Click on any day of the congress to view more details about the program and what each track has to offer; session descriptions and learning objectives.
Lung Cancer Part I
Gerard A. Silvestri, MD, FCCP
Description:
This lecture will be the first in a two- part overview of all aspects of lung cancer diagnosis and treatment.
Learning Objectives:
- Understand the epidemiology of lung cancer.
- Describe the current status of screening for lung cancer.
- Describe the staging system.
Nontuberculous Mycobacterial Disease
Doreen Addrizzo-Harris, MD, FCCP
Description:
The lecture will provide an overview of nontuberculous mycobacterial pulmonary disease (NTMPD).
Learning Objectives:
- Describe the risk factors of NTMPD.
- Review radiography for patients with NTMPD.
- Discuss barriers in the diagnosis of NTMPD.
- Provide an overview of the treatment algorithm of NTMPD, including nonpharmacologic and pharmacologic therapies.
Lung Cancer Part II
Gerard A. Silvestri, MD, FCCP
Description:
This lecture will be the second in a two- part overview of all aspects of lung cancer diagnosis and treatment.
Learning Objectives:
- Overview the pre-reatment evaluation of patients presenting with a lung mass, including physiologic assessment prior to surgery.
- Describe the treatment of non-small cell lung cancer by stage.
- Describe the treatment of small cell lung cancer by stage.
Diagnostic Approach to Patients With Pleural Effusions
Ioannis Kalomenidis, MD, PhD
Description:
This session will discuss a typical diagnostic approach to patients with
pleural effusions, including clinical presentation, the role of imaging,
the need and the impact of diagnostic thoracentesis and pleural biopsy.
Learning Objectives:
- Describe the most likely diagnoses based on the clinical presentation
and chest radiograph, chest ultrasound, or chest CT scan. - Understand when a diagnostic thoracentesis is required, which pleural
fluid tests should be ordered, depending on the clinical circumstances and
how to interpret the results. - Explain when a pleural biopsy is needed and how to decide the optimal
biopsy method.
Case-Based ILD
Kevin K. Brown, MD, FCCP
Description:
This lecture will use a number of individual cases to outline the approach to the diagnostic evaluation of patients with ILD.
Learning Objectives:
- Explore a variety of unique interstitial lung diseases that have similar clinical presentations.
- Describe the role of the clinical context, chest imaging, and pulmonary pathologic patterns in real-world cases.
COPD and Eosinophils: Myth and Reality
Stelios Loukides, MD, PhD, FCCP
Description:
Define the role of either blood or/and sputum eosinophils in COPD. Define their pathophysiologic background, discuss about their specific cut-off values, determine whether they are predictable for different disease outcomes, and, finally, consider whether they could guide treatment decisions in everyday clinical practice.
Learning Objectives:
- Clarify the role of eosinophils in COPD.
- Address their strengths and limitations.
- Explore their stratification in treatment strategies.
- Fill the gaps in the literature.
European Union Projects for Smoking Cessation and Tobacco Control
Cornel Radu-Loghin
Panagiotis Behrakis, MD, PhD, FCCP
Description:
The lecture will cover current EU strategies for tobacco control focusing specifically on Tobacco Product Directive implementation through the actions of the Joint Action on Tobacco Control and TOB-g projects. In addition, the lecture will cover the contributory role of the European Network for Smoking and Tobacco Prevention in Europe.
Cystic Fibrosis, Non-CF Bronchiectasis and Atypical Infections
Doreen Addrizzo-Harris, MD, FCCP
Description:
The lecture will provide an overview of bronchiectasis; CF-related and non-CF-related. It will also review common atypical infections.
Learning Objectives:
- List the causes of bronchiectasis.
- Describe the genetic defects underlying CF.
- List therapeutic approaches to the treatment of pulmonary disease in patients with CF.
- Discuss the therapeutic options for the treatment of non-CF bronchiectasis.
- Recall the classic presentations and radiographic findings of nocardiosis and actinomycosis infections of the lung.
- Discuss the treatment of nocardiosis and actinomycosis infection in the lung.
Pulmonary Hypertension
Stephanie Levine, MD, FCCP
Description:
Pulmonary hypertension (PH) is defined as an elevated mean arterial pressure ≥25 mm Hg at rest. PH has several etiologies and can be a progressive, fatal disease, if untreated. This session will review the epidemiology, classification, pathogenesis, clinical features, diagnostic evaluation, treatment, and prognosis of PH.
Learning Objectives:
- Describe the World Symposium of PH classification of PH and PAH.
- Provide the approach to diagnosis and assessment of PAH.
- Discuss the recommended treatment regimens for PAH.
Diffuse Lung Disease
Kevin K. Brown, MD, FCCP
Description:
This lecture will describe and discuss the structured approach to the diagnostic evaluation of the patient who presents with diffuse lung disease.
Learning Objectives:
- Describe the diagnostic approach to interstitial lung disease.
- Describe the role of the clinician, radiologist, and pathologist in the diagnosis of interstitial lung disease.
- Classify and distinguish among the causes of interstitial lung disease.
The Management of Pulmonary Embolism
Anastasia Anthi, MD, PhD
Description:
Acute pulmonary embolism (PE) remains a major global health burden and a leading cause of cardiovascular mortality.
In recent years, several significant improvements have been made in the diagnostic approach and therapeutic management of acute PE, including the diagnostic algorithm for suspected PE and the introduction of direct oral anticoagulants in the acute and extended treatment of venous thromboembolism (VTE).
This presentation will summarize the current knowledge regarding both diagnosis and treatment strategies for PE and highlight the important issues that remain to be resolved by future or ongoing research.
Learning Objectives:
- Understand the varied spectrum of PE presentation and the various treatment options according to risk stratification.
- Outline the optimum diagnostic strategy for patients with suspected PE.
- Recognize the importance of VTE prophylaxis for the prevention of PE.
CHEST SEEK Questions
Stephanie Levine, MD, FCCP
Description:
This session will be based on select questions from the well-known SEEK Library used for continuing medical education and board preparation. The session will be conducted using an ARS.
Sarcidosis
Kevin K. Brown, MD, FCCP
Description:
This lecture will provide an update on the diagnosis and treatment of sarcoidosis.
Learning bjectives:
- Describe the clinical approach that allows for a diagnosis of sarcoidosis.
- Describe the diagnostic possibilities when sarcoidosis is in the differential
- Describe treatment options for sarcoidosis.
Environmental Lung Disease
Clayton T. Cowl, MD, MS, FCCP
Description:
From a review of taking a good occupational and environmental history to discussing the latest advances in evaluation and treatment of environmentally related issues, such as toxic inhalations, ambient air pollution, work-related asthma, and pneumoconioses, this session will serve as a broad overview of key topics important for the clinician in assessing conditions that affect the respiratory system.
Learning Objectives:
- Understand the importance of good history-taking when considering work-related exposures
- Recall key principles of assessing and treating toxic inhalations, work-related asthma, and environmentally induced interstitial lung diseases.
Update on Bronchoscopy and Interventional Pulmonary Procedures
Nicholas Pastis, MD, FCCP
Description:
As the subspecialty of interventional pulmonology has become more formalized and widespread, therapeutic options for patients via bronchoscopy have expanded. This session will provide a focused update on the newest bronchoscopic procedures to treat benign and malignant conditions.
Learning Objectives:
- An update on the various ablative modalities will be discussed.
- An update on tracheal and bronchial stents will be presented.
- Bronchoscopic treatment options for lung volume reduction in emphysema and for persistent air leaks will be presented.
OSA: The New Era
Sophia E. Schiza, MD, PhD
Description:
Obstructive sleep apnea (OSA) is a highly prevalent sleep disorder and a major challenge for physicians and health-care systems throughout the world. It is a heterogeneous disorder and, if left untreated, has huge health, safety, and economic consequences. Recently, four key contributors to OSA pathogenesis have been characterized. The ”anatomical compromise” with narrow, crowded, or collapsible airway and “nonanatomical” contributors, such as ineffective pharyngeal dilator muscle function during sleep, a low arousal threshold, and high loop gain. Each of these phenotypes, along with patient’s clinical presentation, is target for therapy. This lecture will summarize the current evidence in OSA.
Learning Objectives:
- Discuss the current perspectives of OSA.
- Define indications for patients’ selection and evaluation.
- Review guidelines for cinical evaluation, diagnosis, and treatment of
patients with OSA - Understand the different pathophysiological traits and phenotypes of OSA.
- Review OSA complications in daytime function, in cardiovascular and
metabolic system. - Discuss different treatment options, individualized therapeutic plan,
as well as treatment follow-up.
Management of Malignant Pleural Effusions
Nicholas Pastis, MD, FCCP
Description:
The management of malignant pleural effusions presents a burden to patients with stage IV malignancies and a potential strain on the health-care system. This session will review diagnostic challenges, predictors of successful treatment, and management options. An update on recent literature surrounding the role of tunnel pleural catheters will be emphasized.
Learning Objectives:
- The various prognostic factors for malignant pleural effusions will be discussed.
- A treatment algorithm will be proposed.
- Treatment options, such as thoracentesis, tunneled pleural catheters, and thoracoscopy, will be reviewed, and the latest evidence will be presented.
Difficult-to-Treat Asthma
Petros Bakakos, MD
Description:
Difficult-to-treat asthma is defined as asthma that is uncontrolled despite GINA step 4 or 5 treatment or that requires such treatment to maintain good control. Sometimes, this is due to modifiable factors, such as poor adherence, bad inhaler technique, or comorbidities. It is important to confirm the diagnosis of asthma, check for modifiable factors, optimize treatment, and review the response to it. It is also important to phenotype the difficult-to-treat asthma patient and make decisions on the use of biologic type-2 treatments, as well as nonbiologic treatments.
Learning Objectives:
- Explain the definition of severe and difficult-to-treat asthma.
- Understand anti-IL5 treatments.
- Describe new targeted treatments in severe asthma.
Update on Tuberculosis
Doreen J. Addrizzo-Harris, MD, FCCP
Description:
This lecture will provide an update on the diagnosis and treatment of tuberculosis.
Learning Objectives:
- Understand epidemiology of tuberculosis.
- Understand transmission and pathogenesis.
- Explain the diagnosis and treatment of tuberculosis including MDR/XDR TB.
- Explain emphasis on vulnerable populations.
- Describe the diagnosis and treatment of latent tuberculosis infection.
Lung Transplant
Stephanie Levine, MD, FCCP
Description:
In 2017, more than 4,000 lung transplant procedures were reported to the International Society for Heart and Lung Transplantation.
Learning Objectives:
- Discuss current activity and outcomes following lung transplantation.
- Define indications for lung transplantation.
- Review guidelines for LT candidate selection.
- Understand management of the lung transplant recipient.
- Review complications following lung transplantation.
- Discuss the immunosuppressive and other medications used in lung transplantation.
Pneumonia: Hospital-Acquired and Community-Acquired
Adamantia Liapikou, PhD
Description:
A. Hospital-Acquired Pneumonia
Nosocomial pneumonia (NP) is classified into two groups: 1) HAP, which develops in hospitalized patients after 48 h of admission; and 2) “ventilator-associated pneumonia” (VAP), which occurs in patients requiring mechanical ventilation, representing more than 80% of the pneumonias acquired in intensive care units (ICU). HAP is the second most common hospital infection and has the highest crude mortality. Both types of pneumonia lengthen hospital stay and consume considerable health resources. In 2016, the American Thoracic Society (ATS) jointly with the Infectious Disease Society of America (IDSA) developed guidelines for the management of HAP/ VAP; while in 2017, the ERS/ESCMID/ESICM/ALAT published European guidelines for nosocomial pneumonia. These guidelines include recommendations for risk stratification, diagnosis, initial and definitive antibiotic treatment, and prevention of NP.
Learning Objectives:
- Describe the relative importance of HAP and VAP for patients and the health
care system.
- Name major differences in the 2016 IDSA HAP/VAP Guidelines vs
the previously published version and vs European ones.
- Interpret and use the new guidelines for determining optimal
antimicrobial management of patients with HAP or VAP (drug, dose,
route, duration).
B. Community-Acquired Pneumonia (CAP)
Community-acquired pneumonia remains an important infectious disease with a significant global burden and is considered a major cause of sepsis worldwide. While the etiology of CAP has remained largely unchanged, emerging diagnostic approaches, such as molecular-based techniques, are now better able to rapidly identify both viral and bacterial causative pathogens. The empirical antibiotic choice is a crucial early management decision for patients presenting with CAP, in view of the fact that microbial etiology is usually unknown at presentation. Frontline physicians usually rely on severity scores, such as for the pneumonia severity index (PSI) and the confusion, urea, respiratory rate, blood pressure ,and age (CURB-65), to assist in therapeutic decisions.
Learning Objectives:
- Understand that epidemiologic changes of CAP are the aging worldwide population and increasing antimicrobial resistance.
- Explain the etiology of CAP using recently published data from emerging molecular techniques (PCR), showing a 30% of viral etiology.
- Understand the therapeutic approach using the CURB-65 & PSI scores to guide antibiotic choices according to guidelines.
Wedge, Resection, Segmentectomy, or Sleeve Resection
Loren J. Harris, MD, FCCP
Description:
The lecture will be in the form of a board review of the indications, patient selection, and the surgical techniques for wedge resection, segmental resection, and sleeve resection when applied to patients with lung cancer. It will be based on cases with questions to be discussed by the audience in real time.
Learning Objectives:
- What is the difference between a wedge resection, segmental resection and a sleeve resection when applying this to patients with lung cancer?
- Who are the most appropriate patients for each type of resection in patients with lung cancer?
- What are the techniques used for each type of resection in patients with lung cancer?
EBUS Workshop
Nicholas Pastis, MD, FCCP
Vasileios S. Skouras, MD, PhD, FCCP
Grigoris Stratakos, MD, PhD, FCCP
Description:
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has revolutionized the safe and accurate staging and diagnosis of cancers involving the mediastinum. Needle-based samples obtained via EBUS are now used for molecular analysis and PDL-1 testing in lung cancer patients to guide therapeutic options. In addition, the diagnosis of other mediastinal diseases like sarcoidosis, infection, and lymphoma have been described with EBUS-TBNA.
Learning Objectives:
- The demonstration of EBUS-TBNA for mediastinal staging
- Proper sampling technique to obtain both a diagnosis and molecular analysis with EBUS-TBNA
- The role of EBUS-TBNA in clinical cases will be shown.
PFTs: The Correct Performance and Interpretation
Nikolaos Koulouris, MD, PhD, FCCP
Description:
This session will cover spirometry and pulmonary function testing (PFT) and go over the criteria for correct performance and pitfalls for lung resection.
Learning Objectives:
- Explain how to perform spirometry testing.
- Learn how to detect airway obstruction.
- Be able to give a preoperative assessment.
- Describe the current algorithm for preoperative assessment.
Ultrasound Workshop
Nicholas Pastis, MD, FCCP
Grigoris Stratakos, MD, PhD, FCCP
Description:
Over the past decade, point of care ultrasound in the ICU has gained momentum in Europe and the US. Ultrasound strategies, such as the BLUE Protocol (Lichtenstein, Chest 2008, 134(1): 117–125) have been developed as efficient and accurate tools for guiding therapy in acute respiratory failure. In addition, point of care ultrasound may predict preload responsiveness and guide fluid management in the ICU. This session will use real clinical cases to illustrate the value of point of care ultrasound.
Learning Objectives:
- Acute respiratory failure: How can ultrasound artifacts be used to guide clinical decision making?
- Review the Blue Protocol.
- Fluids in the ICU: How can ultrasound guide us?
- Highlight cases using critical care US.
Working on the Patient With Lung Cancer: Case-Based Discussion
Gerard A. Silvestri, MD, FCCP
Vasileios S. Skouras, MD, PhD, FCCP
Ioannis Gkiozos, MD, PhD, FCCP
Description:
This session will focus on case-based discussions of diagnosis, staging and treatment options of patients with newly diagnosed lung cancer of differing stages, cell types and clinical scenarios.