RESUMO
BACKGROUND: Enteral tube feeding (ETF) is often used in an attempt to optimize the nutritional status. The aim of this study was to observe the long term effect of ETF and to compare the start of ETF with the current European guidelines on nutrition care in CF. METHOD: From all patients who received ETF (ETFp) between February 2000 and September 2016 in the Ghent University Hospital (GUH) or Brussels University Hospital (BUH), z-scores for body weight (W), height (H), growth velocity (GV) and BMI, FEV1%, and FVC% were retrospectively collected from the patients' medical record, 3 years before and 5 years after the year of ETF initiation. Gender, age, and pancreatic status matched controls were selected from the GUH database. RESULTS: All baseline (T0) measurements in ETFp were worse compared to controls. Only 11% of the controls had a Hz < -1.6 compared 58% of the ETFp. After the initiation of ETF a rapid weight gain was noted until the second year (T + 2:-1.9 (-2.8; -1.0) vs. T0:-2.7 (-3.2; -2.1) (p = 0.01) with a stabilization afterwards. A rapid GVz increase was noted at T + 1:1.0 (-0.8; 1.9) vs. T0:-1.5 (-2.0;-0.3). After the start of ETF until T + 3, a stabilization of FEV1% was noted. However, compared to controls, it remained significantly lower (p < 0.05). CONCLUSION: ETF as a nutritional intervention has its effect on weight, height, GV, and BMI. To our knowledge this is the first study that describes the evolution of growth in ETFp. The effect on GV argues for a faster introduction of ETF in malnourished children with CF.
Assuntos
Fibrose Cística , Nutrição Enteral , Bélgica , Criança , Fibrose Cística/terapia , Humanos , Estado Nutricional , Estudos RetrospectivosRESUMO
Most episodes of vomiting, reduced intake and diarrhoea in children can be evaluated and treated without additional tests. However, when the degree of clinical dehydration is not in line with the patient's medical history, other diagnoses should be suspected. In the presence of a hyponatraemic hypochloraemic metabolic alkalosis, cystic fibrosis (CF) should be included in the differential diagnosis, especially if there is failure to thrive even in the absence of respiratory symptoms. Furthermore, young patients diagnosed with CF have a higher risk for an acute electrolyte decompensation caused by increased salt and fluid losses. We present 4 paediatric cases to raise the awareness of electrolyte disturbances in CF patients.
Assuntos
Alcalose , Fibrose Cística , Desidratação , Hiponatremia , Criança , Fibrose Cística/complicações , Desidratação/complicações , Insuficiência de Crescimento , Humanos , Hiponatremia/etiologia , VômitoRESUMO
Cystic fibrosis (CF) is a life-limiting disorder caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR). This defective chloride channel, present in different organ systems such as respiratory system, gastrointestinal tract, reproductive system and sweat glands, disturbs the ion and water transport over the membranes leading to the well known CF symptoms. CF has outgrown paediatric care, as half of CF patients are currently adults. The CF gastrointestinal tract has its own particularities. Some gastrointestinal manifestations are the direct consequence of the CFTR defect whilst others are secondary to treatment. The gastrointestinal diseases are classified according to the way they usually present in symptoms at diagnosis, acute and chronic abdominal pain and silently evolving conditions. (Acta gastroenterol. belg., 2016, 79, 481-486).
Assuntos
Fibrose Cística/complicações , Gerenciamento Clínico , Gastroenteropatias , Avaliação de Sintomas/métodos , Adulto , Criança , Gastroenteropatias/classificação , Gastroenteropatias/diagnóstico , Gastroenteropatias/etiologia , Gastroenteropatias/terapia , Humanos , Recém-NascidoRESUMO
In this paper, we address the problem of building reconstruction in high-resolution stereoscopic aerial imagery. We present a hierarchical strategy to detect and model buildings in urban sites, based on a global focusing process, followed by a local modeling. During the first step, we extract the building regions by exploiting to the full extent the depth information obtained with a new adaptive correlation stereo matching. In the modeling step, we propose a statistical approach, which is competitive to the sequential methods using segmentation and modeling. This parametric method is based on a multiplane model of the data, interpreted as a mixture model. From a Bayesian point of view the so-called augmentation of the model with indicator variables allows using stochastic algorithms to achieve both model parameter estimation and plane segmentation. We then report a Monte Carlo study of the performance of the stochastic algorithm on synthetic data, before displaying results on real data.