Current opinion in pulmonary medicine
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Review
Obstructive sleep apnea, gestational hypertension and preeclampsia: a review of the literature.
The evidence of a putative causal effect of sleep apnea-induced intermittent hypoxia on the pathogenesis of gestational hypertension and preeclampsia is mounting. The present review presents the evidence of current literature and questions whether an early diagnosis and treatment of obstructive sleep apnea during pregnancy can reduce the risk of preeclampsia. ⋯ An association between sleep-disordered breathing, gestational hypertension and preeclampsia has been demonstrated. However, there is a lack of evidence on the effect of continuous positive airway pressure treatment during pregnancy on hypertension and preeclampsia. Further studies are required to ascertain whether continuous positive airway pressure can be a useful adjunct treatment for pregnant women at risk of preeclampsia.
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Recent genetic findings have identified new targets of investigation in the field of pulmonary fibrosis and have the potential to change clinical care. ⋯ The inherited risk for pulmonary fibrosis is substantial, and recent data suggest that genetic risk for familial and sporadic forms of the disease are similar. Further characterizing this genetic risk will influence clinical practice in terms of categorization, diagnosis, and screening of individuals for this disease.
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To review current approaches to the complex intersection of interstitial lung disease (ILD) with the spectrum of connective tissue disease (CTD). ⋯ A multidisciplinary approach can be helpful for CTD-ILD. Further research and controlled trials are needed to determine how to best manage the diverse spectrum of CTD-ILD.
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To describe the methods for derivation of clinical phenotypes in general and how they should be applied in sarcoidosis, taking into account the dimensions of the disease. The results from the small number of studies in this area are summarized. ⋯ Clinical phenotypes, by examining relationships between several domains in sarcoidosis, are likely to better delineate the underlying processes and pathways. Larger studies with appropriate methods should be performed to better delineate clinical phenotypes in sarcoidosis.
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An overview over the role of lung transplantation in interstitial lung diseases will be given. ⋯ Lung transplantation offers a survival benefit in carefully selected patients with interstitial lung diseases.