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Triple combination cystic fibrosis transmembrane conductance regulator modulator therapy in the real world – opportunities and challenges
Purpose of review The purpose of this review is to describe on-going and upcoming real-world studies that will aid the cystic fibrosis (CF) community in understanding the long-term efficacy, safety and challenges in utilizing this therapy and managing care. Recent findings The triple combination of elexacaftor, tezacaftor and ivacaftor (ETI) has been demonstrated to improve lung function, weight and quality of life in children and adults with CF with at least one copy of Phe508del. Treatment with ETI will potentially be available for approximately 90% of the CF population and change the face of CF. Summary ...
Source: Current Opinion in Pulmonary Medicine - October 15, 2021 Category: Respiratory Medicine Tags: CYSTIC FIBROSIS: Edited by Peter J. Barry and Barry J. Plant Source Type: research

Telehealth and virtual health monitoring in cystic fibrosis
Purpose of review At many institutions, the Covid-19 pandemic made it necessary to rapidly change the way services are provided to patients, including those with cystic fibrosis (CF). The purpose of this review is to explore the past, present and future of telehealth and virtual monitoring in CF and to highlight certain challenges/considerations in developing such services. Recent findings The Covid-19 pandemic has proven that telehealth and virtual monitoring are a feasible means for safely providing services to CF patients when traditional care is not possible. However, both telehealth and virtual monitoring c...
Source: Current Opinion in Pulmonary Medicine - October 15, 2021 Category: Respiratory Medicine Tags: CYSTIC FIBROSIS: Edited by Peter J. Barry and Barry J. Plant Source Type: research

COVID-19 outcomes in people with cystic fibrosis
Purpose of review The COVID-19 global pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has had a dramatic impact that is still ongoing around the world. Cystic fibrosis (CF) has been identified as a possible risk factor of poor outcome. Recent findings Data collected by multiple National CF registries around the world have indicated that persons with CF (PwCF) are not more likely to be affected by SARS-CoV-2 than the general population. The course of SARS-CoV-2 is usually mild in PwCF who are relatively young. Severe outcomes have been described in patients with low lung functi...
Source: Current Opinion in Pulmonary Medicine - October 15, 2021 Category: Respiratory Medicine Tags: CYSTIC FIBROSIS: Edited by Peter J. Barry and Barry J. Plant Source Type: research

Editorial: A future focus on cystic fibrosis in an era of uncertainty despite opportunity
No abstract available (Source: Current Opinion in Pulmonary Medicine)
Source: Current Opinion in Pulmonary Medicine - October 15, 2021 Category: Respiratory Medicine Tags: CYSTIC FIBROSIS: Edited by Peter J. Barry and Barry J. Plant Source Type: research

Sleep medicine and coronavirus disease 2019
Purpose of review To evaluate the impact of the COVID-19 pandemic on the care of people with sleep disorders, to explore relationships between OSA and COVID-19, and to describe current knowledge of the effect of the pandemic on sleep globally. Recent findings COVID-19 has led to significant changes in the practice of sleep medicine, including the care of patients with OSA. An OSA diagnosis may portend a worse prognosis with COVID-19, whilst prior COVID-19 may have an impact on sleep breathing. Summary The pandemic has caused marked difficulties with access to diagnostic sleep studies and reduced capacity ...
Source: Current Opinion in Pulmonary Medicine - October 15, 2021 Category: Respiratory Medicine Tags: SLEEP AND RESPIRATORY NEUROBIOLOGY: Edited by Lee Brown and Winfried Johannes Randerath Source Type: research

Telehealth and its implementation in respiratory sleep medicine
Purpose of review The COVID-19 pandemic has clearly demonstrated that the technological progress in digitization is also essential for the medical sector. In the field of sleep-disordered breathing, the novel eHealth methods already do offer smart solutions for currently insufficiently addressed problems. Recent findings In general, the potential of telemedicine tools can be focused on three basic aspects: interaction between clinicians, interaction between clinician and patient, and interaction between patient and the mobile health technology. The pandemic situation resulted in a rapid development of reimbursem...
Source: Current Opinion in Pulmonary Medicine - October 15, 2021 Category: Respiratory Medicine Tags: SLEEP AND RESPIRATORY NEUROBIOLOGY: Edited by Lee Brown and Winfried Johannes Randerath Source Type: research

Rapid eye movement predominant obstructive sleep apnoea: prognostic relevance and clinical approach
Purpose of review Rapid eye movement (REM) obstructive sleep apnoea (OSA) is a stage-specific OSA, in which obstructive events occur primarily during REM sleep. This review discusses REM-OSA definitions, its cardiometabolic correlates, associated comorbidities and treatment, and addresses diagnostic ambiguities and therapeutic pitfalls. Recent findings Current evidence indicates that REM-OSA is prevalent among younger age groups and women and is independently associated with cardiometabolic complications, particularly hypertension, metabolic complications such as insulin resistance and metabolic syndrome. Howeve...
Source: Current Opinion in Pulmonary Medicine - October 15, 2021 Category: Respiratory Medicine Tags: SLEEP AND RESPIRATORY NEUROBIOLOGY: Edited by Lee Brown and Winfried Johannes Randerath Source Type: research

Upper airway muscles: influence on obstructive sleep apnoea pathophysiology and pharmacological and technical treatment options
Purpose of review Obstructive sleep apnoea (OSA) is highly prevalent with numerous deleterious effects on neurocognitive and cardiovascular health. It is characterized by collapse of the upper airway during sleep, due to the decrease in both basal and compensatory UA muscle activities. However, the leading treatment, continuous positive airway pressure, is often poorly tolerated. This review presents latest works focusing on novel interventions targeting upper airway muscles to alleviate OSA severity. Recent findings In the last years, researchers have focused on the development of alternative treatment strategi...
Source: Current Opinion in Pulmonary Medicine - October 15, 2021 Category: Respiratory Medicine Tags: SLEEP AND RESPIRATORY NEUROBIOLOGY: Edited by Lee Brown and Winfried Johannes Randerath Source Type: research

Cyclic alternating patterns and arousals: what is relevant in obstructive sleep apnea? In Memoriam Mario Giovanni Terzano
Purpose of review To review main knowledges and gaps in the field of sleep microstructure, represented by the cyclic alternating pattern (CAP), in obstructive sleep apnea (OSA). Recent findings The (electroencephalographic and autonomic) ‘intensity’ of arousals in OSA patients, measured through the metrics of CAP, correlate with OSA severity and with disease burden. Continuous positive airway pressure determines variations in sleep architecture (conventional parameters) and at the microstructural level, at different time points. Summary CAP is not only an ‘attractor’ of arousals, but also organize...
Source: Current Opinion in Pulmonary Medicine - October 15, 2021 Category: Respiratory Medicine Tags: SLEEP AND RESPIRATORY NEUROBIOLOGY: Edited by Lee Brown and Winfried Johannes Randerath Source Type: research

Arousal-based scoring of obstructive hypopneas
Purpose of review Obstructive sleep apnea in adults is diagnosed by an apnea–hypopnea index (AHI) above five (at least five apneas and/or hypopneas per hour of sleep). Though the definition of apneas has remained stable, the scoring criteria for hypopneas has varied throughout the years. There is even more evidence now that scoring respiratory events associated with arousals should be included in the diagnosis of obstructive sleep apnea, as these patients may benefit from treatment. Recent findings Recent studies, trials and meta-analyses have demonstrated that respiratory events associated with arousal are as...
Source: Current Opinion in Pulmonary Medicine - October 15, 2021 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 15, 2021 Category: Respiratory Medicine Tags: EDITORIAL INTRODUCTIONS Source Type: research

Update on sarcoidosis guidelines
Purpose of review The current review summarizes recent guidance in the diagnosis and management of sarcoidosis. Until recently, the main guidelines were the 1999 International Statement on Sarcoidosis. However, in 2020 two new guidelines were published by the American and British Thoracic Societies. They have a number of key updates and this review aims to summarize these. Recent findings The key findings from 2020 revolve around several themes. First, the need for a histological diagnosis should be supported by a multidisciplinary team approach. When a histological biopsy is needed of the lungs, thought is give...
Source: Current Opinion in Pulmonary Medicine - August 11, 2021 Category: Respiratory Medicine Tags: SARCOIDOSIS: Edited by Marlies S. Wijsenbeek and Nadera J. Sweiss Source Type: research

Detection of early phenotype cardiac sarcoidosis by cardiovascular magnetic resonance
Purpose of review Cardiac sarcoidosis has high prevalence in sarcoidosis patients and contributes to significant morbidity and mortality. Early detection of cardiac sarcoidosis is essential to improving patients’ symptoms and cardiovascular outcomes. Recent findings Cardiovascular magnetic resonance imaging (CMR) is an excellent diagnostic modality for cardiac sarcoidosis. However, early phenotypes of cardiac sarcoidosis have more mild imaging phenotypes. These mild and sometimes subtle imaging phenotypes of cardiac sarcoidosis have lower diagnostic sensitivity and specificity for cardiac sarcoidosis by CMR wh...
Source: Current Opinion in Pulmonary Medicine - August 11, 2021 Category: Respiratory Medicine Tags: SARCOIDOSIS: Edited by Marlies S. Wijsenbeek and Nadera J. Sweiss Source Type: research

Pediatric sarcoidosis with diagnostic and therapeutical insights
Purpose of review Sarcoidosis is a chronic granulomatous disorder involving multiple systems and organs of undefined etiology. Although most of the morbidity relies upon lung disease, the function of several systems and organs can be affected. The natural history of lung disease consists of pulmonary involvement. An exaggerated and abnormal inflammatory response accompanies this aspect. There are noncaseating confluent epithelioid granulomas and, potentially, a progressive airway obstruction ab externo. As the disease is multisystemic, there is an increased likelihood of complications that may be serious and even fatal...
Source: Current Opinion in Pulmonary Medicine - August 11, 2021 Category: Respiratory Medicine Tags: SARCOIDOSIS: Edited by Marlies S. Wijsenbeek and Nadera J. Sweiss Source Type: research

COVID-19 infection in patients with sarcoidosis: susceptibility and clinical outcomes
Purpose of review Patients with sarcoidosis may be at higher risk of coronavirus disease-19 (COVID-19) as over 90% of the patients have pulmonary involvement and many are treated with immunosuppressive agents. This review will summarize the current literature regarding sarcoidosis and COVID-19, with a particular focus on susceptibility, clinical outcomes, management, and approach to vaccination. Recent findings Data about COVID-19 and sarcoidosis include a number of case series and reports, cohort studies, and registries. Literature is not conclusive whether patients with sarcoidosis have increased susceptibilit...
Source: Current Opinion in Pulmonary Medicine - August 11, 2021 Category: Respiratory Medicine Tags: SARCOIDOSIS: Edited by Marlies S. Wijsenbeek and Nadera J. Sweiss Source Type: research