Quality of life in adults with cystic fibrosis: the Greek experience

INTRODUCTION: Recent developments in treatment have steadily raised the median predicted age of survival for people with Cystic Fibrosis (CF). We report the health-related quality of life (HRQoL) in CF adult patients and correlate our findings with the patients’ demographic characteristics. MATERIAL AND METHODS: The Cystic Fibrosis Quality of Life (CFQoL) questionnaire was answered by 77 CF adult patients. The questionnaire included questions pertaining to age, sex and level of education and covered eight sections of functioning. RESULTS: The highest score was reported in the “Social Functioning” section, while the lowest in the “Concerns for the Future” section. When different age groups were compared, statistical significances were reported in “Physical Functioning”, “Interpersonal Relationships”, and the “Career Concerns” section, with older patients reporting statistically higher HRQoL scores than younger ones (p < 0.005). No statistically significant difference was reported amongst the scoring between male and female CF patients. When different educational levels were compared, patients that had received a higher educational training scored statistically higher in all but one sections of the questionnaire when compared with patients of a lower educational level (p < 0.005). CONCLUSION: More than half Greek adult CF patients report that they are capable to participate in social activities but most of them are worried about the outcome of their disease and its effect on their lives.INTRODUCTION: Recent developments in treatment have steadily raised the median predicted age of survival for people with Cystic Fibrosis (CF). We report the health-related quality of life (HRQoL) in CF adult patients and correlate our findings with the patients’ demographic characteristics. MATERIAL AND METHODS: The Cystic Fibrosis Quality of Life (CFQoL) questionnaire was answered by 77 CF adult patients. The questionnaire included questions pertaining to age, sex and level of education and covered eight sections of functioning. RESULTS: The highest score was reported in the “Social Functioning” section, while the lowest in the “Concerns for the Future” section. When different age groups were compared, statistical significances were reported in “Physical Functioning”, “Interpersonal Relationships”, and the “Career Concerns” section, with older patients reporting statistically higher HRQoL scores than younger ones (p < 0.005). No statistically significant difference was reported amongst the scoring between male and female CF patients. When different educational levels were compared, patients that had received a higher educational training scored statistically higher in all but one sections of the questionnaire when compared with patients of a lower educational level (p < 0.005). CONCLUSION: More than half Greek adult CF patients report that they are capable to participate in social activities but most of them are worried about the outcome of their disease and its effect on their lives

Perinatal Changes of Cardiac Troponin-I in Normal and Intrauterine Growth-Restricted Pregnancies

Intrauterine growth restriction (IUGR) implies fetal hypoxia, resulting in blood flow redistribution and sparing of vital organs (brain, heart). Serum cardiac Troponin-I (cTnI), a well-established marker of myocardial ischaemia, was measured in 40 mothers prior to delivery, the doubly clamped umbilical cords (representing fetal state), and their 20 IUGR and 20 appropriate-forgestational-age (AGA) neonates on day 1 and 4 postpartum. At all time points, no differences in cTnI levels were observed between the AGA and IUGR groups. Strong positive correlations were documented between maternal and fetal/neonatal values (r ≥ .498, P ≤ .025 in all cases in the AGA and r ≥ .615, P ≤ .009 in all cases in the IUGR group). These results may indicate (a) normal heart function, due to heart sparing, in the IUGR group (b) potential crossing of the placental barrier by cTnI in both groups

Cord Blood Ischemia-Modified Albumin Levels in Normal and Intrauterine Growth Restricted Pregnancies

Ischemia-modified albumin (IMA) is a sensitive biomarker of cardiac ischemia. Intrauterine growth restriction (IUGR) may imply fetal hypoxia, resulting in blood flow centralization in favour of vital organs (brain, heart, adrenals—“brain sparing effect”). Based on the latter, we hypothesized that cord blood IMA levels should not differ between IUGR and appropriate-for-gestational-age (AGA) full-term pregnancies. IMA was measured in blood samples from doubly-clamped umbilical cords of 110 AGA and 57 asymmetric IUGR pregnancies. No significant differences in IMA levels were documented between AGA and IUGR groups. IMA levels were elevated in cases of elective cesarean section (P = .035), and offspring of multigravidas (P = .021). In conclusion, “brain sparing effect” is possibly responsible for the lack of differences in cord blood IMA levels at term, between IUGR and AGA groups. Furthermore, higher oxidative stress could account for the elevated IMA levels in cases of elective cesarean section, and offspring of multigravidas

Reply to Ghirardello et al Letter to the Editor

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A multi-criteria sustainability assessment framework: development and application in comparing two food waste management options using a UK region as a case study

This is a post-peer-review, pre-copyedit version of an article published in Environmental Science and Pollution Research. The final authenticated version is available online at: https://doi.org/10.1007/s11356-018-2479-

Breastfeeding reduces the risk of obesity in childhood and adolescence

Childhood obesity has increased dramatically over the last decades, representing one of the most serious public health hazards of the 21st century. Efforts must be made by healthcare professionals to prevent it, as it is associated with short- and long-term risks for physical and mental health and because of the increased possibility to persist during adulthood. From antiquity human breast milk was considered the ideal nourishment for the newborn. Breastfeeding is beneficial for the mother-child dyad. Among others, existing data suggest that it reduces the risk for childhood and adolescence obesity. The mechanisms for this are numerous and include the feeding behavior breastfeeding infants acquire, their growth rate, the ‘early protein hypothesis’, the role of leptin that is found in increased levels in human milk, the dietary choices the breastfed infants make during childhood and adolescence and finally the differences in their bowel flora. Meta-analyses provide sufficient evidence for this protective effect, with a dose-response effect as to the duration of breastfeeding. Healthcare professionals involved in the care of the mother-infant dyad must encourage and support mothers to breastfeed their infants for a long period of time, if obesity were to be prevented. Aim of this review is to provide an account of existing data on the association of breastfeeding and the reduced risk of obesity in childhood and adulthood

Congenital diaphragmatic hernia and double-outlet right ventricle: elements of trisomy 18?

We present a case of a term male neonate born with congenital diaphragmatic hernia (CDH), double-outlet right ventricle (DORV) and a “picture of genetic syndrome”, antenatally diagnosed, without any confirmation of a particular syndrome as no amnioparacentesis was performed. The postnatal chromosomal analysis revealed trisomy 18

Jakość życia u dorosłych chorych na mukowiscydozę — doświadczenia greckie

WSTĘP: Postępy w leczeniu spowodowały stabilny wzrost mediany przewidywanego czasu przeżycia chorych na mukowiscydozę. W prezentowanej pracy zbadano jakość życia zależną od zdrowia (HRQoL, health-related quality of life) u dorosłych chorych na mukowiscydozę, a wyniki skorelowano z danymi demograficznymi. MATERIAŁ I METODY: Użyto kwestionariusza jakości życia dla chorych na mukowiscydozę (CFQoL, Cystic Fibrosis Quality of Life). Kwestionariusz zawierał pytania dotyczące wieku, płci, wykształcenia i obejmował osiem sekcji oceniających różnorodne funkcje życiowe. W grupie badanej znalazło się 77 dorosłych chorych na mukowiscydozę. WYNIKI: Najwyższą punktację uzyskano w sekcji „Funkcje społeczne” a najniższą w sekcji „Troska o przyszłość”. Gdy porównano różne grupy wiekowe, różnice znamienne statystycznie uzyskano w sekcjach „Funkcjonowanie fizyczne”, „Relacje interpersonalne” oraz „Obawy związane z karierą”, a starsi pacjenci uzyskiwali statystycznie wyższą punktację w kwestionariuszu HRQoL niż młodsi (p < 0,005). Nie stwierdzono różnic pomiędzy kobietami i mężczyznami. Pacjenci o wyższym poziomie edukacji uzyskiwali znamiennie wyższą punktację (p < 0,005). WNIOSKI: Więcej niż połowa greckich chorych na mukowiscydozę deklaruje gotowość do podejmowania społecznej aktywności, ale większość obawia się o odległe rokowanie i wpływ choroby na ich życie.WSTĘP: Postępy w leczeniu spowodowały stabilny wzrost mediany przewidywanego czasu przeżycia chorych na mukowiscydozę. W prezentowanej pracy zbadano jakość życia zależną od zdrowia (HRQoL, health-related quality of life) u dorosłych chorych na mukowiscydozę, a wyniki skorelowano z danymi demograficznymi. MATERIAŁ I METODY: Użyto kwestionariusza jakości życia dla chorych na mukowiscydozę (CFQoL, Cystic Fibrosis Quality of Life). Kwestionariusz zawierał pytania dotyczące wieku, płci, wykształcenia i obejmował osiem sekcji oceniających różnorodne funkcje życiowe. W grupie badanej znalazło się 77 dorosłych chorych na mukowiscydozę. WYNIKI: Najwyższą punktację uzyskano w sekcji „Funkcje społeczne” a najniższą w sekcji „Troska o przyszłość”. Gdy porównano różne grupy wiekowe, różnice znamienne statystycznie uzyskano w sekcjach „Funkcjonowanie fizyczne”, „Relacje interpersonalne” oraz „Obawy związane z karierą”, a starsi pacjenci uzyskiwali statystycznie wyższą punktację w kwestionariuszu HRQoL niż młodsi (p < 0,005). Nie stwierdzono różnic pomiędzy kobietami i mężczyznami. Pacjenci o wyższym poziomie edukacji uzyskiwali znamiennie wyższą punktację (p < 0,005). WNIOSKI: Więcej niż połowa greckich chorych na mukowiscydozę deklaruje gotowość do podejmowania społecznej aktywności, ale większość obawia się o odległe rokowanie i wpływ choroby na ich życie

Gestational Diabetes Melitus and Cord Blood Platelet Function Studied via the PFA-100 System

Neonatal platelet hemostasis, although it has been well described over the recent years, remains elusive in specific patient populations, including neonates from high-risk pregnancies, such as those complicated with gestational diabetes mellitus (GDM). We aimed at evaluating the platelet function of neonates born to mothers with GDM using the platelet function analyzer (PFA-100). Cord blood samples were drawn from each subject and tested with two different agonists to provide two closure time (CT) values (collagen with epinephrine (COL/EPI) and collagen with adenosine diphosphate (COL/ADP)). A total of 84 and 118 neonates formed the GDM and the control group (neonates from uncomplicated pregnancies), respectively. COL/EPI CTs were prolonged in neonates from the GDM group compared to neonates from the control group, while no statistically significant difference of COL/ADP CTs was noted between the two groups, GDM and the control. Higher COL/ADP CTs were demonstrated in neonates born via cesarean section and in neonates with blood group O. A negative correlation between COL/ADP CT and gestational age, white blood cells (WBCs) and von Willebrand factor (VWF) activity was noted in neonates from the GDM group. In conclusion, neonates from the GDM group demonstrate a more hyporesponsive phenotype of their platelets, in comparison to the control neonates