Antipsychotic medications and risk of respiratory failure in the respiratory high dependency unit.

Background: There is a high incidence of serious mental illness (SMI) and antipsychotic use in the respiratory high dependence unit (HDU) compared with the general population. However, there is a paucity of data in the extant literature evaluating the relationships between respiratory failure and antipsychotics.

Aims: To investigate the relationship between antipsychotics and respiratory failure in people admitted to a respiratory HDU, and to gain a better understanding of the potential impact of antipsychotic medications on respiratory outcomes.

The association between respiratory failure and psychotropic medications: A systematic review.

Objective: To examine the association between psychotropic medication usage and respiratory failure.

Methods: A systematic search of Embase, PubMed, CINAHL, PsycINFO, and the Cochrane Trial Registry databases for publications that evaluated the association between respiratory failure and the use of psychotropic medications in patients with chronic mental health disorders was performed.

Results: Nine studies were included, with a total of 170,435 participants.

Prospective crossover trial of positional and CPAP therapy for the treatment of mild-to-moderate positional obstructive sleep apnea.

Study Objectives: To evaluate efficacy of vibrotactile positional therapy (PT) compared to standard CPAP therapy in mild-to-moderate positional obstructive sleep apnea (pOSA).

Methods: Prospective crossover randomized controlled trial of adult patients with treatment-naïve, symptomatic, mild-to-moderate pOSA - defined as ≥5 total apnea-hypopnea index (AHI) <30 with supine-to-non-supine (s:ns)AHI ratio ≥2. Participants were randomized to in-laboratory treatment initiation polysomnography with either PT or CPAP on sequential nights before an eight-week trial of each therapy.

Factors associated with noninvasive ventilation usage in patients with hypoventilation disorders.

Study Objectives: The objective of this study was to investigate the association between demographic, clinical, and interface factors and noninvasive ventilation (NIV) usage.

Methods: A retrospective cohort analysis of 478 patients prescribed NIV from 2013 to 2021 was performed. Demographic factors, clinical indications for NIV, and interface factors were collected, and linear regression was conducted to evaluate the association between these variables and NIV usage (hour/night).

Management of obstructive sleep apnoea in primary care.

Background: Obstructive sleep apnoea (OSA) is common in the community and is increasing in prevalence. Primary care plays a pivotal role in the diagnosis and management of OSA.

Objective: This article focuses on the management options for a patient with an established diagnosis of OSA and provides a guide for driving licensing requirements.

Australasian Sleep Association 2024 guidelines for sleep studies in adults.

Executive summary: This document is a consensus statement of a subcommittee of experienced sleep physicians and scientists, tasked to review the literature and formulate recommendations on the indications, performance, and reporting of sleep studies, to update clinical practice from the 2017 Australasian Sleep Association (ASA) guidelines for sleep studies in adults (Douglas JA, Chai-Coetzer CL, McEvoy D, et al. Guidelines for sleep studies in adults - a position statement of the Australasian Sleep Association. Sleep Med.

Impact of Left Heart Disease Risk Factors on Outcomes in Pulmonary Arterial Hypertension Therapy.

Background: Current guidelines recommend initial monotherapy for pulmonary arterial hypertension (PAH) with cardiopulmonary comorbidities, despite limited available evidence to guide management.

Research Question: Do left heart disease (LHD) risk factors have an impact on treatment response and influence applicability of risk assessment in a real-world cohort of patients with PAH?

Study Design And Methods: The Ambrisentan and Tadalafil in Patients with Pulmonary Arterial Hypertension (AMBITION) trial criteria was used to define the phenotype of patients with PAH with risk factors for LHD. Treatment strategy, functional outcome, long-term survival, and risk discrimination were compared with a reference PAH cohort using the Pulmonary Hypertension Society of Australia and New Zealand Registry.

Retrospective cohort study of hypersomnias of central origin from two Australian tertiary sleep disorders services.

Background: Hypersomnias of central origin (HOCO) are diverse in origin and symptomatology and remain poorly described in an Australian population. We hypothesised that the rate of human leukocyte antigen (HLA) DQB1*0602 positivity in the Australian cohort would be comparable to international registries.

Aims: The current study aims to evaluate epidemiological and clinical characteristics of Australian patients with HOCO, including prevalence of HLA DQB1*0602 positivity, the most specific HLA marker associated with narcolepsy.

Randomized controlled trial on the efficacy of audio-visual health educational materials on CPAP adherence: the AHEAD trial.

Study Objectives: Educational interventions have been proposed to improve continuous positive airway pressure (CPAP) adherence; however, studies to date have not demonstrated robust effectiveness, due to methodological issues. Furthermore, these educational interventions have not specifically targeted low health literacy communication techniques, which have been demonstrated to improve outcomes in numerous other chronic diseases. We hypothesized that the addition of low-cost audio-visual educational videos (EVs) to usual standard-of-care (SC) education would improve CPAP adherence in adults with obstructive sleep apnea (OSA) syndrome.

Health literacy assessment in the clinic: benefits, pitfalls and practicalities.

Approximately 60% of Australians have low or marginal health literacy, which is associated with poorer outcomes in patients with chronic disease. Patient-centred strategies (such as reduced medical jargon, use of pictograms, multimedia narratives) are effective in improving outcomes for many chronic diseases, with the impact being greatest in individuals with low health literacy. However, clinicians need a reliable and practical tool for assessing health literacy, the results of which help inform the choice of communication techniques best tailored to deliver information to patients.

Prospective cohort study to evaluate the accuracy of sleep measurement by consumer-grade smart devices compared with polysomnography in a sleep disorders population.

Objectives: Consumer-grade smart devices are now commonly used by the public to measure waking activity and sleep. However, the ability of these devices to accurately measure sleep in clinical populations warrants more examination. The aim of the present study was to assess the accuracy of three consumer-grade sleep monitors compared with gold standard polysomnography (PSG).

Home-Based Sleep Sensor Measurements in an Older Australian Population: Before and during a Pandemic.

Older adults are susceptible to poor night-time sleep, characterized by short sleep duration and high sleep disruptions (i.e., more frequent and longer awakenings).

Adequate health literacy is associated with adherence to continuous positive airway pressure in adults with obstructive sleep apnea.

Study Objectives: Obstructive sleep apnea (OSA) is a chronic disease with significant health implications and adequate adherence to continuous positive airway pressure (CPAP) is essential for effective treatment. In many chronic diseases, health literacy has been found to predict treatment adherence and outcomes. In this study, the aim was to determine the health literacy of a sleep clinic population and evaluate the association between health literacy and CPAP adherence.

Outcomes of non-cystic fibrosis-related bronchiectasis post-lung transplantation.

Background: Lung transplantation is a recognised treatment for end-stage lung disease due to bronchiectasis. Non-cystic fibrosis (CF) bronchiectasis and CF are often combined into one cohort; however, outcomes for non-CF bronchiectasis patients vary between centres, and in comparison with those for CF.

Aims: To compare lung transplantation mortality and morbidity of bronchiectasis (non-CF) patients with those with CF and other indications.

Cholecystectomy under thoracic epidural anaesthesia for patient with severe intra-pulmonary shunt.

Pulmonary arteriovenous malformations are common in patients with hereditary haemorrhagic telangiectasia and can be associated with significant hypoxia and intra-pulmonary shunt. We present a case of a young man with a known 57% calculated shunt requiring abdominal surgery and the multidisciplinary decisions required in the preoperative period to minimize post-operative complications.

Safety of IV amikacin in the treatment of pulmonary non-tuberculous mycobacterial disease.

Background And Objective: Pulmonary non-tuberculous mycobacterial (NTM) disease has a high mortality rate and often requires treatment with intravenous amikacin. We report on safety data in patients treated with intravenous amikacin for pulmonary.

Methods: A retrospective observational study (2002-2012) was performed including 45 patients that met American Thoracic Society criteria for pulmonary NTM disease and were treated with intravenous amikacin at three hospitals in Brisbane, Australia.

Autoimmune disease leading to pulmonary AL amyloidosis and pulmonary hypertension.

A 33-year-old woman with past history of Sjögren's syndrome and systemic lupus erythematosus presented with dyspnea and syncope secondary to pulmonary hypertension. After progressive symptoms over 4 years, she received bilateral lung transplantation. Histopathology of the explanted lungs showed isolated pulmonary amyloid light-chain amyloidosis and pulmonary cysts.

Management of refractory chylothorax in pulmonary lymphangioleiomyomatosis.

This case reports the successful management of chylothorax in a non-transplanted patient with pulmonary lymphangioleiomyomatosis (pLAM). Prolonged initial therapy failed, including total parenteral nutrition, pleural drainage, surgical pleurodesis, and pleurectomy. Commencement of sirolimus 2 mg daily (2 mg alternating days had failed) led to resolution of chylothorax after 20 days.