Search Journal-type in search term and press enter
Social Media-Follow Southwest Journal of Pulmonary and Critical Care on Facebook and Twitter

Arizona Thoracic Society Notes

Last 50 Postings

(Click on title to be directed to posting, most recent listed first)

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.

-------------------------------------------------------------------------------------

Thursday
May162013

May 2013 Arizona Thoracic Society Notes

A dinner meeting was held on Wednesday, 5/15/2013 at Scottsdale Shea beginning at 6:30 PM. There were 13 in attendance representing the pulmonary, critical care, sleep, thoracic surgery, and radiology communities.

Dr. George Parides will have served his 2 year tenure as Arizona Thoracic Society President by July, 2013. However, he will be unable to attend the June meeting and for this reason Presidential elections were held. Dr. Lewis Wesselius was nominated and unanimously elected as President.

Three cases were presented:

  1. Dr. Gerald Schwartzberg presented the case of a 49 year old woman with a history of Valley Fever in 2009. She was a nonsmoker and had no other known medical diseases.  However, she developed shortness of breath beginning earlier this year along with a cough productive of clear, jelly-like sputum. Her physical was normal. Pulmonary function testing revealed restrictive disease with significant improvements in the FEV1 and FVC after bronchodilators.  Eosinophils were increased in her CBC at 12%. IgE was moderately increased at 286 IU/ml.  Chest x-ray was normal. A high resolution thoracic CT scan revealed scattered bronchiectasis and mucoid impaction.  Some speculated that this could be a case of allergic bronchopulmonary aspergillosis (ABPA) although all agreed that the level of IgE was lower than commonly occurs with ABPA. It was felt that an Aspergillus specific IgE might be useful. It was also suggested that the coccidiomycosis might have caused the bronchiectasis, noting that mycosis other than Aspergillus sp. may cause the syndrome similar to ABPA which has been termed allergic bronchopulmonary mycosis.
  2. Dr. Jud Tillinghast presented a case of 45 year old woman who worked as a nurse practioner. She had developed rheumatoid arthritis a few years earlier and was being treated with plaquenil and steroids. Recently she had developed shortness of breath. A few squeaks were normal on auscultation of the lungs. Pulmonary function testing was normal. However, a thoracic CT scan revealed a mosaic pattern consistent with air trapping. An open lung biopsy was performed and was consistent with constrictive bronchiolitis. The biopsy did not show inflammation but obliteration of the small bronchioles. Considerable discussion centered on treatment with most agreeing that there were no known efficacious treatments. 
  3. Dr. Allen Thomas presented a case of a 72 year old man with 2 small pulmonary nodules discovered incidentally in Northern California. However, at the time of discovery he was in the process of moving to Arizona and presented a year later. Follow up thoracic CT scan revealed multiple small nodules and mediastinal nodes. Mediastinoscopy revealed noncaseating granulomas. A repeat CT showed that the mediastinal nodes have resolved but the nodules persisted. A PET scan showed markedly enhanced uptake by the nodules and in the mediastinum raising a question of carcinoma. Most felt that this was likely a manifestation of sarcoidosis and not necessarily an indication of cancer.

There being no further business the meeting was adjourned at about 8 PM. The next meeting is scheduled for Wednesday, June 26. The July meeting will be in Tucson on July 24th at 6:30 PM. Location to be determined.  

 

Rick Robbins

Arizona CCR Representative

 

Reference as: Robbins RA. May 2013 Arizona Thoracic Society notes. Southwest J Pulm Crit Care. 2013;6(5):237-8. PDF

 

Friday
Apr262013

April 2013 Arizona Thoracic Society Notes

A dinner meeting was held on Wednesday, 4/24/2013 at Scottsdale Shea beginning at 6:30 PM. There were 13 in attendance representing the pulmonary, critical care, sleep, infectious disease, and radiology communities. Drs. Gotway and August, thoracic radiologists, were both unable to attend. Dr. Tilman Kolesch from Maricopa more than capably filled in as our radiologist.

The meeting was preceded by a discussion on Pharma and the availability of physicians who accept money, including dinners, from pharmaceutical companies. The Arizona Thoracic Society is sponsored by pharmaceutical companies.

Ken Knox asked if Arizona Thoracic Society meetings could be held in Tucson during July and December, the two months meetings have not been scheduled. The attendees enthusiastically endorsed this expansion of the Arizona Thoracic Society meetings.

In addition, Dr. Knox wishes to sponsor a winter symposium in Tucson in collaboration with the Arizona Thoracic Society. The attendees also enthusiastically endorsed this meeting. 

Four cases were presented:

  1. Tim Kuberski, infectious disease from Maricopa, presented a case of a 27 year old woman who was in her 38th week of pregnancy who was referred for an abnormal chest x-ray. She has a positive history of tuberculosis which was treated with only 2 weeks of isoniazid, rifampin and ethambutol. Her chest x-ray showed volume loss and left upper lobe cavitary disease. This had progressed from an old chest x-ray taken several years previously.  Sputum was positive for acid-fast bacilli. Previously the patient had grown Mycobacterium kansasii. Given that she was in her 38th week of pregnancy, the patient was asymptomatic and the tempo of her disease appeared slow, most suggested waiting until after her delivery to start therapy.
  2. Tom Colby, pulmonary pathologist from the Mayo Clinic presented a case of a 5 year old with enlarging nodules in both lungs. The child had a history of cystic pulmonary adenomatoid malformation or congenital cystic adenomatoid malformation (CPAM/CCAM) at 8 days. Biopsy of the lesions revealed histology consistent with mucinous adenocarcinoma. This has been previously reported (Am J Surg Pathol. 2003;27:1139-46).  
  3. Dr. Colby also presented a case of a 38 year old with a history of sarcoidosis that had developed cystic changes in the left upper lobe. Biopsy was consistent with mucinous adenocarcinoma. Dr. Colby discussed the potential association of these lymphocytic predominant lesions with mucinous adenocarcinoma.
  4. Lewis Wesselius, pulmonologist from the Mayo Clinic, presented a 65 year old from Colorado with lung masses. The patient had a history of dermatomyositis and was being with intravenous immunoglobulin (IVIG), prednisone and methotrexate for his dermatomyositis and warfarin for his pulmonary embolism. A thoracic CT scan showed multiple nodules which were new compared to an old chest x-ray. A PET scan was positive. A CT guided biopsy was nondiagnostic.  Video-assisted thorascopic surgery (VATS) biopsy showed an Epstein Barr Virus-positive immunodeficiency-associated lymphoproliferative disorder with Hodgkin lymphoma-like features. Dr Wesselius reviewed immunodeficiency-associated lymphoproliferative diseases. If was thought that the patient’s case was most consistent with a methotrexate-induced lymphoma which have been reported to spontaneously improve with discontinuation of methotrexate. Methotrexate was discontinued and the lesions are shrinking.

There being no further business the meeting was adjourned at about 8 PM. The next meeting is scheduled for Wednesday, May 15 prior to the American Thoracic Society meeting in Philadelphia.

Rick Robbins

Arizona CCR Representative

Reference as: Robbins RA. April 2013 Arizona thoracic society notes. Southwest J Pulm Crit Care. 2013;6(4):189-190. PDF

Thursday
Mar212013

March 2013 Arizona Thoracic Society Notes

A dinner meeting was held on Wednesday, 3/20/2013 at Scottsdale Shea beginning at 6:30 PM. There were 14 in attendance representing the pulmonary, critical care, sleep, infectious disease, nursing, and radiology communities.

Copies of the book “Breathing in America: Diseases, Progress, and Hope” were distributed.

Three cases were presented:

  1. Tim Kuberski, infectious diseases from Maricopa, presented a 49 year old woman with a history of alcoholism who presented with RML pneumonia. Despite azithromycin and cephtriaxone she developed progressive respiratory failure and a right pleural effusion. A right chest tube was placed. Cultures of blood and the pleural fluid were negative. She was suspected of having an anaerobic infection. Follow-up CT scan showed abscess formation in her RML with areas of dense consolidation on the left and a left pleural effusion. Discussion focused on whether RML resection should be performed. Most favored a surgical approach.
  2. Andrew Goldstein, thoracic surgery, presented a 48 year old man with a large extrathoracic chest mass who presented with hematuria. The hematuria eventually proved to be secondary to bladder cancer. On CT the approximate 7 cm mass appears to be growing from the manubrium. Biopsy of the mass revealed transitional cell carcinoma. There are clinically no other metastasis. The sternal tumor was resected and the patient has done well and has returned to work.
  3. Tom Ardiles, pulmonary from Maricopa, presented 21 yo woman who presented with pneumonia after a cardiac arrest. She has a history of alcohol and dextroamphetamine abuse. Her procalcitonin levels were elevated. She developed right lower lung consolidation and a right pneumothorax. Sputum grew Pseudomonas. CT shows diffuse grown glass opacities and pneumomediastinum and intertidal emphysema. She has had progressive consolidation on chest x-ray and persistent respiratory failure. A right pleural effusion developed and was drained which also cultured Pseudomonas. She is gradually improving on oscillatory ventilation and antibiotics.

There being no further business, the meeting was adjourned at about 8 PM. The next meeting is Wednesday, April 24, 2013 at 6:30 PM at Scottsdale Shea.

Richard A. Robbins, MD

CCR Representative

Arizona Thoracic Society

Reference as: Robbins RA. March 2013 Arizona thoracic society notes. Southwest J Pulm Crit Care. 2013;6(3):148. PDF

Thursday
Mar212013

March 2013 Council of Chapter Representatives Meeting and “Hill Day” Notes

March 18, 2013

As part of “Hill Day” the Council of Chapter Representatives meant on March 18, 2012 in Washington, D.C. beginning at 2:00 PM.

1. Welcome/Open meeting: Dona Upson 2:00 PM

Roll call determined there were representatives present from Arizona, Colorado, DC-Metro, Louisiana, Michigan, Mississippi, New York, and Washington. Linda Nicci, CCR Chair from Rhode Island, was delayed by weather and attended by conference call.

2. ATS Leadership Update 2:15pm

Presentations were given by Monica Kraft, ATS president, and Steven Crane, ATS executive director. Highlights of their presentations included –

  • A discussion of hospitalists eligibility for critical care boards
  • The ATS bottom line 
    • Bottom line was positive beginning in 2010 and growing in 2011 and 2012
    • Reserves have also increased (about 2/3 of a year)
  • Ken Adler will serve 3 more years as editor of the “Red Journal”
  • Annals of the ATS will be published shortly. It is hoped to be clinician friendly.
  • A 3 year core curriculum aligned to ABIM’s exam has been posted on the ATS website.
  • 2013 International Meeting
    • Over 5000 abstracts (1500 more than ERS and 3-4000 more than ACCP
    • 40% of revenue comes from ATS meeting
    • Registration down about 12% compared to San Francisco
  • Some drop in membership in 2013 attributed to the meeting not in San Francisco and Hurricane Sandy delayed processing applications-expect numbers to rise
  • ATS webinars have had over 1200 participants
  • 8000 are following ATS on Facebook and Twitter
  • ATS developing bridge funding for NIH grantees because of sequestration
  • ALL money given to the ATS Foundation goes for research-no administrative costs

 3. Chapter Activity Update 2:40pm

  • A handout was distributed with the 2012-13 Chapter Educational Meetings
  • A brief discussion was held of the Chapter publications from Arizona and California
  • Some inactive chapters showing renewed interest
  • A brief discussion of ALA relationship and administration

4. Outstanding Clinician Award (OCA) 3:00pm

  • The 2013 OCA finalists were from AZ, NM, WA
  • The ATS OCA for 2013 is Allen Thomas, MD, Arizona

5. Committee Updates by CCR reps 3:15pm

  • Verbal/written updates from CCR reps on committees they cover
    • Clinicians Advisory-Chris Fukui
    • Education-Linda Nici
    • Ethics and Conflict of Interest-Anthony Scardella
    • Health Policy-Dona Upson
    • Planning and Evaluation-Carol Welsh
    • Quality Improvement-Chris Fukui Wilhelm
    • Research Advocacy-Rajesh Bhagat
    • Training-Rajesh Bhagat

6. Advocacy Update - 3:45pm

Gary Ewart, ATS lobbyists, presented an advocacy update. Highlights included:

  • Advocacy by CCR
  • A review of the list of chapter ‘advocacy’ champions (CCR)
  • An open discussion other (potential) advocacy initiatives

7. Future Activity/Additional Role of CCR 4:25pm

  • Linda Nicci made a presentation.
  • Highlights of the discussion included
    • Increased CCR presence at International Conference
    • Officers to commit to times in Clinicians Center and Fellows Center.
    • Review of CCR brochure
    • CCR/ATS Foundation Partnership
    • Report on CCR involvement with Better Breathing Alliance

8. Great Cases Symposium at International Conference – organized by CCR 4:50pm

A reminder and a brief discussion was held of the Great Cases Symposium Organized by CCR: Session A83: Great Cases: Clinical, Radiologic and Pathologic Correlations by Master Clinicians

9. CCR Meeting date in Philadelphia 4:55pm

A CCR meeting will be held in Philadelphia on Saturday, May 18 from 11:00 AM-1:00 PM.

10. There being no further business the meeting was adjourned 5:00pm

March 19, 2013

1. Presentations were made by James Kiley, Director of the Division of Lung Diseases, and several staff from Congressional including the Veterans Affairs and research related committees from 8 AM-10 AM.

2. Meetings with Congressional representatives were held throughout the day. The offices were presented with handouts advocating (Click on title to be directed to the handouts)

Meetings with Arizona, New Mexico and Colorado representatives included:

 Arizona

  • Michael Nelson from the Office of Senator Jeff Flake (R-AZ)
  • Christopher Bowlin from the Office of Senator John McCain (R-AZ)
  • Lliam Morrison from the Office of Representative Matt Salmon (R-AZ)
  • Laurie Ellington from the Office of Representative Ed Pastor (D-AZ)

New Mexico 

  • Sandra Wilkniss from the Office of Senator Martin Heinrich (D-NM)
  • Representative Michelle Lujan Grisham (D-NM) and Kristin Palmer from her office
  • Lauren Arias from the Office of Tom Udall (R-NM)

Colorado

  • Representative Michael Coffman (R-CO and sponsor of the HR 792 tobacco bill) and legislative assistant Stephen Beck
  • Jacquelyn White, health policy fellow from the office of representative Dianna DeGette (D-CO)
  • Kristen Joyce legislative correspondent from the office of senator Mark Udall (D-CO)
  • Rina Shah, legislative fellow from the office of senator Michael Bennet (D-CO)
  • Morning coffee with Senator Michael Bennet (D-CO)

3. A dinner debriefing was held later that evening to discuss the advocacy efforts.

Richard A. Robbins, MD

Arizona CCR Representative

Reference as: Robbins RA. March 2013 council of chapter representatives meeting and "hill day" notes. Southwest J Pulm Crit Care. 2013;6(3):145-7. PDF

Thursday
Feb282013

February 2013 Arizona Thoracic Society Notes

A dinner meeting was held on Wednesday, 2/27/2013 at Scottsdale Shea beginning at 6:30 PM. There were 27 in attendance representing the pulmonary, critical care, sleep, infectious disease, nursing, pathology and radiology communities.

Dr. George Parides, Arizona Thoracic Society President, congratulated Allen Thomas on being named ATS 2013 Clinician of the Year.

Lewis Wesselius announced the ALA 2013 Fight for Air Walk. This will be at the Scottsdale Civic Center on April 27, 2013. To participate or sponsor a walker contact Lonie Padilla at lpadilla@lungarizona.org or 602-429-0007.

Rick Robbins, editor of the Southwest Journal of Pulmonary and Critical Care, announced Tim Kuberski has been named an associate editor.

A discussion was held regarding other states in the Southwest to partner with the Southwest Journal of Pulmonary and Critical Care.  

Seven cases were presented:

  1. Elijah Poulos, pulmonary fellow from the VA, presented a follow-up to a patient previously presented with optic neuritis, a positive ANCA at 1:40, a positive PR3 antibody at 1:8, and bilateral peribronchial consolidations right greater than left. The patient underwent a core needle biopsy of the lung with a final diagnosis of organizing pneumonia. The patient apparently declined rapidly and is now being given high dose methylprednisolone with the plan to begin cyclophosphamide shortly for a presumptive diagnosis of Wegner’s granulomatosis.
  2. George Parides, pulmonologist, presented a case of a 17 year old woman when first seen in 2006 in the Emergency Department with chest pain. A CT was done which showed probably bronchial atresia on the left. She also had a positive coccidiomycosis serology. A bronchoscopy was negative. She was treated with fluconazole for about 9 months and then lost to follow up. She next presented in 2009 without change in her CT scan and again had a negative bronchoscopy. Rick Helmers saw her later that year. An open lung biopsy was performed but the results are unknown. She again presented in January of 2013 with increasing consolidation at the bases. Coccidiomycosis was seen on smear and she was begun on amphotericin. She has had minimal improvement. Most felt that continuing her amphotericin was appropriate.
  3. Thomas Colby, pulmonary pathologist, presented a 68 year old woman who had a nonsmall cell carcinoma in 2011. She was treated with radiation therapy because her lung function was considered too compromised for pneumonectomy. She presented with increasing bilateral small nodules. A wedge biopsy showed many +CD1A cells and a diagnosis of histiocytosis X was made.
  4. Thomas Colby and Maria L. Cabanas, pulmonary pathologists from the Mayo Clinic, presented a case of a 67 year old that had pulmonary fibrosis on CT scan but was asymptomatic. The fibrosis progressed and biopsy showed adenocarcinoma.
  5. Tim Kuberski, infectious diseases from Maricopa, presented a 51 year old man who presented with cough. Chest x-ray revealed two large masses, one in the RUL and one in LUL, against a background of smaller nodules. The patient was a miner and a diagnosis of silicosis was made. He was followed and CT showed cavitation of one of the nodules. Quantiferon was negative as was PCR for Mycobacterium tuberculosis; however, his acid-fast smear was positive. He eventually grew Mycobacterium kansasii and is now on treatment.
  6. Al Thomas, pulmonologist at the VA, presented a 65 year old who had a large osteophyte with surrounding fibrosis.
  7. Gerald Swartzberg, pulmonologist, presented a 74 year old who had a squamous cell carcinoma resected who now has a fungus ball in a residual cough and has hemoptysis. Some suggested intracavitary amphotericin as a possibility for treatment.  

There being no further business, the meeting was adjourned at about 8 PM. The next meeting is Wednesday, March 20, 2013 at 6:30 PM at Scottsdale Shea.

Richard A. Robbins, MD

CCR Representative

Arizona Thoracic Society

Reference as: Robbins RA. Southwest J Pulm Crit Care. 2013;6(2):91-92. PDF

Page 1 ... 6 7 8 9 10 ... 13 Next 5 Entries »