Intestinal dysbiosis has been observed in children with cystic fibrosis (CF), yet the functional consequences are poorly understood. We investigated the functional capacity of intestinal microbiota and inflammation in children with CF. Stool samples were collected from 27 children with CF and 27 age and gender matched healthy controls (HC) (aged 0.8–18 years). Microbial communities were investigated by iTag sequencing of 16S rRNA genes and functional profiles predicted using Tax4Fun. Inflammation was measured by faecal calprotectin and M2-pyruvate kinase. Paediatric CF gastrointestinal microbiota demonstrated lower richness and diversity compared to HC. CF samples exhibited a marked taxonomic and inferred functional dysbiosis when compared to HC. In children with CF, we predicted an enrichment of genes involved in short-chain fatty acid (SCFA), antioxidant and nutrient metabolism (relevant for growth and nutrition) in CF. The notion of pro-inflammatory GI microbiota in children with CF is supported by positive correlations between intestinal inflammatory markers and both genera and functional pathways. We also observed an association between intestinal genera and both growth z-scores and FEV1%. These taxonomic and functional changes provide insights into gastrointestinal disease in children with CF and future gastrointestinal therapeutics for CF should explore the aforementioned pathways and microbial changes.
Serum lipase ≥7 × ULN within 24 hours of presentation may be a simple clinical predictor of severe AP in children. Lipase levels below this threshold are strongly associated with a milder course.
Adult acquired flatfoot deformity is a complex condition that is difficult to quantify radiographically. The medial cuneiform/fifth metatarsal distance and the calcaneal pitch angle were found to have the highest interobserver reliability. Intraobserver reliability increased with observer experience.
LD-CF, despite NBS, seems to be associated with worse health before diagnosis and worse later growth and respiratory outcomes, thus providing further support for NBS programs for CF.
Fecal calprotectin levels in children with CF and HC were age-dependent and had distinct trajectories. Careful interpretation of calprotectin is required if used in drug trials for CF, particularly in children less than 4years old.
Objective: Bariatric surgery is an effective method for acute weight loss. While the impact of bariatric surgery on general medical conditions (e.g., type 2 diabetes) is well documented, few studies focus on physical functional outcomes following weight-loss induced by bariatric surgery. Design and Methods: We report on 50 women aged 20-74 scheduled for Roux-en-Y gastric bypass (RYGB) procedure who were enrolled for a prospective 1-year study. Height, weight, and waist circumference were recorded preoperatively and at 6 and 12 months, postoperatively. To track musculoskeletal/physical function changes, the timed-get-up-and-go (TGUG) and short-form health survey-36 (SF-36) and short musculoskeletal function assessment (SFMA) questionnaires were administered. Results: Patients had significant weight loss and functional improvement. At 1 year mean weight loss was 48.5 kg and mean TGUG improvement was 3.1 s. SMFA and SF-36 also showed improvement in functional components with weight loss at 6 months and 1-year post surgery. Significant associations were observed between TGUG and SMFA measures at all time points. Final weight at 1 year post bariatric surgery was also significantly correlated with most functional outcomes and changes in these outcomes. Partial correlations controlling for age revealed additional associations between body weight and functional outcomes, especially at the 6-month visit. Conclusion: Our results suggest that significant rapid weight loss, such as that attained by bariatric surgery, acutely improves musculoskeletal function in morbidly obese patients. Additionally, for patients with musculoskeletal disease or injury, weight loss resulting from bariatric surgery may serve as an adjunct for improving global functional outcome, and enhancing the rehabilitation potential.
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