Respiratory Exchange

What do golf clubs, computers and aerospace engineering have in common? They all use a beryllium alloy as part of their manufacturing process. Beryllium is used in many industries and, over time, workers who are in contact with this element can become sensitized to it and may develop chronic beryllium disease. Dr. Maeve MacMurdo discusses ways to identify patients who may be sensitized, as well as those who have developed chronic beryllium disease and how they can be treated.

Eduardo Mireles, MD, director of the Medical Intensive Care Unit and vice-chair of the Department of Critical Care Medicine at Cleveland Clinic, discusses the current gap between ventilator technology, with its multiple options, and the education needed for providers who monitor patients. He reviews the course he developed to address this gap, the Standardized Education on Ventilatory Assistance (SEVA), as well as where AI and the detection algorithms used in mechanical ventilation will take healthcare in the future.

Dr. Fred Hsieh discusses eosinophilic-related diseases and their possible causes, such as allergic diseases or parasitic infection. He covers the best way to proceed when your CBC report shows a high eosinophil number and what hypereosinophilia syndrome actually is. Dr. Hsieh reviews the challenge in treating eosinophilic-related diseases with corticosteroids, and new, FDA-approved treatments that use eosinophil-targeting biologics to reduce the eosinophils in the blood.

ATS LIVE! Part 2 Interviews from the 2023 American Thoracic Society Conference Host: Amy Attaway, MD Recorded live at ATS, Dr. Amy Attaway talks with attendees about their emerging and innovative work. Dr. Anna May: Medication use before starting positive airway pressure therapy. Dr. Neha Solanki: Platelets' association with severe asthma. Dr. Peng Zhang: Repurposing medications to decrease asthma inflammation. Dr. Uddalak Majumdar: Mechanical ventilation and obstructive airway diseases.

Recorded live at ATS, Dr. Amy Attaway, Associate Director of the Cleveland Clinic COPD Center, talks with attendees about their emerging and innovative work: • Dr. Elizabeth Regan: COPDGene study. • Drs. Onder Yildirim and Thom Conlon: COPD iNET. • Dr. Roger Kim: AI radio mix tool. Racial disparities in lung cancer screening.

Dr. Rachel Scheraga and Dr. Brian Southern in the Respiratory Institute at the Cleveland Clinic, cover the best of the 2023 ATS conference. They highlight discussions on recent IPF trials, omics and spatial transcriptomics, incorporating wearables data in clinical trials, climate change impact on lung disease risk and behavior, the updated pulmonary hypertension guidelines and more.

This underrecognized disease is too often diagnosed late in the fungal infection's fibrotic progression. Learn how using a combination of CT scans, bronchoscopy and the assistance of interventional radiologists can help you diagnose and differentiate fibrosing mediastinitis from other pulmonary disorders such as asthma or COPD. Also in this episode, multiple palliative modalities for fibrosing mediastinitis are discussed that can help improve the quality of life of your patient.

Occupational lung disease is anything related to exposures that occurred on the job. This includes something that may be happening now or happened 20, 30 years ago. Hear why talking to your patient about their job or deployment history may be key to determining lung disease origin and developing a successful treatment plan.

Dr. Maryam Valapour, director of Lung Transplant Outcomes Research at Cleveland Clinic, discusses the intersection of transplant science and health policy and the role of the physician-scientist. She also covers the need to build better lung allocation models, the concept of minimizing the impact of geography in organ distribution, looking into who doesn't get access to transplant that should and increasing the organ donor pool.

Alpha-1 antitrypsin deficiency is a genetic disease that commonly goes unrecognized. For some patients who have COPD or emphysema, alpha-1 is a predisposing condition they have that can be identified through a simple blood test. In this episode, Dr. James Stoller discusses this disease, effective therapies and novel treatments being investigated that include corrector molecules, gene editing approaches and more.

Military burn pits were used during deployment to burn away any kind of waste created. The fumes produced have caused serious lung injury and disease. Drs. Mauve MacMurdo and Neha Solanki discuss burn pit exposure, legislation designed to help military who have developed deployment-related lung disease, and the need to evaluate and support these patients.

Dr. Peter Mazzone talks with Drs. Sethi Sonali and Angel Coz about some of the highlights from the CHEST 2022 conference, including the two-part Critical Care Year End Review covering mechanical ventilation, neurology, ICU, sepsis, ARDIS and surgical critical care.

Dr. Humberto Choi, director of Cleveland Clinic's Smoking Cessation Program, discusses ways for clinicians to be proactive and individualize treatment options to help people quit smoking. He also reviews electronic cigarettes, vaping and why they aren't a safer alternative to smoking tobacco.

Dr. Elliot Dasenbrook, founder and director of the Cleveland Clinic Adult Cystic Fibrosis Program, discusses the formation of the multidisciplinary adult program. He covers past treatments and how the new modulators have made such a dramatic difference for patient care, including patients on the lung transplant waiting list. Dr. Dasenbrook also talks about how the need for transitional care, from pediatric to adult care, of the CF patient has become an imperative particularly as CF patients now live well into adulthood.

Liver disease presents a high burden, both on the society as well as healthcare system. Dr. Aanchal Kapoor, founder and director of the Medical Intensive Liver Unit (MILU), talks about the creation of this ICU Critical Care unit completely dedicated to the care of patients with severe liver disease. Dr. Kapoor discusses how this multidisciplinary unit works with staff from multiple areas including transplant hepatology, liver transplant surgery, physical therapy, dieticians, social workers, transplant coordinators and hepatology.

Dr. Daniel Culver, chairman of the Pulmonary Department in the Respiratory Institute at Cleveland Clinic, dives in to the topic of interstitial lung diseases, their diagnosis and management. He covers use of transbronchial cryobiopsy, the benefits of multidisciplinary discussion, and changes in the use of immunosuppressive and anti-fibrotic therapies. Dr. Culver talks about the need for identifying and taking care of comorbidities as a critical part of managing care of these patients, and offers some considerations on the future of diagnosis and therapies.

In the U.S. from March 2020 to June 2021, 147 lung transplants took place for COVID fibrosis or COVID ARDS. In this podcast, Dr. Kenneth McCurry and Dr. Marie Budev, surgical director and medical director, respectively, of the Lung and Heart-Lung Transplant Program at Cleveland Clinic discuss COVID-19, ARDS, fibrosis and the potential role of lung transplantation to treat those patients with advanced disease.

In this episode, Dr. Sumita Khatri, vice chair of Cleveland Clinic's Respiratory Institute and director of the Asthma Center, discusses the multitude of factors that can impact a patient's lung heath, including climate change, particle matter pollution, ozone, proximity to urban heat islands and traffic, as well as occupational influencers like farming and agricultural work. Dr. Khatri urges physicians to become more knowledgeable about these factors and their impact and make it part of the conversation with patients.

Sandra Hong, MD joins Respiratory Exchange to discuss oral immunotherapy (OIT) for food allergy. She reviews the life-changing success of patients who have undergone OIT via an established program, as well as covering “early OIT,” in which children below the age of four are introduced to a food allergen in order to build up a tolerance.

Dr. Peter Mazzone, Director of the Lung Cancer Program for the Respiratory Institute and the Lung Cancer Screening Program for Cleveland Clinic, discusses why the low-dose CT screening test for lung cancer has become the standard of care for high-risk individuals and the necessity of having a system in place to manage the scan's findings. He also talks about follow-up needed for lung nodules found during screening and predictive tools for lung cancer that are on the horizon.

Dr. Marie Budev, director of the Cleveland Clinic Lung Transplant Program, tackles the huge subject of Lung Transplant, covering a range of topics that includes when the right time to refer a patient is and what the contraindications are for transplant. She discusses the Lung Allocation Score, lung transplant survival rate and how long it takes to get a patient ready for transplant. Dr. Budev also talks about new ways in which the donor lung pool is being expanded and the impact of COVID-19 on lung transplant patients.

Dr. Daniel Culver, chair of the Cleveland Clinic Department for Pulmonary Medicine, and Dr. Manuel Ribeiro, director of the Sarcoidosis Center at the Cleveland Clinic, recap the highlights from the December WASOG Diseases conference. They review the discussions on Progressive Fibrosing Interstitial Lung Disease, the relationship between inflammation and fibrosis, the new European Respiratory Society Guidelines and various themes coming out of the Cardiac Sarcoidosis sessions.

Dr. David Lang, chairman of the Cleveland Clinic Department for Allergy and Immunology, updates us on methods allergists may use to challenge self-reported penicillin allergy, desensitize patients who have a documented aspirin allergy and current testing for vaccine allergies.

Dr. Rachel Taliercio, founder and director of the Chronic Cough Clinic, talks about the four main causes of chronic cough: upper airway cough syndrome, cough variant asthma, non-asthmatic eosinophilic bronchitis and GERD. In addition, she discusses the value of really listening to patients and the importance of using guideline-based therapies. Dr. Taliercio also covers cough hypersensitivity syndrome and new developments on the treatment horizon in the areas of medication and therapies.

Dr. Hassan Khouli, chairman of Cleveland Clinic's Critical Care Medicine Department, covers aspects of this young, evolving field, from expanding the ICU team to include pharmacists and nutritionists, to the trend in creating sub-specialized medical ICUs. Dr. Khouli also discusses the movement toward non-invasive technologies, using data to minimize over-testing and the value of engaging families to participate in the goals of care.

Dr. Kristin Englund, founder and director of Cleveland Clinic's post-COVID reCOVer Clinic, discusses the increasing impact of long COVID on patients and healthcare. Learn about the growing list of disease symptoms, the effect on multiple organs and which patients are more at risk for long COVID. Dr. Englund discusses the reCOVer Clinic and the development of multiple care paths and a multidisciplinary approach to treatment for long COVID patients.

Dr. Steven Gordon, chairman of Cleveland Clinic's Infectious Disease Department, discusses how the COVID-19 pathogen has taught us numerous lessons connected to preparedness for dealing with future emerging pathogens. Dr. Gordon covers the need to develop supply chain resiliency and redundancy, and to move from a “just in time” supply mentality to one of “just in case.” He also talks about using big data, mask wearing and PPE, as well as the intersection of clinical trials and treatment and the pressure to act quickly versus acting based on scientific evidence.