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Nutrition is integral to the care of individuals with cystic fibrosis (CF). Better nutritional status is associated with improved pulmonary function. In some individuals with CF, enteral tube feeding can be useful in achieving optimal nutritional status. Current nutrition guidelines do not include detailed recommendations for enteral tube feeding. The Cystic Fibrosis Foundation convened an expert panel to develop enteral tube feeding recommendations based on a systematic review of the evidence and expert opinion. These guidelines address when to consider enteral tube feeding, assessment of confounding causes of poor nutrition in CF, preparation of the patient for placement of the enteral feeding tube, management of the tube after placement and education about enteral feeding. These recommendations are intended to guide the CF care team, individuals with CF, and their families through the enteral tube feeding process.

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causes lung infections in patients with cystic fibrosis (CF). The quinolone signal (PQS) compound is a secreted virulence factor that contributes to the pathogenicity of We were able to detect PQS in sputum samples from CF patients infected with but not in samples from uninfected patients. We then tested the hypothesis that PQS induces oxidative stress in host cells by determining the ability of PQS to induce the production of reactive oxygen species (ROS) in lung epithelial cells (A549 and primary normal human bronchial epithelial [NHBE]) cells and macrophages (J774A.1 and THP-1). ROS production induced by PQS was detected with fluorescent probes (dichlorodihydrofluorescein diacetate, dihydroethidium, and MitoSOX Red) in conjunction with confocal microscopy and flow cytometry. PQS induced ROS production in lung epithelial (A549 and NHBE) cells and macrophages (J774A.1 and THP-1 cells). NHBE cells were sensitive to PQS concentrations as low as 500 ng/ml. PQS significantly induced early apoptosis ( < 0.05, = 6) in lung epithelial cells, as measured by annexin/propidium iodide detection by flow cytometry. However, no change in apoptosis upon PQS treatment was seen in J774A.1 cells. Heme oxygenase-1 (HO-1) protein is an antioxidant enzyme usually induced by oxidative stress. Interestingly, incubation with PQS significantly reduced HO-1 and NrF2 expression in A549 and NHBE cells but increased HO-1 expression in J774A.1 cells ( < 0.05, = 3), as determined by immunoblotting and densitometry. These PQS effects on host cells could play an important role in the pathogenicity of infections.

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The aim of the presented studies was to investigate whether classifications of neglect patients into perceptual (i.e. identifying a patient as suffering from mainly attentional/space representation deficits) and premotor (judging the main impairment to be related towards actions into contralesional space) categories is consistent across different line bisection assessment techniques that have, in the past, been designed to tease these potentially overlapping aspects of hemispatial neglect apart.Twelve patients with hemispatial neglect and three control groups were tested with the Overhead Task, adapted from Nico [Neuropsychologia 34 (1996) 471] in which patients were asked to bisect lines that were mirror reversed, the Pulley Device Technique, adapted from Bisiach et al. [Neurology 40 (1990) 1278] in which they had to perform a movement opposite to the direction of the transaction mark that bisected the line and the Landmark Test, adapted from Milner et al. [Neuropsychologia 30 (1992) 515] in which they had to manually point to the half of a centrally pre-bisected line that, to them, appeared shorter. The specific question was whether these three tasks would categorise the same set of patients in the same way?Most patients could be classified into either the premotor or perceptual category in each task, but no consistent categorisation emerged across the three techniques. Just 1 out of the 12 patients, was consistently classified across all three tasks. It seemed that despite the fact that all tasks essentially required a line bisection response, the perceptual and motor differences between the tasks were still great enough to result in inconsistent classifications. The Landmark Task classified the majority of patients into the perceptual neglect category, while the Overhead and Pulley Device Techniques tended to identify more patients as suffering from a premotor deficit (albeit not the same set of patients).

Background: Previous research has demonstrated that the psychological morbidity experienced by informal caregivers is associated with increased vulnerability to infectious diseases, in particular influenza. A pragmatic trial was conducted to examine whether a stress management intervention (SMI) could reduce psychological morbidity and enhance the antibody response to influenza vaccination in the elderly, and whether changes in immune response of SMI participants were associated with hypothalamic-pituitary-adrenal (HPA) axis activity. Methods: Forty-three elderly spousal carers of dementia patients and 27 non-carer controls were recruited. Sixteen carers were allocated to an 8-week SMI or a non-intervention condition (n = 27). The non-carers formed a no treatment, ‘normal’ comparison group. At the end of the SMI or its equivalent time period, all participants received an influenza vaccination. IgG antibody titres to the vaccine were measured 0, 2, 4 and 6 weeks post-vaccine. Results: There was evidence of elevated distress in both carer groups compared with non-carer controls throughout the SMI period, but no between-group differences in salivary cortisol. Immune responses to the vaccine revealed that 50% of SMI carers, 7% of non-intervention carers and 29% of non-carer controls produced a four-fold increase in antibody titre. Conclusions: The immune response to influenza vaccination appears amenable to improvement through stress management, although the mechanisms underlying this effect remain unclear.