CHEST Journal Podcasts

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.

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.

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. 

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.

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.

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.

The author of this month's Special Feature marking the 50th anniversary of the first publication of cases of alpha-1-antitrypsin deficiency (AATD), Robert A. Stockley, MD, joins Kenneth R. Chapman, MD, and CHEST Podcast Editor, D. Kyle Hogarth, MD, FCCP, to review the impact that this research has had on respiratory medicine and clinical practice. Since this first publication in 1963, among other advances, AATD research has identified the most common genetic susceptibility factor for emphysema, developed the protein structural biology to repair the defect, distinguished the serinopathies in disease pathophysiology affecting other organs, and validated the role of CT scanning and its acceptance as a primary outcome for clinical trials. Duration: 38:11 minutes

In this month's podcast, Nicholas M. Mohr, MD, and Anne M. Drewry, MD debate their Point/Counterpoint editorials with CHEST Podcast Editor, D. Kyle Hogarth, MD, FCCP. Dr. Mohr argues that the sickest patients do not tolerate fever well and that temperature management should be used. Dr. Drewry counters that there are risks involved with antipyretic therapies and that there is little convincing evidence to indicate that fever adversely affects outcomes in septic patients.

John D. Goodson, MD, joins CHEST Podcast Editor, D. Kyle Hogarth, MD, FCCP, to provide background on his Commentary in this month's issue of CHEST making the case that the undervaluation of evaluation and management professional services vis-a-vis procedural services must be addressed and fixed. Duration: 37 min

Momen M. Wahidi, MD, MBA, FCCP, and Robert Browning, MD, FCCP, join CHEST Podcast Editor D. Kyle Hogarth, MD, FCCP, to expand on their Point/Counterpoint debate on the merits of endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) versus conventional TBNA. Duration: 32:40 min