Cystic fibrosis is a genetic disorder that affects the lungs and digestive system. It is caused by mutations in the CFTR gene that result in abnormal ion transport in epithelial cells. This causes very thick, sticky mucus to build up in the lungs, pancreas, and other organs. The most common mutation is F508del. Symptoms include issues with digestion, lung function decline, and infections. Diagnosis is made through sweat chloride tests, genetic testing, and evaluation of clinical features. Treatment focuses on airway clearance, antibiotics, nutrition support, and newer CFTR modulator drugs that target specific mutations. With advances in care, people with cystic fibrosis now live well into adulthood.
Cystic fibrosis (also known as CF or mucoviscidosis) is a recessive multi-system genetic disease characterized by abnormal transport of chloride and sodium across epithelium, leading to thick, viscous secretions in the lungs, pancreas, liver, intestine.[Yankas JR, et al. (2004). "Cystic fibrosis adult care consensus conference report". Chest 125: 1-39.]
Cystic Fibrosis Care as a model for chronic disease care in the clinic. A presentation made on April 29, 2017 to the Wisconsin Chapter of the American Association of Medical Assistants at Lacrosse, WI.
THIS PRESENTATION INCLUDES DEFINITION, OVERVIEW, PATHOLOGY, CLINICAL FEATURES, ASSESSMENT AND PT MANAGEMENT OF CYSTIC FIBROSIS. THIS PPT WILL BE VERY USEFUL FOR FINAL YEAR BPT STUDENTS. IT COVERS BASIC KNOWLEDGE REGARDING THE DISEASE AND ALLOWS BETTER UNDERSTANDING. IT IS MADE ONLY FOR LEARNING AND EXAM PURPOSE.
Cystic fibrosis (also known as CF or mucoviscidosis) is a recessive multi-system genetic disease characterized by abnormal transport of chloride and sodium across epithelium, leading to thick, viscous secretions in the lungs, pancreas, liver, intestine.[Yankas JR, et al. (2004). "Cystic fibrosis adult care consensus conference report". Chest 125: 1-39.]
Cystic Fibrosis Care as a model for chronic disease care in the clinic. A presentation made on April 29, 2017 to the Wisconsin Chapter of the American Association of Medical Assistants at Lacrosse, WI.
THIS PRESENTATION INCLUDES DEFINITION, OVERVIEW, PATHOLOGY, CLINICAL FEATURES, ASSESSMENT AND PT MANAGEMENT OF CYSTIC FIBROSIS. THIS PPT WILL BE VERY USEFUL FOR FINAL YEAR BPT STUDENTS. IT COVERS BASIC KNOWLEDGE REGARDING THE DISEASE AND ALLOWS BETTER UNDERSTANDING. IT IS MADE ONLY FOR LEARNING AND EXAM PURPOSE.
This presentation will surely help the general physicians and paediatricians to understand the symptoms of cystic fibrosis and will educate regarding various diagnostic modalities in cystic fibrosis
Peritoneal dialysis is the most common form of renal replacement therapy performed in the home. Peritoneal dialysis is the process of removing excess fluid and metabolic by-products from the body by circulating dialysis solution through the peritoneal cavity using a peritoneal catheter.
Management of parapneumonic effusion and empyemaDileep Benji
Any pleural effusion associated with bacterial pneumonia,lung abscess or bronchiectasis is defined as parapneumonic effusion.Presence of pus in pleural space is called empyema. Pathogenesis,bacteriology,clinical presentation,diagnosis,management has been described in this powerpoint presentation.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
2. Introduction
Family run genetic disorder of epithelial transport affecting
fluid secretion in exocrine glands & epithelial lining of
respiratory , gastrointestinal & reproductive system
Disfunction of CFTR protein (1480 AA ) – epithelial cells of
airways, GIT,sweat glands, genitourinary system)
Most prevalent mutation F508del
Inheritance :AR
Prevalence in western countries 1: 2500 new born
Asians 1: 31000 live birth
3. PATHOPHYSIOLOGY
• CFTR - ion channel that moves chloride and
bicarbonate ions into the extracellular space.
• This adjusts the viscosity of mucous and other
fluids that line the lungs, intestines, pancreas, bile
ducts of the liver, and reproductive tracts.
• In cystic fibrosis , the mucous becomes thick and
hard to move
4. F508 MUTATION
• Mutation in the gene for the CFTR protein. The
mutation deletes three nucleotides that code for
phenylalanine.
• Causes a person to produce CFTR without
phenylalanine
• CFTR protein breaks down because of its
abnormality
9. New born screening
• Immune reactive trypsinogen / DNA testing on blood
spot- single detected mutation
• Confirmatory sweat analysis
• Screening test is 95% sensitive (median age of
diagnosis 1m)
• Improve early nutritional deficiencies, long term
growth & improve cognitive function
10. Diagnostic criteria
• Two elevated sweat chloride on separate days(≥60 mEq/L) plus
any one
• Presence of typical clinical features including respiratory &
Gastrointestinal
• History of cystic fibrosis in sibling
• Laboratory evidence for CFTR dysfunction
• Identification of 2 CFTR mutations
• An abnormal nasal potential difference measurement
13. Diagnosis
• Gold standard for
diagnosis is the
sweat chloride test
(pilocarpine
iontophoresis)
• Test used to induce
sweating then the
sweat electrolytes are
measured
14. Positive Sweat chloride test
• For infants up to 6 months of age
– Chloride levels of:
– Less than 29 mmol/L=CF is very unlikely
– 30-59 mmol/L= CF is possible
– Greater than 60 mmol/L= CF to be diagnosed
• For people older than 6 months of age
– Chloride levels of:
– Less than 39 mmol/L= CF is very unlikely
– 40-59 mmol/L= CF is possible
– Greater than 60 mmol/L= CF to be diagnosed
15. Diagnosis
Other Tests
• Prenatal Screening
– Genetic testing can show if the fetus has CF
– Amniocentesis- removing small amounts of fluid from the sac around the baby
– Tested to see if the CFTR genes are normal
– Chorionic villus testing- removing a tissue sample from placenta to test for CF
• Chest x ray
• Sinus x-ray
• Lung function tests
• Sputum culture
• Trypsin and chymotrypsin in stool
16. Mutation analysis
Gene for cystic fibrosis has been identified on chromosome 7
Caucasian populations the commonest mutation is DF508 and accounts for
approximately 70% of all CF genes
Over 90% of CF mutations can be identified if a patient’s blood is tested for
a panel of 70 mutations in the general population of the United States
The panel of most common mutations for Indian patients is not yet known.
Small studies indicate that the proportion of patients with DF508 may be 19-
44%
Facilities for identification of CF mutations are not readily available in India.
However attempts should be made to identify mutations by sending the
patient or a blood sample to centers carrying out CF mutation testing for
further evaluation where appropriate.
17. Abnormality in blood biochemistry
and acid base status
• Low or low normal serum sodium.
• Metabolic alkalosis and hypochloremia.
• Anemia can occur along with hypoalbuminemia and
ascites as a result of vitamin E deficiency and
protein malabsorption.
• Also the routine blood count may show signs
suggestive of bacterial infection
18. Airway bacterial colonization and
infection
• Isolation of P. aeruginosa or Burkholdelia cepacia from
sputum or cough swabs is suggestive of a CF diagnosis
• All children suspected of having CF should have
specimens sent for microbiological culture
• Older children should have sputum specimens sent
regularly for culture.
• Young children and infants secretions from the airways
obtained after saline inhalation and physiotherapy or
a cough swab should therefore be cultured.
19. Pancreatic function tests
• Cystic fibrosis is the commonest cause of exocrine
pancreatic deficiency below 20 years of age
• Measurement of stool pancreatic elastase-1 has been
reported as a sensitive and specific test
• Semi quantitative estimates of intestinal fat
malabsorption can be made using either faecal
microscopy or faecal steatocrit
• Glycosylated hemoglobin, urine glucose levels ,OGTT
are sufficiently sensitive
20. Obstructive azoospermia
• In post pubertal boys, a semen analysis for
azoospermia can be carried out.
• Sperms are absent in up to 98% of men with
cystic fibrosis
21. Radiological imaging
• X-ray films of chest may show hyperinflation, peribronchial
thickening, cystic changes and lobar or segmental collapse.
• The findings on CT include cystic or varicose bronchiectasis,
peribronchial thickening, segmental collapse, mucus
impaction and sub pleural bullae formation.
• The imaging studies of sinuses may show delayed
pneumatization or mucosal thickening.
• These investigations are more useful for monitoring
diagnosed patients.
22. Pulmonary function test
• Primary used for research
• Can be tried from 4y , routinely by age 6.
• FEV1 correlate most
• Gradual decline avg 2-3% per year
• Restrictive changes denoted by declining TLC, VC –
extensive lung injury ,fibrosis and are late findings
23. TREATMENT
• No cure for cystic fibrosis
• Treatment ease symptoms and reduce complications
• Goal :
preventing /controlling lung infection
loosening & removing mucus from lungs
preventing /treating intestinal blockage
providing adequate nutrition
24. MEDICATIONS
• Antibiotics
• Mucous thinning drugs to cough out mucus
• Bronchodilators to keep airway open
• Corticosteroids to reduce inflammation in ABPA,
severe asthma
• Oral pancreatic enzymes for digestion- reduce but
not correct stool fat & nitrogen loss
25. Pulmonary therapy
• Inhalational therapy –
Human recombinant DNAse(25mg) , single daily aerosol dose
Enzymatically dissolves extracellular DNA released by
neutrophils, improves symptoms
Improvement is sustained for 1y or longer with continuous
therapy
Nebulized hypertonic saline – hyperosmolar, draw water into
airway and rehydrate mucus. 2-4 times daily increase mucous
clearance
26. Airway clearance therapy(Chest physiotherapy)
• Inflatable vest: a device worn around the chest that
vibrates at high frequency
• Airway clearance with chest percussion
• Recommended 2- 4 times a day
• Breathing devices: a tube or mask to exhale while
performing breathing exercises
• Cessation of PT results in worsening of lung function
within 3 wks
32. Antibiotic therapy
• Mainstay of treatment to control infection
• To delay lung damage
• Intermittant short course 1 antibiotics to continuous 1 or 2 antibiotics
needed
• Dose may be 2-3 times amount needed for normal infection
• Usual course of therapy 2 wks
• Common organisms – MRSA, MSSA, nontypeable H.influenza, P.
Aeruginosa, other gram negative rods
• Azithromycin 3 times a week improves lung function in chronic P.
aeruginosa
33. Aerosolized antibiotic therapy
• Tobramycin, Aztreonam- 1m then off 1m
• Liposomal amikacin, levofloxacin
• All effective against P . Aeruginosa
• For eradication of organism, reduce symptoms,
improve pulmonary function, decrease the
occurrence of pulmonary exacerbation
34. Intravenous antibiotic therapy
• Not responding to oral antibiotics
• Ideal duration of treatment unknown
• Shows response in 1wk , extent treatment to min 2 wks
• 2 drug therapy
• Infection control in health setting to prevent spread of resistant bacterial
organisms
• H. influenza,P.Aeruginosa,Burkholderia- mox ciprofloxacin, azithro, erythromycin
• S. aureus- vancomycin , naficillin, dicloxacillin, clindamycin,linezolid
• P.Aeruginosa- tobra, amikacin,piperacillin,Meropenem
35. Bronchodilator therapy
• Reactive airway obstruction occurs in association
with frank asthma , ABPA
• Reversible obstruction – improvement ≥ 12% in
FEV1 or FVC after inhalation of bronchodilator
• 5-10%(physiologic response)
36. Antiinflammatory agents
• Corticosteroids useful for ABPA & severe asthma
• Ibuprofen with peak serum concentration 50-
100mcg – slowing of disease progression
• Macrolide antibiotics have antiinflammatory effect-
3 days / wk reduce pulmonary exacerbation
especially with pseudomonas infection
37. CFTR modulator therapies
• Ivacaftor:
– Activates CFTR G551D mutant protein , a class 3
CFTR mutation
• Ivacaftor & Tezacaftor indicated for ≥ 12y with 1 or 2
phe F508 del mutation
• Ivacaftor with Lumocaftora connector , stabilise
misfolded F 508
Available for > 6y old with F508 mutation
38. Surgical procedures
• Endoscopy & Lavage : Mucus suctioned from
obstructed airway by endoscope
• Bowel surgery: may need surgery to remove
blockage in bowel.
39. • Aerobic training is essential to increase VO2
peak
• Median survival after lung transplantation is
2.84 years, last resort
40. MNT in Cystic Fibrosis
• Monitor ongoing nutrition status
• Supply pancreatic enzyme replacement therapy
(PERT)
• Meet increased energy requirements
• Provide vitamin/mineral supplements
41. Pancreatic Enzyme Replacement Therapy..... (PERT)
• PERT is first step taken to correct maldigestion
/malabsorption.
• Microspheres are taken orally, designed to
withstand the acidic stomach, and release
enzymes in the duodenum for digestion of
macronutrients.
• Monitoring fecal elastase, fecal fat, or nitrogen
balance may help evaluate adequate enzyme
dosage and efficacy.
42. Macronutrient needs
• CHO needs:
needs change as disease progresses
CF patients may develop lactose intolerances
• Protein needs:
Slightly increased, but 15--20% should meet DRI for protein
requirements
• FAT needs:
CF patients have increased fat needs; 35-40% of total kcals
(especially sources of EFA)
Check for EFA deficiencies in regular lipid profiles
Also watch for fat-soluble vitamin deficiencies since there is likely
fat malabsorption.
Fat intolerances found in stool samples.
43. Specific Vitamin Recommendations
• Water soluble vitamins:
Adequately absorbed; requirements are met by diet and
multivitamin/mineral supplement.
• Fat soluble vitamins:
Usually inadequately absorbed (fat malabsorption)
Low serum vitamin A - impaired mobilization and transportation from
liver.
Decreased vitamin D - related to decreased bone mineral content
Low vitamin E - hemolytic anemia and abnormal neurologic findings.
Vitamin K deficiency - secondary to antibiotics or liver disease.
44. Mineral needs
• Intake should meet CF patients gender / age
recommendations.
• Minerals to watch:
• Na requirements increase because increased
losses in sweat..
45. Minerals to watch (cont)
• Calcium - watch for decreased bone mineralization
during childhood esp.
• Iron - check yearly in children, and monitor hgb
and hct
• Zinc - decreased absorption and increased zinc in
stools (esp in children and infants). Also related to
vitamin A levels.
46. PROGNOSIS
• Remains life limiting disorder
• Survival dramatically improved – remain relatively
healthy into adolescence and adulthood
• Median cumulative survival 40y
• Should not restrict their activities
• Anxiety and depression are prevalent – both is now part
of comprehensive care
• With appropriate medical & phychosocial support
children with CF cope well
In the first part of the test, a colorless, odorless chemical that causes sweating is applied to a small area on an arm or leg. An electrode is then attached to the arm or leg. A weak electrical current is sent to the area to stimulate sweating.
People may feel a tingling in the area, or a feeling of warmth. This part of the procedure lasts for about 5 minutes.