fmre-

alty.com or call (919)358-3520.

25 Scottish Lane Durham, NC. Nice townhome convenient to Duke, UNC, and shopping. Great school district. $165,900. Contact Mark Hutchins Smart Move Realty (919) 294-0041.

45 Birnham Lane Durham, NC. Gor-geous all brick home in beautiful golf course community on a spacious cul-de-sac lot. The master features a won-derful sitting area with fireplace and recently renovated bathroom. Bonus/In-law suite has elevator (rarity in this

price range). Recently remodeled eat-in kitchen features new SS ap-pliances and beautiful granite countertops. There is a wonderful sun room and deck off the kitchen. $620,000 Contact Mark Hutchins Smart Move Realty (919) 294-0041.

Pets

Brindle Boxer Mix Needs His Forever Home. Please consider adopting this loving, sweet, playful, gentle Brindle Boxer mix. Rudy is about 2 years old, still puppyish, housebro-ken, neutered, loves all dogs. His ideal home would include a young dog to play with and a fenced yard. Weighing about 64 pounds, he is full grown, and is up-to-date on all shots and heartworm preventative. He was found injured as a stray, and while recovering was in a foster

home with two dogs, and since then fostered in a home socializing with several dogs. He is great with all of them: male and female, large and small, dominant and submissive. If interested, please contact Wendy at 919-489-4858 or email [email protected].


THE BACK PAgE

Merchandise

Two pairs of size 45 Dansko clogs for sale. I bought these clogs for internship last year but after using them for a few weeks I realized they just don’t work well with my feet. The black pair are a bit more heavily used so I’m asking $30 for them and $40

for the brown pair. If interested please contact Russell Roberson at pager 970-6853 or via eamil at [email protected].

2GB Silver IPod Shuffle for sale. Brand new and still in packaging. Won at office party and was already happy with my MP3 player so haven’t used this device. Asking $40. If interested contact Russell Roberson at pager 970-6853 or via email at [email protected].

Items for sale. Vera Wang, Truly Pink cologne. Full bottle 3.4fl oz. $45.00. 14kt pearl necklace and bracelet. Paid $250.00, will let go for $125.00, OBO. 1/2 (48points) 14kt diamond earrings for $50.00. Pearl necklace and bracelet have been worn once. Interested? Please contact Shelia Johnson at 681-3551 or email [email protected].

Upcoming faculty Development EventsThursday, April 30, 2009 - 5:30 pmGetting Promoted in the Clinical Sciences at Duke: A Guide for Junior FacultyAnn J. Brown, MD, MHSMedical Student Amphitheater, Duke South

Thursday, May 7, 2009 - 5:30-8:30 pmSpring Faculty Meeting and DinnerVarious SpeakersSarah P. Duke Gardens, Doris Duke Center

For the most up-to-date information and to register for events please visit http://facdev.medschool.duke.edu.

April 13 - 19 Birthday WishesKelli Colgan Dr. Kenneth SugiokaDr. Ifeyinwa Ifeanyi Dr. Leonard TalbotDr. Robert Lobato Steven ZieglerAngela Rogers

Note: If you do not want your name listed here, please send a removal notice to [email protected].

04-13-09

Documents

patent issues

utility patent application

basis of us patent law

conference room

room rate

academic year

artwork academic evening

basic tenants of patent