ACCP NetWorks

NetWork Open Meetings and Special Presentations
NetWork Open Meetings and Special Presentations feature a special presentation, as well as discussion and networking with colleagues. Open to all attendees.

NetWork Highlights
Each NetWork presents two sessions, or NetWork Highlights, that focus on important issues in the respective fields.

Airways Disorders NetWork ID #3490 Date and Time: 11/02/2009, 08:00 am - 09:15 am Type: NetWork Open Meeting Location: Convention Center, 26 B Curriculum: Allergy and Airway, Respiratory Care   NetWork Highlight!

Allied Health NetWork ID #3491 Objectives: Tabulate some of the major driving forces and facts mandating change in the practice of medicine.   Discuss the agendas of different special interest groups and perceptions by these groups. The practice of medicine will see more changes in the next 5 years than in the last 100 years. External economic, political, regulatory, and consumer forces will have profound impacts on the traditional patient-physician-family interaction and even the very practice of medicine. Nowhere will these changes be more felt than in the fields of critical care, trauma care, major truncal surgery, and medical disaster management; all areas of focus by members of the ACCP. Date and Time: 11/02/2009, 08:00 am - 09:15 am Type: NetWork Open Meeting Location: Convention Center, 25 C Curriculum: Critical Care, Respiratory Care   NetWork Highlight!

Clinical Pulmonary Medicine NetWork ID #3489 Objectives: Improve your understanding of the relationship between systemic inflammation and the resolution of pneumonia.   Improve your understanding of the impact of systemic inflammation on morbidity and mortality in patients with severe CAP. Restricted inflammation, tailored to stimulus and time, is beneficial in severe community-acquired pneumonia (CAP): however, excessive or persistent systemic inflammation promotes bacterial growth and incites tissue destruction and disease progression. This leads to life-threatening complications such as septic shock, acute respiratory distress syndrome, and multiple organ dysfunction syndrome. Even when patients survive ICU and hospital admission, subclinical elevation in inflammatory cytokine levels at hospital discharge predicts subsequent posthospitalization mortality. Importantly, a single episode of CAP requiring hospital admission is associated with debilitating long-term morbidity and a dramatic reduction (9 to 25% at 1-year) in life expectancy that is independent of a patient Date and Time: 11/02/2009, 08:00 am - 09:15 am Type: NetWork Open Meeting Location: Convention Center, 24 C Curriculum: Pulmonary Manifestations of Systemic Disease, Signs and Symptoms of Chest Diseases   NetWork Highlight!

Controversies in Prescribing: Patients, Prescribers, Industry, and Regulators ID #3276 Objectives: Identify differing perspectives on public availability of data on use of medications in nonapproved settings.   Illustrate the potential impact of limitations on distribution of off-label data on compassionate use programs, insurance reimbursement, and treatment guidelines. Physicians prescribe medications based on information not necessarily included in the prescribing information but of which they are aware. Should this information be made publicly available? There are both medicolegal and medical perspectives to this issue. There is potential impact on compassionate use programs and reimbursement, and practice guidelines often incorporate off label recommendations. Many therapies have become accepted in general use for indications not approved by regulatory agencies and can provide benefit to medical consumers. This is also a controversial topic from a political standpoint, with Congress and the FDA holding differing points of view. These issues will be discussed from the viewpoint of the various stakeholders. Date and Time: 11/02/2009, 08:00 am - 09:15 am Type: Clinical Controversy Location: Convention Center, 30 DE Curriculum: Education, Teaching, and Quality Improvement   NetWork Highlight!

Critical Care NetWork ID #3492 Objectives: Explain the key distinctions between a process and an outcome.   Review common process and outcome measures in a typical ICU. Clinicians are increasingly being asked to improve care in their ICUs. This presentation focuses on a key concept of quality improvement Date and Time: 11/02/2009, 08:00 am - 09:15 am Type: NetWork Open Meeting Location: Convention Center, 24 AB Curriculum: Critical Care   NetWork Highlight!

Follow-up Management of Noninvasive Ventilation in Patients With Neuromuscular Disease ID #3265 Objectives: Identify the evolution of patient conditions and ventilatory needs, based on download data, to assess the safety and efficacy of long-term NIV.   Compare various alternative measures of evaluating and maintaining patients with NMD using polysomnography and other available clinical tools. The refinement of user-friendly noninvasive ventilation (NIV) equipment has allowed a more widespread appropriate use of respiratory assistance devices in the home for patients with neuromuscular disease (NMD). However, there remains a paucity of guidelines or standards to help with the follow-up and maintenance of therapy for these patients. This may be particularly difficult for clinicians who are less familiar with the available interrogative device software necessary to optimize the ongoing treatment of patients with NMD. This session will outline typical practice plans and review patient follow-up download information in a nonproprietary fashion, which will help clinicians respond to the evolving needs of patients with NMD and provide safe ongoing support for these patients in their own homes. Date and Time: 11/02/2009, 08:00 am - 09:15 am Type: Panel Discussion Location: Convention Center, 30 A Curriculum: Sleep Disorders, Respiratory Care   NetWork Highlight!

Occupational and Environmental Health NetWork ID #3493 Objectives: Understand the respiratory health effects associated with occupational soy exposure.   Describe the different soy allergens involved in occupational sensitization. Several soy proteins are known allergens, and sensitization to soy has been associated with respiratory disease in certain settings. Increases in ED visits for asthma following community soy exposure from ship unloading in Barcelona and New Orleans have been well documented. However, the relationship between asthma and soy in workers who have been exposed is less well documented. In this session, a multidisciplinary investigation of asthma among workers at a soy flour processing plant will be described. The investigation integrated an industrial hygiene evaluation of airborne soy and dust exposures with a medical survey of workers that included a questionnaire, allergy testing, spirometry, and methacholine challenge. By evaluating both the workplace and workforce, we were better able to characterize the role of occupational soy exposure in asthma. Date and Time: 11/02/2009, 08:00 am - 09:15 am Type: NetWork Open Meeting Location: Convention Center, 25 A Curriculum: Occupational and Environmental Lung Diseases   NetWork Highlight!

Practice Administration NetWork ID #3495 Objectives: Understand how the managing physician represents shareholders and focuses primarily on strategy and financial results.   Learn how the administrator directs operations through managers who are fully on board with company direction and strongly performance-driven. Pulmonary Associates of Richmond, Inc. is a large group practice. The purpose of this talk is to share our experience regarding business operations from the perspective of the physician owner in partnership with the administrative team. This session will discuss the following concepts: (1) the physician owner as the ultimate decision maker; (2) giving the administrative team given incentives to accomplish predetermined objectives, which allows them to share in both risks and rewards for profitability; (3) regular and consistent communication between the physician leader and the group administrator to maintain focus and facilitate agreement on tactical change; and (4) the most effective relationship between physician and administrator will function as a trust-driven partnership. Date and Time: 11/02/2009, 08:00 am - 09:15 am Type: NetWork Open Meeting Location: Convention Center, 25 B Curriculum: Practice Management and Administration   NetWork Highlight!

Thoracic Oncology NetWork ID #3494 Objectives: Gain an overview of what encompasses outcomes-based research in lung cancer.   Gain an overview of the limitations, challenges, and opportunities associated with the various types of outcomes-based research in lung cancer. Outcomes-based research is a catch-all phrase for investigations that impact clinical decision-making and health-care delivery and policy. Examples of outcomes-based research applied to the investigation of lung cancer include, but are not limited to, clinical trials, translational research, large database investigation, quality-of-life assessment, health economic analysis, decision-making modeling, and methodologic research. Implementing these types of studies requires the expertise of various types of clinical/research scientists. The management of patients with lung cancer requires the expertise of various types of clinicians, so collaboration between clinicians and scientists from different backgrounds is necessary. The goals of this collaboration are to prioritize scientific questions; determine optimal research design and implementation; mitigate scientific bias, costs, and resource utilization; disseminate actionable results; and generate new hypotheses. Date and Time: 11/02/2009, 08:00 am - 09:15 am Type: NetWork Open Meeting Location: Convention Center, 27 AB Curriculum: Lung Cancer, Cardiothoracic Surgery   NetWork Highlight!

Transplant NetWork ID #3496 Date and Time: 11/02/2009, 08:00 am - 09:15 am Type: NetWork Open Meeting Location: Convention Center, 26 A Curriculum: Transplantation, Cultural Diversity   NetWork Highlight!

Palliative and End-of-Life Care Training for Pulmonary and Critical Care Fellows ID #3266 Objectives: Evaluate the extent of postgraduate training in palliative and end-of-life care in pulmonary fellowship training programs.   Identify the palliative medicine principles that should be included in the curriculum for pulmonary/critical care medicine fellowship training programs. Getting a paliative care consultation is not a substitute for a physician's attention to the paliative needs of his or her patients. It has been recommended by the ACCP, ATS, and SCCM that all pulmonary and critical care physicians be trained in palliative medicine principles. However, it remains unclear how fellowship training programs have attempted to integrate palliative medicine training into their curricula. This session will review the results of a national survey of pulmonary fellowship program directors investigating the approaches currently in use, as well as the trainees' opinions about the adequacy of the training. At least two curriculum topics will be reviewed and opportunities for teaching these topics will be presented, based on the results of the survey. Date and Time: 11/02/2009, 10:30 am - 12:00 pm Type: Panel Discussion Location: Convention Center, 32 AB Curriculum: Palliative Care and End of Life/Ethics, Education, Teaching, and Quality Improvement   NetWork Highlight!

The Legacy of Pediatric Lung Disease ID #3309 Objectives: List the typical lung function changes seen in older children and young adults with a history of early lung injury.   Identify the immunologic alterations in airway responsiveness in older children and young adults with a history of early lung injury. The lung undergoes tremendous growth and remodeling over the first few years of life. Injury to the lung or pulmonary vasculature during these formative years can impair lung function and somatic growth and result in permanent alterations. For example, children who develop chronic lung disease of infancy (bronchopulmonary dysplasia) or experience a severe viral lower respiratory tract infection in early life have demonstrable anatomic and functional abnormalities that persist into adulthood. It is important not only for the pediatric pulmonologist to understand how early injury alters lung function throughout childhood, but also for the internist to have an appreciation of how such early alterations affect the lung's response to subsequent insults, such as environmental tobacco smoke or acute viral infections. This panel discussion will review what is currently known about the long-term effects of early lung injury in patients with bronchopulmonary dysplasia, childhood interstitial lung disease, and early viral lower respiratory tract infection. Date and Time: 11/02/2009, 10:30 am - 12:00 pm Type: Plenary Presentation Location: Convention Center, 28 C Curriculum: Pediatrics, Allergy and Airway   NetWork Highlight!

Work-Related Asthma: Practical Aspects of the ACCP Consensus Statement ID #3269 Objectives: Recognize the approach to diagnosis of patients with work-related asthma.   Compare the diagnostic differences in occupational asthma from a high-molecular weight sensitizer, a low-molecular weight sensitizer, and an irritant-induced mechanism. The session's four speakers are from the panel that developed the 2008 ACCP Work-Related Asthma Consensus Statement. Each will present an illustrative case, including diagnostic and management key points from the 2008 ACCP consensus statement, followed by short discussions. Topics will include occupational asthma from a high-molecular weight sensitizer or from a low-molecular weight sensitizer; irritant-induced asthma; and work-exacerbated asthma. Date and Time: 11/02/2009, 10:30 am - 12:00 pm Type: Panel Discussion Location: Convention Center, 30 BC Curriculum: Occupational and Environmental Lung Diseases, Obstructive Lung Diseases   NetWork Highlight!

Affiliate NetWork Open Meeting and Luncheon ID #3841 Objectives: Identify the changes in inpatient care that complicate effective consultative services.   Discuss the attributes of consultants relative to the rules that guide patient-centered consultations. A pulmonary critical care physician plays an important role as consultant for hospitalized patients. In an era of electronic medical records and dictated consultation notes, many of the time-honored principles of serving as a consultant have been overlooked in recent years. Moreover, the changing roles of inpatient physicians and the advent of hospitalists have further complicated communication between physicians and the development of close interprofessional relationships we used to enjoy. Consequently, even greater attention should be paid to the basic rules for good consultations. Adherence to these rules increases effectiveness and enhances patient-centered care. This session will present some of these important rules for seeking excellence in clinical consultations. Date and Time: 11/02/2009, 11:45 am - 01:00 pm Type: NetWork Open Meeting Location: Convention Center, 33 BC Curriculum:   NetWork Highlight!

CT of the Chest for the Pulmonologist-in-Training: Anatomic Correlation, Interpretation, and Case Review ID #3278 Objectives: Review chest anatomy as seen in cross-sectional CT imaging.   Review the essentials of intepretation of high-resolution CT for the evaluation of diffuse parenchymal lung disease. Chest CT intepretation is a vital skill required for completion of pulmonary and critical care training. Confidence in this skill requires knowledge of cross-sectional chest anatomy and the ability to interpret high-resolution and angiogram CT. These essentials will be presented and reviewed. Date and Time: 11/02/2009, 02:30 pm - 03:30 pm Type: Interactive Session Location: Convention Center, 28 DE Curriculum: Imaging, Education, Teaching, and Quality Improvement   NetWork Highlight!

Influenza Update: Vaccine Development to Pandemic Preparedness ID #3275 Objectives: Highlight the current threat, and disclose the current status of avian flu and the predictions for a pandemic.   Discuss the translational research in this field, basic science of the virus to clinical prevention, and therapy to community preparation. Influenza continues to be a significant cause of morbidity and mortality on a yearly basis. The cost to society has recently gained further attention because of fears of a more globally devastating viral illness, such as pandemic avian flu. Our experiences with SARS highlight not only the medical consequences of a significant viral illness, but also its emotional, safety, and economic impact. Prevention remains paramount, but has become significantly more complicated in recent years with the increase in population mobility, as well as an enlarging population of immunocompromised patients. Vaccine prevention remains antiquated using decades-old production processes that cannot meet the demand of a rapidly changing viral genome. Strain prediction oftentimes remains a best guess put forth in order to activate the lengthy vaccine production pipeline. Treatment requires active, early intervention, yet diagnostics are not universally available and, often, strains are resistant to available therapy. Finally, overwhelming numbers of cases will prompt health-care systems and nations to implement disaster measures to cope not only with this increased patient burden but also to maintain societal continuity of operations for public safety and well being. Date and Time: 11/02/2009, 02:30 pm - 03:30 pm Type: Meet-the-Professor Location: Convention Center, 30 BC Curriculum: Disaster Medicine, Chest Infections   NetWork Highlight!

Production and Practice Profiles Survey: Does Your Practice Measure Up? ID #3284 Objectives: Provide benchmarking data for practice performance analysis.   Announce new practice trends in pulmonary, critical care, and sleep medicine. This session will demonstrate the need for practices to employ benchmarking information to demonstrate their success compared with the universe of pulmonary practices. Benchmarking data garnered as a result of the collaboration efforts of the ACCP Practice Administration NetWork and the Medical Group Management Association will be discussed. Results from the ACCP Practice Profiles Survey created by the ACCP Practice Administration NetWork will be shared. The practice profile and benchmarking data presented will identify new practice trends in pulmonry, critical care, and sleep medicine, help practices reach realistic financial goals, and provide best practices information for practice performance. Date and Time: 11/02/2009, 02:30 pm - 03:30 pm Type: Plenary Presentation Location: Convention Center, 33 A Curriculum: Practice Management and Administration   NetWork Highlight!

Atypical Mycobacteria in Patients With Lung Disease ID #3240 Objectives: Discuss the epidemiology, natural history, and treatment options for atypical mycobacterial infections in patients with CF.   Discuss the epidemiology, natural history, and treatment options for lung transplant patients with atypical mycobacterial infections. Discuss the epidemiology, natural history, and treatment options for CF, lung transplantation, bronchiectasis, and COPD. Atypical mycobacteria are becoming more common and are difficult to treat; they pose unique problems for management. The audience will know more about each specific situation and decide on options for epidemiology and management. Date and Time: 11/02/2009, 04:30 pm - 06:00 pm Type: Interactive Session Location: Convention Center, 30 BC Curriculum: Chest Infections, Transplantation   NetWork Highlight!

Chronic Thromboembolic Disease: Essentials for the Busy Pulmonary/Critical Care Physician ID #3280 Objectives: Discuss the disease burden of venous thromboembolism.   Describe the pathophysiology of chronic thromboembolic disease. Acute and chronic thromboembolic disease causes significant morbidity and mortality. At least some of it can be avoided with better prophylaxis and earlier recognition. Chronic thromboembolic disease has been primarily considered a condition that is best treated surgically. Increasingly, medical therapy is showing benefits. State-of-the-art medical and surgical treatment of chronic thromboembolic disease will be reviewed. Date and Time: 11/02/2009, 04:30 pm - 06:00 pm Type: Interactive Session Location: Convention Center, 31 AB Curriculum: Pulmonary Vascular Disease, Cardiovascular Disease   NetWork Highlight!

Exhaled Nitric Oxide and Impulse Oscillometry: Ready for Prime Time? ID #3234 Objectives: Discuss the role of exhaled nitric oxide in elucidating disease mechanisms.   Develop an approach to using exhaled nitric oxide in clinical assessment and patient management. Exhaled nitric oxide and impulse oscillometry increasingly have been used in research studies to elucidate disease mechanisms. These methods are also beginning to be used in clinical practice, and equipment vendors are selling units that can be used in pulmonary function laboratories. However, there is controversy about whether their clinical utility relative to traditional methods has been proven. Date and Time: 11/02/2009, 04:30 pm - 06:00 pm Type: Clinical Controversy Location: Convention Center, 33 A Curriculum: Pulmonary Physiology, Allergy and Airway   NetWork Highlight!

Ventilator Management Symposium: Practical Application of Graphics ID #3282 Objectives: Provide an overview of basic respiratory physiology as it is elucidated by ventilator graphics.   Provide an introduction to the interpretation of graphical information provided by modern mechanical ventilators and the information that it supplies concerning patient-ventilator interactions. Modern microprocessor ventilators are capable of displaying an abundance of data relating to the interaction of the patient with the ventilator. Skilled application of these data can lead to improved patient comfort with the patient ventilator-interaction, provide the clinician with more insight into changing patient physiology, and increase the safety of mechanical ventilation support for the patient. This symposium will highlight the use of ventilator graphics to delineate patient physiology, provide early warnings of inappropriate ventilator settings, and optimize ventilator settings for the patient. Date and Time: 11/02/2009, 04:30 pm - 06:00 pm Type: Interactive Session Location: Convention Center, 29 AB Curriculum: Critical Care, Respiratory Care   NetWork Highlight!

Case Studies in Pulmonary Vascular Disease: What Every Pulmonologist Should Know ID #3285 Objectives: Describe how to perform an appropriate workup for pulmonary arterial hypertension.   Discuss the therapeutic options that exist for pulmonary arterial hypertension. Actual pulmonary arterial hypertension (PAH) cases are presented, and the audience is polled for management decisions, before experts discuss the care of such patients. Cases will encompass the diversity of etiologies and characteristics of patients with PAH. Supported by an educational grant from Actelion Pharmaceuticals. Date and Time: 11/03/2009, 06:00 am - 07:30 am Type: Morning Educational Symposium Location: Grand Hyatt, Manchester Ballroom ABC Curriculum: Pulmonary Vascular Disease, Cardiovascular Disease   NetWork Highlight!

Chest Infections NetWork ID #3498 Objectives: Review of microbial and host factors that influence fungal lung disease and pathogenesis.   Recognize the spectrum of fungal disease, with particular attention to the association between certain immune deficiencies and specific fungal pathogens There are estimated to be 1.5 million species of fungi. Indeed, fungi represent an entire kingdom in the living world. Infections due to species within this kingdom are many and varied, often affecting immunocompromised patients. It follows that diagnostic precision is a daunting task. This presentation will review the host and microbial considerations that will help clinicians improve their diagnostic skills, as well as the recent guidelines for therapy. Date and Time: 11/03/2009, 08:00 am - 09:15 am Type: NetWork Open Meeting Location: Convention Center, 27 AB Curriculum: Chest Infections, Signs and Symptoms of Chest Diseases   NetWork Highlight!

Cultural Diversity in Medicine NetWork ID #3502 Objectives: Enhance your understanding of the complexity of cultural diversity and respect for cultural differences in the context of international humanitarian field work.   Discuss current difficulties in defining universal values and their impact on ethical dilemmas faced by humanitarian assistance professionals working in a culturally diverse environment. When health-care professionals embark on humanitarian relief projects overseas, they face challenges related to the manner in which health care is practiced; the presence of resource limitations: violent or insecure living and practice environments: and culturally different understandings of health, illness, and death. They also must bridge the often deep cultural and linguistic gaps that exist between themselves and the local population. Sometimes, there are substantial incompatibilities between Western medical culture and the culture of the target populations. These differences may include daily life behaviors, basic cultural patterns, and general social relationships. Even in the academic environment, who might define universal values (if they even exist) is highly controversial. Therefore, the challenge for humanitarian assistance professionals is to define what they consider respect for cultural differences while remaining loyal to their own ethics, as well as avoiding the temptation of imposing their own values, or those of their culture, onto the population being served. Date and Time: 11/03/2009, 08:00 am - 09:15 am Type: NetWork Open Meeting Location: Convention Center, 26 B Curriculum: Cultural Diversity   NetWork Highlight!

Home Care NetWork ID #3501 Objectives: Discuss the current use of home telehealth capabilities with an emphasis on pulmonary and sleep medicine.   Outline the legal, regulatory, and financial constraints of home telehealth. The need for home care is expanding dramatically with the aging of the baby boomers who are comfortable with the use of technology and want to remain independent. A greater numbers of people are suffering from chronic conditions, yet the health-care industry is facing a critical shortage of health-care personnel to care for our elderly population. Whether used to deliver care, provide information, monitor patient progress, or provide access to patient records, emerging information technology applications can reduce cost and improve care. Advances in telecommunication technologies used in home health care have expanded application possibilities to include hospice (palliative care), rehabilitation, case management, chronic disease management, virtual house calls, and postsurgical follow-up. This presentation will focus on the history of home telehealth with an emphasis on pulmonary and sleep medicine; future low-cost applications, including mobile phones; and the impact of the $19 billion government stimulus funding for health information technology. Date and Time: 11/03/2009, 08:00 am - 09:15 am Type: NetWork Open Meeting Location: Convention Center, 24 C Curriculum: Respiratory Care, Pulmonary Rehabilitation   NetWork Highlight!

Interstitial and Diffuse Lung Disease NetWork ID #3500 Objectives: Gain an appreciation for the value of rare diseases in understanding more common forms of ILDs.   Understand recent advances in the clinical features, molecular pathogenesis, and diagnostic strategies of rare lung diseases. The development of preventive and therapeutic strategies for many forms of interstitial lung disease (ILD) remains limited by incomplete understanding of the cellular and molecular mechanisms underlying disease pathogenesis. Through knowledge of how specific genes or proteins critically impact biologic processes, investigations into rare diseases can provide opportunities for general scientific advancement. This session will describe recent advances in our understanding of the clinical features, molecular pathogenesis, and diagnostic strategies for several rare ILDs, including Hermansky-Pudlak Syndrome (HPS), lymphangioleiomyomatosis (LAM), and pediatric ILD. Date and Time: 11/03/2009, 08:00 am - 09:15 am Type: NetWork Open Meeting Location: Convention Center, 25 A Curriculum: Diffuse Lung Disease   NetWork Highlight!

Members in Industry NetWork ID #3499 Date and Time: 11/03/2009, 08:00 am - 09:15 am Type: NetWork Open Meeting Location: Convention Center, 25 B Curriculum: Biotechnology, Pulmonology Procedures   NetWork Highlight!

Palliative and End-of-Life Care NetWork ID #3503 Objectives: Become informed about current ethical problems involving palliative care of the transplant patient.   Understand the options available to help solve the ethical problems arising from organ transplantation and end-of life care. There are particular ethical problems related to organ transplantation, palliative care, and end-of-life decision-making. These problems stem from a few simple facts. There are too few available donor organs to supply the needs of those who hope for them. The poor and disadvantaged are disproportionately represented in the frequency of organ donations. There is also a perception of unfairness in allocation of organs to wealthy and notable recipients (eg, Steve Jobs). Even those who are fortunate enough to receive a vital organ transplant may suffer from rejection and still go on to die despite heroic efforts to forestall death. These cases often result in very difficult end-of-life decision-making, with reluctance, especially by family members, to let go. Many people will do almost anything to bring about the organ transplantation. Those waiting for an organ transplant may need palliative care to manage the dying process, but they and their families often are unable to relinquish the hope of a lifesaving organ transplant and accept what is openly available to preserve comfort and dignity. In this session, we will discuss a few real cases involving these issues. Date and Time: 11/03/2009, 08:00 am - 09:15 am Type: NetWork Open Meeting Location: Convention Center, 25 C Curriculum: Palliative Care and End of Life/Ethics, Education, Teaching, and Quality Improvement   NetWork Highlight!

Private Practice NetWork ID #3505 Objectives: Review the evolution of ICD-10 and understand the importance of the transition from ICD-9.   Outline the coding of obstructive lung diseases and thoracic malignancies for optimal reimbursement. ICD coding is important to hospitals, physicians, payers, and government agencies. ICD-9 will officially be phased out in 2013. ICD-10 already has been released and this can result in a difficult transition for those not prepared. This session will highlight the history of the ICD and the changes as they apply to pulmonary and critical care medicine. Specifically, the coding for obstructive lung diseases and thoracic malignancies will be reviewed to lessen the burden of the transition. Many CPT codes are linked to specific ICD codes for reimbursement, and the importance of these links will be reviewed. The total number of diagnostic codes will increase from 14,025 to 68,069 and will generally be more descriptive. Many ICD-9 codes will be replaced by multiple codes in ICD-10. Date and Time: 11/03/2009, 08:00 am - 09:15 am Type: NetWork Open Meeting Location: Convention Center, 26 A Curriculum: Practice Management and Administration   NetWork Highlight!

Sleep Medicine NetWork ID #3504 Objectives: Explore the feasibility of using thermal infrared imaging as a noncontact airflow monitoring device during polysomnography.   Discuss the future development of TIRI as a noncontact airflow monitoring device. Thermal infrared imaging (TIRI) is a emerging technology for airflow monitoring during polysomnography without patient contact. The setup includes a sensitive infrared camera placed about 6 to 8 feet from the patient Date and Time: 11/03/2009, 08:00 am - 09:15 am Type: NetWork Open Meeting Location: Convention Center, 24 AB Curriculum: Sleep Disorders, Respiratory Care   NetWork Highlight!

Building a Collaborative Framework Between the Pharmaceutical Industry, Device Manufacturers, and Academia ID #3259 Objectives: Identify some of the barriers to effective collaborative relationships between industry and academia.   Recognize the possible effects of changes in research support. Academic institutions and the pharmaceutical and device manufacturing industries are struggling to design new models of collaboration to satisfy their shared responsibility to patients and science. Industry support of continuing medical education, what medical education would look like without this support, and alternative sources of support will be discussed. Proposals for changes from the current model will also be considered. Measurable educational outcomes of CME programs supported by medical education grants from industry vs those that are not will be reviewed. Industry support of company-sponsored and independent scientific research performed at academic institutions, and the quality of industry-supported research compared with that from other sources, will be discussed. Real-life decisions related to authorship (understanding that there are guidelines) on manuscripts that do and do not involve industry will be contrasted. Here again, non-industry support alternatives will be considered. Date and Time: 11/03/2009, 10:30 am - 12:00 pm Type: Panel Discussion Location: Convention Center, 32 AB Curriculum: Education, Teaching, and Quality Improvement, Critical Care   NetWork Highlight!

Ethical Issues in the Context of Cultural Diversity ID #3268 Objectives: Identify the skills needed for health-care providers to deal with culturally sensitive matters.   Recognize the importance of different ethnic and cultural backgrounds in the daily practice of medicine. The purpose of this session is to help raise awareness among attendees about health-care provision, discrimination, and ethics issues in the context of cultural diversity. The speakers will use scenes from various films in order to highlight these issues. These scenes will be used as a springboard for discussion. The session will focus on some of the current literature regarding these issues and serve as a forum for discussion and interaction with session participants. Date and Time: 11/03/2009, 10:30 am - 12:00 pm Type: Panel Discussion Location: Convention Center, 30 BC Curriculum: Cultural Diversity   NetWork Highlight!

Update on COPD Clinical Trials ID #3313 Objectives: Review the recent clinical studies in COPD.   Understand how recent clinical studies impact the managemnt of patients with COPD. Several landmark studies have been undertaken or completed that add to our understanding of the pathogenisis, natural history, and management of COPD. This panel discussion will serve as an update on recent and upcoming COPD clinical trials, which include UPLIFT (Understanding Potential Long-term Impacts on Function with Tiotropium) and TORCH (TOwards a Revolution in COPD Health), because there is now so much controversy regarding the risk/benefit of treatment strategies in COPD. Also discussed will be the TRISTAN (TRial of Inhaled STeroids ANd long-acting β2-agonists) trial, the phase 3 cilomilast trials, and one to two additional trials. The outcomes of these studies and their impact on standards of care will be discussed. Additionally, the panel will review upcoming studies and address novel therapies that are being investigated. Date and Time: 11/03/2009, 10:30 am - 12:00 pm Type: Panel Discussion Location: Convention Center, 31 AB Curriculum: Obstructive Lung Diseases, Allergy and Airway   NetWork Highlight!

Women's Health NetWork ID #3506 Objectives: Evaluate gender disparity among physicians performing CPR for in-hospital cardiac arrests.   Develop and apply a simulation-based educational plan to overcome this gender disparity. There will be two presentations during this meeting. (1) Investigation and Correction of Gender Disparity in Chest Compression During CPR - As presented at CHEST 2008, it was demonstrated that female house officers of small body type had difficulty performing adequate chest compressions during CPR despite standard training. Our goal is to develop targeted strategies that female house officers can use to improve chest compression technique. House officers were trained and tested on a computerized patient simulator. A specially designed device allowed measurements of depth and rate of compressions. Half the female house officers received standard training while the other half received intensive simulator-based training. This presentation will discuss the training method and its impact on performance. (2) Gender Differences as They Relate to Outcome in an Older ICU Cohort - Data will be presented on a study that examined gender differences in an older cohort of patients at ICU admission and during the course of ICU stay. It was hypothesized that if there were minimal or no baseline health differences between men and women upon ICU admission, the level of services provided while in the ICU would be equivalent. In this older ICU cohort, men and women received equivalent amounts of critical care intervention during their ICU admission using the TISS-28. There was no evidence of a statistically significant gender-based difference in mortality 15 months after ICU-admission. Date and Time: 11/03/2009, 01:00 pm - 02:15 pm Type: NetWork Open Meeting Location: Convention Center, 31 C Curriculum: Signs and Symptoms of Chest Diseases, Allergy and Airway   NetWork Highlight!

Coding for Optimal Reimbursement: Get Your Questions Answered ID #3281 Objectives: Demonstrate proper coding for work performed.   Recognize underutilization of coding to enhance revenue. This presentation will focus on the proper coding techniques to maximize reimbursement for the services performed by physicians, midlevel providers and and staff. It will be based on the 2009 ACCP Coding for Chest Medicine book. A panel of Practice Administration NetWork Steering Committee members who are also authors of various chapters will present practical applications of the information in their chapters and be available for questions and answers. Coding methods under Medicare guidelines will be emphasized. This information will also help attendees determine potential services to add to their range of services. This session will discuss situations, examples, and documentation methods to code for maximum reimbursement for work performed and documented. Date and Time: 11/03/2009, 02:30 pm - 03:30 pm Type: Panel Discussion Location: Convention Center, 29 CD Curriculum: Practice Management and Administration   NetWork Highlight!

Facilitating Patient Travel With Respiratory Devices ID #3267 Objectives: Identify the options and intricacies associated with oxygen use when traveling.   Recognize the options available for portable power sources and noninvasive ventilation and ventilator devices when traveling. Recent advances have allowed pulmonary patient support devices to be reduced in size and formulated for portability. The ability to travel has never been easier for those with chronic respiratory conditions, yet the realization of this is still limited. Patients look to their health-care providers who frequently have little information about the issues and cannot advise patients in regard to overcoming the hurdles that prevent travel. These hurdles come from navigating technology, legal, and insurance issues. In our society, travel is expected as a freedom and a right but, in reality, has become more and more regulated. To be succesful, those with chronic pulomonary conditions and their health-care teams need to be more aware of the rules of the game. Date and Time: 11/03/2009, 02:30 pm - 03:30 pm Type: Panel Discussion Location: Convention Center, 32 AB Curriculum: Respiratory Care   NetWork Highlight!

Five Papers That Will Change How You Practice ID #3283 Objectives: Understand the controversies and limitations in lung cancer screening.   Evaluate the minimally invasive options for mediastinal staging. This session will review the most relevant new clinical studies that impact the pulmonoloigist's management of lung cancer. An update will be given on screening and staging, with special emphasis on minimally invasive staging of the mediastinum, as well as new treatment strategies. Each study will be chosen for its impact in daily practice. Date and Time: 11/03/2009, 02:30 pm - 03:30 pm Type: Panel Discussion Location: Convention Center, 30 BC Curriculum: Lung Cancer   NetWork Highlight!

Lung Histopathology Review: Preparation for Boards and Daily Practice ID #3273 Objectives: Distinguish between common tumors of the lung and the indication for special stains.   Recognize the histologic patterns of diffuse interstitial lung diseases and the differences between them. The term histopathology is of Greek origin and, quite literally, means tissue of suffering. The ability to recognize patterns and be familiar with the microscopic appearance of common lung tumors and diffuse lung diseases is high in value in terms of board exam preparation. More importantly, these skills can help you care for your patients and communicate with your colleagues. Is a bronchoscopic sampling diagnostic and specific enough? Can the surgeon stop based on the findings of a frozen specimen? What few simple, major special stains are available to distinguish between two possibilities? These essentials will be presented and reviewed. The format will be a series of many cases with very brief histories and images, along with a viewing of the specimens. There will be audience participation by an audience response system, as well as expert commentary on the type of specimens, key characteristics of the patterns, and a comparison and contrast to the histologic patterns from items on the differential diagnosis. Date and Time: 11/03/2009, 02:30 pm - 03:30 pm Type: Interactive Session Location: Convention Center, 29 AB Curriculum: Education, Teaching, and Quality Improvement, Lung Pathology   NetWork Highlight!

Lung Impairment and Disability Evaluation: Tips for the Practitioner ID #3271 Objectives: Define the often-confusing medicolegal terminology in the area of lung impairment and disability.   Recognize the scientific principles in the determination of lung impairment and disability. The session will provide an overview of how to assess patients for pulmonary impairment and disability, the difference between impairment and disability, how to apportion impairment, guidelines for quantifying impairment and categorizing disability, and changes in the most recent (Sixth Edition) Guides to the Evaluation of Permanent Impairment by the American Medical Association. The session will highlight how pulmonologists can best serve patients when conducting impairment and disability assessments. Date and Time: 11/03/2009, 02:30 pm - 03:30 pm Type: Interactive Session Location: Convention Center, 28 DE Curriculum: Occupational and Environmental Lung Diseases, Pulmonary Physiology   NetWork Highlight!

Metabolic Syndrome and Outcomes in Critical Care ID #3308 Objectives: Comprehend the impact of hyperglycemia on metabolic syndrome in the critically ill and discuss the management of these patients.   Recognize the importance of obesity and its contributions to morbidity in the ICU. Metabolic syndrome is a new epidemic sweeping the country. By 2010, it is estimated that up to 40% of the adult US population may be afflicted with this disorder if the current trends continue. Metabolic syndrome will be a common comorbidity in the critically ill, and its components (hyperglycemia, atherogenesis, dyslipidemia, obesity, hypertension, and inflammatory markers) may play an important role in patients who are critically ill. It is vitally important that critical care physicians recognize this condition, as well as the specific considerations needed for optimal therapy for patients in the ICU setting. Neglecting this condition or disrupting therapy due to more pressing health needs may result in unforeseen deleterious outcomes. Date and Time: 11/03/2009, 02:30 pm - 03:30 pm Type: Plenary Presentation Location: Convention Center, 31 AB Curriculum: Cardiovascular Disease, Critical Care   NetWork Highlight!

Thinking Outside the Box: Approaches to the Management of Thoracic Insufficiency Syndrome ID #3307 Objectives: List the functional impairments that result from TIS.   Determine the best tests to evaluate children with TIS. The approach to thoracic insufficiency syndrome (TIS) has changed over the last several years. Newer techniques, including the use of Vertical Expandable Prosthetic Titanium Rib (VEPTR) (Synthes Inc.) devices and expansion thoracoplasty are replacing spinal fusion as preferred interventions, although they are not available at all pediatric centers. These newer procedures are designed to stabilize the spine while promoting thoracic cage and, therefore, lung growth. Understanding of the ramifications of these procedures on thoracic and lung development and function continues to evolve. Traditional measures used to determine the timing of intervention for children with idiopathic scoliosis may not be appropriate for children with TIS because lung growth can be affected. As these procedures have become more widely available, it is imperative for providers to become familiar with the underlying pathophysiology of TIS and the indications for and outcomes of these interventions. This state-of-the-art review will detail the newest information regarding the chest wall and lung pathophysiology of congenital scoliosis, thoracic dysplasia, and other causes of TIS; indications and timing for intervention; and surgical approaches and outcomes of VEPTR use and expansion thoracoplasty. Date and Time: 11/03/2009, 02:30 pm - 03:30 pm Type: Panel Discussion Location: Convention Center, 30 DE Curriculum: Pediatrics, Genetic and Developmental Disorders   NetWork Highlight!

Cardiopulmonary Exercise Testing: Case Conference ID #3236 Objectives: Review the physiology underlying cardiopulmonary exercise testing.   Discuss currently recommended techniques for performing cardiopulmonary exercise testing and 6-min walk tests. This interactive session will attempt to bridge the knowledge gap that exists for many pulmonary specialists in applying general concepts of pulmonary and exercise physiology to clinical practice. Using a case-based format with interactive questions, the basic physiology and nuts and bolts of interpretation will be reviewed. Case material will include cardiopulmonary exercise tests and 6-min walk tests. Date and Time: 11/03/2009, 04:30 pm - 06:00 pm Type: Interactive Session Location: Convention Center, 29 CD Curriculum: Pulmonary Physiology   NetWork Highlight!

Immunomodulation in Pneumonia and Sepsis ID #3241 Objectives: Discuss the potential role of corticosteroids in the management of patients with pneumonia and sepsis.   Discuss the potential role of statins and ACE inhibitors in the management of patients with pneumonia and sepsis. This panel discussion will update participants on new data regarding corticosteroids, statins/angiotensin-converting enzyme (ACE) inhibitors, and macrolides, as well as what is new in the pipeline for the management of patients with pneumonia and sepsis. Date and Time: 11/03/2009, 04:30 pm - 06:00 pm Type: Panel Discussion Location: Convention Center, 30 A Curriculum: Chest Infections, Critical Care   NetWork Highlight!

Management of the Difficult Airway ID #3262 Objectives: Identify focal anatomic, physiologic, pharmacologic, and population-based factors in airway mangement in the ICU patient.   Describe optimal airway management team building and training in an ICU setting. This session will provide participants with a state-of-the-art overview of the challenging issues and controversies in airway management that critical care physicians face in their daily practice. Topics covered will include the following: (1) differences in airway management in the ICU, the risk factors and approach to the difficult airway focusing on anatomic and physiologic considerations in the critically ill patient; (2) pharmacologic considerations in ICU airway management, current evidence and expert opinion on the advantages and disadvantages of common induction agents, the use of paralytic agents and Sellick's maneuver, and special considerations specific ICU populations; (3) designing an airway management program, development of a multidisciplinary airway management team, focusing on the equipment planning and interdepartmental coordination; and (4) training an effective airway management team. Date and Time: 11/03/2009, 04:30 pm - 06:00 pm Type: Panel Discussion Location: Convention Center, 32 AB Curriculum: Critical Care, Allergy and Airway   NetWork Highlight!

Pericardial Disease in the Critical Care Setting ID #3312 Objectives: Understand the anatomy and function of the pericardium and outline the etiology and diagnosis of acute pericarditis.   Discuss the pathophysiology, diagnosis, and management of pericardial effusion, pericardial tamponade, and constrictive pericarditis. Natural history of pericardial diseases can be complicated, with pericardial emergencies requiring prompt diagnosis, intensive care monitoring, and early aggressive management. Medical supportive measures, drainage of pericardial effusion, surgical pericardiotomy, or pericardiectomy may be needed urgently. The most frequent pericardial emergency is cardiac tamponade, but complications of an acute coronary syndrome and aortic dissection and pacemaker implantation may also involve the pericardium. Acute pericarditis can also represent a medical emergency due to chest pain of severe intensity. Acute decompensation in chronic advanced constriction and in the clinical course of purulent pericarditis dictates critical care management, as well. Date and Time: 11/03/2009, 04:30 pm - 06:00 pm Type: Panel Discussion Location: Convention Center, 28 C Curriculum: Critical Care, Imaging   NetWork Highlight!

Cardiovascular Medicine and Surgery NetWork ID #3512 Objectives: Learn how BNP levels are used in clinical practice in the patient with dyspnea.   Learn how BNP levels are used in ICU and outpatient settings. Brain natriuretic peptide (BNP) is a peptide released from the ventricles in response to stress. Therefore, in the setting of dsypnea, BNP is released rapidly. In patients with dyspnea, BNP levels less than 100 pg/mL essentially rules out heart failure, and levels above 100 pg/mL usually rule in heart failure. In patients with respiratory disease, BNP levels should be low. This includes patients with asthma, COPD, and ARDS. However, the right ventricle is also a source of BNP, so levels may be moderately increased in patients with cor pulmonale, pulmonary hypertension, or pulmonary embolism. Other caveats for BNP interpretation include renal function and obesity. However, no matter the setting, the BNP level is of high prognostic value. Accordingly, studies are underway to assess its usefulness in the setting of weaning from mechanical ventilation. Finally, it may be good to follow a patient's BNP level in the outpatient setting, especially in patients with concomitant lung and heart disease. Worsening dyspnea with a rise in BNP level of 50% or more usually means fluid overload. Levels less than this may be associated with worsening lung disease. Date and Time: 11/04/2009, 08:00 am - 09:15 am Type: NetWork Open Meeting Location: Convention Center, 26 B Curriculum: Cardiovascular Disease, Cardiothoracic Surgery   NetWork Highlight!

Disaster Response NetWork ID #3509 Objectives: Understand what the health-care legislation appears to do for the system at this time.   Describe the effects of the legislation on disaster medicine. This talk will be a snapshot in time of the US government health reform initiative. The speaker will attempt to delineate aspects of the health-care reform package that may have an effect on the ability to provide care during a disaster. The speaker will address manpower, infrastructure, and reimbursement issues. The talk will also identify those issues that are improved or are predicted to improve delivery of care in multiple situations by the health-care reform legislation. The talk will be dependent on the amount of information that is available at the time of the lecture. If the legislation is not complete, the speaker will give the audience a good panorama of where the US government is and perhaps some educated predictions of what the outcome may be. Date and Time: 11/04/2009, 08:00 am - 09:15 am Type: NetWork Open Meeting Location: Convention Center, 24 C Curriculum: Disaster Medicine, Critical Care   NetWork Highlight!

Interventional Chest/Diagnostic Procedures NetWork ID #3513 Objectives: Understand the pathogenesis of malignant pleural effusions and the mechanisms by which malignant cells initiate a local change in the pleural space that is conducive to their growth and proliferation.   Understand the mechanisms by which normal pleural mesothelial cells can be targeted to alter the environment, making it inhospitable to malignant cells, and provide symptomatic relief for the patient by achieving pleurodesis. Malignant pleural effusions are a common cause of morbidity in patients with cancer and typically are associated with poor survival. The goal of therapy is to achieve pleurodesis and decreases in tumor size and mass. This leads to decreased dyspnea, improved quality of life, and, perhaps, prolongation of survival. The microenvironment in the pleural space in patients with malignant pleural effusions is highly angiogenic; malignant cells release vascular endothelial growth factor (VEGF), among other factors, that cause the development of new blood vessels to supply nutrients to the malignant cells. Talc (hydrated magnesium silicate) is commonly used to achieve effective pleurodesis. We have recently demonstrated that talc causes normal pleural mesothelial cells to release endostatin, a protein that negates the effects of VEGF, turning the environment into an angiostatic milieu and causing an inhibition of growth of the malignant cells. Stimulating normal pleural mesothelial cells, which surround the malignant deposits on the pleural cells, to activate defense mechanisms that cause malignant cell apoptosis is one method of targeting therapy for malignant pleural effusions. Date and Time: 11/04/2009, 08:00 am - 09:15 am Type: NetWork Open Meeting Location: Convention Center, 24 AB Curriculum: Pulmonology Procedures, Signs and Symptoms of Chest Diseases   NetWork Highlight!

Lung Transplantation Is Not Appropriate for All Patients With Advanced CF ID #3320 Objectives: Present data on outcomes after lung transplantation for patients with CF.   Discuss issues regarding infections with B cepacia complex and its ramifications for transplant. Recent data have suggested that children with CF and CF patients with Burkholderia cepacia infection do not benefit from lung transplantation. However, there is significant controversy on the validity of these data and whether such patients can benefit from lung transplantation. In this pro-con debate, the speakers will present their data-driven perspectives on this topic. Date and Time: 11/04/2009, 08:00 am - 09:15 am Type: Clinical Controversy Location: Convention Center, 30 DE Curriculum: Transplantation, Chest Infections   NetWork Highlight!

Pediatric Chest Medicine NetWork ID #3510 Objectives: Understand the predisposing factors that helped develop pediatric pulmonology into a distinct discipline.   Appreciate the various forces now confronting the discipline and which will reshape it. The formation of pediatric pulmonology as a distinct discipline was facilitated, influenced, and enhanced by a number of factors, including the following: (1) description of cystic fibrosis (1938) and the creation of cystic fibrosis centers (1960); (2) interest in the lung problems of premature babies and the emerging discipline of neonatology (1960s); (3) ventilation of older children and the start of the PICU (1970s); (4) continued interest in TB and pulmonary infections (1940s and on); (5) the growing problem of asthma; and (6) publication of various task force reports, editorials, and books (1960s and 1970s). Pediatric pulmonology went through a tremendous growth phase in the late 1970s and 1980s, highlighted by the development of the certifying board examination and the creation of the journal, Pediatric Pulmonology. Today, the discipline, like many others, is faced with many obstacles, forces, and demands that most likely will reshape divisions and sections; these will be reviewed. Survival and growth will be dependent on creative new ideas. Date and Time: 11/04/2009, 08:00 am - 09:15 am Type: NetWork Open Meeting Location: Convention Center, 25 A Curriculum: Pediatrics   NetWork Highlight!

Pulmonary Physiology, Function, and Rehabilitation NetWork ID #3507 Objectives: Learn about the process by which pulmonary rehabilitation became accepted.   Review aspects of pulmonary rehabilitation that need further study. Individuals with chronic lung disease have suffered from disorders of multiple etiologies. Whether the respiratory disability resulted from polio, TB, or emphysema, the outcome was the same Date and Time: 11/04/2009, 08:00 am - 09:15 am Type: NetWork Open Meeting Location: Convention Center, 25 B Curriculum: Pulmonary Physiology, Pulmonary Rehabilitation   NetWork Highlight!

Pulmonary Vascular Disease NetWork ID #3508 Objectives: Increase your general understanding of pulmonary venous hypertension.   Increase your understanding of the relationship between pulmonary venous hypertension and pulmonary hypertension. Pulmonary venous hypertension is secondary to an elevated left atrial pressure and is a common cause of pulmonary hypertension. It results in a passive elevation of the pulmonary artery pressure with preservation of the normal transpulmonary gradient. With chronic elevation of the pulmonary venous pressure, some patients develop a reactive vasculopathy of the small pulmonary arteries and arterioles similar to that seen in pulmonary arterial hypertension. While the classic cause of pulmonary venous hypertension was mitral valve disease, so-called left ventricular diastolic dysfunction seems to be the dominant cause in the current era. It is our opinion that restrictive cardiomyopathy and pulmonary hypertension is yet another manifestation of obesity and that this obesity-associated pulmonary hypertension represents an extreme form of diastolic dysfunction of both ventricles. Data suggest that obesity-associated restrictive cardiomyopathy is secondary to increased triglyceride content in ventricular myocytes and that this process may be reversible. Date and Time: 11/04/2009, 08:00 am - 09:15 am Type: NetWork Open Meeting Location: Convention Center, 25 C Curriculum: Pulmonary Vascular Disease, Cardiovascular Disease   NetWork Highlight!

Respiratory Care NetWork ID #3511 Objectives: Describe the role of biofilm in hospital water systems in increasing the risk for health-care-associated infections.   Identify waterborne pathogens that pose the greatest risk to immunocompromised patients. Accepted as our most reliable weapon in the battle to reduce health-care-associated infections (HAI), hospital tap water has also been recognized as the most overlooked, important, and controllable source of HAI. Peer-reviewed literature has demonstrated that hospital tap water contains microbial pathogens and that biofilm in water systems resists disinfection, delivering pathogens within the health-care environment. At-risk patients are susceptible to infection through direct contact, ingestion, and inhalation of waterborne pathogens. Systemic water treatment technologies reduce levels of recognized waterborne pathogens; however, they vary in initial and long-term maintenance costs, efficacy against specific organisms, and compatibility with facility plumbing system materials. Plus, they cannot eradicate biofilm within health-care facility plumbing. Point-of-use filtration technologies have been reported to interrupt clinical outbreaks of infection due to recognized waterborne pathogens in the health-care environment and offer a cost-effective complementary infection control strategy, particularly when targeted for patients at high risk. Date and Time: 11/04/2009, 08:00 am - 09:15 am Type: NetWork Open Meeting Location: Convention Center, 26 A Curriculum: Respiratory Care, Pulmonary Physiology   NetWork Highlight!

To Sleep or Not To Sleep: Normal Pathology? ID #3270 Objectives: Recognize normal alerations in sleep architecture related to aging and gender.   Recognize the impact of sleep on overall health and well-being. Sleep hygiene is readily recognized as an essential component to overall health and well-being. How we sleep and how much we sleep changes over the course of a normal life cycle. This session will review the basic physiology of sleep as it is affected by hormonal changes and aging, and discuss the potential impact on quality of life, health, and indications for intervention. Date and Time: 11/04/2009, 08:00 am - 09:15 am Type: Meet-the-Professor Location: Convention Center, 30 BC Curriculum: Sleep Disorders   NetWork Highlight!

Cardiovascular Consequences of Sleep Apnea ID #3317 Objectives: Describe the impact of obstructive sleep apnea on the clinical course of hypertension, stroke, and heart failure.   Determine the pathophysiology of sleep apnea-associated cardiovascular disorders. This session features a discussion of the cardiovascular consequences of obstructive sleep apnea. Date and Time: 11/04/2009, 10:30 am - 12:00 pm Type: Clinical Controversy Location: Convention Center, 32 AB Curriculum: Sleep Disorders, Cardiovascular Disease   NetWork Highlight!

What Is the Best Modality To Sample the Peripheral Lung Nodule? ID #3238 Objectives: Identify available diagnostic and sampling modalities for peripheral lung nodules.   Illustrate the perspectives of physicians from different specialties on the best approach to this clinical problem. Management of the solitary peripheral lung nodule is a common clinical problem that is increasingly encountered by chest physicians because of the widespread use of high-resolution CT scanning. There is significant variability as to what might be considered the most appropriate diagnostic approach for this often-challenging problem. There are multiple diagnostic options available. This session will focus on reviewing these modalities, and, in an evidence-based manner, define updated practice guidelines for management of the solitary pulmonary nodule. Date and Time: 11/04/2009, 10:30 am - 12:00 pm Type: Panel Discussion Location: Convention Center, 31 AB Curriculum: Pulmonology Procedures, Lung Cancer   NetWork Highlight!

Catastrophic Dyspnea at the End of Life ID #3272 Objectives: Describe severe dyspnea in end-stage disease.   Describe the coordination of care and optimization of palliation for dyspnea at the end of life. Catastrophic dyspnea at the end of life may be defined as shortness of breath experienced by end-of-life patients who suffer from acute episodes of breathing discomfort and distress related to underlying end-stage terminal disease. This session will review the assessment, management, and palliative possibilities for patients for whom all disease-mechanism-specific therapies have been exhausted. This interactive session will increase awareness and preparation for end-of-life dyspnea and review key concepts in coordinated palliative care across physicians, nurses, respiratory therapists, palliative care specialists, and family caregivers. Date and Time: 11/04/2009, 02:15 pm - 03:15 pm Type: Interactive Session Location: Convention Center, 28 DE Curriculum: Palliative Care and End of Life/Ethics, Respiratory Care   NetWork Highlight!

Disaster Preparedness: Lessons From Hurricane Ike ID #3244 Objectives: Illustrate regional and local emergency management plans.   Describe the handling of such emergencies by local home care companies. This discussion will underscore the importance of disaster preparedness for those with special needs, including patients who use home oxygen and other life-sustaining equipment. Date and Time: 11/04/2009, 02:15 pm - 03:15 pm Type: Plenary Presentation Location: Convention Center, 32 AB Curriculum: Disaster Medicine, Obstructive Lung Diseases   NetWork Highlight!

Incorporating Pulmonary Rehabilitation Services Into Private Practice: The How, Why, and Why-Not ID #3235 Objectives: Review the legislation guaranteeing pulmonary rehabilitation services for patients with COPD.   Define the essentials of a successful pulmonary rehabilitation program, including staffing and equipment. Pulmonary rehabilitation is considered part of the management of patients with COPD. Until recently, there have been national coverage guidelines to pay for these services under Medicare. Many pulmonary physicians have previously incorporated some aspects of rehabilitation into their practices but have not been adequately reimbursed for these services. At this time, based on the legislation passed in 2008, there are national coverage guidelines for pulmonary rehabilitation, and these guidelines should allow for the establishment of many more opportunities to provide these services. Date and Time: 11/04/2009, 02:15 pm - 03:15 pm Type: Panel Discussion Location: Convention Center, 30 BC Curriculum: Obstructive Lung Diseases, Practice Management and Administration   NetWork Highlight!

The Mind and Body in COPD ID #3252 Objectives: Illustrate the association between COPD and cognitive defects in patients suffering from smoking-related lung disease.   Discuss the frequency of depression in COPD, and learn about factors that predispose patients to depression. This session will lead to an understanding of the association between COPD and cognitive defects in patients suffering from smoking-related lung disease. Attendees will learn about the frequency of depression in COPD and about factors that predispose patients to depression. Panel members will explore novel methods of assessing the interactions of central nervous system functions in COPD patients and present preliminary data concerning associations between assessment tools and outcomes in COPD. Practitioners will discover ways in which treatment for COPD may be associated with improvements in central nervous system function. This talk will focus on the relationship between the occurrence of depression in patients with COPD. The frequency of the occurrence of this co-morbidity will be explored, and the impact of gender differences on the frequency of depression will be discussed. Treatment of depression in patients with COPD will be reviewed. The use of visual-motor assessment in COPD and the association with clinical outcomes. This talk will introduce the application of cognitive tools to the assessment of patients with COPD. The visual cortex is highly affected by decrements in tissue oxygenation. Visual motor assessment tools investigate function in three domains: visual perception, CNS image processing, and executive function. Relationships between Visual-motor assessment, COPD disease severity and clinical outcomes will be reviewed. COPD, cognitive defects, and the effects of treatment. This talk will review the effects of treatment on cognitive defects in COPD. In particular, the effects of pulmonary rehabilitation, oxygen therapy, and lung volume reduction surgery on cognition in patients with COPD will be explored. Date and Time: 11/04/2009, 02:15 pm - 03:15 pm Type: Panel Discussion Location: Convention Center, 33 A Curriculum: Obstructive Lung Diseases, Signs and Symptoms of Chest Diseases   NetWork Highlight!

Thoracic Oncology Interactive Tumor Board ID #3233 Objectives: Define the key elements of a multidisciplinary lung cancer team.   Demonstrate the advantages of a multidisciplinary approach to lung cancer care. A multidisciplinary faculty will review case presentations of actual lung cancer cases and interact with the audience and discuss the best practices in the diagnosis, staging, and treatment of lung cancer. Date and Time: 11/04/2009, 02:15 pm - 03:15 pm Type: Interactive Session Location: Convention Center, 29 CD Curriculum: Lung Cancer, Pulmonology Procedures   NetWork Highlight!

Asthma Education: How Well Does It Work? ID #3242 Objectives: Analyze the asthma patient management controversy.   Describe the role of serial pulmonary function testing. This discussion will underscore the clinical controversies in the diagnosis, management, monitoring, and patient education in patients with moderate to severe asthma. Their conditions may be nonresponsive to standard asthma managment practice. Date and Time: 11/04/2009, 03:30 pm - 05:00 pm Type: Clinical Controversy Location: Convention Center, 30 A Curriculum: Allergy and Airway, Education, Teaching, and Quality Improvement   NetWork Highlight!

Bringing Personalized Medicine to Pulmonary: How the Genetics of Interstitial and Diffuse Lung Disease Will Change Practice ID #3264 Objectives: Recognize the interactions between environmental injury and genetics in interstitial and diffuse lung disease.   Analyze genome-wide association study (GWAS) findings and how they relate to risk and potential therapies. This session will address the state of the art in the field of the genetics of interstitial and diffuse lung disease (IDLD) with specific emphasis on idiopathic pulmonary fibrosis and sarcoidosis. The remarkable progress in IDLD genetics has the potential to revolutionize diagnosis and therapeutics in a field where, currently, disease is recognized late, and treatment options are limited. At the same time, these advances come with difficult questions about predicting lifetime risk and counseling patients and family members regarding testing. This session will review the advances in the field of IDLD genetics and discuss how these findings can be integrated into clinical practice. Date and Time: 11/04/2009, 03:30 pm - 05:00 pm Type: Panel Discussion Location: Convention Center, 33 A Curriculum: Diffuse Lung Disease, Genetic and Developmental Disorders   NetWork Highlight!

Comorbidities in COPD: An Interactive Session ID #3315 Objectives: Describe the impact, evaluation, and management of cardiovascular diseases in patients with COPD.   Recognize the clinical features of psychiatric disease in patients with COPD, and list strategies to effectively manage these comorbidities. Caring for patients with COPD involves understanding the nonpulmonary manifestations of this disorder. Most patients with COPD have several comorbid conditions that impact their quality of life. Common comorbidities include cardiovascular, pyschologicical, and musculoskeletal diseases. This interactive session is designed to review the common comorbid conditions, delineate screening/diagnostic tools to identify comorbid conditions, and provide practical options for treating each comorbidity. Date and Time: 11/04/2009, 03:30 pm - 05:00 pm Type: Interactive Session Location: Convention Center, 29 AB Curriculum: Obstructive Lung Diseases, Allergy and Airway   NetWork Highlight!

Lung Cancer Surgery: Disparities in Treatment Decisions ID #3277 Objectives: Review the state of health-care disparities in patients with lung cancer.   Evaluate the decision components that are important to patients when they make decisions about their cancer treatment. This session will review the decision-making process for potentially lifesaving surgery for minority patients with stage I and II non-small cell lung cancer. Statistics show that significantly more minority patients opt out of surgery than nonminority patients (36% vs 24%). The potential reasons for this statistic will be examined. Date and Time: 11/04/2009, 03:30 pm - 05:00 pm Type: Panel Discussion Location: Convention Center, 28 C Curriculum: Cultural Diversity, Lung Cancer   NetWork Highlight!

Controversies in Patient Selection for Lung Transplantation ID #3314 Objectives: List the issues facing critically ill patients considered for lung transplantation.   Review the data on obesity and outcomes after lung transplantation. Recent implementation of a new lung allocation system has favored transplantation for patients who are likely to die quickly on the waiting list. Critically ill patients now can be considered and have favorable priority scores for lung transplantation. Furthermore, older patients are being considered, and obese patients who had to take time to lose weight prior to transplantation can now get listed with a high priority score. Lastly, there are increasing numbers of patients with difficult-to-treat infections who are considered for transplantation, but there is no consensus on their candidacy. This panel discussion will review the role and outcomes of lung transplantation in critically ill patients, obese candidates, older patients, and those with resistant infections. Date and Time: 11/05/2009, 08:00 am - 09:30 am Type: Panel Discussion Location: Convention Center, 26 B Curriculum: Transplantation, Critical Care   NetWork Highlight!

Female Phenoytype? Influence of Gender on Lung Disease ID #3310 Objectives: Recognize the prevalence of COPD in women and how gender influences disease presentation.   Understand gender differences in lung cancer susceptibility, histologic findings, and mortality. Mounting evidence suggests that the presentation and progression of respiratory disease differs between men and women. The etiology of these phenotypic differences is likely due to a combination of biologic, social, and psychologic factors. This panel discussion will specifically address how gender influences symptoms, disease biology, progression, and mortality in several important areas including COPD, idiopathic pulmonary fibrosis, lung cancer, and lymphangioleiomyomatosis. Date and Time: 11/05/2009, 08:00 am - 09:30 am Type: Panel Discussion Location: Convention Center, 27 AB Curriculum: Diffuse Lung Disease, Lung Cancer   NetWork Highlight!

Introduction of New Interventional and Diagnostic Technologies to the Pulmonary Practice ID #3232 Objectives: Discuss emerging technologies in interventional pulmonology.   Describe comparative assessment of new technologies. New technologies are emerging in the interventional pulmonology field at an unprecedented rate. Pulmonologists are faced with questions regarding the adoption of these new technologies into their practices. In order to appropriately select and implement relevant technologies, an understanding of the clinical, financial, and broad impact of each of these technologies must be acquired. This session aims to educate pulmonologists and help them thoughtfully determine if an emerging technology is right for their patients and programs, and if so, how its introduction can proceed seamlessly. Date and Time: 11/05/2009, 08:00 am - 09:30 am Type: Panel Discussion Location: Convention Center, 26 A Curriculum: Pulmonology Procedures, Cardiothoracic Surgery   NetWork Highlight!

Sleep-Related Hypoventilation Syndromes ID #3316 Objectives: Describe the clinical features of the different sleep-related hypoventilation syndromes.   Determine the various diagnostic tools in the evaluation of sleep-related hypoventilation syndromes. This panel discussion will highlight the various sleep-related hypoventilation syndromes and their clinical features, as well as pathophysiology, evaluation, and therapy. Date and Time: 11/05/2009, 08:00 am - 09:30 am Type: Panel Discussion Location: Convention Center, 30 DE Curriculum: Sleep Disorders, Signs and Symptoms of Chest Diseases   NetWork Highlight!

Ventilatory Strategies for Challenging Patients in the ICU ID #3286 Objectives: Understand the differences in ventilating patients with pneumonia, acute exacerbations of COPD, increased intracranial pressure, obesity, bariatric surgery, and neuromuscular disorders.   Review use of this information to modify current approaches to ventilation of patients with these conditions. The impact of the low tidal strategy by the ARDSnet trial has impacted the way clinicians use mechanical ventilation. However, outside of ARDS, there is significant controversy on how patients who have other pulmonary problems should be ventilated. These include patients with pneumonia, acute exacerbations of COPD, sleep disorders, obesity/bariatric surgery, increased intracranial pressure, neuromuscular conditions, and others. This session will assess the clinician's perspective on how to ventilate patients with different conditions and review the literatue available regarding this issue. Date and Time: 11/05/2009, 08:00 am - 09:30 am Type: Panel Discussion Location: Convention Center, 30 BC Curriculum: Critical Care, Respiratory Care   NetWork Highlight!

Billing Strategies in Critical Care for Optimal Reimbursement ID #3237 Objectives: Describe the recent guidelines for billing of critical care services.   Review the elements of effective billing for time-based critical care services. Critical care services often come under more intense scrutiny than other services by third-party payers. Many of the services are billed in units of time and are inclusive of other cognitive and procedural services. Guidelines recently have been issued with regards to billing these services under Medicare, and the billing of pediatric critical care services remains an area of controversy. This session should help take some of the mystery out of this process and allow for effective, maximized reimbursement. Date and Time: 11/05/2009, 09:45 am - 11:15 am Type: Panel Discussion Location: Convention Center, 30 A Curriculum: Critical Care, Practice Management and Administration   NetWork Highlight!

Drug-Induced Lung Disease: The Lungs as Innocent Bystanders ID #3260 Objectives: Recognize common presentations of drug-induced lung disease from cancer chemotherapeutic agents, antirheumatic agents, and illicit drugs.   Develop appropriate evaluation and diagnostic algorithms for patients with lung disease who are taking cancer chemotherapeutic agents, antirheumatic agents and/or illicit drugs. The question of whether medications are responsible for a patient Date and Time: 11/05/2009, 09:45 am - 11:15 am Type: Panel Discussion Location: Convention Center, 26 A Curriculum: Diffuse Lung Disease   NetWork Highlight!

Neuro Critical Care ID #3263 Objectives: Recognize what neuromonitoring in the ICU entails.   Identify the pros and cons of neuromonitoring in the ICU. This session reviews ICU-based neuromonitoring tools beyond intracranial pressure, including jugular bulb saturation monitoring, brain tissue oxygen monitoring, brain miocrodialysis, CT scanning, and MR perfusion monitoring. It also explores the evidence for their clinical application in specific disease states and populations. Date and Time: 11/05/2009, 09:45 am - 11:15 am Type: Clinical Controversy Location: Convention Center, 28 C Curriculum: Critical Care   NetWork Highlight!

Respiratory Consequences of the California Fires and Other Disasters ID #3274 Objectives: Recognize the potential acute and chronic respiratory consequences and the pathophysiology of wildfire exposure.   Illustrate how to participate effectively with public health workers in designing and articulating a mitigation strategy for wildfire exposure. The State of California has been wracked recently by widespread wildland conflagrations in October 2003 and again in the fall of 2007. These fires covered large areas of rural backcountry, were prolonged, and led to massive exposures in the nearby urban communities. Additionally, firefighters and rural citizens had intense exposures to fire combustion products, dusts, and particulates that developed. Postexposure rates of respiratory disease rose acutely and have continued to pose problems in the respiratory-impaired and previously healthy inhabitants. As we encroach even more on the wildlands, these events are predicted to become more common and involve more of our vulnerable population. This presentation will explore and contrast the two wildfire incidents in terms of impact and secondary mitigation strategies; review the postwildfire respiratory complications, including the pathophysiology of acute lung injury following such fire exposures; and highlight how these issues relate to other disasters with high respiratory impact. Date and Time: 11/05/2009, 09:45 am - 11:15 am Type: Panel Discussion Location: Convention Center, 32 AB Curriculum: Disaster Medicine, Occupational and Environmental Lung Diseases   NetWork Highlight!

Say It Softly: The Hoarse Voice and the Pulmonologist ID #3249 Objectives: Discuss the differential diagnosis for horseness.   Describe noninvasive diagnostic techniques used to evaluate hoarseness. This session will inform practitioners of common clinical problems associated with the hoarse voice and educate physicians as to the appropriate diagnostic evaluation. Treatment options will be reviewed. The American Association of Otolaryngology and the American College of Chest Physicians are currently developing an evidence-based guideline focused on the diagnosis and treatment of hoarseness. Panel members for this session are members of the current evidence-based guideline panel who will share the latest information concerning this clinical topic. The audience will be educated on the pathophysiology, diagnosis, and treatment of hoarseness due to neoplasia. Both laryngeal and extralaryngeal neoplasms will be examined in this discussion. The role of laryngoscopy, bronchoscopy, and radiographic studies will be presented. The role of the speech pathologist will be examined in the assessment of the patient with the hoarse voice, and information concerning treatment options that involve the speech therapist will be covered. The data concerning the incidence and pathophysiology of hoarseness in patients treated with inhaled medications and treatment options will be discussed. Date and Time: 11/05/2009, 09:45 am - 11:15 am Type: Panel Discussion Location: Convention Center, 26 B Curriculum: Allergy and Airway, Obstructive Lung Diseases   NetWork Highlight!

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