This x1million. Solidarity for long sleepers.

Brilliant

Seems to be back up now. My soul nearly left my body for those 5 minutes.

#pulmsky #medsky

www.cell.com/molecular-th...

Have had an oura ring for several years. I generally use it for sleep most, don’t really trust the daytime stress etc. And honestly biggest impact was the initial period of finding out what things seemed to impact my sleep the most.

🙏🏻🙏🏻🙏🏻

Oh I hadn’t seen this, thank you!

Would love to be added, please!

But did they get autism??

I think you meant in vein

#Pedspulmsky

In summary:
1) BPD is changing post-surfactant and likely highly prevalent
2) It’s kinda like asthma, kinda like COPD, but also probably different
3) We don’t really know how to treat it in adults
4) Adult Congenital Lung Disease should be a thing.

Like any ped dz that persists into adulthood (ie ACHD, CF), adolescents with BPD should be transitioned to adult care with an interdisc approach and extra social support (esp given the observed persistent deficits in exec fxn) - this is even rec’d by ERS. (25495600, 31558663)

What we don’t know: Do ICS improve long-term outcomes / increase PNA? Do LAMAs or LABAs help? Role for lung volume reduction? Indicators for transplant appropriateness? Treatment for related PH? Role of low-dose morphine? Role of A1AT as disease modifier? Anything w/ mortality benefit?

What we know #4: Other associations: Neurodevelopmental impairment, Upper airway abnormalities, tracheobronchomalacia, sleep disordered breathing, PH (stiffer pulm vasculature at baseline w/ impairment in recruitment and cardiac fxn in exercise) (33730436; 38050796, 22659256)

What we know #3: Lung function may continue to deteriorate throughout adolescence (31486896). Early life bronchodilator responsiveness tends to decrease, giving way to fixed obstruction; though this is variable (38050796)

What we know #2: Lung immunology may resemble that of COPD (ie lower CD4/8 ratio correlating w/ worse obstruction, lower airway eos and FeNO than asthma) (35210327)