Hypoxaemia common, significant event in people with fibrotic ILD

Exertional and resting hypoxaemia are common developments in patients with fibrotic ILD and both events have significant prognostic value, a large international study has shown.

Researchers from Australia, Canada and Switzerland say the two are important clinical events and can occur at early stages of the disease, particularly in patients with idiopathic pulmonary fibrosis (IPF).

Their analysis of registry data including 848 patients with fibrotic ILD (258 with idiopathic pulmonary fibrosis (IPF)) shows exertional hypoxaemia is a common early feature in fibrotic ILD, with 17.3% of patients developing it within two years of the first objective evidence of lung fibrosis.

Meanwhile, resting hypoxaemia is a late feature that signifies end-stage disease with similar poor prognosis in both IPF and non-IPF patients, with 42% of patients having died or received lung transplantation within a year of developing the condition.

The group has now developed an externally validated extension of the well-validated ILD-GAP model by incorporating oxygenation status, improving prognostic risk stratification in fibrotic ILD.

While acknowledging that individual patients may differ, investigators say regular monitoring resting pulse oximetry and 6MWT can help stratify patients into different mortality risk groups to facilitate discussions for advanced care planning.

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Australian nanotech improves CF antibiotic by 100,000-fold

Researchers at the University of South Australia have developed nanotechnology that improves the efficacy of the CF antibiotic Tobramycin by up to 100,000-fold – without increasing the toxicity of the drug, 

The new technology uses a biomimetic nanostructured lipid liquid crystal nanoparticle-(LCNPs)-based material to augment Tobramycin – the antibiotic  prescribed to treat chronic Pseudomonas aeruginosa lung infections in severe cases of CF – eradicating the infection in as little as two doses, say investigators of the international study.

Writing in Small the research team, led by Dr Nicky Thomas, Senior Research Fellow at UniSA’s Clinical and Health Sciences, says the unique nanostructure of the LCNPs ‘drives the enhanced penetration of tobramycin across the biofilm barrier, but not through the healthy lung epithelium barrier, significantly increasing the available antibiotic concentration at the site of infection.’

The technology is currently entering pre-clinical trials.

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New report shows huge social and economic costs of sleep disorders

Despite Australia’s contribution to the science and technology of sleep health, the majority of sleep disorders in the community remain unrecognised and untreated, costing the economy $14.4 billion in the last financial year, according to a new report released by the Sleep Health Foundation.

The report, which came out this week, shows around one in 10 Australians have a sleep disorder distributed across obstructive sleep apnoea, insomnia and restless legs syndrome – yet less that 7% of the billions lost to poor sleep came from sleep disorder treatments, according to the analysis.

In the last financial year the estimated overall cost of sleep disorders was $14.4 billion in financial costs – dominated by productivity losses of $11 billion and costs associated with increased accident risk.

A further $36.6 billion was estimated in non-financial costs related to lack of well-being.

“What is striking about the results of this analysis is the relatively small amount spent on identifying and treating sleep disorders compared to the large costs of living with their consequences” observes Natasha Doherty, who leads the Deloitte Access Economics Health and Social Policy team.

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