Recent evidence suggests that obstructive sleep apnea (OSA) treatment may cause weight gain, but long-term effects of continuous positive airway pressure (CPAP) on weight are not well-established.

Continuous renal replacement therapy (CRRT) is commonly employed to provide renal support for critically ill patients with acute kidney injury (AKI); particularly patients who are hemodynamically unstable. A variety of techniques that vary in their mode of solute clearance may be used, including continuous venovenous hemofiltration (CVVH) with predominantly convective solute clearance, continuous venovenous hemodialysis (CVVHD) with predominantly diffusive solute clearance and continuous venovenous hemodiafiltration (CVVHDF), which combines both dialysis and hemofiltration. Herein we compare CRRT with other modalities of renal support and review indications for initiation of renal replacement therapy, and dosing and technical aspects in the management of CRRT.

The prevalence of lung conditions, such as chronic obstructive pulmonary disease and pulmonary fibrosis, and lung infections such as pneumonia, increase sharply with age. The physiologic, cellular and immunologic changes that occur during aging contribute to the development of lung disease. Studies of age-related changes in physiology and function are not just key to preventing or ameliorating disease, they are essential for understanding healthy aging. Individuals with good lung function live longer, healthier lives, although the mechanisms by which this occurs are not understood. Herein, we review changes in the aging lung that facilitate development of disease and the evidence supporting the idea that robust lung function reduces the risk of developing chronic inflammatory conditions that occur with age.

Hypersensitivity pneumonitis (HP) is an interstitial lung disease with a better prognosis, on average, than idiopathic pulmonary fibrosis (IPF). We compare survival time and pulmonary function trajectory in patients with HP and IPF by radiologic phenotype.

We examined the relationship between newly diagnosed obstructive sleep apnea (OSA) and incident hospitalized atrial fibrillation (AF) over the subsequent ten years in a large arrhythmia-free cohort.

Malignant pleural effusion (MPE) is common and imposes a significant burden on patients and health care providers. Most patients require definitive treatment, such as drainage and chemical pleurodesis, to prevent fluid and symptom recurrence. Thoracic ultrasound (TUS) can identify pleural adhesions in other clinical scenarios, and might therefore predict long-term pleurodesis success in MPE. Eighteen patients undergoing chest tube drainage and talc slurry instillation for MPE underwent TUS examination immediately before and 24 hours after talc instillation to derive pleural adherence scores for the affected hemithorax. Two independent assessors blinded to the patient's clinical status additionally scored recorded TUS scans. Participants who suffered pleurodesis failure had a lower adherence score at 24 h post-talc instillation than those who were successful (difference, 6.27; 95% CI, 3.94-8.59). A TUS-derived pleural adherence score may predict long-term outcomes following chemical pleurodesis. Further research is needed to evaluate this novel finding.

Over the past 30 years, hypoglossal nerve stimulation has moved through a development pathway to become a viable treatment modality for patients with obstructive sleep apnea. Initial pilot studies in animals and humans laid the conceptual foundation for this approach, leading to the development of fully implantable stimulating systems for therapeutic purposes. These devices were then demonstrated to be both safe and efficacious in feasibility studies. One such closed-loop stimulating device was found effective in treating a limited spectrum of apneic patients and is currently FDA-approved for this purpose. Another open-loop stimulating system is currently being rigorously tested in a pivotal trial. Collectively, clinical trials of hypoglossal stimulating systems have yielded important insights that can help optimize therapeutic responses to hypoglossal nerve stimulation. These insights include specific patient selection criteria and methods for delivering stimulation to specific portions of the hypoglossal nerve and/or genioglossus muscle. New approaches for activating efferent and afferent motor pathways are currently in early-stage laboratory development and hold some long-term promise as a novel therapy.

Historically, scientific knowledge gaps - including a lack of information regarding the minimum amount of sleep needed to sustain nominally adequate, militarily-relevant performance and nescience of the potential impact of chronic sleep restriction on health and psychological well-being - have hindered decision-making vis-à-vis sleep/alertness management in operational environments. However, against a backdrop of increasing awareness of the importance of sleep for sustaining both performance and health, military researchers are currently (a) developing a comprehensive, individualized sleep/alertness management system to optimize the general effectiveness of military personnel (i.e., without regard to the potential relationship between sleep and specific aspects of military performance - thus sidestepping what has historically been an impediment to development of such a system), and (b) investigating the prevalence, potentially unique etiology (e.g., resulting from the interaction of long-term exposure to combat-related stressors and sleep restriction), and treatment of sleep disorders and comorbidities in the military population.

Vasoactive medications are commonly used in the treatment of critically ill patients, but their impact on the development of ICU-acquired weakness is not well described. The objective of this study is to evaluate the relationship between vasoactive medication use and the outcome of ICU-acquired weakness.

Exercise and CPAP improve OSA. This study examined the effects of exercise in patients with heart failure (HF) and OSA.

Idiopathic pulmonary fibrosis (IPF) causes irreversible loss of lung function. The lysophosphatidic acid receptor 1 (LPA) pathway is implicated in IPF etiology. Safety and efficacy of BMS-986020, a high-affinity LPA antagonist, was assessed versus placebo in a phase 2 study in patients with IPF.