• Thursday, April 7th
  • Friday, April 8th
  • Saturday, April 9th
  • Co-Developed Symposia
1100 - 1215

Co-Developed Symposium

1100 - 1215

The Dimensions of Excessive Daytime Sleepiness – Obstructive Sleep Apnea and Beyond

Atul Khullar, MD MSc FRCPC DABPN (Cert Sleep Medicine), FAASM, Northern Alberta Sleep Clinic, Edmonton, AB

Moderator: Robert Skomro, MD, FRCPC, University of Saskachewan, Saskatoon, SK

This session will provide the clinician with an overview of types of excessive daytime sleepiness (EDS) and how they present in patients. Major contributors to EDS such as mental health concerns, a symptom of residual obstructive sleep apnea (OSA), and other sleep disorders will be reviewed. A practical approach to the diagnosis/assessment of EDS with a focus on effective utilization of sleep specialists and sleep testing will also be discussed. The session will conclude with an overview of non-pharmacological and pharmacological treatments for the management of EDS with a focus on data in residual obstructive sleep apnea (OSA).

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

  • Recognize patients presenting with excessive daytime sleepiness (EDS);
  • Assess possible causes for patient’s EDS (including a residual symptom of obstructive sleep apnea) and when to refer for sleep testing and/or sleep specialist intervention
  • Understand pharmacological and non pharmacological treatment options available for EDS and consider intergration for patients with residual obstructive sleep apnea

CanMEDS Roles Addressed: Communicator, Health Advocate, Medical Expert, Professional, Scholar

This session is co-developed by the Canadian Thoracic Society and Paladin Labs and is planned to achieve scientific integrity, objectivity and balance.

Dr. Atul Khullar

Dr. Atul Khullar is a psychiatrist and sleep specialist who specializes in the integrative management of obesity, sleep, mood/anxiety and attention deficit disorders in adolescents and adults. He has a sleep and mood/anxiety disorders fellowship from the University of Toronto and is board certified in Psychiatry and Sleep Medicine.

Dr. Khullar is active nationally and internationally in research, teaching and delivering CME in the above areas. He has given over 600 presentations to public and professional audiences worldwide.

Currently he is the medical director of the Northern Alberta Sleep Clinic in Edmonton and a Associate Professor at the University of Alberta. He is also a senior consultant for MedSleep, a Canada-wide network of community sleep clinics, the Edmonton Oilers and has worked with the Canadian Winter Olympic team in the past.

1100 - 1215

CIA Secrets on Type 2 Inflammation (CIS: Clinical Immunology and Allergy)

Speaker: Jason Kihyuk Lee, MD, FRCPC, FAAAAI, FACAAI, Toronto Allergists, Toronto, ON
Moderator: Andréanne Côté, MD, FRCPC, Université Laval, Quebec City, QC

Type 2 inflammatory diseases are characterized by common shared immune dysregulation, which results in disease and organ specific signs and symptoms, impaired QoL and high burden of traditional standard-of-care treatments. It is commonly associated with an increased presence of other coexisting type 2 inflammatory diseases owing to the same dysregulation. This coexistence of comorbidities increases the patient’s overall disease burden, including impact on other type 2 driven dermatologic, respiratory and gastrointestinal diseases. Understanding the interrelationships will help the Respirologist optimize care for patients being treated.

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

  • Review the pathophysiology of type 2 diseases and with common inflammatory pathways;
  • Understand basic science and clinical evidence and how it is clinically relevant; and
  • Integrate throughout cases that illustrate type 2 coexisting diseases.

CanMEDS Roles: Collaborator, Communicator, Health Advocate, Leader, Medical Expert, Professional, Scholar

Click here for session invitation

This session is co-developed by the Canadian Thoracic Society and Sanofi and is planned to achieve scientific integrity, objectivity and balance.

Dr. Jason Lee

Dr. Jason Lee was the first to publish on gabapentin in idiopathic chronic cough, dupilumab use in CSU, dupilumab use in IgG4 related disease. His clinic in Toronto currently serves over 1,200 patients on biologics for immunologic conditions. He obtained his doctor of medicine degree from the University of Toronto, internal medicine at the University of British Columbia, a fellowship in clinical immunology and allergy at the University of Toronto. Dr. Lee is the immediate past section head of asthma at the CSACI and current member of the ACAAI biologics and therapeutics executive.

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 - 1415

Welcome and Opening Remarks

1415 - 1500

Opening Plenary

Long-Term Aspects of COVID-19: A Focus on the Patient Perspective and Respiratory Outcomes

Samir Gupta, MD, MSc
Unity Health Toronto, St. Michael’s Hospital, and University of Toronto, Toronto, ON

The COVID-19 pandemic has left no one unaffected – from societal upheaval caused by lockdowns and pubic health restrictions, to school closures impacting our youngest. Many lives have been lost and families destroyed. Yet an ongoing toll of this pandemic, which remains much less well-measured and reported than daily statistics, is the burden of long-term post-COVID symptoms experienced by thousands of Canadians. In this presentation, we will discuss the long-term consequences of COVID-19 disease, focussing on respiratory consequences and attempting to include the patient experience and perspective.

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

  • Summarize existing knowledge on the long-term respiratory morbidity associated with COVID-19 infection;
  • Discuss the patient experience of long-term respiratory symptoms that persist or occur after resolution of acute SARS-CoV-2 infection; and
  • Report gaps in existing literature and future areas of focus both for research and for knowledge translation surrounding long-term respiratory complications of COVID-19 infection.

CanMEDS Roles Addressed: Communicator, Health Advocate, Scholar

Dr. Samir Gupta

Dr. Samir Gupta is a Respirologist and clinician-scientist at the Li Ka Shing Knowledge Institute of St. Michael’s Hospital and an Associate Professor in the Department of Medicine at the University of Toronto. His main research interest is in knowledge translation across the spectrum of respiratory illness, with a focus on electronic tools for behaviour change. He has a specific interest in science communication and serves as the medical correspondent for the CBC. He serves as Chair of the Canadian Respiratory Guidelines Committee and holds the University of Toronto Michael Locke Term Chair in Knowledge Translation and Rare Lung Disease Research.

1500 - 1530

Plenary Sessions

1530 - 1615

Beyond the Apnea-Hypopnea Index: Next Steps for Obstructive Sleep Apnea

Atul Malhotra, MD
University of California San Diego Health, San Diego, CA, USA

The presenter will review the existing data on the Apnea-Hypopnea Index and will discuss a recent consensus statement from the Sleep Research Society on this topic.

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

  • Understand the history of the Apnea-Hypopnea Index (AHI);
  • Consider the limitations of the AHI; and
  • Study the metrics of Obstructive Sleep Apnea severity that may be used in the future.
Dr. Atul Malhotra

Dr. Atul Malhotra is a pulmonary critical care and sleep medicine physician at University of California San Diego Health. He runs a large NIH-funded laboratory with over 375 original and over 275 reviews/chapters since coming on faculty in 2000. He was born in Edmonton and went to the University of Alberta for undergraduate science and for medical school. He was President of the American Thoracic Society in 2015-2016. He is active clinically both in the outpatient sleep clinic and in the intensive care unit.

1615 - 1700

CTS Honorary Lecture: Is Interleukin-33 a Protective Cytokine in Irritant Asthma?

James Martin, MD, DSc
McGill University Health Centre and McGill University Health Centre Research Institute and McGill University, Montréal, QC

Irritant asthma is a clinically relevant entity that is recognized best in its acute form but may also complicate treatment of asthma when irritant exposure is not recognized. Irritant asthma is a neutrophilic phenotype and, as such, may not fall into the treatment paradigm of so-called T2 high asthma. Using a murine model of irritant asthma, it has been possible to explore the role of interleukin (IL)-33 in airway hyperresponsiveness and inflammation. Chlorine, a common cause of irritant asthma and a potent oxidant that likely shares many features with other oxidants, triggers IL-33 secretion. IL-33 expands innate lymphoid cells and the secretion of IL-13. This pathway is protective against airway dysfunction and inflammation in contrast to its pathogenic role in T2 high asthma. Novel biologics directed against the IL-33 pathway, although reducing exacerbations in T2 high asthma, may not be appropriate for T2 low irritant asthma.

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

  • Identify the potential importance of irritant exposure for the control of asthma;
  • Understand the endotypic characteristics of irritant asthma; and
  • Evaluate the characteristics of patients likely to benefit from some novel biologics directed against inleukin-33.

CanMEDS Roles Addressed: Health Advocate, Medical Expert, Scholar

Dr. James Martin

Dr. James Martin graduated with a BSc in physiology and an MB, BCh from University College Cork, Ireland. He received his training in internal medicine at Johns Hopkins University and in respiratory medicine at McGill University. He is currently a Professor of Medicine at McGill. He directed the Meakins Christie Laboratories at McGill University from October 1993 to October 2008 and was the Chair of the Department of Medicine at McGill from 2014 to 2019. Dr. Martin has more than 300 publications with a particular focus on the use of animal and cellular models to explore mechanisms of airway hyperresponsiveness and airway remodelling in asthma.

1730 - 1900
1900 - 2015

Co-Developed Symposium

1900 - 2015

Innovation in the Patient Journey: Optimizing Outcomes for PAH Patients

Speaker: John Granton, MD, University of Toronto, ON
Moderator: Paul Hernandez, MDCM, FRCPC, Dalhousie University, Halifax, NS

This presentation will provide the audience with the evidence for early identification of patients with Pulmonary Arterial Hypertension (PAH). It will provide an evidence-based approach to the evaluation of identifying PH in high risk groups and those with an elevated right ventricular systolic pressure (RVSP) on echocardiography to determine patients who would benefit from directed therapies. It will also provide an update on the role of exercise testing in the evaluation of patients with pulmonary hypertension.

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

  • Identify and screen high-risk patients for pulmonary hypertension;
  • Evaluate a patient with an elevation in right ventricular systolic pressure (RVSP) and identify those who might benefit from directed therapies; and
  • Integrate exercise testing into the evaluation of patients with suspected or confirmed pulmonary hypertension.

CanMEDS Roles: Collaborator, Communicator, Medical Expert, Professional, Scholar

Click here for session invitation

This session is co-developed by the Canadian Thoracic Society and Janssen and is planned to achieve scientific integrity, objectivity and balance.

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 a past President of the Canadian Thoracic Society and the current Chair of the Long-term Planning Committee.

1900 - 2015

Precision Medicine: Biologic Treatment in Complex Severe Asthma Patients

Speaker: Del Dorscheid, MD, PhD, University of British Columbia, Vancouver, BC
Moderator: Louis-Phillipe Boulet, MD, FRCPC, Laval University, Quebec, QC

Asthma is a common illness. Initial therapeutics were based upon an understanding that the airway inflammation was “allergic” in nature. Inhaled corticosteroids became the mainstay therapy in the 1990’s, reducing both morbidity and mortality. However, the prevalence and severity of asthma continues to increase and now affects about 10% of the population, with more having uncontrolled and/or severe disease. Guidelines now include pathways for “dual” and triple” therapies however not always resolving the symptoms for the severe asthmatic. The newest class of medications to treat asthma are the “biologics”. In general, these therapeutic monoclonal antibodies can bind IgE, IL-5, IL-5 receptor and the IL-4/13 receptor in effect to inhibit allergic, eosinophillic and Type 2 inflammatory processes. Not all of these biologics will work for all asthmatics. It is important to understand the inflammatory and clinical phenotype of our patients to pick the right drug for the right patient – precision medicine.

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

  • Review biologic therapies for severe asthma, including key efficacy and safety data from clinical trial programs and/or real-world evidence studies;
  • Understand how appropriate biomarkers and clinical features of disease can inform clinical decision making for biologic therapies; and
  • Discuss how comorbid T2 disease and safety considerations can affect the choice of biologic therapy for patients with severe asthma.

CanMEDS Roles Addressed: Medical Expert, Professional, Scholar

Click here for session invitation

This session is co-developed by the Canadian Thoracic Society and GSK and is planned to achieve scientific integrity, objectivity and balance.

Dr. Del Dorscheid

Dr. Del Dorscheid obtained his MD and PhD degrees from McGill University in 1993. He moved onto the University of Chicago for Internal Medicine and a fellowship in Pulmonary and Critical Care Medicine. He has now been at UBC since 2000 and is a tenured Associate Professor. Dr. Dorscheid attends in the medical intensive care unit at St. Pauls, is Director of the Severe Asthma Clinic and is a researcher in the UBC Center for Heart Lung Innovation. As a physician-scientist, he leads an active research group investigating the role of the airway epithelium in inflammatory airways disease that results from inappropriate injury-inflammation-repair cycles. Specific projects include the study of IL-13 in airway repair and the expression/function or the epithelium as an immune barrier. The goal for his research program is to promote and translate research findings into new treatments and improved patient care to reduce the burden of respiratory diseases.

 

0600 - 0715

Co-Developed Symposium

0600 - 0715

Co-management of CTD-ILD to Optimize Patient Outcomes

Speaker: Dr. Janet Pope, MD, FRCPC, Rheumatologist, St. Joseph’s Health Care London, London, ON
Moderator: Dr. Alyson Wong, MD, FRCPC, MHSc, University of British Columbia

ILD in RA and connective tissue diseases is a serious complication and needs identification and a multi-disciplinary treatment approach where we need to treat the underlying disease activity with immunesuppression and remove lung unfriendly medications, have general treatment such as exercise, treating hypoxemia, reducing aspiration (aggressive Rx of GERD), vaccinations and smoking cessation. Additionally, for progressive fibrotic ILD, anti-fibrotic medications have an important role to reduce lung progression. Methotrexate does not worsen ILD in rheumatic diseases but often patients have failed this treatment as they may develop ILD while on background disease modifying drugs. Co-management is important with excellent communication and a treatment plan that optimizes the expertise of both respirology and rheumatology. This state of the art lecture will include practical advice on patient cases, epidemiology and treatment for ILD in various patients such as rheumatoid arthritis, systemic sclerosis and other connective tissue diseases.

Learning objectives:

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

  • Review the workup of a patient with possible CTD-ILD to appraise the data in support of immunomodulatory therapy in CTD-ILD;
  • Explore the emerging role of anti-fibrotic therapy in CTD-ILD; and
  • Review best practices in co-management of ILD patients between the community and the ILD centre.

CanMEDS Roles Addressed: Collaborator, Health Advocate, Medical Expert

This session is co-developed by the Canadian Thoracic Society and Boehringer-Ingelheim and is planned to achieve scientific integrity, objectivity and balance.

Dr. Janet Pope

Dr. Janet Pope is a Professor of Medicine and head of the Division of Rheumatology at the University of Western Ontario (UWO), Schulich School of Medicine, London, Ontario, Canada.  She has published over 500 peer-reviewed articles and mentored more than 125 trainees. Research expertise includes scleroderma, SLE and RA. She has been inducted into the Canadian Academy of Health Sciences. Follow her clinical pearls on twitter @janetbirdope.

0600 - 0715

Moderate-to-Severe Asthma: A Therapeutic World before Biologic

Ron Grossman, MD, FRCPC, FACP, FCCP, University of Toronto, Toronto, ON
Moderator: Clare Ramsey, MD, MSc, FRCPC, University of Manitoba, Winnipeg, MB 

This talk will cover identification of features suggesting poorly controlled asthma and its consequences. The latest treatment paradigms will be discussed. Differentiation of currently available agents will be covered and new therapeutic options, particularly the addition of inhaled antimuscarinics, will be reviewed.

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

  • Detect features that suggest poor asthma control;
  • Recognize the consequences of poorly controlled asthma;
  • Identify new treatment paradigms for asthma; and
  • Appreciate new treatment options in the management of moderate-to-severe asthma.

CanMEDS Roles Addressed: Communicator, Health Advocate, Leader, Medical Expert, Professional, Scholar

Click here for session invitation

This session is co-developed by the Canadian Thoracic Society and Valeo Pharma and is planned to achieve scientific integrity, objectivity and balance.

 

Dr. Ronald Grossman

Dr. Ronald F. Grossman is Professor of Medicine, University of Toronto, and previous Chief of Medicine, Credit Valley Hospital, Mississauga, Ontario, Canada. He has published over 90 articles in a wide number of medical journals including New England Journal of Medicine, American Journal of Respiratory Critical Care Medicine, American Journal of Medicine and Chest. Dr. Grossman’s major research and teaching interests are in respiratory tract infections. He has participated in the creation of Canadian and American guidelines for the management of community-acquired pneumonia, Canadian guidelines for the management of hospital-acquired pneumonia and Canadian and international guidelines for the management of acute exacerbations of chronic obstructive lung disease. He previously served as the chairman of the National Information Program on Antibiotics (NIPA), a coalition of many medical and public health societies that was established to encourage the appropriate use of antibiotics among physicians and patients. Dr. Grossman recently was awarded the Murray Kornfeld Memorial Founder’s Lectureship by the American College of Chest Physicians.

0700 - 0815

Optional Breakfast Session

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

Masters of Ceremonies:
Chris Hergott, MD, FRCPC, FCCP
University of Calgary, Calgary, AB

Cory Yamashita, MD, FRCPC
London Health Sciences Centre, London, ON

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.

CanMEDS Roles Addressed: Collaborator, Communicator, Health Advocate, Leader, Medical Expert, Professional, Scholar

Dr. Cory Yamashita

Dr. Cory Yamashita is a Respirologist and current Program Director in the Division of Respirology at Western University.

Dr. Chris Hergott

Dr. Chris Hergott is a Clinical Associate Professor at the University of Calgary and the current program director of the Interventional Pulmonary Medicine program. He is the Chair of the Chest Procedures Assembly at the Canadian Thoracic Society and the previous Chair of the Membership Committee at the American College of Chest Physicians.

0730 - 0830
0830 - 1000

Plenary Session & Award Presentations

CIHR-ICRH/CTS Distinguished Lecture in Respiratory Sciences: Early Diagnosis and Treatment of Asthma and COPD

Shawn Aaron, MD, FRCPC
University of Ottawa, Ottawa, ON

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 2022 Distinguished Lecture in Respiratory Sciences has been awarded to Dr. Shawn Aaron from the University of Ottawa.

Session Description
This lecture will review the epidemiology and impact of undiagnosed asthma and COPD within our communities. We will discuss potential solutions to impact on this problem via case-finding of symptomatic patients and sending them for spirometry to establish diagnoses.

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

  • Understand the epidemiology and impact of undiagnosed asthma and COPD within our communities;
  • Understand how to identify these subjects and provide early diagnoses; and
  • Review whether early case-finding of symptomatic subjects may provide patient benefits.

CanMEDS Roles Addressed:
Health Advocate, Leader, Medical Expert, Professional

Dr. Shawn Aaron

Dr. Shawn Aaron is a respirologist with special research and clinical interests in chronic obstructive pulmonary disease (COPD), asthma and cystic fibrosis (CF). His research has been focused on investigating acute pulmonary exacerbations of these diseases, with a specific interest in the critical assessment of interventions designed to prevent exacerbations and improve the diagnosis and treatment of exacerbations of COPD and CF. His other major interest is health services research related to the correct diagnosis and treatment of obstructive lung diseases in Canadian communities.

Dr. Aaron is Principal Investigator and Director of The Canadian Respiratory Research Network, a CIHR Emerging Research Network whose goal is to bring together researchers across disciplines to work together in a coordinated fashion in order to improve understanding of the origins and progression of chronic airway diseases in Canada. He is a Professor at the University of Ottawa and a Senior Scientist at the Ottawa Hospital Research Institute.

Dr. Aaron received his M.D.C.M. from McGill University, then trained in internal medicine, respiratory medicine and critical care medicine at the University of Toronto. He joined the Department of Medicine at the University of Ottawa in 1996 and obtained his MSc degree in epidemiology from the University of Ottawa in 1999.

1000 - 1030
1030 - 1200

Concurrent Sessions

CTS Year in Review

1030 - 1115

Post-COVID Effects and Rehabilitation

Marla Beauchamp, PT, PhD
McMaster University, Hamilton, ON

A growing body of literature on the long-term effects of COVID-19 indicates that many patients suffer from persistent bothersome symptoms such as dyspnea, fatigue, and functional limitations. For this reason, major national and international organizations now recommend the provision of rehabilitation for patients with post-COVID conditions. This session will describe evidence on the long-term functional recovery of patients with COVID-19 and summarize the new CTS position statement on rehabilitation for COVID-19 and implications for pulmonary rehabilitation, including key selection criteria and program modifications.

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

  • Summarize the evidence on long-term effects of COVID-19
  • Describe best practice recommendations on rehabilitation for COVID-19
  • Identify patients with COVID-19 most likely to benefit from pulmonary rehabilitation

CanMEDS Roles Addressed: Collaborator, Health Advocate

Dr. Marla Beauchamp

Dr. Marla Beauchamp is a Physical Therapist and Assistant Professor in the School of Rehabilitation Science and Department of Medicine at McMaster University in Hamilton, Ontario, Canada. She holds a tier 2 Canada Research Chair in Mobility, Aging and Chronic Disease and an Early Researcher Award from the Ontario Minister of Colleges and Universities. Dr. Beauchamp’s research program is focused on developing evidence-based strategies to improve mobility among older adults, including those with COPD. Her ongoing research includes a multi-site longitudinal cohort study on long-term outcomes after COVID-19.

1115 - 1200

Aerosol Precautions in Pulmonary Function Testing

Improving Outcomes through Behaviour Change

1030 - 1100

How to Develop Implementable Behaviour Change Interventions in Respiratory Disease Research

Simon Bacon, PhD, FTOS, FCCS, FABMR
Concordia University, Montréal, QC

There is good epidemiological evidence that good health behaviours, e.g., eating well, being physically active, and not smoking, reduce the development and progression of respiratory diseases. However, it has been much harder to translate this evidence into practical implementable behaviour change interventions. A large part of why this is the case is that these interventions have not been systematically developed or tested. This presentation will provide details on newer frameworks to overcome this, and it will provide examples of how this might work in practice.

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

  • Describe systematic approaches to developing implementable behaviour change interventions; and
  • Detail how stakeholders are critical in the development of these kinds of interventions.

CanMEDS Roles Addressed: Collaborator, Leader, Scholar

Dr. Simon Bacon

Dr. Simon Bacon’s research deals with the impact of health behaviours and lifestyle (e.g., physical activity, diet, weight management, stress) on chronic diseases (e.g., obesity, cardiovascular disease, chronic lung disease, and COVID-19). This work uses multiple methodologies, including epidemiological, psychophysiological, evidence synthesis, and behavioural intervention development and testing designs, leveraging patient-oriented research and integrated knowledge translation approaches. Dr. Bacon is the CIHR SPOR Mentoring Chair in Innovative, Patient-Oriented, Behavioural Clinical Trials, the FRQS co-Chair in Artificial Intelligence and Digital Health for Health Behaviour Change, and the co-Director of the Montreal Behavioural Medicine Centre (www.mbmc-cmcm.ca). In addition, he is the co-founder and current co-lead of the International Behavioural Trials Network (www.IBTNetwork.org).

1100 - 1130

Shared Decision-Making in Respiratory Care

Myriam Gagné, PhD
Unity Health Toronto, St. Michael’s Hospital, Toronto, ON

Shared decision-making occurs when patients and providers mutually reach health decisions based on scientific evidence and patient goals and preferences. In asthma, this patient-centred approach has been shown to improve therapeutic adherence, yet implementation remains challenging in real-world care. In this presentation, we will review scientific knowledge about shared decision-making in respiratory care, including barriers and enablers to uptake and available tools to support implementation in routine clinical encounters. We will discuss how the new treatment paradigm for mild asthma represents a unique opportunity to drive shared decision-making in respiratory care.

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

  • Define shared decision-making and evaluate the extent to which this approach is currently implemented in your practice;
  • Use available implementation tools to support shared decision-making in real-world clinical interactions; and
  • Identify health decisions that could be made through a shared decision-making approach in respiratory care.

CanMEDS Roles Addressed: Communicator

Dr. Myriam Gagné

Dr. Myriam Gagné is a scientist who developed the first decision aid in asthma, to support implementation of shared decision-making. First trained in Education, she joined the eHealth Knowledge Translation Research Group at St. Michael’s Hospital as a CIHR- and FRQS-funded postdoctoral fellow, where she led the development of a novel decision aid for mild asthma (available at: www.asthmadecisionaid.com). Her research program focuses on actively engaging patients with chronic conditions (e.g.: asthma, COPD, atrial fibrillation, hepatitis C) in their care, with a focus on improving decision-making around medication use, and medication adherence.

1130 - 1200

Using Motivational Communication to Support Behaviour Change

Kim Lavoie, PhD, FCPA, FABMR
Université du Québec à Montréal (UQAM), Montréal, QC

Poor health behaviours (tobacco smoking, physical inactivity, and treatment non-adherence) are common causes and/or exacerbators of chronic respiratory diseases (asthma, COPD). Interventions focusing on education and “advice-giving” have failed to produce significant behaviour/lifestyle change in the majority of patients, often resulting in patient dissatisfaction with care and provider frustration. Motivational communication (MC) is an evidence-based client-centred communication style that has become increasingly popular within health care settings. At the heart of MC is getting patients to overcome their ambivalence (“I want to quit smoking, but…”) about health behaviour change through the use of basic motivational communication techniques. MC encourages empowering patients to take responsibility for their health and well-being, where healthcare professionals only serve as coaches or guides in the behaviour change process. This presentation will review the basic philosophy and ‘spirit’ of MC and illustrate how it may be used to support behaviour change in respiratory disease patients.

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

  • Describe the importance of communication skills for respiratory disease prevention and management;
  • Recognize the core principles and skills of motivational communication (MC); and
  • Demonstrate some of the basic skills of motivational communication (asking, listening and informing) to improve adherence and health risk behaviours and respiratory disease outcomes.

CanMEDS Roles Addressed: Collaborator, Communicator, Health Advocate, Professional

Dr. Kim Lavoie

Dr. Kim Lavoie is a Full Professor in the Department of Psychology at the Université du Québec à Montréal (UQAM) and holds a Tier 1 Canada Research Chair in Behavioural Medicine. She is the former Director of the Chronic Disease Research Division at the Hôpital du Sacré-Coeur de Montréal and current Co-Director of the Montreal Behavioural Medicine Centre. She holds a number of national and international leadership positions including Co-Lead of the International Behavioural Trials Network and Chair of the Canadian Network for Health Behaviour Change and is a member of the Canadian Expert Advisory Panel for COVID-19. Dr. Lavoie is internationally recognized for her research on chronic disease prevention and the impact of behavioural interventions such as motivational communication on health behaviours and chronic disease outcomes. She has held more than $30 million in grant funding and has more than 190 peer-reviewed papers and book chapters.

Lessons Learned from the Pandemic: E-health, Remote Monitoring and Long-Term Consequences

1030 - 1100

Virtual Care Beyond the Pandemic: A Health Quality Perspective

Geneviève Digby, MD, FRCPC, MSc(HQ)
Queen’s University, Kingston, ON

In this session, participants will reflect on how virtual care has evolved since the COVID-19 pandemic, including an exponential uptake in use and novel approaches to incorporating technologies in health care. The literature around advantages and disadvantages to virtual care will be presented, including considering where virtual care has the opportunity to improve health quality and where it has the potential to exacerbate inequities in care. Quality Improvement methodology will be reviewed, including how this approach can be used to optimize virtual care in an individual practice or organization.

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

  • Reflect on how virtual care has evolved since the COVID-19 pandemic
  • Understand how virtual care can have both positive and negative impacts on health quality
  • Use a Quality Improvement approach to optimize virtual care in an individual practice or organization

CanMEDS Roles Addressed: Collaborator, Communicator, Health Advocate, Leader, Professional

Dr. Geneviève Digby

Dr. Geneviève Digby is an Associate Professor in the Department of Medicine at Queen’s University, where she works as a Respirologist and Clinical Lead of the Diagnostic Assessment Programs.  She holds a Master of Science in Healthcare Quality and Chairs the Physician Quality Committee at Kingston Health Sciences Centre.

She is passionate about Quality Improvement (QI) in healthcare, particularly in terms of improving timeliness and access to care for patients with cancer, as well as optimizing resource utilization and streamlining health care processes. She chaired the Kingston Health Sciences Centre virtual care working group from 2019-2021.

1100 - 1130

Remote Monitoring in Pediatric Respiratory Medicine

Zofia Zysman-Colman, MDCM
McGill University, Montréal, QC

The COVID-19 pandemic disrupted normal healthcare delivery pathways across the world, whether by creating limitations of available space and staff or via a reluctance to attend routine health visits because of concerns for cross-infection. These concerns have led to a significant shift in the uptake of virtual health models. Home monitoring in lung disease, and specifically, remote monitoring of lung function, has emerged as an attractive modality of e-health for the pediatric respirologist. The widespread implementation of e-health has the potential to create a paradigm shift in the management of childhood lung disease. This talk will focus on available modes of remote monitoring in respiratory diseases, discuss the barriers to implementation, and review the advantages and limitations of such an approach. Finally, the effect on patient- and provider-perceived quality of care will be reviewed.

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

  • Review the approaches to remote monitoring of children with respiratory disease, with a focus on asthma and cystic fibrosis;
  • Analyze the limitations of remote monitoring in the care of children with pediatric respiratory disease; and
  • Appraise the effect of remote monitoring on patient- and provider-perceived quality of care.

CanMEDS Roles Addressed: Health Advocate, Medical Expert

Dr. Zofia Zysman-Colman

Dr. Zofia Zysman-Colman is a Pediatric Respirologist currently working at the Montreal Children’s Hospital, where her focus is caring for children with cystic fibrosis. She completed her Respiratory Medicine fellowship at McGill University and post-fellowship training at the Children’s Hospital of Philadelphia.

1130 - 1200

Respiratory Consequences of COVID-19 Infection in Children

Thanh-Diem Nguyen, MD, FRCPC, MSc
Centre hospitalier universitaire Sainte-Justine, Montréal, QC

While most children with COVID-19 recover and return to normal health, some can develop symptoms that last for weeks or even months after recovery from acute illness. Although long COVID symptoms have been well documented and described in pediatric populations, the exact impact and prevalence remains poorly defined. It is also unclear what the best approach to evaluation and management is in the presence of persistent respiratory symptoms. Current knowledge on pediatric long COVID, with a focus on respiratory symptoms, will be summarized and one referral centre’s approach will be reviewed.

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

  • Recognize the global impact of SARS-CoV-2 on children, with a focus on respiratory morbidity; and
  • Describe one centre’s approach to investigation and management of paediatric respiratory long COVID.

CanMEDS Roles Addressed: Medical Expert, Scholar

Dr. Thanh-Diem Nguyen

Dr. Thanh-Diem Nguyen received clinical training at the Centre hospitalier universitaire Sainte-Justine and is an Assistant Professor of Pediatrics at the Université de Montréal. She is a paediatric respirologist at the Post-COVID-19 Clinic at the Centre hospitalier universitaire Sainte-Justine.

1030 - 1200

Test Your ILD Knowledge – An Interactive Multidisciplinary Team Discussion of ILD Cases – Section 3

Margaret Kelly, MBChB, PhD, FCP (SA), FRCPC
University of Calgary and Snyder Institute for Chronic Diseases and Alberta Children’s Hospital Research Institute, Calgary, AB

Daniel Marinescu, MD, FRCPC
University of British Columbia, Vancouver, BC

Julie Morisset, MD, FRCPC
Centre hospitalier de l’Université de Montréal , Montréal, QC

Giang Nguyen, MD, FRCPC
Island Health, Victoria, BC

Alyson Wong, MD, MHSc, FRCPC
St. Paul’s Hospital and University of British Columbia, Vancouver, BC

Presentation of a clinical case to facilitate discussion of diagnostic challenges and demonstrate the value of interdisciplinary 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 interdisciplinary discussion;
  • Understand the potential value of lung biopsy in managing ILD; and
  • Consider the less common causes of ILD.

CanMEDS Roles Addressed: Collaborator, Communicator, Health Advocate, Medical Expert, Professional, Scholar

Dr. Margaret Kelly

Dr. Margaret Kelly is a Professor and a Clinician-Scientist in the Department of Pathology and Laboratory Medicine at the Cumming School of Medicine at the University of Calgary. An Anatomical Pathologist with subspecialization in lung pathology, she is leader of the Lung Pathology Group in Calgary and co-Chair of the Alberta Provincial Thoracic Pathology Group. She holds the Chair in Pediatric Respirology at the University of Calgary, and her research interests include the pathology of asthma and interstitial lung disease. She has over 70 peer-reviewed publications including articles in Nature Medicine, Nature Immunology and the Journal of Clinical Investigation.

Dr. Daniel Marinescu

Dr. Daniel Marinescu received his Doctor of Medicine from McGill University and completed residency training in Internal Medicine and Respirology at the University of Toronto. He subsequently went to Vancouver to complete a fellowship in interstitial lung disease and Master of Health Science at the University of British Columbia. He currently works as a locum at The Lung Centre. His research interests include morphology, diagnosis and genetics of interstitial lung disease.

Dr. Julie Morisset

Dr. Julie Morisset is an Assistant Clinical Professor at the Université de Montréal. She works at the interstitial lung disease clinic and lung transplant program of the Centre hospitalier de l’Université de Montréal. Dr. Morisset completed an interstitial lung disease fellowship and master’s in clinical research at the University of California, San Francisco. Her research focuses on hypersensitivity pneumonitis and the multidisciplinary approach to interstitial lung disease diagnosis.

Dr. Giang Nguyen

Dr. Giang Nguyen graduated from the University of Alberta medical school in 2000 and went on to complete a family medicine residency in 2002.  She re-entered training in Radiology at the University of British Columbia from 2008-2012, with completion of a cardiac fellowship in 2013.  Her academic career includes being a Clinical Instructor for UBC from 2013-2018, Assistant Professor at Queen’s University in the Cardiothoracic Division from 2018-2020, and she is currently an Assistant Professor at UBC – Vancouver Island.

 

Dr. Alyson Wong

Dr. Alyson Wong completed her core medical training at the University of British Columbia (UBC), followed by a Respirology fellowship at Dalhousie University. She subsequently returned to UBC where she completed a 2-year Interstitial Lung Disease (ILD) clinical and research fellowship and Master of Health Science. Dr. Wong is currently a Clinical Instructor in the Department of Medicine at UBC and postdoctoral research fellow with the Centre for Heart Lung Innovation. She works as a respirologist in the ILD program at St. Paul’s Hospital. Her research focus is on health economics and outcomes research in ILD.

Update on Pulmonary Hypertension, Cystic Fibrosis and Lung Transplantation

1030 - 1100

Pulmonary Hypertension – What’s New in 2022?

John Swiston, MD, MPH, FRCPC
Vancouver General Hospital and University of British Columbia, Vancouver, BC

Pulmonary hypertension (PH) is characterized by elevated pressures in the pulmonary circulation and can arise from a number of conditions. Because the management strategies for PH depends on the underlying condition, it is important to accurately identify the cause of this disease in each patient. Recent years have seen a number of therapeutic advances in care of patients with PH. This presentation will review the current guidelines and recommendations for the diagnosis and management of pulmonary hypertension. New therapeutic strategies and treatments for pulmonary hypertension will also be discussed in the context of future directions in this field.

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

  • Understand the current guidelines and recommendations  for the diagnosis and management of pulmonary hypertension
  • Understand new therapeutic strategies for pulmonary hypertension
  • Appreciate future directions in the care of patients with pulmonary hypertension

CanMEDS Roles Addressed: Communicator, Health Advocate, Medical Expert, Scholar

Dr. John Swiston

Dr. John Swiston joined the Respiratory Division at the Vancouver General Hospital in 2007 and is currently an Associate Professor with the University of British Columbia. He is the Medical Director of the UBC Pulmonary Hypertension Program at VGH. He is the Chair of the Medical Advisory Committee for PHA Canada and a member of the Canadian Thoracic Society Pulmonary Vascular Disease Committee. Dr Swiston is also the Chair of the Canadian Pulmonary Hypertension Registry.

1100 - 1130

Cystic Fibrosis in the Era of Highly Effective CFTR Modulators

Larry Lands, MD, PhD
McGill University Health Centre and McGill University, Montréal, QC

Cystic Fibrosis (CF) is an autosomal recessive disorder that leads to progressive lung damage and premature mortality. There are now over 4,300 Canadians with CF, with 62% being over the age of 18 years. Approximately 90% of Canadian patients carry one copy of the delF508 mutation. Understanding the basic defect, a dysfunction of the Cystic Fibrosis Transmembrane conductance Regulator (CFTR), a chloride channel, has led to the development of highly effective CFTR modulators for those with at least one copy of delF508 or those with gating or residual function mutations. This presentation will discuss the development of these highly effective CFTR modulators and their impact on clinical outcomes in CF.

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

  • Describe how mutations in CFTR affect CFTR abundance and function;
  • Select modulators appropriately for the individual patient; and
  • Evaluate the clinical response to modulators.

CanMEDS Roles Addressed: Communicator , Health Advocate, Medical Expert, Professional

Dr. Larry Lands

Dr. Larry Lands is Director, Pediatric Respiratory Medicine, and Director of the Pediatric Cystic Fibrosis (CF) Clinic at the McGill University Health Centre. He is a tenured Full Professor of Pediatrics at McGill University. His primary research interests are in inflammation and infection and functional capacity in patients with chronic lung disease, with a particular focus on CF. He is Chair of the CTS Research Committee, Chair of Cystic Fibrosis Canada’s Research Advisory Council and a member the Patient Data Registry Oversight Committee. He is a member of the steering committee of CF Canada’s clinical research network, CFCanACT, and co-chairs its protocol review subcommittee.

1130 - 1200

Lung Transplantation – Who Is Getting Transplanted in 2022 and What Are the Outcomes?

Alim Hirji, MD, MSc
University of Alberta, Edmonton, AB

During this session we will review current trends across Canada in regards to lung transplant activity and review recent international consensus guideline updates to candidate selection. We will also review the effects of the COVID-19 pandemic as well as review current survival rates and clinical outcomes post-lung transplant and review innovation underway to improve outcomes while on the waitlist and post-lung transplant.

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

  • Identify an appropriate candidate for lung transplantation;
  • Cite lung transplant activity across Canada, survival rates and incidence of frequent comorbidities post-lung transplant; and
  • Recognize the impact of the COVID-19 pandemic on lung transplantation in Canada.

CanMEDS Roles Addressed: Health Advocate, Medical Expert

Dr. Alim Hirji

Dr. Alim Hirji is an Associate Professor in the Department of Medicine at the University of Alberta. He received his Doctor of Medicine from McMaster University, completed his internal medicine training at the University of Toronto and his pulmonary medicine fellowship through the University of British Columbia. He completed a fellowship in lung transplantation in the Toronto Lung Transplant Program and has a Masters in Epidemiology through the London School of Hygiene and Tropical Medicine. His clinical practice includes lung transplantation, general pulmonary medicine, and interventional bronchoscopy. He is the current chair of the lung section for the Canadian Society of Transplantation.

1200 - 1330

Lunch / Sponsor Display / Poster Viewing

1200 - 1330

CTS-CHEST Conjoint Session and Luncheon: Management of Pulmonary and Critical Care Disorders in Pregnancy

Stephanie Levine, MD, FCCP
The University of Texas Health Science Center at San Antonio, San Antonio, TX, USA

The management of common and less common pulmonary and critical care disorders may require modification when caring for the pregnant patient. This session will review some of these topics. Both practitioners and fellows in training require periodic review on this topic. Practitioners may not be as familiar with the unique aspects of the management of these disorders in pregnant patients, and further education on this topic is needed.

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

  • Summarize normal respiratory and cardiovascular physiology in pregnancy;
  • Review the management of pulmonary diseases such as asthma, venous thromboembolism, tuberculosis and other respiratory infection in pregnancy; and
  • Highlight the major causes and management of respiratory failure in pregnancy.

CanMEDS Roles Addressed: Leader, Medical Expert

Dr. Stephanie M. Levine

Dr. Stephanie M. Levine is a Professor of Medicine with tenure in the Department of Medicine, Division of Pulmonary Diseases and Critical Care Medicine, at UT Health San Antonio. She is board-certified in internal medicine, pulmonary disease and critical care medicine. Dr. Levine received her undergraduate degree from the University of Pennsylvania and her medical degree from the George Washington University School of Medicine, where she was a member of the Alpha Omega Alpha Medical Honor Society. She completed her Internship and Residency in Internal Medicine and Fellowship in Pulmonary Disease and Critical Care Medicine at the New York University-Manhattan Veterans Administration-Bellevue Hospital Program in New York City.

Dr. Levine is the Program Director of the Pulmonary and Critical Care Fellowship at UT Health- San Antonio. She also is a staff physician at the Audie Murphy Veteran Administration Hospital. Dr. Levine has authored or co-authored over 270 manuscripts, chapters, reviews, editorials and abstracts, primarily in her major field of interest, lung transplantation. Her other areas of interest include pulmonary and critical care issues in pregnancy and women’s lung health and eosinophilic lung disorders. Dr. Levine is a Fellow and active member of the American College of Chest Physicians (CHEST) and served as CHEST President from 2019-2020.

1330 - 1500

CONCURRENT SESSIONS

Non-invasive Ventilation: Practices in Monitoring and Interpretation – Section 3

1330 - 1400

NIV for Individuals with COPD

François Maltais, MD
Institut universitaire de cardiologie et de pneumologie de Québec – Université Laval, Québec City, QC

Chronic hypercapnic respiratory failure is common in advanced COPD, and it is associated with adverse outcomes. Long-term non-invasive ventilation (NIV) has been used with uncertain efficacy in this condition, but recent clinical trials suggest possible survival and hospital admission rate benefits. The purpose of this presentation will be to review current evidence regarding long-term NIV in the treatment of chronic hypercapnic respiratory failure specifically related to advanced COPD. Current guideline recommendations, including the 2021 Canadian Thoracic Society Clinical Practice Guideline Update on long-term NIV in patients with COPD, will be reviewed. Lastly, we will discuss how to implement long-term NIV in stable COPD.

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

  • Describe the expected benefits of non-invasive ventilation (NIV) in stable COPD;
  • Describe the recent recommendations for the use of NIV in stable COPD, including those from the 2021 Canadian Thoracic Society Clinical Practice Guideline Update; and
  • Prescribe and adjust NIV in stable COPD.

CanMEDS Roles Addressed: Medical Expert, Professional, Scholar

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.

1400 - 1430

Remote Monitoring and Home Mechanical Ventilation

Esther Khor, RRT, MMgt
Provincial Health Service Authority, Vancouver, BC

Home mechanical ventilation is increasing in many countries, including Canada. Individuals using home ventilation are exercising their autonomy to manage complex care at home. The advancement in technology has led to smaller ventilators, which further supports the transition of respiratory care into the home. As health care is evolving into the home setting, strengthening the support system for ventilated individuals and their family caregivers is important. In this presentation, we will review the barriers that ventilated individuals and their family caregivers have expressed and consider the application of remote monitoring to improve care. Remote monitoring will be reviewed in a few cases to demonstrate its application to support continuous care, accessibility of care and improve the ventilated individual’s experience at home.

Learning Objectives:

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

  • Better understand home ventilation in British Columbia;
  • Better understand barriers in delivering home ventilation; and
  • Better understand benefits of remote monitoring.

CanMEDS Roles Addressed: Collaborator, Communicator, Health Advocate

Ms. Esther Khor

Esther Khor is the Research Operation Manager for the Post COVID-19 Interdisciplinary Clinical Care Network (PC-ICCN). She is a Respiratory Therapist and completed her Masters in Health Management at McGill University. Before this opportunity to collaborate with PC-ICCN, she was the Manager for the Provincial Respiratory Outreach Program (PROP) and worked in non-profit community care for over nine years. During this time, she learned to listen openly to patients, caregivers and their local clinicians. To support knowledge translation, she co-chaired a Canadian Home Ventilation Network to share strategies to improve patient care with colleagues across Canada.

1430 - 15:00

NIV and Children with Neuromuscular Disease and Other Medical Complexities

Reshma Amin, MD, FRCPC, MSc
The Hospital for Sick Children and University of Toronto, Toronto, ON

This 30-minute case-based session will provide an approach to the monitoring of patients with NIV including clinic visit frequency, polysomnograms and NIV data download interpretation in children with neuromuscular disease and other comorbidities. Clinic visit frequency and the utility of polysomnography/gas exchange measurements will be discussed. In addition, a stepwise approach to the interpretation of ventilatory data downloads will be reviewed including adherence, leak management and efficacy. The metrics to consider for adherence in pediatric patients will be discussed. Key concepts for leak management including intentional and unintentional leak and differences between manufacturers will be reviewed. Learners will also be provided with an approach to the interpretation of efficacy metrics including tidal volumes, rapid shallow breathing index and percentage spontaneous triggered and cycled breaths as well as inspiratory times. Combined ventilator data download reports with oximetry and heart rate will also be reviewed. The clinical cases will include a wide range of NIV devices and modes.

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

  • Appreciate the importance of routine polysomnograms/gas exchange evaluation to continually evaluate the necessity and efficacy of NIV therapy in conjunction with NIV data download interpretation;
  • Use a stepwise approach to NIV data download interpretation (adherence, leak and efficacy) to augment the clinical management of children using NIV at home; and
  • Troubleshoot common clinical issues identified on NIV data downloads and have an approach to their management.

CanMEDS Roles Addressed: Collaborator, Communicator, Health Advocate, Leader, Medical Expert, Professional, Scholar

Dr. Reshma Amin

Dr. Reshma Amin is the Director of Sleep Medicine and 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.

Palliative Care for People with Respiratory Disease: Beyond Cancer

1330 - 1350

Early Integration of Palliative Care for Chronic Respiratory Diseases

Donna Goodridge, RN, PhD
University of Saskatchewan, Saskatoon, SK

Advanced non-malignant lung diseases, such as COPD and ILD, are associated with significant suffering and mortality. Although evolving therapies have prolonged survival and improved disease management, distressing and debilitating symptoms, such as dyspnea, cough and fatigue, can create persistent high levels of symptom burden. A palliative approach, offered in conjunction with disease-directed therapies, can be incorporated into the care of persons with advanced non-malignant disease many years before death. Early integration of a palliative approach to care in patients with advanced respiratory illnesses is increasingly recognized as an evidence-based approach to alleviating symptom burden and promoting quality of life. This session will provide a synthesis of the literature with respect to emerging models of integrated palliative and respiratory care. This will be followed by an interactive, case-based session highlighting common clinical scenarios encountered in caring for patients with advanced non-malignant respiratory disease.

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

  • Identify the key principles of palliative care;
  • Describe models and outcomes of early integration of a palliative approach for respiratory patients; and
  • Apply the principles of palliative care to the care of patients with advanced respiratory diseases.

CanMEDS Roles Addressed: Communicator, Health Advocate, Medical Expert, Professional

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 current research interests include health systems improvement, particularly as this relates to older adults and women living with chronic diseases such as Obstructive Sleep Apnea. Dr. Goodridge has been involved with the Canadian Thoracic Society (CTS) and Canadian Respiratory Health Professionals (CRHP) since 2005.

1350 - 1500

Palliative Care in Respirology – Whose Job Is It Anyway?

Shalini Nayar, MD, FRCPC
University of British Columbia, Vancouver, BC

Advanced non-malignant lung diseases, such as COPD and ILD, are associated with significant suffering and mortality. Although evolving therapies have prolonged survival and improved disease management, distressing and debilitating symptoms, such as dyspnea, cough and fatigue, can create persistent high levels of symptom burden. A palliative approach, offered in conjunction with disease-directed therapies, can be incorporated into the care of persons with advanced non-malignant disease many years before death. Early integration of a palliative approach to care in patients with advanced respiratory illnesses is increasingly recognized as an evidence-based approach to alleviating symptom burden and promoting quality of life. This session will provide a synthesis of the literature with respect to emerging models of integrated palliative and respiratory care. This will be followed by an interactive, case-based session highlighting common clinical scenarios encountered in caring for patients with advanced non-malignant respiratory disease.

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

  • Identify the key principles of palliative care;
  • Describe models and outcomes of early integration of a palliative approach for respiratory patients; and
  • Apply the principles of palliative care to the care of patients with advanced respiratory diseases.

CanMEDS Roles Addressed: Communicator, Health Advocate, Medical Expert, Professional

Dr. Shalini Nayar

Dr. Shalini Nayar is currently practising as both a Respirologist and Palliative Medicine specialist in British Columbia at the Surrey Memorial Hospital site and the BC Cancer Agency. She attended McMaster University for her Internal Medicine training and subsequently completed the Respirology fellowship at the University of British Columbia (UBC) as well as the Palliative Medicine training program. Dr. Nayar is currently functioning in the capacity of Local Department Head, acute Palliative Care program for Surrey acute and is a Clinical Assistant Professor with the UBC Department of Medicine. Her interests, presentations and publications have focused on the importance of palliative care interventions in both malignant and non-malignant disease.

Present and Future of Cystic Fibrosis

1330 - 1400

Challenges in Newborn Screening for Cystic Fibrosis

Patrick Daigneault, MD
Centre Mère-Enfant Soleil du Centre hospitalier universitaire de Québec-Université Laval, Quebec City, QC

Newborn screening is an essential component of early patient care in cystic fibrosis, allowing for better disease outcomes. However, newborn screening programs for cystic fibrosis still face many challenges – whether organizational, technical or ethical – that need to be regularly addressed. Also, some cases remain challenging and ongoing research is interested in determining which of these children need to be reassessed. This session will discuss these challenges and how to face them.

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

  • Better understand the role of newborn screening for cystic fibrosis in 2022;
  • Learn about the various challenges faced by CF newborn screening programs; and
  • Understand why some indeterminate cases and CFSPID patients need periodic reevaluations.

CanMEDS Roles Addressed: Health Advocate, Leader, Medical Expert

Dr. Patrick Daigneault

Dr. Patrick Daigneault is a pediatric respirologist and director of the cystic fibrosis clinic at the Centre Mère-Enfant du Centre hospitalier universitaire de Québec-Université Laval in Quebec City.

1400 - 1430

CFTR Modulators: Correcting or Potentiating What?

Mark Chilvers, MRCPCH, MD, BSc, MBChB
University of British Columbia, Vancouver, BC

The care of CF has been revolutionized by the development of small molecule therapies known as CFTR modulators. This has opened the field for precision medicine for CF patients based on the underlying CFTR variant. With the approval by Health Canada and recommendation by CADTH of newer CFTR modulators, the aim of this presentation is to give an overview of modulator therapy development, mechanism of action and impact on CF care. In addition, following the recent publication of the Canadian CFTR modulator guideline, the evaluation, monitoring and safety of modulator therapy will be reviewed. Finally, recent published data on newer modulator therapy will be presented.

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

  • Understand the current CFTR modulators mechanism of action;
  • Provide an update on the clinical trials involving CFTR modulators; and
  • Review the impact of CFTR modulators in CF care.

CanMEDS Roles Addressed: Medical Expert, Scholar

Dr. Mark Chilvers

Dr. Mark Chilvers is a Clinical Associate Professor of respiratory medicine in the Division of Pediatric Respiratory Medicine at the University of British Columbia and a clinical investigator with the BC Children’s Hospital Research Institute. As the CF clinic director at BC Children’s Hospital, he coordinates the clinical program and promotes a multidisciplinary approach to CF care and research. Recently appointed as Medical Director for CF Care BC, he and others have been working towards development of provincial care for all patients with CF in BC. His clinical research focus is on childhood diseases in pediatric respirology, including cystic fibrosis (CF), non-CF bronchiectasis and Primary Ciliary Dyskinesia. He is a member of CF CANact, conducting clinical trials for Canadian patients with CF, and is one of the Co-Directors of Canadian Burkholderia cepacia complex research and referral repository.

1430 - 1500

Lung Transplant: Transformations and Transgressions

Melinda Solomon, MD, FRCPC
The Hospital for Sick Children and University of Toronto, Toronto, ON

With improvements in the care of children with Cystic Fibrosis, the demographics of pediatric lung transplantation are changing. This presentation will discuss the changing trends, the nuances of pediatric and infant lung transplantation and highlight new innovative approaches.

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

  • Describe the changing pediatric lung transplant recipient;
  • Recognize the impact of CFTR modulators on pediatric lung transplantation; and
  • Outline the extraordinary innovations in lung transplantation.

CanMEDS Roles Addressed: Collaborator, Health Advocate

Dr. Melinda Solomon

Dr. Melinda Solomon is the Medical Director of the Pediatric Lung Transplant Program and the Director of the Cystic Fibrosis Clinic at The Hospital for Sick Children. She is also the Training Program Director and is passionate about teaching. She is a Professor of Pediatrics at the University of Toronto. Dr. Solomon completed medical school at the University of Toronto, then completed her pediatric residency and respirology fellowship at The Hospital for Sick Children. Following specialized training in lung transplantation, she joined the Division of Respiratory Medicine at The Hospital for Sick Children in 2000.

CTS-European Respiratory Society Conjoint Session

1330 - 1430

Genotype Phenotype Relationships in Heritable Pulmonary Hypertension

Marc Humbert, MD, PhD, FERS
Université Paris-Saclay, Le Kremlin-Bicêtre, France

Pulmonary arterial hypertension (PAH) is a rare and severe condition which can be idiopathic, familial, induced by drugs or toxins, or associated with other conditions such as connective tissue disease or congenital heart disease. Heterozygous BMPR2 mutation is the most common genetic cause of familial/heritable PAH. BMPR2 encodes a type II receptor of the transforming growth factor beta superfamily. BMPR2 mutation carriers have a lifetime risk of developing PAH of ~20%, with penetrance higher in female carriers (42%) compared with male (14%). Genetic counselling allows detection of mutations in PAH predisposing genes in patients with idiopathic, familial or drug-induced PAH. Relatives of patients carrying BMPR2 mutation can also be counselled and tested. In asymptomatic BMPR2 mutation carriers, screening can identify early-stage PAH. Other gene mutations have been identified in PAH (ACVRL1, EIF2AK4, TBX4, SOX17…). This presentation will genotype phenotype relationships in heritable PAH.

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

  • Describe the main gene mutations causing heritable pulmonary hypertension with an emphasis on BMPR2 and EIF2AK4;
  • Discuss the results of a PAH screening program in asymptomatic carriers of BMPR2 mutations; and
  • Present recent findings on rare mutations linking heritable PAH with lung development.
Dr. Marc Humbert

Dr. Marc Humbert is the President of the European Respiratory Society. He is Professor of Respiratory Medicine at the Université Paris-Saclay, Director of the Department of Respiratory and Intensive Care Medicine, French Pulmonary Hypertension Reference Centre and Severe Asthma Clinic at the Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris, France. Dr. Humbert was the Chief Editor of the European Respiratory Journal from 2013 to 2017, and he is currently Section Editor in charge of Pulmonary Vascular Medicine. Clarivate Analytics lists Dr. Humbert as one of the world’s highly cited researchers in the field of Clinical Medicine.

1430 - 1500

Standardized Interpretation of Pulmonary Function Data: The Global Lung Function Initiative

Sanja Stanojevic, PhD
Dalhousie University, Halifax, NS

Pulmonary function test results play an important role in the diagnosis and management of respiratory disease. Interpretation of measured values hinges on the appropriate comparison to a healthy reference population. Choosing an appropriate reference equation that reflects the genetic ancestry, environment and geography of an individual patient is important but becoming increasingly difficult to do. This session will highlight the Global Lung Function Initiative reference equations as a tool to standardize the interpretation of pulmonary function tests worldwide. The advantages and challenges within the Canadian context will be summarized and discussed. In particular, the session will review the challenges and mitigating strategies to using race/ethnic specific equations.

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

  • Summarize the Global Lung Function Initiative reference equations for spirometry, transfer factor for carbon monoxide and static lung volumes;
  • Highlight the advantages and challenges to using a Global reference equation for interpretation of lung function; and
  • Describe the challenges of incorporating race/ethnicity into the interpretation of pulmonary function results.

CanMEDS Roles Addressed: Communicator , Leader, Professional, Scholar

Dr. Sanja Stanojevic

Dr. Sanja Stanojevic is an Assistant Professor in the Department of Community Health and Epidemiology at Dalhousie University, Halifax, Nova Scotia. Her research focuses on epidemiology of respiratory diseases and application of novel statistical methods to improve interpretation of objective measures of lung function. Dr. Stanojevic is Chair of the ERS Global Lung Function Initiative Clinical Research Collaborative and Vice-Chair of the ATS Pulmonary Function Testing Proficiency Committee. She also co-chaired the CTS/CSRT position statement for the Resumption of Pulmonary Function Testing during the post-peak phase of the COVID-19 pandemic.

Canadian Tuberculosis Standards Update / Nontuberculosis Mycobacteria

1330 - 1400

Diagnosis and Treatment of Active TB Including Drug Resistant TB and Extra-pulmonary TB

Dick Menzies, MD
McGill University, Montréal, QC

This presentation will explain the changes and updated recommendations for management of active TB that are part of the newly released 8th edition of the Canadian TB Standards.

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

  • Learn and understand the rationale for the updated recommendations for treatment of drug-sensitive active TB;
  • Learn the rationale and updated recommendations for treatment of drug resistant TB; and
  • Learn about the management of common extra-pulmonary forms of TB.

CanMEDS Roles Addressed: Health Advocate, Medical Expert, Scholar

Dr. Dick Menzies

Dr. Dick Menzies received his medical training at McGill University in Montreal and specialty training in Internal Medicine at the Medical College of Pennsylvania in Philadelphia, USA. He then worked for 2½ years in Lesotho, Africa, where he was first exposed (literally) to tuberculosis – in all its forms and with all its devastation. He then received sub-specialty training in Respiratory Medicine and a Masters degree in Epidemiology & Biostatistics at McGill University. Dr. Menzies served as Medical Director at the Montreal Chest Institute for a total of 10 years ending in 2002 and then as Director of the Respiratory Division for 9 years. He was also Director of the Respiratory Epidemiology Unit at McGill for almost 15 years and is now Director of the McGill WHO Collaborating Centre in TB Research and the McGill International TB Centre.

1400 - 1430

Diagnosis and Treatment of Latent TB

Gonzalo Alvarez, MD, MPH, FRCPC
The Ottawa Hospital, Ottawa, ON

The treatment of latent tuberculosis infection (LTBI), referred to as tuberculosis preventive treatment (TPT), is paramount as Canada moves towards TB elimination. We will review all of the new regimens that are now being recommended since the last Canadian guidelines were published in 2013. We will also review specific populations and recommended treatment approaches including transplants, pregnancy, contacts of a drug resistant case, renal disease. A suggested approach to pre-treatment evaluation and evaluation during treatment will be presented. We will also review emerging regimens that are being investigated.

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

  • Learn the new first line treatments available for latent TB infection treatment;
  • Learn about the management of TB preventive treatment in specific populations; and
  • Learn the pre-treatment evaluation and evaluation during treatment.

CanMEDS Roles Addressed: Scholar

Dr. Gonzalo Alvarez

Dr. Gonzalo Alvarez is the current Chair and Chief of the Division of Respirology at The Ottawa Hospital. He is also an Associate Professor of Medicine at the University of Ottawa, School of Epidemiology and Public Health, as well as a Scientist at the Ottawa Hospital Research Institute. He holds a University Chair in Tuberculosis in Canadian Indigenous communities. Along with Inuit partners, Dr. Alvarez founded the TAIMA TB (which means “Stop TB” in Inuktut) research group in 2010.

1430 - 1500

Nontuberculous Mycobacterial (NTM) Pulmonary Disease: Diagnosis and Management

Julie Jarand, MD, FRCPC
Alberta Health Services, Calgary, AB

Nontuberculous mycobacterial infections are a worldwide problem and are becoming increasingly prevalent in many countries. The role of the environment and the importance of risk factors in different hosts is under active investigation. Diagnostic criteria for NTM pulmonary disease have been outlined in international guidelines but making a diagnosis of NTM pulmonary disease can still be challenging. The decision around whether or not to start treatment in patients who meet diagnostic criteria is often complex. Treatment for NTM lung disease can be difficult as it requires multiple antibiotics (oral +/- intravenous) for a minimum for 12 months after culture conversion. This prolonged therapy is often associated with side effects and/or toxicity. Therefore, communication with the patient, other care providers and long-term follow-up is essential to try to achieve treatment and patient goals.

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

  • Review the epidemiology of NTM and identify risk factors associated with NTM pulmonary disease;
  • Recognize how to diagnose NTM pulmonary disease and which patients are candidates for treatment; and
  • Describe how to treat NTM pulmonary disease (in particular, Mycobacterium avium complex).

CanMEDS Roles Addressed: Collaborator, Medical Expert

Dr. Julie Jarand

Dr. Julie Jarand completed her undergraduate medical education, internal medicine residency and respirology fellowship at the University of Calgary. She then completed a combined clinical and research fellowship in mycobacterial infections at National Jewish Health in Denver, Colorado, and at the University of Cape Town in Cape Town, South Africa. She has been working in Calgary since 2008 as a member of the Division of Respirology at the University of Calgary. She is the medical director of the Nontuberculous Mycobacterial Infection clinic and medical director of the non-CF Bronchiectasis clinic. She also provides care to tuberculosis and general respirology patients. She has an ongoing and keen interest in all aspects of nontuberculous myocbacterial infections, tuberculosis and non-CF bronchiectasis.

1500 - 1530
1530 - 1700

Moderated Poster Session

1700 - 1800

Mix and Mingle Reception / Sponsor Display / Prize Draws

1815 - 1930

Co-Developed Symposia

1815 - 1930

PRO & CON Debate: Earlier Escalation of Pharmacologic Treatment in COPD Management

Panelists:
Charles Chan, MD, FRCPC, FCCP, FACP, University of Toronto, Toronto, ON
Joshua Wald, MD, FRCPC, McMaster University, Hamilton, ON

Moderator: Mohit Bhutani, MD, FRCPC, FCCP

Presentation of the latest evidence guiding clinical decision making for COPD therapies to optimize management of COPD patients using real-world evidence and/or case study-based examples. Debate will focus on the pro/con analysis of clinical data and case-based examples of earlier escalation of pharmacologic treatment in COPD management.

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

  • Review COPD therapies in Canada, including key efficacy and safety data from clinical trial programs and/or real-world evidence studies, highlighting the various considerations needed for treatment optimization in COPD management;
  • Understand how appropriate treatable traits and clinical features of disease can inform clinical decision making for COPD management and safety risk/efficacy benefit considerations when deciding on escalation of COPD treatment; and
  • Discuss how patient outcome, expectations and safety considerations can affect the choice of COPD therapy for patients at varying progression of COPD disease (including mortality).

CanMEDS Roles Addressed: Collaborator, Communicator, Health Advocate, Medical Expert, Professional, Scholar

Click here for session invitation

This session is co-developed by the Canadian Thoracic Society and GSK and is planned to achieve scientific integrity, objectivity and balance.

Dr. Charles Chan

Dr. Charles Chan’s current roles include Emeritus Professor of Medicine at University of Toronto (UofT) and Consultant Respirologist at University Health Network (UHN), and he is the Medical Director and Owner of Rosedale Pulmonary Function Laboratory and Agincourt Pulmonary Services in Toronto. He is the lead Respirology assessor for the College of Physicians and Surgeons of Ontario (CPSO). Dr. Chan completed Internal Medicine and Pulmonary Medicine training at UofT and Yale University in 1987. He was also a Visiting Scholar at Yale University’s Robert Wood Johnson Clinical Scholars Program. He has contributed 113 peer-reviewed publications, 30 book chapters and 185 abstracts. Dr. Chan was promoted to Professor of Medicine at UofT in 2005 and Emeritus Professor of Medicine at UofT in 2021. His leadership roles over 30 years include: UHN – Interim President and Chief Executive Officer, Executive Vice-President and Chief Medical Officer, Vice-President of Medical Affairs, Program Medical Director, Business Units Medical Director and Head of Respirology; UofT – Vice-Chair of Medicine, Interim Division Director of Respirology, Respirology Fellowship Program Director and Interim Head of Respirology at Sunnybrook Health Sciences Centre and Women’s College Hospital; Royal College of Physicians and Surgeons of Canada – member of the examining board for adult Respirology; Ontario Thoracic Society – served as President and became an honorary life member in 2020; philanthropy – board member for several non-profit foundations including Princess Margaret Hospital Foundation and Toronto General and Toronto Western Hospitals Foundation (TGTWHF) and member of the senate for the TGTWHF.

Dr. Joshua Wald

Dr. Joshua Wald trained in respirology at McMaster University and completed a fellowship at the Montreal Chest Institute in pulmonary rehabilitation and chronic disease management before returning to McMaster to begin his clinical practice at the Firestone Institute for Respiratory Health at St. Josephs Hospital in Hamilton where he leads the inpatient COPD service and helped found a COPD post-discharge clinic. He is a member of the Canadian Thoracic Society assembly on COPD steering committee. His clinical and research interests are focused on pulmonary rehabilitation and the comprehensive care of patients with COPD.

0700 - 0815

Co-Developed Symposia

0700 - 0815

Living Longer Lives? The Role of Exacerbation Reduction on Mortality in Patients Living with COPD

Speaker: Alberto Neder, MD, Queen’s University, Kingston, ON
Moderator: Erika Penz, MD, MSc, FRCPC, University of Saskatchewan, Saskatoon, SK

COPD is the third leading cause of death worldwide, and 1 in 5 patients with COPD die within 1 year of their first hospitalization for an exacerbation. The impact of an exacerbation goes beyond the lungs – following an exacerbation, patients have a greater increased risk of MI, stroke and other CV events. The goal of this session is to shed light on the relationship between exacerbation and increased mortality risk and help HCPs identify patients at risk for future exacerbations.

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

  • Describe the relationship between exacerbations and increased mortality risk (including CV risk);
  • Discuss emerging data to support the use of triple therapies on reducing patient mortality;
  • Identify patients at risk for exacerbations (and why they tend to underreport); and
  • Examine life changing clinical practice approaches to improving patient quality of life.

CanMEDS roles addressed: Health Advocate, Medical Expert, Scholar

This session is co-developed by the Canadian Thoracic Society and AstraZeneca and is planned to achieve scientific integrity, objectivity and balance.

Click here for Session invitation

Dr. Alberto Neder

Dr. J. Alberto Neder is a Professor in 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 250 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.

0730 - 0830

Continental Breakfast

0830 - 0930

CONCURRENT SESSIONS

Respiratory Issues in Chronic Cough and Lung Transplant ‘Prehab’

0830 - 0900

“Prehab” for Lung Transplant Candidates

Lisa Wickerson, BScPT, MSc, PhD
University Health Network and University of Toronto, Toronto, ON

This presentation will describe an evidence-based clinical approach to pre-habilitation in lung transplant candidates with a variety of respiratory diagnoses. The emerging evidence for tele-rehabilitation and hybrid pre-habilitation models along with the associated challenges and opportunities will be discussed.

Learning Objectives

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

  • Describe the indications and evidence for prehabilitation in lung transplant candidates;
  • Reflect on the challenges of providing prehabilitation to lung transplant candidates with an unknown surgical date; and
  • Discuss key considerations for the development of a quality hybrid or tele-prehabilitation delivery model.

CanMEDS Roles Addressed: Health Advocate, Professional, Scholar

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 focused on digital health evaluation and remote rehabilitation monitoring. Her current clinical and research program is centred on optimizing hybrid rehabilitation delivery for lung transplant candidates and recipients.

0900 - 0930

Diagnosis and Treatment of Chronic Cough

Imran Satia, MA MB BChir (Cantab), MRCP, PhD
St. Joseph’s Healthcare and McMaster University, Hamilton, ON

This session will address the current definitions of chronic cough, refractory chronic cough, unexplained chronic cough; the epidemiology of chronic cough in Canada; the basic neurophysiology of chronic cough; the current investigations available for investigating chronic cough; the role of neuromodulators and speech therapy in chronic cough; and aim to develop an awareness of new P2X3 antagonists currently in development.

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

  • Define and classify chronic cough;
  • Describe the epidemiology of chronic cough;
  • Know the basic neurophysiology of chronic cough;
  • Apply the step-wise approach to investigate and manage chronic cough;
  • Review the strengths and weaknesses of current guideline recommended treatment; and
  • Know the new purinergic P2X3 antagonists currently under development.

CanMEDS Roles Addressed: Collaborator, Medical Expert, Scholar

Dr. Imran Satia

Dr. Imran Satia was born and brought up in the Blackburn, England. He graduated in Medicine from the University of Cambridge in 2006 with a Masters in Neurophysiology and started his clinical training in the North West of England. He gained his Membership of the Royal College of Physicians (MRCP, London, UK) and completed his specialist training in general internal medicine and respiratory medicine. In 2017 he was awarded a PhD in the mechanisms of cough in asthma under the supervision of Professor Paul O’Byrne and Professor Jacky Smith. He was awarded the British Medical Association James Trust Award for asthma research. He recently completed a prestigious two-year ERS Respire 3 Marie Curie Post-Doctoral Fellowship at McMaster University. Dr. Satia is now on Faculty at McMaster University and the Firestone Institute for Respiratory Health working as an Assistant Professor in Respiratory Medicine. He consults on patients with asthma, refractory chronic cough, complex airways diseases and has a broad research interest in understanding the mechanisms and developing treatments for these troublesome conditions.

0830 - 0930

Dysphagia, Aspiration and Respiratory Disease

Renata Mancopes, PhD
University Health Network, Toronto, ON

Catriona M. Steele, PhD, CCC-SLP, S-LP(C), Reg. CASLPO, ASHA Fellow
University Health Network, Toronto, ON

The upper aerodigestive tract exists as a conduit both for food and liquid in swallowing and for air in breathing and speech production. Safe swallowing requires reconfiguration of the oropharynx from a respiratory into an ingestive pathway via closure of the laryngeal vestibule. Aspiration (entry of food, liquid or salivary secretions into the lower airway) is widely considered a risk for respiratory sequelae in people with oropharyngeal dysphagia (swallowing impairment). Individuals with current pneumonia or chronic obstructive pulmonary disease may also be at increased risk for aspiration. However, the links between aspiration and pneumonia or chronic respiratory disease exacerbation remain unclear. Consequently, the benefits of swallowing assessment for patients with chronic respiratory disease and of interventions to manage aspiration remain controversial. Professors Steele and Mancopes will unpack these issues, sharing current evidence regarding the relationships between aspiration and pneumonia and pathophysiological changes in swallowing in individuals with chronic respiratory disease.

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

  • Describe three factors thought to explain the pathogenesis of aspiration pneumonia in people with dysphagia;
  • List three changes in swallowing physiology that have been observed in people with COPD, which represent a risk for aspiration; and
  • Describe how modified liquid consistencies work to improve airway protection in people who aspirate thin liquids.

CanMEDS Roles Addressed: Collaborator, Communicator, Health Advocate, Leader, Medical Expert, Professional, Scholar

Dr. Renata Mancopes

Dr. Renata Mancopes received her speech-language pathology training in Brazil and worked clinically for over twenty years. Before moving to Toronto, she worked as a professor at the Universidade Federal de Santa Maria in Brazil, teaching in the area of swallowing and dysphagia. She supervised master’s and doctoral students, also conducting research. She currently works as a postdoctoral fellow in the Steele Swallowing Lab. She has a special interest in swallowing and swallowing disorders in people with lung diseases.

Dr. Catriona M. Steele

Dr. Catriona M. Steele is a clinician scientist working in the area of swallowing and swallowing disorders. She has a background as a medical speech-language pathologist and is Director of the Swallowing Rehabilitation Research Laboratory (www.steeleswallowinglab.ca) at the KITE Research Institute, Toronto Rehabilitation Institute – University Health Network. She is a Professor in the Department of Speech-Language Pathology at the University of Toronto. Professor Steele holds research funding from the National Institutes of Health (USA). Her current research focuses on the impact of food texture and liquid consistency on swallowing physiology and on rehabilitative interventions for dysphagia.

Pediatric Respirology Fellow Case Presentations

0830 - 0850

The Importance of Bronchoscopy in the Management of Atelectasis

Clara Fernandez Elviro, MD
BC Children’s Hospital, Vancouver, BC

The case of a 10-year-old girl with cystic fibrosis and persistent atelectasis secondary to inflammatory tissue will be presented. Since 2018, chest X-ray showed persistent consolidation and atelectasis in the right upper lobe associated with recurrent chest exacerbations every 4-6 weeks. Several bronchoscopies for diagnostic and unsuccessful therapeutic purposes were done. However, and despite antibiotic prophylaxis, each attempt resulted in the recurrence of an inflammatory polyp leading to the obstruction of the airway and subsequently the recurrence of chest infections. More aggressive treatment options such as lobectomy have been discussed. However, there is hope that a trial with a new-generation modulator could be a less invasive alternative. The central role of bronchoscopy in the diagnosis and treatment of persistent atelectasis is illustrated in this case. Moreover, the challenges and uncertainty that surround the treatment of persistent atelectasis in cystic fibrosis patients will be discussed.

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

  • Recognize the utility of bronchoscopy in the management of atelectasis; and
  • Review different strategies used to treat endoluminal lesions.

CanMEDS Roles Addressed: Collaborator, Scholar

Dr. Clara Fernandez Elviro

Dr. Clara Fernandez Elviro was born and raised in Madrid, Spain, where she attended medical school. She trained for eight years in Lausanne, Switzerland, and became a pediatrician. She has been in British Columbia for almost a year training as a respiratory fellow. She is interested in all the fields of respiratory medicine but especially in cystic fibrosis where a treatment revolution is under way that will ultimately lead to a paradigm change in the disease management.

0850 - 0910

More Than Just Bronchiolitis…

Audrey Tilly-Gratton, MD
Université de Montréal, Montréal, QC

The case of a healthy term infant with a vertical tracheal septum initially diagnosed with bronchiolitis presenting with severe respiratory distress and developed severe aerophagia secondary to non-invasive ventilation.

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

  • Summarize the differential diagnosis for rare causes of tracheal obstruction (tracheal rings, tracheal webs, vascular rings);
  • Demonstrate the appropriate diagnostic test for the evaluation of tracheal obstruction; and
  • Summarize the potential complications of non-invasive ventilation.

CanMEDS Roles Addressed: Health Advocate, Medical Expert

Dr. Audrey Tilly-Gratton

Dr. Audrey Tilly-Gratton is a 2nd year pediatric respirology fellow at the University of Montreal.

0910 - 0930

An Unsuitable Arrangement

Isaac Martin, MBBS, MD, MRCPCH
The Hospital for Sick Children, Toronto, ON

This case is of a term baby born after a normal pregnancy by spontaneous vaginal delivery in good condition but who developed persistent desaturation with a pre-post ductal difference in the first day of life. At her local hospital, heated high flow nasal cannula oxygen was initiated and a prostaglandin (PGE1) infusion commenced when echocardiogram demonstrated an atrioventricular septal defect (AVSD) and interrupted aortic arch (IAA). She was transferred to SickKids in Toronto for surgical management but had increasing pulmonary hypertension necessitating escalation. In this presentation, we formulate a list of differential diagnoses to be considered in such a case as well evaluating different investigations including imaging modalities, genetic testing and lung biopsy. Ultimately, we will appraise the literature describing the indications and feasibility of infant lung transplant as well as when palliation should be considered.

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

  • Come up with a broad differential for neonatal respiratory distress in term babies;
  • Describe the different investigations and findings consistent different interstitial lung disease processes; and
  • Appraise the indications and contraindications for infant lung transplant.

CanMEDS Roles Addressed: Communicator , Health Advocate, Medical Expert

Dr. Isaac Martin

Dr. Isaac Martin completed his medical and general paediatric training in London, UK. He then completed research looking into lung infection and antimicrobial resistance in cystic fibrosis at Imperial College London and the Royal Brompton Hospital. He has now come to SickKids in Toronto, Canada, to complete his subspecialty respiratory training.

CTS-American Thoracic Society Conjoint Session

0830 - 0930

Current and Future Treatment Approaches for Pulmonary Fibrosis

Gregory Downey, MD, FRCPC, National Jewish Health and University of Colorado School of Medicine, Denver, CO, USA

Idiopathic Pulmonary Fibrosis (IPF) is a chronic, progressive and frequently fatal disorder for which nintedanib and pirfenidone have been shown to slow the rate of decline in lung function. However, responses are variable and side effects are common, and neither drug is curative. We used an in-silico data-driven approach, and identified a strong connection between the transcriptomic perturbations in IPF disease and those induced by saracatinib, a selective Src kinase inhibitor, originally developed for oncological indications. We investigated the anti-fibrotic efficacy of saracatinib in three preclinical models: (i) in vitro in normal human lung fibroblasts (NHLFs); (ii) in vivo in bleomycin and recombinant adenovirus transforming growth factor-beta (Ad-TGF-β) murine models of pulmonary fibrosis; and (iii) ex vivo in precision cut lung slices from these mouse models. In each model, saracatinib was equal to or superior than nintedanib or pirfenidone in blocking fibrogenic responses. These results led to an FDA-approved phase 1B/2A human clinical trial in the use of saracatinib in the treatment of IPF (STOP-IPF) that is currently ongoing.

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

  • Identify recent advances in the epidemiology and molecular basis of fibrosing interstitial lung diseases;
  • Describe the use of genomic and transcriptomic data to identify potential therapeutic targets for pulmonary fibrosis; and
  • Appraise results of preclinical studies in tissue culture and animal models and assess how these are applicable to human clinical trials in pulmonary fibrosis.

CanMEDS Roles Addressed: Collaborator, Communicator, Health Advocate, Leader, Medical Expert, Professional, Scholar

Chris Ryerson, MD, FRCPC
University of British Columbia, Vancouver, BC

This presentation will review recent data informing the pharmacological management of fibrotic interstitial lung disease and new approaches to management that are currently being studied.

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

  • Describe approaches to identifying progressive pulmonary fibrosis;
  • Identify features that impact the timing and choice of pharmacotherapy for progressive pulmonary fibrosis; and
  • Describe the outcomes of progressive pulmonary fibrosis.

CanMEDS Roles Addressed: Collaborator, Medical Expert, Professional, Scholar

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 as Executive Vise President of Academic Affairs and Associate Dean at the University of Colorado 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 30 years. He has over 240 publications in top-ranked journals including the New England Journal of Medicine, Science, Science Translational Medicine, Nature Cell Biology, Journal of Cell Biology, American Journal of Respiratory and Critical Care Medicine, Journal of Experimental Medicine, Blood and Journal of Immunology, and his work has been cited over 20,000 times by other authors (h-index 78). His contributions to research were recognized by an ATS Award for Scientific Accomplishments in 2010. Dr. Downey is currently President-Elect of the American Thoracic Society.

Dr. Chris Ryerson

Dr. Chris Ryerson completed his core clinical training at the University of British Columbia (UBC) and an interstitial lung disease (ILD) fellowship and master’s degree in clinical research at the University of California San Francisco before joining UBC faculty in 2011. He is a Professor of Medicine at UBC, director of the St. Paul’s Hospital ILD clinical and research program, and head of the Division of Respiratory Medicine at Providence Health Care. His research focuses on the diagnosis, management and prognostication of ILD. He is also involved in several national and international clinical practice guidelines on the diagnosis and management of fibrotic ILD.

0930 - 0945
0945 - 1045

CONCURRENT SESSIONS

Research Highlights from Young Investigators

0945 - 1015

Projecting the Outcomes of Early Interventions for Asthma: Data-Driven and Modelling Studies

Tae Yoon (Harry) Lee, MSc
University of British Columbia, Vancouver, BC

The landscape of research and development in asthma management is dynamic and fast-paced, with multiple emerging interventions across all three levels of prevention. Despite such exciting developments, the value-for-money potential of many of the emerging interventions has not been properly investigated. Lack of high-quality economic evaluation is likely to hamper the implementation of interventions and lead to inefficient decisions. The presenter will describe the first reference policy model for asthma that is capable of projecting the outcomes of ‘what if’ scenarios across the entire course of the disease and demonstrate its utility by evaluating a national antibiotic stewardship program. In addition, if time permits, he will report on national trends in asthma and COPD hospital admissions.

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

  • Discuss the need for a reference policy model for asthma; and
  • Interpret results of economic evaluation of a national antibiotic stewardship program for asthma.

CanMEDS Roles Addressed: Scholar

Mr. Harry Lee

Harry Lee is a PhD trainee in the Respiratory Evaluation Sciences Program, Faculty of Pharmaceutical Sciences, University of British Columbia. His research thesis is composed of a coherent set of studies that will result in better understanding of the natural history of asthma and in the development of the first reference policy model for evaluating asthma interventions in Canada.

1015 - 1045

Developing a New Clinical and Biomarker-Driven Definition for COPD Exacerbations: A Pilot Study

Sunita Mulpuru, MD, FRCPC, MSc
The Ottawa Hospital, Ottawa Hospital Research Institute, Ottawa, ON

Exacerbations of COPD (COPDe) are important clinical endpoints in research studies for new therapeutics, assessments of health services, and treatment decision making among people with COPD. Exacerbation events must be distinctly defined, easily ascertained, and highly correlated with relevant clinical and health service outcomes. The current consensus clinical definition for COPDe is symptom-based, but it is highly subjective and lacks important objective clinical data. For these reasons, an international panel of respiratory experts concluded that there is a clear need to improve the objectivity and accuracy of the current definition of COPDe. In this session, we will review the challenges and pitfalls of using the current COPDe definition. We will review the design and progress of a new pilot research study to develop a new clinical and biomarker-driven definition of COPD exacerbations.

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

  • Review the current consensus definition of COPD exacerbations;
  • Understand the challenges of applying the definition in a clinical setting; and
  • Describe a new pilot study to inform the development of a new and objective definition for COPD exacerbations.

CanMEDS Roles Addressed: Collaborator, Health Advocate, Scholar

Dr. Sunita Mulpuru

Dr. Sunita Mulpuru is a Respirologist at The Ottawa Hospital, Assistant Professor at the University of Ottawa, and Associate Scientist at the Ottawa Hospital Research Institute. She trained in Internal Medicine and Respirology at the University of Ottawa. Following this she completed a fellowship in the Clinical Investigator Program with a Masters of Science in Epidemiology at the University of Ottawa. Dr. Mulpuru’s clinical research program is focused on improving the care of patients with Chronic Obstructive Pulmonary Disease (COPD) in Canada. She is currently engaged in research to better understand the epidemiology and impact of respiratory viral infections, exacerbations, and frailty among Canadians with COPD.

Indigenous and Rural Health: Innovations in Access, Treatment and Prevention

0945 - 1015

Lung Health Initiatives in Rural and Indigenous Communities: Partnership, Planning and Participation

Pat Camp, PT, PhD
University of British Columbia, Vancouver, BC

Access to lung health services in rural and Indigenous communities can be limited. These limitations are due to geography, reduced health human resources and systemic underfunding of services. This presentation will focus on innovative partnerships and clinical research initiatives that have the capacity to improve lung-related prevention, diagnostic and treatment services for people who live in rural and remote communities, including First Nations communities, in British Columbia.

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

  • Discuss the factors that limit lung health services in rural and remote communities, including Indigenous communities;
  • Define the principles of community-based research and clinical partnerships; and
  • Describe the processes to expand lung health services outside of urban areas

CanMEDS Roles Addressed: Health Advocate, Professional

Dr. Pat Camp

Dr. Pat Camp is an Associate Professor at the University of British Columbia’s Department of Physical Therapy and a principal investigator at the UBC Centre for Heart Lung Innovation. Dr. Camp’s research is focused on four main themes: First Nations Lung Health; Pulmonary Rehabilitation for Hospitalized Patients with an Acute Exacerbation of COPD (AECOPD); Pulmonary Tele-Rehabilitation; and Knowledge Translation and Quality Assessment for Pulmonary Rehabilitation.

1015 - 1045

Prevention and Treatment of Tuberculosis in Indigenous Communities: Highlights from 2022 Canadian TB Standards

Jonathan Luke Dunn, BSc, MSc
Assembly of First Nations, Ottawa, ON

An overview of the Canadian Tuberculosis (TB) Standard’s An Introductory guide in TB care for health workers and public health professionals serving Indigenous Peoples of Canada. In collaboration with three Indigenous National organizations and leading TB medical professionals, a standalone chapter voiced each Indigenous group’s arduous interrelationship with TB. Each section outlines the unique epidemiological, historical and cultural context of TB and brings awareness to the barriers to eliminating TB. The document serves as a definitive resource for TB healthcare providers. It underscores seven ‘Good Practice Statements’ that will help those providing services on Indigenous lands and working with cultural humility and awareness.

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

  • Summarize the contents of the recent publication of the Canadian Tuberculosis Standard’s Indigenous chapter;
  • Differentiate the epidemiological, historical and cultural context of TB for each of three Indigenous groups in Canada; and
  • Apply the seven ‘Good Practice Statements’ in their TB healthcare work.

CanMEDS Roles Addressed: Collaborator, Scholar

Mr. Jonathan Luke Dunn

Jonathan Luke Dunn is a passionate educator with mixed ancestry, a member of the Mississauga First Nations. He grew up in Southwest Florida, completing his BSc in Biology. He moved to Montreal to study innate immunity and Tuberculosis at McGill University’s Meakins-Christie Laboratories and later taught math and science at Indigenous High Schools in Kuujjuarapik, Nunavik and Kahnawà:ke. He currently works for the Assembly of First Nations, utilizing his scientific background and experiences to support and aid First Nations Communities.

Pulmonary Complications of Complex Pediatric Disease: Sick Sicklers and Bad BPDers – Section 3

0945 - 1015

Sickle Cell Disease

Glenda Bendiak, MD, MSc, FRCPC
Alberta Children’s Hospital and University of Calgary, Calgary, AB

This session will review selected pulmonary complications of sickle cell disease and the role of the respirologist in their management. The management of acute chest syndrome will be discussed, including novel diagnostic strategies and the potential role for early non-invasive ventilation. The associations between wheezing, asthma, airway hyper-responsiveness, and atopy in patients with sickle cell disease will be explored to highlight the challenges in diagnosing and managing asthma in this patient population. Finally, emerging disease-modifying approaches for children with sickle cell disease will be reviewed, with a particular focus on recent literature describing their impacts on pulmonary outcomes of interest.

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

  • Describe the clinical entity of acute chest syndrome, including emerging management strategies for this condition;
  • Define the challenges of diagnosing and managing asthma in this patient population; and
  • Discuss the pulmonary function abnormalities common in patients with sickle cell anemia and novel therapies which may alter their trajectory.

CanMEDS Roles Addressed: Health Advocate, Leader, Medical Expert, Scholar

Dr. Glenda Bendiak

Dr. Glenda Bendiak is a Clinical Associate Professor at the University of Calgary and a Pediatric Respirologist based at the Alberta Children’s Hospital in Calgary, Alberta. Her clinical interests include sickle cell disease, cystic fibrosis, and sleep disorders. She is an enthusiastic medical educator, with a particular focus on assessment and curriculum design. She is the Program Director for the Pediatric Respirology subspecialty training program at the University of Calgary.

1015 - 1045

A Quick Update on Bronchopulmonary Dysplasia in 2022

Theo Moraes, MD, PhD, FRCPC
The Hospital for Sick Children and University of Toronto, Toronto, ON

This session will review the recent literature and incorporate clinical experience to highlight recent developments in bronchopulmonary dysplasia. Specifically the discussion will focus on basic epidemiology, current and novel therapeutics approaches and long term pulmonary outcomes. BPD is relatively common and thus this session should be relevant for anyone who cares for children with lung disease.

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

  • Describe the epidemiology of BPD;
  • Discuss preventative and novel treatments for BPD; and
  • Describe long-term pulmonary outcomes of BPD.

CanMEDS Roles Addressed: Health Advocate, Medical Expert

Dr. Theo Moraes

Dr. Theo Moraes graduated from medical school in 1997 (Toronto) and then completed his Paediatric residency (Kingston) and Paediatric Respirology fellowship (SickKids) before pursuing his PhD and postdoctoral training at the University of Toronto. He is a Scientist at the Hospital for Sick Children and has a broad interest in pediatric lung disease with a focus in respiratory epithelial cell biology. He is a member of the Program for Individualized CF Therapy and is also the Toronto Site Director for the CHILD Study, a prospective longitudinal birth cohort study that aims to advance knowledge about the genetic and environmental determinants of atopic diseases including asthma and allergy. Dr. Moraes has been at SickKids as a full-time staff Respirologist since 2008. He is the lead physician in the Chronic Lung Disease of Prematurity Clinic, a multi D clinic based in SickKids.

1045 - 1100
1100 - 1145

CLOSING PLENARY

Infodemic! Is Misinformation Killing Us?

Timothy Caulfield, BSc, LL.B., LL.M., FRSC, FCAHS
Professor of Health Law & Science Policy, University of Alberta, Edmonton, AB

Cow urine, bleach and cocaine have all been recommended as COVID-19 cures — all nonsense. The pandemic has been cast as a leaked bioweapon, a byproduct of 5G wireless technology and a political hoax — all poppycock. And countless wellness gurus and alternative-medicine practitioners have pushed unproven potions, pills and practices as ways to “boost” the immune system. Misinformation is absolutely everywhere. The coronavirus isn’t just a pandemic, it is an infodemic. It’s caused physical harm and financial loss, added confusion and distraction to an already chaotic environment, and made it even more difficult to implement the needed health policy initiatives. How does this misinformation spread? Why do people believe it? What can we do as individuals and a community to fight back? Who can we trust? In this provocative presentation, Timothy Caulfield will explore these questions and more.

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

  • Understand the scope and nature of the “infodemic” and the primary sources of misinformation;
  • Identify the harms associated with the spread of misinformation in this context;
  • Analyze the arguments for and against debunking misinformation, and utilize effective debunking strategies.

CanMEDS Roles Addressed: Communication, Health Advocate

Prof. Timothy Caulfield

Professor Timothy Caulfield is an unrivalled communicator who debunks myths and assumptions about innovation in the health sector — from research on stem cells to diets to alternative medicine — for the benefit of the public and decision-makers. He is a Canada Research Chair in health law and policy, a professor in the Faculty of Law and the School of Public Health, and a research director of the Health Law Institute at the University of Alberta.

Over the past several years, Caulfield has been involved in a variety of interdisciplinary research endeavours that have allowed him to publish more than 350 articles and book chapters. His research focuses on topics like stem cells, genetics, research ethics, and the public representations of science and health policy issues. The recipient of numerous academic and writing awards, Caulfield is also a Fellow of the Royal Society of Canada and the Canadian Academy of Health Sciences.

Caulfield also writes frequently for the popular press on a range of health and science policy issues and is the author of several bestselling books, including: The Cure for Everything: Untangling the Twisted Messages about Health, Fitness and Happiness; Is Gwyneth Paltrow Wrong About Everything?: When Celebrity Culture and Science Clash; and, most recently, Relax, Dammit!: A User’s Guide to the Age of Anxiety. He is also the host and co-producer of the award-winning documentary TV show, A User’s Guide to Cheating Death, which aired in over 60 countries, including streaming on Netflix in North America.

1145 - 1200

Thursday, April 7th

1100 - 1215

CIA Secrets on Type 2 Inflammation (CIS: Clinical Immunology and Allergy)

Speaker: Jason Kihyuk Lee, MD, FRCPC, FAAAAI, FACAAI, Toronto Allergists, Toronto, ON
Moderator: Andréanne Côté, MD, FRCPC, Université Laval, Quebec City, QC

Type 2 inflammatory diseases are characterized by common shared immune dysregulation, which results in disease and organ specific signs and symptoms, impaired QoL and high burden of traditional standard-of-care treatments. It is commonly associated with an increased presence of other coexisting type 2 inflammatory diseases owing to the same dysregulation. This coexistence of comorbidities increases the patient’s overall disease burden, including impact on other type 2 driven dermatologic, respiratory and gastrointestinal diseases. Understanding the interrelationships will help the Respirologist optimize care for patients being treated.

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

  • Review the pathophysiology of type 2 diseases and with common inflammatory pathways;
  • Understand basic science and clinical evidence and how it is clinically relevant; and
  • Integrate throughout cases that illustrate type 2 coexisting diseases.

CanMEDS Roles: Collaborator, Communicator, Health Advocate, Leader, Medical Expert, Professional, Scholar

Click here for session invitation

This session is co-developed by the Canadian Thoracic Society and Sanofi and is planned to achieve scientific integrity, objectivity and balance.

Dr. Jason Lee

Dr. Jason Lee was the first to publish on gabapentin in idiopathic chronic cough, dupilumab use in CSU, dupilumab use in IgG4 related disease. His clinic in Toronto currently serves over 1,200 patients on biologics for immunologic conditions. He obtained his doctor of medicine degree from the University of Toronto, internal medicine at the University of British Columbia, a fellowship in clinical immunology and allergy at the University of Toronto. Dr. Lee is the immediate past section head of asthma at the CSACI and current member of the ACAAI biologics and therapeutics executive.

1100 - 1215

The Dimensions of Excessive Daytime Sleepiness – Obstructive Sleep Apnea and Beyond

Atul Khullar, MD MSc FRCPC DABPN (Cert Sleep Medicine), FAASM, Northern Alberta Sleep Clinic, Edmonton, AB

Moderator: Robert Skomro, MD, FRCPC, University of Saskachewan, Saskatoon, SK

This session will provide the clinician with an overview of types of excessive daytime sleepiness (EDS) and how they present in patients. Major contributors to EDS such as mental health concerns, a symptom of residual obstructive sleep apnea (OSA), and other sleep disorders will be reviewed. A practical approach to the diagnosis/assessment of EDS with a focus on effective utilization of sleep specialists and sleep testing will also be discussed. The session will conclude with an overview of non-pharmacological and pharmacological treatments for the management of EDS with a focus on data in residual obstructive sleep apnea (OSA).

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

  • Recognize patients presenting with excessive daytime sleepiness (EDS);
  • Assess possible causes for patient’s EDS (including a residual symptom of obstructive sleep apnea) and when to refer for sleep testing and/or sleep specialist intervention
  • Understand pharmacological and non pharmacological treatment options available for EDS and consider intergration for patients with residual obstructive sleep apnea

CanMEDS Roles Addressed: Communicator, Health Advocate, Medical Expert, Professional, Scholar

This session is co-developed by the Canadian Thoracic Society and Paladin Labs and is planned to achieve scientific integrity, objectivity and balance.

Dr. Atul Khullar

Dr. Atul Khullar is a psychiatrist and sleep specialist who specializes in the integrative management of obesity, sleep, mood/anxiety and attention deficit disorders in adolescents and adults. He has a sleep and mood/anxiety disorders fellowship from the University of Toronto and is board certified in Psychiatry and Sleep Medicine.

Dr. Khullar is active nationally and internationally in research, teaching and delivering CME in the above areas. He has given over 600 presentations to public and professional audiences worldwide.

Currently he is the medical director of the Northern Alberta Sleep Clinic in Edmonton and a Associate Professor at the University of Alberta. He is also a senior consultant for MedSleep, a Canada-wide network of community sleep clinics, the Edmonton Oilers and has worked with the Canadian Winter Olympic team in the past.

1900 - 2015

Precision Medicine: Biologic Treatment in Complex Severe Asthma Patients

Speaker: Del Dorscheid, MD, PhD, University of British Columbia, Vancouver, BC
Moderator: Louis-Phillipe Boulet, MD, FRCPC, Laval University, Quebec, QC

Asthma is a common illness. Initial therapeutics were based upon an understanding that the airway inflammation was “allergic” in nature. Inhaled corticosteroids became the mainstay therapy in the 1990’s, reducing both morbidity and mortality. However, the prevalence and severity of asthma continues to increase and now affects about 10% of the population, with more having uncontrolled and/or severe disease. Guidelines now include pathways for “dual” and triple” therapies however not always resolving the symptoms for the severe asthmatic. The newest class of medications to treat asthma are the “biologics”. In general, these therapeutic monoclonal antibodies can bind IgE, IL-5, IL-5 receptor and the IL-4/13 receptor in effect to inhibit allergic, eosinophillic and Type 2 inflammatory processes. Not all of these biologics will work for all asthmatics. It is important to understand the inflammatory and clinical phenotype of our patients to pick the right drug for the right patient – precision medicine.

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

  • Review biologic therapies for severe asthma, including key efficacy and safety data from clinical trial programs and/or real-world evidence studies;
  • Understand how appropriate biomarkers and clinical features of disease can inform clinical decision making for biologic therapies; and
  • Discuss how comorbid T2 disease and safety considerations can affect the choice of biologic therapy for patients with severe asthma.

CanMEDS Roles Addressed: Medical Expert, Professional, Scholar

Click here for session invitation

This session is co-developed by the Canadian Thoracic Society and GSK and is planned to achieve scientific integrity, objectivity and balance.

Dr. Del Dorscheid

Dr. Del Dorscheid obtained his MD and PhD degrees from McGill University in 1993. He moved onto the University of Chicago for Internal Medicine and a fellowship in Pulmonary and Critical Care Medicine. He has now been at UBC since 2000 and is a tenured Associate Professor. Dr. Dorscheid attends in the medical intensive care unit at St. Pauls, is Director of the Severe Asthma Clinic and is a researcher in the UBC Center for Heart Lung Innovation. As a physician-scientist, he leads an active research group investigating the role of the airway epithelium in inflammatory airways disease that results from inappropriate injury-inflammation-repair cycles. Specific projects include the study of IL-13 in airway repair and the expression/function or the epithelium as an immune barrier. The goal for his research program is to promote and translate research findings into new treatments and improved patient care to reduce the burden of respiratory diseases.

 

1900 - 2015

Innovation in the Patient Journey: Optimizing Outcomes for PAH Patients

Speaker: John Granton, MD, University of Toronto, ON
Moderator: Paul Hernandez, MDCM, FRCPC, Dalhousie University, Halifax, NS

This presentation will provide the audience with the evidence for early identification of patients with Pulmonary Arterial Hypertension (PAH). It will provide an evidence-based approach to the evaluation of identifying PH in high risk groups and those with an elevated right ventricular systolic pressure (RVSP) on echocardiography to determine patients who would benefit from directed therapies. It will also provide an update on the role of exercise testing in the evaluation of patients with pulmonary hypertension.

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

  • Identify and screen high-risk patients for pulmonary hypertension;
  • Evaluate a patient with an elevation in right ventricular systolic pressure (RVSP) and identify those who might benefit from directed therapies; and
  • Integrate exercise testing into the evaluation of patients with suspected or confirmed pulmonary hypertension.

CanMEDS Roles: Collaborator, Communicator, Medical Expert, Professional, Scholar

Click here for session invitation

This session is co-developed by the Canadian Thoracic Society and Janssen and is planned to achieve scientific integrity, objectivity and balance.

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 a past President of the Canadian Thoracic Society and the current Chair of the Long-term Planning Committee.

Friday, April 8th

0600 - 0715

Co-management of CTD-ILD to Optimize Patient Outcomes

Speaker: Dr. Janet Pope, MD, FRCPC, Rheumatologist, St. Joseph’s Health Care London, London, ON
Moderator: Dr. Alyson Wong, MD, FRCPC, MHSc, University of British Columbia

ILD in RA and connective tissue diseases is a serious complication and needs identification and a multi-disciplinary treatment approach where we need to treat the underlying disease activity with immunesuppression and remove lung unfriendly medications, have general treatment such as exercise, treating hypoxemia, reducing aspiration (aggressive Rx of GERD), vaccinations and smoking cessation. Additionally, for progressive fibrotic ILD, anti-fibrotic medications have an important role to reduce lung progression. Methotrexate does not worsen ILD in rheumatic diseases but often patients have failed this treatment as they may develop ILD while on background disease modifying drugs. Co-management is important with excellent communication and a treatment plan that optimizes the expertise of both respirology and rheumatology. This state of the art lecture will include practical advice on patient cases, epidemiology and treatment for ILD in various patients such as rheumatoid arthritis, systemic sclerosis and other connective tissue diseases.

Learning objectives:

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

  • Review the workup of a patient with possible CTD-ILD to appraise the data in support of immunomodulatory therapy in CTD-ILD;
  • Explore the emerging role of anti-fibrotic therapy in CTD-ILD; and
  • Review best practices in co-management of ILD patients between the community and the ILD centre.

CanMEDS Roles Addressed: Collaborator, Health Advocate, Medical Expert

This session is co-developed by the Canadian Thoracic Society and Boehringer-Ingelheim and is planned to achieve scientific integrity, objectivity and balance.

Dr. Janet Pope

Dr. Janet Pope is a Professor of Medicine and head of the Division of Rheumatology at the University of Western Ontario (UWO), Schulich School of Medicine, London, Ontario, Canada.  She has published over 500 peer-reviewed articles and mentored more than 125 trainees. Research expertise includes scleroderma, SLE and RA. She has been inducted into the Canadian Academy of Health Sciences. Follow her clinical pearls on twitter @janetbirdope.

0600 - 0715

Moderate-to-Severe Asthma: A Therapeutic World before Biologic

Ron Grossman, MD, FRCPC, FACP, FCCP, University of Toronto, Toronto, ON
Moderator: Clare Ramsey, MD, MSc, FRCPC, University of Manitoba, Winnipeg, MB 

This talk will cover identification of features suggesting poorly controlled asthma and its consequences. The latest treatment paradigms will be discussed. Differentiation of currently available agents will be covered and new therapeutic options, particularly the addition of inhaled antimuscarinics, will be reviewed.

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

  • Detect features that suggest poor asthma control;
  • Recognize the consequences of poorly controlled asthma;
  • Identify new treatment paradigms for asthma; and
  • Appreciate new treatment options in the management of moderate-to-severe asthma.

CanMEDS Roles Addressed: Communicator, Health Advocate, Leader, Medical Expert, Professional, Scholar

Click here for session invitation

This session is co-developed by the Canadian Thoracic Society and Valeo Pharma and is planned to achieve scientific integrity, objectivity and balance.

 

Dr. Ronald Grossman

Dr. Ronald F. Grossman is Professor of Medicine, University of Toronto, and previous Chief of Medicine, Credit Valley Hospital, Mississauga, Ontario, Canada. He has published over 90 articles in a wide number of medical journals including New England Journal of Medicine, American Journal of Respiratory Critical Care Medicine, American Journal of Medicine and Chest. Dr. Grossman’s major research and teaching interests are in respiratory tract infections. He has participated in the creation of Canadian and American guidelines for the management of community-acquired pneumonia, Canadian guidelines for the management of hospital-acquired pneumonia and Canadian and international guidelines for the management of acute exacerbations of chronic obstructive lung disease. He previously served as the chairman of the National Information Program on Antibiotics (NIPA), a coalition of many medical and public health societies that was established to encourage the appropriate use of antibiotics among physicians and patients. Dr. Grossman recently was awarded the Murray Kornfeld Memorial Founder’s Lectureship by the American College of Chest Physicians.

1815 - 1930

PRO & CON Debate: Earlier Escalation of Pharmacologic Treatment in COPD Management

Panelists:
Charles Chan, MD, FRCPC, FCCP, FACP, University of Toronto, Toronto, ON
Joshua Wald, MD, FRCPC, McMaster University, Hamilton, ON

Moderator: Mohit Bhutani, MD, FRCPC, FCCP

Presentation of the latest evidence guiding clinical decision making for COPD therapies to optimize management of COPD patients using real-world evidence and/or case study-based examples. Debate will focus on the pro/con analysis of clinical data and case-based examples of earlier escalation of pharmacologic treatment in COPD management.

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

  • Review COPD therapies in Canada, including key efficacy and safety data from clinical trial programs and/or real-world evidence studies, highlighting the various considerations needed for treatment optimization in COPD management;
  • Understand how appropriate treatable traits and clinical features of disease can inform clinical decision making for COPD management and safety risk/efficacy benefit considerations when deciding on escalation of COPD treatment; and
  • Discuss how patient outcome, expectations and safety considerations can affect the choice of COPD therapy for patients at varying progression of COPD disease (including mortality).

CanMEDS Roles Addressed: Collaborator, Communicator, Health Advocate, Medical Expert, Professional, Scholar

Click here for session invitation

This session is co-developed by the Canadian Thoracic Society and GSK and is planned to achieve scientific integrity, objectivity and balance.

Dr. Charles Chan

Dr. Charles Chan’s current roles include Emeritus Professor of Medicine at University of Toronto (UofT) and Consultant Respirologist at University Health Network (UHN), and he is the Medical Director and Owner of Rosedale Pulmonary Function Laboratory and Agincourt Pulmonary Services in Toronto. He is the lead Respirology assessor for the College of Physicians and Surgeons of Ontario (CPSO). Dr. Chan completed Internal Medicine and Pulmonary Medicine training at UofT and Yale University in 1987. He was also a Visiting Scholar at Yale University’s Robert Wood Johnson Clinical Scholars Program. He has contributed 113 peer-reviewed publications, 30 book chapters and 185 abstracts. Dr. Chan was promoted to Professor of Medicine at UofT in 2005 and Emeritus Professor of Medicine at UofT in 2021. His leadership roles over 30 years include: UHN – Interim President and Chief Executive Officer, Executive Vice-President and Chief Medical Officer, Vice-President of Medical Affairs, Program Medical Director, Business Units Medical Director and Head of Respirology; UofT – Vice-Chair of Medicine, Interim Division Director of Respirology, Respirology Fellowship Program Director and Interim Head of Respirology at Sunnybrook Health Sciences Centre and Women’s College Hospital; Royal College of Physicians and Surgeons of Canada – member of the examining board for adult Respirology; Ontario Thoracic Society – served as President and became an honorary life member in 2020; philanthropy – board member for several non-profit foundations including Princess Margaret Hospital Foundation and Toronto General and Toronto Western Hospitals Foundation (TGTWHF) and member of the senate for the TGTWHF.

Dr. Joshua Wald

Dr. Joshua Wald trained in respirology at McMaster University and completed a fellowship at the Montreal Chest Institute in pulmonary rehabilitation and chronic disease management before returning to McMaster to begin his clinical practice at the Firestone Institute for Respiratory Health at St. Josephs Hospital in Hamilton where he leads the inpatient COPD service and helped found a COPD post-discharge clinic. He is a member of the Canadian Thoracic Society assembly on COPD steering committee. His clinical and research interests are focused on pulmonary rehabilitation and the comprehensive care of patients with COPD.

Saturday, April 9th

0700 - 0815

Living Longer Lives? The Role of Exacerbation Reduction on Mortality in Patients Living with COPD

Speaker: Alberto Neder, MD, Queen’s University, Kingston, ON
Moderator: Erika Penz, MD, MSc, FRCPC, University of Saskatchewan, Saskatoon, SK

COPD is the third leading cause of death worldwide, and 1 in 5 patients with COPD die within 1 year of their first hospitalization for an exacerbation. The impact of an exacerbation goes beyond the lungs – following an exacerbation, patients have a greater increased risk of MI, stroke and other CV events. The goal of this session is to shed light on the relationship between exacerbation and increased mortality risk and help HCPs identify patients at risk for future exacerbations.

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

  • Describe the relationship between exacerbations and increased mortality risk (including CV risk);
  • Discuss emerging data to support the use of triple therapies on reducing patient mortality;
  • Identify patients at risk for exacerbations (and why they tend to underreport); and
  • Examine life changing clinical practice approaches to improving patient quality of life.

CanMEDS roles addressed: Health Advocate, Medical Expert, Scholar

This session is co-developed by the Canadian Thoracic Society and AstraZeneca and is planned to achieve scientific integrity, objectivity and balance.

Click here for Session invitation

Dr. Alberto Neder

Dr. J. Alberto Neder is a Professor in 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 250 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.