Speaker:
Jean Bourbeau, MD, MSc, FRCPC, FCAHS
McGill University; Montreal, QC

Moderator :
Brandie Walker, MD, PhD, FRCPC
University of Calgary, Calgary, AB

Session Description

Raising the urgency for a proactive treatment approach in COPD by identifying at-risk symptomatic patients and addressing cardiopulmonary risk in COPD management.

Learning Objectives

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

• Describe the impact of COPD and exacerbations on cardiopulmonary outcomes
• Highlight strategies for the identification of COPD patients at risk of disease progression and cardiopulmonary events
• Discuss opportunities for early intervention, and the impact this has on long term cardiopulmonary outcomes

CanMEDS Roles: Medical Expert, Communicator, Health advocate, Scholar and Professional

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

Dr. Jean Bourbeau

Dr. Jean Bourbeau is a clinician scientist, professor, and researcher at McGill University and a Senior Scientist at the Research Institute McGill University Health Centre. He is a Fellow of the Canadian Academy of Health Sciences (FCAHS) and has received numerous prestigious awards, including the “Distinguished Scientist Award” from McGill University (2020-2025) and the “Distinguished CHEST Educator” from the American College of Chest Physicians (2017-2022).

Internationally recognized for his expertise in Chronic Obstructive Pulmonary Disease (COPD), he actively participates in various scientific committees and has served as the President and remains on the board of the Canadian Thoracic Society (CTS). His research includes notable contributions like the “Living Well with COPD” self-management program and the Canadian Cohort Obstructive Lung Disease (CanCOLD) prospective study, over 15M$ grant support since 2009, CIHR grants, >100 sub-studies and >80 publications. Over the last decades, he has secured substantial research funding, published over 400 papers, reviews, and chapters, and his work has significantly influenced clinical practice worldwide.

He is the principal investigator for various investigator initiated clinical trials, addressing both non-pharmacological interventions and drug or device interventions for COPD patients. His dedication extends to advancing clinical trial training platforms as he leads the CIHR Clinical Training Trial Platform, CANTRAIN, with 11.3 million dollars in funding (2022-2025).

Dr. Bourbeau has made significant contributions to national and international guidelines, including the GOLD Reports, CTS COPD pharmacotherapy Guidelines, American College of Chest Physicians/CTS Guidelines on prevention of COPD exacerbations, and American Thoracic/European Respiratory Society Guidelines on Pulmonary Rehabilitation.

Sarah Henderson, PhD
BC Centre for Disease Control and National Collaborating Centre for Environmental Health; Vancouver, BC

Session Description

Wildfire smoke is a significant and growing threat to air quality in Canada. Smoke pollution has been associated with a wide range of acute respiratory and other health endpoints, and evidence on more chronic effects is rapidly emerging. This presentation will cover wildfire smoke exposure, health effects across the life course, effective public health interventions, and considerations for the future.

Learning Objectives

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

• Describe how wildfire smoke is different from other types of air pollution
• Summarize what is known about the acute health effects of wildfire smoke exposure
• Communicate effectively about the potential chronic health effects of wildfire smoke exposure
• Advocate for effective public health interventions

CanMEDS Roles: Collaborator, Health Advocate, Leader

Dr. Sarah Henderson

Dr. Sarah Henderson is the Scientific Director of Environmental Health Services at the BC Centre for Disease Control and the Scientific Director of the National Collaborating Centre for Environmental Health (NCCEH). She oversees a broad program of applied research, surveillance, and knowledge translation to support evidence-based environmental health policy and practice in BC and across Canada. She has been studying the population health effects of wildfire smoke for more than 20 years.

Dr. Maziar Divangahi, PhD                                                
McGill University; Montreal, QC

Session Description

The constant exposure of humans to potentially life-threatening respiratory challenges pose a major public health problem, with an estimated 20% of all deaths annually worldwide resulting from lung diseases. The lungs, which are constantly exposed to the outside environment, can become a “portal” entry to infectious agents, toxic gases, and particulate matters as we breath approximately 11,000 liters of air every day. To overcome these environmental insults lung innate immune defense system must be tightly regulated; eliminating invading pathogen, minimizing collateral damage and preserving lung physiology to perform its main task of gas-exchange. These wide range of innate regulatory circuits also promote lung adaptation while individuals are exposed to high or low levels of pollutants / microorganisms. Understanding the long-term impacts of constant exposure to environmental challenges, vaccines, the on/off inflammation on the lung regulatory networks, and subsequently the generation of “lung memory” at the population levels is crucial for developing novel therapeutic interventions.

Learning Objectives

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

• Differentiate between the concept of host resistance vs disease tolerance
• Understand the concept of trained immunity
• Summarize how to harness the power trained immunity against pulmonary infections

CanMEDS Roles: Collaborator, Medical Expert

Dr. Maziar Divangahi

Dr. Maziar Divangahi is a Professor of Medicine at McGill University. Dr. Divangahi is the Associate Director of the Meakins-Christie Laboratories and the Associate Director of the McGill International TB Centre. He is an internationally recognized pulmonary immunologist and the overarching focus of his research program is to investigate the regulatory mechanisms involved in host resistance and disease tolerance against major pulmonary bacterial (Mycobacterium tuberculosis) and viral (influenza virus and SARS-CoV2) pathogens. He is currently investigating how to harness the power of innate memory response (Trained Immunity) in vaccine development. Throughout his career, he has been a proliferative investigator publishing in outstanding journals and received numerous awards, including a CIHR New Investigator Award, FRQS Award, and the CIHR Foundation grant. His scholarly work has been recognized by election to the Royal Society of Canada. He is currently holding the Strauss Chair in Respiratory Diseases.

J. Alberto Neder, MD, PhD, DSc, FRCP(C), FERS
Queen’s University; Kingston, ON

Session Description

I will start by reviewing the complex effects of obesity on lung mechanics and gas exchange at rest and under the stress of exercise. Special attention will be given to the translation of these physiologic adaptations to breathlessness. These pieces of information will set the stage for a case-based overview of the challenges and pitfalls of resting (spirometry, lung volumes, transfer factor, and arterial blood gases) and exercise test interpretation in obese subjects. I will finalize by outlining the main clinical scenarios in which the functional consequences of obesity may confound the diagnosis and follow-up of subjects with suspected or established respiratory disease. Throughout the presentation, I will provide practical hints of clinical relevance to deal with the “shades of grey” in the functional respiratory assessment brought by obesity.

Learning Objectives

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

• Describe the key physiological consequences of obesity on the respiratory system at rest and on exercise.
• Apply this knowledge to optimize the interpretation of pulmonary function and cardiopulmonary exercise testing.
• Recognize the clinical scenarios in which obesity may confound the diagnosis and assessment of functional impairment in respiratory diseases.
  

CanMEDS Roles: Health Advocate, Medical Expert, Scholar

Dr. Alberto Neder

Dr. J Alberto Neder is a respirologist, physician scientist, and Professor of Respiratory Medicine at Queen’s University. He has a broad interest in the field of clinical respiratory physiology.  Dr. Neder has been a senior author in over 300 peer-reviewed papers and has authored many book chapters on respiratory and exercise physiology, pulmonary rehabilitation, and integrated care in chronic respiratory diseases.  Dr. Neder runs a busy clinical service focused on COPD, is the Medical Director of Hotel Dieu Hospital’s Pulmonary Function Tests Laboratory and is the Director of Providence Care Hospital’s Pulmonary Rehabilitation Program. Dr. Neder’s clinical and teaching interests include COPD, COPD-heart failure overlap, cardiac and pulmonary rehabilitation, pulmonary hypertension & pulmonary vascular disease, advanced lung function and cardiopulmonary exercise testing.

Speakers
Sacha Bhinder, MD, FRCPC
Scarborough Health Network, Toronto, Ontario

Kenneth R. Chapman, MD, MSc, FRCPC, FACP, FCCP, FERS 
University of Toronto; Toronto, ON

Moderator
Mohit Bhutani, MD, FRCPC, FCCP
University of Alberta, Edmonton, AB

Session Description

This debate will provide the attendees with an up-to-date review of the clinical trial data with “closed” triple inhaled therapy in asthma and their relevance to daily practice. Upon completion of this activity, participants will better understand the respective roles of triple therapy and biologic therapy in their most difficult patients with asthma.

Learning Objectives

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

• Review the most recent data on single inhaler triple therapy in asthma
• Consider whether LAMA should be added to inhaled regimens at GINA Step 4 or Step 5
• Describe strategies to improve diagnosis and optimize management of severe asthma

CanMEDS Roles: Medical Expert, Communicator, Scholar

This session is co-developed by the CTS and Valeo and is planned to achieve scientific integrity, objectivity and balance.

Dr. Sacha Bhinder

Dr. Sacha Bhinder is an adult respirologist in the Scarborough area, practicing at the Scarborough Health Network Centenary site, the Toronto Lung Care Clinic, and the Heart Health Institute. After having completed his MD degree, he went on to pursue training in Internal Medicine and a fellowship in Adult Respirology, all at the University of Toronto. He is a lecturer in the Division of Respirology at the University of Toronto.

For the Scarborough Health Network (SHN), he has served in a number of leadership roles on the Corporate HSMR, Palliative, and Quality of Care Committees, as well as the Co-Chair of the Corporate Medical Education Committee and SHN Education representative for the Toronto Academic Health Sciences Network. Recently he completed a term in the role of Corporate Chief and Medical Director for the Department of Medicine.

Dr. Kenneth Chapman

Dr. Ken Chapman is Director of the Asthma and Airway Centre of the University Health Network, past President of the Canadian Network for Respiratory Care and Director of the Canadian Registry for Alpha-1 Antitrypsin Deficiency. A Professor of Medicine at the University of Toronto, Dr. Chapman is an internationally respected researcher and lecturer in the fields of asthma and COPD. With more than 25,000 citations to his published work, he is in the top 1% of cited medical researchers.

 

 

Speakers
Joshua Wald, MD, FRCPC
McMaster University, Hamilton, ON

George Zhanel, PharmD, PhD, FCAHS
University of Manitoba, Winnipeg, MB

Moderator
Vivien Brown, CCFP, FCFP, MSCP
University of Toronto, Toronto, ON

Session Description

Respiratory Syncytial Virus (RSV) is well recognized as a predictable seasonal infection in infants; however, older adults including those with underlying comorbidities are at greater risk of severeoutcomes from RSV. This educational session will delve into the latest research and clinical practices surrounding RSV in older adults. Given the increasing recognition of RSV as a significant cause of morbidity and mortality in this population, we will explore the epidemiology, burden of disease, clinical manifestations, diagnostic challenges, and new preventative strategies specifically in the Canadian context. The session will highlight the emerging evidence and implementation into practice of new RSV vaccines. The aim is to equip respirologists and respiratory health professionals with the knowledge and tools to understand the burden of disease, differentiate, and prevent RSV disease in older adults, contributing to improved patient outcomes and public health.

Learning Objectives

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

• Understand the epidemiology, burden of disease and clinical manifestations of RSV in Older Adults: Gain a comprehensive understanding of the prevalence, risk factors including underlying comorbidities of RSV in older adults with a specific focus on the Canadian population and individuals living with chronic lung disease
• Discuss the clinical presentation, testing and current management strategies: Develop an understanding of the clinical presentation and diagnostic challenges presented by RSV in older adults, and current management strategies
• Describe current evidence for emerging RSV vaccines: Review RSV vaccines (authorized and pending approval) for older adults and discuss implementation of RSV vaccination into clinical practice and public health in Canada.

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

This session is co-developed by the CTS and GSK, Moderna and Pfizer and is planned to achieve scientific integrity, objectivity and balance.

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.

Dr. George Zhanel

Dr. George Zhanel is a microbiologist and pharmacologist who received his Ph.D. in the Department of Medical Microbiology/Infectious Diseases at the Faculty of Medicine, University of Manitoba and a Doctor of Clinical Pharmacology at the University of Minnesota. He is presently Professor and Associate Head in the Department of Medical Microbiology/Infectious Diseases, Max Rady College of Medicine and Research Director of the Canadian Antimicrobial Resistance Alliance (CARA).

Dr. Zhanel has received/nominated for > 100 teaching awards including the Canadian Association for Medical Education (CAME) merit teaching award. He was elected as a fellow of the Canadian Academy of Health Sciences (CAHS) in recognition of sustained excellence in research and teaching within the health sciences. In 2023, Web of Science identified him as one of the world’s most influential researchers.

Jean Bourbeau, MD, MSc, FRCPC, FCAHS
McGill University; Montreal, QC

Session Description

The past two decades have seen an explosion of studies into all aspects of patient care with chronic obstructive pulmonary disease (COPD). Pharmacotherapy studies have had the favor compared to non-pharmacotherapy interventions. Over the same period, many questions specific to non-pharmacological intervention have been examined by major landmark RCTs, and real-world evidence studies showing successful integration in clinical practice.

The last decade has also seen increased enthusiasm for observational studies, the prospective study specific to COPD, the Canadian Cohort Obstructive Lung Disease (CanCOLD) with rigorously defined assessment of a variety of clinical, physiological, radiological and biological outcomes. The main clinical gains have come from a better understanding of new risk factors and clinical phenotypes with specific signatures that could help understand the heterogeneity of COPD, prognostic and co-morbidities.

Many of these findings and emerging discoveries will be reviewed and how they may have influence and potentially change clinical practice.

Learning Objectives

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

• Review the great deal achieved of the non-pharmacotherapy interventions in the management of COPD, landmark trials, and real-world evidence studies.
• Describe from a decade of findings and emerging discoveries in CanCOLD, new risk factors and clinical phenotypes that explain the heterogeneity of COPD, prognostic and co-morbidities.

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

Dr. Jean Bourbeau

Dr. Jean Bourbeau is a clinician scientist, professor, and researcher at McGill University and a Senior Scientist at the Research Institute McGill University Health Centre. He is a Fellow of the Canadian Academy of Health Sciences (FCAHS) and has received numerous prestigious awards, including the “Distinguished Scientist Award” from McGill University (2020-2025) and the “Distinguished CHEST Educator” from the American College of Chest Physicians (2017-2022).

Internationally recognized for his expertise in Chronic Obstructive Pulmonary Disease (COPD), he actively participates in various scientific committees and has served as the President and remains on the board of the Canadian Thoracic Society (CTS). His research includes notable contributions like the “Living Well with COPD” self-management program and the Canadian Cohort Obstructive Lung Disease (CanCOLD) prospective study, over 15M$ grant support since 2009, CIHR grants, >100 sub-studies and >80 publications. Over the last decades, he has secured substantial research funding, published over 400 papers, reviews, and chapters, and his work has significantly influenced clinical practice worldwide.

He is the principal investigator for various investigator initiated clinical trials, addressing both non-pharmacological interventions and drug or device interventions for COPD patients. His dedication extends to advancing clinical trial training platforms as he leads the CIHR Clinical Training Trial Platform, CANTRAIN, with 11.3 million dollars in funding (2022-2025).

Dr. Bourbeau has made significant contributions to national and international guidelines, including the GOLD Reports, CTS COPD pharmacotherapy Guidelines, American College of Chest Physicians/CTS Guidelines on prevention of COPD exacerbations, and American Thoracic/European Respiratory Society Guidelines on Pulmonary Rehabilitation.

Kenneth R. Chapman, MD, MSc, FRCPC, FACP, FCCP, FERS
University of Toronto; Toronto, ON

Session Description

Beginning this year, Canadian Blood Services will make intravenous augmentation therapy available to all Canadians with emphysema secondary severe alpha-1 antitrypsin deficiency.  This presentation will review the medical science behind this decision and examine the strategies all Canadian pulmonary physicians must master to detect and treat this disorder.

Learning Objectives

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

• Devise appropriate screening strategies to identify the patients in their practice with alpha-1 antitrypsin deficiency.
• Understand the role and prescribing guidelines for augmentation therapy.
• Identify regional expertise for assistance with clinical challenges in alpha-1 antitrypsin deficiency.

CanMEDS Roles: Communicator, Medical Expert, Scholar

Dr. Kenneth Chapman

Dr. Ken Chapman is Director of the Asthma and Airway Centre of the University Health Network, past President of the Canadian Network for Respiratory Care and Director of the Canadian Registry for Alpha-1 Antitrypsin Deficiency. A Professor of Medicine at the University of Toronto, Dr. Chapman is an internationally respected researcher and lecturer in the fields of asthma and COPD. With more than 25,000 citations to his published work, he is in the top 1% of cited medical researchers.

 

 

Jean Bourbeau, MD, MSc, FRCPC, FCAHS
McGill University; Montreal, QC

Session description:

I will be presenting important paradigms in the management of COPD in Canada and abroad. I will be reviewing the adoption of the CTS COPD guideline across the country and tackling the controversies which have been sustained on long-standing opinion despite recent evidence confirming the contrary.

Learning objectives:

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

• Highlight important paradigms in the management of COPD in Canada and abroad, especially in the real-world setting of patient with recurrent and/or severe exacerbations;
• Describe the responses and adoption across Canada of the CTS COPD Guideline one year later;
• Discuss some of the remaining controversies, new information from the real-world evidence to support the evidence-based clinical practice guideline.

Dr. Jean Bourbeau

Dr. Jean Bourbeau is a clinician scientist, professor, and researcher at McGill University and a Senior Scientist at the Research Institute McGill University Health Centre. He is a Fellow of the Canadian Academy of Health Sciences (FCAHS) and has received numerous prestigious awards, including the “Distinguished Scientist Award” from McGill University (2020-2025) and the “Distinguished CHEST Educator” from the American College of Chest Physicians (2017-2022).

Internationally recognized for his expertise in Chronic Obstructive Pulmonary Disease (COPD), he actively participates in various scientific committees and has served as the President and remains on the board of the Canadian Thoracic Society (CTS). His research includes notable contributions like the “Living Well with COPD” self-management program and the Canadian Cohort Obstructive Lung Disease (CanCOLD) prospective study, over 15M$ grant support since 2009, CIHR grants, >100 sub-studies and >80 publications. Over the last decades, he has secured substantial research funding, published over 400 papers, reviews, and chapters, and his work has significantly influenced clinical practice worldwide.

He is the principal investigator for various investigator initiated clinical trials, addressing both non-pharmacological interventions and drug or device interventions for COPD patients. His dedication extends to advancing clinical trial training platforms as he leads the CIHR Clinical Training Trial Platform, CANTRAIN, with 11.3 million dollars in funding (2022-2025).

Dr. Bourbeau has made significant contributions to national and international guidelines, including the GOLD Reports, CTS COPD pharmacotherapy Guidelines, American College of Chest Physicians/CTS Guidelines on prevention of COPD exacerbations, and American Thoracic/European Respiratory Society Guidelines on Pulmonary Rehabilitation.

Sophie Bergeron Kermelly, MD
Laval University, Hôtel-Dieu de Lévis; Quebec City, QC

Session Description

COPD is now recognized as a heterogeneous entity with multiple treatable traits. Eosinophilic COPD is a well-defined phenotype. This phenotype could be associated with an increased number of acute exacerbations and a worsen prognostic. Three major randomized clinical trials looked at biologic agents in COPD to reduce eosinophilic inflammation. These trials reported mitigated results. To carefully address and assess this phenotype among COPD patients in clinical practice is important in order to identify which COPD patients could benefit from these therapies.

Learning Objectives

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

• Identify eosinophilic COPD phenotype
• Recognize the burden of the disease in eosinophilic COPD
• Analyze and apply main Biologics trials in COPD to guide clinical practice

CanMEDs Roles: Health Advocate, Leader, Medical Expert, Scholar

Dr. Sophie Bergeron Kermelly

Dr. Sophie Bergeron Kermelly completed her respirology residency at Laval University in Québec city and now works as a Respirologist at an academic hospital in Lévis. She subspecialized in COPD and Pulmonary Rehabilitation after completing a one-year clinical and research Fellowship on this topic at McGill University. She is now in charge of the COPD clinic in Hôtel-Dieu de Lévis.

Roger Goldstein, MB, ChB, MRCP (UK), FRCP (UK), FCCP
University of Toronto, Toronto, ON

Session Description

PR is a comprehensive intervention designed to improve physical and mental health and to promote health enhancing behaviours.  Although PR is recognized as an essential component of CRD management it remains underutilized. Previous guidelines (2007, 2011) focused primarily on COPD where the bulk of the evidence was.  This evidence base has now increased substantially to involve other CRD as well as innovative methods of program delivery.

This presentation will focus on the updated (2023) PR international guidelines. The panel identified 6 relevant clinical questions regarding the application of PR for stable and post AECOPD patients, its use in ILD and PH, its remote delivery through tele-rehabilitation and the role of maintenance programs.  Greater knowledge of guidelines for PR should highlight its role in evidence-based healthcare and encourage patient referrals.

Learning Objectives

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

• Identify the six questions addressed in the updated 2023 PR guidelines
• Distinguish recommendations from systematic reviews of randomized controlled trials from implementation issues, values and preferences
• Choose the most important clinical research questions for the future

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

Dr. Roger Goldstein

Dr. Roger Goldstein is a Senior Scientist and Head of Respiratory Medicine at West Park Healthcare Centre. He is a Professor of Medicine and Physical Therapy at the University of Toronto and the Founding NSA Chair in Respiratory Rehabilitation Research. He has extensive experience in the clinical management and investigation of patients with chronic respiratory conditions.

Darlene Reid, PhD, PT
Université de Toronto, Toronto, ON

Session Description

Most daily activities require coordination and multitasking, which require high levels of cortical activation. If these activities are not practiced regularly, even higher neural demands are required. Training or repetition of various movement results in automaticity such that less neural activation is required for the same motor action. This presentation will focus on movement through a motor control lens and describe how dyspnea and multitasking can interfere with purposeful movement. The dual task paradigm, an experimental approach, will demonstrate how performance of two different tasks can call upon similar resources or exceed capacity in people living with chronic respiratory disease. This can lead to errors or decreased performance of the given tasks, termed dual task or cognitive interference. Consideration of cognitive demands during daily activities by utilizing approaches that integrate motor learning, dual tasking, and automaticity that could advance outcomes of pulmonary rehabilitation for people living with chronic respiratory disease.

Learning Objectives

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

• Define motor control, automaticity, cognitive interference, and cognitive impairment;
• Have an awareness of how cognition influences and potentially limits movement in people living with chronic respiratory disease;
• Describe potential assessments, and strategies that mitigate or minimize cognitive limitations on motor control and physical activity.

CanMEDS Roles: Collaborator, Communicator, Leader, Scholar

Dr. Darlene Reid

Darlene Reid obtained her Bachelor of Medical Rehabilitation (PT) from the University of Manitoba and her PhD from the University of British Columbia.  Darlene was a Professor in the Department of Physical Therapy at the University of British Columbia was recruited to the University of Toronto in the fall of 2014.

Dmitry Rozenberg, MD, PhD, FRCPC
University Health Network, University of Toronto; Toronto, ON

Session Description

Frailty represents a state of decreased physiological reserve and is prevalent in individuals with chronic lung disease.  Frailty has been shown to be an important prognostic marker of increased morbidity and mortality in this population.  In addition, individuals with frailty are less likely to complete pulmonary rehabilitation programs, but those that complete rehabilitation programs have been shown to derive significant symptomatic and functional benefits.

The current presentation will help recognize and characterize frailty in chronic lung disease populations referred to pulmonary rehabilitation.  The presentation will highlight key findings from the American Thoracic Society 2023 statement on Frailty in Pulmonary Rehabilitation and the benefits of pulmonary rehabilitation on symptoms, physical function and clinical outcomes.  The talk will provide important considerations of ongoing and future research on frailty and pulmonary rehabilitation.

Learning Objectives

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

• Recognize elements of frailty in chronic lung disease and describe their association with clinical outcomes.
• Highlight rehabilitation strategies in chronic lung disease and their effects on symptoms, physical function, and clinical outcomes.
• Discuss ongoing and future research evaluating mechanisms underlying frailty in chronic lung disease.

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

Dr. Dmitry Rozenberg

Dr. Dmitry Rozenberg is a Respirologist at the University Health Network and is affiliated with the Ajmera Multi-Organ Transplant Program. He is an Assistant Professor in the Temerty Faculty of Medicine, University of Toronto and has been awarded the Sandra Faire and Ivan Fecan Professorship in Rehabilitation Medicine.

Dr. Rozenberg’s research aims to understand the impact of physical fitness and skeletal muscle function on daily function, quality of life, frailty, health care use, and survival before and after lung transplantation.  As a Respirologist with undergraduate training in Kinesiology, Dr. Rozenberg is looking to translate his clinical expertise and passion for exercise training to improve health outcomes in individuals with chronic lung disease and with transplantation.

Joanna MacLean, MD, PhD, FRCPC
University of Alberta; Edmonton, AB

Session Description

Polysomnography, an overnight observed sleep study, is the recommended test to diagnose obstructive sleep apnea in children. This test is difficult to access in many places. In this session, we will review the evidence for alternative tests to diagnose OSA in children, and how to select the best testing options when polysomnography is not available.

Learning Objectives

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

• Identify testing options to diagnose obstructive sleep apnea in children.
• Understand the gaps in evidence relevant to testing options for diagnosing obstructive sleep apnea in children.
• Select the best testing options to investigate symptoms of obstructive sleep apnea in children in their practice.

CanMEDS Roles: Health Advocate, Medical Expert, Professional

Dr. Joanna MacLean

Dr. Joanna MacLean is an Associate Professor at the University of Alberta and a pediatric respirologist and sleep medicine specialist at the Stollery Children’s Hospital where she is also is the Medical Director for the Sleep Laboratory. She is a clinician-scientist whose research focuses on novel approaches to improving the diagnosis and treatment of sleep-related respiratory disorders in children. When not in a clinic, teaching, or working on research projects, Dr. MacLean can be found running, hiking, skiing, or snowshoeing on trails in beautiful places including the Rocky Mountains and coastlines in Australia.

Haley Fishman, MD, MSc, FRCPC
Holland Bloorview Kids Rehabilitation Hospital; Toronto, ON

Session Description

This session will review the practical aspects of initiating non-invasive ventilation (NIV) in an elective setting, including the eligible patient population. Using real cases, we will review how NIV can be titrated with a combination of capnography, oximetry, flow waveform analysis and ventilator data downloads. Finally, we will touch on some newer programs evaluating the feasibility of outpatient NIV initiation in the pediatric population.

Learning Objectives

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

• Identify patients that may be eligible for initiation of NIV in an elective setting
• Apply an approach to the titration of NIV with interpretation from capnography, oximetry, and ventilator data downloads
• Consider the initiation of NIV in an elective setting outside of the pediatric intensive care unit or sleep laboratory

CanMEDS Roles: Collaborator, Health Advocate, Medical Expert

Dr. Haley Fishman

Dr. Haley Fishman is a pediatric respirologist currently practicing at Holland Bloorview Kids Rehabilitation Hospital. Following a fellowship in pediatric respirology at the Hospital for Sick Children, she completed a clinical subspecialty fellowship in sleep medicine and home ventilation at the Children’s Hospital of Eastern Ontario and a Masters of Science in Quality Improvement and Patient Safety at the University of Toronto. Her clinical and research interests include strategies to improve the efficiency and accessibility of care for patients with sleep-disordered breathing and respiratory sequelae of neuromuscular diseases.

Adele Baker, RRT
The Hospital for Sick Children; Toronto, ON

Sundeep Bola, BSc, MD, FRCPC
The Hospital for Sick Children; Toronto, ON

Session Description

This presentation will provide a practical approach to PAP therapy interface fitting for varied paediatric ages and facies, with consideration given to the sleep disorder and underlying medical condition.  The presentation will also provide specific strategies for therapy acclimatization for infants, toddlers, children and teenagers of varying neurocognitive development.  Finally, the presentation will demonstrate how to evaluate the efficacy of the therapy interface and provide strategies to troubleshoot adherence barriers specific to the interface, as well as behavioural barriers to PAP use in children and adolescents.

Learning Objectives

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

• Determine appropriate interfaces for infants/toddlers/children/teenagers according to age, facies, underlying medical condition and sleep related breathing disorder.
• Employ a stepwise approach to PAP therapy acclimatization for infants/toddlers/children/teenagers with strategies specific to developmental status.
• Evaluate the efficacy of PAP therapy; discern PAP adherence barriers as related to interface versus anxiety/behavioural issues; employ strategies to troubleshoot both.

CanMEDS Roles: TBD

Ms. Adele Baker

Ms. Adele Baker is a staff Respiratory Therapist (RT) in Toronto’s Hospital for Sick Children Sleep Disorders Clinic, where she provides patient education on positive airway pressure (PAP) therapy, positional therapy, and heated high flow therapy for treatment of sleep apnea, as well as therapy adherence support. Ms. Baker co-developed the ongoing education program for SickKids sleep lab technologists and founded the Paediatric Sleep RT Network. She has been an invited speaker at conferences on the topic of PAP therapy. She has co-authored publications on respiratory therapy treatments for sleep apnea and has presented study findings on PAP adherence barriers at Canadian and World Sleep conferences.

 

Dr. Sundeep Bola

Dr. Sundeep Bola completed his undergraduate studies in physiology at McGill University. He went on to complete his medical school studies at the University of Western Ontario, Schulich School of Medicine. Following this, he completed his paediatric residency training, respiratory medicine sub-specialty training and paediatric sleep medicine training at the University of Toronto, The Hospital for Sick Children (SickKids). Prior to returning to SickKids as a staff Respirologist and Sleep Physician, Dr. Bola established a large community based paediatric sleep medicine program.

Andrea Gershon, MD, MSc, FRCPC
University of Toronto; Toronto, ON

Session Description

The majority of Canadians have been infected by COVID-19, many who have had Long COVID or Post-COVID condition.  Despite this, we still know little about the long-term effects of COVID on the lungs.

Over the last 2 years, we have been conducting the Canadian Respiratory Research Network (CRRN) Long COVID Study.  At 11 sites across Canada, we have used random digit dialing to recruit a large national population-based sample of people with COVID-19—some who needed hospitalization but most who did not. Through online questionnaires, we have measured their respiratory symptoms, quality of life and medical history. They have been invited to one of our centres to get pulmonary function testing.

The information we learn about the effect of COVID-19 on the lungs will help patients and health care providers manage it better. We invite you to come and hear about some of our results.

Learning Objectives

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

• To learn about respiratory long COVID
• To quantify the long-term burden of COVID on the lung health of Canadians

CanMEDS Roles: Health Advocate, Medical Expert

Dr. Andrea Gershon

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

Tania Janaudis-Ferreira, PT, PhD
McGill University; Montreal, QC

Session Description

People experiencing long COVID commonly report symptoms such as dyspnea, fatigue, brain fog, post-exertional malaise, among others, which impact their everyday functioning and can be disabling. Rehabilitation is recommended by the World Health Organization as well as by national and international respiratory societies to address the persisting symptoms and functional limitations in individuals with long COVID. However, the delivery of rehabilitation in long COVID can be challenging considering the diverse range of symptoms, their fluctuating nature, and the presence of post-exertional malaise. In addition, there is a paucity of high-quality evidence to support and detail the effects of rehabilitation programs in this population. This presentation will review the findings of a Canadian clinical trial in rehabilitation for long COVID and discuss the challenges around delivering rehabilitation to this population.

Learning Objectives

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

• Summarize the evidence for the benefits of rehabilitation for long COVID
• Recognize an effective rehabilitation protocol for long COVID
• Discuss the challenges around delivering rehabilitation to this population

CanMEDS Roles: Communicator, Health Advocate

Dr. Tania Janaudis-Ferreira

Dr. Tania Janaudis-Ferreira is an Associate Professor with the School of Physical and Occupational Therapy at McGill University and a Scientist with the Research Institute of the McGill University Health Centre. The overall goal of Dr. Janaudis-Ferreira’s research program is to improve care and rehabilitation outcomes of individuals with chronic lung disease and transplant candidates and recipients.

Grace Parraga, PhD, FCAHS
Western University; London, ON

Session Description

I will introduce novel quantitative CT and functional MRI methods and how these can be used for rapid, simultaneous and non-invasive measurements in patients with long-COVID.

I will summarize the current state of the art findings in patients with long-COVID and the relationships between thoracic imaging measurements, exercise limitation, dyspnea and quality of life.

Learning Objectives

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

• Discuss how CT may be used to identify quantitative abnormalities in long-COVID
• Recognize relationship of functional MRI abnormalities and quality-of-life in long-COVID
• Understand the quantitative relationships between pulmonary vascular and terminal airway abnormalities in long-COVID

CanMEDS Roles: Collaborator, Communicator, Scholar

Dr. Grace Parraga

Dr. Grace Parraga’s research is focused on developing a deep understanding of lung disease to enable better patient outcomes using CT and MR imaging methods they have discovered and developed. Her team’s research is funded by CIHR, Natural Sciences and Engineering Research Council of Canada, the Ministry of Health Ontario, Canada Foundation for Innovation, the Canada Research Chairs program and GSK. She is an elected member of the Fleischner Society, fellow of the Canadian Academy of Health Sciences, President-Elect of the International Pulmonary Functional Imaging Workshop and serves on the Institute Advisory Board of CIHR Institute of Circulatory and Respiratory Health.

Ewan Goligher, MD, PhD, FRCPC
UHN; Toronto, Ontario

Session Description

Ventilator-induced diaphragm dysfunction is increasingly recognized as an important clinical problem. This lecture will survey mechanisms of diaphragm dysfunction during mechanical ventilation and review state-of-the-art approaches to preventing and treating diaphragm dysfunction.

Learning Objectives

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

• Describe mechanisms of diaphragm dysfunction related to mechanical ventilation
• Identify strategies to prevent and treatment ventilator-induced diaphragm dysfunction
• List methods for monitoring respiratory effort and diaphragm activity during ventilation

CanMEDS Roles: Collaborator, Medical Expert, Scholar

Dr. Ewan Goligher

Ewan Goligher MD, PhD is an Assistant Professor in the Interdepartmental Division of Critical Care Medicine and in the Department of Physiology at the University of Toronto and a Scientist at the Toronto General Hospital Research Institute.  His research program focuses on characterizing the mechanisms and impact of injury to the lung and diaphragm during mechanical ventilation and on the use of innovative clinical trial designs to test lung and diaphragm-protective ventilation strategies. He co-chairs the PRACTICAL international adaptive platform trial testing novel interventions for acute hypoxemic respiratory failure.

Anastasia Newman, MSc(PT), MSc(RS), PhD
McMaster University; Hamilton, ON

Session Description

Prolonged admissions to critical care are associated with the development of several complications, including physical deconditioning, fatigue, loss of functional independence, and decreased quality of life. The early initiation of physical rehabilitation in critical care may help mitigate some of the iatrogenic effects of protracted immobilization and medical management received in the intensive care unit. Over the last several decades, the evidence supporting the early initiation of rehabilitation has been conflicting, leading to challenges with clinical implementation of the evidence. This presentation will explore the historical perspective of early mobilization literature, review the growing body of early rehabilitation research, discuss the challenges in interpreting conflicting results, and highlight knowledge gaps that may inform future research.

Learning Objectives

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

• Summarize the current evidence on the role of early rehabilitation in critical care
• Apply the outcomes from the current research landscape to support the safety, feasibility, efficacy, and sustainability of early mobilization in critical care
• Identify evidentiary gaps in knowledge and future directions for critical care rehabilitation research

CanMEDS Roles: Collaborator

Dr. Anastasia Newman

Dr. Anastasia Newman completed both her Masters of Physiotherapy (2006) and Masters of Rehabilitation Science (2011) at McMaster University. She worked as a critical care physiotherapist at the Hamilton General Hospital from 2007 to 2020. Dr. Newman completed her PhD in 2021 and recently finished a postdoctoral fellowship in August 2023. Her research focuses on the role of early mobilization in the management of patients with critical illnesses and on the impact of pulmonary rehabilitation in people with chronic respiratory conditions. She is currently an Assistant Professor in the School of Rehabilitation Science at McMaster University.

Eddy Fan, MD, PhD, FRCPC
University of Toronto; Toronto, ON

Session Description

This presentation will discuss the rationale and evidence base for the use of extracorporeal support for patients with acute respiratory failure.

Learning Objectives

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

• Review how extracorporeal support can provide respiratory support
• Discuss the current evidence for the use of extracorporeal support for patients with acute respiratory failure
• Discuss ongoing and future research for the use of extracorporeal support for patients with acute respiratory failure

CanMEDS Roles: Collaborator, Health Advocate, Medical Expert, Scholar

Dr. Eddy Fan

Dr. Eddy Fan is a Professor in the Interdepartmental Division of Critical Care Medicine and the Institute of Health Policy, Management and Evaluation at the University of Toronto and a Staff Intensivist at the University Health Network/Mount Sinai Hospital.  Dr. Fan received his undergraduate degree from the University of Toronto, his medical degree from the University of Western Ontario and a PhD in Clinical Investigation from Johns Hopkins University. He is currently the Medical Director of the Extracorporeal Life Support Program at the Toronto General Hospital.  Dr. Fan’s research has focused on advanced life support for acute respiratory failure and patient outcomes from critical illness.

Panelists:
Krystelle Godbout, MD, FRCPC
Quebec Heart and Lung Institute, Quebec City, QC

Richard Leigh, MBChB, MSc, PhD, FCP (SA), FRCPC, FCAHS
University of Calgary, Calgary, AB

Imran Satia, MD, MRCP (UK), PhD
McMaster University; Hamilton, ON

Moderator
Richard Leigh, MBChB, MSc, PhD, FCP (SA), FRCPC, FCAHS
University of Calgary, Calgary, AB

Session Description

Disease modification has emerged as a novel treatment goal in asthma management, and direct targeting of the type 2 cytokines (IL-4, IL-5, IL-13) and proteins (IgE, TSLP) has revealed them to be key factors in the underlying inflammatory processes driving disease. Traditionally, eosinophils have been the key cells implicated in mediating this inflammation, however, the latest research has advanced our understanding beyond the eosinophil to demonstrate how these targets impact airway fibrosis and remodeling. These dynamics are essential to better predict and prevent airway changes in clinical practice and thereby advance our understanding of the next frontier in asthma care.

Learning Objectives

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

• Provide an overview of the key cytokines (IL-4, IL-5, and IL-13) in type 2 inflammation and their central role in the pathobiology of asthma
• Determine how the latest evidence beyond the eosinophil broadens our understanding of type 2 inflammation
• Explore how the mechanisms of inflammation, airway remodeling in asthma, and the role of targeted inhibition are applicable in clinical practice

CanMEDS Roles: Collaborator, Communicator, Health advocate, Leader, Medical Expert, Scholar

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

Dr. Krystelle Godbout

Dr. Krystelle Godbout is the head of the severe asthma clinic at the Heart and Lung Institute in Quebec City, Canada. She specialized in severe asthma in Newcastle (Australia) and has a one-year fellowship in occupational lung diseases. Despite her young age, Dr Godbout has already cumulated a fair amount of experience with the management of severe asthmatics. She is involved in numerous educational activities and committees to improve the care of asthmatics in Canada and perform research with the Asthma Innovative Research team.

Dr. Richard Leigh

Dr. Richard Leigh is a physician-scientist and the Senior Associate Dean – Faculty Affairs in the Cumming School of Medicine at the University of Calgary. Dr. Leigh’s areas of interest include understanding the basic mechanisms underlying airway remodeling in asthma, the assessment of airway inflammation and early phase clinical trials in asthma and COPD. His clinical practice focuses on severe asthma and other airways diseases, and he previously served as the Chair of the Department of Medicine before taking up his current appointment in January 2020. Dr. Leigh was elected as a Fellow of the Canadian Academy of Health Sciences in 2021.

Dr. Imran Satia

Dr. Imran Satia was born in England and graduated in Medicine from the University of Cambridge in 2006 with a Masters in Neurophysiology. 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 the North-West of England. In 2017 he was awarded a PhD in the mechanisms of cough in asthma from the University of Manchester and was awarded the British Medical Association James Trust Award award. He received the ERS Respire 3 Marie Curie Post-Doctoral Fellowship at McMaster University in 2018. Imran was awarded the E.J. Moran Campbell Early Career Award (2021) and European Respiratory Society Mid-Career Gold Medal in Chronic Cough (2023). Imran co-founded the Canadian Thoracic Society (CTS) working group on chronic cough and currently holds a CIHR Planning and Dissemination grant on “Setting priorities and partnerships for chronic cough in Canada – Can-Cough. 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.

Julie Morisset, MD, FRCPC
University of Montreal; Montreal, QC

Session Description

This presentation will review the most recent guidelines on the diagnosis of hypersensitivity pneumonitis and how to integrate them in clinical practice.

Learning Objectives

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

• Review the clinical features of hypersensitivity pneumonitis
• Explain how to make a diagnosis of hypersensitivity pneumonitis

CanMEDS Roles: Medical Expert, Scholar

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.

Martin Kolb, MD, PhD
McMaster University; Hamilton, ON

Session Description

This presentation will describe the recently published ATS clinical practice guideline “Treatment of Systemic Sclerosis–associated Interstitial Lung Disease: Evidence-based Recommendations”. The general process of guideline development will be covered and the specific questions of how to apply these to clinical practice will be discussed using case reports.

Learning Objectives

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

• Understand the methodology process of creating a clinical practice guideline
• Describe the evidence based recommendations for the treatment of SSc-ILD
• Apply these recommendations to clinical practice

CanMEDS Roles: Medical Expert, Professional, Scholar

Dr. Martin Kolb

Martin Kolb is the Jack Gauldie Boehringer Ingelheim Chair in Interstitial Lung Disease and the Director of the Division of Respirology, McMaster University, Hamilton, ON. His major research interests are fibrotic lung disease, with a particular interest in the role of growth factors, matrix abnormalities and pulmonary vessel remodeling in disease progression. He leads activities in biomarker development for lung fibrosis, and is a Principal Investigator and steering committee member in numerous ILD clinical trials. Professor Kolb has authored over 290 peer-reviewed publications on different basic science and clinical topics with an H-Factor above 74. He was the Chief-Editor of the European Respiratory Journal (2018-2022) and currently is the journal’s Section Editor for Interstitial Lung Disease. He is also an editorial board member of several journals, including American Journal of Respiratory and Critical Care Medicine and European Respiratory Review and Respirology.

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

Session Description

The presentation will summarize the PPF guideline document and highlight challenges and controversies in its inception and implementation in clinical practice.

Learning Objectives

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

• Summarize the PPF guideline recommendations.
• Review the data leading to a non-recommendation for pirfenidone in PPF.
• Discuss criticisms of early adoption of the guideline in clinical practice.

CanMEDS Roles: Health Advocate, Leader, Scholar

Dr. Daniel Marinescu

Dr. Daniel Marinescu received his medical degree from McGill University and completed residency training in Internal Medicine and Respirology at the University of Toronto. He subsequently completed a 2-year fellowship in interstitial lung disease and Master of Health Science at the University of British Columbia, with a focus in epidemiology and clinical research. He is a Clinical Assistant Professor in the Department of Medicine at UBC and a postdoctoral research fellow with the Centre for Heart Lung Innovation. His research focuses on imaging and classification of ILD.

Imran Satia, MD, MRCP (UK), PhD
McMaster University; Hamilton, ON

Session Description

Chronic cough (CC), defined as cough lasting greater 8 weeks, affects approximately 10% of adults. Cough is also the leading cause for ambulatory and primary care visits to physicians and one of the most common reasons for referral to secondary care. Chronic coughing leads to distressing physical, psychological and social consequences such as urinary incontinence, exhaustion, sleep disturbances, fatigue, anxiety, frustration, embarrassment, and social isolation. Patients presenting with CC are often investigated and treated for asthma, COPD, pulmonary fibrosis, gastro-esophageal reflux disease and upper airways cough syndromes. However, in many patients, coughing can be refractory to treatment (RCC), or no underlying disease can be identified, i.e., it is unexplained (UCC). Current treatments for RCC/UCC are all ‘off-label’ pain medications such as morphine, hydrocodone, pregabalin, gabapentin and amitriptyline, which are associated with significant side effects. This presentation will describe the current phase 2 and phase 3 development of novel pharmaceutical therapies targeting the peripheral and central nervous system including P2X3, TRPM8, Kappa/Mu, and NMDA.

Learning Objectives

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

• Understand the peripheral and central mechanisms of chronic cough.
• Understand the clinical development programs of P2X3 antagonists gefapixant and camlipixant.
• Understand the potential role of antagonists targeting kappa/mu, TRPM8 and NMDA receptors.

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

Dr. Imran Satia

Dr. Imran Satia was born in England and graduated in Medicine from the University of Cambridge in 2006 with a Masters in Neurophysiology. 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 the North-West of England. In 2017 he was awarded a PhD in the mechanisms of cough in asthma from the University of Manchester and was awarded the British Medical Association James Trust Award award. He received the ERS Respire 3 Marie Curie Post-Doctoral Fellowship at McMaster University in 2018. Imran was awarded the E.J. Moran Campbell Early Career Award (2021) and European Respiratory Society Mid-Career Gold Medal in Chronic Cough (2023). Imran co-founded the Canadian Thoracic Society (CTS) working group on chronic cough and currently holds a CIHR Planning and Dissemination grant on “Setting priorities and partnerships for chronic cough in Canada – Can-Cough. 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.

Sara McRae, B.A., RRT, CRE
MEDIGAS; Lindsay, ON

Session Description

A review of my experience as an RRT/CRE and a patient navigating the healthcare system with chronic cough.  My journey.  From the diagnosis (tests and differential diagnosis) to the treatments that have worked and those that have not.

Learning Objectives

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

• Apply necessary testing to diagnose or rule out chronic cough
• Navigate the medical system
• Review treatment and continual learning and understanding of the “disease” process

CanMEDS Roles: Collaborator, Communicator, Health Advocate

Kim Smith, BMus, MMus, MHSc, SLP (C), Reg. CASLPO
McMaster Children’s Hospital; Hamilton, ON

Session Description

Overview of why/how SLPs do this work. Review of the literature/evidence. Explanation of some of the strategies and techniques used in SLP treatment.

Learning Objectives

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

• Summarize the role of SLP in chronic cough management
• Recognize when a referral to SLP is appropriate
• Describe at least one strategy or technique used to control or suppress a cough

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

Ms. Kim Smith

Kim Smith is a Speech-Language Pathologist in Hamilton, Ontario. She has spent the majority of her career assessing and treating upper airway disorders which include voice, swallowing, and cough. Kim leads the Adult Outpatient Swallowing Clinic at McMaster University Medical Centre in Hamilton, ON, and runs a small private practice treating voice disorders and chronic cough.

Loraine Fabri, MD
B.C. Children’s Hospital, University of British Columbia; Vancouver, BC

Session Description

We report the case of a 20 months old male, born at term with Noonan’s syndrome and lymphangiectasia in the neck, mediastinum and chest, associated with severe tracheo- and bronchomalacia. He was symptomatic from birth, dependent to invasive ventilation and did not respond to medical interventions including aggressive diuresis, medium-chain triglycerides diet, octreotide and propranolol. He was started on trametinib with rapid and significant clinical and radiological improvement. The patient was rapidly weaned off respiratory support following investigations and remains asymptomatic from a respiratory standpoint to this day.

Learning Objectives

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

• Describe the physiopathology features leading to lymphangiectasia in Noonan syndrome
• Demonstrate the effect of MEK inhibitor on lymphangiectasia

CanMEDS Roles: Collaborator, Health Advocate, Medical Expert

Dr. Loraine Fabri

Loraine Fabri is a 2nd year Clinical Fellow in Pediatric Respirology at British Columbia Children’s Hospital in Vancouver. She completed her pediatric training in Brussels, Belgium and spent a year in Melbourne, Australia, doing research focusing on Strep A. When not at work, you will find her in the mountains, ticking the boxes on her Vancouver’s bucket list.

Crista-Lee Berry, MD
B.C. Children’s Hospital, University of British Columbia; Vancouver, BC

Session Description

A previously well 16 year old who presented to ED with fever, worsening cough, shortness of breath and hypoxemia. CXR showed almost complete left sided white out along with elevated inflammatory markers. He improved clinically and radiographically with antibiotics but six weeks later, he returned with a similar presentation and chest x-ray. Subsequent investigations revealed his diagnosis.

Learning Objectives

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

• Review the differential diagnosis for lung opacification on CXR
• Identify the CXR features atypical of pneumonia

CanMEDS Roles: Collaborator, Scholar

Dr. Crista-Lee Berry

Crista-Lee Berry is currently a second year clinical fellow in Pediatric Respirology at the University of British Colombia/BC Children’s Hospital, Vancouver, BC. She attained her MBBS and Doctor of Medicine in Pediatrics at the University of the West Indies, Mona, Jamaica, W.I.

Lydia Mapala, MD
Montreal Children’s Hospital; Montreal, QC

Session Description

A previously healthy 10-year-old immunocompetent male, who had immigrated from Morocco to Canada presented with a left parasternal mass that started small and grew quickly to the size of a tennis ball within 2 months. He had excisional biopsy, and the specimen from the excisional biopsy was PCR positive for Mycobacterium Tuberculosis. Patient was diagnosed with Diseminated Tuberculosis and started on Rifampin, Isoniazid, Ethambutol and Pyrazinamide regimen.

Chest wall TB is a diagnostic challenge. Its presumed to occur by hematogenous route and by direct extenson through the chestwall lymhatics. Clinicians need to be aware and consider it the differential dignosis of a Chest wall mass especially in recent immigrants from TB endemic regions. Anti TB treatment and adjuvant surgery have been shown to be effective in treatment of chest wall TB in case reports.

Learning Objectives

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

• Recognise that Mycobacterium tuberculosis is a good masquerader
• Demonstrate one extrapulmonary manifestation of Mycobacterium Tuberculosis
• Consider Tuberculosis as a differential diagnosis of any mass in persons from endemic regions

CanMEDS Roles: Collaborator, Health Advocate

Dr. Lydia Mapala

Lydia Mapala, currently enrolled as a Pediatric Respirology fellow at Montreal Childrens Hospital.  I obtained a Masters in Pediatrics from Stellenbosch University in Cape town, South Africa and worked as a Pediatrician in Zambia thereafter. One reason I was inspired to pursue respirology stemmed from the sense of satisfaction I get after seeing children running around with no trouble breathing. I’m passionate about climate change and everyone has a role to play. I have an interest in Lung infections especially tuberculosis coming from a LMIC, I also have interest in everything respirology especially childhood ILDs, sleep medicine  and Interventional Respirology

Adeline Lim, MD
The Hospital for Sick Children; Toronto, ON

Session Description

A case surrounding a child who presented with an incidental finding of hypoxia will be discussed, followed by the investigations performed, clinical course, management, and eventual diagnosis of hereditary hemorrhagic telangiectasia (HHT). The causes of hypoxia will be briefly reviewed, followed by the introduction of HHT and the associated genetic testing. The Curaçao Criteria will be described as well as its applicability to the pediatric population. A brief description of the current surveillance programme for patients with HHT will be discussed, with particular focus on the management of pulmonary arteriovenous malformations.

Learning Objectives

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

• Describe the key components of the Curaçao Criteria and its applicability in the pediatric population.
• Demonstrate understanding of the current surveillance programme for patients with HHT.
• Identify the need for further research into the progression of pulmonary arteriovenous malformations in patients with HHT.

CanMEDS Roles: Leader, Scholar

Dr. Adeline Lim

Dr. Adeline Lim is presently a clinical fellow in Respiratory Medicine at the Hospital for Sick Children (SickKids). She previously completed her Paediatric Respiratory and Sleep Medicine fellowship in Brisbane, Australia.

John (Jack) D. Buckley, MD, MPH, FCCP
CHEST; Glenview, IL

Session Description

Generative AI has made tremendous advances in its abilities over the past few years. No place is immune from its potential implementation, including medicine. Where, when, and how AI should / would be used are essential questions for our clinicians and patients. This presentation will address potential benefits and risks of applying AI in health care.

Learning Objectives

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

• Recap the current state of generative artificial intelligence (AI)
• Consider potential benefits and risks of generative AI
• Wonder what we are missing and can not for see

CanMEDS Roles: Collaborator, Health Advocate

Dr. John (Jack) D. Buckley

Dr. Buckley is a respirologist and critical care physician in the US.  He’s spent his career in medical education and faculty development.  Currently he teaches at the Western Michigan University Stryker School of Medicine and serves as President of CHEST for 2024.

Monika Gappa, MD
Evangelisches Krankenhaus Düsseldorf; Düsseldorf, Germany

Session Description

Overview of potential application of AI in the field of Pediatric Respiratory Medicine

Learning Objective

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

• Describe potential applications of AI in paediatric respiratory medicine

CanMEDS Roles: Collaborator, Health Advocate

Prof. Dr. Monika Gappa

Prof. Dr. Monika Gappa is Professor of Paediatrics and Director of the Children’s Hospital, Evangelisches Krankenhaus Düsseldorf. She is the current President of the European Respiratory Society (ERS). Her main areas of interest are paediatric respiratory physiology, particularly  assessment of lung function, early origins of lung disease, severe asthma, and allergy. She has been Associate Editor of Paediatric Pulmonology for many years and is on the Editorial Board of a number of respiratory journals. She has been active member of the ERS for more than 30 years, has contributed to a number of Task Forces and led the paediatric HERMES program. In 2020, she received the ERS Educational Award.

Patricia Rivera, MD, ATSF
President, American Thoracic Society; University of Rochester; Rochester, NY

Session Description

Lung cancer is the leading cause of cancer death in men and women in many countries. While cigarette smoking remains the most important risk factor in the development of lung cancer, there is significant heterogeneity in risk due to sociodemographic factors, occupational and environmental exposures, and underlying concomitant diseases. Lung cancer rates in women in the US have surpassed rates in men, and the incidence of lung cancer continues to rise among people who have never smoked or who haven’t smoked in many years. Risk prediction models can help identify individuals at increased risk of lung cancer; limitations in their use include a lack of data from underrepresented minority populations, resulting in underestimated risk. Using low-dose computed tomography (LDCT), artificial intelligence tools have the potential to predict lung cancer risk without requiring individual clinical or lung nodule characteristics. These tools also hold promise in better-assigning cancer probability in indeterminate lung nodules.

Learning Objectives

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

• Describe the benefits and limitations of risk prediction models in lung cancer.
• Understand the role of AI in lung cancer risk assessment.
• Understand the role of AI in the evaluation of lung nodules.

CanMEDS Roles: Collaborator, Health Advocate, Scholar

Dr. Patricia Rivera

Dr. Patricia Rivera is the C. Jane Davis & C. Robert Davis Distinguished Professor in Pulmonary Medicine and Chief of the Pulmonary and Critical Care Medicine Division at the University of Rochester, Rochester, New York. Dr. Rivera has expertise across the continuum of lung cancer care. Through NIH/NCI-funded research, she studies the delivery, quality, and outcomes of lung cancer screening. Dr. Rivera is the President of the American Thoracic Society. She is passionate about mentoring the next generation of leaders and increasing the representation of women and underrepresented groups in pulmonary and critical care medicine.

Clodagh Ryan, MD, FRCPC
University of Toronto/University Health Network; Toronto, ON

Session Description

Over the last two decades there has been a dramatic rise in opioid use, misuse, morbidity and mortality in North America and the Western World. This is due to a combination of factors, of which the recognition of chronic (non-cancer) pain by the medical community, the encouragement of patients to seek treatment and more importantly, the promotion of opioids as a key treatment modality are prime considerations.  Opioid use is associated with alterations in sleep architecture, respiratory depression and sleep-disordered breathing.  This presentation will review the current literature and evidence relating to the impact of and relationship between opioid use and sleep breathing disorders and explore treatment modalities.

Learning Objectives

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

• Describe the mechanisms of action of opioids on the respiratory system
• Summarize the relationship between opioids and sleep breathing disorders
• Develop and apply treatment recommendations for those with opioid induced sleep disordered breathing

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

Dr. Clodagh Ryan

Dr. Clodagh Ryan is an Assistant Professor and Sleep Program Director at the University of Toronto. She is the sleep lab and pulmonary function medical director at University Health Network-Toronto General Hospital.  She is a clinician investigator with an interest in sleep breathing disorders and comorbid cardiopulmonary disease.  She has over 80 peer reviewed publications.

Marta Kaminska, MD, M.Sc., FRCP(C)
McGill University Health Centre; Montreal, QC

Session Description

OSA is common in the general population and in most prevalent respiratory disorders such as COPD, asthma and interstitial lung diseases. This session will describe epidemiology, physiology, and data on clinical implications as well as outcomes of treatment of the overlap between OSA and these respiratory disorders.

Learning Objectives

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

• Describe the epidemiology of the overlap between OSA and COPD, asthma and interstitial lung disease (ILD).
• Understand the physiological underpinning of the clinical manifestations of the overlap between OSA and COPD, asthma and ILD.
• Explain the impact on clinical outcomes of treatment of OSA in the context of overlap with COPD, asthma or ILD.

CanMEDS Roles: Health Advocate, Medical Expert, Scholar

Dr. Marta Kaminska

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

Richard Leung, MD, PhD
University of Toronto; Toronto, ON

Session Description

Dr. Leung will provide a brief summary of the evolution of our understanding of sleep disordered breathing in heart failure, with special emphasis on Cheyne-Stokes respiration.  He will then review the current state of the art of management, with presentation and analysis of the CANPAP, SERVE-HF and ADVENT-HF studies.

Learning Objectives

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

• Review the history of sleep disordered breathing heart failure
• Recognize the randomized controlled trials of PAP therapies in this setting
• Have an approach to management of sleep disordered breathing in heart failure

CanMEDS Roles: Medical Expert, Professional, Scholar

Dr. Richard Leung

Dr. Richard Leung is the Director of the Sleep Laboratory of St. Michael’s Hospital, and Assistant Professor at the University of Toronto.  He is the former program director of the Sleep Fellowship program of the Division of Respirology, University of Toronto.  His main research interest is in the long term complications of sleep disordered breathing, and has over sixty peer reviewed publications.

Chris Hergott, MD, FRCPC, FCCP
University of Calgary, Calgary, AB

Cory Yamashita, MD, FRCPC
Western University, London, ON

Session Description

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

Dr. Chris Hergott

Dr. Christopher Hergott completed medical school at the University of Toronto and Internal Medicine and Respirology training at Western University. He obtained his advanced clinical fellowship in Interventional Pulmonary Medicine at the University of Calgary. Dr. Hergott is currently the Adult Respirology program director at the University of Calgary. He is also Chair of the Canadian Assembly for Chest Procedures and the Education & CPD Committee at the Canadian Thoracic Society. He loves the mountains and enjoys photography.

Dr. Cory Yamashita

Dr. Cory Yamashita is an Associate Professor of Medicine in the Division of Respirology (Department of Medicine, Western University) at St. Joseph’s Health Care.  He has been in practice since 2007 after completing medical School at the University of Manitoba (2001), Internal Medicine (2004) and Respirology (2007) at Western and post-fellowship training at the National Jewish Hospital in Denver, CO.  He has a clinical interest in COPD, asthma and research interests in asthma and cystic fibrosis.  He serves as Site Chief of Respirology at London Health Sciences Centre (University Hospital).

Speaker
Charles Chan, MD, FRCPC, FCCP, FACP
University of Toronto, Toronto, ON

Moderator
Irvin Mayers, MD, FRCPC
University of Alberta, Edmonton, AB

Session Description

CASCADE is the largest Canadian data collection on the management of severe asthma with 78 Specialists enrolled and capturing 503 patients. Key highlights to be presented at the session:

1 – Assess current standard of care in severe asthma management through insights gained from CASCADE Program.

2 – Evaluate the role and further potential of biologic therapy in the management of severe uncontrolled asthma patients.

3 – Uncover opportunities in the current standard of care to improve severe asthma management as identified in CASCADE.

Learning Objectives

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

• Gain insight into the current state of disease management in severe asthma among specialists
• Identify and discuss barriers for doctors and patients to access optimal therapy in severe asthma
• Discuss implications to clinical practice by reviewing data and insights on current severe asthma management among Specialists in Canada

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

This session is co-developed by the CTS and AstraZeneca & Amgen 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, Consultant Respirologist at University Health Network, and he is the Medical Director & Owner of Rosedale Pulmonary Function Laboratory & Agincourt Pulmonary Services.

Over the last 35 years, Dr. Chan’s hospital leadership roles included Interim President & CEO, Executive Vice-President & Chief Medical Officer, VP of Medical Affairs, Program Medical Director, Business Units Medical Director & Head of Respirology. His university leadership roles included Vice-Chair of Medicine, Interim Division Director of Respirology, Respirology Fellowship Program Director & Interim Head of Respirology at Sunnybrook & Women College Hospitals.

Speakers
Melinda Solomon, MD, FRCPC
The Hospital for Sick Children (SickKids), Toronto, ON

Diana Elizabeth Tullis, MD, FRCPC
Unity Health, Toronto, ON

Moderator
Mark Chilvers, MRCPCH, MD, BSc, MBChB
BC Children’s Hospital, Vancouver, BC

Session Description

The 2022 Annual Data Report for the Canadian Cystic Fibrosis Registry has shown a substantial increase in the median age of survival for Canadians living with cystic fibrosis (CF), rising to 60 years in 2022. This can be attributed to quality of CF care, research, and treatments, including expanding access to CFTR modulators. With this increasing lifespan, many questions arise around implications for patients with CF and how clinical care can evolve accordingly. This program would provide an update on CF clinical care in Canada and use interactive patient cases to explore unique considerations for both pediatric and adult audiences, from nutrition recommendations/evolving treatment plans to family planning/future planning/cancer risk/menopause (key topics of interest can be found in the included needs assessment). The proposed speakers will bring both adult and pediatric patient perspectives to the symposium, allowing for a balanced look at unique cross-country challenges for each age group, including optimizing the transition from pediatric to adult care. While focused on CF, the potential role of local respiratory care teams in the evolving care of patients with CF can be featured, making this symposium of interest to a broad respiratory audience.

Learning Objectives

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

• Describe the evolution of the cystic fibrosis (CF) treatment paradigm in Canada and its impact on clinical management and burden of care, including increased survival
• Identify important new aging considerations for both pediatric and adult patients and apply available management strategies
• Incorporate strategies to optimize the transition to adulthood in patients with CF

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

This session is co-developed by the CTS and Vertex and is planned to achieve scientific integrity, objectivity and balance.

Dr. Melinda Solomon

Dr. Melinda Solomon is a Pediatric Respirologist at The Hospital for Sick Children (SickKids) and Professor of Paediatrics at the University of Toronto. She has been the Cystic Fibrosis Clinic Director as well as the Medical Director of the Pediatric Lung Transplant Program at SickKids for over 20 years. She has a strong passion for clinical excellence and education.  Her research endeavors have been aligned with her clinical expertise, including CF clinical trials. Currently she is the President-Elect of the Canadian Thoracic Society.

 

Dr. Elizabeth Tullis

As the founding Director of the Toronto Adult Cystic Fibrosis Clinic at St. Michael’s Hospital, Dr. Tullis is responsible for the care of more than 600 adults with CF. Dr. Tullis is a Professor of Medicine at the University of Toronto and an Adjunct Scientist at the Keenan Research Centre of Li Ka Shing Knowledge Institute. Dr. Tullis has published over 180 articles and book chapters and has lectured nationally and internationally on issues related to CF in adults.  She has trained 29 CF fellows who are now working in CF clinics around the world.

Parameswaran Nair, MD, PhD, FRCP, FRCPC, FCAHS
McMaster University; Hamilton, ON

Session Description

This lecture will examine the definition and identification of “T2 low” asthma, clinical presentations and physiological associates of this “endotype”, and potential pharmacological and non-pharmacological interventions for asthma control. The lecture will pay particular attention to neutrophilic inflammation of the airways, the role of infections and hyperresponsiveness, and data from clinical trials targeting non-T2 pathways in asthma.

Learning Objectives

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

• Understand Endotype severe asthma in clinical practice
• Understand mechanisms of T2 low asthma, emphasis on infections and role of mast cell
• Apply practical approach and management to apparent T2 low asthma

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

Dr. Parameswaran Nair

Dr. Parameswaran Nair is the Frederick E. Hargreave Teva Innovation Chair in Airway Diseases & Professor of Medicine in the Division of Respirology at McMaster University in Hamilton, Ontario, Canada, providing tertiary care to patients with severe asthma and other complex airway and eosinophilic lung diseases. He directs a patient-centred translational research program at the Firestone Institute of St Joseph’s Healthcare, focussed on charactering bronchitis using sputum biomarkers, bio-imaging, and targeted therapy with biologics and small molecule antagonists. His laboratory has contributed to over 300 peer-reviewed publications in high impact general medical, allergy, and respiratory journals (h-index 72), and has been recognized by a Canada Research Chair, Fellowships of the Canadian Academy of Health Sciences, the European Respiratory Society, the American College of Chest Physicians, and Memberships of the National Academy of Medical Sciences of India and Collegium Allergologicum Internationale.

Krystelle Godbout, MD, FRCPC
Laval University; Quebec City, QC

Session Description

Therapeutic goals in asthma have evolved with the development and marketing of new and highly effective drugs. Remission is now regarded as the new standard to achieve. But is it really achievable? And how can we define and identify it? Is it really relevant for the clinical practice?

The presentation will try to answer these key questions regarding remission.

Learning Objectives

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

• Differentiate remission from clinical response and control in patients with severe asthma on biologic therapy
• Recognize remission when encountered in patients with asthma in clinical practice
• Modulate the asthma treatment to achieve clinical remission

CanMEDS Roles: Health Advocate, Medical Expert

Dr. Krystelle Godbout

Dr. Krystelle Godbout is the head of the severe asthma clinic at the Heart and Lung Institute in Quebec City, Canada. She specialized in severe asthma in Newcastle (Australia) and has a one-year fellowship in occupational lung diseases. Despite her young age, Dr Godbout has already cumulated a fair amount of experience with the management of severe asthmatics. She is involved in numerous educational activities and committees to improve the care of asthmatics in Canada and perform research with the Asthma Innovative Research team.

Judy King, PT, PhD
University of Ottawa, Ottawa, ON

Session Description

60% of Canadian adults are unable to obtain, understand and act upon health information and services and to make appropriate health decisions on their own according to the Public Health Agency of Canada. This is often unappreciated among highly educated health care professionals, who are often not aware that they must modify their patient education practices to ensure understanding and safety. This is compounded by the fact that both reliable as well as unreliable or even misinformation is readily available to both patients and health care professionals.

This often results in a gap between what patients understand and what health care professionals expect them to know or think they know.

This interactive presentation will provide an overview of health literacy as well as provide participants with evidenced based patient education strategies to optimize the care of people living with respiratory conditions.

 Learning Objectives

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

• Describe how health literacy impacts on respiratory care.
• Recognize and identify challenges faced by people living with respiratory conditions when accessing and appraising health-related information.
• Identify specific strategies to reduce some of these challenges faced by patients in their own practice regardless of role or clinical setting.

CanMEDs Roles: Collaborator, Communicator, Health Advocate

Dr. Judy King

Dr. Judy King is the Vice Dean of Interprofessionalism, Partnerships and Practical Education, Faculty of Health Sciences and an Associate Professor in the Physiotherapy Program in the School of Rehabilitation Sciences, at the University of Ottawa. Dr. King holds a Chair in University Teaching with a focus on critical thinking.

Her patient centred research program is in patient and health care professional education, which includes patient education, health literacy and transformative learning.

Over her career, she has volunteered on several provincial, national and international committees focused on lung health including recently being on the executive of the Canadian Respiratory Health Professionals (CRHP), a multi-disciplinary healthcare professional assembly of the CTS.

Larry Lands, MD, PhD
Montreal Children’s Hospital, McGill University Health Centre; Montreal, QC

Session Description

Dyspnea in children negatively impacts their ability to fully participate in activities and quality of life. The investigation of dyspnea requires a detailed history to appreciate what the child is feeling, evaluation of any physical manifestations that can suggest potential causes, coupled with a directed use of laboratory tests. These can then be used to develop a therapeutic strategy.

Learning Objectives

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

• Recognize the different qualities of dyspnea
• Quantitate the degree of dypsnea
• Employ a diagnostic clinical and laboratory approach to dyspnea

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

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. He is a member of Board of Directors of the Canadian Lung Association.

André Isaac, MD, MSC, FRCSC
Stollery Children’s Hospital, University of Alberta; Edmonton, AB

Session Description

Dyspnea is a common complaint in the pediatric population and a challenging one to work-up and treat. Whereas exercise-induced dyspnea is often attributed to asthma, there are a host of other diagnoses that can imitate and co-exist with asthma. Inducible laryngeal obstruction (ILO) has increased in prevalence, which is likely due in part to increased awareness and a wider range of available diagnostic tools. Other related diagnoses including allergic laryngitis, exercised-induced laryngomalacia and laryngopharyngeal reflux can also cloud the picture. The purpose of this session is to present a diagnostic and therapeutic approach to non-asthma related dyspnea in the pediatric population with a focus on ILO and a sweeping review of the most up to date evidence on this topic.

Learning Objectives

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

• Formulate an appropriately wide differential diagnosis for the pediatric patient presenting with dyspnea
• Evaluate a patient for inducible laryngeal obstruction including a multidisciplinary approach and appropriate referrals
• Compare and contrast various causes of exercised and non-exercise induced dyspnea in the pediatric population

CanMEDS Roles: Collaborator, Communicator, Medical Expert

Dr. André Isaac

Dr. André Isaac is an Assistant Professor and Pediatric Otolaryngologist at the Stollery Children’s Hospital. He completed medical school and Otolaryngology-Head and Neck Surgery residency at the University of Alberta. He then completed pediatric fellowship training focussed on airway reconstruction at Lurie Children’s Hospital of Chicago.

Dr. Isaac also holds a Master of Science in Global Health Policy from the London School of Hygiene and Tropical Medicine, and is the director of the Moi Surgical Initiative, in Eldoret, Kenya. His clinical and research interests are related to pediatric airway, voice and swallowing disorders, and global surgery in resource-limited settings.

Benjamin Shieh, MD
McGill University; Montreal, QC

Session Description

There has been a significant increase in the number and type of systemic cancer therapies. Pneumonitis secondary to these treatments can occur at varying frequencies, with associated morbidity and mortality.

This session will familiarize the respirologist to a number of these drugs, the radiological patterns associated with them, and to review the recommended management.

Learning Objectives

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

• Recognize systemic cancer therapies associated with pneumonitis.
• Describe radiological patterns of drug induced pneumonitis.
• Manage pneumonitis related to systemic cancer therapies.

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

Dr. Benjamin Shieh

Dr. Benjamin Shieh is an assistant professor of medicine at McGill University and associate member in the Gerald Bronfman department of oncology. He is a respirologist by trade and completed fellowships in interventional pulmonology and thoracic oncology at the University of Calgary. His interests range from the workup and diagnostics of thoracic tumors to their systemic treatment. After participating in tumor board, he enjoys slide tackling his opponents on the soccer field and chasing his toddlers around.

Elizabeth Kurien, MD, CM, FRCPC
Tom Baker Cancer Centre; Calgary, BC

Session Description

This presentation will review the role for curative intent radiotherapy in the management of early stage lung cancer, including stereotactic body radiotherapy (SBRT). It will identify risk factors and patient selection criteria. The presentation will provide an overview of the expected benefits, risks, and outcomes.

Learning Objectives

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

• Describe the role of stereotactic body radiotherapy (SBRT) and curative intent radiotherapy in the management of early stage lung cancer.
• Review patient selection criteria.
• Summarize expected toxicities and outcomes.

CanMEDS Roles: Collaborator, Communicator, Medical Expert

Dr. Elizabeth Kurien

Dr. Elizabeth Kurien obtained her medical degree from McGill University, completed her specialty training in radiation oncology at the University of Ottawa followed by fellowship training at the Cross Cancer Institute. She has worked as a radiation oncologist at Tom Baker Cancer Centre for 24 years, specializing in the care of patients with lung cancer and sarcoma. She has undertaken several administrative roles at the local and provincial level over the years. She serves as a coach for residents in difficulty for University of Calgary Post-Graduate Medical Education and is currently Vice Chair of the Royal College Radiation Oncology Examination Board.

Felix Girard, PhD Student, FKQ
Clinical Exercise & Respiratory Physiology Laboratory, Department of Kinesiology & Physical Education, McGill University; Montreal, QC

Session Description

Exertional breathlessness is a prevalent and disabling symptom of respiratory disease; however, the neurophysiological mechanisms are unclear. My doctoral research will test the hypothesis that exertional breathlessness reflects the awareness of an inspiratory load compensating reflex that maintains ventilation during exercise by increasing (in response to respiratory mechanical loading) or decreasing (in response to respiratory mechanical unloading) inspiratory neural drive. To this end, intensity ratings of breathlessness and neural activation of the diaphragm and extra-diaphragmatic inspiratory muscles will be assessed at rest and during bicycle exercise in healthy volunteers aged 18 years: while breathing against a variety of inspiratory flow resistive or elastic loads (Study 1); while breathing room air or a low-density helium gas mixture (Study 2); and after experimentally induced diaphragm fatigue (Study 3). Anticipated findings will generate new knowledge on the mechanisms of exertional breathlessness, which may inform new and/or more effective therapeutic interventions.

Learning Objectives

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

• Summarize the inter-relationships between ventilation, inspiratory neural drive, respiratory muscle pressure development, and breathlessness.
• Explain how the respiratory system responds to intrinsic and extrinsic respiratory mechanical loads during exercise, and how perception of breathlessness is affected.
• Better understand the neurophysiological mechanism of exertional breathlessness in people living with obstructive or restrictive lung health conditions.

CanMEDS Roles: Medical Expert, Scholar

Mr. Felix Girard

Mr. Felix Girard is a second-year Ph.D. student in Prof. Dennis Jensen’s Clinical Exercise & Respiratory Physiology Laboratory at McGill University in Montreal, QC, Canada. His research focuses on studying breathing mechanics, the control of respiration, and the neurophysiological mechanisms of exertional breathlessness. As a researcher with a background in kinesiology and clinical exercise physiology, Mr. Girard has a strong scientific interest in leveraging exercise as a systematic and integrative stimulus capable of revealing critical mechanistic features of human respiratory (patho)physiology. He aims to contribute valuable insights to the fields of respiratory health and exercise physiology.

Cole Bowerman, MSc
Michael G. DeGroote School of Medicine, McMaster University; Hamilton, ON

Session Description

Lung function thresholds to diagnose respiratory diseases are derived from Global Lung Function Initiative (GLI) reference populations that meet an oversimplified set of eligibility criteria including lifelong non-smoking, no respiratory symptoms, and no physician diagnosed respiratory disease. These limited criteria overlook important determinants of lung health, including air pollution, second hand smoke, and other factors which may differ by socioeconomic status (SES). We tested the hypothesis that lung pathology on CT would be common among GLI reference population-eligible adults and associated with lung function impairment, indices of SES, and mortality using data from the Multi-Ethnic Study of Atherosclerosis (MESA). We identified 31.8% of GLI eligible individuals in MESA with lung pathology on CT. These individuals had lower lung function, lower socioeconomic status, poor healthcare access, and higher mortality.

Learning Objectives

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

• Identify the limitations of currently used pulmonary function test reference equations
• Critically apply a patient’s results from pulmonary function test reference equations to their unique scenarios.

CanMEDS Roles: Health Advocate, Medical Expert, Scholar

Mr. Cole Bowerman

Cole Bowerman is a final year medical student at McMaster University who will be starting residency training in Internal Medicine in 2024. He completed his Master’s of Epidemiology at Dalhousie University. He became involved with the Global Lung Function Initiative (GLI) in 2020 where he re-analyzed the GLI’s large spirometry database to create race-neutral spirometry reference equations. He is currently a junior executive with the GLI and is committed to identifying the shortcomings of currently used approaches to lung function interpretation and identifying equitable and sustainable solutions for the path forward.

Devin Phillips, PhD
York University, Toronto, ON

Session Description

It is increasingly recognized that adults with preserved ratio impaired spirometry (PRISm) lung function patterns are prone to increased morbidity. This talk will review the current state of knowledge on the physiology of PRISm.  Emerging evidence interrogating the physiological responses to cardiopulmonary exercise testing, and the mechanisms of exertional dyspnea and exercise intolerance in PRISm will be discussed.

Learning Objectives

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

• Identify pulmonary function patterns consistent with PRISm
• Compare and contrast PFT and CPET patterns in PRISm versus COPD
• Summarize the basic neurophysiological constructs of dyspnea
• Summarize the known pathophysiological mechanisms of activity-related dyspnea in PRISm

CanMEDS Roles: Collaborator, Medical Expert, Scholar

Dr. Devin Phillips

Dr. Devin Phillips is an Assistant Professor of Cardiorespiratory Physiology at York University in Toronto, Canada. He completed his doctoral training at the University of Alberta (Edmonton, AB) followed by a postdoctoral fellowship in the Respiratory Investigation Unit at Queen’s University (Kingston, ON).

Dr. Phillips’ clinical research program focuses on better understanding the mechanistic link between pulmonary gas-exchange abnormalities, ventilatory mechanical constraint, perceived breathlessness, and exercise limitation in adults living with cardiopulmonary disease. Dr. Phillips is an expert in cardiopulmonary exercise test (CPET) interpretation and uses CPET as a prognostic research tool.

Darcy Marciniuk, MD, FRCPC, FCAHS, Master FCCP
University of Saskatchewan; Saskatoon, SK

Session Description

Pulmonary function testing (PFT) is essential to the field of respiratory medicine.  Beyond its foundational use evaluating symptoms and informing patient care, testing is utilized for assessing and monitoring occupational health, determining suitability for employment, targeted screening of individuals/populations who may be at increased risk of disease, and for evaluation and monitoring of overall population respiratory health.  Moreover, recent evidence has also demonstrated that lung function testing may help predict the future risk of cardiovascular and metabolic disease, as well as all-cause mortality.

Recent updates to standards for the conduct and interpretation of lung function tests have been released, and introduced changes to normal comparative values, principles for bronchodilator responsiveness testing, interpretative strategies, and classification protocols of common impairments.  The quantity and magnitude of changes have been disruptive to clinicians but reflect rapidly evolving understanding and recent advances.  In this session, these changes will be explained and discussed, and practical means to integrate into clinical practice and patient care will be reviewed.

Learning Objectives

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

• Understand updated ERS/ATS Technical Standards on interpretive strategies for lung function testing.
• Appreciate evolving concepts and recent research in pulmonary function testing.
• Discuss and manage implications for practicing clinicians providing patient care.

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

Dr. Darcy Marciniuk

Dr. Darcy Marciniuk is Associate Vice-President Research at the University of Saskatchewan and Medical Director of the LiveWell COPD Management Program in the Saskatchewan Health Authority.  He is recognized internationally as an expert and leader, with more than 480 invited national and international presentations, and 250 peer-reviewed publications. He is a past President of the CTS and the American College of Chest Physicians, and past Chair of the Forum of International Respiratory Societies.  Dr. Marciniuk has led and participated in many COPD, CPET and Pulmonary Rehabilitation guidelines and recently chaired a multi-society international guideline on race and pulmonary function testing.

Sharon Dell, MD, FRCPC
University of British Columbia; Vancouver, BC

Session Description

Children’s interstitial lung disease (chILD) is rare but associated with the highest mortality of all pediatric chronic lung diseases. Modern genome sequencing techniques have revealed novel mechanisms of disease in chILD. Multicenter clinical research networks have provided the infrastructure for driving advances in this field. This session will briefly review our current understanding of the basic epidemiology, diagnosis and management of children’s interstitial lung disease (chILD) and then focus on recent literature advancing the field.

Learning Objectives

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

• Recognize clinical presentations of chILD in infancy and older children
• Know when to order genetic testing to diagnose chILD
• Recognize new chILD (kids) on the block

CanMEDS Roles: Collaborator, Health Advocate, Medical Expert, Scholar

Dr. Sharon Dell

Dr. Sharon Dell, BEng, MD, FRCPC is a professor of pediatrics and head, division of respiratory medicine, at the University of British Columbia and BC Children’s Hospital since June 2020. Previously she was professor of pediatrics at the University of Toronto and SickKids Hospital. She is past director (2010-2015) of the Clinical Epidemiology and Health Care Research MSc/PhD graduate program at the University of Toronto. Dr. Dell leads sub-specialty clinics in primary ciliary dyskinesia (PCD), Children’s Interstitial Lung Disease (ChILD) and severe asthma.  Her research program focuses on evaluating health outcomes, risk factors, genotype/phenotype correlations and diagnostic tests in children with chronic lung diseases. She has held continuous federal grant funding (NIH, CIHR, Health Canada, Canadian Thoracic Society) since starting her academic career in 2002.  Dr. Dell is an active member of multiple Canadian and international professional societies and has many international research collaborations in pediatric rare lung disease. She is Deputy Editor for Annals of the American Thoracic Society (ATS) journal since 2017.

Adam Shapiro, MD
McGill University; Montreal, QC

Session Description

Primary ciliary dyskinesia and non-CF bronchiectasis are under-recognized conditions leading to significant morbidity in pediatric patients. From this state-of-the-art review, clinicians will understand the recent advances in diagnostics, genotype-phenotype correlations, therapeutics, and clinical outcomes in these conditions.

Learning Objectives

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

• Discuss the advances and limitations in current primary ciliary dyskinesia (PCD) diagnostics
• Recognize genotype-phenotype correlations in PCD and how these affect clinical outcomes
• Understand how endotyping can change our understanding and therapies of non-CF bronchiectasis

CanMEDS Roles: Health Advocate, Medical Expert

Dr. Adam Shapiro

Dr. Adam Shapiro is an Associate Professor of Pediatric Respiratory Medicine at McGill University. He is the creator and director of the first and only clinic for Primary Ciliary Dyskinesia in Quebec. He is also the Medical Director of the PCD Foundation’s Clinical and Research Center Network. Dr. Shapiro is the Committee co-chair of the American Thoracic Society sponsored clinical practice guidelines for diagnosing Primary Ciliary Dyskinesia. His ongoing research in non-CF bronchiectasis and Primary Ciliary Dyskinesia through the Genetic Disorders of Mucociliary Clearance Consortium, is a multi-center, NIH sponsored consortium in the US and Canada.

Jillian Horton, MD
University of Manitoba; Winnipeg, MB

Session Description

Burnout is an existential threat affecting all of healthcare…but what can we actually do about it? In this talk, Dr. Horton will introduce a key framework that allows us to begin developing a deep conceptual understanding of our burnout crisis so we can begin to conceive of the most important thing of all: formulating a strategy for finding our way out.

Learning Objectives:

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

• Understand the components of the Stanford Professional Fulfillment model and their relationship to healthcare professional wellness
• Recognize common flaws and barriers to engagement with healthcare professional health-and-wellness initiatives
• Reflect on local data and identify 2-3 potential strategies to increase fulfillment in our clinical environments

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

Dr. Jillian Horton

Dr. Jillian Horton is an Associate Professor of Internal Medicine at the Health Sciences Centre and the University of Manitoba. Dr. Horton has completed a longitudinal internship in teaching Mindful Practice (at the University of Rochester) and Chief Wellness Officer training at Stanford University. Her writing about medicine and medical culture appears regularly in the LA Times, the Globe and Mail, The Toronto Star, Maclean’s, and a variety of American news outlets by syndication. In April 2020 she was awarded the Gold Humanism award by the Association of Faculties of Medicine of Canada for her national contributions to compassion in clinical care and her leadership in the field of humanities in medical education. Her award-winning first book, We Are All Perfectly Fine: A Memoir of Love, Medicine and Healing was released by HarperCollins Canada in February 2021 to critical acclaim, and is a national bestseller.

Speaker
Deborah Assayag, MD, FRCPC
McGill University, Montreal, QC

Moderator
Colin Adams, MD, FRCPC
KW Cardiopulmonary Services, Waterloo, ON

Session Description

Discussing Importance of early diagnostic, setting patient expectation for therapy and practical tips for managing side effects in a community setting.

Learning Objectives

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

• Recognize the importance of early diagnosis of ILD /IPF
• Understand the benefits and limitations of ILD/IPF medications
• Develop a practical approach to management of ILD/IPF medications and their side effects

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

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

Dr. Deborah Assayag

Dr. Deborah Assayag completed a residency in pulmonary medicine at McGill University and went on to do a master’s in clinical research, and a Fellowship in Interstitial Lung disease at the University of California San Francisco. She is an Assistant Professor at McGill University in the Department of Medicine, and a Scientist at the Research Institute of the McGill University Health Center. She specializes in the care of patients with interstitial lung diseases. Her research focuses on addressing disparities in ILD, and on optimizing care for all patients with ILD.

Speaker
Kenneth R. Chapman, MD, MSc, FRCPC, FACP, FCCP, FERS 
University of Toronto; Toronto, ON

Moderator
Erika Penz, MD, MSc, FRCPC
University of Saskatchewan, Saskatoon, SK

Session Description

In this presentation, we will examine the potential and actual impact of biological therapy in severe COPD patients. Insights are provided by studies with a range of biologics including anti-IL-5, IL-5r, IL-4r, TSLP and emerging non-Type 2 molecules.

Learning Objectives

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

• Review the most current understanding of the heterogeneity of COPD, the spectrum of inflammatory pathways involved and the role of type 2 inflammation in COPD pathophysiology.
• Review relevant data and provide rationale on existing treatment options for severe COPD patients from recent guidelines and pivotal studies with a focus on emerging biologic and targeted therapies.
• Present the evolution of the clinical landscape, biologic therapies and propose what the futurestandard of care could be for patients based on the latest evidence.

CanMEDS Roles: Medical Expert, Communicator, Scholar

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

Dr. Kenneth Chapman

Dr. Ken Chapman is Director of the Asthma and Airway Centre of the University Health Network, past President of the Canadian Network for Respiratory Care and Director of the Canadian Registry for Alpha-1 Antitrypsin Deficiency. A Professor of Medicine at the University of Toronto, Dr. Chapman is an internationally respected researcher and lecturer in the fields of asthma and COPD. With more than 25,000 citations to his published work, he is in the top 1% of cited medical researchers.

 

 

Speaker:
Jean Bourbeau, MD, MSc, FRCPC, FCAHS
McGill University; Montreal, QC

Moderator :
Brandie Walker, MD, PhD, FRCPC
University of Calgary, Calgary, AB

Session Description

Raising the urgency for a proactive treatment approach in COPD by identifying at-risk symptomatic patients and addressing cardiopulmonary risk in COPD management.

Learning Objectives

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

• Describe the impact of COPD and exacerbations on cardiopulmonary outcomes
• Highlight strategies for the identification of COPD patients at risk of disease progression and cardiopulmonary events
• Discuss opportunities for early intervention, and the impact this has on long term cardiopulmonary outcomes

CanMEDS Roles: Medical Expert, Communicator, Health advocate, Scholar and Professional

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

Dr. Jean Bourbeau

Dr. Jean Bourbeau is a clinician scientist, professor, and researcher at McGill University and a Senior Scientist at the Research Institute McGill University Health Centre. He is a Fellow of the Canadian Academy of Health Sciences (FCAHS) and has received numerous prestigious awards, including the “Distinguished Scientist Award” from McGill University (2020-2025) and the “Distinguished CHEST Educator” from the American College of Chest Physicians (2017-2022).

Internationally recognized for his expertise in Chronic Obstructive Pulmonary Disease (COPD), he actively participates in various scientific committees and has served as the President and remains on the board of the Canadian Thoracic Society (CTS). His research includes notable contributions like the “Living Well with COPD” self-management program and the Canadian Cohort Obstructive Lung Disease (CanCOLD) prospective study, over 15M$ grant support since 2009, CIHR grants, >100 sub-studies and >80 publications. Over the last decades, he has secured substantial research funding, published over 400 papers, reviews, and chapters, and his work has significantly influenced clinical practice worldwide.

He is the principal investigator for various investigator initiated clinical trials, addressing both non-pharmacological interventions and drug or device interventions for COPD patients. His dedication extends to advancing clinical trial training platforms as he leads the CIHR Clinical Training Trial Platform, CANTRAIN, with 11.3 million dollars in funding (2022-2025).

Dr. Bourbeau has made significant contributions to national and international guidelines, including the GOLD Reports, CTS COPD pharmacotherapy Guidelines, American College of Chest Physicians/CTS Guidelines on prevention of COPD exacerbations, and American Thoracic/European Respiratory Society Guidelines on Pulmonary Rehabilitation.

Speakers
Sacha Bhinder, MD, FRCPC
Scarborough Health Network, Toronto, Ontario

Kenneth R. Chapman, MD, MSc, FRCPC, FACP, FCCP, FERS 
University of Toronto; Toronto, ON

Moderator
Mohit Bhutani, MD, FRCPC, FCCP
University of Alberta, Edmonton, AB

Session Description

This debate will provide the attendees with an up-to-date review of the clinical trial data with “closed” triple inhaled therapy in asthma and their relevance to daily practice. Upon completion of this activity, participants will better understand the respective roles of triple therapy and biologic therapy in their most difficult patients with asthma.

Learning Objectives

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

• Review the most recent data on single inhaler triple therapy in asthma
• Consider whether LAMA should be added to inhaled regimens at GINA Step 4 or Step 5
• Describe strategies to improve diagnosis and optimize management of severe asthma

CanMEDS Roles: Medical Expert, Communicator, Scholar

This session is co-developed by the CTS and Valeo and is planned to achieve scientific integrity, objectivity and balance.

Dr. Sacha Bhinder

Dr. Sacha Bhinder is an adult respirologist in the Scarborough area, practicing at the Scarborough Health Network Centenary site, the Toronto Lung Care Clinic, and the Heart Health Institute. After having completed his MD degree, he went on to pursue training in Internal Medicine and a fellowship in Adult Respirology, all at the University of Toronto. He is a lecturer in the Division of Respirology at the University of Toronto.

For the Scarborough Health Network (SHN), he has served in a number of leadership roles on the Corporate HSMR, Palliative, and Quality of Care Committees, as well as the Co-Chair of the Corporate Medical Education Committee and SHN Education representative for the Toronto Academic Health Sciences Network. Recently he completed a term in the role of Corporate Chief and Medical Director for the Department of Medicine.

Dr. Kenneth Chapman

Dr. Ken Chapman is Director of the Asthma and Airway Centre of the University Health Network, past President of the Canadian Network for Respiratory Care and Director of the Canadian Registry for Alpha-1 Antitrypsin Deficiency. A Professor of Medicine at the University of Toronto, Dr. Chapman is an internationally respected researcher and lecturer in the fields of asthma and COPD. With more than 25,000 citations to his published work, he is in the top 1% of cited medical researchers.

 

 

Speakers
Joshua Wald, MD, FRCPC
McMaster University, Hamilton, ON

George Zhanel, PharmD, PhD, FCAHS
University of Manitoba, Winnipeg, MB

Moderator
Vivien Brown, CCFP, FCFP, MSCP
University of Toronto, Toronto, ON

Session Description

Respiratory Syncytial Virus (RSV) is well recognized as a predictable seasonal infection in infants; however, older adults including those with underlying comorbidities are at greater risk of severeoutcomes from RSV. This educational session will delve into the latest research and clinical practices surrounding RSV in older adults. Given the increasing recognition of RSV as a significant cause of morbidity and mortality in this population, we will explore the epidemiology, burden of disease, clinical manifestations, diagnostic challenges, and new preventative strategies specifically in the Canadian context. The session will highlight the emerging evidence and implementation into practice of new RSV vaccines. The aim is to equip respirologists and respiratory health professionals with the knowledge and tools to understand the burden of disease, differentiate, and prevent RSV disease in older adults, contributing to improved patient outcomes and public health.

Learning Objectives

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

• Understand the epidemiology, burden of disease and clinical manifestations of RSV in Older Adults: Gain a comprehensive understanding of the prevalence, risk factors including underlying comorbidities of RSV in older adults with a specific focus on the Canadian population and individuals living with chronic lung disease
• Discuss the clinical presentation, testing and current management strategies: Develop an understanding of the clinical presentation and diagnostic challenges presented by RSV in older adults, and current management strategies
• Describe current evidence for emerging RSV vaccines: Review RSV vaccines (authorized and pending approval) for older adults and discuss implementation of RSV vaccination into clinical practice and public health in Canada.

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

This session is co-developed by the CTS and GSK, Moderna and Pfizer and is planned to achieve scientific integrity, objectivity and balance.

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.

Dr. George Zhanel

Dr. George Zhanel is a microbiologist and pharmacologist who received his Ph.D. in the Department of Medical Microbiology/Infectious Diseases at the Faculty of Medicine, University of Manitoba and a Doctor of Clinical Pharmacology at the University of Minnesota. He is presently Professor and Associate Head in the Department of Medical Microbiology/Infectious Diseases, Max Rady College of Medicine and Research Director of the Canadian Antimicrobial Resistance Alliance (CARA).

Dr. Zhanel has received/nominated for > 100 teaching awards including the Canadian Association for Medical Education (CAME) merit teaching award. He was elected as a fellow of the Canadian Academy of Health Sciences (CAHS) in recognition of sustained excellence in research and teaching within the health sciences. In 2023, Web of Science identified him as one of the world’s most influential researchers.

Panelists:
Krystelle Godbout, MD, FRCPC
Quebec Heart and Lung Institute, Quebec City, QC

Richard Leigh, MBChB, MSc, PhD, FCP (SA), FRCPC, FCAHS
University of Calgary, Calgary, AB

Imran Satia, MD, MRCP (UK), PhD
McMaster University; Hamilton, ON

Moderator
Richard Leigh, MBChB, MSc, PhD, FCP (SA), FRCPC, FCAHS
University of Calgary, Calgary, AB

Session Description

Disease modification has emerged as a novel treatment goal in asthma management, and direct targeting of the type 2 cytokines (IL-4, IL-5, IL-13) and proteins (IgE, TSLP) has revealed them to be key factors in the underlying inflammatory processes driving disease. Traditionally, eosinophils have been the key cells implicated in mediating this inflammation, however, the latest research has advanced our understanding beyond the eosinophil to demonstrate how these targets impact airway fibrosis and remodeling. These dynamics are essential to better predict and prevent airway changes in clinical practice and thereby advance our understanding of the next frontier in asthma care.

Learning Objectives

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

• Provide an overview of the key cytokines (IL-4, IL-5, and IL-13) in type 2 inflammation and their central role in the pathobiology of asthma
• Determine how the latest evidence beyond the eosinophil broadens our understanding of type 2 inflammation
• Explore how the mechanisms of inflammation, airway remodeling in asthma, and the role of targeted inhibition are applicable in clinical practice

CanMEDS Roles: Collaborator, Communicator, Health advocate, Leader, Medical Expert, Scholar

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

Dr. Krystelle Godbout

Dr. Krystelle Godbout is the head of the severe asthma clinic at the Heart and Lung Institute in Quebec City, Canada. She specialized in severe asthma in Newcastle (Australia) and has a one-year fellowship in occupational lung diseases. Despite her young age, Dr Godbout has already cumulated a fair amount of experience with the management of severe asthmatics. She is involved in numerous educational activities and committees to improve the care of asthmatics in Canada and perform research with the Asthma Innovative Research team.

Dr. Richard Leigh

Dr. Richard Leigh is a physician-scientist and the Senior Associate Dean – Faculty Affairs in the Cumming School of Medicine at the University of Calgary. Dr. Leigh’s areas of interest include understanding the basic mechanisms underlying airway remodeling in asthma, the assessment of airway inflammation and early phase clinical trials in asthma and COPD. His clinical practice focuses on severe asthma and other airways diseases, and he previously served as the Chair of the Department of Medicine before taking up his current appointment in January 2020. Dr. Leigh was elected as a Fellow of the Canadian Academy of Health Sciences in 2021.

Dr. Imran Satia

Dr. Imran Satia was born in England and graduated in Medicine from the University of Cambridge in 2006 with a Masters in Neurophysiology. 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 the North-West of England. In 2017 he was awarded a PhD in the mechanisms of cough in asthma from the University of Manchester and was awarded the British Medical Association James Trust Award award. He received the ERS Respire 3 Marie Curie Post-Doctoral Fellowship at McMaster University in 2018. Imran was awarded the E.J. Moran Campbell Early Career Award (2021) and European Respiratory Society Mid-Career Gold Medal in Chronic Cough (2023). Imran co-founded the Canadian Thoracic Society (CTS) working group on chronic cough and currently holds a CIHR Planning and Dissemination grant on “Setting priorities and partnerships for chronic cough in Canada – Can-Cough. 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.

Speaker
Charles Chan, MD, FRCPC, FCCP, FACP
University of Toronto, Toronto, ON

Moderator
Irvin Mayers, MD, FRCPC
University of Alberta, Edmonton, AB

Session Description

CASCADE is the largest Canadian data collection on the management of severe asthma with 78 Specialists enrolled and capturing 503 patients. Key highlights to be presented at the session:

1 – Assess current standard of care in severe asthma management through insights gained from CASCADE Program.

2 – Evaluate the role and further potential of biologic therapy in the management of severe uncontrolled asthma patients.

3 – Uncover opportunities in the current standard of care to improve severe asthma management as identified in CASCADE.

Learning Objectives

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

• Gain insight into the current state of disease management in severe asthma among specialists
• Identify and discuss barriers for doctors and patients to access optimal therapy in severe asthma
• Discuss implications to clinical practice by reviewing data and insights on current severe asthma management among Specialists in Canada

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

This session is co-developed by the CTS and AstraZeneca & Amgen 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, Consultant Respirologist at University Health Network, and he is the Medical Director & Owner of Rosedale Pulmonary Function Laboratory & Agincourt Pulmonary Services.

Over the last 35 years, Dr. Chan’s hospital leadership roles included Interim President & CEO, Executive Vice-President & Chief Medical Officer, VP of Medical Affairs, Program Medical Director, Business Units Medical Director & Head of Respirology. His university leadership roles included Vice-Chair of Medicine, Interim Division Director of Respirology, Respirology Fellowship Program Director & Interim Head of Respirology at Sunnybrook & Women College Hospitals.

Speakers
Melinda Solomon, MD, FRCPC
The Hospital for Sick Children (SickKids), Toronto, ON

Diana Elizabeth Tullis, MD, FRCPC
Unity Health, Toronto, ON

Moderator
Mark Chilvers, MRCPCH, MD, BSc, MBChB
BC Children’s Hospital, Vancouver, BC

Session Description

The 2022 Annual Data Report for the Canadian Cystic Fibrosis Registry has shown a substantial increase in the median age of survival for Canadians living with cystic fibrosis (CF), rising to 60 years in 2022. This can be attributed to quality of CF care, research, and treatments, including expanding access to CFTR modulators. With this increasing lifespan, many questions arise around implications for patients with CF and how clinical care can evolve accordingly. This program would provide an update on CF clinical care in Canada and use interactive patient cases to explore unique considerations for both pediatric and adult audiences, from nutrition recommendations/evolving treatment plans to family planning/future planning/cancer risk/menopause (key topics of interest can be found in the included needs assessment). The proposed speakers will bring both adult and pediatric patient perspectives to the symposium, allowing for a balanced look at unique cross-country challenges for each age group, including optimizing the transition from pediatric to adult care. While focused on CF, the potential role of local respiratory care teams in the evolving care of patients with CF can be featured, making this symposium of interest to a broad respiratory audience.

Learning Objectives

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

• Describe the evolution of the cystic fibrosis (CF) treatment paradigm in Canada and its impact on clinical management and burden of care, including increased survival
• Identify important new aging considerations for both pediatric and adult patients and apply available management strategies
• Incorporate strategies to optimize the transition to adulthood in patients with CF

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

This session is co-developed by the CTS and Vertex and is planned to achieve scientific integrity, objectivity and balance.

Dr. Melinda Solomon

Dr. Melinda Solomon is a Pediatric Respirologist at The Hospital for Sick Children (SickKids) and Professor of Paediatrics at the University of Toronto. She has been the Cystic Fibrosis Clinic Director as well as the Medical Director of the Pediatric Lung Transplant Program at SickKids for over 20 years. She has a strong passion for clinical excellence and education.  Her research endeavors have been aligned with her clinical expertise, including CF clinical trials. Currently she is the President-Elect of the Canadian Thoracic Society.

 

Dr. Elizabeth Tullis

As the founding Director of the Toronto Adult Cystic Fibrosis Clinic at St. Michael’s Hospital, Dr. Tullis is responsible for the care of more than 600 adults with CF. Dr. Tullis is a Professor of Medicine at the University of Toronto and an Adjunct Scientist at the Keenan Research Centre of Li Ka Shing Knowledge Institute. Dr. Tullis has published over 180 articles and book chapters and has lectured nationally and internationally on issues related to CF in adults.  She has trained 29 CF fellows who are now working in CF clinics around the world.

Speaker
Deborah Assayag, MD, FRCPC
McGill University, Montreal, QC

Moderator
Colin Adams, MD, FRCPC
KW Cardiopulmonary Services, Waterloo, ON

Session Description

Discussing Importance of early diagnostic, setting patient expectation for therapy and practical tips for managing side effects in a community setting.

Learning Objectives

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

• Recognize the importance of early diagnosis of ILD /IPF
• Understand the benefits and limitations of ILD/IPF medications
• Develop a practical approach to management of ILD/IPF medications and their side effects

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

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

Dr. Deborah Assayag

Dr. Deborah Assayag completed a residency in pulmonary medicine at McGill University and went on to do a master’s in clinical research, and a Fellowship in Interstitial Lung disease at the University of California San Francisco. She is an Assistant Professor at McGill University in the Department of Medicine, and a Scientist at the Research Institute of the McGill University Health Center. She specializes in the care of patients with interstitial lung diseases. Her research focuses on addressing disparities in ILD, and on optimizing care for all patients with ILD.

Speaker
Kenneth R. Chapman, MD, MSc, FRCPC, FACP, FCCP, FERS 
University of Toronto; Toronto, ON

Moderator
Erika Penz, MD, MSc, FRCPC
University of Saskatchewan, Saskatoon, SK

Session Description

In this presentation, we will examine the potential and actual impact of biological therapy in severe COPD patients. Insights are provided by studies with a range of biologics including anti-IL-5, IL-5r, IL-4r, TSLP and emerging non-Type 2 molecules.

Learning Objectives

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

• Review the most current understanding of the heterogeneity of COPD, the spectrum of inflammatory pathways involved and the role of type 2 inflammation in COPD pathophysiology.
• Review relevant data and provide rationale on existing treatment options for severe COPD patients from recent guidelines and pivotal studies with a focus on emerging biologic and targeted therapies.
• Present the evolution of the clinical landscape, biologic therapies and propose what the futurestandard of care could be for patients based on the latest evidence.

CanMEDS Roles: Medical Expert, Communicator, Scholar

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

Dr. Kenneth Chapman

Dr. Ken Chapman is Director of the Asthma and Airway Centre of the University Health Network, past President of the Canadian Network for Respiratory Care and Director of the Canadian Registry for Alpha-1 Antitrypsin Deficiency. A Professor of Medicine at the University of Toronto, Dr. Chapman is an internationally respected researcher and lecturer in the fields of asthma and COPD. With more than 25,000 citations to his published work, he is in the top 1% of cited medical researchers.