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Arizona Thoracic Society Notes

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November 2018 Arizona Thoracic Society Notes
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November 2017 Arizona Thoracic Society Notes
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January 2017 Arizona Thoracic Society Notes
November 2016 Arizona Thoracic Society Notes
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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
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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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Entries in pulmonary pyoderma gangrenosum (1)

Thursday
Jul232015

July 2015 Arizona Thoracic Society Notes

The July 2015 Arizona Thoracic Society meeting was held on Wednesday, July 23, 2015 at the Scottsdale Shea Hospital beginning at 6:30 PM. This was a dinner meeting with case presentations. There were 16 in attendance representing the pulmonary, critical care, sleep, and radiology communities.

It was decided to continue holding the meeting on the fourth Wednesday of the odd numbered months.

Lewis Wesselius relayed a request from the Mayo Clinic regarding a survey on how physicians in Arizona treat Valley Fever. There were no objections to using our mailing list to send out the survey.

Dr. Parides formed a committee to encourage younger clinicians to attend the Arizona Thoracic Society meetings.

Richard A. Robbins was chose as the Arizona Thoracic Society's nominee for clinician of the year.

There were 3 case presentations:

  1. George Parides presented a 58-year-old woman with a past medical history of cavitating coccidioidomycosis in both upper lobes from which she had recovered. However, on thoracic CT scan she had traction bronchiectasis as well as narrowing of the inferior vena cava. It had been recommended that a vena cava filter be placed to prevent pulmonary embolism. She had no history of deep venous thrombosis. None in the audience knew of any data suggesting placement of a filter was indicated.
  2. Lewis Wesselius presented a case of a 19-year-old man who presented with dyspnea and bilateral large pulmonary nodules. He had a history of smoking about 5 cigarettes per day and use of medical marijuana for sinusitis. Laboratory workup showed an elevated white blood cell count but a cANCA and cultures was negative. Bronchoscopy with bronchoalveolar lavage demonstrated alveolar hemorrhage. Open biopsy was consistent with pulmonary pyoderma gangrenosum. The patient was begun on corticosteroids and had resolution of both his symptoms and nodules.
  3. Rick Robbins presented Drs. Ling and Boivin's case of a 40 year old man with a history of opioid abuse who was mechanically ventilated but failed an extubation trial (1). The videos of the diaphragm were presented along with a discussion of the diaphragm thickening fraction (DTF) assessed by ultrasound as a predictor for the success of extubation. DTF is calculated using the following formula: Thickness at end inspiration - Thickness at end expiration / Thickness at end expiration. Based on the study published by Ferarri and associates (2), they found that a DTF > 36% would provide a sensitivity of 0.82, a specificity of 0.88, a positive predictive value (PPV) of 0.92 and a negative predictive value (NPV) of 0.75.

There being no further business, the meeting was adjourned about 8 PM. The next meeting will be in Phoenix at Scottsdale Shea on Wednesday, September 28 at 6:30 PM.

Richard A. Robbins, MD

Editor, SWJPCC

References

  1. Ling D, Boivin M. Ultrasound for critical care physicians: take a deep breath. Southwest J Pulm Crit Care. 2015;11(1):38-41. [CrossRef]
  2. Ferrari G, De Filippi G, Elia F, Panero F, Volpicelli G, Aprà F. Diaphragm ultrasound as a new index of discontinuation from mechanical ventilation. Crit Ultrasound J. 2014;6(1):8. [CrossRef] [PubMed]

Reference as: Robbins RA. July 2015 Arizona thoracic society notes. Southwest J Pulm Crit Care. 2015;11(1):49-50. doi: http://dx.doi.org/10.13175/swjpcc098-15 PDF