• Thursday, April 16th
  • Friday, April 17th
  • Saturday, April 18th
  • Co-Developed Symposia
1230 – 1330

CTS Annual General Meeting

CTS members are invited to take part in CTS’ Annual General Meeting over lunch. The CTS President and Treasurer will present their annual reports and members will vote for a new Executive Committee secretary and ratify appointments to the CTS Board of Directors. There will be ample time for questions and answers and the meeting will conclude in time for members to join the CRC Opening Plenary. Prospective members are also invited to attend to learn more about the CTS.

For more information, please contact: Janet Sutherland, CTS Executive Director, 613-235-6650, ext. 120 |  jsutherland@cts-sct.ca

1400 - 1500

Plenary Sessions

Welcome and Opening Remarks

Opening remarks by Dr. Dina Brooks and Dr. John Granton – CTS Board of Directors

Genetic Testing in Adult and Pediatric Lung Diseases: Towards Personalized Pulmonary Medicine

Dr. Benjamin Raby, Boston Children’s Hospital, Harvard University, Boston, MA (USA)

The indications for genetic testing in pulmonary medicine are rapidly increasing. More than 100 genes have been identified that harbour highly penetrant mutations that cause pulmonary disease, including many for which their clinical recognition would impact disease management strategies, including therapeutic indications. In this session, we will review the current state of clinical pulmonary genetics and demonstrate the utility of genetic diagnostics – including gene sequencing and epigenetic assays – in the care of both children and adults with disorders of the respiratory system. We will also review the current limitations of testing, the merits of a sequence-first approach, and the implications of a genetic pulmonary diagnosis for both patients and their relatives.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Define the spectrum of respiratory disorders for which genetic testing may be warranted and beneficial;
  • Understand the limitations of current technologies and genome analysis approaches; and
  • Recognize the importance of the patient as a sentinel and the potential need for outreach to other at-risk family members.
Dr. Benjamin Raby

Dr. Benjamin Raby is the Leila and Irving Perlmutter Professor of Pediatrics and Chief of the Division of Pulmonary Medicine at Boston Children’s Hospital and the founder and director of the Brigham and Women’s Hospital Pulmonary Genetics Center. He obtained his medical degree and completed his residency and fellowship training in pulmonary medicine from McGill Medical School. He is recognized as an expert on the genetics and genomics of asthma and in the integration of genetic diagnostics in the clinical practice of pulmonary medicine.

1500 – 1530
1530 – 1730

Plenary Sessions

Big Data for the Lung Health Specialist

Dr. Andrea Gershon, University of Toronto, Toronto, ON

Artificial intelligence (AI) has the potential to change the delivery of health care. It builds on technology such as decision support and machine learning. All use Big Data. This presentation will review what these terms mean, discuss the promise of AI, point out its limitation, and present what new innovative work is happening with big data in lung health today.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Discuss what are artificial intelligence and machine learning;
  • Understand the potential of AI in healthcare; and
  • Understand the limitations of machine learning and big data in respirology.
Dr. Andrea Gershon

Dr. Andrea Gershon is an Associate Professor at the University of Toronto, Scientist and Respirologist at the Sunnybrook Health Sciences Centre and a Canadian Institutes for Health Research Investigator. Her award-winning research investigates health outcomes, health services, and drug safety and effectiveness in individuals with respiratory disease. Her research and knowledge translation program uses ‘Big Data’ to learn from the real-world experiences of people with lung disease, with a focus on vulnerable groups. She has published over 160 peer-reviewed articles and her findings inform clinical care, government and non-profit organizations.

Pro/Con Debate: Treatment of Mild Asthma in Adults and Adolescents: On Demand ICS/Formoterol or Regular ICS + SABA?

Dr. Louis-Philippe Boulet, Université Laval, Québec, QC
Dr. Patrick Mitchell, University of Calgary, AB

Session Description and Learning Objectives – Dr. Louis-Phillipe Boulet
This talk will discuss the agreements in favour of ICS/SABA (Formoterol) on demand in mild asthma as in the GINA report.

At the end of this presentation, attendees will be able to:

  • Understand the historical background of GINA recommendations on mild to very mild asthma;
  • Know the current evidence supporting the above recommendations; and
  • Understand the limitations of these recommendations and need for additional studies.

Session Description and Learning Objectives  Dr. Patrick Mitchell
The preponderance of the evidence is that regular ICS (alone or in combination with formoterol) is the treatment of choice for mild asthma. My side of the debate shall rationally and empirically highlight that whilst superior to SABA usage in isolation it is inferior to regular ICS with a SABA as a reliver. The belief that as needed ICS/LABA to treat mild asthma is superior to low dose regular ICS as is evidenced by the clinical trials data and real world evidence reflect that this is just a cover up for poor compliance and not in fact a superior treatment.

At the end of this presentation, attendees will be able to:

  • Demonstrate that ICS is the backbone of asthma therapy;
  • Demonstrate that by tackling compliance, asthma outcomes would be improved; and
  • Refute the one-size-fits-all hypothesis for treating step 1 and 2 mild asthma.
Dr. Louis-Philippe Boulet

Dr. Louis-Philippe Boulet is a respirologist at the Institut de cardiologie et de pneumologie de Québec (Quebec Heart and Lung Institute). He is a professor of medicine at Laval University, where he holds a chair in knowledge translation education and prevention in respiratory and cardiorespiratory health. He is a past president of the Canadian Thoracic Society (CTS), is the current chair of the Board of Directors of the Global Initiative for Asthma (GINA), and president of InterAsma, the Global Asthma Association. He has written more than 650 medical publications, including 410 peer-reviewed manuscripts, 43 book chapters and edited/authored 17 medical books.

Dr. Patrick Mitchell

Dr. Patrick Mitchell joined the University of Calgary’s respiratory team in July 2016. He trained as a specialist in respiratory and internal medicine in Ireland. He undertook a two-year clinical and research fellowship at McMaster University under Professor Paul O’Byrne. This encompassed translational research in airway inflammation and servicing both general respiratory and airway inflammation clinics. Dr. Mitchell also completed a two-year Medical Doctorate thesis on the role of IL-33 in allergic asthma. He has been appointed director of the Asthma and COPD program at the Rockyview Hospital. He has authored numerous peer -reviewed research manuscripts and co-authored a book chapter on asthma. His clinic interests are asthma, COPD, chronic eosinophilic airways disease, autoimmune pulmonary diseases, sarcoidosis, pulmonary thromboembolic disease, and airways disease in pregnancy.

1730 – 1900
0700 – 0815

Optional Breakfast Session

2nd Annual CTS Mastermind Challenge: A Team-based Competition Among Respirology Fellows

Masters of Ceremonies:
Dr. Gerard Cox
Dr. David McCormack

This session will feature a trivia-style competition between PGY-4/5 trainees from respirology programs across Canada. Their knowledge will be “pushed to the limit” in what promises to be a highly entertaining session!

Learning Objectives
During this session, attendees will:

  • Participate in a ‘trivia-style’ competition;
  • Be tested on their knowledge related to both common and uncommon clinical pulmonary cases; and
  • Be expected to cheer on trainees from their respective programs.
0730 – 0830
0830 - 1000

Plenary Session & Award Presentations

CIHR-ICRH/CTS Distinguished Lecture in Respiratory Sciences: COPD in the Era of Precision Health

The ICRH and CTS established the Distinguished Lecture in Respiratory Sciences Award in 2006 to honour scholars in the respiratory field. Nominations are solicited from the respiratory research community and assessed against the following criteria:

  • impact of the nominee’s research on respiratory sciences in Canada and the extent to which the nominee has contributed significantly to the advancement of respiratory sciences in Canada over the last ten years;
  • relevance/application/impact of nominee’s research to a clinical setting; and
  • demonstrated strength and reputation of the nominee in the field of respiratory sciences in Canada.

It is with great pleasure that CIHR-ICRH and CTS announce that the 2020 Distinguished Lecture in Respiratory Sciences has been awarded to Dr. Don Sin from the University of British Columbia.

Session Description
Although there is a dearth of disease-modifying therapies for COPD currently, the omics technology, coupled with incredible improvements in in vivo phenotyping abilities, is poised to revolutionize the assessment and management of patients with COPD. These tools can accurately characterize patients and enable development of “personalized” treatment of patients. This talk will provide some examples of where COPD treatment has already moved from the “average” patient to the “individual” patient and discuss future strategies to accelerate precision health for millions of Canadians affected by this disease.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Define precision health in COPD;
  • Cite specific examples of “precision health” technologies/treatments in COPD; and
  • Describe the role of biomarkers in enabling precision health.
Dr. Don Sin

Dr. Don D. Sin is the Director of the Centre for Heart Lung Innovation (HLI) and a Professor of Medicine at the University of British Columbia (UBC) in Vancouver, Canada. He holds a Tier 1 Canada Research Chair in COPD and the De Lazzari Family Chair at HLI. He has published more than 500 peer-reviewed papers and has an H-index of 90. He has served on the Global initiative for Chronic Obstructive Lung Disease (GOLD) scientific committee since 2009 and is the Section Editor for the European Respiratory Journal and an editorial board member of the American Journal of Respiratory and Critical Care Medicine. He obtained his medical degree at the University of Alberta and completed his postdoctoral research fellowship at the University of Toronto. His research focus is using “omics” data to discover novel biomarkers of disease activity and new therapeutic targets to reduce hospitalization and mortality in patients with COPD.

1000 – 1030
1030 – 1200

Concurrent Sessions

CTS Guidelines Update

Leading respiratory experts will present the latest evidence-based clinical practice updates from CTS.

2020 Asthma Guideline Update: Is There Anything New in the Management of “Mild” Asthma?

Dr. Connie Yang, BC Children’s Hospital, Vancouver, BC

This presentation will review the latest CTS Guideline on the Management of Mild Asthma in Children and Adults. It will discuss whether ICS-formoterol should be used instead of short acting beta agonists and whether ICS-formoterol as needed should be used instead of daily inhaled corticosteroids.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Understand the evidence for ICS-formoterol PRN versus SABA in mild intermittent asthma; and
  • Understand the evidence for ICS-formoterol PRN versus daily inhaled corticosteroids in mild persistent asthma.
Dr. Connie Yang

Dr. Connie Yang is a pediatric respirologist at BC Children’s Hospital in Vancouver where she is the director of the Pediatric Asthma Program. She is currently the co-chair of the Asthma Assembly and led the development of the latest CTS Asthma Guideline on the Management of Very Mild and Mild Asthma. She is also the president of the Respiratory Health section of the Canadian Pediatric Society where she helps disseminate unified information on pediatric respiratory health topics.

HMV in Patients with Stable COPD

Dr. Marta Kaminska, McGill University Health Centre, Montréal, QC
Dr. François Maltais, Quebec Heart and Lung Institute, Québec, QC

We will first discuss the current (2011) Canadian recommendation regarding the use of home mechanical ventilation in patients with stable COPD. We will then review the recent literature concerning the use of home mechanical ventilation in patients with stable COPD and present the new Canadian recommendations for the use of home mechanical ventilation.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Describe the expected benefits of home mechanical ventilation in stable COPD;
  • Describe the 2020 Canadian recommendations for the use of home mechanical ventilation in stable COPD; and
  • Describe how to prescribe and adjust home mechanical ventilation in stable COPD.
Dr. Marta Kaminska

Dr. Marta Kaminska is an Associate Professor and a sleep-trained pulmonologist in the Respiratory Division of the McGill University Health Centre (MUHC). She is a Scientist at the Research Institute of the MUHC and member of the Respiratory Epidemiology and Clinical Research Unit. She is a Medical Director of the Quebec National Program for Home Ventilatory Assistance. Her research interests are sleep-disordered breathing in neurodegenerative disorders, neuromuscular disorders and COPD, as well as long-term non-invasive ventilation.

Dr. Francois Maltais

Dr. François Maltais is a pulmonologist at the Institut universitaire de cardiologie et de pneumologie de Québec where he is the current chief of the pulmonary and thoracic surgery department. He is a professor at the Faculté de médecine at Université Laval, and in 2009, he became the research chair on COPD at the same university. His major interests include the physiopathology of exercise intolerance in chronic obstructive pulmonary disease (COPD) and pulmonary rehabilitation. His research, which is supported by the Canadian Institutes of Health Research (CIHR), Canada’s premier funding agency for health research, is focused on understanding the mechanism of limb muscle dysfunction in COPD. In 2006, he won the Romain Pauwels Award and in 2016, the COPD Gold Medal, both given by the European Respiratory Society in recognition of his outstanding contribution to the field of COPD. Dr. Maltais has authored or co-authored 300 scientific publications, and he regularly speaks at international conferences.

Cardiopulmonary Exercise Testing (CPET) Workshop

The Methodology and Interpretation of Inspiratory Capacity Manoeuvres and Flow Volume Loops during CPET

Dr. Jordan A. Guenette, University of British Columbia, Vancouver, BC

Inspiratory capacity manoeuvres and flow-volume loops are increasingly being used to characterize ventilatory limitations during cardiopulmonary exercise testing (CPET). Accurately measuring inspiratory capacity is essential when examining dynamic hyperinflation and if using flow-volume loops to measure expiratory flow limitation and other ventilatory abnormalities during exercise. This presentation will discuss key methodological factors to maximize the accuracy of these measurements and to ensure correct CPET interpretation.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Determine how to accurately measure, analyze and interpret inspiratory capacity manoeuvres during CPET; and
  • Critically evaluate the factors involved in generating exercise flow-volume loops and determine how key errors can affect your interpretation.
Dr. Jordan Guenette

Dr. Jordan A. Guenette is an Associate Professor in the Faculty of Medicine at the University of British Columbia and is the Associate Director of the Centre for Heart Lung Innovation at St. Paul’s Hospital. His research program examines the mechanisms and management of exercise intolerance and dyspnoea in athletes and patients with chronic cardiopulmonary conditions.

Exposing Critical Ventilatory Constraints during CPET: Case Studies

Dr. Denis O’Donnell, Queen’s University, Kingston, ON

Cardiopulmonary exercise testing is often performed to explore mechanisms of dyspnea and exercise limitation in individual patients presenting with these symptoms. Abnormalities in ventilatory mechanics often contribute to these symptoms and can be exposed by the stress of exercise even when resting pulmonary function tests are normal. This presentation will outline the main measurements of dynamic ventilatory mechanics based on ventilatory responses, breathing pattern, operating lung volumes, and flow volume loop analysis during incremental exercise testing. A number of case studies will be presented to illustrate how this simple approach can provide useful clinical information on the dynamic mechanical constraints on ventilation that might exist in symptomatic patients. The main objective is to enlighten the interpreter as to the major physiological contributors to exercise intolerance in individual patients.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Understand the value of operating lung volumes, breathing pattern, flow volume loops and dyspnea ratings in non-invasive assessments of respiratory mechanics during exercise;
  • Understand the connections between abnormalities of ventilatory mechanics during exercise, exercise limitation and intolerable symptoms; and
  • Know how this approach allows refinement in the clinical evaluation of symptomatic patients with pulmonary disease beyond traditional resting pulmonary function tests.
Dr. Denis O’Donnell

Dr. Denis O’Donnell is a Professor of Medicine at Queen’s University, Kingston, Ontario. His research is focused on clinical integrative physiology in chronic lung diseases, including the physiological mechanisms of dyspnea and exercise limitation. At Queen’s, he assembled a highly productive research team, which has been successful over the past 30 years, contributing more than 360 papers and 50 chapters to date. The Respiratory Investigation Unit at Queen’s enjoys international recognition for scientific excellence and training in clinical physiology. Dr. O’Donnell has received numerous national and international awards, including the Lifetime Achievement Award from the European Respiratory Society in 2019, in recognition of his contribution to research and education in respiratory diseases.

Clinical Usefulness of Exercise Ventilatory Inefficiency: Case Studies

Dr. J. Alberto Neder, Queen’s University, Kingston, ON

In this session, Dr. Neder will present selected cases in which the relationship between ventilation and carbon dioxide output during incremental exercise provided unique insights into the mechanisms and consequences of exertional dyspnea in different clinical scenarios.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Understand the physiological basis of ventilatory efficiency;
  • Recognize the different metrics of ventilatory efficiency and their potential to provide complementary information; and
  • Integrate measurements of ventilatory efficiency with other key CPET variables to maximize the yield of the test in answering clinically-relevant questions.
Dr. Alberto Neder

Dr. J. Alberto Neder is a Professor at the Division of Respirology, Department of Medicine, at Queen’s University in Kingston, Ontario. He is a clinician-scientist with a specific interest in clinical respiratory physiology applied to chronic cardiopulmonary diseases. Dr. Neder has authored over 200 peer-reviewed papers and several books and book chapters on respiratory and exercise physiology, pulmonary rehabilitation and integrated care in chronic respiratory diseases. He currently heads the Laboratory of Clinical Exercise Physiology at Kingston General Hospital and the Hotel Dieu Hospital’s Pulmonary Function Tests Laboratory.

Caregivers in Chronic Lung Disease Management

Caregivers’ Role in Living with Chronic Lung Disease

Dr. Alda Marques, University of Aveiro, Aveiro (Portugal)

This session will present the dynamic process of caregiving, differentiate the different types of caregiving, share the experiences and needs of those caring for a person with a chronic lung disease, provide state of the art information on informal caregiving in different chronic lung diseases, and approach pulmonary rehabilitation as a possible response to support the family. It will also identify possible gaps to be improved clinically and indicate future research avenues.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Understand the current state of the art in caregiving in chronic lung disease;
  • Identify the gaps for clinical improvement; and
  • Identify needs for future research.
Dr. Alda Marques

Dr. Alda Marques is a physiotherapist, currently working as a senior lecturer at School of Health Sciences (ESSUA) at the University of Aveiro, Portugal. She coordinates the LAB3R-Respiratory Research and Rehabilitation Laboratory at ESSUA. Her research interests are to: i) explore the effectiveness of delivering pulmonary rehabilitation; ii) improve the management of patients with chronic diseases and their families; and iii) develop/implement new measures or core outcome sets to be used clinically. She has vast experience in publishing, coordinating research projects and supervising students and is dedicated to improve the non-pharmacological management of patients with chronic diseases and their families.

Caring for the Caregiver: Self-compassion as an Approach to Foster Coping and Quality of Life

Dr. Donna Goodridge, University of Saskatchewan, Grasswood, SK

Family caregivers can face considerable stress when caring for a person with chronic illness. This can result in depression and anxiety, social isolation, lower levels of subjective well-being and poor physical health and lead to premature institutionalization of the person for whom care is provided. Caregiver overload (fatigue and burn-out), a sense of “role captivity”, adverse events and the quality of the relationship can contribute to caregiver burden. Mindfulness-based interventions, such as self-compassion, can buffer the stressors faced by caregivers through enhancement of internal coping resources.

This presentation will review current evidence on: a) caregiver burden and its implications in chronic respiratory illnesses; and b) the use of self-compassion to ameliorate caregiver burden. Findings from a 12-week app-based program designed to train and support caregivers to incorporate self-compassion into their daily lives will be discussed. Participants will be guided through one self-compassion exercise in this session.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Define caregiver burden and identify its common manifestations;
  • Describe the concept of self-compassion and the evidence supporting this approach; and
  • Understand how self-compassion might contribute to improved outcomes for caregivers of people with chronic respiratory illnesses.
Dr. Donna Goodridge

Dr. Donna Goodridge is a registered nurse, Professor in the Division of Respirology and Director of the Respiratory Research Centre at the University of Saskatchewan. Her research interests include health systems improvement for persons with chronic illnesses, health literacy and patient-oriented research. Dr. Goodridge has been involved with the Canadian Thoracic Society (CTS) and Canadian Respiratory Health Professionals since 2005. She is currently leading a provincial research priority setting partnership through the Respiratory Research Centre in collaboration with the James Lind Alliance (UK) to determine the research priorities of patients, families and clinicians related to obstructive sleep apnea.

Experiences of an Individual with COPD and Her Caregiver: Ann and Ray’s Story

Mrs. Ann Hawkins, Kitchener, ON
Mr. Ray Hawkins, Kitchener, ON

Ann and Ray truly have a great partnership in every way and look forward to helping a group of health care professionals understand what it is like to live with COPD (Ann) and what it means to live with and care for someone with this disease (Ray).

Learning Objectives
At the end of the session, participants will be able to:

  • Gain better understanding of the lived experiences of an individual with COPD;
  • Understand first-hand the experiences of a caregiver of an individual with COPD; and
  • Discuss the challenges and rewards of caregiving.
Mrs. Ann Hawkings

Mrs. Ann Hawkings was born in London, UK. She emigrated to Canada in 1966 with her husband and 3 children. She worked as a department manager for a large grocery store chain for nearly 30 years. Ann has had COPD for approximately 18 years, and it has been very well controlled. Since retiring she has facilitated a support group for people with COPD. In January she was prescribed with oxygen which has changed some of her life, but she is thankful for her husband and team of professionals.

Mr. Ray Hawkings

Mr. Ray Hawkings was born in London, UK. He served in the British Army (Queens Guards) for 12 years. He emigrated to Canada in 1966 with his wife and 3 children. He began his employment in Canada by selling life insurance and then working in sales for several food companies. At the age of 48 he joined the Ontario Ministry of Corrections and worked at the Guelph Correction Centre for 17 years before retiring. In January his wife (Ann) was prescribed with oxygen and he has been her caregiver since.

A Common Problem: How Do the Airways Digest Food? Duh?

Assessing Aspiration in Children: The Speech-Language Pathologist’s Perspective

Ms. Wendy Johannsen, Stollery Children’s Hospital, Edmonton, AB

This session will explain the difference between a feeding and a swallowing disorder and provide an overview of the indicators for possible swallowing dysfunction. The standard practice includes completing a clinical feeding and swallowing assessment with discussion as to why a clinical assessment alone may not be sufficient in identifying a possible swallowing dysfunction. The indicators for further instrumental assessment will be outlined. The best way to assess aspiration is by doing an instrumental assessment. The Videofluoroscopic Swallow Study (VFSS) and the Fiberoptic Endoscopic Evaluation of the Swallow (FEES) are two main ways for objectively assessing the swallow. The strengths and limitations of each with be reviewed.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Identify the signs and symptoms of possible swallowing dysfunction;
  • Understand the standards of management, the limitations of a clinical assessment and the indications for instrumental assessment; and
  • Recognize the advantages and limitations of the Videofluoroscopic Swallow Study (VFSS) vs. the Fiberoptic Endoscopic Evaluation of the Swallow (FEES).
Ms. Wendy Johannsen

Ms. Wendy Johannsen is a speech language pathologist who has been working in the area of pediatric dysphagia for the past 15 years. She has been working at the Stollery Children’s Hospital in Edmonton, Alberta for the past 12 years in the Outpatient Feeding and Swallowing Service. She was instrumental in the development of the two multidisciplinary specialty clinics – the Aspiration Clinic and the Aerodigestive Clinic, which she also coordinates.

Surgical Causes of Aspiration in Children and Management

Dr. Mathieu Bergeron, Centre hospitalier universitaire Sainte-Justine, Montréal, QC

This session will cover the causes, workup and management of surgical causes of dysphagia. These causes will include laryngeal cleft, tracheo-esophageal fistula and vocal fold immobility, and other less frequent causes. Investigations such as flexible endoscopic evaluation of swallowing (FEES) and bronchoscopy will also be discussed.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Name the surgical causes of dysphagia;
  • Understand the investigation of these causes; and
  • Summarize the management of surgical causes of dysphagia.
Dr. Mathieu Bergeron

Dr. Mathieu Bergeron is a pediatric otolaryngologist currently working at Sainte-Justine Hospital in Montréal, Québec. He recently completed his pediatric otolaryngology fellowship at Cincinnati Children’s Hospital Medical Center. He has a clinical interest in the management of pediatric aerodigestive disorders, dysphonia and persistent obstructive sleep apnea. His research interests included quality of life, voice and aerodigestive disorders and persistent sleep apnea.

An Update on Pulmonary Aspiration: The Pediatric Respirologist’s Perspective

Dr. Darryl J. Adamko, University of Saskatchewan, Saskatoon, SK

Children, especially young children, present with recurrent cough, bronchitis and pneumonitis. It is surprising how often this common problem is associated with pulmonary aspiration. While children with neurologic difficulty are expected to have pulmonary aspiration, there are many reasons why it also occurs in neurologically normal children. This lecture will update our understanding of the problem including new insights into pathophysiology, diagnosis and management.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Understand the causes of pulmonary aspiration and appreciate how common a problem it is;
  • Understand the difficulties in diagnosis; and
  • Understand management options and long-term outcomes depending on the clinical situation.
Dr. Darryl J. Adamko

Dr. Darryl J. Adamko is a pediatric pulmonary specialist with a strong bench research background after training at The Johns Hopkins University in Baltimore, Maryland (USA). He is professor of pediatric pulmonary medicine at the University of Saskatchewan where he is division head of respirology and pediatric research. Dr. Adamko’s research focuses on mechanisms of virus-induced asthma attacks and the development of a novel urine‐based diagnostic test for asthma using mass spectrometry.

Career Pathways and Physician Wellness

Physician Wellness: Staying Healthy, Coping Strategies and Resilience

Dr. Joy Albuquerque, Ontario Medical Association, Toronto, ON

Burnout is a serious issue in health care impacting all members of the health care team. This presentation will review the syndrome of burnout in the context of physician health. The impact of burnout on physicians correlates with personal and professional outcomes. Burnout is seen increasingly as a systems issue, a cultural issue associated with transformative changes in the delivery of health care, organizational strains and rising professional expectations. Yet there is reason to be optimistic for change, which includes wellness programs and initiatives to address engagement and satisfaction of health care providers while improving the bottom line, patient care. The hope is that participants will be more aware of personal stressors that may impact their health and wellbeing and be encouraged to use tools and consider skills discussed in this session.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Identify drivers of physician burnout and potential consequences;
  • Differentiate between the responsibilities of the health care system and those of the individual with regard to burnout; and
  • List several factors relevant to a personal resiliency strategy.
Dr. Joy Albuquerque

Dr. Joy Albuquerque is the Medical Director of the Ontario Medical Association’s physician health program. She completed her medical training in Manitoba, psychiatric training in Ottawa (1997) and, with an interest in mental health advocacy, a Master’s in philosophy (2007). Dr. Albuquerque’s role has evolved beyond the management of mental health conditions to expertise in the risk management of physicians and their work. She contributes regularly to medical education events and publications on topics related to physician health. Dr. Albuquerque practices at St. Michael’s Hospital and is an Assistant Professor at the University of Toronto.

Community vs Academia: What’s the Right Path for You?

Dr. Joy Albuquerque, Ontario Medical Association, Toronto, ON
Dr. M. Diane Lougheed, Queen’s University, Kingston, ON
Dr. Heather Racz, St. Mary’s General Hospital and London Health Sciences Centre, Kitchener, ON

Navigating career decisions can be challenging. Targeted at respirology fellows and staff respirologists, this session focuses on high impact strategies to manage your professional journey. Build a tool kit of resources, including mentors and advisors, who are right for you. Learn from an academic respirologist, a community respirologist and a physician wellness psychiatrist who have taken different professional pathways, including their decision criteria, the risks and the opportunities. The panel will invite audience participation with questions about their own career decisions.

Learning Objectives
At the end of the session, attendees will be able to:

  • Understand the differences between academic and community based Respirology practices
  • Explore how mentorship can impact your career/practice
  • Learn how to stay up to date and build research into your practice
Dr. Joy Albuquerque

Dr. Joy Albuquerque is the Medical Director of the Ontario Medical Association’s physician health program. She completed her medical training in Manitoba, psychiatric training in Ottawa (1997) and, with an interest in mental health advocacy, a Master’s in philosophy (2007). Dr. Albuquerque’s role has evolved beyond the management of mental health conditions to expertise in the risk management of physicians and their work. She contributes regularly to medical education events and publications on topics related to physician health. Dr. Albuquerque practices at St. Michael’s Hospital and is an Assistant Professor at the University of Toronto.

Dr. Diane Lougheed

Dr. M. Diane Lougheed is a Professor of Medicine, Biomedical and Molecular Sciences and Public Health Sciences, and Chair of the Division of Respirology at Queen’s University. She is the Director of the Kingston Health Sciences Centre Asthma Program and Research Unit. Dr. Lougheed obtained her medical degree from McMaster University where she also completed her Internal Medicine residency. She completed her Respirology fellowship and obtained a Master’s degree in Epidemiology at Queen’s University. Dr. Lougheed has authored over 80 peer-reviewed publications and 2 book chapters. Her research interests include asthma symptom perception, asthma epidemiology, work-related asthma and guidelines implementation.

Dr. Heather Racz

Dr. Heather Racz completed fellowships in both adult cystic fibrosis and sleep medicine. She is a community-based respirologist who splits her time between her respirology practice in Kitchener-Waterloo and the London Health Sciences Centre where she works in both the Adult CF Program and the Sleep Medicine Program.

1200 - 1330
1200 - 1330

CTS-CHEST Conjoint Session and Luncheon: Making an Occupational or Environmental Diagnosis as a Pulmonologist

Dr. Clayton T. Cowl, CHEST (American College of Chest Physicians), Rochester, MN (USA)

When an occupational or environmentally related diagnosis is made, it typically follows with administrative sequelae such as reporting requirements to regulatory agencies, specialized documentation for medicolegal purposes, and a unique language employed with these types of cases. This case-based presentation will feature a review of the basics in making an occupational or environmental diagnosis, provide tips to improve clinical documentation skills and suggestions on how to manage the administrative aspects of these cases from the pulmonary clinician’s perspective.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Recognize the importance of an expanded occupational and environmental history;
  • Understand some of the more common pitfalls made by clinicians in assessing work-related cases who may be unfamiliar with doing so; and
  • Recall strategies for separating the clinical versus administrative/legal aspects of care.
Dr. Clayton T. Cowl

Dr. Clayton T. Cowl is the Chair of the Division of Preventive, Occupational and Aerospace Medicine at Mayo Clinic in Rochester, Minnesota with a joint appointment in the Division of Pulmonary & Critical Care Medicine. Dr. Cowl has ongoing projects focused on respiratory physiology at altitude and environmental aspects of pulmonary disease. He has also conducted research in other areas of transportation medicine, such as safety issues in the commercial driving industry. Dr. Cowl is currently the Immediate Past-President of CHEST (American College of Chest Physicians) and is on the editorial boards of several medical journals.

1230 - 1330

CRHP Research Poster Adjudication

1330 - 1500

Concurrent Sessions

What’s New in COPD?

Quality Indicators for Pulmonary Rehabilitation

Dr. Gail Dechman, Dalhousie University, Halifax, NS

Quality indicators (QI) for pulmonary rehabilitation (PR) have been developed in Spain and the UK but QI are not easily transferable among countries. This presentation will describe the process and results of a project by a multidisciplinary working group of the CTS to develop QI for PR. The development process was based on the modified RAND Appropriateness Method that included a systematic review of the literature to identify candidate QI before they were sent for further refinement to a Delphi panel that included a patient representative. This process resulted in a comprehensive set of 56 QI and a shorter list of 14 core QI that can be used for evaluation and feedback to improve PR and patient outcomes. During this presentation, the audience will be engaged in discussion of the QI and the feasibility of their implementation in the context of PR in Canada.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Discuss the role of quality indicators to guide improvement of structure, processes and outcome in pulmonary rehabilitation;
  • Identify the 14 core quality indicators that describe the minimum requirements for pulmonary rehabilitation in Canada; and
  • Support the implementation of a national audit of pulmonary rehabilitation programs.
Dr. Gail Dechman

Dr. Gail Dechman is physiotherapist with over 30 years of experience working in pulmonary rehabilitation. She has worked clinically and taught across Canada and internationally. She holds academic positions in the Schools of Physiotherapy and Health and Human Performance at Dalhousie University and is an affiliate scientist in the Division of Respirology at the Nova Scotia Health Authority. Dr. Dechman chaired the CRHP Leadership Council from 2016-2018. Currently she co-chairs the COPD Assembly’s Steering Committee. Dr. Dechman is the first author on Quality indicators for pulmonary rehabilitation programs in Canada: A Canadian Thoracic Society expert working group report, published in 2019.

The Acute COPD Exacerbation Prediction Tool (ACCEPT): Development and External Validation of a Personalized Prediction Model

Mr. Amin Adibi, University of British Columbia, Vancouver, BC

Chronic Obstructive Pulmonary Disease (COPD) is characterised by symptoms of breathlessness and cough, which worsen acutely during exacerbations. COPD is known to be a heterogeneous disorder with large variations in the risk of exacerbation across patients. In clinical practice, a history of two or more exacerbations and one severe exacerbation per year is used to guide therapeutic choices for exacerbation prevention. However, this approach is clinically limited owing to significant heterogeneity in risk even within those who frequently exacerbate.

In this talk, we will discuss development and validation of a personalised clinical prediction model to predict frequency and severity of COPD exacerbations. Using data from three randomized trials, we show that simple clinical and demographic variables in aggregate can be used to predict the exacerbation risk with improved accuracy. We discuss the performance of the model in an independent external cohort, and explain, using case studies, its potential clinical applications.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Describe the importance of exacerbation risk prediction in clinical management of COPD;
  • Compare the performance of different clinical prediction models; and
  • Use the Acute COPD Exacerbation Prediction Tool (ACCEPT) to obtain individualized prediction of exacerbation rate and severity in clinical settings.
Mr. Amin Adibi

Mr. Amin Adibi is a bioengineer and a statistical research analyst at the Faculty of Pharmaceutical Sciences at the University of British Columbia, where he focuses on developing decision analytics and clinical prediction models for respiratory diseases.

The Site and Nature of Peripheral Airway Obstruction in Chronic Obstructive Pulmonary Disease (COPD)

Dr. James C. Hogg, UBC Heart Lung Innovation, Vancouver, BC

Earlier study by our group showed that the terminal bronchioles are reduced by approximately 90% in very severe (GOLD 4) COPD. In addition a subsequent study confirmed and substantially extended the observations in the initial report by showing patients with mild (GOLD 1) and moderate (GOLD 2) COPD have already lost approximately 30-40% of their terminal bronchioles. The purpose of this presentation is to show new experimental evidence that the reduction in terminal bronchiolar number in lungs affected by COPD takes place in regions of microscopic emphysematous destruction confirmed and extended using a combination of microCT, quantitative histology , and gene expression profiling.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Identify the site of small airway obstruction in COPD;
  • Improve their understanding of the pathology of small airway obstruction; and
  • Appreciate why small airway disease can accumulate without being noticed by either the patient or the physician responsible for their care.
Dr. James C. Hogg

Dr. James C. Hogg has been on the staff of the University of British Columbia located at St. Paul’s Hospital since 1977 and is currently an emeritus professor of pathology at UBC. He earned his medical degree from the University of Manitoba in 1962, a PhD in experimental medicine from McGill University in 1969, and completed residency training in anatomic pathology at the Massachusetts General Hospital and McGill University. Dr. Hogg maintains an active research program focused on the inflammatory process in the lung, with particular reference to the structure and function of the lungs in COPD.

CTS-ERS Conjoint Session: Pulmonary Rehabilitation, It Truly Makes the Difference

Dr. Thierry Troosters, European Respiratory Society  and KU Leuven, Lausanne, Switzerland and Leuven, Belgium

Pulmonary rehabilitation is a treatment that is largely underused yet in several subgroups of patients with respiratory disease, it is the best intervention we have to obtain true improvements to patients’ lives. This presentation will provide an overview of the evidence as well as main barriers to implementation. We will discuss how we can make an attempt to move the field forward.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Summarize the evidence of state-of-the-science rehabilitation;
  • Identify patients where rehabilitation must be started; and
  • Identify what needs to be modified in a health care system to increase uptake for rehabilitation.
Prof. Thierry Troosters

Prof. Thierry Troosters studied physiotherapy and rehabilitation sciences at the Katholieke Universiteit Leuven where he also conducted his PhD work, guided by Professor Marc Decramer and Professor Rik Gosselink. A one-year post-doctoral stay at the Hospital Clinic in Barcelona, funded through a long-term fellowship of the European Respiratory Society, further guided his research career.

Along with the Respiratory Division at the University Hospitals in Leuven, he investigates the devastating non-respiratory consequences lung diseases, often induced by physical inactivity or exacerbations of COPD. With his group he is also looking at optimizing exercise training strategies for patients with lung disease as well as strategies to enhance physical activity.

With their laboratory they pioneered on investigating the impact of physical inactivity patients with COPD and other respiratory conditions including cystic fibrosis and lung transplantation. They showed that patients with COPD become inactive already early in the disease even before the diagnosis of COPD is established. Prof. Troosters led the IMI-JU consortium PROactive to develop a sensitive Patient Reported Outcome tool to assess the dimensions of physical activity relevant to patients with COPD: PROactive. The tools developed by the consortium are now approved for use in medicinal studies by EMA. Prof. Troosters received the honour of becoming a Fellow of the European Respiratory Society in 2014. He published more than 200 peer-reviewed papers (ISI H-index 60) and several book chapters. He co-edited the ‘text book on pulmonary rehabilitation” with his colleagues E. Clini, A. Holland and F. Pitta. Since 2008 Prof. Troosters has been appointed as a professor in the Faculty of Kinesiology and Rehabilitation Sciences at the University of Leuven, Belgium, where he leads the Cardiovascular and Respiratory Rehabilitation research group. He is currently president of the European Respiratory Society.

Hone your Lung Cancer Staging Skills – An Interactive Case-based Session with the Experts

Dr. Kasia Czarnecka-Kujawa, University Health Network, Toronto, ON
Dr. Christine McDonald, University of Toronto, Toronto, ON
Dr. Sébastien Nguyen, Université de Montréal, Montréal, QC

This session will be a case-based review of lung cancer staging guidelines.

Learning Objectives
At the end of the session, participants will be able to:

  1. Recognize the role and performance of non-invasive and invasive modalities utilized in lung cancer staging;
  2. Differentiate the role of a Respirologist and an Interventional Respirologist in Lung Cancer staging process; and
  3. Summarize tissue and molecular testing requirements in lung cancer.
Dr. Kasia Czarnecka-Kujawa

Dr. Kasia Czarnecka-Kujawa completed her Medical School at the Michael DeGroote School of Medicine at the McMaster University, Internal Medicine and Respirology and Interventional Pulmonology training at the University of Toronto. She then pursued graduate studies at the Harvard School of Public Health with her thesis exploring cost-effectiveness of mediastinal lymph node staging in non-small cell lung cancer. Dr. Czarnecka-Kujawa now works as an Interventional Pulmonologist at the University Health Network in Toronto within the Division of Respirology and Thoracic Surgery, and is an assistant Professor at the University of Toronto. Her clinical practice focuses on minimally-invasive diagnosis and management of intrathoracic disease focusing on primary and metastatic lung cancer, and pleural disease using cutting-edge technologies. Her research focuses on health technology assessment with specific focus on population with thoracic malignancy, evaluating the relationships between evidence based medicine and decision modeling and use of administrative data to develop longitudinal costing models.  

Dr. Czarnecka-Kujawa is actively involved in education of the Thoracic Surgery, Respirology and other specialty trainees and community Thoracic Surgeons and Respirologists in topics related to Interventional Pulmonology through local and international CME courses. She is also involved in development of clinical practice guideline through the Cancer Care Ontario.

Dr. Christine McDonald

Dr. Christine McDonald completed her specialty training in Adult Respirology at the University of Toronto and further fellowship training in Interventional Pulmonology at the Toronto General Hospital. She completed her MSc through the Institute of Health Policy, Management and Evaluation at the University of Toronto, with a concentration in Quality Improvement and Patient Safety. Dr. McDonald is an Assistant Professor at the University of Toronto. Her areas of academic interest include improving access to minimally invasive pulmonary procedures, lung cancer diagnostic pathways, and patient safety surrounding chest procedures.

Dr. Sébastien Nguyen

Dr. Sébastien Nguyen completed his MD degree at McGill University, his specialty training in adult respirology at the Université de Montréal and further interventional pulmonology fellowship at the Quebec Heart and Lung Institute (IUCPQ). Dr. Nguyen is a clinical assistant professor at the Université de Montréal, respirologist and medical director of the Respiratory Endoscopy Unit at the Hôpital du Sacré-Coeur de Montréal. A major part of his practice is dedicated to interventional pulmonology. His areas of academic interest include advanced diagnostic procedures such as linear and radial EBUS, pleural procedures and therapeutic bronchoscopy. He is board certified by the American Association for Bronchology and Interventional Pulmonology (AABIP).

Management of IPF in the Community

Managing Disabling Symptoms

Dr. Martin Kolb, McMaster University, Hamilton, ON

IPF is a progressive disease with high morbidity and mortality. The past years have brought significant improvements in the pharmacological therapy of IPF, but disease progression nevertheless occurs in most patients, albeit at a slower rate. This means that symptomatic treatment of patients with IPF (and other fibrotic lung disorders) remains a major element of patient care.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Understand the progressive nature of fibrotic lung disorders, especially IPF;
  • Make decisions about pharmacological therapies that affect the disease progression versus interventions that aim at symptom control; and
  • Understand the potential benefit of collaborating with palliative care at an earlier stage of IPF.
Dr. Martin Kolb

Dr. Martin Kolb is the Moran Campbell Chair and Professor in Respiratory Medicine and Director of the Division of Respirology, McMaster University. His major research interest is fibrotic lung disease, with a particular interest in the role of growth factors and matrix abnormalities in disease progression. He leads activities in biomarker development for lung fibrosis and is a Principal Investigator and steering committee member in numerous ILD clinical trials. Dr. Kolb has authored over 130 peer-reviewed publications on different basic science and clinical topics. He is the Chief Editor of the European Respiratory Journal (2018-2023).

Supporting Oxygen Needs Overtime

Dr. Lisa Wickerson, University Health Network, Toronto, ON

Despite the prevalence of domiciliary oxygen therapy in ILD/IPF, there is a paucity of disease-specific evidence alongside heterogeneity in clinical guidelines and practices. This presentation will provide an overview of the oxygen needs of people with ILD/IPF, summarize the recent studies on oxygen therapy in ILD/IPF, and discuss potential strategies to manage hypoxemia over the course of disease progression.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Describe the epidemiology and significance of hypoxemia in IPF;
  • Discuss the current evidence and gaps around long-term, ambulatory and nocturnal oxygen therapy in ILD/IPF; and
  • Identify challenges and clinical strategies for managing oxygen needs over time in IPF.
Dr. Lisa Wickerson

Dr. Lisa Wickerson is a physical therapist and clinician-investigator in the Lung Transplant Program at the University Health Network. She completed her PhD in Rehabilitation Science examining oxygenation during exercise in interstitial lung disease. Her postdoctoral fellowship at Women’s College Hospital and the University Health Network focused on digital health evaluation and remote rehabilitation monitoring. Her current clinical and research program is centred around optimizing tele-rehabilitation for lung transplant candidates and recipients.

Physical Activity in Fibrotic ILD

Mr. Seo Am Hur, University of British Columbia, Vancouver, BC

This session will share major findings from a large prospective cohort project that investigated physical activity in patients with fibrotic ILD. The talk will focus on 1) the impact of psychological deficits (depression, anxiety, sleep quality) and pain on daily physical activity in patients with ILD; 2) the validity of physical activity self-report; and 3) minimal important difference in moderate-to-vigorous physical activity in patients with ILD.

At the end of this presentation, attendees will be able to:

  • Understand the importance of physical activity in the maintenance of health in patients with fibrotic ILD;
  • Understand the potential impact of psychological deficits and pain on daily physical activity in patients with fibrotic ILD; and
  • Describe the concept of minimal important difference (MID) and the MID for weekly moderate-to-vigorous physical activity minutes in patients with fibrotic ILD.
Mr. Seo Am Hur

Mr. Seo Am Hur was born in Seoul, Korea and immigrated to Vancouver, Canada in 2004. He completed his MSc in experimental medicine in 2018 at the University of British Columbia. During his graduate studies, he worked with Dr. Chris Ryerson at the Centre for Heart Lung Innovation to study physical activity in patients with fibrotic interstitial lung disease. Currently, Seo Am is a second-year medical student at the University of British Columbia and plans to pursue internal medicine as his career.

A Different View of the Lungs: Cutting Edge Technology is Here

Vaping and Smoking: Lung Imaging Biomarkers in E-Cigarette and Cannabis Users

Dr. Grace Parraga, Western University, London, ON

In this session, Dr. Parraga will review state of the art chest imaging methods appropriate for use in children and focus on recent results in children who vape and smoke combustible cannabis cigarettes. She will review the literature and current results and recent data acquired in patients.

Learning Objectives
At the end of this session, attendees will be able to:

  • Recognize novel CT and MRI chest imaging biomarkers in children and young adults;
  • Understand previous case reports in patients and preclinical studies about vaping and cannabis use; and
  • Have a good understanding of the relationships between clinical and imaging measurements of pulmonary disease in younger patients.
Dr. Grace Parraga

Dr. Grace Parraga was born and raised in Sudbury, Ontario and completed a PhD at the University of Washington in Seattle, Washington (USA). Upon completing post-doctoral studies at the University of Basel, (Switzerland), she joined F. Hoffman La Roche AG as a scientist. She returned to academic research at Western University in London and currently serves on the CHEST Editorial Board, the Scientific Advisory Committee of the Canadian Lung Association, CIHR and NSERC peer-review-panels. She is a board member of the CIHR-ICRS Institute for Circulatory and Respiratory Health and Western University. Dr. Parraga’s lab is focused on developing a deep understanding of chronic lung disease using novel imaging methods.

Clinical Utility of Oscillometry in Childhood Asthma: Where Are We Now?

Dr. Francine M. Ducharme, Centre hospitalier universitaire Sainte-Justine, Montréal, QC

An alternative means to spirometry is needed to assess lung function in children who cannot cooperate with spirometry because of young age, developmental ability, etc. Several lung function tests, including oscillometry, have been developed for preschoolers that must meet crucial psychometric properties required of lung function tests to be indicated for clinical use. In a 2013 ATS workshop, oscillometry met most prerequisites but discriminative properties were unclear and clinical utility remained to be assessed. This presentation will review the current status of oscillometry and its prerequisites for clinical use in childhood asthma/wheezing illnesses.

Learning Objectives
At the end of this session, attendees will be able to:

  • Understand the lung properties measured by oscillometry;
  • Recognize psychometric properties of lung function testing met by oscillometry;
  • Review the scientific evidence regarding the clinical utility of oscillometry in clinical pediatric practice; and
  • Consider future research directions.
Dr. Francine Ducharme

Dr. Francine M. Ducharme is a Professor in the Departments of Paediatrics and Social and Preventive Medicine at the Université de Montréal. As a paediatrician and clinical epidemiologist at the CHU Sainte-Justine, she leads a productive career as physician caring for asthmatic children, teacher, research mentor and scientist. Her research program, which has received uninterrupted research funding, focuses on improving paediatric morbidity through the development of instruments specific to children, educational and drug interventions, systematic reviews and dissemination of evidence-based guidelines. Her research program has led to over 200 publications, 200 invited talks, numerous research awards, and co-authorship on several Canadian Asthma Consensus and international statements.

Clinical Applications of Lung Ultrasound

Dr. Yasser Elsayed, University of Manitoba, Winnipeg, MB

Use of point of care ultrasound has expanded over the last decades particularly in intensive care to the point that it is now readily available for use by the clinical care practitioners in this setting. The focus of ultrasound by radiologists is on anatomic details, now, with clinicians actively using this technology at the bedside, attention has shifted to the critical evaluation of physiological abnormalities in different body systems. In the last 10 years, research studies have shown that lung ultrasound (LUS) is an accurate, non-invasive method for predicting ventilatory failure and offers advantages over traditional chest radiograph.

We developed a screening model of bedside lung ultrasound assessment for infants requiring respiratory support, and to be reproducible and used after completion of the course and required audited training. This presentation will focus on the utility of LUS as a new emerging modality for assessment of lung parenchyma.

Learning Objectives
At the end of this session, attendees will be able to:

  • Understand the basic interpretation of lung ultrasound;
  • Recognize the value of lung ultrasound as a new modality in diagnostic modality in different respiratory diseases; and
  • Understand the evidence supporting use of lung ultrasound in critical care.
Dr. Yasser Elsayed

Dr. Yasser Elsayed is Assistant Professor of pediatric and child health, Faculty of Health Sciences at the University of Manitoba, staff neonatologist, director of the Hemodynamics and targeted neonatal echocardiography program, registered echo-cardiologist, and chair of the POCUS NEO group. His clinical interests are focused on improving the ways we monitor sick infants. He is the founder of the Integrated Hemodynamics program in Winnipeg. In 2017, they started to use (POCUS) in the neonatal intensive care unit (NICU). As a certified medical sonographer, he began exploring whether we could use ultrasound instead of traditional x-rays to evaluate the condition of newborn lungs and to diagnose necrotizing enterocolitis.

1500 - 1530
1530 - 1700

Moderated Poster Session

0730 - 0830
0830 - 1000

Concurrent Sessions

Test Your ILD Knowledge – An Interactive Multidisciplinary Team Discussion of ILD Cases

Dr. Gerard Cox, McMaster University, Hamilton, ON
Dr. Jolene Fisher, University Health Network, Toronto, ON
Dr. David Hwang, Sunnybrook Health Sciences Centre, Toronto, ON
Dr. Sonja Kandel, University Health Network, Toronto, ON
Dr. Shane Shapera, University Health Network, Toronto, ON

Presentation of clinical cases to facilitate discussion of diagnostic challenges and demonstrate the value of inter-disciplinary inputs from experts in radiology and pathology.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Recognize the potential value of inter-disciplinary discussion;
  • Understand the potential value of lung biopsy in managing ILD; and
  • Consider the less common causes of ILD.
Dr. David Hwang

Dr. David Hwang is a pulmonary pathologist and chief of the Department of Laboratory Medicine and Molecular Diagnostics at Sunnybrook Health Sciences Centre, and a professor in the Department of Laboratory Medicine & Pathobiology at the University of Toronto. His clinical and research interests span several areas of pulmonary pathology, including both neoplastic and non-neoplastic lung disease, and lung transplantation. He has served as chair of the Lung Expert Review Panel for the Canadian Partnership Against Cancer and is currently a member of the Pathology Committee for the International Association for the Study of Lung Cancer.

Dr. Shane Shapera

Dr. Shane Shapera obtained his Doctor of Medicine in 2003 from the University of Toronto and went on to continue in Toronto during his Internal Medicine and Respirology residency training. With the help of the Dr. Cameron C. Gray Award, he completed an additional year of clinical fellowship with an emphasis in Interstitial Lung Diseases. He was appointed to the Faculty of Medicine as an Assistant Professor and Clinician Educator in December 2011. He has been an innovator in his role as an educator and has received numerous teaching awards since his appointment. He is currently the Director of the Interstitial Lung Diseases Program at the Toronto General Hospital, UHN. He also works with the Toronto Lung Transplant Program providing pre-lung transplant assessments for patients with ILDs.

CTS-ATS Conjoint Session: Diffuse Cystic Lung Disease

Dr. Gregory Downey, National Jewish Health, Denver, CO (USA)

The presentation will begin with a series of clinical cases that represent actual clinical scenarios of patients who have presented for evaluation of diffuse cystic lung disease. This part of the presentation will include high-resolution chest CT images and a discussion of the differential diagnosis. A more detailed mechanistic discussion of selected diffuse cystic lung diseases will be provided including lymphangioleiomyomatosis (LAM), Birt Hogg Dubé Syndrome, lymphocytic interstitial pneumonitis (LIP), and Langerhans’ cell histiocytosis (LCH). A discussion of the genetic basis of specific diffuse cystic lung diseases and current treatment recommendations, where available, will be provided. Finally, a diagnostic algorithm that represents a logical approach to the differential diagnosis of diffuse cystic lung disease will be discussed.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Review the diverse clinical presentations of patients with cystic lung disease;
  • Learn about the latest information on the genetic basis of cystic lung disease and the use of molecular diagnostic testing; and
  • Learn about an algorithmic clinical, radiological and genetic analysis approach to patients with cystic lung disease.
Dr. Gregory Downey

Dr. Gregory Downey began his career at the University of Toronto and rose through the ranks to become Professor and Director of the Division of Respirology and Vice-Chair of the Department of Medicine. He was awarded a Tier 1 Canada Research Chair in Respiration Sciences. In 2007, Dr. Downey returned to Denver to National Jewish Health, where he previously completed his postdoctoral training, and where he now leads a basic and translational science research laboratory focused on mechanisms of lung injury, repair and fibrosis. He maintains an active practice in general pulmonary medicine and is a member of the ILD and Rare Lung Disease clinic. Dr. Downey’s research program has been funded by the NIH, the Canadian Institutes of Health Research, and the U.S. Department of Defense for over 25 years. He has over 240 publications in top-ranked journals including the New England Journal of Medicine, Science, Science Translational Medicine, Nature Cell Biology, the Journal of Cell Biology, the American Journal of Respiratory and Critical Care Medicine, the Journal of Experimental Medicine, Blood, and the Journal of Immunology, and his work has been cited over 17,000 times by other authors (h-index 72). His contributions to research were recognized by an ATS Award for Scientific Accomplishments in 2010. Dr. Downey is currently Vice President of the American Thoracic Society.

Approaches and Diagnostic Testing for Children and Adults with Suspected OSA

Diagnostic Testing for OSA in Children

Dr. Joanna MacLean, University of Alberta, Edmonton, AB

Identifying children with OSA is hampered by limited access to polysomnography with more accessible screening tests but no clear guidance on how the results of these tests relate to polysomnography. In this presentation, the evidence for the tools used to assist clinicians in the diagnosis of pediatric OSA will be reviewed and compared. This will include a summary of the types of tools that have been studied and the risk/benefits of each tool type.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Compare the tools used in the assessment of children with suspected OSA;
  • Formulate an approach to the assessment of children with suspected OSA for your context; and
  • Understand the gaps in knowledge related to the diagnosis of OSA in children and future work that is needed to fill these gaps.
Dr. Joanna MacLean

Dr. Joanna MacLean is an associate professor and clinician-scientist in the Department of Pediatrics at the University of Alberta. She is paediatric respirologist, sleep medicine specialist, and medical director for the Pediatric Sleep Laboratory at the Stollery Children’s Hospital. Both her clinical practice and research focus on understanding breathing and sleep problems in children.

Diagnostic Approach for Obstructive Sleep Apnea in Adults. Home vs In-Lab Studies: What Is the Latest Evidence?

Dr. Caroline Minville, Quebec Heart and Lung Institute, Québec, QC

Obstructive Sleep Apnea (OSA) is a major public health problem and is highly prevalent. In-laboratory polysomnography is the gold standard test for OSA diagnosis but its access is limited and costly. Home sleep studies are now frequently utilized as an alternative diagnostic test for OSA because they are less expensive to deploy and more accessible although they are less sensitive and specific than PSG. This presentation will describe a diagnostic approach for OSA in adults. It will explain the advantages and limitations of home sleep testing based on the latest evidence and on the new CTS Sleep Disordered Breathing Guideline, which will also be presented.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Describe the differences between sleep apnea diagnostic tests and their respective limitations;
  • Recognize the role and the place of home sleep testing to diagnose OSA in adults; and
  • Choose the most appropriate diagnostic approach for their patients based on the latest evidence as presented in the new CTS Sleep Disordered Breathing Guideline
Dr. Caroline Minville

Dr. Caroline Minville is a respirologist and a sleep specialist at the Quebec Heart and Lung Institute. She completed her residency training program in adult respiratory medicine at Laval University then did a two-year fellowship in sleep medicine in Grenoble, France, with Professor Jean-Louis Pépin. Aside from her clinical work at the Quebec Heart and Lung Institute Sleep Clinique, she is also implicated in clinical research. She is one of the medical directors of the National Program for Home Ventilatory Assistance. Dr. Minville is a member of the CTS Sleep Disordered Breathing Clinical Assembly and she participated in writing the new CTS Sleep Disordered Breathing Guideline.

Diagnostic and Management Approach to OSA in Children: A Surgical Perspective

Dr. Paolo Campisi, Hospital for Sick Children, University of Toronto

It is not uncommon for an otolaryngologist to propose a surgical remedy for the management of OSA in children without definitive evidence of OSA. This reality is the result of limited access to PSG and reliable screening methods. In this presentation, an overview of the historical and clinical features that lead to a surgical treatment recommendation will be reviewed. Specifically, the common airway findings that have been studied in the literature will be reviewed.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Identify the common anatomical airway findings that predispose to OSA in children
  • Formulate an approach to the timely referral of children requiring a surgical consultation
Dr. Paolo Campisi

Dr. Paolo Campisi is Professor and Vice Chair Education of the Department of Otolaryngology – Head & Neck Surgery, University of Toronto practicing at the Hospital for Sick Children, Toronto, Canada. He has a clinical interest in disorders of the airway and voice and is the Director of the Centre for Paediatric Voice and Laryngeal Function, a subspecialty clinic designed for the care of children with voice disorders. His research interests are focused on medical education and simulation and the epidemiology and management of recurrent respiratory papillomatosis in children. He is the current Director of Postgraduate Education for the Department of Otolaryngology – Head and Neck Surgery, University of Toronto.

Theorical and Practical Application of the Cough Assist

Ms. Sandy Fodey, Ontario Ventilator Equipment Pool, Kingston, ON
Ms. Kathy Walker, CANVent Respiratory Unit, The Ottawa Hospital Rehabilitation Centre, Ottawa, ON

A hands-on education workshop for respiratory healthcare professionals to understand and practice mechanical cough assist and lung volume recruitment techniques and their role in secretion clearance. Led by two respiratory therapists, one from CANVent (Canadian Alternatives in Noninvasive Ventilation) Respiratory Services at the Ottawa Hospital, and the other from the Ontario Ventilator Equipment Pool (Kingston), this workshop will be of interest to respiratory therapists, physiotherapists, nurses and others providing care to patients requiring non-invasive airways management. The session will include a brief review of the literature on mechanical insufflation/exsufflation and peak cough flow as well as current recommendations and guidelines for clinical use and the process for acquiring cough assist unit. There will be time for participants to practice their new knowledge in a break-out session.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Describe PCF and its role in M-IE;
  • Summarize essential skills for effective MIE; and
  • Effectively set up and use M-IE for treatment on NMD patients.
Ms. Sandy Fodey

Ms. Sandy Fodey began her career in both the home care and critical care setting. For 20 years she was the clinical instructor at Kingston General Hospital affiliated with the Algonquin College Respiratory Therapy Program. During this time she worked extensively with ventilator assisted individuals preparing them for discharge. In 2012 she joined the Ontario Ventilator Equipment Pool as Coordinator. Sandy believes ventilator assisted individuals can lead a full and enriched life.

Ms. Kathy Walker

Ms. Kathy Walker graduated from the University of Waterloo with an Honours degree in kinesiology and followed that with a diploma in respiratory therapy. She has been at The Ottawa Hospital Rehabilitation Centre since 1991. Kathy and her colleagues have been exploring alternative non-invasive ventilation techniques in neuromuscular diseases since 1992 with Dr. Doug McKim, one of Canada’s leading respirologists in this field. The clinic has over 100 neuromuscular patients managed non-invasively at home on bilevel or volume ventilators. The non-invasive alternative techniques developed by the CANVent team keep the patient out of the hospital resulting in an improved quality of life.

Breathing Better – Case-based Brain Teasers

A Case of Acute Hypoxemia – or Is It Chronic?

Dr. Dhenuka Radhakrishan, Children’s Hospital of Eastern Ontario, Ottawa, ON

This session will describe an adolescent with incidentally noted acute hypoxemia. Causes of hypoxemia, a diagnostic algorithm, and the final diagnosis will be discussed.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Identify common and rare causes of hypoxemia in adolescents; and
  • Use a systematic approach to confirm the cause of hypoxemia in adolescents.
Dr. Dhenuka Radhakrishnan

Dr. Dhenuka Radhakrishnan is a pediatric respirologist and Director of the Asthma Program at the Children’s Hospital of Eastern Ontario and Assistant Professor in the Department of Pediatrics at the University of Ottawa. Her clinical interests include the care of children with airways diseases including asthma and cystic fibrosis. She is an advocate for lung health in children and has participated extensively in projects through the Lung Association in Ontario and at the Canadian Thoracic Society. She is the co-chair of the Health Quality Ontario Asthma Quality Standards Committee and sits on the Asthma Assembly at the CTS. Her research involves the use of health administrative data at ICES to investigate outcomes and healthcare delivery to children with asthma and other respiratory diseases.

A Second Case of Acute Hypoxemia

Dr. Sze Man Tse, Centre hospitalier universitaire Sainte-Justine, Montréal, QC

This session will present a case of acute hypoxemia and respiratory distress associated with localized sclerotherapy. The literature in this field will be reviewed and questions will be answered using interactive methods and audience participation.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Recognize respiratory complications associated with bleomycin sclerotherapy;
  • Describe the pathophysiology of acute respiratory distress syndrome (ARDS) in children; and
  • Understand the current evidence behind the management of pediatric ARDS.
Dr. Sze Man Tse

Dr. Sze Man Tse is a pediatric respirologist and clinician-scientist at the CHU Sainte-Justine in Montréal, Québec. She completed her pediatrics residency at McGill University, after which she pursued a fellowship in pediatric respirology at the Massachusetts General Hospital in Boston. She also completed a research fellowship at the Brigham and Women’s Hospital in Boston and a master’s in public health at the Harvard School of Public Health. Her clinical and research interests include the outcomes of children following an acute respiratory illness such as acute respiratory distress syndrome or critical asthma.

Code Blue in the Pulmonary Function Testing Lab

Dr. Sophie Laberge, Centre hospitalier universitaire Sainte-Justine, Montréal, QC

This session will present a case of acute pneumothorax in a 16-year-old boy with past history of hemoptysis. Literature review in the field will be presented in an interactive manner with the participants.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Recognize the genetic contribution of spontaneous pneumothorax; and
  • Discuss the management recommendations specific to rare causes of pneumothorax.
Dr. Sophie Laberge

Dr. Sophie Laberge is a pediatricrespirologist at CHU Sainte-Justine and an associate professor in the Department of Pediatrics of the Université de Montréal. Following her clinical training in pediatric respirology, she completed a research fellowship at McGill University and at Boston University. She participated in various research projects in the field of asthma and pharmacogenomics. Her clinical interest comprises asthma, respiratory complications of esophageal atresia and sleepmedicine. She is the director of the Paediatric Respiratory Division at CHU Sainte-Justine.

1000 - 1030
1030 - 1130

Concurrent Sessions

Pulmonary Vascular Diseases: From Large Clots to Capillaritis

Pulmonary Vasculitis and Its Various Subsets

Dr. Christian Pagnoux, CanVasc, Toronto, ON

During this session, the evidence about the choice of immunosuppressive therapy for the main, various forms of pulmonary vasculitis will be reviewed. This will include discussion on the role of plasma exchange for ANCA-associated vasculitis and anti-GBM disease, immunosuppression for vasculitis-related subglottic/endobronchial stenosis, and rituximab or mepolizumab in eosinophilic granulomatosis with polyangiitis.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Review the evidence about the choice and duration of immunosuppressive therapy for pulmonary vasculitis;
  • Discuss the role of plasma exchange;
  • Understand the role of immunosuppression for vasculitis-related subglottic/endobronchial stenosis; and
  • Discuss the role of mepolizumab in eosinophilic granulomatosis with polyangiitis.
Dr. Christian Pagnoux

Dr. Christian Pagnoux graduated in internal medicine and clinical immunology in Paris, France. Between 2002 and 2010, he has served as vice-president of the French Vasculitis Study Group (FVSG) and has been involved in several therapeutic trials and cohort studies conducted by the latter or the European Vasculitis Study Group. Dr. Pagnoux moved to Canada in 2010 and was appointed to the Division of Rheumatology at Mount Sinai Hospital, Toronto. He joined the steering committee of the North-American Vasculitis Clinical Research Consortium (VCRC) and founded CanVasc, the Canadian network for research on vasculitis. He has written or co-authored more than 250 peer-reviewed publications and several textbook chapters on vasculitis.

Post PE Syndrome – The Clot Thickens…

Dr. John Granton, University of Toronto, Toronto, ON

Despite the burden of pulmonary embolism, very little is known about the long-term outcomes after PE. In the face of adequate treatment, people often have persistent exercise limitations, reduced quality of life, and frequently persistent residual disease on imaging. This “Post PE” syndrome includes chronic thromboembolic pulmonary hypertension as well as those without pulmonary hypertension.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Understand how pulmonary embolism affects the lives of patients;
  • Understand the spectrum of conditions that encompasses the Post PE syndrome; and
  • Understand the role of surgery and medical therapy for patients with chronic thromboembolic disease (without pulmonary hypertension).
Dr. John Granton

Dr. John Granton is a Professor of Medicine, in the Faculty of Medicine at the University of Toronto. He specializes in pulmonary hypertension and critical care. His research interests include pulmonary hypertension, pulmonary embolic disease, exercise physiology, and heart-lung interactions. He is the Head of Respirology at the University Health Network and Sinai Health System. He is the current President of the Canadian Thoracic Society.

What the Health? E-health, M-health, U-health to Support Self Management

Barriers and Facilitators of Implementing Tele-Rehab

Dr. Michel Tousignant, Université de Sherbrooke, Sherbrooke, QC

Providing in-home telehealth services is challenging from a technical and clinical point of view. From a technical level, many considerations need to be addressed to enable the use of such a system including providing video and audio communication over a standard residential high-speed Internet link, developing software to support clinical assessment and rehabilitation, and packaging software and hardware components such that in-home installation is as unobtrusive as possible. From a clinical point of view, the technology needs to be simple to use, reliable, well integrated, and have an added value over standard clinical approach.

ESTRAD, the team specialized in in-home telerehabilitation at the Research Centre on Aging in Sherbrooke, had to address those requirements in various projects. Barriers and facilitators that emerged from their experience will be discussed in this presentation.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Discuss the choice of technical solution for telerehabilitation;
  • Know more about barriers and facilitators on implementing telerehabilitation; and
  • Take into consideration barriers and facilitators in the decision to implement telerehabilitation.
Dr. Michel Tousignant

Dr. Michel Tousignant is a physical therapist and full professor. He is the Vice-Dean of rehabilitation, Director of the School of Rehabilitation in the Faculty of Medicine and Health Sciences at Université de Sherbrooke. He held a research Chair in Telerehabilitation. His research program is on teletreatment from the healthcare centre to the patient’s home, as a new way of delivering rehabilitation services

How Tele-health (or Health/E-health) Can Enhance Self-efficacy and Improve Outcomes and Behaviour?

Dr. Anne-Marie Selzler, West Park Healthcare Centre, Toronto, ON

The purpose of this presentation is to increase understanding of the self-efficacy concept and provide guidance on how to enhance self-efficacy to improve patient outcomes within telehealth platforms. This session will begin with a conceptual discussion of self-efficacy and its importance to patient behaviour and clinical outcomes. This will be followed by a description of approaches to enhance self-efficacy and suggestions of how to apply those approaches to interactions with patients. While the focus of the presentation will be on enhancing self-efficacy in telehealth platforms, most of the content will apply to face-to-face interactions with patients. The content of this presentation will draw on theory, previous research, and clinical observation.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Describe self-efficacy and its importance to patient behaviour and clinical outcomes;
  • Describe the four approaches to enhancing self-efficacy; and
  • Integrate various approaches to enhancing patient self-efficacy within a telehealth platform.
Dr. Anne-Marie Selzler

Dr. Anne-Marie (Annie) Selzler is a Research Associate at Alberta Health Services and the University of Alberta. She studies psychosocial theories as they relate to behaviour change in varying contexts and populations, with a focus on exercise and physical activity in pulmonary rehabilitation. Her work examines individual level motivational characteristics and contextual factors as they relate to supporting and impeding behaviour change efforts. Dr. Selzler completed her postdoctoral training at West Park Healthcare Centre in Toronto. She is an alumna of the University of Northern British Columbia, completing a BSc (Hons) in psychology in 2009, and an alumna of the University of Alberta, completing a MA in 2013 and PhD in 2018.

Too Weak to Breathe

Treatment of Spinal Muscular Atrophy: Options and More Options – Review of Mechanisms, Indications and Outcomes

Dr. Craig Campbell, Children’s Hospital London Health Sciences Centre, London, ON

There are now multiple novel therapies for SMA that have been shown effective in clinical trials, with nusinersen being the first approved therapy in Canada. The pathogenetic process of SMA will be reviewed and new therapy mechanisms will be presented. Data from clinical trials with a focus on respiratory outcomes will be presented. The focus will be on pediatric patients and trials.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Understand the clinical presentation and underlying genetic underpinning for SMA;
  • Describe the new therapeutic options for children with SMA; and
  • Determine the best outcome measures in research and clinical practice for SMA with a focus on respiratory impact.
Dr. Craig Campbell

Dr. Craig Campbell is the Deputy Chair of pediatrics, the Head of the Division of Pediatric Neurology and the Medical Director of the multidisciplinary neuromuscular clinic and the Pediatric Neurophysiology Laboratory at Children’s Hospital London Health Sciences Centre. He is an Associate Professor in pediatrics, clinical neurological sciences and epidemiology at Western University and a scientist at the Children’s Health Research Institute. He is the Chair of the TREAT-NMD Global Registry Oversight Committee. Dr. Campbell has been awarded the George Karpati Award Researcher of the Year in 2011 and 2015, Muscular Dystrophy Canada.

Management of Children with Neuromuscular Diseases: The Pediatric Respirologist’s Perspective

Dr. Reshma Amin, The Hospital for Sick Children, Toronto, ON

This session will provide an overview of the evaluation of respiratory function and sleep disordered breathing in pediatric neuromuscular disease. The pathophysiology of breathing in neuromuscular disease including progression of dysfunction as well as the relevance of sleep will be discussed. The indications and methods for evaluation of respiratory function and sleep disordered breathing as well as the limitations in pediatrics will also be reviewed.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Understand the physiology and pathophysiology of breathing in neuromuscular disease;
  • Recognize the indications and methods for evaluation of respiratory function in neuromuscular disease as well as their limitations in pediatrics; and
  • Discuss the evaluation and management of sleep disordered breathing in pediatric neuromuscular disease.
Dr. Reshma Amin

Dr. Reshma Amin is the Director of the Long-term Ventilation (LTV) Program at SickKids and an Associate Professor at the University of Toronto. She is also the Program Director for the Sleep Medicine and Long-term Ventilation training program. She is lead author for the Canadian Guidelines for Pediatric Long-term Mechanical Ventilation at home. Her research focuses on improving the impact of LTV on the patient, the family and the healthcare system. She is currently leading a provincial randomized controlled trial to evaluate the impact of an eHealth app for children and adults transitioning home on long-term ventilation on healthcare utilization.

Research Highlights from Young Investigators

Lung Imaging and Biomarkers to Better Understand Asthma

Dr. Sarah Svenningsen, McMaster University, Hamilton, ON

Novel pulmonary CT and MRI biomarkers of airways disease relevant to the clinical understanding, decision making, and therapy guidance of severe asthma will be introduced, and recent scientific literature will be reviewed.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Describe and interpret novel CT and functional MRI biomarkers of asthma;
  • Understand the contributors to ventilation defects visualized by MRI in asthma and their clinical relevance; and
  • Understand the potential role of pulmonary imaging in asthma clinical decision making and therapy guidance.
Dr. Sarah Svenningsen

Dr. Sarah Svenningsen is a translational pulmonary imaging scientist who recently joined McMaster University faculty (2020) as an Assistant Professor in the Department of Medicine (Division of Respirology). She is an Affiliate Scientist at the Firestone Institute for Respiratory Health and The Research Institute of St. Joe’s Hamilton. She graduated with an Honours Specialization degree in Medical Biophysics (2011) and a PhD in Medical Biophysics (2015) at Western University. Her research focuses on the development and application of novel pulmonary imaging methods to better understand complex airways diseases such as asthma and chronic obstructive pulmonary disease. Dr. Svenningsen has authored 46 publications in the fields of pulmonary medicine and medical imaging and has an h-index of 19 (i10-index 31, >1400 citations). She was a Banting Postdoctoral Fellow (2018-2020) and the recipient of the 2017 Charles Polanyi Prize in Physiology/Medicine.

Airway Dysanapsis: Exposing a Major COPD Risk Factor That Is on Par with Smoking

Dr. Benjamin Smith, McGill University, Montréal, QC

Smoking is a major risk factor for chronic obstructive pulmonary disease (COPD), yet much of the variation in COPD risk remains unexplained. Indeed, only a minority of lifelong smokers will develop COPD, and nearly 30% of COPD occurs among never smokers. These observations suggest that other factors must play a major role in COPD susceptibility. Dr. Smith will try to convince you of a novel COPD risk factor that surpasses smoking and other standard risk factors.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Describe the pathophysiologic basis of COPD;
  • Identify established COPD risk factors; and
  • Describe the contribution of dysanapsis to COPD risk and progression.
Dr. Benjamin Smith

Dr. Benjamin Smith is a physician-scientist at the McGill University Health Centre Research Institute. His research program aims to reduce the burden of chronic obstructive lung disease by understanding the heterogeneity of disease susceptibility and impairment. Leveraging contemporary deeply phenotyped cohorts, Dr. Smith uses epidemiological methods to test mechanistic hypotheses in humans (‘translational epidemiology’). His research is supported by the Quebec Health Research Fund (FRQS), the Canadian Institutes of Health Research, and the National Institutes of Health (USA). Dr. Smith’s training is in epidemiology, respiratory medicine, physiology, and mathematics, and was obtained at McGill and Columbia Universities.

1130 - 1230

Closing Plenary

Vaping: Myths, Facts and Ongoing Public Health Concerns

Dr. Albert A. Rizzo, American Lung Association, Newark, DE (USA)

This lecture will discuss the entry of electronic inhalation delivery systems into the U.S. markets and the consequences of misinformation, lax regulation, and a mixed public health message regarding harm reduction.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Understand the development and evolution of electronic inhalational drug delivery systems as they entered the U.S. markets;
  • Appreciate the concern over the youth epidemic of e-cigarettes in the U.S. and the E-cigarette and Vaping Associated Lung Illness (EVALI); and
  • Discuss the public health measures needed to help prevent the medical consequences of vaping devices.
Dr. Albert A. Rizzo

Dr. Albert A. Rizzo is the Chief Medical Officer for the American Lung Association. He is responsible for ensuring that the American Lung Association uses the best science and medicine to formulate and deliver its mission. He oversees the medical aspects of the organization’s research, education and advocacy arms of its mission. Dr. Rizzo practices at Christiana Care Health System in Newark, Delaware (USA). He is board certified in internal medicine, pulmonary, critical care and sleep medicine and is a clinical assistant professor of medicine at Thomas Jefferson University Medical School in Philadelphia, Pennsylvania (USA).

Poster Award Presentations and Closing Remarks

Poster Award Presentations & Closing Remarks by Dr. Dina Brooks and Dr. John Granton – CTS Board of Directors.

Saturday April 18, 2020

0700 - 0815

Are all inhaled corticosteroids (ICS) created equally?

Dr. Don Cockcroft, University of Saskatchewan, SK

The presentation will review the history of inhaled corticosteroid (ICS) use in asthma from early use of cortisone acetate powder in the 1950s to the first commercial ICS MDI (BDP) in the 1970s, up to more recently introduced ICS. It will concentrate on the evolution of ICS structural features as it relates to potency and therapeutic index.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Summarize data supporting older and modern ICS medications in asthma and how steroids evolved since the 1970s.
  • Re-evaluate the concept of ICS dose equivalence – what evidence supports low, med, high dose ICS?
  • Discuss the unique structural features of older and modern ICS, the concept of steroid potency, therapeutic index, and its clinical impact.

This session is developed by the Canadian Thoracic Society with an independent educational grant from GSK.

Dr. Donald Cockcroft

Dr. Donald Cockcroft trained with Freddy Hargreave (1975-1977) in respirology and allergy research predominantly asthma. He has worked in academic respiratory medicine at the University of Saskatchewan for 43 years with clinical practice and research focussing on asthma. His area of research interest is mainly bronchoprovocation with allergen, methacholine mannitol and other stimuli.

1230 - 1345

PF-ILD in the Canadian Landscape: Sharing Best Practices in Management

Dr. Martin Kolb, McMaster University, Hamilton, ON

IPF is a progressive disease with high morbidity and mortality. The past years have brought significant improvements in the pharmacological therapy of IPF, but disease progression nevertheless occurs in most patients, albeit at a slower rate. This means that symptomatic treatment of patients with IPF (and other fibrotic lung disorders) remains a major element of patient care.

Learning Objectives
At the end of this presentation, attendees will be able to:

  • Explain the unmet clinical need around PF-ILD;
  • Evaluate emerging evidence in PF-ILD treatments, specifically CTD-ILD; and
  • Discuss best practice approaches for collaborative care in the diagnosis and monitoring of CTD‑ILD.

This session is developed by the Canadian Thoracic Society with an independent educational grant from Boehringer Ingelheim.

Dr. Martin Kolb

Dr. Martin Kolb is the Moran Campbell Chair and Professor in Respiratory Medicine and Director of the Division of Respirology, McMaster University. His major research interest is fibrotic lung disease, with a particular interest in the role of growth factors and matrix abnormalities in disease progression. He leads activities in biomarker development for lung fibrosis and is a Principal Investigator and steering committee member in numerous ILD clinical trials. Dr. Kolb has authored over 130 peer-reviewed publications on different basic science and clinical topics. He is the Chief Editor of the European Respiratory Journal (2018-2023).