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Grand Rounds - Sep 30, 2022
"Work‐up and Diagnosis of Thyroid Disease"

Speaker: Natasa Janicic, MD, PhD. Division of Endocrinology and Metabolism, Medstar Georgetown University Hospital, Washington DC.

 

 

Objectives

  1. Incorporate an interdisciplinary approach to the diagnosis and management of patients with thyroid disease.
  2. Evaluate screening methods for thyroid disease.
  3. Recognize when to treat subclinical thyroid disease, hypothyroidism, and thyroiditis.
  4. Determine whether the incidence of thyroid disease is increasing at disproportionate rates for different races and ethnicities.

Accreditation: St. Charles Health System is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. St. Charles Health System designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)TM.

The period to claim credit for this activity expires one year after its original publication. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Claim Credit

Target Audience: Physicians, Nurses, Pharmacists, Allied Health Professionals

Accessibility/Program Questions: St. Charles Health System encourages persons with disabilities to participate in its programs and activities. If you anticipate needing any type of accommodation or have questions about the physical access provided, please contact Continuing Medical Education at [email protected].

Oher CME or Clerkship questions: also contact Continuing Medical Education at [email protected].

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A few of our clinics in Redmond have moved recently!

Now located at 655 NW Jackpine Avenue in Redmond:

  • St. Charles Anticoagulation Clinic
  • St. Charles Heart and Lung Specialists
  • St. Charles Pulmonary Clinic
  • St. Charles Sleep Center

Now located at 916 SW 17th Street in Redmond:

  • St. Charles Behavioral Health
  • St. Charles Preoperative Medicine
  • St. Charles Rheumatology

St. Charles clinics are no longer located at 244 NW Kingwood.

Also, there is no longer a St. Charles lab at 1245 NW 4th Street. Lab services are available at St. Charles Family Care, 211 NW Larch Avenue.

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The COVID-19 virus is ever-changing, and so is our collective response to the pandemic. One thing that hasn’t changed, however, is this: The best way to protect yourself against severe illness as the result of COVID-19 is to make sure you’re up to date on your vaccinations and boosters.

St. Charles has the new bivalent boosters, emergency authorized by the FDA, which provide broad protection against both the original strain of COVID-19 as well as the omicron variant. Appointments are available for those 12 and older at any St. Charles Urgent Care clinic. If our schedule doesn’t work for you, please check out the many options for vaccination in Central Oregon.

“COVID-19 vaccines available in the United States are effective at protecting people from getting seriously ill, being hospitalized, and dying,” says the U.S. Centers for Disease Control, which publishes recommendations for different age groups. “As with other diseases, you are protected best from COVID-19 when you stay up to date with the recommended vaccines, including recommended boosters.”

Here are answers to five frequently asked questions about COVID-19 boosters:

What is a bivalent vaccine? How does it work?

Bivalent COVID-19 vaccines include a component of the original virus strain to provide broad protection against COVID-19 and a component of the omicron variant to provide better protection against COVID-19 caused by the omicron variant. They are called bivalent COVID-19 vaccines because they contain these two components.

When should I get a booster? Should I wait for another surge?

The CDC recommends vaccination for everyone ages 6 months and older and boosters for everyone age 5 and older, if eligible. Children ages 5-11 are recommended to get the original (monovalent) booster, and people age 12 and older are recommended to get the updated (bivalent) booster. More information is here, and the CDC has a handy chart showing who should get what (and when) here.

With a busy holiday season on the horizon and Australia experiencing a severe flu season (which is often an indication of what’s to come in the United States), October is a great time to get up to date on your flu shot and COVID vaccines.

I recently had COVID-19. Should I get a booster?

Getting a COVID-19 vaccine after you recover from COVID-19 infection provides added protection against the virus. People who already had COVID-19 and do not get vaccinated after their recovery are more likely to contract the virus again, according to the CDC.

However, per the CDC: “You may consider delaying your vaccine by three months from when your symptoms started or, if you had no symptoms, when you received a positive test.”

Are there side effects from the booster?

Reactions reported after getting a booster are similar to those after the primary series, including fever, headache, fatigue and pain at the injection site. Most side effects have been mild to moderate, and they vary from person to person. More information is here.

Can I get a COVID-19 booster and my flu vaccine at the same time?

Yes. There is no recommended waiting time between the COVID-19 booster and the flu vaccine or any other vaccine.

 

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Hello and happy autumn! It’s a busy time of year at St. Charles, and I want to make sure you’re aware of a few things that might otherwise slip past your radar:

We’ve welcomed a new member to the St. Charles Board of Directors: Jon Bullock, a resident of Redmond and co-founder and executive director of the Redmond Proficiency Academy. Before he founded RPA, he worked as an administrator with the Redmond School District and the Bethel School District in Eugene and served as a high school teacher and coach in Corvallis and Salem. In addition to his work at the K-12 level, Jon has also taught courses at the college and university level and currently serves as a member of the Southern Oregon University Board of Trustees. He is also a former member of the Redmond City Council and the Economic Development Central Oregon board.

I am excited to have a member of the board with such extensive experience and a career-long focus on education, not to mention deep roots in Redmond. Jon joined us to help St. Charles as we work to ensure the people of Central Oregon get the care and support they need and deserve.

"Access to high-quality, affordable health care is essential for our community,” he said. “Serving on the St. Charles Board of Directors provides the opportunity to directly and positively influence our community's future.”

Please join me in welcoming Jon to the board and thanking him for his service!


Being up to date on your COVID-19 vaccinations and boosters is still the best way to protect yourself against severe illness and hospitalization as a result of the virus, and experts say October is a great time to get the booster (and a flu shot, too). St. Charles has the new bivalent boosters, which are emergency authorized by the FDA. Appointments are available for those 12 and older at any St. Charles Urgent Care clinic. If our schedule doesn’t work for yours, please check out the many options for vaccination in our community.


At St. Charles, we are cautiously returning to in-person events and, like you, enjoying spending more time with others – both in our facilities and in the communities we serve.

In recent weeks, our caregivers have attended the Bend Health Fair, the Latino Fest in Madras and Prineville and the Jefferson County Senior Center Health Fair, with more stops on the horizon. If you’re out and about and you see our blue tent or tablecloth, please stop by and say hi!

This Sunday you’ll find many of us at St. Charles Foundation’s annual 5K run/walk fundraiser, Heaven Can Wait, which returns to an in-person format after two years as a virtual event. Heaven Can Wait raises money for Sara’s Project, which provides education, early detection and support services to ease the challenges of breast cancer for people in Central and Eastern Oregon. And this year, the event moves to Redmond! It’s a fun time for a good cause and a celebration of life, survivorship and those who have passed on.


Finally, you may have noticed the American flag flying at half-mast at our hospitals in Bend, Madras, Prineville and Redmond. We lowered them to show our respect for Atwai Wasco Chief Alfred Smith Jr., who passed away earlier this week. St. Charles Health System sends its heartfelt condolences to his family and the Confederated Tribes of Warm Springs.

Sincerely,
Steve

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After two years of limited travel because of COVID-19, Americans are getting back to going overseas.

And in St. Charles’ new Infectious Disease (ID) clinic, Central Oregonians have a trusted and robust resource to help them stay healthy and safe during international travel.

The clinic is staffed by two infectious disease specialists: Dr. Cynthia Maree, who helped oversee St. Charles’ COVID-19 response, and Dr. Laura Selby, who is new to the health system. Selby’s arrival earlier this year allowed the health system to expand its ID program and open a dedicated clinic.

The physicians’ duties include managing complex infections for pre- and post-operative patients, hospital inpatients, immunocompromised people and others, as well as caring for patients with HIV, hepatitis, tuberculosis and sexually transmitted diseases. Additionally, they are available for consultation about medications, vaccinations and other health and safety issues for people traveling out of the country. (Traveling families are welcome at the clinic, too.)

“A lot of doctors are capable of doing pre-travel assessments,” Selby said. “But as ID specialists, we’re actually trained in pre- and post-travel counseling, diagnosis and treatment, from immunization to just-in-case prescriptions for diarrhea to fever evaluation after you return.”

Travel to Africa, Asia, South America and Central America comes with specific travel medicine recommendations, Selby said. People going to those areas of the world should see an ID physician before they travel – ideally four to six weeks before departure, though Selby said they will see people who are closer to their travel date.

If you are traveling and are unsure if you need a travel medicine consult, you can call the clinic for guidance, Selby said.

“We don’t just talk about infectious diseases,” she said. “We also discuss topics such as water and altitude safety. We look at embassy recommendations and make sure people are aware of any potential health or safety concerns in the country they’re visiting.”

The clinic can provide a number of commonly needed preventive drugs such as malaria prophylaxis, as well as an array of vaccines, including yellow fever, typhoid, hepatitis, influenza and COVID-19.

The pandemic did not spur St. Charles to launch the clinic, but the timing is fortuitous, Selby said.

“Most travel was on hold for the past couple of years, but people are traveling again and I think there’s a need for this kind of service – especially having providers who are trained to manage post-travel concerns. I think that’s a big plus,” she said, “and it’s exciting to offer this to the people of Central Oregon.”

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When looking for information about a topic, or even just browsing the internet, it's always a good reminder to evaluate the resources we run into to make sure we can trust them. The International Federation of Library Associations and Institutions (IFLA) published some practical recommendations that can help in the process. Here is what we need to check:

  • Who is the source?
  • Who is the author?
  • What is there beyond the title or the headline?
  • Does it reference other sources?
  • Is it current?
  • Is it serious?
  • Are you being objective?

You can see the complete resource below: 

 

Citation: 

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Grand Rounds - Sep 23, 2022
"Lessons from the Cockpit"

Speaker: Robert Stephenson. Military Pilot.

 

 

Objectives

  1. Build upon medical professionals' teamwork and crisis management skills by applying 'best practices' utilized in aviation.
  2. Equip medical professionals to analyze medical mishaps with techniques applied during aviation accident investigations.
  3. Enable medical professionals to identify hazards, mitigate risk, and prevent mishaps based on lessons learned and existing programs in aviation.
  4. Draw a direct correlation between medical and aviation professionals concerning human error and teamwork performance.
  5. Identify areas for improvement in the medical profession for teamwork, risk management, and mishap prevention.

Accreditation: St. Charles Health System is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. St. Charles Health System designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)TM.

The period to claim credit for this activity expires one year after its original publication. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Claim Credit

Target Audience: Physicians, Nurses, Pharmacists, Allied Health Professionals

Accessibility/Program Questions: St. Charles Health System encourages persons with disabilities to participate in its programs and activities. If you anticipate needing any type of accommodation or have questions about the physical access provided, please contact Continuing Medical Education at [email protected].

Oher CME or Clerkship questions: also contact Continuing Medical Education at [email protected].

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Grand Rounds - Sep 16, 2022
"Aspirin for Primary Prevention"

Speaker: Matt Budoff, MD, FACC. Professor of Medicine, Director, Cardiac CT, Program Director, Division of Cardiology, Harbor-UCLA Medical Center, Torrance CA.

 

 

Objectives

  1. Review primary prevention trials for aspirin.
  2. Evaluate benefit-risk balance for aspirin in primary and secondary prevention.
  3. Discuss guideline recommendations.

Accreditation: St. Charles Health System is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. St. Charles Health System designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)TM.

The period to claim credit for this activity expires one year after its original publication. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Claim Credit

Target Audience: Physicians, Nurses, Pharmacists, Allied Health Professionals

Accessibility/Program Questions: St. Charles Health System encourages persons with disabilities to participate in its programs and activities. If you anticipate needing any type of accommodation or have questions about the physical access provided, please contact Continuing Medical Education at [email protected].

Oher CME or Clerkship questions: also contact Continuing Medical Education at [email protected].

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As the pandemic evolves, St. Charles updates COVID-19 vaccination policy for health care workers  

Unvaccinated health care workers who apply for and receive a medical or religious exception from the state’s vaccine mandate can provide patient care if they wear a N95 respirator 

St. Charles Health System is now allowing unvaccinated people who apply for and receive a medical or religious exception to the state’s vaccine mandate to work in a health care setting if they wear a N95 or higher filtering respirator—or other reasonable accommodation to the extent applicable—while providing direct care. 

“With the use of this type of personal protective equipment, we believe we are taking reasonable steps to ensure unvaccinated providers and staff are protected from contracting and spreading COVID-19 to coworkers, patients and visitors in a manner consistent with state and federal mandates,” said Joan Ching, St. Charles’ chief nursing executive.  

When unvaccinated employees are in a St. Charles health care setting but are not rendering direct patient care, they will be expected to wear a medical grade procedure mask. Masks can be removed to eat in a break room, but physical distance of 6 feet or more is expected to be maintained. 

St. Charles’ infectious disease subject matter experts—who convene regularly to review the latest scientific literature and the organization’s internal policies—recently concluded that because of  

revised CDC guidance, the prevalence of COVID-19 in the community, the severity of the current strains of COVID-19, availability of personal protective equipment, COVID-19 treatment options and immunity levels in the community, the health system could make reasonable accommodations that allow unvaccinated people who apply for and receive a medical or religious exception to work in a St. Charles health care setting. 

“As the pandemic evolves, it is important that St. Charles evolve with it,” Ching said. “We believe we’re now in a place where we can reasonably allow unvaccinated people to work in a health care setting—without putting others at significant risk—if they wear a N95 respirator.” 

Unvaccinated people who were previously granted an exception but could not be reasonably accommodated in a St. Charles health care setting are invited to apply for available positions for which they are qualified. St. Charles will use its regular hiring practices to assess re-employment as well as wages and benefits for successful candidates. New candidates interested in working for St. Charles who are not fully vaccinated against COVID-19 will be given the opportunity to apply for a medical or religious exception as allowed by the Oregon state mandate, which remains in effect.  

“To be clear, we believe staying current on your vaccination series remains the very best way to protect yourself from the virus,” said Dr. Cynthia Maree, medical director of infection prevention. “The data tell us that staying current on recommended boosters prevents infection, severe disease and death. The bivalent COVID-19 vaccine is now available and is designed to provide broad protection against the Omicron variant. We strongly encourage people to talk to their health care provider about receiving it.” 

About St. Charles Health System 

St. Charles Health System, Inc., headquartered in Bend, Ore., owns and operates St. Charles Bend, Madras, Prineville and Redmond. It also owns family care clinics in Bend, La Pine, Madras, Prineville, Redmond and Sisters. St. Charles is a private, not-for-profit Oregon corporation and is the largest employer in Central Oregon with more than 4,500 caregivers. In addition, there are more than 350 active medical staff members and nearly 200 visiting medical staff members who partner with the health system to provide a wide range of care and service to our communities. 

 

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Grand Rounds - Sep 9, 2022
"Utility of Psychedelics for Palliative Care and the Treatment of End‐of‐Life Existential Distress"

Speaker: Anthony P. Bossis, MD, PhD. NYU Grossman School of Medicine.

 

 

Objectives

  1. Identify factors and symptoms in existential and psycho-spiritual distress in palliative and end-of-life care.
  2. Recognize the importance of meaning and transcendence in end-of-life distress and psychedelic research.
  3. Describe the characteristics of mystical experience; summarize the scientific findings from current psilocybin cancer anxiety research.
  4. Identify clinical implications from psychedelic research for palliative / hospice care.

Accreditation: St. Charles Health System is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. St. Charles Health System designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)TM.

The period to claim credit for this activity expires one year after its original publication. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Claim Credit

Target Audience: Physicians, Nurses, Pharmacists, Allied Health Professionals

Accessibility/Program Questions: St. Charles Health System encourages persons with disabilities to participate in its programs and activities. If you anticipate needing any type of accommodation or have questions about the physical access provided, please contact Continuing Medical Education at [email protected].

Oher CME or Clerkship questions: also contact Continuing Medical Education at [email protected].

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