Slot System
Featured Buckets
Featured Buckets Admin

This month in the journal CHEST®

Article Type
Changed
Tue, 04/12/2022 - 00:15

Editor’s picks

Barriers and Enablers to Objective Testing for Asthma and COPD in Primary Care: A Systematic Review Using the Theoretical Domains Framework
By Dr. Janet Yamada et al.

COVID Complications: Diagnostic and Therapeutic Considerations for Critical Covid
By Dr. David M. Maslove et al.

Interstitial Lung Abnormalities, Emphysema, and Spirometry in Smokers
By Dr. Aravind A. Menon et al.

Sleep-Disordered Breathing in Hospitalized Patients: A Game Changer?
By Dr. Sunil Sharma and Dr. Robert Stansbury.

Distribution, Risk Factors, and Temporal Trends for Lung Cancer Incidence and Mortality: A Global Analysis 
By Dr. Junjie Huang et al.

Publications
Topics
Sections

Editor’s picks

Editor’s picks

Barriers and Enablers to Objective Testing for Asthma and COPD in Primary Care: A Systematic Review Using the Theoretical Domains Framework
By Dr. Janet Yamada et al.

COVID Complications: Diagnostic and Therapeutic Considerations for Critical Covid
By Dr. David M. Maslove et al.

Interstitial Lung Abnormalities, Emphysema, and Spirometry in Smokers
By Dr. Aravind A. Menon et al.

Sleep-Disordered Breathing in Hospitalized Patients: A Game Changer?
By Dr. Sunil Sharma and Dr. Robert Stansbury.

Distribution, Risk Factors, and Temporal Trends for Lung Cancer Incidence and Mortality: A Global Analysis 
By Dr. Junjie Huang et al.

Barriers and Enablers to Objective Testing for Asthma and COPD in Primary Care: A Systematic Review Using the Theoretical Domains Framework
By Dr. Janet Yamada et al.

COVID Complications: Diagnostic and Therapeutic Considerations for Critical Covid
By Dr. David M. Maslove et al.

Interstitial Lung Abnormalities, Emphysema, and Spirometry in Smokers
By Dr. Aravind A. Menon et al.

Sleep-Disordered Breathing in Hospitalized Patients: A Game Changer?
By Dr. Sunil Sharma and Dr. Robert Stansbury.

Distribution, Risk Factors, and Temporal Trends for Lung Cancer Incidence and Mortality: A Global Analysis 
By Dr. Junjie Huang et al.

Publications
Publications
Topics
Article Type
Sections
Disallow All Ads
Content Gating
No Gating (article Unlocked/Free)
Alternative CME
Disqus Comments
Default
Use ProPublica
Hide sidebar & use full width
render the right sidebar.
Conference Recap Checkbox
Not Conference Recap
Clinical Edge
Display the Slideshow in this Article
Medscape Article
Display survey writer
Reuters content
Disable Inline Native ads
WebMD Article

Take action: Turn up the heat on prior auth

Article Type
Changed
Mon, 03/28/2022 - 18:04

In our recent member survey, 99% of respondents expressed that prior authorization has a negative impact on patients’ access to clinically appropriate treatments. We need to continue to put pressure on legislators to eliminate prior authorization burdens.

AGA endorses the Improving Seniors Timely Access to Care Act, which would streamline the prior authorization process in Medicare Advantage by approving in real-time commonly approved services and implementing a standardized electronic prior authorization process.

Despite large bipartisan support, we need your help getting this bill across the finish line! Please take five minutes to ask your Representative to cosponsor this necessary bill by participating in our campaign.

Go to the AGA action center to contact your lawmakers!

Publications
Topics
Sections

In our recent member survey, 99% of respondents expressed that prior authorization has a negative impact on patients’ access to clinically appropriate treatments. We need to continue to put pressure on legislators to eliminate prior authorization burdens.

AGA endorses the Improving Seniors Timely Access to Care Act, which would streamline the prior authorization process in Medicare Advantage by approving in real-time commonly approved services and implementing a standardized electronic prior authorization process.

Despite large bipartisan support, we need your help getting this bill across the finish line! Please take five minutes to ask your Representative to cosponsor this necessary bill by participating in our campaign.

Go to the AGA action center to contact your lawmakers!

In our recent member survey, 99% of respondents expressed that prior authorization has a negative impact on patients’ access to clinically appropriate treatments. We need to continue to put pressure on legislators to eliminate prior authorization burdens.

AGA endorses the Improving Seniors Timely Access to Care Act, which would streamline the prior authorization process in Medicare Advantage by approving in real-time commonly approved services and implementing a standardized electronic prior authorization process.

Despite large bipartisan support, we need your help getting this bill across the finish line! Please take five minutes to ask your Representative to cosponsor this necessary bill by participating in our campaign.

Go to the AGA action center to contact your lawmakers!

Publications
Publications
Topics
Article Type
Sections
Disallow All Ads
Content Gating
No Gating (article Unlocked/Free)
Alternative CME
Disqus Comments
Default
Use ProPublica
Hide sidebar & use full width
render the right sidebar.
Conference Recap Checkbox
Not Conference Recap
Clinical Edge
Display the Slideshow in this Article
Medscape Article
Display survey writer
Reuters content
Disable Inline Native ads
WebMD Article

2022 AGA recognition prize award recipients

Article Type
Changed
Mon, 03/28/2022 - 17:54

The American Gastroenterological Association has announced the 2022 recipients of its annual recognition prizes, given in honor of outstanding contributions and achievements in gastroenterology. 

“AGA is proud to officially announce the exceptional individuals selected for 2022 AGA Recognition Prizes. I wish to thank all the nominators and those who provided nomination letters, and the selection committees for the tough task they had to select among the many superb nominees,” said Bishr Omary, MD, PhD, AGAF, chair of the AGA. “Please join us in congratulating this year’s distinguished awardees and applauding their contributions to the field of gastroenterology that advance our profession and the patients we serve.” 

AGA looks forward to celebrating the recipients during Digestive Disease Week® 2022, May 21-24, in San Diego, Calif.

Meet and learn more about our award recipients here.

Publications
Topics
Sections

The American Gastroenterological Association has announced the 2022 recipients of its annual recognition prizes, given in honor of outstanding contributions and achievements in gastroenterology. 

“AGA is proud to officially announce the exceptional individuals selected for 2022 AGA Recognition Prizes. I wish to thank all the nominators and those who provided nomination letters, and the selection committees for the tough task they had to select among the many superb nominees,” said Bishr Omary, MD, PhD, AGAF, chair of the AGA. “Please join us in congratulating this year’s distinguished awardees and applauding their contributions to the field of gastroenterology that advance our profession and the patients we serve.” 

AGA looks forward to celebrating the recipients during Digestive Disease Week® 2022, May 21-24, in San Diego, Calif.

Meet and learn more about our award recipients here.

The American Gastroenterological Association has announced the 2022 recipients of its annual recognition prizes, given in honor of outstanding contributions and achievements in gastroenterology. 

“AGA is proud to officially announce the exceptional individuals selected for 2022 AGA Recognition Prizes. I wish to thank all the nominators and those who provided nomination letters, and the selection committees for the tough task they had to select among the many superb nominees,” said Bishr Omary, MD, PhD, AGAF, chair of the AGA. “Please join us in congratulating this year’s distinguished awardees and applauding their contributions to the field of gastroenterology that advance our profession and the patients we serve.” 

AGA looks forward to celebrating the recipients during Digestive Disease Week® 2022, May 21-24, in San Diego, Calif.

Meet and learn more about our award recipients here.

Publications
Publications
Topics
Article Type
Sections
Disallow All Ads
Content Gating
No Gating (article Unlocked/Free)
Alternative CME
Disqus Comments
Default
Use ProPublica
Hide sidebar & use full width
render the right sidebar.
Conference Recap Checkbox
Not Conference Recap
Clinical Edge
Display the Slideshow in this Article
Medscape Article
Display survey writer
Reuters content
Disable Inline Native ads
WebMD Article

New governing board members

Article Type
Changed
Mon, 03/28/2022 - 17:48

M. Bishr Omary, MD, PhD, AGAF, chair of the AGA Nominating Committee, is pleased to announce that Maria T. Abreu, MD, AGAF, joins the presidential line-up for AGA.

Vice President
Maria T. Abreu, MD, AGAF

Director, Crohn’s and Colitis Center
University of Miami

Dr. Maria T. Abreu

Maria T. Abreu, MD, AGAF, has more than 20 years of leadership experience in basic, translational, and clinical research and mentoring. She is AGA’s current councillor at-large, past chair of the AGA Institute Council, and an AGA Institute Council Section Research Mentor Award recipient (2020) for the IMIBD section. Dr. Abreu is also a recipient of the 2019 Sherman Prize by The Bruce and Cynthia Sherman Charitable Foundation that recognizes outstanding achievements in intestinal bowel disease.

Read her bio from the University of Miami.



The nominating committee also appointed the following slate of councillors which is subject to membership vote.

At-Large Councillor
Kim Barrett, PhD, AGAF

Vice dean for research
University of California, Davis

Dr. Kim Barrett

Kim Barrett, PhD, AGAF, is the current chair of the AGA Publications Committee, former chair of the AGA Ethics And Audit Committees, and served twice as director of the Academic Skills Workshop. She was recognized with AGA’s top research award, the AGA Distinguished Achievement Award in Basic Science (2021).

Her research interests have centered on the physiology and pathophysiology of the intestinal epithelium and their relevance to inflammatory bowel diseases and diarrheal diseases and have resulted in more than 300 publications.

Read her bio from UC Davis.



Councillor For Development And Growth
Lawrence Kosinski, MD, MBA, AGAF

Chief medical officer
SonarMD

Dr. Lawrence Kosinski

A serial entrepreneur and thought leader in the world of value-based payment, Larry Kosinski, MD, MBA, AGAF, currently serves as chief medical officer of SonarMD, the leading value-based care coordination solution for complex chronic diseases. He founded SonarMD in 2014 to make it easier for specialists and patients to work together to manage symptomatic chronic illness and prevent clinical deterioration, improving health outcomes, and lowering the cost of care. 

In 2021, Dr. Kosinski was selected for his expertise in value-based payment to serve on the Centers for Medicare & Medicaid Services’ Physician-Focused Payment Model Technical Advisory Committee and help develop bold, new Medicare payment models.

Read his bio from the SonarMD website.



Education & Training Councillor
Sheryl Pfeil, MD, AGAF

Medical director and professor of clinical medicine, Clinical Skills Education and Assessment Center
The Ohio State University Wexner Medical Center

Dr. Sheryl Pfeil

Sheryl Pfeil, MD, AGAF, has been an AGA member for 30 years, serving on the Education And Training Committee, as past chair of the Academy of Educators, as cochair of the AGA future leaders program, and on the editorial board for Gastro Hep Advances. Dr. Pfeil has 30 years of experience in medical education, leading medical students, residents, and fellow education.

Her educational research interests include professional development, training and assessment methods, and virtual education. 

Read her bio from The Ohio State University.

Pending approval by the voting membership, all board members begin their terms after DDW 2022. The voting membership will be sent a ballot to approve the slate of councillors on or before March 28, 2022, with a response date of no later than April 29, 2022. Results will be announced at the AGA Annual Business Meeting on June 1, 2022.

Publications
Topics
Sections

M. Bishr Omary, MD, PhD, AGAF, chair of the AGA Nominating Committee, is pleased to announce that Maria T. Abreu, MD, AGAF, joins the presidential line-up for AGA.

Vice President
Maria T. Abreu, MD, AGAF

Director, Crohn’s and Colitis Center
University of Miami

Dr. Maria T. Abreu

Maria T. Abreu, MD, AGAF, has more than 20 years of leadership experience in basic, translational, and clinical research and mentoring. She is AGA’s current councillor at-large, past chair of the AGA Institute Council, and an AGA Institute Council Section Research Mentor Award recipient (2020) for the IMIBD section. Dr. Abreu is also a recipient of the 2019 Sherman Prize by The Bruce and Cynthia Sherman Charitable Foundation that recognizes outstanding achievements in intestinal bowel disease.

Read her bio from the University of Miami.



The nominating committee also appointed the following slate of councillors which is subject to membership vote.

At-Large Councillor
Kim Barrett, PhD, AGAF

Vice dean for research
University of California, Davis

Dr. Kim Barrett

Kim Barrett, PhD, AGAF, is the current chair of the AGA Publications Committee, former chair of the AGA Ethics And Audit Committees, and served twice as director of the Academic Skills Workshop. She was recognized with AGA’s top research award, the AGA Distinguished Achievement Award in Basic Science (2021).

Her research interests have centered on the physiology and pathophysiology of the intestinal epithelium and their relevance to inflammatory bowel diseases and diarrheal diseases and have resulted in more than 300 publications.

Read her bio from UC Davis.



Councillor For Development And Growth
Lawrence Kosinski, MD, MBA, AGAF

Chief medical officer
SonarMD

Dr. Lawrence Kosinski

A serial entrepreneur and thought leader in the world of value-based payment, Larry Kosinski, MD, MBA, AGAF, currently serves as chief medical officer of SonarMD, the leading value-based care coordination solution for complex chronic diseases. He founded SonarMD in 2014 to make it easier for specialists and patients to work together to manage symptomatic chronic illness and prevent clinical deterioration, improving health outcomes, and lowering the cost of care. 

In 2021, Dr. Kosinski was selected for his expertise in value-based payment to serve on the Centers for Medicare & Medicaid Services’ Physician-Focused Payment Model Technical Advisory Committee and help develop bold, new Medicare payment models.

Read his bio from the SonarMD website.



Education & Training Councillor
Sheryl Pfeil, MD, AGAF

Medical director and professor of clinical medicine, Clinical Skills Education and Assessment Center
The Ohio State University Wexner Medical Center

Dr. Sheryl Pfeil

Sheryl Pfeil, MD, AGAF, has been an AGA member for 30 years, serving on the Education And Training Committee, as past chair of the Academy of Educators, as cochair of the AGA future leaders program, and on the editorial board for Gastro Hep Advances. Dr. Pfeil has 30 years of experience in medical education, leading medical students, residents, and fellow education.

Her educational research interests include professional development, training and assessment methods, and virtual education. 

Read her bio from The Ohio State University.

Pending approval by the voting membership, all board members begin their terms after DDW 2022. The voting membership will be sent a ballot to approve the slate of councillors on or before March 28, 2022, with a response date of no later than April 29, 2022. Results will be announced at the AGA Annual Business Meeting on June 1, 2022.

M. Bishr Omary, MD, PhD, AGAF, chair of the AGA Nominating Committee, is pleased to announce that Maria T. Abreu, MD, AGAF, joins the presidential line-up for AGA.

Vice President
Maria T. Abreu, MD, AGAF

Director, Crohn’s and Colitis Center
University of Miami

Dr. Maria T. Abreu

Maria T. Abreu, MD, AGAF, has more than 20 years of leadership experience in basic, translational, and clinical research and mentoring. She is AGA’s current councillor at-large, past chair of the AGA Institute Council, and an AGA Institute Council Section Research Mentor Award recipient (2020) for the IMIBD section. Dr. Abreu is also a recipient of the 2019 Sherman Prize by The Bruce and Cynthia Sherman Charitable Foundation that recognizes outstanding achievements in intestinal bowel disease.

Read her bio from the University of Miami.



The nominating committee also appointed the following slate of councillors which is subject to membership vote.

At-Large Councillor
Kim Barrett, PhD, AGAF

Vice dean for research
University of California, Davis

Dr. Kim Barrett

Kim Barrett, PhD, AGAF, is the current chair of the AGA Publications Committee, former chair of the AGA Ethics And Audit Committees, and served twice as director of the Academic Skills Workshop. She was recognized with AGA’s top research award, the AGA Distinguished Achievement Award in Basic Science (2021).

Her research interests have centered on the physiology and pathophysiology of the intestinal epithelium and their relevance to inflammatory bowel diseases and diarrheal diseases and have resulted in more than 300 publications.

Read her bio from UC Davis.



Councillor For Development And Growth
Lawrence Kosinski, MD, MBA, AGAF

Chief medical officer
SonarMD

Dr. Lawrence Kosinski

A serial entrepreneur and thought leader in the world of value-based payment, Larry Kosinski, MD, MBA, AGAF, currently serves as chief medical officer of SonarMD, the leading value-based care coordination solution for complex chronic diseases. He founded SonarMD in 2014 to make it easier for specialists and patients to work together to manage symptomatic chronic illness and prevent clinical deterioration, improving health outcomes, and lowering the cost of care. 

In 2021, Dr. Kosinski was selected for his expertise in value-based payment to serve on the Centers for Medicare & Medicaid Services’ Physician-Focused Payment Model Technical Advisory Committee and help develop bold, new Medicare payment models.

Read his bio from the SonarMD website.



Education & Training Councillor
Sheryl Pfeil, MD, AGAF

Medical director and professor of clinical medicine, Clinical Skills Education and Assessment Center
The Ohio State University Wexner Medical Center

Dr. Sheryl Pfeil

Sheryl Pfeil, MD, AGAF, has been an AGA member for 30 years, serving on the Education And Training Committee, as past chair of the Academy of Educators, as cochair of the AGA future leaders program, and on the editorial board for Gastro Hep Advances. Dr. Pfeil has 30 years of experience in medical education, leading medical students, residents, and fellow education.

Her educational research interests include professional development, training and assessment methods, and virtual education. 

Read her bio from The Ohio State University.

Pending approval by the voting membership, all board members begin their terms after DDW 2022. The voting membership will be sent a ballot to approve the slate of councillors on or before March 28, 2022, with a response date of no later than April 29, 2022. Results will be announced at the AGA Annual Business Meeting on June 1, 2022.

Publications
Publications
Topics
Article Type
Sections
Disallow All Ads
Content Gating
No Gating (article Unlocked/Free)
Alternative CME
Disqus Comments
Default
Use ProPublica
Hide sidebar & use full width
render the right sidebar.
Conference Recap Checkbox
Not Conference Recap
Clinical Edge
Display the Slideshow in this Article
Medscape Article
Display survey writer
Reuters content
Disable Inline Native ads
WebMD Article

Five reasons to update your will

Article Type
Changed
Mon, 03/28/2022 - 17:11

You have a will, so you can rest easy, right? Not necessarily. If your will is outdated, it can cause more harm than good. Even though it can provide for some contingencies, an old will can’t cover every change that may have occurred since it was first drawn. Professionals advise that you review your will every few years and more often if situations such as the following five have occurred since you last updated your will.

#1. Family changes
If you’ve had any changes in your family situation, you will probably need to update your will. Events such as marriage, divorce, death, birth, adoption, or a falling out with a loved one may affect how your estate will be distributed, who should act as guardian for your dependents, and who should be named as executor of your estate.

#2. Relocating to a new state
The laws among the states vary. Moving to a new state or purchasing property in another state can affect your estate plan and how property in that state will be taxed and distributed.

#3. Tax law changes
Federal and state legislatures are continually tinkering with federal estate and state inheritance tax laws. An old will may fail to take advantage of strategies that will minimize estate taxes.

#4. You want to support a favorite cause
If you have developed a connection to a cause, you may want to benefit a particular charity with a gift in your estate. Contact us for sample language you can share with your attorney to include a gift to us in your will.

#5. Changes in your estate’s value
When you made your will, your assets may have been relatively modest. Now the value may be larger and your will no longer reflects how you would like your estate divided.


Consider including a gift to the AGA Research Foundation in your will. You will help spark future discoveries in GI. Visit our website at https://gastro.planmylegacy.org or contact us at [email protected].

Publications
Topics
Sections

You have a will, so you can rest easy, right? Not necessarily. If your will is outdated, it can cause more harm than good. Even though it can provide for some contingencies, an old will can’t cover every change that may have occurred since it was first drawn. Professionals advise that you review your will every few years and more often if situations such as the following five have occurred since you last updated your will.

#1. Family changes
If you’ve had any changes in your family situation, you will probably need to update your will. Events such as marriage, divorce, death, birth, adoption, or a falling out with a loved one may affect how your estate will be distributed, who should act as guardian for your dependents, and who should be named as executor of your estate.

#2. Relocating to a new state
The laws among the states vary. Moving to a new state or purchasing property in another state can affect your estate plan and how property in that state will be taxed and distributed.

#3. Tax law changes
Federal and state legislatures are continually tinkering with federal estate and state inheritance tax laws. An old will may fail to take advantage of strategies that will minimize estate taxes.

#4. You want to support a favorite cause
If you have developed a connection to a cause, you may want to benefit a particular charity with a gift in your estate. Contact us for sample language you can share with your attorney to include a gift to us in your will.

#5. Changes in your estate’s value
When you made your will, your assets may have been relatively modest. Now the value may be larger and your will no longer reflects how you would like your estate divided.


Consider including a gift to the AGA Research Foundation in your will. You will help spark future discoveries in GI. Visit our website at https://gastro.planmylegacy.org or contact us at [email protected].

You have a will, so you can rest easy, right? Not necessarily. If your will is outdated, it can cause more harm than good. Even though it can provide for some contingencies, an old will can’t cover every change that may have occurred since it was first drawn. Professionals advise that you review your will every few years and more often if situations such as the following five have occurred since you last updated your will.

#1. Family changes
If you’ve had any changes in your family situation, you will probably need to update your will. Events such as marriage, divorce, death, birth, adoption, or a falling out with a loved one may affect how your estate will be distributed, who should act as guardian for your dependents, and who should be named as executor of your estate.

#2. Relocating to a new state
The laws among the states vary. Moving to a new state or purchasing property in another state can affect your estate plan and how property in that state will be taxed and distributed.

#3. Tax law changes
Federal and state legislatures are continually tinkering with federal estate and state inheritance tax laws. An old will may fail to take advantage of strategies that will minimize estate taxes.

#4. You want to support a favorite cause
If you have developed a connection to a cause, you may want to benefit a particular charity with a gift in your estate. Contact us for sample language you can share with your attorney to include a gift to us in your will.

#5. Changes in your estate’s value
When you made your will, your assets may have been relatively modest. Now the value may be larger and your will no longer reflects how you would like your estate divided.


Consider including a gift to the AGA Research Foundation in your will. You will help spark future discoveries in GI. Visit our website at https://gastro.planmylegacy.org or contact us at [email protected].

Publications
Publications
Topics
Article Type
Sections
Disallow All Ads
Content Gating
No Gating (article Unlocked/Free)
Alternative CME
Disqus Comments
Default
Use ProPublica
Hide sidebar & use full width
render the right sidebar.
Conference Recap Checkbox
Not Conference Recap
Clinical Edge
Display the Slideshow in this Article
Medscape Article
Display survey writer
Reuters content
Disable Inline Native ads
WebMD Article

Victor Test, MD, FCCP, receives Medal of Valor from AMA

Article Type
Changed
Fri, 03/11/2022 - 00:15

The American Medical Association (AMA) honored CHEST Board Member Victor J. Test, MD, FCCP, with the AMA Medal of Valor for his work on behalf of patients and his community during the COVID-19 pandemic.

Dr. Victor J. Test


The award, which recognizes physicians who demonstrate courage under extraordinary circumstances, was presented to Dr. Test because of his quick decisive actions during the onset of the pandemic, including personally securing personal protective equipment to supply the critical care faculty and fellows at the Texas Tech University hospital in Lubbock and building plexiglass and PVC chambers for the physicians and nursing staff caring for patients with COVID-19.

Read more here.

Publications
Topics
Sections

The American Medical Association (AMA) honored CHEST Board Member Victor J. Test, MD, FCCP, with the AMA Medal of Valor for his work on behalf of patients and his community during the COVID-19 pandemic.

Dr. Victor J. Test


The award, which recognizes physicians who demonstrate courage under extraordinary circumstances, was presented to Dr. Test because of his quick decisive actions during the onset of the pandemic, including personally securing personal protective equipment to supply the critical care faculty and fellows at the Texas Tech University hospital in Lubbock and building plexiglass and PVC chambers for the physicians and nursing staff caring for patients with COVID-19.

Read more here.

The American Medical Association (AMA) honored CHEST Board Member Victor J. Test, MD, FCCP, with the AMA Medal of Valor for his work on behalf of patients and his community during the COVID-19 pandemic.

Dr. Victor J. Test


The award, which recognizes physicians who demonstrate courage under extraordinary circumstances, was presented to Dr. Test because of his quick decisive actions during the onset of the pandemic, including personally securing personal protective equipment to supply the critical care faculty and fellows at the Texas Tech University hospital in Lubbock and building plexiglass and PVC chambers for the physicians and nursing staff caring for patients with COVID-19.

Read more here.

Publications
Publications
Topics
Article Type
Sections
Disallow All Ads
Content Gating
No Gating (article Unlocked/Free)
Alternative CME
Disqus Comments
Default
Use ProPublica
Hide sidebar & use full width
render the right sidebar.
Conference Recap Checkbox
Not Conference Recap
Clinical Edge
Display the Slideshow in this Article
Medscape Article
Display survey writer
Reuters content
Disable Inline Native ads
WebMD Article

Off to the races with The CHEST Foundation

Article Type
Changed
Fri, 03/11/2022 - 00:15

The CHEST Foundation cordially invites CHEST members and colleagues, health care professionals, and others to champion lung health and attend the annual Belmont Stakes Dinner and Auction, Saturday, June 11, in New York at the beautiful Water Club overlooking the East River.

Courtesy ACCP


Hosted by CHEST President-Elect Doreen Addrizzo-Harris, MD, FCCP, this year’s celebration will include a lively cocktail reception, a silent and live auction, dinner, and a rooftop after-party for young professionals to network with colleagues and CHEST leadership and take the challenge for a chance to win great prizes, including a Peloton, ultrasound machine, and access to CHEST courses and events. Fully immerse yourself in the event, and wear your race-day best!

This year, we are honoring two outstanding patients and advocates, Betsy Glaeser and Fred Schick, for their remarkable achievements in patient empowerment and access. Glaeser, who was diagnosed with nontuberculous mycobacteria (disease NTM) more than 20 years ago, pioneered opportunities for NTM-specific research funding and runs a hundreds-strong support group for people with NTM and bronchiectasis. Schick, who has pulmonary fibrosis, is an active ambassador in the patient community in Chicago and also leads local support groups for others with the disease.

All proceeds from the evening’s events will benefit the CHEST Foundation’s continued work toward bringing impactful, informative resources to patients.

Courtesy ACCP
All proceeds from the Belmont Stakes Dinner and Auction will benefit the CHEST Foundation’s continued work bringing impactful, informative resources to patients.


As the patient-focused philanthropic arm of the American College of Chest Physicians, the CHEST Foundation is on a mission to champion lung health and strives to give health care professionals, patients, and caregivers opportunities to come together, give back, and advocate for change.

Since its inception, the Foundation has provided more than $8 million in research grants and $3 million in community grants, created free patient education resources for more than 80 disease states, and provided thousands of units of personal protective equipment and $1 million for pandemic relief efforts through COVID-19 Reaction Microgrants.

Support the continued work of the Foundation – and watch some of the most exciting few minutes in sports among colleagues and friends – at this year’s Belmont Stakes Dinner and Auction. To purchase a ticket, or to learn more about sponsorship benefits or underwriting opportunities, contact Angela Perillo at [email protected] or +1 (224) 521-9520.

Publications
Topics
Sections

The CHEST Foundation cordially invites CHEST members and colleagues, health care professionals, and others to champion lung health and attend the annual Belmont Stakes Dinner and Auction, Saturday, June 11, in New York at the beautiful Water Club overlooking the East River.

Courtesy ACCP


Hosted by CHEST President-Elect Doreen Addrizzo-Harris, MD, FCCP, this year’s celebration will include a lively cocktail reception, a silent and live auction, dinner, and a rooftop after-party for young professionals to network with colleagues and CHEST leadership and take the challenge for a chance to win great prizes, including a Peloton, ultrasound machine, and access to CHEST courses and events. Fully immerse yourself in the event, and wear your race-day best!

This year, we are honoring two outstanding patients and advocates, Betsy Glaeser and Fred Schick, for their remarkable achievements in patient empowerment and access. Glaeser, who was diagnosed with nontuberculous mycobacteria (disease NTM) more than 20 years ago, pioneered opportunities for NTM-specific research funding and runs a hundreds-strong support group for people with NTM and bronchiectasis. Schick, who has pulmonary fibrosis, is an active ambassador in the patient community in Chicago and also leads local support groups for others with the disease.

All proceeds from the evening’s events will benefit the CHEST Foundation’s continued work toward bringing impactful, informative resources to patients.

Courtesy ACCP
All proceeds from the Belmont Stakes Dinner and Auction will benefit the CHEST Foundation’s continued work bringing impactful, informative resources to patients.


As the patient-focused philanthropic arm of the American College of Chest Physicians, the CHEST Foundation is on a mission to champion lung health and strives to give health care professionals, patients, and caregivers opportunities to come together, give back, and advocate for change.

Since its inception, the Foundation has provided more than $8 million in research grants and $3 million in community grants, created free patient education resources for more than 80 disease states, and provided thousands of units of personal protective equipment and $1 million for pandemic relief efforts through COVID-19 Reaction Microgrants.

Support the continued work of the Foundation – and watch some of the most exciting few minutes in sports among colleagues and friends – at this year’s Belmont Stakes Dinner and Auction. To purchase a ticket, or to learn more about sponsorship benefits or underwriting opportunities, contact Angela Perillo at [email protected] or +1 (224) 521-9520.

The CHEST Foundation cordially invites CHEST members and colleagues, health care professionals, and others to champion lung health and attend the annual Belmont Stakes Dinner and Auction, Saturday, June 11, in New York at the beautiful Water Club overlooking the East River.

Courtesy ACCP


Hosted by CHEST President-Elect Doreen Addrizzo-Harris, MD, FCCP, this year’s celebration will include a lively cocktail reception, a silent and live auction, dinner, and a rooftop after-party for young professionals to network with colleagues and CHEST leadership and take the challenge for a chance to win great prizes, including a Peloton, ultrasound machine, and access to CHEST courses and events. Fully immerse yourself in the event, and wear your race-day best!

This year, we are honoring two outstanding patients and advocates, Betsy Glaeser and Fred Schick, for their remarkable achievements in patient empowerment and access. Glaeser, who was diagnosed with nontuberculous mycobacteria (disease NTM) more than 20 years ago, pioneered opportunities for NTM-specific research funding and runs a hundreds-strong support group for people with NTM and bronchiectasis. Schick, who has pulmonary fibrosis, is an active ambassador in the patient community in Chicago and also leads local support groups for others with the disease.

All proceeds from the evening’s events will benefit the CHEST Foundation’s continued work toward bringing impactful, informative resources to patients.

Courtesy ACCP
All proceeds from the Belmont Stakes Dinner and Auction will benefit the CHEST Foundation’s continued work bringing impactful, informative resources to patients.


As the patient-focused philanthropic arm of the American College of Chest Physicians, the CHEST Foundation is on a mission to champion lung health and strives to give health care professionals, patients, and caregivers opportunities to come together, give back, and advocate for change.

Since its inception, the Foundation has provided more than $8 million in research grants and $3 million in community grants, created free patient education resources for more than 80 disease states, and provided thousands of units of personal protective equipment and $1 million for pandemic relief efforts through COVID-19 Reaction Microgrants.

Support the continued work of the Foundation – and watch some of the most exciting few minutes in sports among colleagues and friends – at this year’s Belmont Stakes Dinner and Auction. To purchase a ticket, or to learn more about sponsorship benefits or underwriting opportunities, contact Angela Perillo at [email protected] or +1 (224) 521-9520.

Publications
Publications
Topics
Article Type
Sections
Disallow All Ads
Content Gating
No Gating (article Unlocked/Free)
Alternative CME
Disqus Comments
Default
Use ProPublica
Hide sidebar & use full width
render the right sidebar.
Conference Recap Checkbox
Not Conference Recap
Clinical Edge
Display the Slideshow in this Article
Medscape Article
Display survey writer
Reuters content
Disable Inline Native ads
WebMD Article

Chest Infections and Disaster Response

Article Type
Changed
Fri, 03/11/2022 - 00:15

Addressing disparities of socioeconomic status, race, and education in vaccine hesitancy and uptake

Vaccine hesitancy is described by the World Health Organization (WHO) as a “delay in acceptance or refusal of vaccination, despite availability of vaccine services.”1 Disparities in COVID-19 vaccine uptake, in addition to preexisting views of vaccine hesitancy, are consistently in the mainstream news.

The United States has a high rate of vaccine hesitancy, with a third of the country surveyed in 2021 stating they were unlikely to become vaccinated against COVID-19.2 This is in contrast to over 90% of people in Australia, China, and Norway saying they were highly likely to become vaccinated. Prepandemic, however, vaccination rates for preventable respiratory illness were already suboptimal. In fact, in 2019, the WHO declared vaccine hesitancy a top 10 priority due to the threat low vaccination causes on a global level.1

Dr. Jamie R. Felzer

U.S. health care systems’ cost to patients may serve as a disincentive for health care utilization, decreasing health care contacts. Further, changes in insurance can lead to provider discontinuity, which may erode the trusted patient-physician relationship. These realities may contribute to vaccine hesitancy that has been inversely correlated to both number of health care visits and trust in health care providers. Vaccine hesitancy exacerbates health disparities.1 Health literacy (understanding of health), education level, and general vaccine knowledge contribute to vaccine hesitancy also. Additionally, high social vulnerability (a score calculated from factors related to socioeconomic status, race, household makeup, housing type, and transportation) is strongly inversely correlated with vaccination rates. In places with both high social vulnerability and vaccine hesitancy, the vaccine-hesitant individuals have far fewer vaccinations.3

Dr. Cassie C. Kennedy

Providers can impact vaccine uptake. Broadly, efforts to understand and address issues of trust in health care are needed. Educational materials should be disseminated to high-risk and medically underserved communities. At medical appointments, assessment of vaccination status, followed by providing individualized information regarding vaccine benefits and specific concerns may help increase uptake. In a survey of high-risk adults, only 14.8 and 18.5% of patients stated that the pneumococcal vaccine was offered to them in the last year and 5 years, respectively.1 Providers can have a strong impact on people obtaining vaccines; over half of patients receive vaccines when their provider recommends it.1,4 As a medical community focused on respiratory health, we need to prioritize offering vaccinations during inpatient and outpatient encounters.

By Jamie R. Felzer, MD, MPH

Network Member

Cassie C. Kennedy, MD, FCCP

Vice Chair, Council of Networks

Dr. Felzer is a Fellow and Dr. Kennedy is Associate Professor of Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN.



References

1. Gatwood J et al. Am J Health Promot. 2021;35:908.

2. Wong LP et al. Infect Dis Poverty. 2021;10:122.

3. Crane MA et al. Health Aff (Millwood). 2021;40:1792.

4. Strully KW et al. Front Public Health. 2021;9:645268.

Publications
Topics
Sections

Addressing disparities of socioeconomic status, race, and education in vaccine hesitancy and uptake

Vaccine hesitancy is described by the World Health Organization (WHO) as a “delay in acceptance or refusal of vaccination, despite availability of vaccine services.”1 Disparities in COVID-19 vaccine uptake, in addition to preexisting views of vaccine hesitancy, are consistently in the mainstream news.

The United States has a high rate of vaccine hesitancy, with a third of the country surveyed in 2021 stating they were unlikely to become vaccinated against COVID-19.2 This is in contrast to over 90% of people in Australia, China, and Norway saying they were highly likely to become vaccinated. Prepandemic, however, vaccination rates for preventable respiratory illness were already suboptimal. In fact, in 2019, the WHO declared vaccine hesitancy a top 10 priority due to the threat low vaccination causes on a global level.1

Dr. Jamie R. Felzer

U.S. health care systems’ cost to patients may serve as a disincentive for health care utilization, decreasing health care contacts. Further, changes in insurance can lead to provider discontinuity, which may erode the trusted patient-physician relationship. These realities may contribute to vaccine hesitancy that has been inversely correlated to both number of health care visits and trust in health care providers. Vaccine hesitancy exacerbates health disparities.1 Health literacy (understanding of health), education level, and general vaccine knowledge contribute to vaccine hesitancy also. Additionally, high social vulnerability (a score calculated from factors related to socioeconomic status, race, household makeup, housing type, and transportation) is strongly inversely correlated with vaccination rates. In places with both high social vulnerability and vaccine hesitancy, the vaccine-hesitant individuals have far fewer vaccinations.3

Dr. Cassie C. Kennedy

Providers can impact vaccine uptake. Broadly, efforts to understand and address issues of trust in health care are needed. Educational materials should be disseminated to high-risk and medically underserved communities. At medical appointments, assessment of vaccination status, followed by providing individualized information regarding vaccine benefits and specific concerns may help increase uptake. In a survey of high-risk adults, only 14.8 and 18.5% of patients stated that the pneumococcal vaccine was offered to them in the last year and 5 years, respectively.1 Providers can have a strong impact on people obtaining vaccines; over half of patients receive vaccines when their provider recommends it.1,4 As a medical community focused on respiratory health, we need to prioritize offering vaccinations during inpatient and outpatient encounters.

By Jamie R. Felzer, MD, MPH

Network Member

Cassie C. Kennedy, MD, FCCP

Vice Chair, Council of Networks

Dr. Felzer is a Fellow and Dr. Kennedy is Associate Professor of Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN.



References

1. Gatwood J et al. Am J Health Promot. 2021;35:908.

2. Wong LP et al. Infect Dis Poverty. 2021;10:122.

3. Crane MA et al. Health Aff (Millwood). 2021;40:1792.

4. Strully KW et al. Front Public Health. 2021;9:645268.

Addressing disparities of socioeconomic status, race, and education in vaccine hesitancy and uptake

Vaccine hesitancy is described by the World Health Organization (WHO) as a “delay in acceptance or refusal of vaccination, despite availability of vaccine services.”1 Disparities in COVID-19 vaccine uptake, in addition to preexisting views of vaccine hesitancy, are consistently in the mainstream news.

The United States has a high rate of vaccine hesitancy, with a third of the country surveyed in 2021 stating they were unlikely to become vaccinated against COVID-19.2 This is in contrast to over 90% of people in Australia, China, and Norway saying they were highly likely to become vaccinated. Prepandemic, however, vaccination rates for preventable respiratory illness were already suboptimal. In fact, in 2019, the WHO declared vaccine hesitancy a top 10 priority due to the threat low vaccination causes on a global level.1

Dr. Jamie R. Felzer

U.S. health care systems’ cost to patients may serve as a disincentive for health care utilization, decreasing health care contacts. Further, changes in insurance can lead to provider discontinuity, which may erode the trusted patient-physician relationship. These realities may contribute to vaccine hesitancy that has been inversely correlated to both number of health care visits and trust in health care providers. Vaccine hesitancy exacerbates health disparities.1 Health literacy (understanding of health), education level, and general vaccine knowledge contribute to vaccine hesitancy also. Additionally, high social vulnerability (a score calculated from factors related to socioeconomic status, race, household makeup, housing type, and transportation) is strongly inversely correlated with vaccination rates. In places with both high social vulnerability and vaccine hesitancy, the vaccine-hesitant individuals have far fewer vaccinations.3

Dr. Cassie C. Kennedy

Providers can impact vaccine uptake. Broadly, efforts to understand and address issues of trust in health care are needed. Educational materials should be disseminated to high-risk and medically underserved communities. At medical appointments, assessment of vaccination status, followed by providing individualized information regarding vaccine benefits and specific concerns may help increase uptake. In a survey of high-risk adults, only 14.8 and 18.5% of patients stated that the pneumococcal vaccine was offered to them in the last year and 5 years, respectively.1 Providers can have a strong impact on people obtaining vaccines; over half of patients receive vaccines when their provider recommends it.1,4 As a medical community focused on respiratory health, we need to prioritize offering vaccinations during inpatient and outpatient encounters.

By Jamie R. Felzer, MD, MPH

Network Member

Cassie C. Kennedy, MD, FCCP

Vice Chair, Council of Networks

Dr. Felzer is a Fellow and Dr. Kennedy is Associate Professor of Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN.



References

1. Gatwood J et al. Am J Health Promot. 2021;35:908.

2. Wong LP et al. Infect Dis Poverty. 2021;10:122.

3. Crane MA et al. Health Aff (Millwood). 2021;40:1792.

4. Strully KW et al. Front Public Health. 2021;9:645268.

Publications
Publications
Topics
Article Type
Sections
Disallow All Ads
Content Gating
No Gating (article Unlocked/Free)
Alternative CME
Disqus Comments
Default
Use ProPublica
Hide sidebar & use full width
render the right sidebar.
Conference Recap Checkbox
Not Conference Recap
Clinical Edge
Display the Slideshow in this Article
Medscape Article
Display survey writer
Reuters content
Disable Inline Native ads
WebMD Article

FeNO guidelines. Marijuana use in pregnancy.

Article Type
Changed
Fri, 03/11/2022 - 00:15

 

Airway disorders

FeNO guidelines and the art of clinical medicine

The American Thoracic Society (ATS) recently published new guidelines on the use of fractional exhaled nitric oxide (FeNO) in the management of asthma (Khatri S. Am J Respir Crit Care Med. 2021;204[10]:e97-e109). The previous iteration dealt with questions about the interpretation of FeNO levels. However, the updated guidelines address a single question: Should patients with asthma in whom treatment is being contemplated undergo FeNO testing?

Several roles of nitric oxide (NO) have been discovered, including as a marker of eosinophilic airway inflammation or T2-inflammation. The fraction of NO during steady-state exhalation, easily measured by a handheld device, is a standardized quantitative noninvasive method to assess severity of airway eosinophilic inflammation. However, factors like concomitant sinusitis, bronchoconstriction, obesity, and smoking can also affect FeNO levels, and interpretation is context-dependent. Moreover, some biologic agents have variable effects on FeNO while still being effective in controlling T2 inflammation. Therefore, FeNO is neither the broadest nor the most sensitive signal of T2 inflammation, and there is much unknown about using FeNO to guide asthma treatment. Heterogeneity is one of the many challenges, as different endotypes and clinical subsets vary in the inflammatory pathways leading to airway hyperresponsiveness and remodeling.

ACCP
Dr. Uddalak Majumdar

The panel assessed the value of FeNO testing in improving asthma control questionnaire scores (ACT, ACQ-7), oral corticosteroid use, asthma exacerbations, lung function, health care utilization, and cost-effectiveness. FeNO-guided therapy compared with therapy without FeNO reduced exacerbations and oral corticosteroid use, though effect size was modest. Among other outcomes, while the trend favored FeNO, it did not reach statistical significance. Adverse effects of FeNO testing were trivial, and the cost is moderate though dependent on the institution size and testing frequency. Thus, for clinicians who manage adults and children 4 years of age and older, in whom treatment for asthma is being considered, it is suggested that FeNO testing be done in addition to usual care. The guidelines do not recommend specific steps to modify treatment based on FeNO results but suggest a decision framework, reminding us that clinical context is key and FeNO is merely one signal. In recognizing its own fallibility, this document suggests that in the continually evolving world of asthma, the art of clinical medicine still reigns supreme.

Uddalak Majumdar, MDDr. Majumdar is a Fellow, Pulmonary & Critical Care Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, Ohio.

Sleep medicine

Marijuana use in pregnancy

Marijuana is the most commonly used illegal drug in the United States. According to the CDC, about 1 in 20 women report using marijuana while pregnant (https://www.cdc.gov/marijuana/health-effects/pregnancy.html). As states legalize marijuana for medicinal or recreational purposes, its use by pregnant women could increase even further. While some use it to ease morning sickness and anxiety, they may not be aware that it can pose risks.

Research has been raising concerns about the effects of marijuana use during pregnancy for years. A study from 1978 linked maternal cannabis use with children’s behavioral problems and deficits in language comprehension, visual perception, attention, and memory (Life Sci. 1995;56[23-24]:2159-68). ). More recent research has linked use to low birth weight, reduced IQ, autism, delusional thoughts, and attention problems, although some other studies have not identified such associations.

A new study shows that children of women who use marijuana during or soon after pregnancy were twice as likely to become anxious, aggressive, or hyperactive. This corresponded with widespread reductions in immune-related gene expression in the placenta, which correlated with anxiety and hyperactivity (Proc National Acad Sci. 2021;118[47]e2106115118).

Chemicals from marijuana can be passed to the baby through breast milk. THC is stored in body fat and slowly released over time. Exposure could still occur even after stopping use (Marijuana use during pregnancy and lactation. ACOG Committee Opinion, Number 722, October 2017).

Studies have shown that THC can pass through the mother’s bloodstream to the placenta and the fetus. This occurs independent of how cannabis is consumed (smoking, vaping, eating, or oils/creams). Patients should be educated that no amount has been proven safe to use during pregnancy or breastfeeding.

Anita Rajagopal, MD, FCCP, Respiratory-Related Sleep Disorders Section, Member-at-Large

Dr. Rajagopal is Network Medical Director, Community Physician Network, Sleep Medicine/Medical Director, Community Health Network Sleep-Wake Disorders Center, Community Health Network, Indianapolis, Indiana.

Publications
Topics
Sections

 

Airway disorders

FeNO guidelines and the art of clinical medicine

The American Thoracic Society (ATS) recently published new guidelines on the use of fractional exhaled nitric oxide (FeNO) in the management of asthma (Khatri S. Am J Respir Crit Care Med. 2021;204[10]:e97-e109). The previous iteration dealt with questions about the interpretation of FeNO levels. However, the updated guidelines address a single question: Should patients with asthma in whom treatment is being contemplated undergo FeNO testing?

Several roles of nitric oxide (NO) have been discovered, including as a marker of eosinophilic airway inflammation or T2-inflammation. The fraction of NO during steady-state exhalation, easily measured by a handheld device, is a standardized quantitative noninvasive method to assess severity of airway eosinophilic inflammation. However, factors like concomitant sinusitis, bronchoconstriction, obesity, and smoking can also affect FeNO levels, and interpretation is context-dependent. Moreover, some biologic agents have variable effects on FeNO while still being effective in controlling T2 inflammation. Therefore, FeNO is neither the broadest nor the most sensitive signal of T2 inflammation, and there is much unknown about using FeNO to guide asthma treatment. Heterogeneity is one of the many challenges, as different endotypes and clinical subsets vary in the inflammatory pathways leading to airway hyperresponsiveness and remodeling.

ACCP
Dr. Uddalak Majumdar

The panel assessed the value of FeNO testing in improving asthma control questionnaire scores (ACT, ACQ-7), oral corticosteroid use, asthma exacerbations, lung function, health care utilization, and cost-effectiveness. FeNO-guided therapy compared with therapy without FeNO reduced exacerbations and oral corticosteroid use, though effect size was modest. Among other outcomes, while the trend favored FeNO, it did not reach statistical significance. Adverse effects of FeNO testing were trivial, and the cost is moderate though dependent on the institution size and testing frequency. Thus, for clinicians who manage adults and children 4 years of age and older, in whom treatment for asthma is being considered, it is suggested that FeNO testing be done in addition to usual care. The guidelines do not recommend specific steps to modify treatment based on FeNO results but suggest a decision framework, reminding us that clinical context is key and FeNO is merely one signal. In recognizing its own fallibility, this document suggests that in the continually evolving world of asthma, the art of clinical medicine still reigns supreme.

Uddalak Majumdar, MDDr. Majumdar is a Fellow, Pulmonary & Critical Care Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, Ohio.

Sleep medicine

Marijuana use in pregnancy

Marijuana is the most commonly used illegal drug in the United States. According to the CDC, about 1 in 20 women report using marijuana while pregnant (https://www.cdc.gov/marijuana/health-effects/pregnancy.html). As states legalize marijuana for medicinal or recreational purposes, its use by pregnant women could increase even further. While some use it to ease morning sickness and anxiety, they may not be aware that it can pose risks.

Research has been raising concerns about the effects of marijuana use during pregnancy for years. A study from 1978 linked maternal cannabis use with children’s behavioral problems and deficits in language comprehension, visual perception, attention, and memory (Life Sci. 1995;56[23-24]:2159-68). ). More recent research has linked use to low birth weight, reduced IQ, autism, delusional thoughts, and attention problems, although some other studies have not identified such associations.

A new study shows that children of women who use marijuana during or soon after pregnancy were twice as likely to become anxious, aggressive, or hyperactive. This corresponded with widespread reductions in immune-related gene expression in the placenta, which correlated with anxiety and hyperactivity (Proc National Acad Sci. 2021;118[47]e2106115118).

Chemicals from marijuana can be passed to the baby through breast milk. THC is stored in body fat and slowly released over time. Exposure could still occur even after stopping use (Marijuana use during pregnancy and lactation. ACOG Committee Opinion, Number 722, October 2017).

Studies have shown that THC can pass through the mother’s bloodstream to the placenta and the fetus. This occurs independent of how cannabis is consumed (smoking, vaping, eating, or oils/creams). Patients should be educated that no amount has been proven safe to use during pregnancy or breastfeeding.

Anita Rajagopal, MD, FCCP, Respiratory-Related Sleep Disorders Section, Member-at-Large

Dr. Rajagopal is Network Medical Director, Community Physician Network, Sleep Medicine/Medical Director, Community Health Network Sleep-Wake Disorders Center, Community Health Network, Indianapolis, Indiana.

 

Airway disorders

FeNO guidelines and the art of clinical medicine

The American Thoracic Society (ATS) recently published new guidelines on the use of fractional exhaled nitric oxide (FeNO) in the management of asthma (Khatri S. Am J Respir Crit Care Med. 2021;204[10]:e97-e109). The previous iteration dealt with questions about the interpretation of FeNO levels. However, the updated guidelines address a single question: Should patients with asthma in whom treatment is being contemplated undergo FeNO testing?

Several roles of nitric oxide (NO) have been discovered, including as a marker of eosinophilic airway inflammation or T2-inflammation. The fraction of NO during steady-state exhalation, easily measured by a handheld device, is a standardized quantitative noninvasive method to assess severity of airway eosinophilic inflammation. However, factors like concomitant sinusitis, bronchoconstriction, obesity, and smoking can also affect FeNO levels, and interpretation is context-dependent. Moreover, some biologic agents have variable effects on FeNO while still being effective in controlling T2 inflammation. Therefore, FeNO is neither the broadest nor the most sensitive signal of T2 inflammation, and there is much unknown about using FeNO to guide asthma treatment. Heterogeneity is one of the many challenges, as different endotypes and clinical subsets vary in the inflammatory pathways leading to airway hyperresponsiveness and remodeling.

ACCP
Dr. Uddalak Majumdar

The panel assessed the value of FeNO testing in improving asthma control questionnaire scores (ACT, ACQ-7), oral corticosteroid use, asthma exacerbations, lung function, health care utilization, and cost-effectiveness. FeNO-guided therapy compared with therapy without FeNO reduced exacerbations and oral corticosteroid use, though effect size was modest. Among other outcomes, while the trend favored FeNO, it did not reach statistical significance. Adverse effects of FeNO testing were trivial, and the cost is moderate though dependent on the institution size and testing frequency. Thus, for clinicians who manage adults and children 4 years of age and older, in whom treatment for asthma is being considered, it is suggested that FeNO testing be done in addition to usual care. The guidelines do not recommend specific steps to modify treatment based on FeNO results but suggest a decision framework, reminding us that clinical context is key and FeNO is merely one signal. In recognizing its own fallibility, this document suggests that in the continually evolving world of asthma, the art of clinical medicine still reigns supreme.

Uddalak Majumdar, MDDr. Majumdar is a Fellow, Pulmonary & Critical Care Medicine, Respiratory Institute, Cleveland Clinic, Cleveland, Ohio.

Sleep medicine

Marijuana use in pregnancy

Marijuana is the most commonly used illegal drug in the United States. According to the CDC, about 1 in 20 women report using marijuana while pregnant (https://www.cdc.gov/marijuana/health-effects/pregnancy.html). As states legalize marijuana for medicinal or recreational purposes, its use by pregnant women could increase even further. While some use it to ease morning sickness and anxiety, they may not be aware that it can pose risks.

Research has been raising concerns about the effects of marijuana use during pregnancy for years. A study from 1978 linked maternal cannabis use with children’s behavioral problems and deficits in language comprehension, visual perception, attention, and memory (Life Sci. 1995;56[23-24]:2159-68). ). More recent research has linked use to low birth weight, reduced IQ, autism, delusional thoughts, and attention problems, although some other studies have not identified such associations.

A new study shows that children of women who use marijuana during or soon after pregnancy were twice as likely to become anxious, aggressive, or hyperactive. This corresponded with widespread reductions in immune-related gene expression in the placenta, which correlated with anxiety and hyperactivity (Proc National Acad Sci. 2021;118[47]e2106115118).

Chemicals from marijuana can be passed to the baby through breast milk. THC is stored in body fat and slowly released over time. Exposure could still occur even after stopping use (Marijuana use during pregnancy and lactation. ACOG Committee Opinion, Number 722, October 2017).

Studies have shown that THC can pass through the mother’s bloodstream to the placenta and the fetus. This occurs independent of how cannabis is consumed (smoking, vaping, eating, or oils/creams). Patients should be educated that no amount has been proven safe to use during pregnancy or breastfeeding.

Anita Rajagopal, MD, FCCP, Respiratory-Related Sleep Disorders Section, Member-at-Large

Dr. Rajagopal is Network Medical Director, Community Physician Network, Sleep Medicine/Medical Director, Community Health Network Sleep-Wake Disorders Center, Community Health Network, Indianapolis, Indiana.

Publications
Publications
Topics
Article Type
Sections
Disallow All Ads
Content Gating
No Gating (article Unlocked/Free)
Alternative CME
Disqus Comments
Default
Use ProPublica
Hide sidebar & use full width
render the right sidebar.
Conference Recap Checkbox
Not Conference Recap
Clinical Edge
Display the Slideshow in this Article
Medscape Article
Display survey writer
Reuters content
Disable Inline Native ads
WebMD Article

President’s report

Article Type
Changed
Fri, 03/11/2022 - 00:15

New year, new CHEST President. Same as it has always been, except it has never been this way before. In past years, the transition of the CHEST Presidency occurred at our annual meeting, with a formal handover of leadership and a large reception. While there’s no Presidential football to hand over or secret codes to change for the incoming administration, there are usually several pending issues related to ongoing endeavors that need to be discussed between the outgoing and incoming leadership, in addition to some pearls of wisdom and the figurative “keys to the car.”

Now that CHEST has changed its President’s year to transition alongside the calendar year, there are few associated formalities. I awakened on New Year’s Day with my new title and the associated responsibility. Past President Steve Simpson, the mensch that he is, sent along with my colluding spouse a lovely and inspirational message for me to peruse, full of thoughtful advice and reflections on his year as President. I don’t know if this has ever been done before, but it is a tradition that I fully intend on continuing at the end of my term.

ACCP
Dr. David Schulman

What has CHEST been up to during the first few months of my tenure? January saw us hold our first Board of Regents meeting for 2022, as well as the meeting of the CHEST Critical Care SEEK editorial board, where they worked to put together Volume 32, which will be out later this year. Watching some of the best and brightest medical minds from around the country discuss hot topics in critical care was a great experience (even if I didn’t have much to offer this august group), but the educational content was secondary to the interactions. Not only are these really smart folks teaching and learning from each other, but many of them are also clearly long-term colleagues, and watching this medical meeting was a lot like watching a reunion of friends who hadn’t seen each other in years. And, it struck me that what I’ve really been missing the most in the context of the social isolation that has accompanied the medical challenges of the pandemic is the pleasure of meeting in person with other folks to share stories, tell jokes, commiserate a bit, and catch up on the time that COVID-19 has stolen from us.

As we move further into 2022, I’m hoping that CHEST and our sister societies can help make up for this lost time by giving us the chance to meet in person once again. And to help build these experiences, we held an experiential design team along with our annual CHEST Program Committee meeting in February. Not only will the 2022 annual meeting in Nashville have the opportunity to hear from and network the best and brightest in pulmonary, critical care, and sleep medicine, but to celebrate our getting back together for the first time in years, we are also putting together some special surprises that CHEST has never done before. Keep an eye out for sneak peaks of these plans later in the spring and summer.

Another of our foci in 2022 is our ongoing push to help historically disenfranchised groups feel more engaged with CHEST. Many of you contributed to last year’s initiative to gather data on the kinds of things that we can do better, and I’ve just put together a presidential task force to develop final recommendations to further our goals of improving diversity, equity, and inclusion and to present to the Board of Regents for our April meeting.

Hopefully, many of you have seen some of the “Pardon the Introduction” series that CHEST has been featuring on its social media channels. We’ve put these together to showcase some of our leadership, their experiences, and opportunities for our members to get more involved with the College. Selfishly, I admit that they have also served as an excuse for me to catch up with some old friends and share our CHEST stories. We will be continuing to produce this series throughout the year; please let us know if there are specific folks you’d like us to feature!

ACCP

Lastly, I wanted to thank the many of you who have reached out to me with questions, comments, and feedback. One of my main initiatives for the year is to make sure we are meeting the needs of as many of our members as possible, and this is something we can only do well if the lines of communication are wide open. Please continue to reach out to me, either by emailing me at [email protected] or messaging me on Twitter @ChestPrez.

Publications
Topics
Sections

New year, new CHEST President. Same as it has always been, except it has never been this way before. In past years, the transition of the CHEST Presidency occurred at our annual meeting, with a formal handover of leadership and a large reception. While there’s no Presidential football to hand over or secret codes to change for the incoming administration, there are usually several pending issues related to ongoing endeavors that need to be discussed between the outgoing and incoming leadership, in addition to some pearls of wisdom and the figurative “keys to the car.”

Now that CHEST has changed its President’s year to transition alongside the calendar year, there are few associated formalities. I awakened on New Year’s Day with my new title and the associated responsibility. Past President Steve Simpson, the mensch that he is, sent along with my colluding spouse a lovely and inspirational message for me to peruse, full of thoughtful advice and reflections on his year as President. I don’t know if this has ever been done before, but it is a tradition that I fully intend on continuing at the end of my term.

ACCP
Dr. David Schulman

What has CHEST been up to during the first few months of my tenure? January saw us hold our first Board of Regents meeting for 2022, as well as the meeting of the CHEST Critical Care SEEK editorial board, where they worked to put together Volume 32, which will be out later this year. Watching some of the best and brightest medical minds from around the country discuss hot topics in critical care was a great experience (even if I didn’t have much to offer this august group), but the educational content was secondary to the interactions. Not only are these really smart folks teaching and learning from each other, but many of them are also clearly long-term colleagues, and watching this medical meeting was a lot like watching a reunion of friends who hadn’t seen each other in years. And, it struck me that what I’ve really been missing the most in the context of the social isolation that has accompanied the medical challenges of the pandemic is the pleasure of meeting in person with other folks to share stories, tell jokes, commiserate a bit, and catch up on the time that COVID-19 has stolen from us.

As we move further into 2022, I’m hoping that CHEST and our sister societies can help make up for this lost time by giving us the chance to meet in person once again. And to help build these experiences, we held an experiential design team along with our annual CHEST Program Committee meeting in February. Not only will the 2022 annual meeting in Nashville have the opportunity to hear from and network the best and brightest in pulmonary, critical care, and sleep medicine, but to celebrate our getting back together for the first time in years, we are also putting together some special surprises that CHEST has never done before. Keep an eye out for sneak peaks of these plans later in the spring and summer.

Another of our foci in 2022 is our ongoing push to help historically disenfranchised groups feel more engaged with CHEST. Many of you contributed to last year’s initiative to gather data on the kinds of things that we can do better, and I’ve just put together a presidential task force to develop final recommendations to further our goals of improving diversity, equity, and inclusion and to present to the Board of Regents for our April meeting.

Hopefully, many of you have seen some of the “Pardon the Introduction” series that CHEST has been featuring on its social media channels. We’ve put these together to showcase some of our leadership, their experiences, and opportunities for our members to get more involved with the College. Selfishly, I admit that they have also served as an excuse for me to catch up with some old friends and share our CHEST stories. We will be continuing to produce this series throughout the year; please let us know if there are specific folks you’d like us to feature!

ACCP

Lastly, I wanted to thank the many of you who have reached out to me with questions, comments, and feedback. One of my main initiatives for the year is to make sure we are meeting the needs of as many of our members as possible, and this is something we can only do well if the lines of communication are wide open. Please continue to reach out to me, either by emailing me at [email protected] or messaging me on Twitter @ChestPrez.

New year, new CHEST President. Same as it has always been, except it has never been this way before. In past years, the transition of the CHEST Presidency occurred at our annual meeting, with a formal handover of leadership and a large reception. While there’s no Presidential football to hand over or secret codes to change for the incoming administration, there are usually several pending issues related to ongoing endeavors that need to be discussed between the outgoing and incoming leadership, in addition to some pearls of wisdom and the figurative “keys to the car.”

Now that CHEST has changed its President’s year to transition alongside the calendar year, there are few associated formalities. I awakened on New Year’s Day with my new title and the associated responsibility. Past President Steve Simpson, the mensch that he is, sent along with my colluding spouse a lovely and inspirational message for me to peruse, full of thoughtful advice and reflections on his year as President. I don’t know if this has ever been done before, but it is a tradition that I fully intend on continuing at the end of my term.

ACCP
Dr. David Schulman

What has CHEST been up to during the first few months of my tenure? January saw us hold our first Board of Regents meeting for 2022, as well as the meeting of the CHEST Critical Care SEEK editorial board, where they worked to put together Volume 32, which will be out later this year. Watching some of the best and brightest medical minds from around the country discuss hot topics in critical care was a great experience (even if I didn’t have much to offer this august group), but the educational content was secondary to the interactions. Not only are these really smart folks teaching and learning from each other, but many of them are also clearly long-term colleagues, and watching this medical meeting was a lot like watching a reunion of friends who hadn’t seen each other in years. And, it struck me that what I’ve really been missing the most in the context of the social isolation that has accompanied the medical challenges of the pandemic is the pleasure of meeting in person with other folks to share stories, tell jokes, commiserate a bit, and catch up on the time that COVID-19 has stolen from us.

As we move further into 2022, I’m hoping that CHEST and our sister societies can help make up for this lost time by giving us the chance to meet in person once again. And to help build these experiences, we held an experiential design team along with our annual CHEST Program Committee meeting in February. Not only will the 2022 annual meeting in Nashville have the opportunity to hear from and network the best and brightest in pulmonary, critical care, and sleep medicine, but to celebrate our getting back together for the first time in years, we are also putting together some special surprises that CHEST has never done before. Keep an eye out for sneak peaks of these plans later in the spring and summer.

Another of our foci in 2022 is our ongoing push to help historically disenfranchised groups feel more engaged with CHEST. Many of you contributed to last year’s initiative to gather data on the kinds of things that we can do better, and I’ve just put together a presidential task force to develop final recommendations to further our goals of improving diversity, equity, and inclusion and to present to the Board of Regents for our April meeting.

Hopefully, many of you have seen some of the “Pardon the Introduction” series that CHEST has been featuring on its social media channels. We’ve put these together to showcase some of our leadership, their experiences, and opportunities for our members to get more involved with the College. Selfishly, I admit that they have also served as an excuse for me to catch up with some old friends and share our CHEST stories. We will be continuing to produce this series throughout the year; please let us know if there are specific folks you’d like us to feature!

ACCP

Lastly, I wanted to thank the many of you who have reached out to me with questions, comments, and feedback. One of my main initiatives for the year is to make sure we are meeting the needs of as many of our members as possible, and this is something we can only do well if the lines of communication are wide open. Please continue to reach out to me, either by emailing me at [email protected] or messaging me on Twitter @ChestPrez.

Publications
Publications
Topics
Article Type
Sections
Disallow All Ads
Content Gating
No Gating (article Unlocked/Free)
Alternative CME
Disqus Comments
Default
Use ProPublica
Hide sidebar & use full width
render the right sidebar.
Conference Recap Checkbox
Not Conference Recap
Clinical Edge
Display the Slideshow in this Article
Medscape Article
Display survey writer
Reuters content
Disable Inline Native ads
WebMD Article