Progress and challenges in fungal lung disease in cystic fibrosis
Purpose of review This review is an overview of the recent progress made for the diagnosis and understanding of fungal lung disease in people with cystic fibrosis (CF), with a focus on Aspergillus fumigatus, the most common filamentous fungus in the CF airway. Currently, the longstanding question of the clinical significance of Aspergillus fumigatus and other fungi in CF respiratory cultures, in the absence of allergy, remains. Clinical criteria and biomarkers are needed to classify fungal lung disease and determine who may warrant therapy. Recent findings Several retrospective and prospective studies have descr...
Source: Current Opinion in Pulmonary Medicine - October 6, 2022 Category: Respiratory Medicine Tags: CYSTIC FIBROSIS: Edited by Peter Barry and Barry Plant Source Type: research

Nutritional and metabolic management for cystic fibrosis in a post-cystic fibrosis transmembrane conductance modulator era
Purpose of review The introduction of highly effective cystic fibrosis transmembrane conductance regulator modulators has resulted in a paradigm shift towards treating underlying cause of cystic fibrosis (CF) rather than the ensuing complications. In this review, we will describe the impact of these small molecules on growth, nutrition, and metabolic status in people with CF (pwCF). Recent finding Results of clinical trials and real world data demonstrate that these small molecules are having a significant impact of on augmenting body weight, improving nutritional status and reducing gastrointestinal symptom bur...
Source: Current Opinion in Pulmonary Medicine - October 6, 2022 Category: Respiratory Medicine Tags: CYSTIC FIBROSIS: Edited by Peter Barry and Barry Plant Source Type: research

Infection control in cystic fibrosis: evolving perspectives and challenges
This article reviews the impact of some of the most recent changes in clinical care management in cystic fibrosis on infection prevention practice and advice for people with cystic fibrosis. Recent findings People with cystic fibrosis (CF) consistently highlight infection control as one of their major concerns. Infection prevention guidance and practice has facilitated successful decreases in rates of many transmissible CF pathogens. The coronavirus disease 2019 pandemic highlighted the clinical significance of respiratory viral infections and has accelerated the implementation of remote monitoring and telemedicine ...
Source: Current Opinion in Pulmonary Medicine - October 6, 2022 Category: Respiratory Medicine Tags: CYSTIC FIBROSIS: Edited by Peter Barry and Barry Plant Source Type: research

Micro-RNA in obstructive sleep apnoea: biomarker of cardiovascular outcome?
The objective is to provide an updated perspective on the role of microRNAs (miRNAs) in OSA as a biomarker of cardiovascular risk. Recent findings Specific miRNAs have already been associated with patients with OSA and specific cardiovascular diseases such as hypertension, myocardial infarction or endothelial dysfunction. Numerous studies have addressed the use of miRNAs to identify the cardiovascular risk associated with OSA, both in patients and in animals with in vivo hypoxia models. Thus, these studies identified profiles of differentially expressed miRNAs in patients with OSA. In addition, the in vitro studies ...
Source: Current Opinion in Pulmonary Medicine - October 6, 2022 Category: Respiratory Medicine Tags: SLEEP AND RESPIRATORY NEUROBIOLOGY: Edited by Lee Brown and Winfried Johannes Randerath Source Type: research

More than sleepiness: prevalence and relevance of nonclassical symptoms of obstructive sleep apnea
Purpose of review The purpose of this review is to describe the nonclassical symptoms and manifestations occurring in patients with obstructive sleep apnea (OSA), both from a standpoint of prevalence and in terms of clinical relevance. Particular emphasis will be given to nightmares, comorbid insomnia, restless legs syndrome and periodic limb movement disorder, bruxism, morning headache, nocturia, acid reflux, chronic cough and dysphagia. Recent findings A review of the recent literature suggests that nonclassical symptoms have a high prevalence, are underestimated, and can interact with quality of life. Althoug...
Source: Current Opinion in Pulmonary Medicine - October 6, 2022 Category: Respiratory Medicine Tags: SLEEP AND RESPIRATORY NEUROBIOLOGY: Edited by Lee Brown and Winfried Johannes Randerath Source Type: research

Chronic obstructive pulmonary disease and obstructive sleep apnoea overlap: co-existence, co-morbidity, or causality?
Purpose of review The chronic obstructive pulmonary disease and obstructive sleep apnoea overlap syndrome is associated with higher morbidity and mortality rates than either disease alone. There is evidence of a bidirectional relationship between the two conditions, with the overlap syndrome encompassing a spectrum of clinical phenotypes. Recent findings This review examines the evidence for the various factors that determine the overlap syndrome, the impact overlap syndrome has on co-morbidities, and implications for diagnosis and treatment. Summary The accurate diagnosis of the overlap syndrome is criti...
Source: Current Opinion in Pulmonary Medicine - October 6, 2022 Category: Respiratory Medicine Tags: SLEEP AND RESPIRATORY NEUROBIOLOGY: Edited by Lee Brown and Winfried Johannes Randerath Source Type: research

Adenotonsillectomy: the good, the bad and the unknown
Purpose of review Adenotonsillar hypertrophy is the most common pathogenetic contributor to obstructive sleep apnea syndrome (OSAS) in childhood, and adenotonsillectomy is the standard initial treatment. Here, we summarize the most recent evidence on the efficacy and complications of adenotonsillectomy and explore knowledge gaps in clinical management. Recent findings Favorable adenotonsillectomy effects have been reported in children with very severe OSAS [apnea–hypopnea index (AHI)>20 episodes/h] and extremely severe OSAS (AHI>100 episodes/h), without postoperative mortality, need for endotracheal intuba...
Source: Current Opinion in Pulmonary Medicine - October 6, 2022 Category: Respiratory Medicine Tags: SLEEP AND RESPIRATORY NEUROBIOLOGY: Edited by Lee Brown and Winfried Johannes Randerath Source Type: research

Transcutaneous electrical stimulation in obstructive sleep apnoea: current developments and concepts of the TESLA-home programme
Purpose of review Obstructive sleep apnoea (OSA) is a highly prevalent condition affecting about 1 billion people worldwide. The first line therapy for most patients with OSA is continuous positive airway pressure (CPAP) therapy. However, there are significant limitations with long-term adherence to CPAP therapy, which may be as low as 30–60%. Recent finding Electrical stimulation of the hypoglossal nerve has been studied in recent years. It achieves upper airway patency by causing a contraction of the genioglossus muscle, the strongest dilator of the upper airway, and by maintaining its neuromuscular tone in ...
Source: Current Opinion in Pulmonary Medicine - October 6, 2022 Category: Respiratory Medicine Tags: SLEEP AND RESPIRATORY NEUROBIOLOGY: Edited by Lee Brown and Winfried Johannes Randerath Source Type: research

New pharmacologic agents for obstructive sleep apnoea: what do we know and what can we expect?
Purpose of review This review provides a condensed description of pharmacological remedies explored in patients with obstructive sleep apnoea (OSA) as well as projections of what we might expect in terms of clinical performance of these drugs. Recent findings Conventional drug therapies explored in OSA have generally produced disappointing results and there is a shortage of pharmacological treatment alternatives in this disorder. Recent insights into pathophysiological mechanisms potentially involved in OSA suggest that the condition may be divided into distinct subgroups based on clusters or defined by means of...
Source: Current Opinion in Pulmonary Medicine - October 6, 2022 Category: Respiratory Medicine Tags: SLEEP AND RESPIRATORY NEUROBIOLOGY: Edited by Lee Brown and Winfried Johannes Randerath Source Type: research

Sleep in the intensive care unit
Purpose of review Sleep is particularly important for critically ill patients. Here, we review the latest evidence on how sleep and circadian disruption in the intensive care unit (ICU) affects physiology and clinical outcomes, as well as the most recent advances in sleep and circadian rhythm promoting interventions including therapeutics. Recent findings On a molecular level, clock genes dysrhythmia and altered immunity are clearly linked, particularly in sepsis. Melatonin may also be associated with insulin sensitivity in ICU patients. Clinically, changes in sleep architecture are associated with delirium, and...
Source: Current Opinion in Pulmonary Medicine - October 6, 2022 Category: Respiratory Medicine Tags: SLEEP AND RESPIRATORY NEUROBIOLOGY: Edited by Lee Brown and Winfried Johannes Randerath Source Type: research

Updates in the use of cannabis for insomnia
Purpose of review This review aims to summarize recent updates in the area of cannabis use for insomnia. Recent findings Cannabis products have continued to become more potent, particularly in regard to delta-9- tetrahydrocannabinol (THC) concentration. Additionally, the use of cannabis has continued to become more accepted with less legal restrictions. The reported use of cannabis for relief of symptoms in sleep disorders appears to be increasing, however the specific effects of cannabinoids on sleep varies with cannabinoid type and concentration. Some evidence supports claims of efficacy of cannabinoids in sle...
Source: Current Opinion in Pulmonary Medicine - October 6, 2022 Category: Respiratory Medicine Tags: SLEEP AND RESPIRATORY NEUROBIOLOGY: Edited by Lee Brown and Winfried Johannes Randerath Source Type: research

Glymphatic MRI techniques in sleep and neurodegenerative diseases
Purpose of review The purpose of this review article is to summarize the current in-vivo imaging techniques for the evaluation of the glymphatic function and discuss the factors influencing the glymphatic function and research directions in the future. Recent findings The glymphatic system allows the clearance of metabolic waste from the central nervous system (CNS). The glymphatic pathway has been investigated using intrathecal or intravenous injection of a gadolinium-based contrast agent (GBCA) on MRI, so-called glymphatic MRI. The glymphatic MRI indirectly visualizes the dynamic CSF flow and evaluated the gly...
Source: Current Opinion in Pulmonary Medicine - October 6, 2022 Category: Respiratory Medicine Tags: SLEEP AND RESPIRATORY NEUROBIOLOGY: Edited by Lee Brown and Winfried Johannes Randerath Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Pulmonary Medicine)
Source: Current Opinion in Pulmonary Medicine - October 6, 2022 Category: Respiratory Medicine Tags: EDITORIAL INTRODUCTIONS Source Type: research

Quantitative computed tomography and machine learning: recent data in fibrotic interstitial lung disease and potential role in pulmonary sarcoidosis
Purpose of review The aim of this study was to summarize quantitative computed tomography (CT) and machine learning data in fibrotic lung disease and to explore the potential application of these technologies in pulmonary sarcoidosis. Recent findings Recent data in the use of quantitative CT in fibrotic interstitial lung disease (ILD) are covered. Machine learning includes deep learning, a branch of machine learning particularly suited to medical imaging analysis. Deep learning imaging biomarker research in ILD is currently undergoing accelerated development, driven by technological advances in image processing ...
Source: Current Opinion in Pulmonary Medicine - August 9, 2022 Category: Respiratory Medicine Tags: SARCOIDOSIS: Edited by Ogugua Ndili Obi and Mareye Voortman Source Type: research

The role of PET in the management of sarcoidosis
Purpose of review PET has emerged as method to determine the location and extent of disease activity in sarcoidosis. As most clinicians do not routinely utilize PET in the management of sarcoidosis, an understanding of the imaging technique is needed to comprehend the impact that PET abnormalities have on diagnosis, prognosis, and treatment. Recent findings Although PET can detect inflammation because of sarcoidosis throughout the body, it is most often utilized for the diagnosis of cardiac sarcoidosis for which it may provide information about prognosis and adverse events. Whenever PET is combined with cardiac ...
Source: Current Opinion in Pulmonary Medicine - August 9, 2022 Category: Respiratory Medicine Tags: SARCOIDOSIS: Edited by Ogugua Ndili Obi and Mareye Voortman Source Type: research