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Department of Medicine

Acclaimed as one of the premier medical departments in the country, physicians in the Department of Medicine have achieved international recognition for pioneering research and important clinical applications. A number of physicians in this Department have received prestigious National Institutes of Health (NIH) grants supporting both clinical and basic research programs. Research and referral areas in the Department's thirteen divisions include:

Division of Allergy and Clinical Immunology

• Allergic and other Immune Mediated Disease Problems. Difficult diagnostic and therapeutic problems, including:
• Allergic and other types of rhinitis
• Asthma
• Breast implants and autoimmunity
• Chronic urticaria and angioedema
• Drug reactions
• Immunologic assessment (T and B cells, complement, etc.)
• Immunologic deficiencies
• Immunologic pneumonitis
• Systemic vasculitis
• Tissue typing (histocompatibility testing)
• Recurrent miscarriage and failed IVF

Division of Cardiology

• Comprehensive cardiac evaluation through The Heart Center. The hallmarks of our center are our nationally recognized programs which offer comprehensive cardiac care for adults. These services range from noninvasive diagnostic evaluation to interventional treatments such as electrophysiology studies, cardiac catheterization and angioplasty.
• Treatment of Heart Failure. This program which was started in 1991 is aimed at the advanced treatment of patients with heart failure and heart muscle degeneration. We are recognized as one of the leading facilities in the world offering access to investigational drug therapies and diagnostic techniques not available to other medical centers.
• Heart Transplantation Program. This program is one of the most successful transplant programs in the United States with one of the best survival statistic rates. The Heart Transplant program is run jointly with the Heart Failure program in order to provide the most comprehensive care possible to patients with heart failure and heart muscle disease.

Division of Clinical Pharmacology and Toxicology

• Drug Toxicity. Diagnosis and management, including drug screens, drug analysis and clinical management of overdoses and poisonings.
• Hypertension. Management of refractory and secondary forms of hypertension.
• Drug Research. Development and testing of new pharmacologic agents, preclinical through Phase IV. Design, execution and monitoring of clinical trials. Pharmacokinetics of antiviral and antifungal agents. Development of stereoselective drug separation.
• Implant of fetal brain tissue for treatment of Parkinson's disease.
• Autonomic Dysfunction. Diagnosis and management of autonomic dysfunction causing chronic orthostatic hypotension.
• Therapy for HIV Infection.

Division of Endocrinology

• Thyroid. Nationally recognized referral center for thyroid diseases including hyperthyroidism, hypothyroidism, thyroid nodules, thyroid cancer, and techniques of fine needle aspiration.
• Pituitary Disorders. Nationally recognized referral center for provocative testing, diagnosis, medical and surgical management.
• Diabetes. Center of Excellence in collaboration with the Barbara Davis Center for Childhood Diabetes. Patient management and research for all adults with diabetes. Specialty is in patient education and prevention focusing on glucose control, disease process, foot care, and screening and prevention of cardiovascular disease, renal disease, retinopathy and neuropathy.
• Hyperlipidemia.Nationally recognized referral center for the Lipid Clinic. Diagnosis, management and research of complex disorders of lipid and lipoprotein metabolism. Patients with severe obesity can also be evaluated.
• Metabolic Bone Disease. Diagnosis, management and research in metabolic bone diseases such as Osteoporosis, Osteomalacia and Paget's Disease.
• Parathyroid, Adrenal and Gonadal Disorders. Provocative/diagnostic testing; medical and surgical management.
• Reproductive Endocrinology. Disorders of the hypothalamic-pituitary-gonadal and adrenal axis.

Division of Gastroenterology and Hepatology

• Chronic Gastrointestinal (GI) Disorders. Consultative and/or continuing clinical evaluation, including study of functional and inflammatory bowel diseases, unusually aggressive or refractory peptic diseases and chronic pancreatitis.
• Inflammatory bowel disease. Diagnosis, innovative medical therapy, clinical investigation.
• Breath Tests. Evaluation of malabsorption, diarrhea and food intolerance.
• Diagnostic and Therapeutic Endoscopy. Endoscopic retrograde cholangiopancreatography, peritoneoscopy, colonoscopy and polypectomy, sclerosis and banding of esophageal varices, nonsurgical placement of gastrostomy feeding tubes, and endoscopic ultrasound.
• Hepatic and Biliary Diseases. Consultative and/or continuing clinical management of liver and biliary tract disease, including hepatitis. Specific areas of interest include: hepatitis, primary biliary cirrhosis, primary sclerosing cholangitis, alcoholic liver disease, end-stage liver disease, gallstones.
• Gastrointestinal Cancer. Consultative and/or continuing clinical evaluation and treatment including colon, esophagus, stomach, pancreas, liver, rectum and small intestinal tumors. Multidisciplinary program of the University of Colorado Cancer Center.
• Hepatic Transplantation. Evaluation of candidates, pre-and-post-operative care, management of patients with prior hepatic transplant, and interpretation of liver biopsies. Evaluation and treatment of complications of immunosuppressive therapy.
• Immunologic Deficiency Diseases with GI Manifestations. Evaluation and treatment, including acquired immune deficiency syndrome (AIDS).
• Intestinal Motility Disorders. Diagnosis and specific testing includes, among other methods, motility and 24 hour pH monitoring for reflux in esophageal disorders, radionuclide emptying studies for gastric disorders, sphincter of Oddi manometry for biliary disorders and anorectal manometry for defecation disorders.
• Laser Photocoagulation. Treatment of refractory gastroin-testinal bleeding and as palliation of obstructing tumors.
• Swallowing Center. Multidisciplinary evaluation and treatment of swallowing disorders.

Division of Geriatrics

Services include:

• Primary care of persons aged 70 and older, provided by internists with added qualifications in geriatrics and a geriatric nurse practitioner. Emphasis is on preventive care.
• Interdisciplinary evaluation of elderly persons with complex problems, utilizing a nutritionist, social worker, dentist, pharmacist and psychologist.
• Consultations on problematic issues such as memory loss, urinary incontinence and polypharmacy.

Division of Hematology

• Hematologic Diseases. Consultative and clinical evaluation, including anemias, white blood cell and platelet disorders.
• Hematologic Malignancies. Including leukemias and lymphomas.
• Hereditary Coagulation and Bleeding Disorders. Hemochromatosis, Vitamin B12 and Folic Acid deficiencies.

Division of Infectious Diseases

• Infectious Diseases. Consultation for complex infectious disorders, including infections of the diabetic or immuno-compromised patient, hospital-acquired infections, chronic infections, such as osteomyelitis and management of AIDS patients.
• Protocols for Testing of New Treatment Regimens. The University Hospital serves as the parent institution for the Colorado AIDS Clinical Trials Unit. The Infectious Diseases Division coordinates clinical and research activities to provide comprehensive access to the newest approved and investigational antibiotics and antiviral agents.
• Infectious Diseases in the Traveler. Infections acquired outside the United States, consultation regarding appropriate precautions and prophylactic measures prior to travel.
• Sexually Transmitted Diseases. Management of these diseases, especially the complications of AIDS; testing of new therapeutic agents for these diseases.

• Adult General Medical Care. Including comprehensive continuity care as primary care physicians.
• Peripheral Vascular Disease, and Arterial Occlusive Disease and Venous Thrombotic Diseases. The Vascular Center offers a coordinated approach to the surgical, medical and interventional radiological treatment of vascular diseases.
• Severe Resistant Hypertension. Diagnosis and management is provided utilizing the latest medical techniques, including continuous ambulatory blood pressure monitoring (similar to a Holter monitor).
• Severe Osteoporosis.
• Prevention and Health Promotion. Keeping patients healthy is a major goal of our practice. We promote a healthy lifestyle which includes exercise, diet, smoking cessation, stress management, screening for early disease, and appropriate immunizations. Special health care programs are designed for patients considered to have high-risk status.
• Women's Health. Health issues of both young and older women are addressed. These include issues of contraception, hormone replacement for menopausal women, and pelvic exams with pap smears. We emphasize breast exams, prevention and selfcare.
• Medical Complications of Pregnancy. Medical High Risk Consultation is given for pregnant women with co-existing medical problems such as diabetes, hypertension, thyroid disease, rheumatologic disease, heart disease, pulmonary disease, seizure disorders, and thromboembolic disease. The consultant has a joint appointment in Internal Medicine and Obstetrics allowing for optimal interaction between these disciplines. A multidisciplinary approach toward the most appropriate care and treatment of high risk patients is our goal.
• Pre-operative risk assessment and peri-operative medical care.
• Infectious Diseases and care of HIV infected patients.

• AIDS Malignancies. Diagnosis and treatment of lymphomas, Kaposi's sarcoma and others as part of the AIDs Clinical Trials Unit.
• Hematologic Malignancies. Research protocols for hairy cell leukemia and chronic myelogenous leukemia.
• Neuro-Oncology - A Multidisciplinary Clinic. Staging and treatment, including availability of experimental protocols in association with the Southwest Oncology Group and a number of University of Colorado Cancer Center sponsored protocols.
• Gastrointestinal Oncology Multispecialty Clinic. Staging and treatment, including availability of experimental protocols from the University of Colorado Cancer Center as well as the Southwest Oncology Group.
• Head and Neck Cancer. A multispecialty approach to patients with head and neck cancer with an emphasis on available experimental protocols from the Southwest Oncology Group as well as the University of Colorado Cancer Center. Research protocols looking at organ preservation protocols.
• Lung Cancer. Staging and treatment, including availability of experimental protocols in association with the Southwest Oncology Group, SPORE in Lung Cancer and a number of biologic agents.
• Hereditary Cancer Clinic. A multidisciplinary clinic for the evaluation of individuals and/or families who may have an inherited risk for cancer.

Division of Pulmonary Sciences and Critical Care Medicine

• Advanced Chronic Pulmonary Diseases. Management through pulmonary rehabilitation service, including emphysema, cystic fibrosis and interstitial lung diseases.
• Center for Critical Care Medicine. Trials of new pharmacologic agents, and support modalities.
• Adult Cystic Fibrosis Center.
• Emphysema Surgery Center.
• Interstitial Lung Disease.
• Lung Transplantation Center.
• Pulmonary Hypertension Center.

Division of Renal Diseases and Hypertension

• Acute Renal Failure. Referral center for evaluation and management.
• Diabetic Nephropathy. Referral center for management and study of progression.
• Dialysis. Acute, chronic and home dialysis programs for both hemodialysis and peritoneal dialysis.
• Hypertension. Referral, including workup and management of patients with renovascular and renoparenchymal hypertension.
• Plasmapheresis. Treatment of immunological, neurological and hematological diseases.
• Polycystic Kidney Disease. Diagnostic workup, genetic counseling and long-term management.
• Primary Renal Disease. Referral center for dialysis and transplantation evaluation. Multidisciplinary diagnosis and treatment including extensive immunological workup, in cooperation with the Divisions of Rheumatology and Immunology; and renal biopsy, in cooperation with the Department of Pathology.
• Renal Metabolic Imbalances. Management of electrolyte imbalances and acid-base problems, including abnormal water metabolism, severe refractory hypokalemia and severe recurrent metabolic acidosis.
• Transplantation. Post-operative and long-term management of transplant-related problems.

Division of Rheumatology

Arthritis Conditions. Evaluation and treatment of patients with complex or unusual forms of arthritis, including but not limited to:

• Rheumatoid Arthritis.
• Systemic Lupus Erythematous.
• Progressive Systemic Sclerosis (Scleroderma).
• Other Autoimmune Diseases.
• Treatment Protocols utilizing new/experimental therapies.

Full Reference Laboratory for the diagnosis of rheumatic disorders, including anti-nuclear antibodies (ANA), ANA profile, rheumatoid factor and other specific antibodies.

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