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NetWorks Compete to Combat Health Disparities

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One way members get involved in CHEST’s philanthropic efforts takes place each year with the start of the NetWorks Challenge. CHEST members compete through their NetWorks – special interest groups that focus on particular areas of chest medicine – to raise funds that support Foundation microgrants.

NetWorks Challenge 2021 kicked off in June with a special twist to celebrate the Foundation’s 25th anniversary. Each NetWork is asked to complete a 25k virtual physical challenge. This can be done by walking, running, biking, swimming—or any other physical activity.

Through the challenge, members engage in friendly competition while supporting the goals of the Foundation. This year, money raised will directly help the Foundation in addressing health disparities through our microgrants program. In addition, the funds will support travel grants for doctors in training looking to attend CHEST 2021.

By participating in the NetWorks Challenge, members help fund grants that aim to lend a hand to those who need it the most. Expanding research capabilities, improving patient care, and giving access to medical equipment are just a few ways microgrants from the CHEST Foundation have been used in the past.

Inspired by the Listening Tour and the struggles experienced by underserved communities, money raised through the Network Challenge will go to a new pilot microgrant program called Rita’s Fund. The grants aim to supplement community-based projects that provide resources to individuals to help drastically change their quality of life. Funding will assist with coverage for medical equipment, transportation, and access to technology for those living with lung disease and other medical complications.

NetWork members are asked to encourage one another to join in this summer’s race to 25k.

To learn more about this initiative and this year’s NetWorks Challenge, visit chestfoundation.org/nwc21. And, don’t miss the summer issue of Donor Spotlight.

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One way members get involved in CHEST’s philanthropic efforts takes place each year with the start of the NetWorks Challenge. CHEST members compete through their NetWorks – special interest groups that focus on particular areas of chest medicine – to raise funds that support Foundation microgrants.

NetWorks Challenge 2021 kicked off in June with a special twist to celebrate the Foundation’s 25th anniversary. Each NetWork is asked to complete a 25k virtual physical challenge. This can be done by walking, running, biking, swimming—or any other physical activity.

Through the challenge, members engage in friendly competition while supporting the goals of the Foundation. This year, money raised will directly help the Foundation in addressing health disparities through our microgrants program. In addition, the funds will support travel grants for doctors in training looking to attend CHEST 2021.

By participating in the NetWorks Challenge, members help fund grants that aim to lend a hand to those who need it the most. Expanding research capabilities, improving patient care, and giving access to medical equipment are just a few ways microgrants from the CHEST Foundation have been used in the past.

Inspired by the Listening Tour and the struggles experienced by underserved communities, money raised through the Network Challenge will go to a new pilot microgrant program called Rita’s Fund. The grants aim to supplement community-based projects that provide resources to individuals to help drastically change their quality of life. Funding will assist with coverage for medical equipment, transportation, and access to technology for those living with lung disease and other medical complications.

NetWork members are asked to encourage one another to join in this summer’s race to 25k.

To learn more about this initiative and this year’s NetWorks Challenge, visit chestfoundation.org/nwc21. And, don’t miss the summer issue of Donor Spotlight.

 

One way members get involved in CHEST’s philanthropic efforts takes place each year with the start of the NetWorks Challenge. CHEST members compete through their NetWorks – special interest groups that focus on particular areas of chest medicine – to raise funds that support Foundation microgrants.

NetWorks Challenge 2021 kicked off in June with a special twist to celebrate the Foundation’s 25th anniversary. Each NetWork is asked to complete a 25k virtual physical challenge. This can be done by walking, running, biking, swimming—or any other physical activity.

Through the challenge, members engage in friendly competition while supporting the goals of the Foundation. This year, money raised will directly help the Foundation in addressing health disparities through our microgrants program. In addition, the funds will support travel grants for doctors in training looking to attend CHEST 2021.

By participating in the NetWorks Challenge, members help fund grants that aim to lend a hand to those who need it the most. Expanding research capabilities, improving patient care, and giving access to medical equipment are just a few ways microgrants from the CHEST Foundation have been used in the past.

Inspired by the Listening Tour and the struggles experienced by underserved communities, money raised through the Network Challenge will go to a new pilot microgrant program called Rita’s Fund. The grants aim to supplement community-based projects that provide resources to individuals to help drastically change their quality of life. Funding will assist with coverage for medical equipment, transportation, and access to technology for those living with lung disease and other medical complications.

NetWork members are asked to encourage one another to join in this summer’s race to 25k.

To learn more about this initiative and this year’s NetWorks Challenge, visit chestfoundation.org/nwc21. And, don’t miss the summer issue of Donor Spotlight.

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This month in the journal CHEST®Editor’s Picks

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Peak inspiratory flow as a predictive therapeutic biomarker in COPD. By Drs. D. Mahler and D. Halpin.Family presence for critically ill patients during a pandemic. By Drs. J. Hart and S. Taylor.



Executive summary: diagnosis and evaluation of hypersensitivity pneumonitis: CHEST guideline and expert panel report. By Dr. L. Fernandez Perez et al.



The usefulness of chest CT imaging in patients with suspected or diagnosed COVID-19: A review of literature. By Dr. S. Machnicki et al.



Oxygen therapy in sleep-disordered breathing. By Dr. S. Zeineddine et al.

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Peak inspiratory flow as a predictive therapeutic biomarker in COPD. By Drs. D. Mahler and D. Halpin.Family presence for critically ill patients during a pandemic. By Drs. J. Hart and S. Taylor.



Executive summary: diagnosis and evaluation of hypersensitivity pneumonitis: CHEST guideline and expert panel report. By Dr. L. Fernandez Perez et al.



The usefulness of chest CT imaging in patients with suspected or diagnosed COVID-19: A review of literature. By Dr. S. Machnicki et al.



Oxygen therapy in sleep-disordered breathing. By Dr. S. Zeineddine et al.

 

Peak inspiratory flow as a predictive therapeutic biomarker in COPD. By Drs. D. Mahler and D. Halpin.Family presence for critically ill patients during a pandemic. By Drs. J. Hart and S. Taylor.



Executive summary: diagnosis and evaluation of hypersensitivity pneumonitis: CHEST guideline and expert panel report. By Dr. L. Fernandez Perez et al.



The usefulness of chest CT imaging in patients with suspected or diagnosed COVID-19: A review of literature. By Dr. S. Machnicki et al.



Oxygen therapy in sleep-disordered breathing. By Dr. S. Zeineddine et al.

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CHEST website redesign puts the user first

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You’ve probably noticed that we recently rolled out a new website – one that is updated, streamlined, and user-friendly (and if you haven’t, go check it out!). Our goal for this project was to ensure that chestnet.org remains your go-to resource when it comes to pulmonary, critical care, and sleep medicine, and to accomplish that, we recognized that some major changes were needed. In short, while we were on the cutting-edge of chest medicine, our website definitely was not.

That’s why we’ve redesigned everything from the ground up. Our very best tools, resources, and offerings are now front and center, which means that you’ll be able to find everything you’re looking for, plus some extras you aren’t, with a few simple clicks.

While there are a lot of new features on the site that we can’t wait for you to discover, here are the upgrades that we’re most excited about.
 

Mobile responsiveness

One of the biggest changes to the site is that it is now mobile responsive. That means you’ll have a seamless experience regardless of what device you’re on. Whether that’s a phone or a tablet, you’ll be able to log in to your account, view any of our resources, and purchase products – functions that used to be only accessible from a desktop.

Intuitive navigation

We have so much content to offer that finding a place for everything can be difficult, and, in the past, resources often got buried within the navigation. That’s why we spent months taking an inventory of our entire site so that we could reorganize all of our resources in a way that would make more sense to you – our users.

Community-centered

We know that you joined CHEST for more than our top-tier resources; you joined to be part of a community. That’s why the new site includes more community-based hubs and opportunities for peer-to-peer interaction. We’ll continue to add more features like blog commenting and Twitter feeds so that you can continue to engage with your colleagues, let your voice be heard, and expand your circle of peers.

User-focused design

What are you hoping to find when coming to our site? What do you want to accomplish? What features would make that easier? By asking these questions, employing a succinct set of design principles, and completing several rounds of member prototype testing, we believe that we redesigned the site not only for you, but with you.

While we’ve made some major upgrades, we’re not done yet. We’ll continue to enhance the site in the upcoming month with one goal in mind – to ensure you’re getting more out of your membership than ever before.

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You’ve probably noticed that we recently rolled out a new website – one that is updated, streamlined, and user-friendly (and if you haven’t, go check it out!). Our goal for this project was to ensure that chestnet.org remains your go-to resource when it comes to pulmonary, critical care, and sleep medicine, and to accomplish that, we recognized that some major changes were needed. In short, while we were on the cutting-edge of chest medicine, our website definitely was not.

That’s why we’ve redesigned everything from the ground up. Our very best tools, resources, and offerings are now front and center, which means that you’ll be able to find everything you’re looking for, plus some extras you aren’t, with a few simple clicks.

While there are a lot of new features on the site that we can’t wait for you to discover, here are the upgrades that we’re most excited about.
 

Mobile responsiveness

One of the biggest changes to the site is that it is now mobile responsive. That means you’ll have a seamless experience regardless of what device you’re on. Whether that’s a phone or a tablet, you’ll be able to log in to your account, view any of our resources, and purchase products – functions that used to be only accessible from a desktop.

Intuitive navigation

We have so much content to offer that finding a place for everything can be difficult, and, in the past, resources often got buried within the navigation. That’s why we spent months taking an inventory of our entire site so that we could reorganize all of our resources in a way that would make more sense to you – our users.

Community-centered

We know that you joined CHEST for more than our top-tier resources; you joined to be part of a community. That’s why the new site includes more community-based hubs and opportunities for peer-to-peer interaction. We’ll continue to add more features like blog commenting and Twitter feeds so that you can continue to engage with your colleagues, let your voice be heard, and expand your circle of peers.

User-focused design

What are you hoping to find when coming to our site? What do you want to accomplish? What features would make that easier? By asking these questions, employing a succinct set of design principles, and completing several rounds of member prototype testing, we believe that we redesigned the site not only for you, but with you.

While we’ve made some major upgrades, we’re not done yet. We’ll continue to enhance the site in the upcoming month with one goal in mind – to ensure you’re getting more out of your membership than ever before.

 

You’ve probably noticed that we recently rolled out a new website – one that is updated, streamlined, and user-friendly (and if you haven’t, go check it out!). Our goal for this project was to ensure that chestnet.org remains your go-to resource when it comes to pulmonary, critical care, and sleep medicine, and to accomplish that, we recognized that some major changes were needed. In short, while we were on the cutting-edge of chest medicine, our website definitely was not.

That’s why we’ve redesigned everything from the ground up. Our very best tools, resources, and offerings are now front and center, which means that you’ll be able to find everything you’re looking for, plus some extras you aren’t, with a few simple clicks.

While there are a lot of new features on the site that we can’t wait for you to discover, here are the upgrades that we’re most excited about.
 

Mobile responsiveness

One of the biggest changes to the site is that it is now mobile responsive. That means you’ll have a seamless experience regardless of what device you’re on. Whether that’s a phone or a tablet, you’ll be able to log in to your account, view any of our resources, and purchase products – functions that used to be only accessible from a desktop.

Intuitive navigation

We have so much content to offer that finding a place for everything can be difficult, and, in the past, resources often got buried within the navigation. That’s why we spent months taking an inventory of our entire site so that we could reorganize all of our resources in a way that would make more sense to you – our users.

Community-centered

We know that you joined CHEST for more than our top-tier resources; you joined to be part of a community. That’s why the new site includes more community-based hubs and opportunities for peer-to-peer interaction. We’ll continue to add more features like blog commenting and Twitter feeds so that you can continue to engage with your colleagues, let your voice be heard, and expand your circle of peers.

User-focused design

What are you hoping to find when coming to our site? What do you want to accomplish? What features would make that easier? By asking these questions, employing a succinct set of design principles, and completing several rounds of member prototype testing, we believe that we redesigned the site not only for you, but with you.

While we’ve made some major upgrades, we’re not done yet. We’ll continue to enhance the site in the upcoming month with one goal in mind – to ensure you’re getting more out of your membership than ever before.

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Disaster medicine in the pandemic; telehealth; rise in lung transplants for older patients; women’s lung health; and more

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Disaster response

Advancing disaster medicine and global health in times of pandemic

Worldwide hardships due to COVID-19 have revealed opportunities for improvement. Disaster education, telemedicine, knowledge sharing, and resource allocation have been highlighted as such areas. In an August 2020 publication, Hart et al. argue, “Every hospital needs a Disaster Medicine physician now” (Hart et al. “Why Every US Hospital Needs a Disaster Medicine Physician Now”).

Dr. Christopher Miller

Every physician must be prepared to be the expert in times of disaster. A survey of U.S. medical students showed that despite few respondents (<27%) feeling adequately educated, >90% are willing to respond to a natural disaster or a pandemic (Kaiser et al. Disaster Med Pub Health Prep. 2009;3[4]:210-16). While natural disasters have increased by almost 35% since the 1990s, a robust approach to disaster education is not routinely implemented across the fields of medicine, nursing, allied health, and health administration (Freebairn. World Disasters Report 2020: Executive Summary. 2020 ed. IFRC. ). Notably, disaster education provides opportunities for multidisciplinary team-building where learners build a foundation of knowledge together. While no ideal educational model has been fully adopted, high-quality educational opportunities include National Disaster Life Support Foundation courses, SALT triage, and ATLS (Homer et al. Prehospital and Disaster Medicine).

Dr. Sarang Patil

Telemedicine has emerged as a very effective means of disaster support through both direct patient encounters and provider education. Tele-triage used to delineate patients requiring urgent hospitalization from those who can be managed at home has proven effective in areas with limited health care facilities (World Health Organization. Coronavirus disease.). Knowledge sharing opportunities from organizations like Project ECHO have allowed for >368,000 learners from 146 countries to exchange information during >8,000 learning sessions (Project ECHO COVID-19 response.).

Physicians of all specialties should continue to develop skills in triage, surge capacity management, ethical/legal issues surrounding disasters, organizational interoperability, and telemedicine, and emphasize skills to ensure their own personal protection.

Christopher Miller, DO, MPH

Steering Committee Fellow-in-Training Member

Sarang Patil, MD

Steering Committee Member

 

Practice operations

Telehealth and postpandemic care

Telehealth is the use of electronic information and telecommunication technologies to provide care when the physician and the patient are not in the same place. Telehealth has been available for 40 years. The COVID-19 pandemic forced health care providers, systems, and patients to quickly adapt to virtual audio and visual visits, new documentation parameters, billing, and reimbursement structures. Emergency rules have removed the barriers to adoption of home-based diagnostics and virtual visits. It is expected that 20% to 30% post-pandemic care will be provided via telehealth.

Dr. Caitlin Baxter

Telehealth is particularly beneficial in providing counseling services or managing chronic illnesses, such as COPD and heart failure. There has been an explosion of monitoring devices both wearable and implantable. Some devices, which monitor PA pressure, have been shown to reduce heart failure hospitalizations and all-cause hospitalizations (Shavelle DM, et al. Circ Heart Fail. 2020;13: e006863). Studies have been conducted on home spirometry and oximetry devices in post-lung transplant, ILD (Russell AM et al. Am J Respir Crit Care Med. 2016 Oct 15; 194[8]:989-997), and CF patients (Compton M et al. Telemed J E Health . 2020 Aug;26[8]:978-84). As we move forward, we will have to ascertain what data acquisition is relevant and develop processes to address it in real time.

In this changing landscape of health care delivery, we can anticipate an increase in virtual visits and a trend toward e-consults, which will necessitate further advancements in remote monitoring and assessment and will require us to adopt new practice models.

Caitlin Baxter, MBBS

Steering Committee Fellow-in-Training

Namita Sood, MBBCh, FCCP

Steering Committee Member

 

 

 

Transplant network

The rise in lung transplant for older patients

Over the past 20 years, there has been a dramatic increase in lung transplantation in elderly patients, with wide variability in age limit amongst transplant centers. The number of recipients over the age of 65 has risen from 6.9% in 2004 to 29.6% in 2016 in the United States, and 2.6% to 17% internationally. There is a number of factors driving this increase; the prevalence of advanced lung disease with increasing age, advances in targeted therapies to treat cystic fibrosis, an increased willingness of centers to perform transplants in older patients, and the 2005 revision of the Lung Allocation Scoring System (Courtwright A, Cantu E. J Thoracic Dis. 2017:9[9]:3346-51).

Dr. Melissa B. Lesko

In the past, outcomes posttransplant for elderly patients have been conflicting in single-center studies. More recently, Hayanga et al. found no difference in survival up to 1 year between individuals 60-69 and those over 70 (J Heart Lung Transplant. 2015;34[2]:182-88). Mosher et al., however, found the median survival dropped from 4.64 years for patients aged 65-69 to 3.07 years for patients ≥74 (J Heart Lung Transplant. 2021;40[1]:42-55). Notably, older recipients were more likely to be readmitted at 30 and 90 days, and more likely to be discharged to an inpatient rehabilitation facility following transplant (McCarthy et al. J Heart Lung Transplant. 2017;36:S115; Tang et al. Clin Transplant. 2015;29:581-587).

Dr. Grant Turner

The use of transplant in elderly patients comes with many concerns regarding neurocognitive status, frailty, and other comorbidities, all of which must be rigorously tested prior to consideration(Biswas R et al. Ann Thorac Surg. 2015;100:443-51). Recipient age, creatinine level, bilirubin level, steroid use at the time of transplant, and hospitalization at the time of transplant were associated with increased mortality (Mosher et al. J Heart Lung Transplant. 2021;40[1]:42-55). Further research is warranted in this evolving area.

Melissa B. Lesko, DO

Grant Turner, MD, MHA

Steering Committee Members

 

Women’s lung health

Will the new pulmonary hypertension hemodynamic classification temper the PH ‘sex-paradox’?

Older and contemporary PH registries have consistently shown that PH predominantly affects women ~2 to 3.5 times than men, with female patients having better survival compared with men (Kozu K et al. Heart Vessels. 2018;33[8]:93), a fact attributed to better RV function in female than male subjects. This PH sex-paradox denotes that while estrogen leads to increased susceptibility to PH, it appears to confer better outcomes after PH develops due to improved RV function, since RV dysfunction is a strong predictor of poor outcomes in PH. Multiple preclinical studies have described how estrogen provides protective effects on the RV (Cheng TC et al. Am J Physiol Heart Circ Physiol. 2020;319:H1459; Frump AL et al. Am J Physiol Lung Cell Mol Physiol. 2015;308:L873).
 

Dr. Lavannya Pandit

The recent recommended updates to the hemodynamic definition reflect acknowledgment of irrefutable evidence that even mildly elevated mPAP (between 19 and 24 mm Hg) is associated with increased morbidity and mortality based on consistent data from pulmonary arterial hypertension (PAH) as well as from other forms of PH [Simonneau G et al. Eur Respir J. 2019;(Jan 24);53(1):1801913). With incorporation of the updated definition that more accurately captures the disease state and its progression, an unaddressed question still remains as to how the new classification will change PH treatment algorithm and outcomes in women compared with men. Setting the definition of PH at a mPAP of 20 mm Hg not only better represents the typical patients with PH in practice, such as those with PH due to left-sided heart disease (Group 2) or PH associated with chronic lung disease (Group 3), but incorporates the preclinical pathologic disease state of PH, in which symptoms may not be evident (Maron BA, et al. Circulation. 2016;133:1240). In adhering to the new PH definition, will earlier diagnosis across the spectrum of all individuals with PH before RV dysfunction has developed improve outcomes for all those afflicted with PH and equalize outcomes between men and women? As future studies continue to investigate the direct effects of sex hormones on the RV and dissect the mechanisms leading to the sex differences in RV function in PH, a pre-clinical diagnosis in all PH patients, particularly male patients with Group 2/3 disease, may mitigate some of the previously observed advantages of estrogen on outcomes in PH.

Lavannya Pandit, MD, FCCP

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Disaster response

Advancing disaster medicine and global health in times of pandemic

Worldwide hardships due to COVID-19 have revealed opportunities for improvement. Disaster education, telemedicine, knowledge sharing, and resource allocation have been highlighted as such areas. In an August 2020 publication, Hart et al. argue, “Every hospital needs a Disaster Medicine physician now” (Hart et al. “Why Every US Hospital Needs a Disaster Medicine Physician Now”).

Dr. Christopher Miller

Every physician must be prepared to be the expert in times of disaster. A survey of U.S. medical students showed that despite few respondents (<27%) feeling adequately educated, >90% are willing to respond to a natural disaster or a pandemic (Kaiser et al. Disaster Med Pub Health Prep. 2009;3[4]:210-16). While natural disasters have increased by almost 35% since the 1990s, a robust approach to disaster education is not routinely implemented across the fields of medicine, nursing, allied health, and health administration (Freebairn. World Disasters Report 2020: Executive Summary. 2020 ed. IFRC. ). Notably, disaster education provides opportunities for multidisciplinary team-building where learners build a foundation of knowledge together. While no ideal educational model has been fully adopted, high-quality educational opportunities include National Disaster Life Support Foundation courses, SALT triage, and ATLS (Homer et al. Prehospital and Disaster Medicine).

Dr. Sarang Patil

Telemedicine has emerged as a very effective means of disaster support through both direct patient encounters and provider education. Tele-triage used to delineate patients requiring urgent hospitalization from those who can be managed at home has proven effective in areas with limited health care facilities (World Health Organization. Coronavirus disease.). Knowledge sharing opportunities from organizations like Project ECHO have allowed for >368,000 learners from 146 countries to exchange information during >8,000 learning sessions (Project ECHO COVID-19 response.).

Physicians of all specialties should continue to develop skills in triage, surge capacity management, ethical/legal issues surrounding disasters, organizational interoperability, and telemedicine, and emphasize skills to ensure their own personal protection.

Christopher Miller, DO, MPH

Steering Committee Fellow-in-Training Member

Sarang Patil, MD

Steering Committee Member

 

Practice operations

Telehealth and postpandemic care

Telehealth is the use of electronic information and telecommunication technologies to provide care when the physician and the patient are not in the same place. Telehealth has been available for 40 years. The COVID-19 pandemic forced health care providers, systems, and patients to quickly adapt to virtual audio and visual visits, new documentation parameters, billing, and reimbursement structures. Emergency rules have removed the barriers to adoption of home-based diagnostics and virtual visits. It is expected that 20% to 30% post-pandemic care will be provided via telehealth.

Dr. Caitlin Baxter

Telehealth is particularly beneficial in providing counseling services or managing chronic illnesses, such as COPD and heart failure. There has been an explosion of monitoring devices both wearable and implantable. Some devices, which monitor PA pressure, have been shown to reduce heart failure hospitalizations and all-cause hospitalizations (Shavelle DM, et al. Circ Heart Fail. 2020;13: e006863). Studies have been conducted on home spirometry and oximetry devices in post-lung transplant, ILD (Russell AM et al. Am J Respir Crit Care Med. 2016 Oct 15; 194[8]:989-997), and CF patients (Compton M et al. Telemed J E Health . 2020 Aug;26[8]:978-84). As we move forward, we will have to ascertain what data acquisition is relevant and develop processes to address it in real time.

In this changing landscape of health care delivery, we can anticipate an increase in virtual visits and a trend toward e-consults, which will necessitate further advancements in remote monitoring and assessment and will require us to adopt new practice models.

Caitlin Baxter, MBBS

Steering Committee Fellow-in-Training

Namita Sood, MBBCh, FCCP

Steering Committee Member

 

 

 

Transplant network

The rise in lung transplant for older patients

Over the past 20 years, there has been a dramatic increase in lung transplantation in elderly patients, with wide variability in age limit amongst transplant centers. The number of recipients over the age of 65 has risen from 6.9% in 2004 to 29.6% in 2016 in the United States, and 2.6% to 17% internationally. There is a number of factors driving this increase; the prevalence of advanced lung disease with increasing age, advances in targeted therapies to treat cystic fibrosis, an increased willingness of centers to perform transplants in older patients, and the 2005 revision of the Lung Allocation Scoring System (Courtwright A, Cantu E. J Thoracic Dis. 2017:9[9]:3346-51).

Dr. Melissa B. Lesko

In the past, outcomes posttransplant for elderly patients have been conflicting in single-center studies. More recently, Hayanga et al. found no difference in survival up to 1 year between individuals 60-69 and those over 70 (J Heart Lung Transplant. 2015;34[2]:182-88). Mosher et al., however, found the median survival dropped from 4.64 years for patients aged 65-69 to 3.07 years for patients ≥74 (J Heart Lung Transplant. 2021;40[1]:42-55). Notably, older recipients were more likely to be readmitted at 30 and 90 days, and more likely to be discharged to an inpatient rehabilitation facility following transplant (McCarthy et al. J Heart Lung Transplant. 2017;36:S115; Tang et al. Clin Transplant. 2015;29:581-587).

Dr. Grant Turner

The use of transplant in elderly patients comes with many concerns regarding neurocognitive status, frailty, and other comorbidities, all of which must be rigorously tested prior to consideration(Biswas R et al. Ann Thorac Surg. 2015;100:443-51). Recipient age, creatinine level, bilirubin level, steroid use at the time of transplant, and hospitalization at the time of transplant were associated with increased mortality (Mosher et al. J Heart Lung Transplant. 2021;40[1]:42-55). Further research is warranted in this evolving area.

Melissa B. Lesko, DO

Grant Turner, MD, MHA

Steering Committee Members

 

Women’s lung health

Will the new pulmonary hypertension hemodynamic classification temper the PH ‘sex-paradox’?

Older and contemporary PH registries have consistently shown that PH predominantly affects women ~2 to 3.5 times than men, with female patients having better survival compared with men (Kozu K et al. Heart Vessels. 2018;33[8]:93), a fact attributed to better RV function in female than male subjects. This PH sex-paradox denotes that while estrogen leads to increased susceptibility to PH, it appears to confer better outcomes after PH develops due to improved RV function, since RV dysfunction is a strong predictor of poor outcomes in PH. Multiple preclinical studies have described how estrogen provides protective effects on the RV (Cheng TC et al. Am J Physiol Heart Circ Physiol. 2020;319:H1459; Frump AL et al. Am J Physiol Lung Cell Mol Physiol. 2015;308:L873).
 

Dr. Lavannya Pandit

The recent recommended updates to the hemodynamic definition reflect acknowledgment of irrefutable evidence that even mildly elevated mPAP (between 19 and 24 mm Hg) is associated with increased morbidity and mortality based on consistent data from pulmonary arterial hypertension (PAH) as well as from other forms of PH [Simonneau G et al. Eur Respir J. 2019;(Jan 24);53(1):1801913). With incorporation of the updated definition that more accurately captures the disease state and its progression, an unaddressed question still remains as to how the new classification will change PH treatment algorithm and outcomes in women compared with men. Setting the definition of PH at a mPAP of 20 mm Hg not only better represents the typical patients with PH in practice, such as those with PH due to left-sided heart disease (Group 2) or PH associated with chronic lung disease (Group 3), but incorporates the preclinical pathologic disease state of PH, in which symptoms may not be evident (Maron BA, et al. Circulation. 2016;133:1240). In adhering to the new PH definition, will earlier diagnosis across the spectrum of all individuals with PH before RV dysfunction has developed improve outcomes for all those afflicted with PH and equalize outcomes between men and women? As future studies continue to investigate the direct effects of sex hormones on the RV and dissect the mechanisms leading to the sex differences in RV function in PH, a pre-clinical diagnosis in all PH patients, particularly male patients with Group 2/3 disease, may mitigate some of the previously observed advantages of estrogen on outcomes in PH.

Lavannya Pandit, MD, FCCP

 

Disaster response

Advancing disaster medicine and global health in times of pandemic

Worldwide hardships due to COVID-19 have revealed opportunities for improvement. Disaster education, telemedicine, knowledge sharing, and resource allocation have been highlighted as such areas. In an August 2020 publication, Hart et al. argue, “Every hospital needs a Disaster Medicine physician now” (Hart et al. “Why Every US Hospital Needs a Disaster Medicine Physician Now”).

Dr. Christopher Miller

Every physician must be prepared to be the expert in times of disaster. A survey of U.S. medical students showed that despite few respondents (<27%) feeling adequately educated, >90% are willing to respond to a natural disaster or a pandemic (Kaiser et al. Disaster Med Pub Health Prep. 2009;3[4]:210-16). While natural disasters have increased by almost 35% since the 1990s, a robust approach to disaster education is not routinely implemented across the fields of medicine, nursing, allied health, and health administration (Freebairn. World Disasters Report 2020: Executive Summary. 2020 ed. IFRC. ). Notably, disaster education provides opportunities for multidisciplinary team-building where learners build a foundation of knowledge together. While no ideal educational model has been fully adopted, high-quality educational opportunities include National Disaster Life Support Foundation courses, SALT triage, and ATLS (Homer et al. Prehospital and Disaster Medicine).

Dr. Sarang Patil

Telemedicine has emerged as a very effective means of disaster support through both direct patient encounters and provider education. Tele-triage used to delineate patients requiring urgent hospitalization from those who can be managed at home has proven effective in areas with limited health care facilities (World Health Organization. Coronavirus disease.). Knowledge sharing opportunities from organizations like Project ECHO have allowed for >368,000 learners from 146 countries to exchange information during >8,000 learning sessions (Project ECHO COVID-19 response.).

Physicians of all specialties should continue to develop skills in triage, surge capacity management, ethical/legal issues surrounding disasters, organizational interoperability, and telemedicine, and emphasize skills to ensure their own personal protection.

Christopher Miller, DO, MPH

Steering Committee Fellow-in-Training Member

Sarang Patil, MD

Steering Committee Member

 

Practice operations

Telehealth and postpandemic care

Telehealth is the use of electronic information and telecommunication technologies to provide care when the physician and the patient are not in the same place. Telehealth has been available for 40 years. The COVID-19 pandemic forced health care providers, systems, and patients to quickly adapt to virtual audio and visual visits, new documentation parameters, billing, and reimbursement structures. Emergency rules have removed the barriers to adoption of home-based diagnostics and virtual visits. It is expected that 20% to 30% post-pandemic care will be provided via telehealth.

Dr. Caitlin Baxter

Telehealth is particularly beneficial in providing counseling services or managing chronic illnesses, such as COPD and heart failure. There has been an explosion of monitoring devices both wearable and implantable. Some devices, which monitor PA pressure, have been shown to reduce heart failure hospitalizations and all-cause hospitalizations (Shavelle DM, et al. Circ Heart Fail. 2020;13: e006863). Studies have been conducted on home spirometry and oximetry devices in post-lung transplant, ILD (Russell AM et al. Am J Respir Crit Care Med. 2016 Oct 15; 194[8]:989-997), and CF patients (Compton M et al. Telemed J E Health . 2020 Aug;26[8]:978-84). As we move forward, we will have to ascertain what data acquisition is relevant and develop processes to address it in real time.

In this changing landscape of health care delivery, we can anticipate an increase in virtual visits and a trend toward e-consults, which will necessitate further advancements in remote monitoring and assessment and will require us to adopt new practice models.

Caitlin Baxter, MBBS

Steering Committee Fellow-in-Training

Namita Sood, MBBCh, FCCP

Steering Committee Member

 

 

 

Transplant network

The rise in lung transplant for older patients

Over the past 20 years, there has been a dramatic increase in lung transplantation in elderly patients, with wide variability in age limit amongst transplant centers. The number of recipients over the age of 65 has risen from 6.9% in 2004 to 29.6% in 2016 in the United States, and 2.6% to 17% internationally. There is a number of factors driving this increase; the prevalence of advanced lung disease with increasing age, advances in targeted therapies to treat cystic fibrosis, an increased willingness of centers to perform transplants in older patients, and the 2005 revision of the Lung Allocation Scoring System (Courtwright A, Cantu E. J Thoracic Dis. 2017:9[9]:3346-51).

Dr. Melissa B. Lesko

In the past, outcomes posttransplant for elderly patients have been conflicting in single-center studies. More recently, Hayanga et al. found no difference in survival up to 1 year between individuals 60-69 and those over 70 (J Heart Lung Transplant. 2015;34[2]:182-88). Mosher et al., however, found the median survival dropped from 4.64 years for patients aged 65-69 to 3.07 years for patients ≥74 (J Heart Lung Transplant. 2021;40[1]:42-55). Notably, older recipients were more likely to be readmitted at 30 and 90 days, and more likely to be discharged to an inpatient rehabilitation facility following transplant (McCarthy et al. J Heart Lung Transplant. 2017;36:S115; Tang et al. Clin Transplant. 2015;29:581-587).

Dr. Grant Turner

The use of transplant in elderly patients comes with many concerns regarding neurocognitive status, frailty, and other comorbidities, all of which must be rigorously tested prior to consideration(Biswas R et al. Ann Thorac Surg. 2015;100:443-51). Recipient age, creatinine level, bilirubin level, steroid use at the time of transplant, and hospitalization at the time of transplant were associated with increased mortality (Mosher et al. J Heart Lung Transplant. 2021;40[1]:42-55). Further research is warranted in this evolving area.

Melissa B. Lesko, DO

Grant Turner, MD, MHA

Steering Committee Members

 

Women’s lung health

Will the new pulmonary hypertension hemodynamic classification temper the PH ‘sex-paradox’?

Older and contemporary PH registries have consistently shown that PH predominantly affects women ~2 to 3.5 times than men, with female patients having better survival compared with men (Kozu K et al. Heart Vessels. 2018;33[8]:93), a fact attributed to better RV function in female than male subjects. This PH sex-paradox denotes that while estrogen leads to increased susceptibility to PH, it appears to confer better outcomes after PH develops due to improved RV function, since RV dysfunction is a strong predictor of poor outcomes in PH. Multiple preclinical studies have described how estrogen provides protective effects on the RV (Cheng TC et al. Am J Physiol Heart Circ Physiol. 2020;319:H1459; Frump AL et al. Am J Physiol Lung Cell Mol Physiol. 2015;308:L873).
 

Dr. Lavannya Pandit

The recent recommended updates to the hemodynamic definition reflect acknowledgment of irrefutable evidence that even mildly elevated mPAP (between 19 and 24 mm Hg) is associated with increased morbidity and mortality based on consistent data from pulmonary arterial hypertension (PAH) as well as from other forms of PH [Simonneau G et al. Eur Respir J. 2019;(Jan 24);53(1):1801913). With incorporation of the updated definition that more accurately captures the disease state and its progression, an unaddressed question still remains as to how the new classification will change PH treatment algorithm and outcomes in women compared with men. Setting the definition of PH at a mPAP of 20 mm Hg not only better represents the typical patients with PH in practice, such as those with PH due to left-sided heart disease (Group 2) or PH associated with chronic lung disease (Group 3), but incorporates the preclinical pathologic disease state of PH, in which symptoms may not be evident (Maron BA, et al. Circulation. 2016;133:1240). In adhering to the new PH definition, will earlier diagnosis across the spectrum of all individuals with PH before RV dysfunction has developed improve outcomes for all those afflicted with PH and equalize outcomes between men and women? As future studies continue to investigate the direct effects of sex hormones on the RV and dissect the mechanisms leading to the sex differences in RV function in PH, a pre-clinical diagnosis in all PH patients, particularly male patients with Group 2/3 disease, may mitigate some of the previously observed advantages of estrogen on outcomes in PH.

Lavannya Pandit, MD, FCCP

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AGA journals select new editorial fellows

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The AGA journals Gastroenterology, Clinical Gastroenterology and Hepatology (CGH), Cellular and Molecular Gastroenterology and Hepatology (CMGH), and Techniques and Innovations in Gastrointestinal Endoscopy (TIGE) recently selected the recipients of their editorial fellowships, which runs from July 2021 through June 2022. The AGA editorial fellowship program is in its fourth year. 

  • Amisha Ahuja, MD (Gastroenterology)
  • Helenie Kefalalkes, MD (Gastroenterology)
  • Katherine Falloon, MD (CGH)
  • Judy Trieu, MD, MPH (CGH)
  • Lindsey Kennedy, PhD (CMGH)
  • Vivian Ortiz, MD (CMGH)  
  • Sagarika Satyavada, MD (TIGE)
  • Eric Swei, MD (TIGE)
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The AGA journals Gastroenterology, Clinical Gastroenterology and Hepatology (CGH), Cellular and Molecular Gastroenterology and Hepatology (CMGH), and Techniques and Innovations in Gastrointestinal Endoscopy (TIGE) recently selected the recipients of their editorial fellowships, which runs from July 2021 through June 2022. The AGA editorial fellowship program is in its fourth year. 

  • Amisha Ahuja, MD (Gastroenterology)
  • Helenie Kefalalkes, MD (Gastroenterology)
  • Katherine Falloon, MD (CGH)
  • Judy Trieu, MD, MPH (CGH)
  • Lindsey Kennedy, PhD (CMGH)
  • Vivian Ortiz, MD (CMGH)  
  • Sagarika Satyavada, MD (TIGE)
  • Eric Swei, MD (TIGE)

The AGA journals Gastroenterology, Clinical Gastroenterology and Hepatology (CGH), Cellular and Molecular Gastroenterology and Hepatology (CMGH), and Techniques and Innovations in Gastrointestinal Endoscopy (TIGE) recently selected the recipients of their editorial fellowships, which runs from July 2021 through June 2022. The AGA editorial fellowship program is in its fourth year. 

  • Amisha Ahuja, MD (Gastroenterology)
  • Helenie Kefalalkes, MD (Gastroenterology)
  • Katherine Falloon, MD (CGH)
  • Judy Trieu, MD, MPH (CGH)
  • Lindsey Kennedy, PhD (CMGH)
  • Vivian Ortiz, MD (CMGH)  
  • Sagarika Satyavada, MD (TIGE)
  • Eric Swei, MD (TIGE)
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Get to know 2021 award winners

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David Y. Graham, MD – William Beaumont Prize in Gastroenterology

Dr. David Graham is this year’s recipient of the AGA William Beaumont Prize in Gastroenterology. A remarkable clinician, scientist, and mentor to the next generation of GI, Dr. Graham currently serves as professor of medicine-gastroenterology at Baylor College of Medicine in Houston, Texas.

Dr. Graham was born in Ancon, in the Panama Canal Zone, where his father was working as an engineer. The family eventually settled in Lake Jackson, a small gulf coast town outside of Houston. There he developed a love for outdoor activities including hunting, fishing, and riding horses. He received a bachelor’s degree from the University of Notre Dame and returned home to Houston to receive his medical degree with honors from Baylor College of Medicine. Dr. Graham’s training was interrupted by the Vietnam War during which he was drafted into the U.S. Army as a flight surgeon.

In addition to his clinical and research missions, Dr. Graham has mentored numerous individuals during his years as a clinician scientist, many of whom have gone on to have successful careers in academic medicine. He has been an active AGA member for more than 4 decades, receiving several honors including the prestigious AGA Mentor Award in 2015 and the Janssen Award for Special Achievement in Gastroenterology.

Read more about Dr. Graham’s life and contribution to the GI community in a commentary in Gastroenterology written by Fasiha Kanwal, MD, and Hashem B. El-Serag, M, MPH. 
 

Kim E. Barrett, PHD, AGAF – Distinguished Achievement Award in Basic Science

Dr. Kim E. Barrett is the 2021 recipient of the AGA Distinguished Achievement Award in Basic Science for her outstanding contributions to understanding mechanisms and regulation of intestinal epithelial transport and barrier function. She currently serves as distinguished professor of medicine at the University of California, San Diego, and is serving as a rotating appointment as director of the Division of Graduate Education of the National Science Foundation.

Born in London, Dr. Barrett was the first of her family to attend college. She earned a BSc in Medicinal Chemistry at University College London where she also stayed to complete her PhD studies. Following the completion of her PhD, Dr. Barrett moved to the U.S. to continue her training at the National Institutes of Health, where she continued her work in studies on the functional heterogeneity of mast cells. Alongside her many contributions to the GI field, she still believes in having fun, living by the phrase “put yourself about a bit.” She is a proud member of the band GI Distress as one of the “Fabulous Fasebettes.”

Read more about Dr. Barrett’s contributions to the GI community in a commentary in Gastroenterology, written by Mark Donowitz, MD, and Stephen Keely, MD.

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David Y. Graham, MD – William Beaumont Prize in Gastroenterology

Dr. David Graham is this year’s recipient of the AGA William Beaumont Prize in Gastroenterology. A remarkable clinician, scientist, and mentor to the next generation of GI, Dr. Graham currently serves as professor of medicine-gastroenterology at Baylor College of Medicine in Houston, Texas.

Dr. Graham was born in Ancon, in the Panama Canal Zone, where his father was working as an engineer. The family eventually settled in Lake Jackson, a small gulf coast town outside of Houston. There he developed a love for outdoor activities including hunting, fishing, and riding horses. He received a bachelor’s degree from the University of Notre Dame and returned home to Houston to receive his medical degree with honors from Baylor College of Medicine. Dr. Graham’s training was interrupted by the Vietnam War during which he was drafted into the U.S. Army as a flight surgeon.

In addition to his clinical and research missions, Dr. Graham has mentored numerous individuals during his years as a clinician scientist, many of whom have gone on to have successful careers in academic medicine. He has been an active AGA member for more than 4 decades, receiving several honors including the prestigious AGA Mentor Award in 2015 and the Janssen Award for Special Achievement in Gastroenterology.

Read more about Dr. Graham’s life and contribution to the GI community in a commentary in Gastroenterology written by Fasiha Kanwal, MD, and Hashem B. El-Serag, M, MPH. 
 

Kim E. Barrett, PHD, AGAF – Distinguished Achievement Award in Basic Science

Dr. Kim E. Barrett is the 2021 recipient of the AGA Distinguished Achievement Award in Basic Science for her outstanding contributions to understanding mechanisms and regulation of intestinal epithelial transport and barrier function. She currently serves as distinguished professor of medicine at the University of California, San Diego, and is serving as a rotating appointment as director of the Division of Graduate Education of the National Science Foundation.

Born in London, Dr. Barrett was the first of her family to attend college. She earned a BSc in Medicinal Chemistry at University College London where she also stayed to complete her PhD studies. Following the completion of her PhD, Dr. Barrett moved to the U.S. to continue her training at the National Institutes of Health, where she continued her work in studies on the functional heterogeneity of mast cells. Alongside her many contributions to the GI field, she still believes in having fun, living by the phrase “put yourself about a bit.” She is a proud member of the band GI Distress as one of the “Fabulous Fasebettes.”

Read more about Dr. Barrett’s contributions to the GI community in a commentary in Gastroenterology, written by Mark Donowitz, MD, and Stephen Keely, MD.

 

David Y. Graham, MD – William Beaumont Prize in Gastroenterology

Dr. David Graham is this year’s recipient of the AGA William Beaumont Prize in Gastroenterology. A remarkable clinician, scientist, and mentor to the next generation of GI, Dr. Graham currently serves as professor of medicine-gastroenterology at Baylor College of Medicine in Houston, Texas.

Dr. Graham was born in Ancon, in the Panama Canal Zone, where his father was working as an engineer. The family eventually settled in Lake Jackson, a small gulf coast town outside of Houston. There he developed a love for outdoor activities including hunting, fishing, and riding horses. He received a bachelor’s degree from the University of Notre Dame and returned home to Houston to receive his medical degree with honors from Baylor College of Medicine. Dr. Graham’s training was interrupted by the Vietnam War during which he was drafted into the U.S. Army as a flight surgeon.

In addition to his clinical and research missions, Dr. Graham has mentored numerous individuals during his years as a clinician scientist, many of whom have gone on to have successful careers in academic medicine. He has been an active AGA member for more than 4 decades, receiving several honors including the prestigious AGA Mentor Award in 2015 and the Janssen Award for Special Achievement in Gastroenterology.

Read more about Dr. Graham’s life and contribution to the GI community in a commentary in Gastroenterology written by Fasiha Kanwal, MD, and Hashem B. El-Serag, M, MPH. 
 

Kim E. Barrett, PHD, AGAF – Distinguished Achievement Award in Basic Science

Dr. Kim E. Barrett is the 2021 recipient of the AGA Distinguished Achievement Award in Basic Science for her outstanding contributions to understanding mechanisms and regulation of intestinal epithelial transport and barrier function. She currently serves as distinguished professor of medicine at the University of California, San Diego, and is serving as a rotating appointment as director of the Division of Graduate Education of the National Science Foundation.

Born in London, Dr. Barrett was the first of her family to attend college. She earned a BSc in Medicinal Chemistry at University College London where she also stayed to complete her PhD studies. Following the completion of her PhD, Dr. Barrett moved to the U.S. to continue her training at the National Institutes of Health, where she continued her work in studies on the functional heterogeneity of mast cells. Alongside her many contributions to the GI field, she still believes in having fun, living by the phrase “put yourself about a bit.” She is a proud member of the band GI Distress as one of the “Fabulous Fasebettes.”

Read more about Dr. Barrett’s contributions to the GI community in a commentary in Gastroenterology, written by Mark Donowitz, MD, and Stephen Keely, MD.

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New Clinical Practice Update Expert Review: Management of bleeding gastric varices

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AGA has released a new Clinical Practice Update Expert Review providing 12 best practice advice statements on the diagnosis and management of bleeding gastric varices. The evidence-based advice includes the following: 

  • Initial therapy for bleeding gastric varices should focus on acute hemostasis for hemodynamic stabilization with a plan for further diagnostic evaluation and/or transfer to a tertiary care center with expertise in gastric varices management. 
  • Following initial endoscopic hemostasis, cross-sectional (magnetic resonance or CT) imaging with portal venous contrast phase should be obtained to determine vascular anatomy, including the presence or absence of portosystemic shunts and gastrorenal shunts. 
  • Determination of definitive therapy for bleeding gastric varices should be based on endoscopic appearance of the gastric varix, the underlying vascular anatomy, presence of comorbid portal hypertensive complications, and available local resources. This is ideally done via a multidisciplinary discussion between the GI or hepatologist and the interventional radiologist. 

In this AGA Clinical Practice Update Expert Review, the experts also suggest adding an estimate of variceal size and high-risk stigmata (discolored marks, platelet plugs) to the Sarin classification when describing patients’ gastric varices.  

Read the full list of the best practice advice statements in the AGA Clinical Practice Update on Management of Bleeding Gastric Varices: Expert Review

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AGA has released a new Clinical Practice Update Expert Review providing 12 best practice advice statements on the diagnosis and management of bleeding gastric varices. The evidence-based advice includes the following: 

  • Initial therapy for bleeding gastric varices should focus on acute hemostasis for hemodynamic stabilization with a plan for further diagnostic evaluation and/or transfer to a tertiary care center with expertise in gastric varices management. 
  • Following initial endoscopic hemostasis, cross-sectional (magnetic resonance or CT) imaging with portal venous contrast phase should be obtained to determine vascular anatomy, including the presence or absence of portosystemic shunts and gastrorenal shunts. 
  • Determination of definitive therapy for bleeding gastric varices should be based on endoscopic appearance of the gastric varix, the underlying vascular anatomy, presence of comorbid portal hypertensive complications, and available local resources. This is ideally done via a multidisciplinary discussion between the GI or hepatologist and the interventional radiologist. 

In this AGA Clinical Practice Update Expert Review, the experts also suggest adding an estimate of variceal size and high-risk stigmata (discolored marks, platelet plugs) to the Sarin classification when describing patients’ gastric varices.  

Read the full list of the best practice advice statements in the AGA Clinical Practice Update on Management of Bleeding Gastric Varices: Expert Review

AGA has released a new Clinical Practice Update Expert Review providing 12 best practice advice statements on the diagnosis and management of bleeding gastric varices. The evidence-based advice includes the following: 

  • Initial therapy for bleeding gastric varices should focus on acute hemostasis for hemodynamic stabilization with a plan for further diagnostic evaluation and/or transfer to a tertiary care center with expertise in gastric varices management. 
  • Following initial endoscopic hemostasis, cross-sectional (magnetic resonance or CT) imaging with portal venous contrast phase should be obtained to determine vascular anatomy, including the presence or absence of portosystemic shunts and gastrorenal shunts. 
  • Determination of definitive therapy for bleeding gastric varices should be based on endoscopic appearance of the gastric varix, the underlying vascular anatomy, presence of comorbid portal hypertensive complications, and available local resources. This is ideally done via a multidisciplinary discussion between the GI or hepatologist and the interventional radiologist. 

In this AGA Clinical Practice Update Expert Review, the experts also suggest adding an estimate of variceal size and high-risk stigmata (discolored marks, platelet plugs) to the Sarin classification when describing patients’ gastric varices.  

Read the full list of the best practice advice statements in the AGA Clinical Practice Update on Management of Bleeding Gastric Varices: Expert Review

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This month in the journal CHEST®

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Editor’s picks

 



Hormone replacement therapy and development of new asthma. By Dr. E. Hansen et al.



Sex and gender omic biomarkers in men and women with COPD: Considerations for precision medicine. By Dr. D. Demeo.



Pulmonary function and radiological features in survivors of critical covid-19: A 3-month prospective cohort. By Dr. F. Barbe et al.



Characteristics and prevalence of domestic and occupational inhalational exposures across interstitial lung diseases. By Dr. C. Lee et al.



Identification and remediation of environmental exposures in patients with interstitial lung disease: Evidence review and practical considerations. By Dr. M. Salisbury et al.



How we do it: Creating an organizational culture for the chest physician. By Dr. J. Stoller et al..



Proposed quality metrics for lung cancer screening programs: A national lung cancer roundtable project. By Dr. P. Mazzone et al.

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Editor’s picks

Editor’s picks

 



Hormone replacement therapy and development of new asthma. By Dr. E. Hansen et al.



Sex and gender omic biomarkers in men and women with COPD: Considerations for precision medicine. By Dr. D. Demeo.



Pulmonary function and radiological features in survivors of critical covid-19: A 3-month prospective cohort. By Dr. F. Barbe et al.



Characteristics and prevalence of domestic and occupational inhalational exposures across interstitial lung diseases. By Dr. C. Lee et al.



Identification and remediation of environmental exposures in patients with interstitial lung disease: Evidence review and practical considerations. By Dr. M. Salisbury et al.



How we do it: Creating an organizational culture for the chest physician. By Dr. J. Stoller et al..



Proposed quality metrics for lung cancer screening programs: A national lung cancer roundtable project. By Dr. P. Mazzone et al.

 



Hormone replacement therapy and development of new asthma. By Dr. E. Hansen et al.



Sex and gender omic biomarkers in men and women with COPD: Considerations for precision medicine. By Dr. D. Demeo.



Pulmonary function and radiological features in survivors of critical covid-19: A 3-month prospective cohort. By Dr. F. Barbe et al.



Characteristics and prevalence of domestic and occupational inhalational exposures across interstitial lung diseases. By Dr. C. Lee et al.



Identification and remediation of environmental exposures in patients with interstitial lung disease: Evidence review and practical considerations. By Dr. M. Salisbury et al.



How we do it: Creating an organizational culture for the chest physician. By Dr. J. Stoller et al..



Proposed quality metrics for lung cancer screening programs: A national lung cancer roundtable project. By Dr. P. Mazzone et al.

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Get active while funding CHEST Foundation microgrants

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The NetWorks Challenge 2021 is kicking off in July with a 25k to celebrate the Foundation’s 25th anniversary. This year, we’re asking each NetWork to participate in a physical challenge, virtually. Make your way to 25k by walking, running, biking – or any activity that suits you.

Through the challenge, you can engage in friendly competition while supporting the goals of the Foundation. This year, money raised will directly help us in addressing health disparities through our microgrants program and will support travel grants for doctors-in-training looking to attend CHEST 2021.

With your help, by participating in the NetWorks Challenge, we can fund grants that aim to lend a hand to those who need it the most. Expanding research capabilities, improving patient care, and giving access to medical equipment are just a few ways microgrants from the CHEST Foundation have been used in the past.

Salim Surani, MD, MSc, FCCP, is a long-time supporter of the NetWorks Challenge and the Foundation’s grants program. “Whatever the Foundation pays in terms of grants and awards not only impacts the recipient but also the community as a whole ... For me, it was a no-brainer to get involved in an organization that actually raises funding to support community, education, and research,” Dr. Surani said.

With your support, during the NetWorks Challenge, we can provide grants to more clinicians looking to make a difference in chest medicine.

Encourage your NetWork members to join you this summer in the race to 25k.

“When you work within the NetWorks and join together, and work along with the CHEST Foundation, the impact is much more powerful. I always believed that it is a privilege for us that we have the outlet at the CHEST Foundation to provide grants,” Dr. Surani said.

To learn more about this initiative and this year’s NetWorks Challenge, visit the CHEST Foundation’s website at https://foundation.chestnet.org/.

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The NetWorks Challenge 2021 is kicking off in July with a 25k to celebrate the Foundation’s 25th anniversary. This year, we’re asking each NetWork to participate in a physical challenge, virtually. Make your way to 25k by walking, running, biking – or any activity that suits you.

Through the challenge, you can engage in friendly competition while supporting the goals of the Foundation. This year, money raised will directly help us in addressing health disparities through our microgrants program and will support travel grants for doctors-in-training looking to attend CHEST 2021.

With your help, by participating in the NetWorks Challenge, we can fund grants that aim to lend a hand to those who need it the most. Expanding research capabilities, improving patient care, and giving access to medical equipment are just a few ways microgrants from the CHEST Foundation have been used in the past.

Salim Surani, MD, MSc, FCCP, is a long-time supporter of the NetWorks Challenge and the Foundation’s grants program. “Whatever the Foundation pays in terms of grants and awards not only impacts the recipient but also the community as a whole ... For me, it was a no-brainer to get involved in an organization that actually raises funding to support community, education, and research,” Dr. Surani said.

With your support, during the NetWorks Challenge, we can provide grants to more clinicians looking to make a difference in chest medicine.

Encourage your NetWork members to join you this summer in the race to 25k.

“When you work within the NetWorks and join together, and work along with the CHEST Foundation, the impact is much more powerful. I always believed that it is a privilege for us that we have the outlet at the CHEST Foundation to provide grants,” Dr. Surani said.

To learn more about this initiative and this year’s NetWorks Challenge, visit the CHEST Foundation’s website at https://foundation.chestnet.org/.

 

The NetWorks Challenge 2021 is kicking off in July with a 25k to celebrate the Foundation’s 25th anniversary. This year, we’re asking each NetWork to participate in a physical challenge, virtually. Make your way to 25k by walking, running, biking – or any activity that suits you.

Through the challenge, you can engage in friendly competition while supporting the goals of the Foundation. This year, money raised will directly help us in addressing health disparities through our microgrants program and will support travel grants for doctors-in-training looking to attend CHEST 2021.

With your help, by participating in the NetWorks Challenge, we can fund grants that aim to lend a hand to those who need it the most. Expanding research capabilities, improving patient care, and giving access to medical equipment are just a few ways microgrants from the CHEST Foundation have been used in the past.

Salim Surani, MD, MSc, FCCP, is a long-time supporter of the NetWorks Challenge and the Foundation’s grants program. “Whatever the Foundation pays in terms of grants and awards not only impacts the recipient but also the community as a whole ... For me, it was a no-brainer to get involved in an organization that actually raises funding to support community, education, and research,” Dr. Surani said.

With your support, during the NetWorks Challenge, we can provide grants to more clinicians looking to make a difference in chest medicine.

Encourage your NetWork members to join you this summer in the race to 25k.

“When you work within the NetWorks and join together, and work along with the CHEST Foundation, the impact is much more powerful. I always believed that it is a privilege for us that we have the outlet at the CHEST Foundation to provide grants,” Dr. Surani said.

To learn more about this initiative and this year’s NetWorks Challenge, visit the CHEST Foundation’s website at https://foundation.chestnet.org/.

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Get ready for the FUN at CHEST 2021 with CHEST games

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This year’s CHEST Annual Meeting will push the envelope of fun through various educational games and experiences for those attending on-site and online.

CHEST is supercharging the escape room experience with the expansion of two unique on-site escape scenarios to solve, First Contact and Shuttle Crash. In escape rooms, small teams work against the clock to solve a medical puzzle and unlock the final challenges. Those attending online can take a break and join the excitement with First Contact, a mission to Jupiter led by our space lieutenant, William Kelly, MD, FCCP, and faculty and staff game fleet. To build off the futuristic hands-on experiences, CHEST will be debuting intubation procedural simulations using state-of-the-art virtual reality technology.

If you prefer to join the fun using your mobile device, CHEST is releasing daily task-based missions that you can track and complete using your phone. These missions will include a variety of social activities designed around the conference halls, hotels, clinic, and your own home that are sure to get you moving and working as a team.

During the 4 days of the annual meeting, CHEST will also host an exclusive event called “Play With the Pros.” You can test your knowledge and play alongside annual meeting cochairs, Chris Carroll, MD, FCCP, and David Zielinski, MD, FCCP, for the chance to win a grand prize. As an added bonus, CHEST is offering daily prize drawings for players and social media recognition to those who top the leaderboards in the CHEST Player Hub. The Player Hub hosts more than 10 bite-sized mobile games and is available on demand with your CHEST ID.

Additionally, live game breaks hosted by our faculty between education sessions will give you the chance to unwind and play in real time with your peers and colleagues. On-site, CHEST invites you to shoot hoops, drive remote-controlled cars, and shuffle across the gameboard floors. From your couch or desk, you can tune in to test your knowledge in our livestreamed trivia or sign up for the chance to receive a trivia question phone call from our faculty, which is tied to a grand prize.

The opportunities to play and learn during CHEST Games are endless at CHEST 2021!

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This year’s CHEST Annual Meeting will push the envelope of fun through various educational games and experiences for those attending on-site and online.

CHEST is supercharging the escape room experience with the expansion of two unique on-site escape scenarios to solve, First Contact and Shuttle Crash. In escape rooms, small teams work against the clock to solve a medical puzzle and unlock the final challenges. Those attending online can take a break and join the excitement with First Contact, a mission to Jupiter led by our space lieutenant, William Kelly, MD, FCCP, and faculty and staff game fleet. To build off the futuristic hands-on experiences, CHEST will be debuting intubation procedural simulations using state-of-the-art virtual reality technology.

If you prefer to join the fun using your mobile device, CHEST is releasing daily task-based missions that you can track and complete using your phone. These missions will include a variety of social activities designed around the conference halls, hotels, clinic, and your own home that are sure to get you moving and working as a team.

During the 4 days of the annual meeting, CHEST will also host an exclusive event called “Play With the Pros.” You can test your knowledge and play alongside annual meeting cochairs, Chris Carroll, MD, FCCP, and David Zielinski, MD, FCCP, for the chance to win a grand prize. As an added bonus, CHEST is offering daily prize drawings for players and social media recognition to those who top the leaderboards in the CHEST Player Hub. The Player Hub hosts more than 10 bite-sized mobile games and is available on demand with your CHEST ID.

Additionally, live game breaks hosted by our faculty between education sessions will give you the chance to unwind and play in real time with your peers and colleagues. On-site, CHEST invites you to shoot hoops, drive remote-controlled cars, and shuffle across the gameboard floors. From your couch or desk, you can tune in to test your knowledge in our livestreamed trivia or sign up for the chance to receive a trivia question phone call from our faculty, which is tied to a grand prize.

The opportunities to play and learn during CHEST Games are endless at CHEST 2021!

 

This year’s CHEST Annual Meeting will push the envelope of fun through various educational games and experiences for those attending on-site and online.

CHEST is supercharging the escape room experience with the expansion of two unique on-site escape scenarios to solve, First Contact and Shuttle Crash. In escape rooms, small teams work against the clock to solve a medical puzzle and unlock the final challenges. Those attending online can take a break and join the excitement with First Contact, a mission to Jupiter led by our space lieutenant, William Kelly, MD, FCCP, and faculty and staff game fleet. To build off the futuristic hands-on experiences, CHEST will be debuting intubation procedural simulations using state-of-the-art virtual reality technology.

If you prefer to join the fun using your mobile device, CHEST is releasing daily task-based missions that you can track and complete using your phone. These missions will include a variety of social activities designed around the conference halls, hotels, clinic, and your own home that are sure to get you moving and working as a team.

During the 4 days of the annual meeting, CHEST will also host an exclusive event called “Play With the Pros.” You can test your knowledge and play alongside annual meeting cochairs, Chris Carroll, MD, FCCP, and David Zielinski, MD, FCCP, for the chance to win a grand prize. As an added bonus, CHEST is offering daily prize drawings for players and social media recognition to those who top the leaderboards in the CHEST Player Hub. The Player Hub hosts more than 10 bite-sized mobile games and is available on demand with your CHEST ID.

Additionally, live game breaks hosted by our faculty between education sessions will give you the chance to unwind and play in real time with your peers and colleagues. On-site, CHEST invites you to shoot hoops, drive remote-controlled cars, and shuffle across the gameboard floors. From your couch or desk, you can tune in to test your knowledge in our livestreamed trivia or sign up for the chance to receive a trivia question phone call from our faculty, which is tied to a grand prize.

The opportunities to play and learn during CHEST Games are endless at CHEST 2021!

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