Iatrogenic infection associated with positive airway pressure therapy: A review of precedent, epidemiology, bioaerosols and risk mitigation.

Currently, evidence-based guidelines about cleaning positive airway pressure devices for maintenance or reprocessing for a new user do not exist. There is no strong evidence of harm caused by contaminated positive airway pressure equipment. Future research opportunities exist to streamline cleaning processes, assure hygiene, and reduce waste.

Insights from a 10-year Australasian idiopathic hypersomnia patient data registry study.

Study Objectives: Idiopathic hypersomnia (IH) is a disorder of central hypersomnolence that results in excessive daytime sleepiness in the absence of another identifying cause. Case studies from sleep clinic patients may not be a fair representation of the wider IH population. This study aims to better characterize patients diagnosed with IH in Australia and New Zealand using online patient-driven survey data.

Opioid use disorder in pediatric populations: considerations for perioperative pain management and precision opioid analgesia.

Introduction: Opioids are commonly used for perioperative analgesia, yet children still suffer high rates of severe post-surgical pain and opioid-related adverse effects. Persistent and severe acute surgical pain greatly increases the child's chances of chronic surgical pain, long-term opioid use, and opioid use disorder.

Areas Covered: Enhanced recovery after surgery (ERAS) protocols are often inadequate in treating a child's severe surgical pain.

Giant PMMA Foreign Body Granulomas with Imaging.

Filler complications have a wide array of presentations including early and late manifestations. A rare late complication is the foreign body granuloma or granulomatous foreign body reaction. We present a case of giant foreign body granulomas developing 7 years after polymethylmethacrylate (PMMA) filler injection.

Impact of cystic fibrosis multidisciplinary virtual clinics on patient experience, time commitments and costs.

Background And Aims: The experience of outpatient care may differ for select patient groups. This prospective study evaluates the adult patient experience of multidisciplinary outpatient cystic fibrosis (CF) care with videoconferencing through telehealth compared with face-to-face care the year prior.

Methods: People with CF without a lung transplant were recruited.

Screening for Cystic Fibrosis Related Complications in the Context of a Pandemic and Altered Models of Care.

Background: Standard of care recommend that patients with cystic fibrosis (CF) require screening investigations to assess for complications. Changing models of care due to the COVID19 pandemic may have impacted completion of recommended screening.

Objective: To compare the frequency of screening investigations completed in people with CF before and after the onset of the COVID19 pandemic.

Considerations for Functional Nasal Surgery in the Obstructive Sleep Apnea Population.

Obstructive sleep apnea (OSA) and nasal obstruction are common in the general population and frequently treated by otolaryngologists and facial plastic surgeons. Understanding the appropriate pre-, peri-, and postoperative management of OSA patients undergoing functional nasal surgery is important. OSA patients should be appropriately counseled in the preoperative period on their increased anesthetic risk.

Q1291H-CFTR molecular dynamics simulations and theratyping in nasal epithelial models and clinical response to elexacaftor/tezacaftor/ivacaftor in a Q1291H/F508del patient.

Cystic fibrosis (CF) is caused by a wide spectrum of mutations in the CF transmembrane conductance regulator () gene, with some leading to non-classical clinical presentations. We present an integrated and investigation of an individual with CF carrying the rare Q1291H allele and the common F508del allele. At age 56 years, the participant had obstructive lung disease and bronchiectasis, qualifying for Elexacaftor/Tezacaftor/Ivacaftor (ETI) CFTR modulator treatment due to their F508del allele.

Repairing the Nose after Failed Minimally Invasive Procedures.

Minimally invasive nasal procedures can be aimed at treating both functional and cosmetic problems. These procedures include lateral nasal wall implants, dermal fillers, thread lifting, and radiofrequency ablation. Though increasingly popular, nasal surgeons have limited data to draw from when faced with operating in a nose that has been altered by these techniques.

Pediatric orbital fractures.

Purpose Of Review: The aim of this study was to summarize current evidence on the clinical presentation, evaluation, and management of pediatric orbital fractures. Recent trends in management strategies as well as emerging surgical techniques for pediatric orbital fracture repair are presented.

Recent Findings: Although somewhat limited, growing bodies of evidence support a conservative approach with close follow up in pediatric orbital fractures.

Effects of oxycodone pharmacogenetics on postoperative analgesia and related clinical outcomes in children: a pilot prospective study.

Variability in the pharmacokinetics and pharmacodynamics of oxycodone in children undergoing surgery could be due to genetic polymorphisms. The authors studied the association between clinical outcomes and pharmacogenes in children undergoing major surgery. A total of 89 children (35 undergoing pectus excavatum repair and 54 undergoing spinal fusion) were recruited.

Characteristics of Orbital Injuries Associated with Maxillofacial Trauma.

Introduction: The incidence of ocular injury associated with maxillofacial trauma remains poorly defined, with reported rates ranging from 0.8% to 92%. Our study aims to more accurately characterize ocular injuries associated with midface fractures.

Clinical outcomes of adults and children with cystic fibrosis during the COVID-19 pandemic.

Background: The onset of the COVID-19 pandemic was associated with restricted community movement and limited access to healthcare facilities, resulting in changed clinical service delivery to people with cystic fibrosis (CF). This study aimed to determine clinical outcomes of Australian adults and children with CF in the 12-months following the onset of the COVID-19 pandemic.

Methods: This longitudinal cohort study used national registry data.

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.

Narcolepsy: Comorbidities, complexities and future directions.

Patients with narcolepsy live with a lifelong sleep-wake disorder, impairing their quality of life, productivity, educational and employment outcomes. Clinicians are becoming aware that a significant aspect of the burden of this disease relates to frequent comorbid conditions, including aspects of the patient's emotional, metabolic, sleep and immune health. This review explores the literature describing the comorbidities seen in patients with narcolepsy, to enhance understanding of these often complex presentations.

Surgical considerations in cystic fibrosis: what every general surgeon needs to know.

Cystic fibrosis (CF) is a complex multiorgan disease, which often affects the gastrointestinal tract. With improved CF specific therapies and multidisciplinary management, patients with CF are now living longer with a median life expectancy of around 50 years. This increased life expectancy has resulted in corresponding increase in presentations of the CF patient with comorbid surgical conditions that were never important considerations.

Minimally Invasive Nasal Valve Treatment.

The objective of this article is to explore minimally invasive techniques to treat a poorly functioning nasal valve. It reviews the literature to introduce anatomy and examination, detail efficacy, instruct procedural protocols, and summarize utility. The article was composed based upon literature review and expert opinion.

Predictors of Delayed Enophthalmos After Orbital Fractures: A Systematic Review.

Orbital fractures are a commonly encountered problem with 7-10% of patients developing delayed enophthalmos when managed conservatively with observation. To characterize the literature regarding incidence of delayed enophthalmos among patients with untreated unilateral isolated orbital wall fractures and determine what factors may predict this untoward outcome. Preferred reporting items for systematic review and meta-analyses (PRISMA) guidelines were adhered to and a literature search was conducted using multiple medical subject headings (MeSH) headings.

Cardiopulmonary coupling and serum cardiac biomarkers in obesity hypoventilation syndrome and obstructive sleep apnea with morbid obesity.

Study Objectives: The main cause of death in patients with obesity hypoventilation syndrome (OHS) is cardiac rather than respiratory failure. Here, we investigated autonomic-respiratory coupling and serum cardiac biomarkers in patients with OHS and obstructive sleep apnea (OSA) with comparable body mass index and apnea-hypopnea index.

Methods: Cardiopulmonary coupling (CPC) and cyclic variation of heart rate analysis was performed on the electrocardiogram signal from the overnight polysomnogram.