Search

Background: Cough and sputum are major symptoms in cystic fibrosis (CF) that contribute to the impairment of quality of life., Methods: This prospective single centre cross-sectional pilot study aimed to evaluate the results of a self-administered questionnaire assessing cough and sputum symptoms (2 domains), and their impact (2 domains) on daily activities in the previous week, named the Cough and Sputum Assessment Questionnaire (CASA-Q) in CF adult patients at stable state, and to analyse associations with clinical, functional, microbiological, radiological data, and two quality of life scales: the Cystic Fibrosis Questionnaire Revised (CFQ-R) and the Saint George Respiratory Questionnaire (SGRQ)., Results: Forty-eight patients were included in this analysis (69% men; median age of 27.8 ± 8.1 years; median body mass index of 21.8 + 3.3 kg/m²; mean FEV 1 of 64 ± 30% of the predicted value). The mean values of the CASA-Q domains were 58 ± 23 for cough symptoms, 77 ± 24 for cough impact, 62 ± 25 for sputum symptoms and 84 ± 21 for sputum impact. Impairment in CASA-Q cough and sputum domains was associated with dyspnea mMRC scale (p < 0.005 for all 4 domains of CASA-Q) and exacerbations in the previous year (p < 0.05 for CASA-Q symptoms domains). We also found correlations between all domains of the CASA-Q and quality of life questionnaires including SGRQ (p < 0.001) and to a lesser extend CFQ-R. We identified a clinical phenotype (female gender, ΔF508 heterozygous mutation, dyspnea mMRC scale) associated with an impairment of CASA-Q score and quality of life using a 2-step cluster analysis., Conclusions: CASA-Q allows the assessment of cough and sputum in CF adult patients and is associated with quality of life impairment. This simple easy-to-use tool could be used in routine clinical practice and in clinical studies to assess cough and sputum in CF patients., Trial Registration: The study was registered on ClinicalTrials.gov (NCT02924818, first posted on 5th October 2016)., (© 2023. The Author(s).)

Background: Cystic Fibrosis (CF) adult patients experience daily physical symptoms and disabilities that may impact their quality of life and mental health., Methods: This prospective study aimed to evaluate the relative contribution of the familial, occupational, and social environment, besides that of the main physical and mental health factors, to the quality of life of CF adult patients using the Cystic Fibrosis Questionnaire-Revised (CFQ-R) in a multivariate model., Results: Fifty patients were analyzed (70% of men; median age of 25 years; median body mass index of 21 kg/m²; median FEV1 of 57%). Anxiety and depression scores were negatively associated with 9 of the 12 CFQ-R domains. When controlling for anxiety and depression, FEV1% and BMI were significant positive predictors of several domains of the CFQ-R. All the familial, occupational, and social components analyzed but one (professional training) were predictors of at least one domain of the CFQ-R., Conclusion: Anxiety and depression explained a greater proportion of the variance than physical variables (age, sex, BMI, FEV1%, and exacerbation in the last year) in CF HRQoL. Many familial, occupational, and social components were also specifically and independently predictors of some HRQoL domains. Their screening might help identifying CF patients eligible for specific interventions, focusing on the impaired QoL dimensions.

Background: With the improvement of cystic fibrosis (CF) patient survival, the prevalence of long-term complications increased, among them rheumatologic disorders., Methods: The aim of this prospective study was to evaluate the prevalence of spinal and joint pain, and their impact on disability, anxiety, depression, and quality of life in CF adult patients., Results: Forty-seven patients were analyzed, 72% of men, mean aged 28 years, with a mean body mass index of 22 kg/m 2 and a mean FEV 1 % of 63%. Twenty-two patients (47%) described rheumatologic pain either spinal ( n = 15, 32%) and/or joint pain ( n = 14, 30%). Patients with spinal and/or joint pain were shorter ( p = 0.023), more frequently colonized with Staphylococcus aureus ( p < 0.008), had more frequent ΔF508 homozygous mutations ( p = 0.014), and a trend for more impairment of the 6-min walking distance ( p = 0.050). The presence of rheumatologic pain tended to be associated with disability according to the Health Assessment Questionnaire (HAQ) and anxiety. Compared with patients with no pain patients with both spinal and joint pain exhibited a more pronounced impact on the St George's Respiratory Questionnaire (SGRQ)., Conclusion: Rheumatologic pain is frequent in CF adult patients, and may affect daily living, anxiety and quality of life. Systematic assessment of rheumatologic pain should be included in the management of CF patients., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Schmoll, Launois, Perotin, Ravoninjatovo, Griffon, Carré, Mulette, Ancel, Hagenburg, Lebargy, Deslée, Salmon and Dury.)

Background: Adult patients with cystic fibrosis (CF) experience daily physical symptoms and disabilities that can be challenging to address for health care teams., Methods: We sought to identify the most frequent topics that CF adults need to discuss with health care teams using a custom questionnaire including 62 items., Results: Fifty patients were included, 70% men, mean age 27.6 years, with a mean body mass index of 21.8 kg/m 2 . Mean FEV 1 % was 64% of predicted value. Forty-two percent of patients selected at least one topic. The most frequently selected topics were fatigue (20%), professional or scholar worries (18%), procreation (16%), physical activities (16%) and evolution of CF disease (16%). Women were more frequently concerned about fatigue, procreation and profession/school., Conclusions: Using a custom questionnaire, we identified that CF adults express various unmet needs that extend beyond usual respiratory and nutritional concerns or treatment adherence. The interest of this questionnaire by health care team for improving therapeutic management of CF patients remains to be validated., Trial Registration: The study was registered on ClinicalTrials.gov (NCT02924818) on 5th October 2016., (© 2021. The Author(s).)

Rationale and Objectives: The increasing use of computed tomography (CT) has been accompanied by rising concerns over potential radiation-related health risks, especially cancer, and a need to minimize such risks., Materials and Methods: We conducted 2186 low-dose helical chest CT scans among 1235 nuclear weapons workers at elevated risk of lung cancer, setting the CT scanner tube current at 30 mAs for all participants with BMI <35 kg/m(2) and permitting technologists to raise mAs levels for participants with BMI ≥35 kg/m(2). Dose-length product (DLP) was recorded from the CT scanner, permitting calculation of effective dose. Phantom-based estimates of effective dose were also made. A chest radiologist recorded acceptability of image quality., Results: The study population was significantly overweight: 79% exceeded a body mass index (BMI) >25 kg/m(2) and 37.1% exceeded a BMI ≥30 kg/m(2). Nearly 90% of CT scans were performed using a tube current setting of 30 mAs and had a mean DLP-based effective dose of 1.3 mSv. The phantom-based estimate of effective dose was lower at 1.1 mSv. Among participants with a BMI ≥35 kg/m(2), 92% were scanned at 40 or 50 mAs, which was associated with a DLP-based effective dose of 1.6 and 2.0 mSv, respectively. Image quality was satisfactory in 99.8% of scans., Conclusion: Application of simple BMI-based guidelines and DLP tracking of low-dose helical chest CT scans in a lung cancer screening program minimizes radiation dose, even in a largely overweight population., (Copyright © 2012 AUR. Published by Elsevier Inc. All rights reserved.)