CHEST 2013

CHICAGO – Intensive counseling and other nonpharmacologic strategies to quit smoking dramatically increased abstinence rates among elderly long-term-care residents in a multicenter study.

Among 74 current smokers, 34 residents (46%) successfully quit smoking and 26 (35%) remained tobacco free at 1 year.

Prior research shows that medical advice to quit smoking typically produces 1-year abstinence rates of 5% to 10%.

"With a 46% quit rate, we were successful in showing that pharmacologic therapy isn’t the only way," Dr. Aleksander Shalshin said at the annual meeting of the American College of Chest Physicians.

Smokers over the age of 60 years represent about 23% of current smokers and are at increased risk of dying from disorders related to smoking. A recent prospective study found that the risk of dying from cancer, cardiovascular disease, and respiratory disease was 50% higher among men who continued to smoke into their 70s than for never-smokers.

Further, recent studies in the United States and England have shown that smokers who quit at either age 60 or age 65 years gained 2.7-3.7 years of life, said Dr. Shalshin, a pulmonary and critical care physician with North Shore Long Island Jewish Health System, in Syosset, N.Y.

"I always tell my patients it’s never too late to be a quitter," he said.

For the current study, the investigators prospectively recruited 74 long-term-care residents, aged 65-78 years, who were currently smoking an average of half a pack of cigarettes a day and had a tobacco history of more than 5 years. All were interested in quitting.

The intervention included daily smoking-cessation counseling visits from their primary care physician, nurse, or nurse educator, and regular access to a pulmonary consultant.

Counseling was supplemented with educational self-help, video and printed materials and the facilities set up smoke-free zones within 50 feet of their entrances. Participant’s families were also encouraged to provide support and received education on the benefits of a multifaceted approach to tobacco-addiction treatment.

"For patients in long-term-care facilities, where access is immediate and often easy, you don’t have to wait for the next appointment. It can be done on a daily basis with a little bit of time and effort." Dr. Shalshin said.

Session co-moderator Dr. Linda Efferen, chief medical officer, South Nassau Communities Hospital, Oceanside, N.Y., said targeting this captive audience makes sense and provides a bigger bang for the buck.

"These are our future readmissions, especially if they have underlying COPD [chronic obstructive pulmonary disease], asthma, or heart disease," she said in an interview. "To do this without pharmaceuticals and get these results is just phenomenal. We’re in the antipolypharmacy mode also because most of our patients are already on 20 different medications."

Pharmaceutical options will be used in the next phase of the study, however, to target the remaining patients who were unable to quit with the multidisciplinary nonpharmaceutical approach, Dr. Shalshin said in an interview.

Dr. Shalshin and his coauthors reported having no financial disclosures.

pwendling@frontlinemedcom.com

CHICAGO – Intensive counseling and other nonpharmacologic strategies to quit smoking dramatically increased abstinence rates among elderly long-term-care residents in a multicenter study.

Among 74 current smokers, 34 residents (46%) successfully quit smoking and 26 (35%) remained tobacco free at 1 year.

Prior research shows that medical advice to quit smoking typically produces 1-year abstinence rates of 5% to 10%.

"With a 46% quit rate, we were successful in showing that pharmacologic therapy isn’t the only way," Dr. Aleksander Shalshin said at the annual meeting of the American College of Chest Physicians.

Smokers over the age of 60 years represent about 23% of current smokers and are at increased risk of dying from disorders related to smoking. A recent prospective study found that the risk of dying from cancer, cardiovascular disease, and respiratory disease was 50% higher among men who continued to smoke into their 70s than for never-smokers.

Further, recent studies in the United States and England have shown that smokers who quit at either age 60 or age 65 years gained 2.7-3.7 years of life, said Dr. Shalshin, a pulmonary and critical care physician with North Shore Long Island Jewish Health System, in Syosset, N.Y.

"I always tell my patients it’s never too late to be a quitter," he said.

For the current study, the investigators prospectively recruited 74 long-term-care residents, aged 65-78 years, who were currently smoking an average of half a pack of cigarettes a day and had a tobacco history of more than 5 years. All were interested in quitting.

The intervention included daily smoking-cessation counseling visits from their primary care physician, nurse, or nurse educator, and regular access to a pulmonary consultant.

Counseling was supplemented with educational self-help, video and printed materials and the facilities set up smoke-free zones within 50 feet of their entrances. Participant’s families were also encouraged to provide support and received education on the benefits of a multifaceted approach to tobacco-addiction treatment.

"For patients in long-term-care facilities, where access is immediate and often easy, you don’t have to wait for the next appointment. It can be done on a daily basis with a little bit of time and effort." Dr. Shalshin said.

Session co-moderator Dr. Linda Efferen, chief medical officer, South Nassau Communities Hospital, Oceanside, N.Y., said targeting this captive audience makes sense and provides a bigger bang for the buck.

"These are our future readmissions, especially if they have underlying COPD [chronic obstructive pulmonary disease], asthma, or heart disease," she said in an interview. "To do this without pharmaceuticals and get these results is just phenomenal. We’re in the antipolypharmacy mode also because most of our patients are already on 20 different medications."

Pharmaceutical options will be used in the next phase of the study, however, to target the remaining patients who were unable to quit with the multidisciplinary nonpharmaceutical approach, Dr. Shalshin said in an interview.

Dr. Shalshin and his coauthors reported having no financial disclosures.

pwendling@frontlinemedcom.com

CHICAGO – Intensive counseling and other nonpharmacologic strategies to quit smoking dramatically increased abstinence rates among elderly long-term-care residents in a multicenter study.

Among 74 current smokers, 34 residents (46%) successfully quit smoking and 26 (35%) remained tobacco free at 1 year.

Prior research shows that medical advice to quit smoking typically produces 1-year abstinence rates of 5% to 10%.

"With a 46% quit rate, we were successful in showing that pharmacologic therapy isn’t the only way," Dr. Aleksander Shalshin said at the annual meeting of the American College of Chest Physicians.

Smokers over the age of 60 years represent about 23% of current smokers and are at increased risk of dying from disorders related to smoking. A recent prospective study found that the risk of dying from cancer, cardiovascular disease, and respiratory disease was 50% higher among men who continued to smoke into their 70s than for never-smokers.

Further, recent studies in the United States and England have shown that smokers who quit at either age 60 or age 65 years gained 2.7-3.7 years of life, said Dr. Shalshin, a pulmonary and critical care physician with North Shore Long Island Jewish Health System, in Syosset, N.Y.

"I always tell my patients it’s never too late to be a quitter," he said.

For the current study, the investigators prospectively recruited 74 long-term-care residents, aged 65-78 years, who were currently smoking an average of half a pack of cigarettes a day and had a tobacco history of more than 5 years. All were interested in quitting.

The intervention included daily smoking-cessation counseling visits from their primary care physician, nurse, or nurse educator, and regular access to a pulmonary consultant.

Counseling was supplemented with educational self-help, video and printed materials and the facilities set up smoke-free zones within 50 feet of their entrances. Participant’s families were also encouraged to provide support and received education on the benefits of a multifaceted approach to tobacco-addiction treatment.

"For patients in long-term-care facilities, where access is immediate and often easy, you don’t have to wait for the next appointment. It can be done on a daily basis with a little bit of time and effort." Dr. Shalshin said.

Session co-moderator Dr. Linda Efferen, chief medical officer, South Nassau Communities Hospital, Oceanside, N.Y., said targeting this captive audience makes sense and provides a bigger bang for the buck.

"These are our future readmissions, especially if they have underlying COPD [chronic obstructive pulmonary disease], asthma, or heart disease," she said in an interview. "To do this without pharmaceuticals and get these results is just phenomenal. We’re in the antipolypharmacy mode also because most of our patients are already on 20 different medications."

Pharmaceutical options will be used in the next phase of the study, however, to target the remaining patients who were unable to quit with the multidisciplinary nonpharmaceutical approach, Dr. Shalshin said in an interview.

Dr. Shalshin and his coauthors reported having no financial disclosures.

pwendling@frontlinemedcom.com

CHICAGO – Taking a personalized approach to treating dyspnea will result in better outcomes, and will make choosing between surgical and the increasing number of nonsurgical techniques an easier process, according to Dr. Frank Sciurba, a presenter at the annual meeting of the American College of Chest Physicians.

In a talk that reviewed current and trial surgical and bronchoscopic treatments of dyspnea in chronic obstructive pulmonary disease, Dr. Sciurba said, "Just treating diseases that are now naively classified as COPD or [interstitial lung disease] is not enough. We can instead look at variations within those diseases that may or may not be responsive to different therapies."

For example, because the Impact of Heterogeneity on Outcome Following Endobronchial Valves (VENT) trial data showed that fissure integrity (collateral tracts) significantly influenced target and adjacent lobe volume changes, Dr. Sciurba said that medical device manufacturers have begun to develop technologies that are more specific to the patient.

Straight nitinol coils (PneumRx), which are placed bronchoscopically, are implanted in stages, and according to collateral tracts. "The concept is to target the most affected areas of the lung, allowing regional expansion of the least affected lung. It’s not dependent on just lobar re-expansion," said Dr. Sciurba, director of the emphysema research center at the University of Pittsburgh Medical Center. 

Pilot trial data for this technique published in CHEST earlier this year showed that patients (n = 56) had a 17.5% improvement in forced expiratory volume in 1 second (FEV₁) and a greater than 10% drop in residual volume, and clinical meaningful improvements in 6-minute walk distances at more than a 28% improvement from baseline: 73% had a greater than 25 meter improvement at 6 months post treatment.

The hydro-gel foam, AeriSeal (Aeris) is another bronchoscopic technique currently undergoing a small (n = 20) pilot trial. After fibrinogen was eliminated from the sealant, this polymeric lung volume reduction technology was cleared by the Food and Drug Administration for testing in humans.

The sealant is administered into specific subsegments of the lungs, where the foam adheres to surrounding tissues; air and water in the foam are reabsorbed when collapse occurs, with durable absorption in atelectasis.

The results will soon be published, although Dr. Sciurba said that at this point, "the mechanical benefits seem to exceed the symptomatic benefits," but that a trial in a larger population would produce more definitive results.

Other factors to consider include "understanding the pulmonary physiologic interaction in lung volume reduction, and how that translates downstream, and the importance of linking the mechanical intervention with pulmonary rehab."

Expanding the ‘tool chest’

In determining whether bronchoscopic solutions can achieve the same benefits of surgical ones, while also minimizing adverse effects, Dr. Sciurba said, the FDA is beginning to take a more personalized view when approving trials, which he hopes will increase the "tool chest" available to physicians.

Clinical trials going forward may need to consider selection criteria such as interlobar collaterals, regional emphysema heterogeneity, and the degree of hyperinflation, as well as the most relevant outcomes when determining adverse events, Dr. Sciurba said.

Whether therapies are reversible also will be relevant, and will have an impact on future criteria for lung volume reduction surgery and transplant candidacy.

"If we actually look in a little more detail and start to classify these patients both on physiologic and clinical patterns, and as we evolve, on genetic patterns and molecular patterns, we will isolate groups of patients who are home run responders from those in whom certain therapies may not be cost effective."

Dr. Sciurba disclosed that he has received support from AstraZeneca, GlaxoSmithKline, Pfizer, and other companies, as well as grant monies from the National Institutes of Health and the University of Pittsburgh.

wmcknight@frontlinemedcom.com

CHICAGO – Taking a personalized approach to treating dyspnea will result in better outcomes, and will make choosing between surgical and the increasing number of nonsurgical techniques an easier process, according to Dr. Frank Sciurba, a presenter at the annual meeting of the American College of Chest Physicians.

In a talk that reviewed current and trial surgical and bronchoscopic treatments of dyspnea in chronic obstructive pulmonary disease, Dr. Sciurba said, "Just treating diseases that are now naively classified as COPD or [interstitial lung disease] is not enough. We can instead look at variations within those diseases that may or may not be responsive to different therapies."

For example, because the Impact of Heterogeneity on Outcome Following Endobronchial Valves (VENT) trial data showed that fissure integrity (collateral tracts) significantly influenced target and adjacent lobe volume changes, Dr. Sciurba said that medical device manufacturers have begun to develop technologies that are more specific to the patient.

Straight nitinol coils (PneumRx), which are placed bronchoscopically, are implanted in stages, and according to collateral tracts. "The concept is to target the most affected areas of the lung, allowing regional expansion of the least affected lung. It’s not dependent on just lobar re-expansion," said Dr. Sciurba, director of the emphysema research center at the University of Pittsburgh Medical Center. 

Pilot trial data for this technique published in CHEST earlier this year showed that patients (n = 56) had a 17.5% improvement in forced expiratory volume in 1 second (FEV₁) and a greater than 10% drop in residual volume, and clinical meaningful improvements in 6-minute walk distances at more than a 28% improvement from baseline: 73% had a greater than 25 meter improvement at 6 months post treatment.

The hydro-gel foam, AeriSeal (Aeris) is another bronchoscopic technique currently undergoing a small (n = 20) pilot trial. After fibrinogen was eliminated from the sealant, this polymeric lung volume reduction technology was cleared by the Food and Drug Administration for testing in humans.

The sealant is administered into specific subsegments of the lungs, where the foam adheres to surrounding tissues; air and water in the foam are reabsorbed when collapse occurs, with durable absorption in atelectasis.

The results will soon be published, although Dr. Sciurba said that at this point, "the mechanical benefits seem to exceed the symptomatic benefits," but that a trial in a larger population would produce more definitive results.

Other factors to consider include "understanding the pulmonary physiologic interaction in lung volume reduction, and how that translates downstream, and the importance of linking the mechanical intervention with pulmonary rehab."

Expanding the ‘tool chest’

In determining whether bronchoscopic solutions can achieve the same benefits of surgical ones, while also minimizing adverse effects, Dr. Sciurba said, the FDA is beginning to take a more personalized view when approving trials, which he hopes will increase the "tool chest" available to physicians.

Clinical trials going forward may need to consider selection criteria such as interlobar collaterals, regional emphysema heterogeneity, and the degree of hyperinflation, as well as the most relevant outcomes when determining adverse events, Dr. Sciurba said.

Whether therapies are reversible also will be relevant, and will have an impact on future criteria for lung volume reduction surgery and transplant candidacy.

"If we actually look in a little more detail and start to classify these patients both on physiologic and clinical patterns, and as we evolve, on genetic patterns and molecular patterns, we will isolate groups of patients who are home run responders from those in whom certain therapies may not be cost effective."

Dr. Sciurba disclosed that he has received support from AstraZeneca, GlaxoSmithKline, Pfizer, and other companies, as well as grant monies from the National Institutes of Health and the University of Pittsburgh.

wmcknight@frontlinemedcom.com

CHICAGO – Taking a personalized approach to treating dyspnea will result in better outcomes, and will make choosing between surgical and the increasing number of nonsurgical techniques an easier process, according to Dr. Frank Sciurba, a presenter at the annual meeting of the American College of Chest Physicians.

In a talk that reviewed current and trial surgical and bronchoscopic treatments of dyspnea in chronic obstructive pulmonary disease, Dr. Sciurba said, "Just treating diseases that are now naively classified as COPD or [interstitial lung disease] is not enough. We can instead look at variations within those diseases that may or may not be responsive to different therapies."

For example, because the Impact of Heterogeneity on Outcome Following Endobronchial Valves (VENT) trial data showed that fissure integrity (collateral tracts) significantly influenced target and adjacent lobe volume changes, Dr. Sciurba said that medical device manufacturers have begun to develop technologies that are more specific to the patient.

Straight nitinol coils (PneumRx), which are placed bronchoscopically, are implanted in stages, and according to collateral tracts. "The concept is to target the most affected areas of the lung, allowing regional expansion of the least affected lung. It’s not dependent on just lobar re-expansion," said Dr. Sciurba, director of the emphysema research center at the University of Pittsburgh Medical Center. 

Pilot trial data for this technique published in CHEST earlier this year showed that patients (n = 56) had a 17.5% improvement in forced expiratory volume in 1 second (FEV₁) and a greater than 10% drop in residual volume, and clinical meaningful improvements in 6-minute walk distances at more than a 28% improvement from baseline: 73% had a greater than 25 meter improvement at 6 months post treatment.

The hydro-gel foam, AeriSeal (Aeris) is another bronchoscopic technique currently undergoing a small (n = 20) pilot trial. After fibrinogen was eliminated from the sealant, this polymeric lung volume reduction technology was cleared by the Food and Drug Administration for testing in humans.

The sealant is administered into specific subsegments of the lungs, where the foam adheres to surrounding tissues; air and water in the foam are reabsorbed when collapse occurs, with durable absorption in atelectasis.

The results will soon be published, although Dr. Sciurba said that at this point, "the mechanical benefits seem to exceed the symptomatic benefits," but that a trial in a larger population would produce more definitive results.

Other factors to consider include "understanding the pulmonary physiologic interaction in lung volume reduction, and how that translates downstream, and the importance of linking the mechanical intervention with pulmonary rehab."

Expanding the ‘tool chest’

In determining whether bronchoscopic solutions can achieve the same benefits of surgical ones, while also minimizing adverse effects, Dr. Sciurba said, the FDA is beginning to take a more personalized view when approving trials, which he hopes will increase the "tool chest" available to physicians.

Clinical trials going forward may need to consider selection criteria such as interlobar collaterals, regional emphysema heterogeneity, and the degree of hyperinflation, as well as the most relevant outcomes when determining adverse events, Dr. Sciurba said.

Whether therapies are reversible also will be relevant, and will have an impact on future criteria for lung volume reduction surgery and transplant candidacy.

"If we actually look in a little more detail and start to classify these patients both on physiologic and clinical patterns, and as we evolve, on genetic patterns and molecular patterns, we will isolate groups of patients who are home run responders from those in whom certain therapies may not be cost effective."

Dr. Sciurba disclosed that he has received support from AstraZeneca, GlaxoSmithKline, Pfizer, and other companies, as well as grant monies from the National Institutes of Health and the University of Pittsburgh.

wmcknight@frontlinemedcom.com

You could spend a lifetime exploring Chicago’s unique arts, culture, and entertainment. But, since you’ll likely be in town for just a short time, here are some great places to start.

Museums, galleries, and exhibitions

From the bottom of the sea up to the stars, Chicago has it all on display. Start at the famous Museum Campus along Lake Michigan, where you’ll find three world-renowned museums: The Adler Planetarium & Astronomy Museum, The Field Museum, and The Shedd Aquarium. For art lovers, the Art Institute of Chicago offers masterpieces from ancient to ultramodern, and cultural institutions cover everything from famous historical events to current issues. And, don’t miss the International Museum of Surgical Science.

© Choose Chicago

Theater and performing arts

Soak up story lines, take in dazzling sights and sounds, journey through fairy tale wonderlands, and laugh or cry until it hurts. On any given night, Chicago’s 200+ theaters present everything from Broadway world premieres to edgy original plays. Beyond theater are renowned dance companies, opera that will make you want to take up singing lessons, and the Chicago Symphony Orchestra, a musical force of over 100 talented musicians.

Music and comedy

Chicago is famous for legendary blues and jazz, heard nightly in venues throughout the city. Chicago’s music scene can also offer up indie, hip-hop, electronic, or just plain rock n’ roll. Whatever is on your iPod^® is also in Chicago. If you like to laugh, you’ll be in the right place. Chicago’s comedy scene launched the careers of John Belushi, Steve Carrell, Stephen Colbert, Tina Fey, and many others. From traditional stand-up to competitive improv, you can find it in Chicago.

Find what interests you at ChooseChicago.com. The site has links for finding things to do, trip planning, and scoring some deals. Download the Choose Chicago app to access information and maps, stay on top of the weather, and more.

CHEST 2013, taking place October 26-31, is your connection to education opportunities in pulmonary, critical care, and sleep medicine. Cutting-edge sessions and the community of innovative problem-solvers in attendance will energize and inspire your patient care and the clinical decisions you make. Register by August 30 to save. Learn more at chestmeeting.chestnet.org.

You could spend a lifetime exploring Chicago’s unique arts, culture, and entertainment. But, since you’ll likely be in town for just a short time, here are some great places to start.

Museums, galleries, and exhibitions

From the bottom of the sea up to the stars, Chicago has it all on display. Start at the famous Museum Campus along Lake Michigan, where you’ll find three world-renowned museums: The Adler Planetarium & Astronomy Museum, The Field Museum, and The Shedd Aquarium. For art lovers, the Art Institute of Chicago offers masterpieces from ancient to ultramodern, and cultural institutions cover everything from famous historical events to current issues. And, don’t miss the International Museum of Surgical Science.

© Choose Chicago

Theater and performing arts

Soak up story lines, take in dazzling sights and sounds, journey through fairy tale wonderlands, and laugh or cry until it hurts. On any given night, Chicago’s 200+ theaters present everything from Broadway world premieres to edgy original plays. Beyond theater are renowned dance companies, opera that will make you want to take up singing lessons, and the Chicago Symphony Orchestra, a musical force of over 100 talented musicians.

Music and comedy

Chicago is famous for legendary blues and jazz, heard nightly in venues throughout the city. Chicago’s music scene can also offer up indie, hip-hop, electronic, or just plain rock n’ roll. Whatever is on your iPod^® is also in Chicago. If you like to laugh, you’ll be in the right place. Chicago’s comedy scene launched the careers of John Belushi, Steve Carrell, Stephen Colbert, Tina Fey, and many others. From traditional stand-up to competitive improv, you can find it in Chicago.

Find what interests you at ChooseChicago.com. The site has links for finding things to do, trip planning, and scoring some deals. Download the Choose Chicago app to access information and maps, stay on top of the weather, and more.

CHEST 2013, taking place October 26-31, is your connection to education opportunities in pulmonary, critical care, and sleep medicine. Cutting-edge sessions and the community of innovative problem-solvers in attendance will energize and inspire your patient care and the clinical decisions you make. Register by August 30 to save. Learn more at chestmeeting.chestnet.org.

You could spend a lifetime exploring Chicago’s unique arts, culture, and entertainment. But, since you’ll likely be in town for just a short time, here are some great places to start.

Museums, galleries, and exhibitions

From the bottom of the sea up to the stars, Chicago has it all on display. Start at the famous Museum Campus along Lake Michigan, where you’ll find three world-renowned museums: The Adler Planetarium & Astronomy Museum, The Field Museum, and The Shedd Aquarium. For art lovers, the Art Institute of Chicago offers masterpieces from ancient to ultramodern, and cultural institutions cover everything from famous historical events to current issues. And, don’t miss the International Museum of Surgical Science.

© Choose Chicago

Theater and performing arts

Soak up story lines, take in dazzling sights and sounds, journey through fairy tale wonderlands, and laugh or cry until it hurts. On any given night, Chicago’s 200+ theaters present everything from Broadway world premieres to edgy original plays. Beyond theater are renowned dance companies, opera that will make you want to take up singing lessons, and the Chicago Symphony Orchestra, a musical force of over 100 talented musicians.

Music and comedy

Chicago is famous for legendary blues and jazz, heard nightly in venues throughout the city. Chicago’s music scene can also offer up indie, hip-hop, electronic, or just plain rock n’ roll. Whatever is on your iPod^® is also in Chicago. If you like to laugh, you’ll be in the right place. Chicago’s comedy scene launched the careers of John Belushi, Steve Carrell, Stephen Colbert, Tina Fey, and many others. From traditional stand-up to competitive improv, you can find it in Chicago.

Find what interests you at ChooseChicago.com. The site has links for finding things to do, trip planning, and scoring some deals. Download the Choose Chicago app to access information and maps, stay on top of the weather, and more.

CHEST 2013, taking place October 26-31, is your connection to education opportunities in pulmonary, critical care, and sleep medicine. Cutting-edge sessions and the community of innovative problem-solvers in attendance will energize and inspire your patient care and the clinical decisions you make. Register by August 30 to save. Learn more at chestmeeting.chestnet.org.

While you may be prepared to enjoy Chicago’s iconic culinary staples – like deep dish pizza, hotdogs, and Italian beef – let out your inner foodie while you’re attending CHEST 2013, and explore a wide-range of Chicago’s culinary treasures.

Chicago’s dining scene features celebrity chefs, world-renowned restaurants, and ethnic dining from around the globe.

Want recommendations from those who know best? Here are some top picks from our favorite, local Chicagoans – ACCP staff!

• 312 Chicago – authentic Italian cuisine

• Au Cheval – hip take on diner food

• The Aviary – high tech cocktails

• BIN 36 – wine and contemporary, American cuisine

• Chicago Cut – steakhouse overlooking the Chicago River

• Chicago Q – modern, urban BBQ

• Girl & the Goat – fun foods from Top Chef Award Winner, Stephanie Izard

• RPM Italian - Giuliana and Bill Rancic’s Italian restaurant

• Sable – Top Chef contestant Heather Turhene’s American gastro-lounge

• Tortoise Club - American fare in a classic Chicago clubhouse

• Trencherman – contemporary, American food in a former Turkish bathhouse

Read more information about the staff’s top picks chestmeeting.chestnet.org.

If you’re set on getting some authentic Chicago eats, check out these classics:

Deep dish pizza:

• The Original Gino’s East of Chicago – deep dish slices in a unique, casual ambiance

• Lou Malnati’s Pizzeria – pizza pies in a family-owned restaurant

Chicago-style hot dogs:

• Portillo's – famous, dive eatery with jumbo franks

• Hot Doug’s – Chicago-style hot dogs made with every topping

Italian beef:

• Al’s Beef – located in little Italy, and claims to be the inventor of the sandwich

• Mr. Beef on Orleans – small dive with big flavors

If you’d like more recommendations or further reading about Chicago dining, explore all that Chicago has to offer at ChooseChicago.com. The site has a search engine where you can pick a food category (French, pizza, wine bar, etc.); certification (Green Restaurant, Zagat, etc.); and Chicago neighborhood.

While Chicago cuisine keeps your stomach satisfied, CHEST 2013 will be sure to fill your educational needs. CHEST 2013, taking place October 26-31, will serve up cutting-edge sessions and surround you with an international community of the best minds in pulmonary, critical care, and sleep medicine. Find everything you need to know to make the best clinical decisions and inspire your patient care. Learn more at chestmeeting.chestnet.org.

While you may be prepared to enjoy Chicago’s iconic culinary staples – like deep dish pizza, hotdogs, and Italian beef – let out your inner foodie while you’re attending CHEST 2013, and explore a wide-range of Chicago’s culinary treasures.

Chicago’s dining scene features celebrity chefs, world-renowned restaurants, and ethnic dining from around the globe.

Want recommendations from those who know best? Here are some top picks from our favorite, local Chicagoans – ACCP staff!

• 312 Chicago – authentic Italian cuisine

• Au Cheval – hip take on diner food

• The Aviary – high tech cocktails

• BIN 36 – wine and contemporary, American cuisine

• Chicago Cut – steakhouse overlooking the Chicago River

• Chicago Q – modern, urban BBQ

• Girl & the Goat – fun foods from Top Chef Award Winner, Stephanie Izard

• RPM Italian - Giuliana and Bill Rancic’s Italian restaurant

• Sable – Top Chef contestant Heather Turhene’s American gastro-lounge

• Tortoise Club - American fare in a classic Chicago clubhouse

• Trencherman – contemporary, American food in a former Turkish bathhouse

Read more information about the staff’s top picks chestmeeting.chestnet.org.

If you’re set on getting some authentic Chicago eats, check out these classics:

Deep dish pizza:

• The Original Gino’s East of Chicago – deep dish slices in a unique, casual ambiance

• Lou Malnati’s Pizzeria – pizza pies in a family-owned restaurant

Chicago-style hot dogs:

• Portillo's – famous, dive eatery with jumbo franks

• Hot Doug’s – Chicago-style hot dogs made with every topping

Italian beef:

• Al’s Beef – located in little Italy, and claims to be the inventor of the sandwich

• Mr. Beef on Orleans – small dive with big flavors

If you’d like more recommendations or further reading about Chicago dining, explore all that Chicago has to offer at ChooseChicago.com. The site has a search engine where you can pick a food category (French, pizza, wine bar, etc.); certification (Green Restaurant, Zagat, etc.); and Chicago neighborhood.

While Chicago cuisine keeps your stomach satisfied, CHEST 2013 will be sure to fill your educational needs. CHEST 2013, taking place October 26-31, will serve up cutting-edge sessions and surround you with an international community of the best minds in pulmonary, critical care, and sleep medicine. Find everything you need to know to make the best clinical decisions and inspire your patient care. Learn more at chestmeeting.chestnet.org.

While you may be prepared to enjoy Chicago’s iconic culinary staples – like deep dish pizza, hotdogs, and Italian beef – let out your inner foodie while you’re attending CHEST 2013, and explore a wide-range of Chicago’s culinary treasures.

Chicago’s dining scene features celebrity chefs, world-renowned restaurants, and ethnic dining from around the globe.

Want recommendations from those who know best? Here are some top picks from our favorite, local Chicagoans – ACCP staff!

• 312 Chicago – authentic Italian cuisine

• Au Cheval – hip take on diner food

• The Aviary – high tech cocktails

• BIN 36 – wine and contemporary, American cuisine

• Chicago Cut – steakhouse overlooking the Chicago River

• Chicago Q – modern, urban BBQ

• Girl & the Goat – fun foods from Top Chef Award Winner, Stephanie Izard

• RPM Italian - Giuliana and Bill Rancic’s Italian restaurant

• Sable – Top Chef contestant Heather Turhene’s American gastro-lounge

• Tortoise Club - American fare in a classic Chicago clubhouse

• Trencherman – contemporary, American food in a former Turkish bathhouse

Read more information about the staff’s top picks chestmeeting.chestnet.org.

If you’re set on getting some authentic Chicago eats, check out these classics:

Deep dish pizza:

• The Original Gino’s East of Chicago – deep dish slices in a unique, casual ambiance

• Lou Malnati’s Pizzeria – pizza pies in a family-owned restaurant

Chicago-style hot dogs:

• Portillo's – famous, dive eatery with jumbo franks

• Hot Doug’s – Chicago-style hot dogs made with every topping

Italian beef:

• Al’s Beef – located in little Italy, and claims to be the inventor of the sandwich

• Mr. Beef on Orleans – small dive with big flavors

If you’d like more recommendations or further reading about Chicago dining, explore all that Chicago has to offer at ChooseChicago.com. The site has a search engine where you can pick a food category (French, pizza, wine bar, etc.); certification (Green Restaurant, Zagat, etc.); and Chicago neighborhood.

While Chicago cuisine keeps your stomach satisfied, CHEST 2013 will be sure to fill your educational needs. CHEST 2013, taking place October 26-31, will serve up cutting-edge sessions and surround you with an international community of the best minds in pulmonary, critical care, and sleep medicine. Find everything you need to know to make the best clinical decisions and inspire your patient care. Learn more at chestmeeting.chestnet.org.

Palliative and End-of-Life Care

Telemedicine as a tool for early family conferences in critically ill patients transferring to a tertiary care center

Evidence suggests that early palliative care consultations in critically ill patients may be associated with reduced health-care costs while improving family satisfaction. However, critically ill patients at smaller rural hospitals who are often transferred to tertiary care center (TCC) ICUs are often not able to participate in discussions regarding disease processes, prognosis, goals of care, and shared decision making until after they have been transferred. There is a gap in the standard of care related to early communication in this particular group of critically ill patients.

Telemedicine is a tool that we are using to provide family members and treatment teams the opportunity to participate in early family conferences and/or palliative care consultations prior to a patient transferring to a tertiary care center.

We conducted a small retrospective study of these telemedicine family conferences that showed 64% of patients did transfer to a TCC; however, ultimately 58% transferred back to the referring hospital for end of life care. We have also conducted a prospective qualitative study on the experience of participants of these conferences. Family members and clinicians have responded favorably to this form of communication, and we have created a structured intervention for use during these discussions.

We believe this telemedicine intervention will increase family satisfaction, decrease symptoms of posttraumatic stress disorder and anxiety among family members, and align care with patients’ wishes. In order to investigate this further, we are currently conducting a prospective comparative study of a structured telemedicine family conference intervention vs conference conducted after transfer.

Prema R., Menon, MD

Steering Committee Member

Sleep Medicine

AGuide guide to Sleep at CHEST 2013

I hope that you are all gearing up for our meeting this fall in Chicago; as always, the Program Committee has arranged a fantastic meeting with a diverse program, but I wanted to point out a couple of agenda items in the sleep curriculum that I thought would be worth highlighting.

Our postgraduate course on Saturday, October 26, was initially intended as a board review, before the ABIM saw fit to move up the examination date. As a result, this course will instead be a year-in-review, covering the best of the literature over the last 12 months; the session will also be supplemented by the use of an audience response system, allowing the audience to play along and show their knowledge of the newest developments in sleep medicine.

There is a ridiculous number of great sessions on Sunday, including "Management of Insomnia in 2013," developed based on results from our survey in the spring; this session will include a brief primer on cognitive behavioral therapy. Later that day will be one of our NetWork highlights, "Highly Controversial Topics in Sleep Medicine," with discussions on the growing use of sodium oxybate for insomnia and the role of modafinil for cognitive enhancement.

In the afternoon, Dr. Mark Rosekind, member of the National Transportation Safety Board, will be highlighting a session on sleep medicine and transportation safety. The day will be capped off by an evening session led by our NetWork Vice Chair, who will be orchestrating a panel discussion on the future of sleep medicine.

Attendance at Monday’s NetWork Open Forum is a must for anyone wanting to get more involved in the Sleep NetWork. The session will offer a chance to meet with NetWork leadership and to hear about the current activities and priorities of the Steering Committee. We are almost always looking for volunteers for one or more of our ongoing projects; attending the session ensures that you can both sign up and express your interest in person! In addition, you get to hear a great lecture, this year from Dr. Fred Turek.

The rest of the meeting is similarly packed; Tuesday will feature a panel discussion on sleep deprivation and the restriction of resident work hours. Wednesday houses our second NetWork highlight, "Intermittent Hypoxia and OSA Comorbidity," which may make many of us rethink our focus on the apnea-hypopnea index as the prime target for therapy of sleep-disordered breathing. Lastly, Thursday will feature a 4-hour symposium, "Sleep Medicine in 2013," highlighted by the debut of the College’s newest game show, "Who Wants to be a Somnologist?" with prizes for the winners.

For all of these reasons, 2013 is looking to be a spectacular year for sleep medicine education at CHEST, and there are many more sessions that I haven’t enough space to highlight. I sincerely hope that you will join us in Chicago and come by and say "hi" at the NetWork Forum!

Dr. David Schulman, FCCP

Chair

Palliative and End-of-Life Care

Telemedicine as a tool for early family conferences in critically ill patients transferring to a tertiary care center

Evidence suggests that early palliative care consultations in critically ill patients may be associated with reduced health-care costs while improving family satisfaction. However, critically ill patients at smaller rural hospitals who are often transferred to tertiary care center (TCC) ICUs are often not able to participate in discussions regarding disease processes, prognosis, goals of care, and shared decision making until after they have been transferred. There is a gap in the standard of care related to early communication in this particular group of critically ill patients.

Telemedicine is a tool that we are using to provide family members and treatment teams the opportunity to participate in early family conferences and/or palliative care consultations prior to a patient transferring to a tertiary care center.

We conducted a small retrospective study of these telemedicine family conferences that showed 64% of patients did transfer to a TCC; however, ultimately 58% transferred back to the referring hospital for end of life care. We have also conducted a prospective qualitative study on the experience of participants of these conferences. Family members and clinicians have responded favorably to this form of communication, and we have created a structured intervention for use during these discussions.

We believe this telemedicine intervention will increase family satisfaction, decrease symptoms of posttraumatic stress disorder and anxiety among family members, and align care with patients’ wishes. In order to investigate this further, we are currently conducting a prospective comparative study of a structured telemedicine family conference intervention vs conference conducted after transfer.

Prema R., Menon, MD

Steering Committee Member

Sleep Medicine

AGuide guide to Sleep at CHEST 2013

I hope that you are all gearing up for our meeting this fall in Chicago; as always, the Program Committee has arranged a fantastic meeting with a diverse program, but I wanted to point out a couple of agenda items in the sleep curriculum that I thought would be worth highlighting.

Our postgraduate course on Saturday, October 26, was initially intended as a board review, before the ABIM saw fit to move up the examination date. As a result, this course will instead be a year-in-review, covering the best of the literature over the last 12 months; the session will also be supplemented by the use of an audience response system, allowing the audience to play along and show their knowledge of the newest developments in sleep medicine.

There is a ridiculous number of great sessions on Sunday, including "Management of Insomnia in 2013," developed based on results from our survey in the spring; this session will include a brief primer on cognitive behavioral therapy. Later that day will be one of our NetWork highlights, "Highly Controversial Topics in Sleep Medicine," with discussions on the growing use of sodium oxybate for insomnia and the role of modafinil for cognitive enhancement.

In the afternoon, Dr. Mark Rosekind, member of the National Transportation Safety Board, will be highlighting a session on sleep medicine and transportation safety. The day will be capped off by an evening session led by our NetWork Vice Chair, who will be orchestrating a panel discussion on the future of sleep medicine.

Attendance at Monday’s NetWork Open Forum is a must for anyone wanting to get more involved in the Sleep NetWork. The session will offer a chance to meet with NetWork leadership and to hear about the current activities and priorities of the Steering Committee. We are almost always looking for volunteers for one or more of our ongoing projects; attending the session ensures that you can both sign up and express your interest in person! In addition, you get to hear a great lecture, this year from Dr. Fred Turek.

The rest of the meeting is similarly packed; Tuesday will feature a panel discussion on sleep deprivation and the restriction of resident work hours. Wednesday houses our second NetWork highlight, "Intermittent Hypoxia and OSA Comorbidity," which may make many of us rethink our focus on the apnea-hypopnea index as the prime target for therapy of sleep-disordered breathing. Lastly, Thursday will feature a 4-hour symposium, "Sleep Medicine in 2013," highlighted by the debut of the College’s newest game show, "Who Wants to be a Somnologist?" with prizes for the winners.

For all of these reasons, 2013 is looking to be a spectacular year for sleep medicine education at CHEST, and there are many more sessions that I haven’t enough space to highlight. I sincerely hope that you will join us in Chicago and come by and say "hi" at the NetWork Forum!

Dr. David Schulman, FCCP

Chair

Palliative and End-of-Life Care

Telemedicine as a tool for early family conferences in critically ill patients transferring to a tertiary care center

Evidence suggests that early palliative care consultations in critically ill patients may be associated with reduced health-care costs while improving family satisfaction. However, critically ill patients at smaller rural hospitals who are often transferred to tertiary care center (TCC) ICUs are often not able to participate in discussions regarding disease processes, prognosis, goals of care, and shared decision making until after they have been transferred. There is a gap in the standard of care related to early communication in this particular group of critically ill patients.

Telemedicine is a tool that we are using to provide family members and treatment teams the opportunity to participate in early family conferences and/or palliative care consultations prior to a patient transferring to a tertiary care center.

We conducted a small retrospective study of these telemedicine family conferences that showed 64% of patients did transfer to a TCC; however, ultimately 58% transferred back to the referring hospital for end of life care. We have also conducted a prospective qualitative study on the experience of participants of these conferences. Family members and clinicians have responded favorably to this form of communication, and we have created a structured intervention for use during these discussions.

We believe this telemedicine intervention will increase family satisfaction, decrease symptoms of posttraumatic stress disorder and anxiety among family members, and align care with patients’ wishes. In order to investigate this further, we are currently conducting a prospective comparative study of a structured telemedicine family conference intervention vs conference conducted after transfer.

Prema R., Menon, MD

Steering Committee Member

Sleep Medicine

AGuide guide to Sleep at CHEST 2013

I hope that you are all gearing up for our meeting this fall in Chicago; as always, the Program Committee has arranged a fantastic meeting with a diverse program, but I wanted to point out a couple of agenda items in the sleep curriculum that I thought would be worth highlighting.

Our postgraduate course on Saturday, October 26, was initially intended as a board review, before the ABIM saw fit to move up the examination date. As a result, this course will instead be a year-in-review, covering the best of the literature over the last 12 months; the session will also be supplemented by the use of an audience response system, allowing the audience to play along and show their knowledge of the newest developments in sleep medicine.

There is a ridiculous number of great sessions on Sunday, including "Management of Insomnia in 2013," developed based on results from our survey in the spring; this session will include a brief primer on cognitive behavioral therapy. Later that day will be one of our NetWork highlights, "Highly Controversial Topics in Sleep Medicine," with discussions on the growing use of sodium oxybate for insomnia and the role of modafinil for cognitive enhancement.

In the afternoon, Dr. Mark Rosekind, member of the National Transportation Safety Board, will be highlighting a session on sleep medicine and transportation safety. The day will be capped off by an evening session led by our NetWork Vice Chair, who will be orchestrating a panel discussion on the future of sleep medicine.

Attendance at Monday’s NetWork Open Forum is a must for anyone wanting to get more involved in the Sleep NetWork. The session will offer a chance to meet with NetWork leadership and to hear about the current activities and priorities of the Steering Committee. We are almost always looking for volunteers for one or more of our ongoing projects; attending the session ensures that you can both sign up and express your interest in person! In addition, you get to hear a great lecture, this year from Dr. Fred Turek.

The rest of the meeting is similarly packed; Tuesday will feature a panel discussion on sleep deprivation and the restriction of resident work hours. Wednesday houses our second NetWork highlight, "Intermittent Hypoxia and OSA Comorbidity," which may make many of us rethink our focus on the apnea-hypopnea index as the prime target for therapy of sleep-disordered breathing. Lastly, Thursday will feature a 4-hour symposium, "Sleep Medicine in 2013," highlighted by the debut of the College’s newest game show, "Who Wants to be a Somnologist?" with prizes for the winners.

For all of these reasons, 2013 is looking to be a spectacular year for sleep medicine education at CHEST, and there are many more sessions that I haven’t enough space to highlight. I sincerely hope that you will join us in Chicago and come by and say "hi" at the NetWork Forum!

Dr. David Schulman, FCCP

Chair