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Harvard Update in Hospital Medicine 2024

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Harvard Update in Hospital Medicine 2024

Comprehensive updates, advances, and best practices to optimize inpatient care

Update in Hospital Medicine will be held online this year, using live streaming, electronic Q&A, and other remote learning technologies.

OVERVIEW

This 4-day intensive program updates busy practitioners on current best practices in hospital medicine. The curriculum covers over 30 core topics, with an emphasis on practical management of common problems (See schedule):

  • Heart failure
  • Atrial fibrillation
  • Pregnancy
  • Acute coronary syndromes
  • Diabetes
  • Psychiatric disorders
  • ECG interpretation
  • Radiology interpretation
  • Laboratory interpretation
  • Bacteremia
  • UTI
  • Pneumonia
  • Obesity
  • Critical care
  • Skin and soft tissue infections
  • Stroke/TIA
  • C. difficile
  • End-stage renal disease
  • Acute kidney injury
  • HIV
  • Endocrinology
  • Health equity
  • GI bleed
  • Hematology
  • Allergy
  • Geriatrics
  • Delirium
  • Pain and palliative care
  • Alcohol withdrawal
  • Opioid use disorder
  • COPD
  • Preoperative evaluation
  • Dermatology
  • Electrolyte disorders
  • Syncope
  • Venous thromboembolism
  • Pancreatobiliary disease
  • Cirrhosis
  • Artificial intelligence
  • Antibiotics
  • Goals of care conversations
  • Trauma-informed care

Using a case-based format, lecturers distill recent evidence, guidelines, and expert opinion to offer “bottom line” recommendations. Faculty include both hospitalists and specialists, and rank among the best teachers at Harvard Medical School.

2024 PROGRAM HIGHLIGHTS

  • Comprehensive review of inpatient antibiotic therapy
  • Thrombolysis in acute stroke: are we going to need a bigger window?
  • New data on optimal treatment duration for skin and soft tissue infections
  • Treating acute and chronic pain in patients with substance use disorders
  • Less is more in the long run? DAPT vs. monotherapy in ACS
  • State-of-the-art management of systolic and diastolic heart failure
  • Oral fecal microbiota therapy: new first-line for C. difficile?
  • The jury is out: anticoagulation in silent atrial fibrillation with a low CHA2DS2-VASc
  • Differentiating skin infections and mimics in hospitalized patients
  • GLP-1 agonists for weight loss: hot takes for the hospitalist
  • Trauma-informed care in the hospital
  • Anti-racism in hospital medicine, from triage to care transitions
  • Covert hepatic encephalopathy: more common than you think
  • New kid on the block: cystatin C for GFR
  • Thrombolytics vs. DAPT for mild strokes: weighing the risks and benefits
  • Best practices in pharmacotherapy for agitated delirium
  • Injectable therapy for HIV
  • Harm reduction: reducing the risk of opiate overdose at discharge
  • Evolving strategies for hepatorenal syndrome: terlipressin
  • Eliminate drug-resistant infections with this one weird trick
  • Delirium: an ounce of prevention is worth a pound of cure
  • Best practices and risk mitigation surrounding patient-directed discharges
  • Do they really need admission? Identifying the low-risk PE patient
  • Should you switch anticoagulants in patients with breakthrough strokes?
  • The debate continues: cefepime vs. piperacillin-tazobactam for sepsis
  • Are DOACs the preferred anticoagulant in patients with cancer?
  • Evidence-based tools for risk stratification in syncope
  • Microdosing protocols for buprenorphine induction
  • Evidence-based strategies for serious illness conversations in the hospital
  • To DAPT or not to DAPT: antiplatelet therapy in stroke and TIA
  • HELLP me: managing medical complications in pregnant and postpartum patients
  • The never-ending story: steroids in sepsis
  • Are GLP-1 agonists and SGLT2 inhibitors kidney-saving medications?
  • Capacity assessment: can this patient make their own decisions?

2024 Course Highlights

This is the highlights list from the 2024 course.

ALLERGY/IMMUNOLOGY

  • What to do when there is no allergist
  • How to resolve inappropriate low-risk penicillin allergy labels
  • Updates in anaphylaxis management
  • Things we do for no reason: steroids for anaphylaxis?
  • Class action: sorting out the overlap between penicillin and cephalosporins

CARDIOVASCULAR

  • Less is more in the long run? DAPT vs. monotherapy in ACS
  • End of an era? Beta-blockers after acute MI
  • Coronary CTA: as good as cardiac catheterization?
  • How low should you go? Hemoglobin targets in acute coronary syndromes
  • State-of-the-art management of systolic and diastolic heart failure
  • Titration of GDMT: are we being too wimpy?
  • More data to support GLP-1 receptor agonists for obesity-related HFpEF
  • Overcoming diuretic resistance in heart failure
  • Reducing readmissions for heart failure: best practices in discharge planning
  • Updated guidelines on atrial fibrillation management
  • Avoiding common pitfalls of anticoagulation in atrial fibrillation
  • Rhythm control versus rate control for atrial fibrillation revisited
  • The jury is out: anticoagulation in silent atrial fibrillation with a low CHA2DS2-VASc
  • Drug-drug interactions: DOACs and diltiazem
  • Should you switch anticoagulants in patients with breakthrough strokes?

DERMATOLOGY

  • Cellulitis: antibiotic dilemmas and when to call dermatology
  • New data on optimal treatment duration for skin and soft tissue infections
  • DRESSed to kill: drug reactions and other can’t-miss dermatology diagnoses
  • Cutaneous findings of systemic disease
  • Differentiating skin infections and mimics in hospitalized patients
  • Cellulitis or venous stasis? Demystifying the swollen red leg
  • A cautionary tale: antibiotics with high risk of dermatologic reactions

DIAGNOSTICS

  • Can’t-miss ECG diagnoses
  • Radiology pearls: identifying subtle findings on CXR
  • Rapid-fire review of electrolyte, liver, and hematology cases
  • Contrast or no contrast? Choosing the right imaging protocols

ENDOCRINE

  • Dangers of SGLT2 inhibitors: euglycemic DKA and UTIs
  • GLP-1 agonists for weight loss: hot takes for the hospitalist
  • Challenging cases in inpatient insulin management
  • Continuous glucose monitoring in hospitalized patients with diabetes
  • New guidelines for the management of hyperglycemia in the hospital
  • Adrenal insufficiency: whom to treat and how to taper steroids
  • Pitfalls in managing thyroid disease in medically ill patients
  • Practical approach to adrenal incidentalomas
  • When to worry about pheochromocytoma

EQUITY

  • Anti-racism in hospital medicine, from triage to care transitions
  • Providing top-notch inpatient care to patients with obesity
  • Trauma-informed care in the hospital
  • Inequities in organ transplantation in the US
  • Race-based reference ranges: end of an error
  • Racial equity and pain management in the hospital
  • Improving patient outcomes with interpreter services

GASTROINTESTINAL

  • Covert hepatic encephalopathy: more common than you think
  • Evolving strategies for hepatorenal syndrome: terlipressin
  • New guidelines for spontaneous bacterial peritonitis management and prophylaxis
  • Managing the cirrhotic patient with bleeding and thrombosis
  • Updates on management of upper and lower GI bleeds
  • Optimal timing of endoscopy in upper GI bleeds
  • New risk scores to help manage patients with upper GI bleeds
  • Too soon? When to resume anticoagulation and antiplatelet agents after a GI bleed
  • Fluid resuscitation in acute pancreatitis: less is more
  • Optimal timing for intra-abdominal drainage in necrotizing pancreatitis
  • Urgent and non-urgent indications for ERCP
  • Current approaches to preventing post-ERCP pancreatitis

GERIATRICS

  • Preoperative frailty assessment in older adults
  • Delirium: an ounce of prevention is worth a pound of cure
  • Non-pharmacologic interventions for delirium prevention
  • Difficult cases in delirium management
  • Best practices in pharmacotherapy for agitated delirium
  • Greater caution with antipsychotics in dementia
  • Less is more: polypharmacy and deprescribing in older patients

HEMATOLOGY

  • Management of patients with bleeding and thrombosis
  • Diagnosis and management of hypercoagulable states
  • Pearls for the diagnosis and management of thrombocytopenia
  • Diagnostic approach to anemia in the hospital
  • Transfusion thresholds in the hospital: how low should you go?
  • Updated venous thromboembolism guidelines
  • Is it ever OK to stop anticoagulation in unprovoked venous thrombosis?
  • What’s in a name: should we use “provoked” vs. “unprovoked” VTE?
  • Do they really need admission? Identifying the low-risk PE patient
  • Are DOACs the preferred anticoagulant in patients with cancer?
  • More data on DOACs in patients with obesity and chronic kidney disease

INFECTIOUS DISEASES

  • Comprehensive review of inpatient antibiotic therapy
  • Short-course antibiotics for common infections
  • The debate continues: cefepime vs. piperacillin-tazobactam for sepsis
  • Piperacillin-tazobactam and acute kidney injury: overblown?
  • Injectable therapy for HIV
  • Who should we screen for HIV in the inpatient setting?
  • Mirror, mirror, on the wall, what’s the least “C-diffy” antibiotic of all?
  • Does vancomycin still work against C. difficile?
  • Oral fecal microbiota therapy: new first-line for C. difficile? 
  • Fidaxomicin for C difficile: is it worth the expense?
  • Eliminate multidrug-resistant infections with this one weird trick
  • Controversies in the management of bacteremia
  • When should we consult ID for bacteremia?
  • Err on the side of caution: when to switch from IV to PO therapy in bacteremia
  • Breakthroughs in MRSA therapeutics
  • When should we cover for MRSA pneumonia?
  • New treatment options for complicated UTIs

PALLIATIVE CARE

  • Evidence-based strategies for serious illness conversations in the hospital
  • Which patients benefit most from palliative care?
  • Best practices for leading family meetings

PERIOPERATIVE MEDICINE

  • Updates on perioperative aspirin, statins, beta blockers, and ACE inhibitors
  • To hold or not to hold: understanding the latest on perioperative medication management
  • GLP-1 management in perioperative settings
  • The importance of frailty in assessing perioperative risk
  • Reducing pulmonary risk in perioperative patients
  • Perioperative anticoagulation: when should patients be bridged?

PREGNANCY

  • Best practices for hypertension management in pregnancy
  • Benefits, risks, and contraindications to radiologic studies in pregnant patients
  • HELLP me: managing medical complications in pregnant and postpartum patients
  • Periprocedural management of pregnant patients
  • Treatment guidelines for UTI in pregnancy

PSYCHIATRY

  • Pearls for managing patients with personality disorders in the hospital
  • Inpatient management of psychiatric medications
  • Diagnostic yield of neuroimaging for common psychiatric presentations
  • Capacity assessment: can this patient make their own decisions?
  • Best practices and risk mitigation for patient-directed discharges

PULMONARY/CRITICAL CARE

  • Tailored steroid therapy in acute COPD exacerbations
  • Practical applications of the 2023 GOLD guidelines
  • Short-course antibiotics in COPD exacerbations
  • Uses and limitations of cardioselective beta-blockade in COPD exacerbations
  • Current recommendations for supplemental and high-flow O2 in critical illness
  • New Surviving Sepsis guidelines
  • The never-ending story: steroids in sepsis

RENAL

  • New kid on the block: cystatin C for GFR
  • Preventing the progression of chronic kidney disease: another win for GLP-1 agonists
  • Are GLP-1 agonists and SGLT2 inhibitors kidney-saving medications?
  • Diagnostic approach to acute kidney injury
  • Is acute kidney injury a risk factor for dementia?
  • New data: early renal replacement therapy in acute kidney injury
  • Dialysis access: what the hospitalist needs to know
  • PICC and choose: IV access in ESRD patients
  • Ironing it out: managing anemia in ESRD
  • Blood pressure management in end-stage renal disease
  • Updates on hyperkalemia and hyperphosphatemia management

STROKE

  • Approach to imaging in acute stroke syndromes
  • Updates on AHA/ASA guidelines for stroke management
  • To DAPT or not to DAPT: antiplatelet therapy in stroke and TIA
  • Thrombolysis in acute stroke: are we going to need a bigger window?
  • New agents for thrombolysis in acute stroke
  • Thrombolytics vs. DAPT for mild strokes: weighing the risks and benefits
  • Thrombectomy for acute stroke: is it underused?
  • Telestroke: an idea whose time has come?
  • Staying cryptocurrent on cryptogenic stroke
  • Avoiding hemorrhagic transformation in stroke: when is it safe to start anticoagulation?
  • Should you switch anticoagulants in patients with breakthrough strokes?

SUBSTANCE USE DISORDERS 

  • Treating acute and chronic pain in patients with substance use disorders
  • Management of complicated alcohol withdrawal
  • Updates on phenobarbital for alcohol withdrawal management
  • Medication management for alcohol use disorder at discharge
  • Microdosing protocols for buprenorphine induction
  • Harm reduction: reducing the risk of opiate overdose at discharge

SYNCOPE

  • Syncope: when to worry about cardiac causes
  • Diagnostic approach to the patient with recurrent syncope
  • Evidence-based tools for risk-stratification in syncope
  • Orthostatic syncope: does midodrine help?

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