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.

Direct download: 133032.mp3
Category:medical -- posted at: 12:30am EST

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.

Direct download: 142500.mp3
Category:medical -- posted at: 8:53am EST

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.

Direct download: 140003.mp3
Category:medical -- posted at: 12:30am EST

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. 

Direct download: 141485.mp3
Category:medical -- posted at: 12:30am EST

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.

Direct download: 140076.mp3
Category:medical -- posted at: 12:30am EST

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.

Direct download: 140732.mp3
Category:medical -- posted at: 9:25am EST

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.

Direct download: 140793.mp3
Category:medical -- posted at: 10:42am EST

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. 

Direct download: 131394.mp3
Category:medical -- posted at: 12:30am EST

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.

Direct download: 140014.mp3
Category:medical -- posted at: 12:30am EST

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

Direct download: 131640.mp3
Category:medical -- posted at: 3:40pm EST

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.

Direct download: 132404.mp3
Category:medical -- posted at: 3:31pm EST

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.

Direct download: 131023.mp3
Category:medical -- posted at: 12:30am EST

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.

Direct download: LC_screening_CMS.mp3
Category:medical -- posted at: 9:36am EST

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.

Direct download: 131474.mp3
Category:medical -- posted at: 7:09am EST

Robert J. McCunney, MD, MPH, and David C. Christiani, MD, MPH, FCCP, are interviewed by CHEST Podcast Editor, D. Kyle Hogarth, MD, FCCP, as they discuss the many issues posed by the increasing use of low-dose spriral CT (LDCT) in lung cancer screening. The focus is on McCunney and Li's article in this month's issue of CHEST, comparing 20- to 30-year exposure to LDCT with that of nuclear workers and atomic bomb survivors. The conversation covers many topics, including level of exposure, the problem of false positives, machine calibration, and appropriate candidates for LDCT.

Direct download: 131420.mp3
Category:general -- posted at: 12:30am EST

Richard S. Saver, JD, is interviewed by CHEST Podcast Editor, D. Kyle Hogarth to answer questions that physicians in research medicine will have about the new Physician Payments Sunshine Act; the new regulations mandate the a Centers for Medicare and Medicaid Services website begin publishing data provided by manufacturers on payments to physicians. Topics they cover include how patients might use the website, how physicians might monitor what is reported, and which entities are required to report.

Direct download: 131719.mp3
Category:medical -- posted at: 12:30am EST

C. Gregory Elliott, MD, FCCP, and editorialist David Langlaben, MD, join CHEST Podcast Editor, D. Kyle Hogarth, MD, FCCP, to discuss the recent research of Dr. Elliott et al that determined the genetic mutations responsible for pulmonary capillary hemangiomatosis (PCH), a rare cause of pulmonary hypertension. The EIF2AK4 mutuations were found using exome sequencing. 

Direct download: 132366.mp3
Category:medical -- posted at: 12:30am EST

In this month's Point/Counterpoint editorials, Najib M. Rahman, DPhil, takes the "yes" side of the debate, arguing that pleural infection continues to result in significant morbidity and mortality despite current therapeutic strategies. He joins CHEST Podcast Editor, D. Kyle Hogarth, MD, FCCP, and Gene Colice, MD, FCCP, who takes on the "no" position. Dr. Colice argues that dosing regimens for fibrinolytics do not ensure effective intrapleural fibrinolysis, clinical trials in adults have not shown consistent clinical benefits, and an alternative approach (surgical drainage by video-assisted thoracoscopic surgery) provides effective drainage of the pleural space with improved clinical outcomes.

Direct download: 132354.mp3
Category:medical -- posted at: 12:30am EST

Milo A. Puhan, MD, PhD, and editorialist David M. Mannino, MD, FCCP, join CHEST Podcast Editor, D. Kyle Hogarth, MD, FCCP, to discuss Dr. Puhan et al's multicenter prospective study that showed no association between lower levels of 25-hydroxyvitamin D and either rate of COPD exacerbation or all cause mortality. Dr. Mannino concludes that the current Institute of Medicine recommendations of 600-800 IU/day of vitamin D intake, along with exercise and moderate amounts of sun exposure are still the best advice for patients.

Direct download: 131296.mp3
Category:medical -- posted at: 12:30am EST