Spurious hyperphosphatemia in a patient with alteplase-locked central venous catheter

Alteplase has been shown to be effective in preventing central venous access clotting in patients on hemodialysis. Because of a high phosphorus content in its excipient, it can inadvertently contaminate blood samples, leading the physician in care of the patient to erroneously increase dialysis time or change diet in order to control the pseudo-hyperphosphatemi

Improved lung function using a therapeutic educational multidisciplinary program in a pediatric cystic fibrosis clinic

Background: Pulmonary disease remains the most common cause of morbidity and mortality in cystic fibrosis. The clearing of mucus by chest physiotherapy is a major keystone of treatment. Daily therapy is time consuming, with respiratory therapy, inhalation therapy and a lot of medications to be taken all day long. Treatment burden becomes always a reason for intra-familial conflicts and stress. Adherence to treatment is a main issue, and influences the efficiency of physiotherapy and inhalation Objective: The objective was to implement and evaluate TPE in a pediatric cystic fibrosis consultation. Method: Open interventional study in patient  ≥ 6 years of age. Patients were followed on their regular 3-month basis over 2 years. Interventional education by cystic fibrosis physician and nurse took place at each visit with assessment once yearly. At visit 1, a contract defining the content of the educational program was discussed. Primary endpoint: Evolution of FEV1 and FEF25-75%. Secondary endpoint: Evaluation of disease knowledge and quality of life (CFQR®). At the end of the study we tested the knowledge about nutritional aspects of the disease in the study group. Results: Out of 32 patients from 6 to 16 years, 17 accepted the study. FEV1% predicted increased 5.3% in the intervention group. Conclusion: Using TPE, there is a clear trend to improve lung functions (+2.65% annual rate of change of FEV1% predicted). TPE could be an important strategy to stabilize lung function