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  1. Article ; Online: Obstructive sleep apnoea and sleep disorders in pregnancy.

    Middleton, Peter G

    Best practice & research. Clinical obstetrics & gynaecology

    2022  Volume 85, Issue Pt A, Page(s) 107–113

    Abstract: This review provides a summary for obstetricians, midwives, other health professionals and women contemplating pregnancy about the interactions between pregnancy and breathing during sleep. This review will first examine the normal physiological changes ... ...

    Abstract This review provides a summary for obstetricians, midwives, other health professionals and women contemplating pregnancy about the interactions between pregnancy and breathing during sleep. This review will first examine the normal physiological changes of pregnancy and their relationship to sleep-disordered breathing (SDB), and it will then summarise the current knowledge of SDB in pregnancy. Many changes in the respiratory system during pregnancy, particularly during the third trimester, can alter respiratory function during sleep, increasing the incidence and severity of SDB. These changes include increased ventilatory drive and metabolic rate, reduced functional residual capacity and residual volume, increased alveolar-arterial oxygen gradients and changes in the upper airway. The clinical importance of these changes during pregnancy is demonstrated by the increased incidence of snoring and obstructive sleep apnoea hypopnoea syndrome. As SDB is associated with obesity, the increasing incidence of obesity pre-pregnancy will likely increase SDB during pregnancy over the next decade. If a physician is asked to review a pregnant patient, they should always consider the possibility of SDB.
    Language English
    Publishing date 2022-11-15
    Publishing country Netherlands
    Document type Journal Article ; Review
    ZDB-ID 2050090-7
    ISSN 1532-1932 ; 1521-6934
    ISSN (online) 1532-1932
    ISSN 1521-6934
    DOI 10.1016/j.bpobgyn.2022.11.004
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  2. Article ; Online: Pregnancy in women with Cystic Fibrosis in the 21

    Middleton, Peter G

    Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society

    2021  Volume 20, Issue 3, Page(s) 375–376

    MeSH term(s) Cystic Fibrosis/complications ; Female ; Humans ; Pregnancy ; Pregnancy Complications ; Pregnancy Outcome
    Language English
    Publishing date 2021-04-05
    Publishing country Netherlands
    Document type Editorial
    ZDB-ID 2084724-5
    ISSN 1873-5010 ; 1569-1993
    ISSN (online) 1873-5010
    ISSN 1569-1993
    DOI 10.1016/j.jcf.2021.03.020
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  3. Article ; Online: Cystic Fibrosis Screen Positive, Inconclusive Diagnosis Genotypes in the Cystic Fibrosis Registry.

    Thompson, Cassandra / Middleton, Peter G

    Annals of the American Thoracic Society

    2023  Volume 20, Issue 4, Page(s) 512–513

    MeSH term(s) Humans ; Cystic Fibrosis/diagnosis ; Cystic Fibrosis/genetics ; Cystic Fibrosis Transmembrane Conductance Regulator/genetics ; Genotype ; Mass Screening ; Registries
    Chemical Substances Cystic Fibrosis Transmembrane Conductance Regulator (126880-72-6)
    Language English
    Publishing date 2023-03-31
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 2717461-X
    ISSN 2325-6621 ; 1943-5665 ; 2325-6621
    ISSN (online) 2325-6621 ; 1943-5665
    ISSN 2325-6621
    DOI 10.1513/AnnalsATS.202212-1051ED
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  4. Article: Cystic fibrosis modulator therapy can reverse cystic bronchiectasis.

    Middleton, Peter G / Simmonds, Nicholas J

    Respirology case reports

    2023  Volume 11, Issue 7, Page(s) e01172

    Abstract: Bronchiectasis is often considered progressive and irreversible, so cases of regression or reversal are an important step in understanding the underlying pathophysiological mechanisms. Cystic fibrosis, (CF) caused by pathogenic variants in ... ...

    Abstract Bronchiectasis is often considered progressive and irreversible, so cases of regression or reversal are an important step in understanding the underlying pathophysiological mechanisms. Cystic fibrosis, (CF) caused by pathogenic variants in the
    Language English
    Publishing date 2023-06-12
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2750180-2
    ISSN 2051-3380
    ISSN 2051-3380
    DOI 10.1002/rcr2.1172
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  5. Article ; Online: Pulmonary disorders in pregnancy: Bronchiectasis, cystic fibrosis, sarcoidosis and interstitial diseases.

    Haines, Alena J / Middleton, Peter G

    Best practice & research. Clinical obstetrics & gynaecology

    2022  Volume 85, Issue Pt A, Page(s) 114–126

    Abstract: This chapter aims to provide expert guidance to obstetricians, general practitioners, allied health staff and women with lung disease about the interactions between pregnancy and different lung diseases. This chapter will cover other airway diseases such ...

    Abstract This chapter aims to provide expert guidance to obstetricians, general practitioners, allied health staff and women with lung disease about the interactions between pregnancy and different lung diseases. This chapter will cover other airway diseases such as bronchiectasis and cystic fibrosis (CF) together with sarcoidosis and interstitial lung disease (ILD), noting that another chapter covers asthma. The physiological changes which occur in pregnancy, such as the changes in airway physiology, resting ventilation and sleep, are summarised in another chapter. This chapter extends the evidence-based approach and clinical expertise of the recent European Respiratory Society/Thoracic Society of Australia and New Zealand (ERS/TSANZ) taskforce. The papers selected were based on the population (pregnant women with lung disease other than asthma) and the effects of these diseases on risks of pregnancy-associated complications and miscarriages, breastfeeding, nutritional considerations, lung function, long-term maternal outcomes and management considerations during pregnancy. As there are very few randomised control trials in the area, the majority of the literature consists of observational studies (prospective or retrospective), cross-sectional surveys and case series. Other guidelines have also recently been published, which may be helpful to the reader.
    Language English
    Publishing date 2022-09-13
    Publishing country Netherlands
    Document type Journal Article ; Review
    ZDB-ID 2050090-7
    ISSN 1532-1932 ; 1521-6934
    ISSN (online) 1532-1932
    ISSN 1521-6934
    DOI 10.1016/j.bpobgyn.2022.09.001
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  6. Article ; Online: Long-Term CFTR Modulators and Changes in Hemoglobin.

    Middleton, Peter G

    Annals of the American Thoracic Society

    2019  Volume 16, Issue 3, Page(s) 305–306

    MeSH term(s) Aminophenols ; Aminopyridines ; Cystic Fibrosis ; Cystic Fibrosis Transmembrane Conductance Regulator ; Hemoglobins ; Humans
    Chemical Substances Aminophenols ; Aminopyridines ; Hemoglobins ; Cystic Fibrosis Transmembrane Conductance Regulator (126880-72-6)
    Language English
    Publishing date 2019-04-13
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 2717461-X
    ISSN 2325-6621 ; 1943-5665 ; 2325-6621
    ISSN (online) 2325-6621 ; 1943-5665
    ISSN 2325-6621
    DOI 10.1513/AnnalsATS.201812-904ED
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  7. Article ; Online: Occupations and balance during the transition to motherhood with a lifetime chronic illness: A scoping review examining cystic fibrosis, asthma, and Type-1 diabetes.

    Haines, Alena Jane / Mackenzie, Lynette / Honey, Anne / Middleton, Peter G

    Australian occupational therapy journal

    2023  Volume 70, Issue 6, Page(s) 730–744

    Abstract: Introduction: Throughout the transition to motherhood, changes are experienced across a woman's physical, mental, social, and occupational self. Maternal chronic illness adds the complexity of increased healthcare needs and navigating a high-risk, ... ...

    Abstract Introduction: Throughout the transition to motherhood, changes are experienced across a woman's physical, mental, social, and occupational self. Maternal chronic illness adds the complexity of increased healthcare needs and navigating a high-risk, medicalised pregnancy, birth, and post-natal period. Literature concerning motherhood transitions in chronic illness generally focusses on the mother's medical health and pregnancy outcomes; little is known about the impacts on women's occupations, balance, and quality of life. Understanding these issues may help support women in a more tailored and holistic way.
    Objective: This scoping review aims to gather, analyse, and synthesise existing empirical research on occupational engagement and occupational balance as they impact on wellbeing and quality of life in women with a lifetime chronic illness before and during pregnancy and in early motherhood.
    Method: The review follows the nine-stage framework described in the Joanna Briggs Institute Manual for Evidence Synthesis (2020). Five databases were searched: Embase, Medline, PsycINFO, CINAHL, Scopus, and OT Seeker. Data were extracted and examined via content analysis, described in narrative synthesis, summarised into a conceptual framework, and tabulated.
    Findings: A total of 8,655 papers were discovered on initial search. Following title and abstract screening, 220 full-text studies were assessed for eligibility, and 46 papers were finally included. Analysis generated four major themes: The Disrupted Transition Journey; Adaptation, Compromise and Choice; Outcomes; and Drawing on What's Available. The themes were conceptualised into a framework to explain how women sought to balance motherhood and illness-related occupations. Adequate access to information, social support, expert care, and financial resources improved both quality of life and healthcare compliance.
    Conclusion: Findings of this scoping review deepen the understanding of occupational balance during the transition to motherhood in the context of lifetime chronic illness. Healthcare providers and supportive family and friends can use this knowledge to adapt their approach to assisting women with chronic illness on the motherhood journey. These findings may also inform further inquiry into the scope of occupational therapy practice with this population.
    MeSH term(s) Pregnancy ; Female ; Humans ; Cystic Fibrosis ; Quality of Life ; Occupational Therapy ; Occupations ; Asthma ; Diabetes Mellitus
    Language English
    Publishing date 2023-07-31
    Publishing country Australia
    Document type Journal Article ; Review
    ZDB-ID 604554-6
    ISSN 1440-1630 ; 0045-0766
    ISSN (online) 1440-1630
    ISSN 0045-0766
    DOI 10.1111/1440-1630.12899
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  8. Article ; Online: Development of elexacaftor - tezacaftor - ivacaftor: Highly effective CFTR modulation for the majority of people with Cystic Fibrosis.

    Middleton, Peter G / Taylor-Cousar, Jennifer L

    Expert review of respiratory medicine

    2021  Volume 15, Issue 6, Page(s) 723–735

    Abstract: ... ...

    Abstract Introduction
    MeSH term(s) Aminophenols ; Benzodioxoles ; Chloride Channel Agonists/therapeutic use ; Cystic Fibrosis/drug therapy ; Cystic Fibrosis/genetics ; Cystic Fibrosis Transmembrane Conductance Regulator/genetics ; Drug Combinations ; Humans ; Indoles ; Mutation ; Pyrazoles ; Pyridines ; Pyrrolidines ; Quinolones
    Chemical Substances Aminophenols ; Benzodioxoles ; CFTR protein, human ; Chloride Channel Agonists ; Drug Combinations ; Indoles ; Pyrazoles ; Pyridines ; Pyrrolidines ; Quinolones ; tezacaftor, ivacaftor drug combination ; Cystic Fibrosis Transmembrane Conductance Regulator (126880-72-6) ; elexacaftor (RRN67GMB0V)
    Language English
    Publishing date 2021-02-17
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2479146-5
    ISSN 1747-6356 ; 1747-6348
    ISSN (online) 1747-6356
    ISSN 1747-6348
    DOI 10.1080/17476348.2021.1855980
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  9. Article ; Online: Triple Therapy for Cystic Fibrosis with a Phe508del CFTR Mutation. Reply.

    Jain, Raksha / Middleton, Peter G / Rowe, Steven M

    The New England journal of medicine

    2020  Volume 382, Issue 7, Page(s) 684

    MeSH term(s) Aminophenols ; Chloride Channel Agonists ; Cystic Fibrosis ; Cystic Fibrosis Transmembrane Conductance Regulator/genetics ; Humans ; Mutation
    Chemical Substances Aminophenols ; Chloride Channel Agonists ; Cystic Fibrosis Transmembrane Conductance Regulator (126880-72-6)
    Language English
    Publishing date 2020-01-01
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 207154-x
    ISSN 1533-4406 ; 0028-4793
    ISSN (online) 1533-4406
    ISSN 0028-4793
    DOI 10.1056/NEJMc1916747
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  10. Article ; Online: Thoracic Society of Australia and New Zealand position statement: The safe clinical use of sputum induction for bio-sampling of the lower airways in children and adults.

    Schultz, André / Balaguruswamy, Sathya / Dentice, Ruth / Dobler, Claudia C / Geake, James / Gibson, Peter / Goulter, Patricia / Jayaram, Lata / Laird, Pamela J / Middleton, Peter G / Seale, Helen

    Respirology (Carlton, Vic.)

    2024  Volume 29, Issue 5, Page(s) 372–378

    Abstract: Sputum induction is widely used in clinical settings for collection of biological samples from the lower airways. However, in recent years sputum induction has been associated with serious adverse events and even death. This position statement was ... ...

    Abstract Sputum induction is widely used in clinical settings for collection of biological samples from the lower airways. However, in recent years sputum induction has been associated with serious adverse events and even death. This position statement was commissioned by the Thoracic Society of Australia and New Zealand to address major adverse events of two deaths associated with sputum induction that have occurred in Australia in 2021, and outlines best practice for the safe use of sputum induction. The statement resulted from systematic literature searches by a multi-disciplinary group including respiratory physicians, nurses and physiotherapists (paediatric and adults focused). Consumers had input to an advanced draft of the position statement. The position statement covers indications for sputum induction, informed consent, scope of practice of personnel administering the procedure, infection control considerations, details about the sputum induction procedure, safety considerations and risk assessment in clinical settings.
    MeSH term(s) Adult ; Humans ; Child ; Sputum ; Saline Solution, Hypertonic ; New Zealand ; Australia ; Forced Expiratory Volume
    Chemical Substances Saline Solution, Hypertonic
    Language English
    Publishing date 2024-03-31
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 1435849-9
    ISSN 1440-1843 ; 1323-7799
    ISSN (online) 1440-1843
    ISSN 1323-7799
    DOI 10.1111/resp.14707
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