Document Detail


Gastric acid inhibition for fat malabsorption or gastroesophageal reflux disease in cystic fibrosis: longitudinal effect on bacterial colonization and pulmonary function.
MedLine Citation:
PMID:  19683256     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To investigate bacterial colonization and pulmonary function longitudinally in patients with cystic fibrosis (CF) receiving drugs for gastric acid (GA) inhibition for fat malabsorption or for gastroesophageal reflux disease (GERD). STUDY DESIGN: A retrospective cohort study of 218 pediatric patients with CF was performed. Multilevel modeling was used to perform longitudinal analysis of forced expiratory volume in 1 second (FEV(1)), forced vital capacity (FVC), maximum expiratory flow at 50% of FVC (MEF(50)), and maximal mid-expiratory flow between 25% and 75% of FVC (MMEF(25-75)). Cox regression was used to calculate Pseudomonas aeruginosa- and Staphylococcus aureus-free survival. RESULTS: Patients with CF and GA inhibition had a significantly smaller yearly decline of MEF(50) and MMEF(25-75) compared with control subjects. Other pulmonary function parameters and P aeruginosa or S aureus acquisition or colonization were not different from that of control subjects. GERD was associated with a significantly reduced pulmonary function (FEV(1) and FVC) and an earlier acquisition of P aeruginosa and S aureus. CONCLUSIONS: GA inhibition did not affect pulmonary function or bacterial acquisition and therefore is not contraindicated in patients with CF. GA inhibition might improve pulmonary function with time, because the decline of MEF(50) and MMEF(25-75) was less pronounced. GERD was associated with a reduced pulmonary function and an earlier acquisition of P aeruginosa and S aureus. Therefore the diagnosis and treatment of GERD should be aggressively pursued in patients with CF.
Authors:
Hubert P J van der Doef; Hubertus G M Arets; Steven P Froeling; Paul Westers; Roderick H J Houwen
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Publication Detail:
Type:  Comment; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-08-14
Journal Detail:
Title:  The Journal of pediatrics     Volume:  155     ISSN:  1097-6833     ISO Abbreviation:  J. Pediatr.     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-10-20     Completed Date:  2009-12-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  629-33     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatric Gastroenterology, University Medical Center Utrecht, Utrecht, The Netherlands. h.p.j.vanderdoef@umcutrecht.nl
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Child
Cohort Studies
Colony Count, Microbial
Cystic Fibrosis / complications,  drug therapy,  microbiology*
Female
Follow-Up Studies
Forced Expiratory Volume / drug effects,  physiology
Gastric Acid / secretion
Gastroesophageal Reflux / complications,  diagnosis,  drug therapy*
Humans
Infant
Infant, Newborn
Longitudinal Studies
Malabsorption Syndromes / complications,  diagnosis,  drug therapy*
Male
Multivariate Analysis
Odds Ratio
Probability
Proportional Hazards Models
Proton Pump Inhibitors / therapeutic use*
Pseudomonas aeruginosa / drug effects,  isolation & purification*
Retrospective Studies
Risk Assessment
Severity of Illness Index
Staphylococcus aureus / drug effects,  isolation & purification*
Treatment Outcome
Vital Capacity / drug effects
Chemical
Reg. No./Substance:
0/Proton Pump Inhibitors
Comments/Corrections
Comment On:
J Pediatr. 2009 Nov;155(5):623-8.e1   [PMID:  19616787 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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