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      Translated title: Body Mass Index and its correlation with pulmonary function in patients with cystic fibrosis from Cartagena (Colombia)

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          Abstract

          Background. Sinus-pulmonary manifestations are a major concern in CF patients. Pulmonary function shows a strong relationship with nutritional status. In Colombia, malnutrition is a public health issue; however there are no reports that fully analyze nutritional status and lung function in CF children. Materials and Methods. A cross-sectional study was developed conducted with 32 patients registered in the CF Attention Program. Measurements were performed following the NIOSH Spirometry Training Guide. Body Mass Index (Z-Score) was calculated according to Onis.et.al. Correlation was determined by a regression model. Results. 14 children were able to perform the test with criteria for the study, mean for age 12.4 ± 3.4 years. % Forced Expiratory Volume1 and % Forced Vital Capacity means were 66.7 ± 28.5 and 69.5 ± 2.0, respectively. Body Mass Index (Z-score) mean was -1.17. BMI-regression for % Forced Expiratory Volume1, r2=0.31(P<0.01); % Forced Vital Capacity, r2=0.22(P<.01). Conclusions. Results demonstrated a correlation between Body Mass Index and Lung Function. This correlation persists, even in populations with notorious nutritional deficit such as this group. Special nutritional therapies should be implemented for this group and similar populations.

          Translated abstract

          Introducción: Las manifestaciones sinopulmonares son de gran interés en pacientes con fibrosis quística. La función pulmonar se ha correlacionado con el estado nutricional en estos pacientes. En Colombia, la malnutrición es un problema de importancia para la salud pública; sin embargo, no se han publicado reportes que analicen el estado nutricional y la función pulmonar en pacientes con fibrosis quística. Materiales y métodos: Se disenó un estudio transversal con 32 pacientes registrados en el Programa de Atención Integral para Pacientes con Fibrosis Quística y sus familias. Los exámenes se realizaron siguiendo la guía de entrenamiento de la NIOSH. El índice de Masa Corporal (Z-Score) fue calculado siguiendo las recomendaciones de Onis et al. El grado de correlación fue determinado por un modelo de regresión. Resultados: 14 ninos fueron incluidos para realizar las pruebas con los criterios del estudio; la edad media fue 12,4±3,4anos; para %Volumen Expiratorio Forzado y %Capacidad Vital Forzada las medias fueron 66,7±28,5 y 69,5±22,0 respectivamente. La media del índice de Masa Corporal (Z-score) fue -1,17. La regresión del índice de Masa Corporal para %Volumen Expiratorio Forzado1 fue r²=0,31(P<0,01), y para %Capacidad Vital Forzada, r²=0,22(P<0,01). Conclusiones: Los resultados demostraron correlación entre el índice de Masa Corporal y la función pulmonar. Esta correlación persistió incluso en poblaciones con un notorio déficit nutricional como la de este estudio. Una terapia nutricional específica debería ser implementada en este grupo y poblaciones similares.

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          Most cited references52

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          Development of a WHO growth reference for school-aged children and adolescents

          OBJECTIVE: To construct growth curves for school-aged children and adolescents that accord with the WHO Child Growth Standards for preschool children and the body mass index (BMI) cut-offs for adults. METHODS: Data from the 1977 National Center for Health Statistics (NCHS)/WHO growth reference (1-24 years) were merged with data from the under-fives growth standards' cross-sectional sample (18-71 months) to smooth the transition between the two samples. State-of-the-art statistical methods used to construct the WHO Child Growth Standards (0-5 years), i.e. the Box-Cox power exponential (BCPE) method with appropriate diagnostic tools for the selection of best models, were applied to this combined sample. FINDINGS: The merged data sets resulted in a smooth transition at 5 years for height-for-age, weight-for-age and BMI-for-age. For BMI-for-age across all centiles the magnitude of the difference between the two curves at age 5 years is mostly 0.0 kg/m² to 0.1 kg/m². At 19 years, the new BMI values at +1 standard deviation (SD) are 25.4 kg/m² for boys and 25.0 kg/m² for girls. These values are equivalent to the overweight cut-off for adults (> 25.0 kg/m²). Similarly, the +2 SD value (29.7 kg/m² for both sexes) compares closely with the cut-off for obesity (> 30.0 kg/m²). CONCLUSION: The new curves are closely aligned with the WHO Child Growth Standards at 5 years, and the recommended adult cut-offs for overweight and obesity at 19 years. They fill the gap in growth curves and provide an appropriate reference for the 5 to 19 years age group.
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            Effect of genotype on phenotype and mortality in cystic fibrosis: a retrospective cohort study.

            Over 1000 mutations of the cystic fibrosis transmembrane conductance regulator gene (CFTR) that cause cystic fibrosis have been identified. We examined the effect of CFTR genotype on mortality and disease phenotype. Using the US Cystic Fibrosis Foundation National Registry, we did a retrospective cohort study to compare standardised mortality rates for the 11 most common genotypes heterozygous for DeltaF508 with those homozygous for DeltaF508. Of the 28455 patients enrolled in the registry at the time of our analysis, 17853 (63%) were genotyped. We also compared the clinical phenotype, including lung function, age at diagnosis, and nutritional measures, of 22 DeltaF508 heterozygous genotypes. Mortality rates and clinical phenotype were also compared between genotypes classified into six classes on the basis of their functional effect on CFTR production. Between 1991 and 1999, genetic and clinical data were available for 17853 patients with cystic fibrosis, which was 63% of the total cohort. There were 1547 deaths during the 9 years of follow-up. In the analysis of the 11 most common genotypes, DeltaF508/R117H, DeltaF508/DeltaI507, DeltaF508/3849+10kbC-->T, and DeltaF508/2789+5G-->A had a significantly lower mortality rate (4.7, 8.0, 11.9, and 4.4, respectively) than the genotype homozygous for DeltaF508 (21.8, p=0.0060). DeltaF508/R117H, DeltaF508/DeltaI507, DeltaF508/ 3849+10 kbC-->T, DeltaF508/2789+5G-->A, and DeltaF508/A455E have a milder clinical phenotype. Outcomes for all functional classes were compared with that of class II (containing DeltaF508 homozygotes) and classes IV and V had a significantly lower mortality rate and milder clinical phenotype. Patients with cystic fibrosis have distinct genetic subgroups that are associated with mild clinical manifestations and low mortality. These differences in phenotype are also related to the functional classification of CFTR genotype.
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              Prevalence and antimicrobial susceptibility of microorganisms isolated from sputa of patients with cystic fibrosis.

              New emerging pathogens and associated antimicrobial resistance mechanisms have been observed in the respiratory tract of patients suffering from cystic fibrosis (CF) in the last years. Amongst others, the rate of metallo-beta-lactamase (MBL)-producing Pseudomonas aeruginosa strains is growing. However, there are no published data on the prevalence of MBL-producing P. aeruginosa in CF patients to our knowledge. In this study, 271 sputum samples of 60 CF patients were collected during a 12-months period. Microbiological cultures and antimicrobial susceptibility tests of the most frequently isolated bacteria were performed. 464 bacterial and 414 fungal strains were isolated and characterized. 63.3% of the patients harbored Staphylococcus aureus, 50% P. aeruginosa, 16.6% Haemophilus influenzae, 15% Stenotrophomonas maltophilia and 13.3% non tuberculous Mycobacteria (NTM). Methicillin resistant S. aureus (MRSA) and MBL-producing P. aeruginosa were detected in 3 (5%) and 5 (8.3%) patients respectively. Among the fungi, Aspergillus fumigatus and Candida albicans showed the highest prevalence. The detection of MBL-producing P. aeruginosa and MRSA in CF patients confirms that antimicrobial resistance patterns should be always kept under surveillance. Moreover hygiene regulations in CF clinics should prevent a further spread of resistant bacterial strains.
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                Author and article information

                Journal
                sun
                Revista Salud Uninorte
                Salud, Barranquilla
                Fundación Universidad del Norte, División de Ciencias de la (Barranquilla, Atlantico, Colombia )
                0120-5552
                2011-7531
                January 2011
                : 27
                : 1
                : 22-29
                Affiliations
                [01] orgnameUniversidad de Cartagena
                [03] orgnameDepartamento de Neumología Pediátrica
                [02] orgnameUniversidad de Cartagena orgdiv1Departamento de Investigaciones
                [06] orgnameUniversidad de Cartagena Colombia degomez@ 123456hotmail.com
                [04] orgnameUniversidad de Cartagena
                [05] orgnameUniversidad Nacional orgdiv1Departamento de Farmacia
                Article
                S0120-55522011000100003 S0120-5552(11)02700103
                781ec521-0e3d-43b0-967f-756b18539867

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 08 February 2011
                : 26 October 2010
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 31, Pages: 8
                Product

                SciELO Colombia

                Categories
                Original aticles

                Body Mass Index,nutritional status,Cystic fibrosis,espirometría,índice de Masa Corporal,estado nutricional,Fibrosis quística

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