Prevalence and risk factors of functional gastrointestinal disorders in early period medical students: a pilot study in Tunisia.

Functional gastrointestinal disorders (FGIDs) are highly prevalent in medical students around the world. However, there is no specific data on FGIDs in Tunisia. The objectives of this study were to evaluate the prevalence of FGIDs in medical students according to the rome III criteria and to identify risk factors associated with these disorders. A self-administered questionnaire survey was carried out among the students from the first and the second year of medical studies. We studied the influence of socio-demographic characteristics, lifestyle, health care seeking, psychosomatic symptoms and hospital anxiety and depression scale on the prevalence of FGIDs among these students. Three hundred and forty-three students (20.3 ± 0.8years) were included in our study. The prevalence of FGIDs was 54.2%. The main FGIDs found were the unspecified functional bowel disorder (46.6%), functional constipation (11.6%), irritable bowel syndrome (7.6%) and functional dyspepsia (6.7%). In logistic regression, abnormal BMI (OR = 2.1, 95% CI= 1-4.3), living in school dormitory (OR = 3.7, 95% CI = 1.7-7.8), low water intake (OR = 2.2, 95% CI = 1.1-4.2), digestive medication use (OR = 3.4, 95% CI= 1.3-8.5), and probable or definite anxiety (OR = 2.5, 95% CI = 1.1-5.8) were the five risk factors associated with FGIDs. We demonstrate a high prevalence of FGIDs (54.2%) among our students. Risk factors for FGIDs were abnormal BMI, living in school dormitory, low water intake, digestive medication use and anxiety.

The 'clinically significant' bronchodilator responsiveness (BDR) in children: a comparative study between six definitions of scholarly societies and a mini-review.

Objective: To compare the percentages of children with and without airway obstruction (obstructive and non-obstructive groups, respectively) presenting a 'clinically significant' BDR according to the following definitions: GINA: FEV1 increase >12% predicted (∆Predicted), ATS/ERS: FEV1 increase ≥12% initial (∆Initial) and ∆FEV1 absolute (∆) ≥200 ml and/or ∆FVCInitial ≥12% and ∆FVC ≥200 ml, British thoracic society (BTS): ∆FEV1Initial ≥12%, National asthma education and prevention program (NAEPP): ∆FEV1Initial ≥12% and ∆FEV1 > 200 ml, Group of research on advances in pediatric pneumology: ∆FEV1Initial ≥12% or ∆PEFInitial ≥20%, and South African thoracic society (SATS): ∆FEV1Initial ≥12% or ∆FEV1 >200 ml and/or ∆FVCInitial ≥12% or ∆FVC >200 ml.Methods: This was a multicenter comparative study involving 278 children aged 6 to16 years: obstructive group (FEV1/FVC < lower-limit-of-normal, n = 116) and non-obstructive group (FEV1/FVC ≥ lower-limit-of-normal, n = 162). Spirometry was performed before/after a bronchodilator test. The Cochrane Q test was used to compare the percentage of responders according to the six definitions.Results: The percentages of responders among the obstructive [ranging from 51.72 (NAEPP) to 74.14% (SATS)] and the non-obstructive [ranging from 0.62 (NAEPP, BTS) to 8.64% (SATS)] groups were definition-dependent.Conclusion: In children, a 'clinically significant' BDR is definition-dependent.

How to Stage Airflow Limitation in Stable Chronic Obstructive Pulmonary Disease Male Patients?

No study has evaluated the utility of different classifications of chronic obstructive pulmonary disease (COPD) airflow limitation (AFL) in terms of the refined "ABCD" classification of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) or in terms of the impacts on quality of life. This study aimed to compare some relevant health outcomes (i.e., GOLD classification and quality-of-life scores) between COPD patients having "light" and "severe" AFL according to five COPD AFL classifications. It was a cross-sectional prospective study including 55 stable COPD male patients. The COPD assessment test (CAT), the VQ11 quality-of-life questionnaire, a spirometry, and a bronchodilator test were performed. The patients were divided into GOLD "A/B" and "C/D." The following five classifications of AFL severity, based on different post-bronchodilator forced expiratory volume in 1 s (FEV1) expressions, were applied: FEV1%pred: "light" (≥50), "severe" (<50); FEV1z-score: "light" (≥-3), "severe" (<-3); FEV1/height2: "light" (≥0.40), "severe" (<0.40); FEV1/height3: "light" (≥0.29), "severe" (<0.29); and FEV1Quotient: "light" (≥2.50), "severe" (<2.50). The percentages of the patients with "severe" AFL were significantly influenced by the applied classification of the AFL severity (89.1 [FEV1z-score], 63.6 [FEV1%pred], 41.8 [FEV1/height3], 40.0 [FEV1Quotient], and 25.4 [FEV1/height2]; Cochrane test = 91.49, df = 4). The CAT and VQ11 scores were significantly different between the patients having "light" and "severe" AFL. In GOLD "C/D" patients, only the FEV1Quotient was able to distinguish between the two AFL severities. To conclude, the five classifications of COPD AFL were not similar when compared with regard to some relevant health outcomes.