Current opinion in pulmonary medicine
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Hypertension (HTN) and obstructive sleep apnea (OSA) are coexistent in millions of people, and both have been associated with heart disease, stroke, and premature death. OSA is an important risk factor for HTN. However, the relationship between OSA and HTN may be bidirectional, with high blood pressure (BP) contributing to an increased risk and severity of OSA. The aim of this review is to summarize the current literature supporting a bidirectional relationship of sleep apnea and HTN. ⋯ Intensive BP and volume overload control may be a promising approach to treat OSA. Future studies examining the hormonal mechanisms and comparing the effect of different antihypertensive medications on OSA are needed.
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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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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.
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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 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.