Texas Club of Internists

Fall Clinical Meeting October 4-9, 2014

The Nines Hotel Portland, Oregon

CME jointly sponsored by Oregon Health & Science University and the Texas Club of Internists TCI Fall Clinical Meeting

President’s Welcome Message Leighton and I are excited that you will be joining us in Portland, Oregon this fall. We have spent a week there each of the last two summers, and have come to love this city. We know you will enjoy the trip to Mt. Hood on Sunday: we watched people skiing there in July! And we don’t think the club has ever offered a short hike as part of the Sunday outing. But that’s optional, and shops in Hood River await the more urban members. Of course we get to visit the Willamette Valley for wine tasting, and that will take place on Tuesday. Make special note of the options for wineries, as you may want to experience some others before or after the meeting. While some of the places we would have liked to visit wouldn’t take large groups during harvest season, you may be able to drop in on your own. We also hope you have an extra day or two to enjoy the amazing Oregon coastline. OHSU is excited about our group. The CME department tells us they never had such a willing group of speakers as for this meeting. If you get the chance, take the aerial tram up to the campus. It’s spectacular. We have an out-of-sight band for Wednesday night. Check out Hit Machine if you are so inclined and bring your dancing shoes! It’s gonna be a great ride! All our best, Teresa Godbey & Leighton Clark Portland Facts • Portland is the birth place of Wiki. • The rum and fruit juice drink mai tai was created in 1944 by Vic Bergeron, owner of Portland tiki bar and restaurant, TraderVic’s. • One of many Portland nicknames is Stumptown, named after the City’s quick and early growth when trees were cut but their stumps were often left in the middle of new streets. Local residents often jumped from stump to stump to make their way along muddy, unpaved streets. • “Portland is one of the few destinations outside of France where you can take your dog into pubs.” • Tom McCall (former Portland resident, Oregonian journalist and Governor,) signed the Oregon Bottle Bill (1971), the first legislation of its kind in the U.S. It requires cans, bottles, and other carbonated beverages -- plus water since 2009 -- sold in Oregon to be returnable and refundable. • You can quench your thirst downtown with public drinking fountains called Benson Bubblers. They were originally donated to Portland by a lumberman who hoped to provide a drinking alternative to taverns. • The city of Portland won its name from a coin toss between Francis Pettygrove, from Portland, ME; and Asa Lovejoy, from Boston, MA. Our fair town could’ve been named Boston, Oregon. It doesn’t have the same ring to it, does it? • Portland is a favorite movie and television back drop for several films and series. Oregon film history includes Untraceable (2008), Twilight (2008), Wendy & Lucy (2007), Paranoid Park (2006); and television shows Portlandia, Leverage, and Grimm. • Portland was named the second best foodie town in the U.S. in a 2010 study. This Northwest city also boasts a high amount of community supported agriculture and has “the largest number of vegetarian and vegan options for diners.” • The explosion of local mobile kitchens -- or food carts as they’re commonly known -- has branded Portland with a national reputation for being “food-truck crazed.” • Portland still has the remnants of its Wild West past -- Horse Rings are all over the city...yes, the ones you tie a horse to! • There is a long and vibrant underground hip-hop, techno and house music scene in Portland. • In 2001, Portland introduced the first modern streetcar in North America, becoming a model for cities all over the country...In the 1920s, Portland had the third largest narrow gauge electric rail system in the [U.S.]. The streetcar lines formed many streets and neighborhoods that still exist today. October 4-9, 2014

Airports Amenities and Oregon has six dynamic airports, each consisting of many terminals: Portland Accommodations (PDX), Eugene (EUG), North Bend (OTH), Medford (MFR), Pendleton (PDT) Taking our cue from the rich history and and Redmond (RDM). historic customer service of this legendary destination, the Nines offers an array of Transportation from the airport to The Nines hotel. exceptional services and amenities in the heart of downtown Portland. Our expert concierge PDX – 20 minutes team looks forward to unfolding the city before EUG – 2 hours you by arranging any number of excursions OTH – 3 hours and 45 minutes to nearby restaurants, theaters, and more. MFR – 4 hours Our international newspaper delivery service, PDT – 3 hours NewspaperDirect, and the luggage transport RDM – 3 hours service, Luggage Liaison, provide a seamless travel experience. Hotel Information **The hotel is close to selling out. Please call Laura if you need A pristine fitness facility invites you to assistance with your reservation. Also, if you have made a reservation explore and indulge in a fitness routine but no longer need it, please call Laura before cancelling your reservation morning and night, and when it’s time to work with the hotel** complimentary High Speed Internet Access is available throughout the hotel to get you The Nines connected in no time. 525 SW Morrison • Fitness Center - Shape your own Portland, Oregon 97204 masterpiece with our LifeFitness® by Bally cardio equipment, including five LifeFitness Toll Free Telephone: 1-888-627-7208 Treadmills, five EFX, two Summit Trainers and three bikes. Professional-grade free Room Reservation Deadline: weights, a dedicated stretching area and September 12, 2014 the most current fitness accessories complete the experience. Chris Horbecker’s Room Rates stirring “Adonis” photography collection $239 for run of house adorns the walls of our 24-hour fitness facility, inspiring guests with images of the $289 for the club level physique as a rolling landscape. Access is complimentary, along with earphones, towels, fruit infused water, magazines and newspapers. Personal training sessions are Room cancellation policy: Rooms must be cancelled 72 hours prior to arrival. available upon request. Those cancelled afterwards will incur a fee of one night’s room plus • Business Center applicable taxes. • Luggage Liaison Ideally situated next to Portland’s • Celebration of Fine Art Pioneer Square and the MAX • The Luxury Collection Concierge light rail, the Nines rests atop the landmark Meier & Frank Building and • NewspaperDirect is a contemporary homage to the • Internet Access structure’s storied past both in its striking décor and impeccable service. • Environmental Practices Check In/Out Times: Check in – 3:00 pm Check out – 12:00 pm TCI Fall Clinical Meeting

Local Attractions within Walking Distance: Attraction Distance Portland Art Museum ...... 0.1 km/0.1 miles Oregon Museum of Science & Industry...... 3.2 km/2.0 miles Chinese Garden ...... 1.6 km/1.0 miles Arlene Schnitzer Concert Hall ...... 0.1 km/0.0 miles Tom McCall Waterfront Park ...... 0.1 km/0.1 miles Keller Auditorium ...... 0.2 km/0.1 miles Rose Quarter ...... 1.6 km/1.0 miles Washington Park ...... 4.8 km/3.0 miles Powell’s Bookstore ...... 0.1 km/0.1 miles Fifth Avenue Shopping ...... 0.2 mile Accreditation This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Ac- creditation Council for Continuing Medical Education (ACCME) through the joint providership of OHSU School of Medicine and the Texas Club of Internists. The OHSU School of Medicine, Division of Continuing Medical Education is accredited by the ACCME to provide continuing medical education for physicians.

Credit OHSU School of Medicine, Division of CME, designates this live activity for a maximum of 16.75 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit Restaurants and Bars commensurate with the extent of their participation in the activity. Escape everyday life with two unique dining experiences right in the hotel: Urban Farmer Steakhouse and Departure The lecture titled “Changing the Conventional Wisdom Restaurant + Lounge. Urban Farmer delivers the best of & Algorithms of Pulmonary Embolus” on Wednesday, Oct. 8th Northwest farms to your table including the best variety of will count as 1 hr of Ethics. beef options in a farmer chic atmosphere located in the 8th floor atrium lobby. Departure elevates your experience offering fantastic rooftop city views and Modern Asian cuisine in a futuristic setting evoking different images of travel. Questions? • Departure Restaurant + Lounge - Located atop the Nines, Departure is an escape from the ordinary, a journey into Contact the TCI Business Office: sophisticated surroundings with innovative Modern Asian cuisine and breathtaking city views. 401 W. 15th Street, Austin, TX 78701 • Urban Farmer Steakhouse - Urban Farmer redefines the Phone: (512) 370-1553 | Fax: (512) 370-1626 modern steakhouse with a menu and beverage program Laura Madole, Executive Director: focused on local and sustainable offerings in a uniquely sophisticated farmhouse setting. [email protected] • The Library - The Library, adjacent to Urban Farmer in the Amanda Rivera, Membership Coordinator lobby, is the ideal venue for guests to host private parties, [email protected] play a game of pool or enjoy a quiet cocktail. October 4-9, 2014

Sunday, October 5, 2014 Beauty and Bounty of Oregon Tour – Timberline at Mt. Hood & The Columbia River Gorge

Time: 9:00 a.m. – 5:30 p.m. Option A cost per person: $185 Option B cost per person: $195 *Space on each tour is limited so please be sure to sign up quickly! OPTION A: 9:00 a.m. Depart the Nines Hotel 10:30 a.m. Timberline Lodge – Lunch, tour & free time to explore 1:15 p.m. Hood River Fruit Loop Farm Stand, Shopping in the town of Hood River, Multnomah Falls 5:30 p.m. Return to Hotel

Enjoy a scenic drive to Mt. Hood, Oregon’s tallest volcano at 11,245 feet. The group will tour the famous National Historic Landmark, Timberline Lodge, with astonishing vistas from 6,000 feet overlooking both the Willamette Valley and Central Valley, including views of other volcanos in the Cascade mountain chain. After the fantastic tour, the group will be invited to a special lunch that is centered around an open fire pit for a traditional Native American Salmon Bake.

After lunch, the group will pass through the Oregon fruit loop region and visit one of the local farms known for famous pears, apples, cherries and more. The historic town of Hood River is the next stop for a little shopping and browsing through this charming town known as the “Windsurfing Capital of Oregon” and possibly the world!

The tour loop continues westbound through the Columbia River Gorge with a stop at Multnomah Falls, the second highest year-round waterfall in the United States! You will enjoy spectacular views every inch of the way along the Columbia River. We will return to Portland by 5:30 p.m. to complete this tour and an unforgettable NW adventure! OPTION B: This adventurous group will follow the same itinerary above, except after the fruit stand a hiking excursion will be included. The group will hike one of the must-do easy hikes in the Gorge, the Wahclella Falls Trailhead. On this hike the group will start with a flat walk, pass the Bonneville Fish Hatchery, see Munra Falls and then hike quite a bit up the east side of the canyon. You’ll then continue on to Wahclella Falls, one of the more interesting falls in the gorge. 2:30 p.m. Hike 4:00 p.m. Multnomah Falls: Visit the falls, gift shop, visitor center 5:30 p.m. Return to Hotel TCI Fall Clinical Meeting

Finally, everyone will be guided on a tasting from 5 unique food Monday, October 6, 2014 carts/restaurants while touring this creative neighborhood. Each food experience is selected for its quality and creativity. Portland Feeding the Senses – City Tour Portion sizes will be such that all guests can enjoy each dish, and Neighborhood Foodie Tour and the total samplings will be enough to be considered a size- able lunch. After everyone’s bellies are happily full, the group will head back to the Nines hotel. Time: 9:30 a.m. – 3:30 p.m. Cost per person: $170 Tuesday afternoon, October 7, 2014 Get ready for a morning filled with all things “Portland!” To start things off right, the group will be greeted with the famous Voodoo Doughnuts as they board the private motor coach. Willamette Valley Wine Tour

The first stop today will be the famous Rose Gardens. With Time: 11:45 a.m. – 5:30 p.m. Portland’s 550 different varieties of roses, beautiful Washing- ton Park features some of the most amazing Cascade Moun- Cost per person: $195 tain views around. Take a stroll through one of Portland’s most notable and famous landmarks and enjoy a natural and green The Willamette Valley is known as the center of the Oregon environment in the middle of the city. wine industry and features some of the best Pinot Noirs anywhere. Our wineries are approachable and intimate; we are The second stop on the a place where owners and winemakers still enjoy connecting tour will be to the 5.5 acre with their guests creating truly unique and special memories. Japanese Garden. This On the drive out to the wineries, a wine enthusiast and friendly garden is composed of guide will discuss the Oregon wine region and why it is such five distinct garden styles. a special place, producing wonderfully complex, nuanced and Three of the essential subtle Pinot Noirs. The TCI will have a chance to experience elements used to create first-hand what the fuss is all about. a Japanese garden are stone - the “bones” of October is the peak of harvest season and is an exciting the landscape; water - the time in the vineyards. To create a truly intimate Oregon wine life-giving force; and plants experience, the group will use three different motor coaches, - the tapestry of the four each heading to a separate winery*. Upon arrival at each of the seasons. After a guided vineyards, the groups will have the opportunity to tour, taste tour the group will head and be educated on the local wine making process. out to the next adventure. After this winery experience, all groups will head to the Ribbon As the group moves through the city, the guide will share many Ridge AVA on the outskirts of Newberg. There, the TCI will facts that even local residents are surprised to hear. The expert enjoy a hand-picked selection of boutique small-production guide will educate all on Portland’s early history and how that wines (and their wine-makers, most of whom reside in this history helped shape one of the most livable cities in America small, coveted region of Oregon Wine Country). The setting with its many parks, rich artwork and clean public transporta- of this enjoyable tasting excursion takes place at the newest tion. The group will understand why the City of Roses is voted winery on Ribbon Ridge, Claygate Estate. Here, the group as one of the most livable cities in America. can take in the rural landscape, stroll the vines or enjoy live music and gourmet bites in the large event space/arena The final stop will take everyone to the historic Mississippi Ave- (covered since Oregon tends to surprise us all)! Wood-fired nue where taste buds will come alive! This hip neighborhood is ovens will cook gourmet pizzas for the group to enjoy during well known for its culinary pleasures. Portland is hailed as one this unforgettable afternoon in the Oregon Wine Valley. This of the best places for street food and this group will have the experience will introduce guests to an “off the beaten path” opportunity to be guided through a sampling that will introduce look at Oregon Wine Country, several of its boutique wine- Portland’s vibrant food scene and the unique history of Mis- makers, and an estimated 15-20 wines that can’t be found sissippi Avenue. Mississippi Avenue Shopping and Restaurant anywhere else but here on Ribbon Ridge. District has a culture all its own, combining originality, variety and excellence with style and energy. Almost every business *Everyone will have the opportunity to sign up for one of is locally owned and operated, making it a welcome break from these three individual wineries on-site at the See Who’s Here corporate fare found elsewhere. reception, on a first come, first served basis. October 4-9, 2014

you with a perfect pairing of cheese, chosen by our local cheese purveyor. The progressive experience at Penner-Ash Wine Cellars will leave the guests with a more intimate knowledge of the area, the vineyard, the architecture, and the history of our winemaker, Lynn Penner-Ash.

The individual wineries will include: Ponzi Vineyards Set atop a northwest facing Chehalem Mountains slope, the state of the art winery and modern tasting room are surrounded by the majestic Avellana Vineyard. The Progressive Tour & Tasting offers our guests the opportunity to explore the four level, gravity flow winery and witness the process from vine to bottle. Our representative of the winery will lead you through Sokol Blosser Winery our viticulture and oenology practices in this fun, informative 45 When Bill Blosser and Susan Sokol Blosser planted their minute tour. We will taste current Ponzi wines along the way first vines in 1971, they needed all of their youthful self- from the crush pad to the barrel room. Concluding the tour, confidence, energy and determination to make their way, you will have the opportunity to enjoy our modern new tasting because there was no wine industry in Oregon. Today, with room featuring fireside seating, a covered terrace and bocce ball over 400 wineries and more than 19,000 acres of vineyards, courts. Panoramic views of the vineyard and valley will complete Oregon wines are appreciated throughout the world. Sokol this elevated experience at Ponzi Vineyards. Our hope is you Blosser has survived, grown and prospered as a family-owned will leave with a better understanding and appreciation for the and certified organic vineyard and world-class winery. Upon dedication and commitment that goes into each of our bottles of arriving, our group will be broken into two separate groups. wine, as well as learn more about the inspiring story of the Ponzi Weather permitting, we will be taken on an brief tour of the family, one of the founding Oregon wineries. estate with preset wine stations. We will have the opportunity to check out some of the first vines ever planted in Oregon, learn about distinctive soil types, see newly planted vines, and Penner-Ash Wine Cellars discover the history of the Oregon wine industry. The tour of Penner-Ash Wine Cellars will begin on the patio with amazing views of the Chehalem Valley right at the apex of multiple AVAs. We will discuss the differences of these AVAs and begin our first progressive pour. You will be visiting the winery during the hustle and bustle of harvest, and will have the opportunity to see our sorting line, and fermentation deck in full spin. You will enjoy a different tasting of Penner-Ash Wines, become educated about our vineyard, our philosophy of winemaking, and we will also discuss our choice of becoming LIVE certified in our vineyard as well as our beautifully designed building. With each pour of wine, we will provide TCI Fall Clinical Meeting

Full Meeting Schedule TUESDAY, OCTOBER 7 7:15 a.m. Continental Breakfast SATURDAY, OCTOBER 4 8:00 a.m. Drug Interaction Update 2014 6:30 p.m. See Who’s Here and New Member Welcome Ali Olyaei, PharmD Reception at The Nines Hotel 9:00 a.m. Contraception for Women with Chronic Medical Conditions SUNDAY, OCTOBER 5 Paula Bednarek, MD

9:00 a.m. Tour departs for the Beauty and 10:00 a.m. BREAK Bounty of Oregon tour 10:15 a.m. New Cholesterol Treatment Guidelines – What the LDL Are We Supposed to Do Now? MONDAY, OCTOBER 6 Michael Shapiro, DO

7:15 a.m. Continental Breakfast 11:15 a.m. ADJOURN

7:50 a.m. Welcome/Introduction 11:15 a.m. Quick Lunch at the hotel Elizabeth Bower, MD, MPH 11:45 a.m. Load Buses and Depart for Oregon Wine 8:00 a.m. Solving Medical Mysteries: Hidden Stresses and Valley Tour Unexplained Symptoms David Clarke, MD WEDNESDAY, OCTOBER 8 9:00 a.m. New Anticoagulants – For Who and For Who Not Thomas DeLoughery, MD 7:15 a.m. Continental Breakfast

10:00 a.m. BREAK 8:00 a.m. Management of Cirrhotic Patients Atif Zaman, MD, MPH 10:15 a.m. Office Evaluation of Running Injuries James Chesnutt, MD 9:00 a.m. Changing the Conventional Wisdom & Algorithms of Pulmonary Embolus 11:15 a.m. Most Common Pulmonary Consults Marc Gosselin, MD Gopal Allada, MD 10:00 a.m. BREAK 12:15 p.m. LUNCH 10:15 a.m. Prostate Cancer 2014 1:00 p.m. Osteoporosis 2014 - Breaking News Tomasz Beer, MD Robert Klein, MD 11:15 a.m. Oral Lesions 1:45 p.m. Cervical Cancer Screening: Pap Update Lynne Morrison, MD Michelle Berlin, MD, MPH 12:15 p.m. LUNCH 2:45 p.m. BREAK 1:00 p.m. The Difficult Patient: Personality Issues in Medicine 3:00 p.m. Update in Hypertension Pritham Raj, MD Raghav Wusirika, MD 2:00 p.m. Axial Spondyloarthritis: Why Should an 4:00 p.m. Rehabilitation Concepts for Low Back Pain Internist Care? Janelle Trempe, PT Atul Deodhar, MD

5:00 p.m. ADJOURN 3:00 p.m. ADJOURN

5:30 p.m. Board Meeting 6:30 p.m. Dinner Dance Reception

7:00 p.m. Board Dinner 7:30 p.m. Dinner Dance October 4-9, 2014

Faculty List Faculty All faculty are from the School of Medicine, Michael Shapiro, DO Oregon Health & Science University. Assistant Professor of Medicine (Division of Cardiovascular Medicine) and Director of Cardiac MRI & CT Lab Gopal Allada, MD Clinical Associate Professor of Medicine (Division of Pulmonary Janelle Trempe, PT, ATC & Critical Care Medicine) Division of Orthopedics & Rehabilitation

Paula Bednarek, MD Raghav Wusirika, MD Assistant Professor of Obstetrics & Gynecology Assistant Professor of Medicine (Division of Nephrology & Hypertension) Tomasz Beer, MD Professor of Medicine (Division of Hematology & Oncology) Atif Zaman, MD, MPH Professor of Medicine (Division of Gastroenterology & Michelle Berlin, MD, MPH Hepatology) Associate Professor of Obstetrics & Gynecology; and Co-Director, Center for Women’s Health Planners James Chesnutt, MD Clinical Associate Professor of Orthopedics & Rehabilitation Elizabeth Bower, MD, MPH Associate Professor of Medicine (Division of General Internal David Clarke, MD Medicine & Geriatrics) Affiliate Assistant Professor of Medicine (Division of Gastroenterology & Hepatology); Assistant Director, OHSU Leslie Doering Center for Ethics Administrative Director, Division of Continuing Medical Education Thomas DeLoughery, MD Professor of Medicine (Division of Hematology & Medical Oncology); Professor of Pediatrics

Atul Deodhar, MD Professor of Medicine (Division of Arthritis & Rheumatic Diseases)

Marc Gosselin, MD Associate Professor of Diagnostic Radiology

Robert Klein, MD Professor of Medicine (Division of Endocrinology, Diabetes & Clinical Nutrition)

Lynne Morrison, MD Associate Professor of Dermatology

Ali Olyaei, PharmD Professor of Medicine (Division of Nephrology & Hypertension) and Pharmacology and Professor, Department of Pharmacy Practice, Oregon State University College of Pharmacy, Corvallis, OR

Pritham Raj, MD Assistant Professor of Medicine (General Internal Medicine & Geriatrics) TCI Fall Clinical Meeting

Important Deadlines:

Meeting Registration Deadline: September 12, 2014 Hotel Room Reservation Deadline: September 12, 2014

Save the date! TCI Spring Business Meeting March 5-7, 2015 The Fairmont Hotel Dallas, TX

Dallas, Texas

Arboretum Save the date! TCI Fall Clinical Meeting October 10-15, 2015 The Ritz Carlton New Orleans, LA

Ritz Carlton, New Orleans

Swamp Tours

Commander’s Palace Texas Meeting Registration Form October 4-9, 2014

The Nines | Portland, Oregon Meeting Registration Deadline is September 12, 2014

Name: First Middle Last Designation Preferred Badge Name:

Preferred Mailing Address: This is my q home q business address City State Zip

Phone Fax Email Will your spouse be coming to Portland? q yes q no Spouse Name: Email

Will you have children or guests at the meeting? q Yes [ # Children; ages ] # Guests q No

Additional children/guest(s) name(s) for badges: q Special diet needs: q vegetarian q food allergies: q In accordance with the American with Disabilities Act, please check here if you have any special needs. Specify:

MEETING REGISTRATION # OF PEOPLE AMOUNT DUE Active, Senior Active, Honorary @ $200 per person $ Inactive & Emeritus @ $850 per person $ Member’s Spouse (only if attending for CME) @ $500 per person $ Printed Syllabus @ $50 each $ *Everyone will receive a complimentary USB syllabus. Total Due for Meeting Registration ...... $ Intended Meal Attendance Monday, 10/6 q Breakfast q Lunch Tuesday, 10/7 q Breakfast q Lunch (spouses going on the tour are welcome) Wednesday, 10/8 q Breakfast q Lunch

SOCIAL ACTIVITIES # OF PEOPLE AMOUNT DUE Welcome Reception (Saturday, 10/4) Member + 1 Guest @ $0 per person $0.00 Additional Guests @ $40 per person $ Sunday Tour Option A @ $185 per person $ Sunday Tour Option B @ $195 per person $ Monday Tour @ $170 per person $ Tuesday Tour @ $195 per person $ Dinner Dance at The Nines (Wednesday, 10/8) Member + 1 Guest @ $0 per person $0.00 Additional Guests @ $100 per person $

Total Due for Social Activities ...... $

TOTAL DUE WITH REGISTRATION FORM ...... $

PAYMENT BY: q MASTERCARD q VISA q DISCOVER q CHECK # CARD HOLDER’S NAME ON CARD: CARD NUMBER: EXPIRATION DATE: AUTHORIZED SIGNATURE: Please note: This charge on your credit card statement will appear as “Texas Medical Society” as the TCI uses the TMA credit card services. Due to an increase in credit card fees, the TCI will now charge a 2% surcharge for all credit cards used for payments. Please return this form along with payment to: TCI, Attn: Laura Madole, 401 W. 15th Street, Austin, Texas 78701-1680; Phone: (512) 370-1553; Fax: (512) 370-1626; Email: [email protected] presorted first-class mail U.S. Postage PAID Austin, Texas Permit No. 1787 401 West 15th Street Austin, TX 78701

Texas Club of Internists Fall Clinical Meeting October 4-9, 2014 The Nines Hotel Portland, Oregon

CME jointly sponsored by Oregon Health & Science University and the Texas Club of Internists