Vital Capacity

This week, symptoms after first mRNA vaccine dose linked to previous SARS-CoV-2 infection; US to offer booster shots to fully vaccinated Americans starting Sept. 20; CBD eases emotional exhaustion, burnout symptoms in study of frontline health care workers; and more.

Read the full coverage here:

Symptoms after first mRNA vaccine dose linked to previous SARS-CoV-2 infection

US to offer booster shots to fully vaccinated Americans starting Sept. 20

CBD eases emotional exhaustion, burnout symptoms in study of frontline health care workers

Vegan diet provides most health benefits among plant-based eating patterns

Dexamethasone may be 'underused' among critically ill patients with COVID-19

References:

Debes AK, et al. JAMA Intern Med. 2021;doi:10.1001/jamainternmed.2021.4580.

Press Conference

Crippa JAS, et al. JAMA Netw Open. 2021;doi:10.1001/jamanetworkopen.2021.20603.

Jardine M, et al. D-18. Presented at: ADCES21; Aug. 12-15, 2021 (virtual meeting).

Mehta HB, et al. 2021;doi: Ann Intern Med. doi:10.7326/M21-0857.

This week, the FDA approves single-use bronchoscopes; a study finds the Moderna COVID-19 vaccine is safe and effective in adolescents; CMS nixes the most-favored nation pricing model for Medicare Part B; and more.

Read the full coverage here:

Single-use bronchoscope receives FDA clearance

Moderna COVID-19 vaccine safe, efficacious in adolescents

Adoption of newer antifibrotic medications for IPF low in US in everyday practice: Study

FDA allows third dose of COVID-19 vaccine for immunocompromised patients

CMS nixes 'most-favored nation' pricing model for Medicare Part B

References:

Ali K, et al. N Engl J Med. 2021;doi:10.1057/NEJMoa2109522.

CMS proposed rule.

Dempsey TM, et al. Ann Am Thorac Soc. 2021;doi:10.1513/AnnalsATS.202007-901OC.

Press Release.

Press Release.

This week, the CDC confirms a fatal case of melioidosis in Georgia; Moderna says its vaccine is 93% effective at 6 months; a survey shows patients prefer that physicians wear white coats; and more.

Read the full coverage here:

CDC confirms fatal case of melioidosis in Georgia, links it to previous US cases

Moderna COVID-19 vaccine 93% effective, 'durable' at 6 months, company says

Casual attire is becoming more popular among physicians, but patients prefer white coats

Modified Mediterranean-ketogenic diet may reduce cognitive decline

Coexistence of bronchiectasis with asthma, chronic rhinosinusitis common

References:

Kawas MI, et al. Modified Mediterranean Ketogenic diet resolves default node network connectivity differences between adults with normal and impaired cognition: A pilot study. Presented at: Alzheimer's Association International Conference; July 26-30, 2021 (virtual meeting).

Press Release.

Press Release.

Sheng H, et al. BMC Pulm Med. 2021;doi:10.1186/s12890-021-01575-7.

Xun H, et al. JAMA Netw Open. 2021;doi:10.1001/jamanetworkopen.2021.17779.

This week, Pfizer says a third dose of the vaccine boosts protection, even against the delta variant; US News and World Report ranks Mayo Clinic number 1 for pulmonology and lung surgery; the FDA approves IV selexipag for adults with PAH; and more.

Read the full coverage here:

Pfizer says third dose of vaccine boosts protection, including against delta variant

CDC alters mask guidance, says even vaccinated Americans need them in some places

Mayo Clinic ranked No. 1 hospital in US for pulmonology, lung surgery

FDA approves selexipag for IV use in adults with PAH

FDA approves Saphnelo, first new lupus treatment since 2011

References:

AstraZeneca press release.

Lupus Research Alliance press release.

Pfizer. Second quarter 2021 earnings teleconference. July 28, 2021. https://s21.q4cdn.com/317678438/files/doc_financials/2021/q2/Q2-2021-Earnings-Charts-FINAL.pdf. Accessed on July 28, 2021.

Press Conference.

Press Release.

U.S. News & World Report.

This week, CHEST issues guidelines for low-dose CT screening for lung cancer; severe COVID-19 survivors experience pulmonary impairment; the FDA approves Prograf to prevent lung transplant rejection; and more.

Read the full coverage here:

CHEST issues new guideline on benefits, harms, use of low-dose CT screening for lung cancer

Pulmonary impairment 'highly prevalent' in severe COVID-19 survivors following discharge

FDA approves Prograf to prevent organ rejection in lung transplant recipients

In omega-3 fatty acid trials, EPA alone yields greater CV risk reduction vs. EPA plus DHA

Benefit of full-dose heparin for patients with COVID-19 warrants 'new standard of care'

References:

González J, et al. Chest. 2021;doi:10.1016/j.chest.2021.02.062.

Khan SU, et al. eClinical Medicine. 2021;doi:10.1016/j.eclinm.2021.100997.

Mazzone PJ, et al. Chest. 2021;doi:10.1016/j.chest.2021.06.063.

Press Release.

Sholzberg M, et al. medRxiv. 2021;doi:10.1101/2021.07.08.21259351.

In this episode, the original "zentensivisit" Matt Siuba, DO, sits down with me to discuss the concept of zentensivism, tips for social media, and much more. Don't miss his top critical care papers every fellow should know.

• Intro :15
• About Siuba :41
• The interview 1:30
• Tell me a bit about yourself in your own words 1:54
• Did you always know you wanted to be a doctor? 3:59
• The whole concept of zentensivism … how did it start? 6:30
• When did you get involved with Twitter? 11:26
• Do you have advice for people who want to minimize negative attraction on social media? 13:50
• How do you manage time? 16:44
• Has this time management strategy been something you have been doing for very long? 19:48
• Have you ever experienced imposter syndrome? 21:41
• Do you have some examples from your med school or residency days where you felt like you were too hard on yourself? 25:16
• What makes you happy? What fun things do you like to do? 27:44
• Any examples of things in your professional life that you were disappointed in or wished could have gone differently? 32:35
• Are there strategies to minimize and delay burnout and have more resilience? 37:06
• Do you have any specific advice for the listeners apart from the three points of 'sleep more,' 'less is more' and 'be more curious?' 42:51
• Have you noticed the difference in how foreign-born DOs go through a much harder time? 44:20
• Can you share with me some of the important papers that every critical care fellow needs to know? 47:03
• Thanks for listening 50:47

Matt Siuba, DO, is an intensivist at the Cleveland Clinic. His interests include circulatory shock as well as severe forms of respiratory failure, especially acute respiratory distress syndrome. He is invested in zentensivism: minimally invasive, maximally attentive medical care. Siuba is enrolled in the M.S. in Clinical Research program at Case Western Reserve University.

We'd love to hear from you! Send your comments/questions to Dr. Bhardwaj at [email protected]. Follow us on Twitter @HealioPulm @abhi_bhardwaj99. Dr. Siuba can be reached on Twitter @msiuba.

Disclosures: Bhardwaj and Siuba report no relevant financial disclosures.

This week, surging caseloads are linked to nearly one quarter of US COVID-19 deaths; booster doses may not be necessary for the Pfizer vaccine; the FDA calls for an investigation into the recent Alzheimer's drug approval; cancer death rates continue to decline; and frailty is tied to longer mechanical ventilation.

Read the full coverage here:

23% of COVID-19 deaths at US hospitals linked to surging caseloads

CDC, FDA say booster doses not needed as Pfizer eyes authorization

FDA calls for a federal investigation into Aduhelm approval

Declines in cancer death rates continue, but not for all common types

Frailty tied to longer mechanical ventilation, identifies those less likely to be liberated

References:

BioNTech. Pfizer and BioNTech provide update on booster program in light of the delta-variant. https://investors.biontech.de/news-releases/news-release-details/pfizer-and-biontech-provide-update-booster-program-light-delta. Accessed on July 9, 2021.

HHS. Joint CDC and FDA statement on vaccine boosters. https://www.hhs.gov/about/news/2021/07/08/joint-cdc-and-fda-statement-vaccine-boosters.html. Accessed on July 9, 2021.

Islami F, et al. J Natl Cancer Inst. 2021;doi:10.1093/jnci/djab131.

Kadri SS, et al. Ann Intern Med. 2021;doi:10.7326/M21-1213.

Okahara S, et al. Ann Am Thorac Soc. 2021;doi:10.1513/AnnalsATS.202102-178OC.

STAT. FDA calls for federal investigation into its controversial Alzheimer's drug approval. Available at: https://www.statnews.com/2021/07/09/fda-investigation-alzheimers-drug-approval/?utm_source=STAT+Newsletters&utm_campaign=972fd2c048-breaking_COPY_01&utm_medium=email&utm_term=0_8cab1d7961-972fd2c048-151965521. Accessed July 9, 2021.

This week, low-dose azithromycin did not improve cough in patients with IPF; tele-pulmonary rehab may lower barriers to care; the J&J vaccine provides 8-month protection from the delta variant; a daily ECMO liberation protocol was found to be safe and feasible; and portable air cleaners could reduce exposure to SARS-CoV-2 aerosols.

Read the full coverage here:

Study does not support low-dose azithromycin to treat chronic cough in IPF

Telehealth pulmonary rehabilitation program for COPD accessible, feasible, safe

J&J vaccine protects against delta variant for at least 8 months, studies find

ECMO-free protocol feasible, may aid earlier identification of patients for decannulation

Portable air cleaners could reduce exposure to SARS-CoV-2 aerosols, study finds

References:

Alwakeel AJ, et al. Ann Am Thorac Soc. 2021;doi:10.1513/AnnalsATS.202006-638OC.

Gannon WD, et al. Chest. 2021;doi:10.1016/j.chest.2021.05.066.

Guler SA, et al. Ann Am Thorac Soc. 2021;doi:10.1513/AnnalsATS.202103-266OC.

Lindsley WG, et al. MMWR Morb Mortal Wkly Rep. 2021;doi:10.15585/mmwr.mm7027e1.

This week, the FDA issues an EUA for tocilizumab in COVID-19; an electronic tool detects ovarian and pancreatic cancers; the delta variant accounts for 20% of new COVID-19 cases; researchers uncover variables linked with COVID-19 fatalities; and the ACIP recommends the dengue vaccine for children in endemic areas.

Read the full coverage here:

FDA issues EUA for tocilizumab to treat patients hospitalized with COVID-19

'Electronic nose' accurately detects ovarian, pancreatic cancers

Fauci: 20% of new COVID-19 cases are from delta variant

Researchers identify variables associated with COVID-19 fatalities during first wave

ACIP unanimously recommends dengue vaccine for children aged 9 to 16 years

References:

CDC. Advisory Committee on Immunization Practices. https://www.cdc.gov/vaccines/acip/index.html. Accessed June 24, 2021.

FDA press release.

Genentech press release.

Johnson ATC, et al. Abstract 9004. Presented at: ASCO Annual Meeting (virtual meeting); June 4-8, 2021.

Millar JA, et al. Risk factors for increased COVID-19 case-fatality in the United States: A county-level analysis during the first wave. Presented at World Microbe Forum; June 20-24, 2021 (virtual meeting).

James Stoller, MD, MS, is chair of the Education Institute at Cleveland Clinic. His love for patient care and passion for medical education is palpable. In this episode we discuss burnout, imposter syndrome and thought leadership.

• Intro :34
• About Stoller :38
• The interview 2:03
• Tell me about yourself 2:04

• Do you remember making an active effort to create such a positive training environment here at Cleveland Clinic? 3:26
• Becoming a doctor is intrinsically arduous 6:11
• Did you plan to be in the role you're in today? 6:56
• How do you overcome internal doubt, and can leadership traits be cultivated? 13:34
• Do you agree there's a role for leadership curriculum in medical school training? 21:07
• How have you managed to attend every one of your son's NFL games? 23:14
• Lessons from the pandemic 26:55
• As a kid, were you always this disciplined? 29:17
• Are there any memories from your training that stand out? 34:56
• What are some of the happiest memories from your childhood? 38:52
• Is there any other way that you double up resilience in your trainees so that they can continue and have a long, fulfilling career? 40:50
• What are some of the challenges you face on a daily basis? 41:12
• What advice would you give your younger self? 47:11
• Do you have advice for the listeners? 48:18
• Thank you, Dr. Stoller 50:57

James Stoller, MD, MS, is executive director of physician leadership development and chair of the Education Institute at Cleveland Clinic.

We'd love to hear from you! Send your comments/questions to Dr. Bhardwaj at [email protected]. Follow us on Twitter @HealioPulm @abhi_bhardwaj99.

Disclosures: Bhardwaj and Stoller report no relevant financial disclosures.