RESUMO
BACKGROUND: Vitamin A deficiency with eye symptoms has been reported in patients with cystic fibrosis who received the recommended daily intake of vitamin A. METHODS: We measured serum retinol, dark adaptation, contrast sensitivity, and dry eye status in 35 adult cystic fibrosis patients to ascertain whether they had ocular signs or symptoms. RESULTS: Median serum retinol concentration was 1.95 mumol/l, range 1.08-4.01 mumol/l, with no values indicating vitamin A deficiency. Retinal light sensitivity was normal. Nineteen patients had reduced contrast sensitivity. Conjunctival imprints all showed plenty of goblet cells, but were characteristic of dry eye in 42% of patients (n = 14). Decreased tear film stability was found in 49% (n = 17), tear production was low in 31% (n = 11), and 23% (n = 8) showed an increased amount of dying epithelial cells. Nine patients (26%) had keratoconjunctivitis sicca according to the Copenhagen criteria. CONCLUSION: Our patients had no biochemical or clinical signs of vitamin A deficiency. We speculate that the high incidence of dry eye could be a primary manifestation of cystic fibrosis.
Assuntos
Fibrose Cística/complicações , Ceratoconjuntivite Seca/etiologia , Cegueira Noturna/tratamento farmacológico , Deficiência de Vitamina A/tratamento farmacológico , Vitamina A/uso terapêutico , Xeroftalmia/tratamento farmacológico , Adolescente , Adulto , Defeitos da Visão Cromática/etiologia , Túnica Conjuntiva/patologia , Sensibilidades de Contraste , Fibrose Cística/sangue , Adaptação à Escuridão , Feminino , Humanos , Incidência , Masculino , Cegueira Noturna/sangue , Cegueira Noturna/etiologia , Vitamina A/sangue , Deficiência de Vitamina A/sangue , Deficiência de Vitamina A/etiologia , Xeroftalmia/sangue , Xeroftalmia/etiologiaRESUMO
A survey of Staphylococcus aureus lung infection in 243 patients with cystic fibrosis (CF) was conducted between 1986 and 1988. A total of 217 patients (89%) received 1605 courses of anti-staphylococcal therapy given during this period. The majority of courses comprised combined therapy with two anti-staphylococcal drugs. The combination of dicloxacillin and fusidic acid was employed most frequently. Some patients were given other anti-staphylococcal regimens, because of penicillin allergy (14 cases) or dyspeptic side effects with fusidic acid (21 patients). A small but significant increase in precipitins against S. aureus was observed during the study period. Bacterial resistance to the anti-staphylococcal drugs used remained at a low level (strains resistant to methicillin less than 0.1%, strains resistant to fusidic acid 1.2%). When the isolates were compared with 56,140 strains of S. aureus isolated from non-CF patients hospitalized in Denmark over the same period, no differences in phagetypes or in antibiotic resistance were seen, indicating that selection of strains and cross infection do not seem to be a major problem in CF patients.