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Arizona Thoracic Society Notes

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November 2018 Arizona Thoracic Society Notes
September 2018 Arizona Thoracic Society Notes 
July 2018 Arizona Thoracic Society Notes
March 2018 Arizona Thoracic Society Notes
January 2018 Arizona Thoracic Society Notes
November 2017 Arizona Thoracic Society Notes
September 2017 Arizona Thoracic Society Notes
March 2017 Arizona Thoracic Society Notes
January 2017 Arizona Thoracic Society Notes
November 2016 Arizona Thoracic Society Notes
July 2016 Arizona Thoracic Society Notes
March 2016 Arizona Thoracic Society Notes
November 2015 Arizona Thoracic Society Notes
September 2015 Arizona Thoracic Society Notes
July 2015 Arizona Thoracic Society Notes
May 2015 Arizona Thoracic Society Notes
March 2015 Arizona Thoracic Society Notes
January 2015 Arizona Thoracic Society Notes
November 2014 Arizona Thoracic Society Notes
September 2014 Arizona Thoracic Society Notes
August 2014 Arizona Thoracic Society Notes
June 2014 Arizona Thoracic Society Notes
May 2014 Arizona Thoracic Society Notes
April 2014 Arizona Thoracic Society Notes
March 2014 Arizona Thoracic Society Notes
February 2014 Arizona Thoracic Society Notes
January 2014 Arizona Thoracic Society Notes
December 2013 Arizona Thoracic Society Notes
November 2013 Arizona Thoracic Society Notes
October 2013 Arizona Thoracic Society Notes
September 2013 Arizona Thoracic Society Notes
August 2013 Arizona Thoracic Society Notes
July 2013 Arizona Thoracic Society Notes
June 2013 Arizona Thoracic Society Notes
May 2013 Council of Chapter Representatives Notes
May 2013 Arizona Thoracic Society Notes
April 2013 Arizona Thoracic Society Notes 
March 2013 Arizona Thoracic Society Notes
March 2013 Council of Chapter Representatives Meeting 
and “Hill Day” Notes
February 2013 Arizona Thoracic Society Notes
January 2013 Arizona Thoracic Society Notes
November 2012 Arizona Thoracic Society Notes
October 2012 Arizona Thoracic Society Notes
September 2012 Arizona Thoracic Society Notes
August 2012 Arizona Thoracic Society Notes
August 2012 Special Meeting Arizona Thoracic Society Notes
June 2012 Arizona Thoracic Society Notes
May 2012 Council of Chapter Representatives Meeting
May 2012 Arizona Thoracic Society Notes

 

For a complete list of the Arizona Thoracic Society notes click here.

The Arizona Thoracic Society meets every other month in Phoenix, usually on the fourth Wednesday of odd numbered months, from 6:30-8:00  PM at Scottsdale Healthcare Shea Hospital located at Shea and 90th Street in Phoenix. During these meetings dinner and case presentations occur.

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Wednesday
Apr132011

April 2011 Arizona Thoracic Society Notes

A dinner meeting was held at Scottsdale Shea Medical Center on April 12, 2011 from 6:30-8:00 PM. Twenty-seven were in attendance including representatives from the pulmonary and chest radiology communities. Six cases were presented and discussed:

1. Alexis Christie and Rick Helmers presented a case of acute respiratory failure in a 51 year old woman who had an “ARDS”-like picture, an initially negative bronchoscopy with bronchoalveolar lavage and a non-specific open lung biopsy. The bronchoalveolar lavage eventually cultured influenza A. Discussion centered on whether the patient should have received corticosteroids.

2. Lew Wesselius presented a 55 year old man evaluated for renal transplant secondary to chronic renal failure from polycystic kidney disease. The patient was asymptomatic but found to have lower lung nodules on CT which were thought to be pulmonary arteriovenous malformations. The patient was referred for embolization. The invasive radiologist identified these as pulmonary varices. No therapy was given. A brief review of pulmonary varices was done by Dr. Wesselius and Mike Gotway discussed the radiographic appearance.

3. Gerald Swartzberg presented a case of a 64 year old woman with a rash on her palms, fever and multiple pulmonary nodules. Cultures and coccidiomycosis serology were negative. The patient was found to have coccidiomycosis on video-assisted thoracic surgery. Discussion centered on the 70% sensitivity of coccidiomycosis serology.

4. Gerald Swartzberg presented a second case of a 55 year old man with dyspnea, a 20 pack-year smoking history, and lower lobe fibrosis. The PFTs were presented which demonstrated a mixed obstructive and restrictive disease with a diffusing capacity of 47% of predicted. Most thought this was a case of COPD with idiopathic pulmonary fibrosis. Management was discussed.

5. John Roehrs presented a case of 52 year old woman with dyspnea with a normal chest x-ray and spirometry. However, on echocardiogram pulmonary hypertension was found with right atrial and ventricular enlargement. A bubble study demonstrated an atrial septal defect. Right-sided cardiac catherization confirmed the elevated pulmonary artery pressure and demonstrated an O2 step up at the atrial level. Discussion centered on therapy with most suggesting cardiology evaluation for a percutaneous closure of the ASD.

6. Christian Jivcu and Manny Mathew presented a case dyspnea of a man who had Hodgkin’s disease in 1987 who had received radiation therapy. CXR revealed bilateral pleural effusions which were exudative. A chest CT scan revealed mediastinal lymphadenopathy. At operation he was found to have mesothelioma which even in retrospect was not recognizable on his CT scan. The patient had no known asbestos exposure. Discussion focused on the association between prior radiation therapy and mesothelioma.

Richard A. Robbins, MD

Wednesday
Mar162011

March 2011 Arizona Thoracic Society Notes

A dinner meeting was held at Scottsdale Shea Medical Center on March 15, 2011 from 6:30-8:00 PM. Fifteen were in attendance including representatives from the pulmonary and chest radiology communities. A brief presentation was made by Rick Robbins of current ATS activities. Five cases were presented and discussed: 1. Gerald Swartzberg presented a case of a 73 year old with dyspnea and severe restrictive physiology but without evidence of pulmonary fibrosis. Discussion centered on sniff testing and the possibility of bilateral diaphragmatic paralysis. 2. Henry Luedy presented a case of a thoracic duct-cutaneous fistula draining lymph percutaneously. The patient was not considered a surgical candidate and radiologic evaluation and nonsurgical interventions were discussed. 3. George Parides presented a case of a 47 year old with shrinking lung nodules and microscopic hematuria. Discussion centered on microscopic polyangitis and the most expeditious diagnostic tests. 4. George Parides presented a second case of a 79 year old who is asymptomatic but with an incidental finding of scattered lung nodules. Discussion centered on atypical mycobacterium and the necessity of diagnosis versus observation.  5. John Roehrs presented a case of a 53 year old woman with dyspnea and mild pulmonary hypertension discovered to have a patent foramen ovale. Discussion centered on management including correction and anticoagulation.

Richard A. Robbins, MD

Wednesday
Feb162011

February 2011 Arizona Thoracic Society Notes

A dinner meeting was held at Scottsdale Shea Medical Center on February 15 from 6:30-8:00 PM. Twenty were in attendance including representatives from the pulmonary, chest radiology, and thoracic surgery communities. Several cases were presented and discussed: 1. Metastatic testicular cancer by Henry Luedy 2. A left pleural effusion with an inverted diaphragm was presented by Allen Thomas. Michael Gotway showed several cases from his teaching files of reexpansion pulmonary edema. A discussion ensued afterwards regarding the volume of fluid which can be safely removed at one time. The thoracic surgeons noted that they have removed large volumes during video-assisted thorascopy without any adverse consequences. It was felt that up to 1-1.5 liters could be removed safely but larger volumes probably required manometry; 3. Manny Mathew showed a case of hydropneumothorax after resection of a Coccidiodes cavity with subcutaneous air and multiple air-fluid levels including in the soft tissues. Discussion centered on management; and 4. Evan Schmitz presented a case of Nocardia in an immunocompromised host with a low FEV1 emphasizing the importance of aggressively pursuing the diagnosis.

Richard A. Robbins, MD

Tuesday
Jan252011

January 2011 Arizona Thoracic Society Notes

A dinner meeting was held at Scottsdale Shea Medical Center on January 18 from 6:30-8:00 PM. Thirty-six were in attendance including representatives from the pulmonary, chest radiology, thoracic surgery and pulmonary pathology communities. A brief discussion of American Thoracic Society dues occurred. A report was given on the first three months of the Arizona Thoracic Society's official publication, the Southwest Journal of Pulmonary and Critical Care (click here for PowerPoint presentation of the report and see Editorial section for a brief summary). Three cases were presented and discussed: 1. Parsonage-Turner Syndrome; 2. Strongyloidiasis in an immunocompromised host; and 3. An unusual manifestitation of sarcoidosis.

Richard A. Robbins, MD

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