CHEST Journal Podcasts

Planning for Care During Pandemics and Disasters

Michael D. Christian, MD, FCCP, Niranjan Kissoon, MBBS, and editorialist Christian E. Sandrock, MD, MPH, FCCP, join CHEST Podcast Editor D. Kyle Hogarth, MD, FCCP, to talk about what is new in the just released collection of CHEST Consensus Statement articles on "Care of the Critically Ill and Injured During Pandemics and Disasters." This is the first comprehensive update to these statements since 2008 and provides suggestions for physicians, administrators, and others on the gamut of challenges that must be prepared for when events strain medical resources.  Among the new and updated topics they discuss are pediatric patients, resource poor environments, special patient populations, and planning and implementation issues across regions and country boundaries. The special problems of collecting evidence-based data in these events are also discussed.

Pulmonary Arterial Hypertension: New CHEST Guidelines and New CDC Surveillance Data

Terence K. Trow, MD, FCCP (one of the authors for the new Pharmacologic Therapy for Pulmonary Arterial Hypertension (PAH) in Adults CHEST Guideline and Expert Panel Report); Mary G. George, MD (corresponding author of the new CDC pulmonary hypertension surveillance report); and editorialist Anna R. Hemnes, MD, join CHEST Podcast Editor D. Kyle Hogarth, MD, FCCP to review these important articles. The new CHEST PAH Guidelines distill the available evidence on new therapies and treatment. Among the points emphasized by Dr. Trow is the need to use more than echocardiograms in diagnosis; right-sided heart catheterization is also required. Dr. George reviews the data from the National Vital Statistics System and from the National Hospital Discharge Survey, noting that after a period of decline, the mortality associated with PH among men is beginning to rise; a rise among women also continues.

Interstitial Lung Abnormalities in Rheumatoid Arthritis

Tracy J. Doyle, MD, MPH, and Ivan O. Rosas, MD, FCCP, discuss the findings of their research, suggesting that subclinical rheumatoid arthritis-associated interstitial lung disease is prevalent and that a subset of patients will experience progression of lung disease over time. D. Kyle Hogarth, MD, FCCP, podcast editor of CHEST interviews them and editorialist Gregory P. Cosgrove, MD, FCCP, to review the data, particularly at-risk patients. 

Giants in Chest Medicine: Lawrence D. H. Wood, MD, PhD

One of the founding greats of critical care medicine and a renowned teacher, Dr. Lawrence D. H. Wood, is interviewed by D. Kyle Hogarth, MD, FCCP, podcast editor of CHEST on the highlights of his career.

Introducing a New, National Approach to Surveillance for Ventilator-Associated Events

In this month's podcast, Shelley S. Magill, MD, PhD, of the Centers for Disease Control and Prevention (CDC) provides an introduction to the new three-tier, adult surveillance definition algorithm for ventilator-associated events (VAE) developed by the multi-organization Ventilator-Associated Pneumonia (VAP) Surveillance Definiition Working Group and implemented in January 2013 by the CDC's National Healthcare Safety Network. The Executive Summary of the report appears in this month's issue and is being co-published with other Working Group society publisher journals. CHEST Podcast Editor, D. Kyle Hogarth, MD, FCCP, moderates the discussion with Dr. Magill and editorialist Craig M. Lilly, MD, FCCP, to debate the merits of the new focus on VAE vs. VAP

Point/Counterpoint Discussion: Does the Risk of Cross-Infection Warrant the Exclusion of Adults with Cystic Fibrosis From Cystic Fibrosis Events?

Manu Jain, MD, and Steven Shepherd, MPH and a long-time cystic fibrosis patient, join D. Kyle Hogarth, MD, FCCP, for this discussion of the debate on the policy of allowing only one adult patient with cystic fibrosis to attend any indoor events. Dr. Jain argues that risks are great enough to make this policy a good one. Mr. Shepherd argues that the concept is based on outdated ideas, the risks are very small, and that adults should be able to make their own choices on the risks they want to take.

Modifying Criteria For Systemic Inflammatory Response Syndrome To Improve Its Predictive Value

Simon J. Finney, PhD, MBChB, editiorialist Arthur P. Wheeler, MD, FCCP, and CHEST Podcast Editor, D. Kyle Hogarth, MD, FCCP, discuss an article by Dr. Finney and others that reviews their research into modifying the traditional definition of the systemic inflammatory response syndrome (SIRS) following cardiac surgery. They found that they could improve the predictive value of SIRS criteria when the definition was adjusted to meeting three or more criteria or, most especially, fulfilling two or more of the criteria for at least six consecutive hours.

Reaction to the CMS Advisory Group Recommendation Not to Reimburse for Low-Dose CT Screening for Lung Cancer

This month, CHEST Podcast Editor D. Kyle Hogarth, MD, FCCP, presents a special topic podcast on the recent vote of the Centers for Medicare and Medicaid Services (CMS) national coverage determination panel that there is not enough evidence to warrant Medicare coverage of low-dose CT screening for lung cancer. He is joined in conversation by Frank C. Detterbeck, MD, FCCP (Yale University), Scott Manaker, MD, PhD, FCCP (University of Pennyslvania), and David F. Yankelevitz, MD (Mount Sinai Hospital). They address some of the factors that went into the decision. Drs. Detterbeck, Manaker, and Yankelevitz also provide their interpretations of the important National Lung Screening Trial (NLST) and the results of studies from the International Early Lung Cancer Action Program (I-ELCAP), a multicenter clinical study in which patients were screened with CT using a common protocol.

Can the Interstitial Lung Disease-GAP Model Be Used to Accurately Predict Mortality in Chronic ILD Subtypes?

Christopher J. Ryerson, MD, and editorialist Athol U. Wells, MD, join CHEST Podcast Editor, D. Kyle Hogarth, MD, FCCP, to discuss the study by Dr. Ryerson and others extending the use of the GAP risk prediction model (which is based on gender, age, and lung physiology) for chronic interstitial lung disease (ILD) to patients with idiopathic pulmonary fibrosis (IPF) and non-IPF ILDs. They consider the utilty of applying a single clinical prediction model for accurate mortality estimation across multiple ILD subtypes and discuss the possibilities of staging.