Chest Journal Podcasts

Subroto Paul, MD, FCCP, and Malcolm M. DeCamp, MD, FCCP, take time to discuss the article by Dr. Paul and colleagues in the December 2014 issue of CHEST with Podcast Editor D. Kyle Hogarth, MD, FCCP. Their study evaluated the effectiveness of robotic-assisted vs thoracoscopic lobectomy. Thus far, in the early days of its use, they found that robotic-assisted lobectomy is associated with more injury and bleeding at a higher cost. The participants discussed potential future directions for robotics in this area.

Two of the policy statement's authors, Peter J. Mazzone, MD, FCCP, and Gerard A. Silverstri, MD, FCCP, are interviewed by CHEST Podcast Editor, D. Kyle Hogarth, MD, FCCP, to outline the nine components needed for high quality lung cancer screening programs as identified by speciality groups of CHEST and ATS. It is hoped that this statement will guide those who set up lung cancer screening programs and will help to clarify standards for reimbursement.

Allan J. Walkey, MD, and editorialist Gregory Y. H. Lip, MD, join CHEST Podcast Editor D. Kyle Hogarth, MD, FCCP, to discuss the research by Dr. Walkey et al showing that patients who developed new-onset atrial fibrillation during sepsis were more likely than those who did not to be at greater risk for hospitalizations for heart failure, ischemic stroke, and death. They discuss the need for follow up for these patients.

Richard S. Irwin, MD, Master FCCP (CHEST Editor in Chief and Cough Guidelines Panel Chair) and Cough Expert Panel Member Tamara Pringsheim, MD, are interviewed by CHEST Podcast Editor, D. Kyle Hogarth, MD, FCCP, to introduce the latest updates to the CHEST Cough Guidelines. The introductory overview article is published in this month's issue and other cough topic updates will be published in upcoming issues of CHEST. The focus of this month's podcast is the development of the current guidelines. Drs. Irwin and Pringsheim emphasize the importance of evaluating research to make recommendations and the importance of bringing experts in all fields to the table. Dr. Pringsheim, in addition to being a guideline writing expert, was invited to join the panel because she is a neuroscientist specializing in movement disorders and could better help to evaluate evidence for habit cough. 

Professor Dame Margaret Turner-Warwick is interviewed by CHEST Associate Editor Peter J. Barnes, DM, Master FCCP, discussing her medical and research career, the problems facing women in medicine, her research into interstitial lung disease and asthma, and her time as the first female president of the Royal College of Physicians at a time of many changes to the UK National Health System. This interview can be also be viewed here.

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.

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.

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.

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. 

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

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.

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.

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.

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.