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Amado X. Freire, MD
Associate Professor of Medicine & Preventive Medicine
Director, Pulmonary, Critical Care, and Sleep Medicine |
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Welcome to The University of Tennessee Health Science Center Division of Pulmonary, Critical Care, and Sleep Medicine’s website. The Division is committed to its tripartite mission of providing excellent patient care, being on the cutting edge of research, and promoting superior education and training.
Excellence in Patient Care
The Division of Pulmonary, Critical Care, and Sleep Medicine has an excellent reputation in the medical school and excels in patient care, teaching and research.
With a team of nine nationally renowned faculty, we are able to provide expertise in the diagnosis and management of patients with acute and chronic diseases of the chest, and sleep disordered breathing. Majority of our faculty members are board certified in internal medicine, pulmonary medicine, critical care medicine, and sleep medicine. Specialty areas include:
- Asthma
- COPD (including Alpha-1 antitrypsin deficiency)
- Cystic Fibrosis
- Interstitial Lung Disease (especially IPF and Scleroderma)
- Interventional pulmonary medicine
- Lung Cancer
- Occupational Lung Disease
- Palliative Care
- Pleural Disease
- Pulmonary Hypertension
- Pulmonary Thromboembolism
- Sarcoidosis
- Sleep Medicine
- Tuberculosis
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The Division is responsible for the care of patients with acute respiratory failure and other critical illnesses in the Medical Intensive Care Unit at the Regional Medical Center “The MED” Hospital http://www.the-med.org/, the Memphis VAMC http://www.memphis.va.gov/, and Methodist University http://www.methodisthealth.org/portal/site/methodist/. In addition to providing care for patients with advanced lung disease, the Division evaluates patients with end-stage lung disease for lung transplantation, including COPD, interstitial lung disease, and cystic fibrosis. The Division also cares for chronic “difficult to wean” ventilator patients at Medical University Hospital.
Procedures and special techniques performed by the Division include:
- Cardiopulmonary exercise testing
- Chest tube placement and management
- Diagnostic thoracoscopy and talc poudrage
- Endobrochial laser therapy and stent placement
- Endobronchial ultrasound (EBUS) for staging of lung cancer and diagnosis of sarcoidosis
- Evaluation of sleep disordered breathing
- Fiberoptic bronchoscopy with transbronchial biopsy, transbronchial needle aspiration, and bronchoalveolar lavage
- Insertion of indwelling catheters for management of malignant effusions
- Pleurodesis for malignant and non-malignant effusions
- Pulmonary function testing and arterial blood gas analysis
- Right heart catheterization
- Rigid bronchoscopy
- Laser
- Stent
- Ultrasound guided thoracentesis and pleural biopsy
- Ventilator management
Experience is also provided in specialty clinics that diagnose and manage asthma, sarcoidosis, pleural disease, lung cancer, pulmonary hypertension, interstitial lung diseases including idiopathic pulmonary fibrosis, cystic fibrosis, sleep disordered breathing, and occupational lung disease.
The Division has a state-of-the-art Sleep Medicine focusing on the comprehensive evaluation and management of a myriad of sleep disorders including obstructive sleep apnea, snoring, upper airway resistance syndrome, narcolepsy, insomnia, restless leg syndrome, and sleep related problems (add simulations if available). A multidisciplinary and comprehensive approach is taken in the evaluation of patients with specialists from our Division plus Neurology. The 4-bed facility is designed to meet the rigorous standards of the American Academy of Sleep Medicine.
Cutting Edge Research
Dr. Scott E. Sinclair has a NIH-funded research laboratory at UTHSC and is investigating the mechanisms responsible for ventilator-induced lung injury (VILI). He has found that large tidal volume ventilation combined with moderate hyperoxia (FIO2 50%, generally considered a ‘safe’ FIO2) produces accelerated lung injury and early alveolar-capillary barrier dysfunction compared to the same ventilation strategy with room air. He uses both in vivo and in vitro systems to study the mechanisms responsible for this differential lung injury, particularly focusing on damage to the alveolar type II epithelial cell. Superior Education and Training
The Division of Pulmonary, Critical Care, and Sleep Medicine is committed to the lifelong education and training of physicians, patients, and the community through fellowships, publications, symposiums, committees, health fairs and community outreach.
The division offers a three year combined fellowship in pulmonary and critical care medicine. Fellowship training focuses on developing clinical expertise as well as research skills in pulmonary disease, intensive care medicine, and sleep medicine. The fellowship program includes three tracks – clinical, clinical research, and basic research – to allow fellows to meet their professional goals. At the end of three years of training, the fellow is eligible for the American Board of Internal Medicine certification in pulmonary disease and and critical care medicine.
UTHSC Memphis team wins the National “CHEST Challenge VI” at the 2007 American College of Chest Physicians National Meeting in Chicago
Our Chief fellows, Dr. Annie Nawab, Dr. Kanchan Koirala, and Dr. Mehrdad Ghaffari; participated in “Chest Challenge VI” and placed first among to PCCM Fellowship programs from throughout North America. CHEST Challenge is a yearly competition where fellows (Pulmonary and Critical Care Medicine trainees) participate in a “Jeopardy” style contest that tests the players knowledge on the diagnosis and treatment of complex diseases of the chest and intensive care medicine. Fellows-in training from the 300-pulmonary/critical care medicine programs in the United States and Canada compete by taking an initial online multiple-choice qualifying exam.
The top nine best-scoring programs in America compete live at CHEST 2007, which was held in Chicago during the national meeting week/October 20-25. Only 3 teams advanced to the finals, each a winner of their qualifier round. The Chief Fellows from UTHSC defeated
the armed forces team (National Capital Consortium) and Drexel University to be crowned CHEST Challenge Champions for 2007!
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