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Jose R. Maldonado, MD, FAPM, FACFE

Medical Director Psychosomatic Medicine & Emergency Psychiatric Services, Stanford University, Stanford, California

presenter photoDr. Maldonado obtained his medical degree from Ponce School of Medicine and his psychiatric training from Temple University. He joined the faculty at Stanford in 1993 and is currently an Associate Professor of Psychiatry, Medicine, Surgery, Emergency Medicine, and Law at Stanford University, where he serves as Chief of Psychosomatic Medicine. He joined ASAM in 2010; has been a member of the Academy of Psychosomatic Medicine since 1991 and Fellow since 1996. In 2012 he joined the Board of Directors of the American Delirium Society, where he helps shape educational, research and policy aspects of this condition. He served as co-Chair of the Ethics Committee at Stanford Medical Center for 10 years, and has served as neuropsychiatrist for all 6 transplant programs at Stanford. He is currently a member-at-large of SHC- Medical Executive Committee, and a member of the Medical School Senate. His research interests include: the diagnosis, neurobiology, prevention and management of delirium; psychosocial aspects of solid organ and composite tissue transplantation; and the medical use of hypnosis. Over the last 6 years, Dr Maldonado has led his research team in studying the neuropathophysiology of alcohol withdrawal syndrome and its relationship to delirium tremens. This eventually led to the development of a new tool for the prediction of patients at risk of severe AWS: the Prediction of Alcohol Withdrawal Severity Scale (PAWSS); and novel pharmacological techniques for the prophylaxis and treatment of complicated alcohol withdrawal syndromes.

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Yelizaveta Sher, MD

Clinical Assistant Professor, Stanford University, Stanford, California

Dr. Sher reeived her B.A. degree from UC Berkeley and her M.D. degree from Washington University in Saint Louis. She then completed Residency in Psychiatry and Fellowship in Psychosomatic Medicine at Stanford University Medical Center. She is currently a Clinical Assistant Professor of Psychiatry at Stanford Univerisity. Her interests include delirium, alcohol withdrawal, transplant psychiatry, and psychiatric comorbidites in patients with pulmonary disorders and lung transplant.

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Kelsey Hills-Evans, BA

Medical Student, Stanford University, Stanford, California

presenter photoKelsey Hills-Evans is a fourth year medical student who has always had a passion for addiction medicine. Kelsey served as an anti-tobacco advocate for 5 years in Colorado before she came to Stanford University for her undergraduate education. After graduation, Kelsey studied substance use and infectious disease at the Massachusetts General Hospital. She returned to Stanford University for medical school, where Kelsey is now a fourth year medical student. She plans to enter residency this summer in Internal Medicine. Her research interests include emerging substance use epidemics, risk profiles for addiction-related medical issues, and alcohol withdrawal in the hospital setting.

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Smita Das, MD, PhD, MPH

Addiction Psychiatry Fellow, University of California at San Francisco, Stanford, California

presenter photoSmita Das, MD, PhD, MPH, has been involved in addiction research many years. She is and addiction psychiatry fellow at UCSF. She was chief resident in the Department of Psychiatry and Behavioral Sciences at Stanford University School of Medicine. A native of the San Francisco Bay Area, she studied Chemistry and Statistics at Stanford, completed her Masters in Public Health at Dartmouth College, and then completed her MD and PhD in Community Health at the University of Illinois at Urbana Champaign. Throughout her training, she accumulated over 15 years of experience, starting in the year 2000, with Dr. C. Barr Taylor in studying smoking cessation methods/dissemination for hospital inpatients as well as JCAHO hospital quality measures. Currently Dr. Das’ research areas of interest are addiction-behavior, community outreach, hospital quality and development/implementation of behavioral interventions in public health. She is heavily involved in research with Dr. Judith Prochaska in the area of public health and psychiatry with a current focus in smoking, addiction and mental illness in disadvantaged youth and families. Dr. Das is very involved in education and organized psychiatry. She has received several prestigious awards and fellowships over the last two years including: The Stanford Psychiatry Miller Foundation Grant for research, The American Psychiatric Leadership Fellowship, The Association of Women Psychiatrists Leadership Fellowship, the American Psychiatric Association Resident Recognition Award, the American Academy of Addiction Psychiatry Resident Travel Scholarship funded in part by the National Institute on Drug Abuse (NIDA), and the ASAM Ruth Fox Scholarship.

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Anna Frenklach, MD

Resident, Stanford University, Stanford, California



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Sermsak Lolak, MD

Medical Director Psychosomatic Medicine, The George Washington University Hospital, Washington, District of Columbia



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Eric Neri, MS

Statisticia, Stanford University, Stanford, California



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Focus Session Track

Prediction of Alcohol Withdrawal Severity Scale (PAWSS) - Predicting Moderate-Severe Alcohol Withdrawal

4/24/2015

4:00 PM - 5:30 PM

Room: 412, Fourth Floor

Presenter(s):

Jose R. Maldonado, MD, FAPM, FACFE

Medical Director Psychosomatic Medicine & Emergency Psychiatric Services, Stanford University, Stanford, California

Author (Not Presenting)(s):

Yelizaveta Sher, MD

Clinical Assistant Professor, Stanford University, Stanford, California

Kelsey Hills-Evans, BA

Medical Student, Stanford University, Stanford, California

Smita Das, MD, PhD, MPH

Addiction Psychiatry Fellow, University of California at San Francisco, Stanford, California

Anna Frenklach, MD

Resident, Stanford University, Stanford, California

Sermsak Lolak, MD

Medical Director Psychosomatic Medicine, The George Washington University Hospital, Washington, District of Columbia

Eric Neri, MS

Statisticia, Stanford University, Stanford, California

The prevalence of alcohol use disorders among general medical units is up to 40%. Up to 20% of these patients develop symptoms associated with complicated alcohol withdrawal syndrome (AWS) including seizures and delirium tremens. AWS is associated with increased morbidity, mortality, hospital stay, costs, and worsened cognitive functioning. Thus, identification and prevention can reduce the risk of neurocognitive decompensation, medical comorbidities, and length of hospital stay. While several available tools quantify the severity of ongoing AWS, none predict subjects at risk of AWS, thus missing the opportunity for timely prophylaxis. Presenters prospectively tested and validated the Prediction of Alcohol Withdrawal Severity Scale (PAWSS), a new tool to identify patients at risk for developing complicated AWS, in a large population of medically-ill individuals. PAWSS appears to have excellent psychometric characteristics and predictive value among medically-ill in-patients, helping clinicians identify those at risk for complicated AWS and allowing for timely prophylactic treatment. The use of PAWSS will minimize the excessive use of medications in those at low risk for complicated AWS, thus minimizing undesirable side effects.