Vital Capacity

This week, the FDA grants approval on two treatments: oral omadacycline for community-acquired bacterial pneumonia and Trikafta for children aged 6 to 11 with cystic fibrosis; more than 70% of COVID-19 patients experience at least one persistent symptom; many patients self-identify the need for pulmonary rehab following COVID-19 hospitalization; and children who had mild or asymptomatic COVID-19 do not need to be cleared for sports, according to the AAP.

Read the full coverage here:

FDA approves omadacycline oral regimen for community-acquired bacterial pneumonia

FDA approves Trikafta for children aged 6 to 11 with cystic fibrosis

More than 70% of COVID-19 patients experience at least one persistent symptom

Many patients self-identify need for pulmonary rehab following COVID-19 hospitalization

AAP: Children who had mild or asymptomatic COVID-19 do not need to be cleared for sports

This week, the ATS issued a new clinical practice guideline for noninfluenza viral pathogen testing in community-acquired pneumonia; the FDA issued two approvals: the first new Alzheimer's treatment since 2003, as well as once-weekly semaglutide for weight loss; and Healio spoke with experts regarding the use of face masks among children, and the link between COVID-19 vaccination and tinnitus.

This week, the CDC reported that breakthrough infections are rare among the first 101 million fully vaccinated people; tai chi is found to be effective to reduce belly fat in older adults; the CDC's COVID-19 vaccine safety group says its reviewed 'few' reports of myocarditis in young people; a follow-up analysis supports tocilizumab in moderate-to-severe COVID-19-associated pneumonia; and lidocaine throat spray reduces cough frequency in patients with refractory chronic cough.

Read the full coverage here:

Breakthrough infections rare among first 101 million fully vaccinated people, CDC finds

Tai chi 'effective approach' in reducing belly fat in older adults

CDC's COVID-19 vaccine safety group reviews 'few' reports of myocarditis in young people

Trial supports tocilizumab in moderate-to-severe COVID-19-associated pneumonia

Lidocaine throat spray reduces cough frequency in patients with refractory chronic cough

In this episode, I sit down with Sumita Khatri, MD, director of the Asthma Center at Cleveland Clinic, to discuss unconscious bias, advocating for immigrant physicians, overcoming imposter syndrome and balancing work and family life.

Brought to you by Amgen and AstraZeneca.

• Intro :15
• About Khatri :39
• The interview 1:12
• You have so many hats you wear … how do you do justice to this? 2:49
• Is there a strategy to working with and instructing fellows? 4:25
• You are a strong ally and a strong advocate for both immigrant physicians or foreign graduates … and you're a role model to women in medicine. How did you manage to do that? 7:29
• Do you have any advice for people who are aware of the unconscious bias between male and female physicians and who want to do more? 13:30
• How did you manage raising triplets while balancing your career? 17:00
• In your own words, describe your journey 21:02
• Is there a solution to that level of anxiety when it comes to fellows finding a good job? 25:47
• What did you do to be more disciplined about work and personal life? How did you make it more personalized? 28:23
• Do you have any specific experiences from med school and residency that have always stayed with you? 30:00
• How do you get over your impostor syndrome? How do you get over your fears? 33:57
• How do you handle your successes and failures? 35:36
• You're a full professor and you started a leadership program for women … how did that start? 39:23
• You are also involved with advocacy and you're a part of the leadership at the American Lung Association. How did that happen? 42:25
• As an advocate, as a leader, as a clinician, as a teacher, as a researcher, how do you do justice to family time? 44:09
• You love traveling. What have been some of your favorite places to travel to? 49:01
• Some of Khatri's favorite books 50:29
• Final words of advice for the listeners 53:28
• Thank you so much for joining today 53:46

Sumita Khatri, MD, MS, is a professor of medicine at Cleveland Clinic Lerner College of Medicine/Case Western Reserve University School of Medicine and an adult pulmonary and ICU physician with a specialized focus in asthma patient care and clinical research. Khatri is also the director of the Asthma Center at Cleveland Clinic and cares for patients in the Medical ICU.

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 Khatri report no relevant financial disclosures.

This week, a monoclonal antibody cocktail cut COVID-19 hospitalization and death by 70% in an outpatient setting; removing race correction in lung function tests shows more severe disease in Black patients; gefapixant reduces chronic cough frequency in a large pooled analysis; daily probiotics reduced upper respiratory tract infection symptoms; and moderate alcohol intake lowers stress-related brain activity and may reduce CVD risk.

Read the full coverage here:

Monoclonal antibody cocktail cut COVID-19 hospitalization, death by 70% in outpatient setting

Removing race correction in lung function tests shows more severe disease in Black patients

Gefapixant reduces chronic cough frequency in large pooled analysis

Probiotics, reduction in upper respiratory tract infection symptoms

Moderate alcohol intake lowers stress-related brain activity, may reduce CVD risk

Neal Chaisson, MD, is the program director of the Critical Care Medicine fellowship at Cleveland Clinic. He is an innovator at heart and a renowned clinician with expertise in pulmonary arterial hypertension associated with congenital heart disease. He is a phenomenal educator with a special interest in pulmonary hemodynamics and shock management. He is an outstanding proceduralist and fellows love him for his procedure teaching skills. Listen to his inspiring journey and learn how he is able to do justice to all the different roles he plays at work and in life.

• Intro :15
• About Chaisson :39
• How did this all start? What made you choose this career and this path? 1:12
• What encompasses a regular day? 6:23
• Are you the type of person who waits until the end to get everything done at the same time or are you meticulous that you cannot sleep until all your tasks are arranged and in order? 8:12
• What makes you happy as a program director and what are the challenges that come with this role? 10:09
• How are you able to gather a team of motivated, driven residents transitioning into fellowship? Is there a secret sauce for that? 13:56
• Is there anything that you are looking for in a fellowship candidate that stands out in the application process? 15:30
• When you started or when you were about to finish your fellowship, did you know that this was the career path that was built for you? 17:26
• When you became the program director, was the reality of the job the same as you imagined? 21:25
• Your specific interest is in pulmonary arterial hypertension congenital heart disease … how did that start? 27:00
• How do you manage and make a balance between work and your personal life? 33:04
• Do you have any good or fun memories from med school, or residency days or fellowship days? 36:47
• 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
• Do you watch any TV shows or movies … what do you like to do as a family? 45:48
• Do you like travelling? 47:27
• What is the most important piece of advice that you would give to the listeners? 49:20
• Thank you for coming to the show 52:59
• Thanks for listening 53:17

Neal Chaisson, MD, is an assistant professor of medicine and the program director of the Critical Care Medicine Fellowship in the Respiratory 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 Chaisson report no relevant financial disclosures.

This week, a study identifies two distinct phenotypes of COVID-19-associated ARDS; COVID-19 'long haulers' face 'substantial burden of health loss'; disparities in COVID-19 are 'striking' according to the director of the CDC; and some weight loss and sports supplements contain potentially harmful stimulants.

Read the full coverage here:

Study identifies two distinct phenotypes of COVID-19-associated ARDS

COVID-19 'long haulers' face 'substantial burden of health loss'

CDC director: Disparities in COVID-19 are 'striking'

Some weight loss, sports supplements contain potentially harmful stimulants

This week, the question of whether we'll need COVID-19 booster shots; the ACIP recommends resuming use of the J&J COVID-19 vaccine; humans in the UK transmitted SARS-CoV-2 to their cats; an NBA study shows that persistent positive cases do not transmit COVID-19 after recovery; and neurological symptoms with COVID-19 serve as an 'important predictor' of poor outcomes.

Read the full coverage here:

Will we need COVID-19 booster shots?

CDC advisory group recommends resuming use of J&J COVID-19 vaccine

New study demonstrates human-to-cat SARS-CoV-2 transmission

NBA study shows persistent positive cases do not transmit COVID-19 after recovery

Neurological symptoms with COVID-19 serve as 'important predictor' of poor outcomes

References:

Advisory Committee on Immunization Practices.

Hosie MJ, et al. Vet Rec. 2021;doi:10.1002/vetr.24.

Mack CD, et al. JAMA Intern Med. 2021;doi:10.1001/jamainternmed.2021.2114.

Paul N, et al. Acute hospital outcomes COVID-19 associated neurological dysfunction. Presented at: American Academy of Neurology Annual Meeting; April 17-22, 2021 (virtual meeting).

In this episode, we take a deep dive into the journey of a role model educator. As the program director of one of the most prestigious pulmonary and critical care medicine fellowship programs in the country, Rendell Ashton, MD, has mentored, inspired and shaped the careers of hundreds of physicians. Listen to his inspiring story of grit, passion and perseverance; we hope that afterwards you can reflect on the positive in your life, find meaning in your work and take away the message that kindness and care matter above all. #belikeRen

• Intro :15
• About Ashton :37
• The interview 1:13
• How did this all start? What made you choose this career and this path? 1:51
• Who all are in your family and what do you do for fun with them? 4:33
• What makes you happy as a program director and what are some of the challenges that come with this role? 7:23
• What advice do you have for prospective fellows when they go through the application process? 11:03
• When you became a program director, were administrative tasks very heavy on you? Did it take away some of the joy of teaching? 15:08
• Is there a specific way a fellow can stand out in their program that will make them likely to have a successful career path in that field? 17:49
• How do you do justice to family and your work having so many responsibilities? 21:09
• How do you prevent burnout in your own life and how do you help the fellows not get burned out at the beginning of their careers? 25:35
• Have you heard of people having imposter syndrome? 32:11
• Do you have any specific examples of setbacks that you were able to recover from? 35:56
• You shared one story about your med school days that were so profound about you from day one … do you have some examples from your time in residency and fellowship? 42:38
• Do you have any advice on how to handle failure? 49:58
• Do you have any other recommendations for must-read papers for fellows? 53:50
• What's the most important advice you have for listeners? 55:27
• Thank you, Dr. Ashton 57:48

Rendell Ashton, MD, is program director of the Pulmonary and Critical Care Fellowship 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: Ashton and Bhardwaj report no relevant financial disclosures.

This week, the benefits of using telemedicine to address sleep disorders and provide cystic fibrosis care; rituximab may be an effective adjuvant treatment for systemic sclerosis and PAH; the FDA says facilities should move away from crisis capacity conservation measures; and researchers call for standardization to identify and categorize environmental exposures when assessing interstitial lung disease progression.

Read the full coverage here:

American Academy of Sleep Medicine updates guidance on telemedicine for sleep disorders

Rituximab safe, potentially effective adjuvant treatment for systemic sclerosis-PAH

Clinician survey highlights benefits of telehealth for cystic fibrosis care delivery

FDA says HCP can transition away from reusing disposable respirators

Insights on identification, remediation of environmental exposures in patients with ILD

References:

Copeland CR, et al. Chest. 2021;doi:10.1016/j.chest.2021.02.021.

FDA. FDA Recommends Transition from Use of Decontaminated Disposable Respirators - Letter to Health Care Personnel and Facilities. https://www.fda.gov/medical-devices/letters-health-care-providers/fda-recommends-transition-use-decontaminated-disposable-respirators-letter-health-care-personnel-and. Accessed April 9, 2021.

Perkins RC, et al. Ann Am Thorac Soc. 2021;doi:10.1513/AnnalsATS.202012-1484RL.

Shamim-Uzzaman QA, et al. J Clin Sleep Med. 2021;doi:10.5664/jcsm.9194.

Zamanian RT, et al. Am J Respir Crit Care Med. 2021;doi:10.1164/rccm.202009-3481OC.