Asthma and COPD in cystic fibrosis intron-8 5T carriers. A population-based study

BACKGROUND: Carriers of cystic fibrosis intron-8 5T alleles with high exon-9 skipping could have increased annual lung function decline and increased risk for asthma or chronic obstructive pulmonary disease (COPD). METHODS: We genotyped 9131 individuals from the adult Danish population for cystic fibrosis 5T, 7T, 9T, and F508del alleles, and examined associations between 11 different genotype combinations, and annual FEV(1 )decline and risk of asthma or COPD. RESULTS: 5T heterozygotes vs. 7T homozygous controls had no increase in annual FEV(1 )decline, self-reported asthma, spirometry-defined COPD, or incidence of hospitalization from asthma or COPD. In 5T/7T heterozygotes vs. 7T homozygous controls we had 90% power to detect an increase in FEV(1 )decline of 8 ml, an odds ratio for self-reported asthma and spirometry-defined COPD of 1.9 and 1.7, and a hazard ratio for asthma and COPD hospitalization of 1.8 and 1.6, respectively. Both 5T homozygotes identified in the study showed evidence of asthma, while none of four 5T/F508del compound heterozygotes had severe pulmonary disease. 7T/9T individuals had annual decline in FEV(1 )of 19 ml compared with 21 ml in 7T homozygous controls (t-test:P = 0.03). 6.7% of 7T homozygotes without an F508del allele in the cystic fibrosis transmembrane conductance regulator gene reported asthma vs. 11% of 7T/9T individuals with an F508del allele (χ(2):P = 0.01) and 40% of 7T homozygotes with an F508del allele (P = 0.04). 7T homozygotes with vs. without an F508del allele also had higher incidence of asthma hospitalization (log-rank:P = 0.003); unadjusted and adjusted equivalent hazard ratios for asthma hospitalization were 11 (95%CI:1.5–78) and 6.3 (0.84–47) in 7T homozygotes with vs. without an F508del allele. CONCLUSION: Polythymidine 5T heterozygosity is not associated with pulmonary dysfunction or disease in the adult Caucasian population. Furthermore, our results support that F508del heterozygosity is associated with increased asthma risk independently of the 5T allele

Associations between adherence, depressive symptoms and health-related quality of life in young adults with cystic fibrosis

BACKGROUND: Cystic fibrosis (CF) is a life shortening disease, however prognosis has improved and the adult population is growing. Most adults with cystic fibrosis live independent lives and balance the demands of work and family life with a significant treatment burden. The aim of this study was to examine the relationships among treatment adherence, symptoms of depression and health-related quality of life (HRQoL) in a population of young adults with CF. METHODS: We administered three standardized questionnaires to 67 patients with CF aged 18–30 years; Morisky Medication Adherence Scale, Major Depression Inventory, and Cystic Fibrosis Questionnaire-Revised. RESULTS: There was a response rate of 77 % and a majority of the young adults (84 %) were employed or in an education program. Most participants (74 %) reported low adherence to medications. One third (32.8 %) of the participants reported symptoms of depression. HRQoL scores were especially low on Vitality and Treatment Burden, and symptoms of depression were associated with low HRQoL scores (p < 0.01) with medium to large deficits across on all HRQoL domains (Cohen’s d 0.60–1.72) except for the domain treatment burden. High depression symptom scores were associated with low adherence (r = −0.412, p < 0.001). CONCLUSIONS: Despite improved physical health, many patients with CF report poor adherence, as well as impaired mental wellbeing and HRQoL. Thus, more attention to mental health issues is needed

Corrida em piscina funda: limites e possibilidades para o alto desempenho Velocidad en piscina de profundidad: límites y posibilidades para un alto desempeño Deep water running: limits and possibilities for high performance

O objetivo deste estudo foi analisar os limites e possibilidades da utilização da corrida em piscina funda no treinamento de corredores de rendimento. Além disso, são discutidas as respostas agudas submáximas, máximas e crônicas, do ponto de vista fisiológico e biomecânico entre a corrida em terra e em piscina funda. As respostas máximas de freqüência cardíaca e consumo de oxigênio são menores no exercício aquático do que na corrida terrestre. Dados experimentais sugerem o uso do treinamento de corrida em piscina funda para corredores de rendimento; contudo, essas evidências são limitadas para treinamentos de até 10 semanas.<br>El objetivo de este estudio ha sido el de analizar los límites y posibilidades de la utilización de carreras de velocidad en piscina de profundidad durante el entrenamiento de velocista de rendimiento. Además de esto, son discutidas las respuestas agudas submáximas, máximas y crónicas, bajo el punto de vista fisiológico y biomecánico entre la carrera en tierra y en piscina profunda. Las respuestas máximas de frecuencia cardíaca y consumo de oxígeno son menores en el ejercicio acuático que en la de tierra. Datos experimentales sugieren el uso de entrenamiento de carrera en piscina profunda para velocistas de rendimiento, sin embargo estas evidencias son limitadas a entrenamientos de hasta 10 semanas.<br>The purpose of this study was to analyze the limits and possibilities of deep water running on training of performance runners. Besides, it has been discussed the submaximal acute, maximal acute and chronical responses, following physiological and biomechanical aspects between running on land and deep water running. Heart rate and oxygen uptake's maximal responses are lower in aquatic exercise than in running on land. Experimental evidences suggest the deep water running training for performance athletes, but these studies are limited in training program until ten weeks