RESUMO
BACKGROUND & AIMS: Malnutrition is related with pulmonary disease. The aim was to analyze the association of lung function respectively to nutritional status, identified pulmonary pathogens and socioeconomic condition of patients attending a pediatric CF reference center. METHODS: Cross-sectional study performed with CF patients aged 6 to 18 years attending a CF-Center in southern Brazil. Nutritional status, plasma albumin level and pulmonary bacterial colonization were assessed. The outcome studied was forced expiratory volume in 1 second (FEV1). RESULTS: Eighty-five patients were included in this study. FEV1 was significantly associated with body mass index (BMI) percentiles, plasma albumin level and methicillin resistant Staphylococcus aureus (MRSA) pulmonary colonization. Regression analysis showed that BMI below the 10th percentile was associated with a 25.58% drop in FEV1, and plasma albumin levels equal to or lower than 4.1 mg/dL was associated with 18.6% FEV1 reduction. FEV1 was 14.4% lower in the MRSA infected patients. Plasma albumin of 4.25 mg/dL predicted FEV1 of 60% with 76.9% sensitivity and 72.2% specificity, and 85.7% accuracy. The socioeconomic status was not association with pulmonary function. CONCLUSION: BMI below the 10th percentile and albumin below 4.1 mg/dL were predictors of low FEV1. Chronic MRSA infection was associated with lower FEV1. Longitudinal studies may better complement these results.
Assuntos
Fibrose Cística/sangue , Fibrose Cística/fisiopatologia , Pulmão/fisiopatologia , Estado Nutricional , Testes de Função Respiratória , Albumina Sérica/análise , Adolescente , Índice de Massa Corporal , Brasil , Criança , Doença Crônica , Estudos Transversais , Feminino , Volume Expiratório Forçado , Humanos , Pneumopatias/microbiologia , Masculino , Desnutrição/complicações , Desnutrição/fisiopatologia , Staphylococcus aureus Resistente à Meticilina/química , Tamanho da Amostra , Fatores Socioeconômicos , Infecções Estafilocócicas/sangue , Infecções Estafilocócicas/fisiopatologiaRESUMO
We performed a prospective observational study to define the clinical course and the prognostic factors of 31 patients with postinfectious bronchiolitis obliterans. All patients presented with an episode of acute bronchiolitis in the first 2 years of life, and respiratory symptoms and signs persisted since then. Other diseases which may cause chronic airflow obstruction were excluded. The patients were followed after their inclusion in the study and the clinical findings were recorded in a standardized questionnaire and form. Repeated chest radiographs and lung perfusion scans were obtained in all 31 patients and semiannual spirometry was performed in 8 older patients. Eight patients had lung biopsies. The clinical course varied in the 31 patients during a mean of 3.5 years of follow-up. The outcome of the patients included clinical remission (22.6%), persistence of respiratory symptoms and signs (67.7%), and death (9.7%). An older age at onset of illness and presence of atopy as suggested by an elevated serum IgE appeared to predispose to a poor prognosis.
Assuntos
Bronquiolite Obliterante/patologia , Bronquiolite Viral/complicações , Doença Aguda , Idade de Início , Atrofia , Feminino , Seguimentos , Humanos , Imunoglobulina E/análise , Lactente , Masculino , Prognóstico , Estudos ProspectivosRESUMO
Sixty-one cystic fibrosis patients admitted for check-up or antibiotic treatment were enrolled for genetic and clinical evaluation. Genetic analysis was performed on blood samples stored on neonatal screening cards using PCR techniques to determine the presence of delta F508 mutations. Clinical evaluation included Shwachman and Chrispin-Norman scores, age at onset of symptoms and diagnosis, spirometry, awake and sleep pulse oximetry, hyponychial angle measurement and presence of chronic Pseudomonas aeruginosa colonization. Eighteen patients (29.5%) were homozygous for the delta F508 mutation, 26 (42.6%) had one delta F508 mutation and 17 (27.9%) were noncarriers, corresponding to a 50.8% prevalence of the mutation in the whole population. Analysis by the Kruskal-Wallis test for comparison of genetic status with continuous variables or by the chi-square test and logistic regression for dichotomous variables showed no significant differences between any two groups for alpha = 0.05. We conclude that genetic status in relation to the delta F508 mutation is not associated with pulmonary status as evaluated by the above variables.
Assuntos
Fibrose Cística/genética , Homozigoto , Pulmão/fisiopatologia , Mutação/genética , Fenilalanina/genética , Adolescente , Brasil , Criança , Pré-Escolar , Estudos Transversais , Fibrose Cística/fisiopatologia , Feminino , Humanos , Lactente , Modelos Logísticos , Masculino , Razão de Chances , Testes de Função RespiratóriaRESUMO
Sixty-one cystic fibrosis patients admitted for check-up or antibiotic tretment were enrolled for genetic and clinical evaluation. Genetic analysis was performed on blood samples stored on neonatal screening cards using PCR techniques to determine the presence of deltaF508 mutations. Clinical evaluation included Shwachman and Chrispin-Norman scores, age at onset of symptoms and diagnosis, spirometry, awake and sleep pulse oximetry, hyponychial angle measurement and presence of chronic Pseudomonas aeruginosa colonization. Eighteen patients (29.5 percent) were homozygous for the deltaF508 mutation, 26 (42.6 percent) had one deltaF508 mutation and 17 (27.9 percent) were noncarriers, corresponding to a 50.8 percent prevalence of the mutation in the whole population. Analysis by the Kruskal-Wallis test for comparison of genetic status with continuous variables or by the chi-square test and logistic regression for dichotomous variables showed no significant differences between any two groups for alpha=0.05. We conclude that genetic status in relation to the deltaF508 mutation is not associated with pulomnary status as evaluated by the above variables.