A case-control study of the effects of Aspergillus clinical phenotypes on pulmonary functions in patients with cystic fibrosis.

INTRODUCTION: There are no precise data about the effect of Aspergillus infection on lung function other than allergic bronchopulmonary aspergillosis (ABPA) in patients with cystic fibrosis (pwCF). Here, we aimed to determine clinical phenotypes caused by Aspergillus spp. using laboratory and immunologic parameters and to compare Aspergillus phenotypes in terms of pulmonary function tests (PFT) prospectively. METHODS: Twenty-three pwCF who had Aspergillus isolation from respiratory cultures in the last year (case group) and 20 pwCF without Aspergillus isolation in sputum (control group) were included. Aspergillus immunoglobulin (Ig)-G, Aspergillus IgE, Aspergillus polymerase chain reaction (PCR), galactomannan, total IgE from blood samples, and Aspergillus PCR and galactomannan from sputum, and skin prick test reactivity to Aspergillus antigen were used to distinguish different Aspergillus phenotypes. Pulmonary functions and frequency of pulmonary exacerbations were evaluated during a 1-year follow-up. RESULTS: Of 23 pwCF, 11 (47.8%) had Aspergillus colonization, nine (39.1%) had Aspergillus bronchitis, and three (13%) had ABPA. Aspergillus infection was not associated with worse z-scores of forced expiratory volume in the first second (FEV1) (p = 0.612), forced vital capacity  (p = 0.939), and the median FEV 1% decline (0.0%/year vs. -4.7%/year, p = 0.626). The frequency of pulmonary exacerbations in the Aspergillus infected and noninfected groups was similar. CONCLUSION: Although Aspergillus spp. Isolation in pwCF was not associated with decreased lung function, a further decline was seen in the ABPA subgroup, and frequent pulmonary exacerbations during the 1-year follow-up.

The Reliability and Validation of the Turkish Version of the Asthma Self-Management Knowledge Questionnaire.

OBJECTIVES: There is no validated questionnaire in Turkish to assess asthma knowledge. In this study, we aimed to evaluate the reliability and validity of the Turkish version of the Asthma Self-Management Knowledge Questionnaire (AKQ) among asthmatic adults. MATERIAL AND METHODS: The AKQ was translated into Turkish by two medical-text translators, followed by back translation and final review by two clinicians with experience in asthma management. The Turkish Asthma Self-Management Questionnaire was then applied to 202 adult asthma patients, and additional demographic and clinical features of the patients were collected for analysis. RESULTS: The internal reliability of the 24-item AKQ was not high (Cronbach's alpha=0.55). Tukey's test of additivity was significant (p<0.001). This result revealed that all questions are consistent and measure the same concepts. Factor analysis demonstrated a probable structure of 10 factors that together explained 63.7% of total variance in results. Intra-class reliability of the AKQ was quite high. CONCLUSION: This study shows that AKQ seems to be a suitable instrument to evaluate the effect of different components of asthma knowledge - such as triggers, medications, asthma exacerbations, and avoidance measures - in adult asthmatics.