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Swann JR, Rajilic-Stojanovic M, Salonen A, Sakwinska O, Gill C, Meynier A, Fança-Berthon P, Schelkle B, Segata N, Shortt C, Tuohy K, Hasselwander O. Considerations for the design and conduct of human gut microbiota intervention studies relating to foods. Eur J Nutr 2020; 59:3347-3368. [PMID: 32246263 PMCID: PMC7669793 DOI: 10.1007/s00394-020-02232-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 03/18/2020] [Indexed: 12/15/2022]
Abstract
With the growing appreciation for the influence of the intestinal microbiota on human health, there is increasing motivation to design and refine interventions to promote favorable shifts in the microbiota and their interactions with the host. Technological advances have improved our understanding and ability to measure this indigenous population and the impact of such interventions. However, the rapid growth and evolution of the field, as well as the diversity of methods used, parameters measured and populations studied, make it difficult to interpret the significance of the findings and translate their outcomes to the wider population. This can prevent comparisons across studies and hinder the drawing of appropriate conclusions. This review outlines considerations to facilitate the design, implementation and interpretation of human gut microbiota intervention studies relating to foods based upon our current understanding of the intestinal microbiota, its functionality and interactions with the human host. This includes parameters associated with study design, eligibility criteria, statistical considerations, characterization of products and the measurement of compliance. Methodologies and markers to assess compositional and functional changes in the microbiota, following interventions are discussed in addition to approaches to assess changes in microbiota-host interactions and host responses. Last, EU legislative aspects in relation to foods and health claims are presented. While it is appreciated that the field of gastrointestinal microbiology is rapidly evolving, such guidance will assist in the design and interpretation of human gut microbiota interventional studies relating to foods.
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Affiliation(s)
- J. R. Swann
- Division of Integrative Systems Medicine and Digestive Diseases, Imperial College London, London, UK
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - M. Rajilic-Stojanovic
- Department for Biochemical Engineering and Biotechnology, Faculty of Technology and Metallurgy, University of Belgrade, Belgrade, Serbia
| | - A. Salonen
- Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - O. Sakwinska
- Société Des Produits Nestlé S.A, Nestlé Research, Lausanne, Switzerland
| | - C. Gill
- Nutrition Innovation Centre for Food and Health, Centre for Molecular Biosciences, Ulster University, Londonderry, Northern Ireland, UK
| | | | | | | | - N. Segata
- Department CIBIO, University of Trento, Trento, Italy
| | - C. Shortt
- Johnson & Johnson Consumer Services EAME Ltd., Foundation Park, Maidenhead, UK
| | - K. Tuohy
- Department of Food Quality and Nutrition, Research and Innovation Centre, Fondazione Edmund Mach, Trento, Italy
| | - O. Hasselwander
- DuPont Nutrition and Biosciences, c/o Danisco (UK) Limited, Reigate, UK
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Vagg T, Morrissy D, Shortt C, Fleming C, Daly M, Tabirca S, Plant B. P235 Using virtual reality to enhance the transition process. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30528-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Arooj P, Morrissy D, Ronan N, McCarthy Y, Daly M, Flanagan E, Shortt C, McCarthy M, Flemming C, Eustace J, Murphy D, Plant B. P264 Real-world Orkambi cohort CorK study (ROCK) - a prospective twelve months' analysis addressing the effectiveness of CFTR modulation in patients with cystic fibrosis homozygous for F508del CFTR. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30557-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Arooj P, Ronan N, Mccarthy Y, Daly M, Flanagan E, Shortt C, Mccarthy M, Flemming C, Eustace J, Murphy D, Plant B. P026 Real-world Orkambi Cohort Cork study (ROCKS) - a prospective three months’ analysis addressing the impact of CFTR modulation in patients with cystic fibrosis homozygous for ΔF508del CFTR. J Cyst Fibros 2018. [DOI: 10.1016/s1569-1993(18)30323-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Ronan N, McCarthy Y, James K, Arooj P, Hunt E, Shortt C, Fleming C, McCarthy M, Howlett C, Hickey C, Flanagan E, Daly M, Eustace J, Maher M, Plant B. 232 Lumacaftor/Ivacaftor is associated with a significant improvement in walk test and reduction in sweat chloride in a cohort of homozygous F508del CF patients with severe disease – a single centre experience. J Cyst Fibros 2017. [DOI: 10.1016/s1569-1993(17)30577-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Fouhy F, Ronan N, McCarthy Y, Arooj P, Daly M, Flanagan E, Deane J, O'Sullivan O, Murphy K, Fleming C, McCarthy M, Shortt C, Eustace J, Shanahan F, Rea M, Ross R, Floto R, Harrison M, Haworth C, Dupont L, Stanton C, Plant B. WS03.3 A longitudinal, multi-centre investigation into the gut microbiota of adult CF patients – the CFMATTERS perspective. J Cyst Fibros 2017. [DOI: 10.1016/s1569-1993(17)30170-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Burke DG, Harrison MJ, Fleming C, McCarthy M, Shortt C, Sulaiman I, Murphy DM, Eustace JA, Shanahan F, Hill C, Stanton C, Rea MC, Ross RP, Plant BJ. Clostridium difficile carriage in adult cystic fibrosis (CF); implications for patients with CF and the potential for transmission of nosocomial infection. J Cyst Fibros 2016; 16:291-298. [PMID: 27908697 DOI: 10.1016/j.jcf.2016.09.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 09/18/2016] [Accepted: 09/22/2016] [Indexed: 01/29/2023]
Abstract
Clostridium difficile is an anaerobic Gram-positive, spore-forming, toxin-producing bacillus transmitted among humans through the faecal-oral route. Despite increasing carriage rates and the presence of C. difficile toxin in stool, patients with CF rarely appear to develop typical manifestations of C. difficile infection (CDI). In this study, we examined the carriage, toxin production, ribotype distribution and antibiotic susceptibility of C. difficile in a cohort of 60 adult patients with CF who were pre-lung transplant. C. difficile was detected in 50% (30/60) of patients with CF by culturing for the bacteria. C. difficile toxin was detected in 63% (19/30) of C. difficile-positive stool samples. All toxin-positive stool samples contained toxigenic C. difficile strains harbouring toxin genes, tcdA and tcdB. Despite the presence of C. difficile and its toxin in patient stool, no acute gastrointestinal symptoms were reported. Ribotyping of C. difficile strains revealed 16 distinct ribotypes (RT), 11 of which are known to be disease-causing including the hyper-virulent RT078. Additionally, strains RT002, RT014, and RT015, which are common in non-CF nosocomial infection were described. All strains were susceptible to vancomycin, metronidazole, fusidic acid and rifampicin. No correlation was observed between carriage of C. difficile or any characteristics of isolated strains and any recorded clinical parameters or treatment received. We demonstrate a high prevalence of hypervirulent, toxigenic strains of C. difficile in asymptomatic patients with CF. This highlights the potential role of asymptomatic patients with CF in nosocomial transmission of C. difficile.
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Affiliation(s)
- D G Burke
- APC Microbiome Institute, University College Cork, Ireland
| | - M J Harrison
- Cork Adult CF Centre, Dept. of Respiratory Medicine, Cork University Hospital, University College Cork, Ireland
| | - C Fleming
- Cork Adult CF Centre, Dept. of Respiratory Medicine, Cork University Hospital, University College Cork, Ireland
| | - M McCarthy
- Cork Adult CF Centre, Dept. of Respiratory Medicine, Cork University Hospital, University College Cork, Ireland
| | - C Shortt
- Cork Adult CF Centre, Dept. of Respiratory Medicine, Cork University Hospital, University College Cork, Ireland
| | - I Sulaiman
- Dept. of Respiratory Medicine, Cork University Hospital, University College Cork, Ireland
| | - D M Murphy
- Cork Adult CF Centre, Dept. of Respiratory Medicine, Cork University Hospital, University College Cork, Ireland
| | - J A Eustace
- Health Research Board, Clinical Research Facility, University College Cork, Ireland
| | - F Shanahan
- APC Microbiome Institute, University College Cork, Ireland
| | - C Hill
- School of Microbiology, University College Cork, Ireland
| | - C Stanton
- Teagasc Food Research Centre, Moorepark, Fermoy, Co. Cork, Ireland
| | - M C Rea
- Teagasc Food Research Centre, Moorepark, Fermoy, Co. Cork, Ireland
| | - R P Ross
- APC Microbiome Institute, University College Cork, Ireland
| | - B J Plant
- Cork Adult CF Centre, Dept. of Medicine, Cork University Hospital, University College Cork, Ireland.
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Ronan N, O'Callaghan G, Mooney D, Einarsson G, Elborn J, Ni Chroinin M, Mullane D, Murphy D, O'Connor O, Shortt C, Tunney M, Twomey M, Maher M, Eustace J, Plant B. WS20.4 Clinical outcomes of Real-World Kalydeco (CORK) study – a prospective 12 month analysis addressing the impact of CFTR modulation on the cystic fibrosis lung. J Cyst Fibros 2015. [DOI: 10.1016/s1569-1993(15)30119-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Ronan G, Ronan N, Shortt C, Fleming C, Cronin K, McCarthy M, Hickey C, Murphy D, Eustace J, O'Halloran D, Plant B. 128 The metabolic consequences of CFTR modulation with ivacaftor in a single adult cystic fibrosis centre cohort. J Cyst Fibros 2015. [DOI: 10.1016/s1569-1993(15)30305-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Greenslade J, Kavsak P, Parsonage W, Shortt C, Than M, Pickering J, Aldous S, Cullen L. Combining presentation high-sensitivity cardiac troponin I and glucose measurements to rule-out an acute myocardial infarction in patients presenting to emergency department with chest pain. Clin Biochem 2015; 48:288-91. [DOI: 10.1016/j.clinbiochem.2014.11.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2014] [Accepted: 11/24/2014] [Indexed: 10/24/2022]
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Harrison M, McCarthy M, Fleming C, Hickey C, Shortt C, Eustace J, Murphy D, Plant B. Inhaled versus nebulised tobramycin: A real world comparison in adult cystic fibrosis (CF). J Cyst Fibros 2014; 13:692-8. [DOI: 10.1016/j.jcf.2014.04.004] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 04/09/2014] [Accepted: 04/09/2014] [Indexed: 11/27/2022]
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Power B, Harrison M, Shortt C, Fleming C, Mccarthy M, Murphy D, Plant B. 201 Vitamin A deficiency: prevalence and clinical implications for adult cystic fibrosis. J Cyst Fibros 2014. [DOI: 10.1016/s1569-1993(14)60336-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Moore D, English S, Eustace J, Shortt C, Plant B, Plant W. 286 Adult patients with cystic fibrosis exhibit an increasing prevalence of chronic kidney disease with increasing age, particularly those with cystic fibrosis-associated diabetes mellitus and/or an organ transplant. J Cyst Fibros 2014. [DOI: 10.1016/s1569-1993(14)60421-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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English S, Eustace J, Shortt C, Plant B, Plant W. WS6.8 Acute kidney injury afflicts a significant proportion of adult patients with cystic fibrosis, with an incidence in excess of that of the general population which clusters with specific risk factors. J Cyst Fibros 2014. [DOI: 10.1016/s1569-1993(14)60044-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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O'Halloran K, Harrison M, Shortt C, Fleming C, Mccarthy M, Murphy D, Plant B. 289 Ageing in cystic fibrosis: a comparison of adult patients attending a tertiary referral centre. J Cyst Fibros 2014. [DOI: 10.1016/s1569-1993(14)60424-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Harrison M, Burke D, Fleming C, Mccarthy M, Shortt C, O'Callaghan G, Murphy D, Shanahan F, Hill C, Ross P, Stanton C, Eustace J, Rea M, Plant B. WS3.5 Clostridium difficile in adult cystic fibrosis (CF): Prevalence, ribotyping and toxigenic capability. A prospective study. J Cyst Fibros 2013. [DOI: 10.1016/s1569-1993(13)60017-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Harrison M, Neff K, Shortt C, Fleming C, Mccarthy M, O'Riordan S, Murphy D, O'Halloran D, Plant B. 254 The prognostic significance of hypoglycaemia on oral glucose tolerance tests in adults with cystic fibrosis (CF): A prospective clinical study. J Cyst Fibros 2013. [DOI: 10.1016/s1569-1993(13)60395-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Harrison M, Mccarthy M, Fleming C, Shortt C, Hickey C, Eustace J, Murphy D, Plant B. 74 Improved tolerability, adherence and reduced intravenous (IV) antibiotic usage in CF patients receiving inhaled versus nebulised antibiotic prophylaxis. A real world comparison of tobramycin inhaled powder (TIP) and tobramycin inhaled solution (TIS). J Cyst Fibros 2013. [DOI: 10.1016/s1569-1993(13)60216-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Edgeworth D, Ho T, O'Connell O, Clancy L, Fleming C, Shortt C, Murphy D, Corcoran D, Plant B. 131 The clinical implications of MRSA colonisation in a cohort of Irish adult cystic fibrosis (CF) patients and MRSA carrier frequency and clinical sequelae in their household contacts. J Cyst Fibros 2012. [DOI: 10.1016/s1569-1993(12)60301-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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McSwiney E, O'Connell O, Fleming C, Shortt C, Murphy D, Plant B. 296 Why do adult patients with cystic fibrosis attend their general practitioner? A specialist CF centre's perspective. J Cyst Fibros 2012. [DOI: 10.1016/s1569-1993(12)60464-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Abstract
Assessment of prognostic indicators in patients with cystic fibrosis (CF) is important. The study's aim was to assess the relative contribution of gender, genetics and microbiology on survival in adults with CF. Adult patients were studied from 1995 to 2005 and data collected included FEV(1) (%predicted), body mass index (BMI), genetics, and microbiology. Data was available on 183 patients in 1995. Forty-five patients died in the subsequent 10 years. Patients who died during the study had lower mean (SD) FEV(1) %predicted in 1995 when compared to those remaining alive, 41.5 (15.2)% versus 69.8 (23.2)% predicted, respectively, P<0.001 and they had lower mean (SD) BMI in 1995, 19.2 (3.3) kg/m(2) in comparison to those remaining alive, 20.7 (3.4) kg/m(2), P=0.008. The proportion of patients infected with Pseudomonas aeruginosa and Burkholderia cepacia complex was higher in the group who died during the study compared to those remaining alive, odds ratio 20.9 P<0.0001 and 7.1 P<0.0001, respectively. The presence of the Delta F508 homozygous mutation did not alter survival, P=0.3. Patients infected with either P.aeruginosa or B.cepacia complex had reduced survival compared to those without infection, P=0.01 and P<0.0001, respectively. FEV(1)% (P<0.0001), infection with P.aeruginosa (P=0.005) or B.cepacia complex (P=0.03) were the only significant predictors of mortality. This study demonstrates adults who died were more likely to have worse lung function and be infected with either P.aeruginosa or B.cepacia complex. FEV(1)% and infection with P.aeruginosa or B.cepacia complex were the most significant predictors of survival in adults with CF.
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Affiliation(s)
- J M Courtney
- Adult Cystic Fibrosis Unit, Belfast City Hospital, Belfast, Northern Ireland, Ireland.
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Adams C, Morris-Quinn M, McConnell F, West J, Lucey B, Shortt C, Cryan B, Watson JB, O'Gara F. Epidemiology and clinical impact of Pseudomonas aeruginosa infection in cystic fibrosis using AP-PCR fingerprinting. J Infect 1998; 37:151-8. [PMID: 9821090 DOI: 10.1016/s0163-4453(98)80170-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Arbitrarily primed PCR (AP-PCR) was utilized to genetically fingerprint 252 Pseudomonas aeruginosa strains isolated from the sputa of 50 cystic fibrosis (CF) patients attending the Cork CF clinic over a period of 3 years. Ten distinct P. aeruginosa strains were identified and the distribution, temporal trends and clinical impact of colonization with these individual P. aeruginosa clones was studied. A number of random isolates from each AP-PCR group were analysed using pulsed field gel electrophoresis (PFGE) in order to confirm the discriminatory power of the AP-PCR technique. The majority of patients were colonized with a single strain over the time period of the study, but it was also possible to harbour two or more strains transiently or simultaneously. Four main strains were relatively evenly distributed throughout the CF population, and it was noted that patients from the same family or attending the same school tended to harbour the same P. aeruginosa clone. Disease severity was significantly associated with the age of the patient (P < 0.001), clearly indicating an increase in severity with increase in age. The general clinical status of the CF patients was not significantly associated with the P. aeruginosa variant isolated from their sputa. Lung status was defined by FEV1 measurement and chest X-ray score (CXR). The non parametric Kruskal-Wallis significance test of FEV1, CXR and age by colonizing P. aeruginosa clone indicated that FEV1 (P = 0.017), but not CXR (P = 0.19) or age (P = 0.842), differed significantly across the clones of P. aeruginosa isolated. Patients harbouring P. aeruginosa strains B, F or G clearly had lower FEV1 scores while those harbouring clones A, C, D or H generally had higher FEV1 scores. Thus, the sub-species variant of P. aeruginosa colonizing CF patients may be associated with the severity of progressive lung disease.
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Affiliation(s)
- C Adams
- Department of Microbiology, University College Cork, Ireland
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Coakley R, O’Neill S, Coakley R, Glynn P, O’Neill S, Finlay GA, Russell KJ, McMahon K, D’Arcy EM, Masterson JB, Fitzgerald MX, O’Connor CM, O’Driscoll LR, Finlay GA, Fitzgerald MX, O’Connor CM, McGarvey LPA, Forsythe P, Heaney LG, MacMahon J, Ennis M, Leonard C, Tormey V, Burke CM, Poulter LW, Keatings VM, FitzGerald MX, Barnes PJ, Harty HR, Corfield DR, Adams L, Schwartzstein RM, Kiely JF, Buckley A, Shiels P, Deegan PC, Maurer B, McNicholas WT, Dunlop KA, Martin B, Riley M, Shields MD, Glynn P, Kilgallen I, Coakley R, O’Neill S, McElvaney NG, Cervantes-Laurean D, Wehr N, Gabriele K, Robinson W, Moss J, Levine RL, Urbach V, Walsh D, Harvey B, McElroy MC, Pittet JF, Allen L, Wiener-Kroonish J, Dobbs LG, O’Donnell DM, McMahon KJ, O’Connor C, Fitzgerald MX, McGuirk P, Mahon B, Griffin F, Mills KHG, Murphy R, Brijker F, Mulloy E, Cohen Tervaert JW, Walshe J, O’Neill S, McGarvey LPA, Heaney LG, Lowry RC, Shepherd DRT, MacMahon J, Gamble LA, Carton C, Memon R, Winter D, Chan A, Aherne T, O’Reilly P, Harbison JA, McNicholas WT, O’Callaghan S, Mulloy E, Keane M, McKenna M, Woods S, O’Neill S, Lamon A, Leonard C, Faul J, Murphy M, Burke CM, Tormey V, Riley M, Porszasz J, Engelen MPKJ, Brundage B, Wasserman K, Sweeney M, O’Regan RG, McLoughlin P, Sweeney M, Honner V, Sinnott B, O’Regan RG, McLoughlin P, Kilgallen I, O’Neill S, McGrath DS, Kiely J, Cryan B, Bredin CP, McGrath DS, Shortt C, Stack M, Kelleher N, Bredin CP, Russell KJ, McRedmond J, Mulkerji N, Keatings V, Fitzgerald MX, O’Connor CM, Boylan GM, McElroy MC, Dobbs LG, Forsythe P, McGarvey LPA, Cross LJM, Ennis M, Heaney LG, MacMahon J, Davern S, O’Connor CM, McDonnell TJ, Kiely JL, Lawless G, Cunningham S, McNicholas WT, Lordan J, Clancy L, Manning P, Plunkett P, Donaghy D, Kiely J, McDonnell TJ, Ben Musbah F, Loftus BG, Ben Musbah F, Loftus BG, Rutherford R, Watson SNE, Gilmartin JJ, Henry M, Mullins G, Brennan N, Kiely JL, Deegan PC, McNicholas WT. Irish thoracic society. Ir J Med Sci 1998. [DOI: 10.1007/bf02937212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Rauf F, O'Halloran T, Watson JB, Shortt C, McKiernan J. Diabetes mellitus in childhood cystic fibrosis. Ir Med J 1997; 90:31-2. [PMID: 9230562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Since 1984, five patients in the cystic fibrosis (CF) clinic at Cork Regional Hospital have developed diabetes mellitus (DM) and were treated with Insulin. None had received systemic corticosteroids but two had high calorie naso-gastric feeding regimes. Two died from lung disease. A fifteen year old boy developed bilateral cataracts. In nine other paediatric CF clinics in the Republic of Ireland (total: 420 patients), three patients have DM, two receiving Insulin. Abnormal glucose tolerance is becoming more common in CF as patients survive longer. The possible role of corticosteroid treatment and intensive carbohydrate feeding regimes in development of glucose intolerance must be considered. DM in CF differs from the usual childhood DM. Regular screening and early Insulin supplementation may be beneficial.
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Affiliation(s)
- F Rauf
- Department of Paediatrics, Cork University Hospital, Wilton
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Chan KH, Singh HP, Aherne T, Carabine U, Gilliland H, Johnston JR, Lowry KG, McGuigan J, Cosgrove J, Veerasingham D, McCarthy J, Hurley J, Wood AE, Gilliland R, McGuigan JA, McManus KG, Wilkinson P, Johnston LC, MacMahon J, Wilson D, Austin C, Anikin V, McManus K, McGuigan J, McManus K, Anikin V, Gibbons JRP, McGuigan J, Sharkey R, Long M, Maree A, O’Neill S, Maguire CP, Hayes JP, Masterson J, Fitzgerald MX, Hayes M, Maguire CP, Hayes JP, Masterson J, Fitzgerald MX, Quigley C, Mofidi A, Mofidi R, Fitzgerald MX, O’Neill M, Watson JBG, O’Halloran ET, Shortt C, Taylor M, Holland C, O’Lorcain P, Taylor M, Holland C, O’Lorcain P, Pathmakanthan S, Sreenan S, Power CK, Poulter LW, Burke CM, Reilly D, Pathmakanthan S, Sreenan S, Doyle S, Burke CM, Sreenan S, Power C, Pathmakanthan S, Goggin A, Burke CM, Poulter LW, Sreenan S, Doyle S, Pathmakanthan S, Poulter LW, Burke CM, Sreenan S, Debenham P, Pathmakanthan S, Burke CM, Poulter LW, Southey A, O’Connor CM, Fitzgerald MX, Bourke WJ, McDonnell TJ, Buck JB, Magee TRA, Lowry RC, Graham ANJ, Owens WA, Kelly SB, McGuigan JA, Costelloe RW, Ryan J, Collins J, Guerin D, Rooney D, Long E, O’Donnell M, O’Neill S, Cotter TP, Bredin CP, Buick JB, Lowry RC, MacMahon JJ, Finlay G, Concannon D, McDonnell TJ, Reid PT, Alderdice J, Carson J, Sinnamon DG, Murphy S, Scott T, Keane CT, Walsh JB, Coakley D, McKeown D, Kelly P, Clancy L, Kiely JL, Cryan B, Bredin CP, Killeen P, Farrell S, Kelly P, Clancy L, Kiely JL, O’Riordan DM, Sheehan S, Curtain J, Hogan J, Bredin CP, Malone A, Ahmed S, Watson JBG, Murphy M, Fennell W, Ahmed S, Watson JBG, Aherne T, Keohane C, O’Neill M, Gleeson CM, McGuigan J, Ritchie AJ, Russell SEH, Molloy E, Keane M, Coakley R, Costello R, Condron C, Watson RGW, O’Neill S, Kelly C, Redmond H, Watson W, Burke P, Bouchier-Hayes D, Donnelly SC, Haslett C, Dransfield I, Robertson CE, Carter DC, Ross JA, Grant IS, Tedder TF, Doyle S, Sreenan S, Pathmakanthan S, Burke CM, Heaney LG, Cross LJM, Stanford CF, Ennis M, Sreenan S, Pathmakanthan S, Power C, Goggin A, Poulter LW, Burke CM, Murphy S, Scott T, Keane CT, Walsh JB, Coakley D, O’Riordan DM, Gergely L, Deng N, Rose RM, Hennessy T, Hickey L, Thornton L, Collum C, Durity M, Power J, Johnson H, Lee B, Doherty E, Kelly E, McDonnell T, McKeown D, Kelly P, Clancy L, Wilkinson P, Varghese G, Anikin V, Gibbons J, McManus K, McGuigan J, Reid PT, Gower NH, Rudd RM. Irish thoracic society. Ir J Med Sci 1994. [DOI: 10.1007/bf02967229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Pradeepkumar VK, Waseem E, Shortt C, Barry D, Watson JB. Home intravenous therapy using a silastic long line catheter in cystic fibrosis patients. Ir Med J 1992; 85:110-1. [PMID: 1399475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Young patients with cystic fibrosis are now accustomed to having regular periods of intravenous therapy to help in the management of their recurring respiratory infections particularly due to pseudomonas organisms. Most patients will eventually experience difficulties in accepting recurring intravenous cannulations and the life span of the conventional intravenous cannula is frequently brief. We have compared percutaneous long line silastic catheters with conventional intravenous cannulas as intravenous access in children with cystic fibrosis being treated for pulmonary exacerbations. We conclude that silastic long lines are superior to conventional cannulas in terms of patient tolerance, reduction in the number of hospital admissions, reduction in the number of repeat venepunctures/cannulations and reduction in local complications. The high degree of patient acceptability has been impressive and has increased with the enthusiasm of children with cystic fibrosis for more frequent intravenous therapy.
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Abstract
The effects of salt (sodium chloride) supplementation of rat diets (80 g/kg diet), with or without lactose (150 g/kg), were studied in weanling rats over 14 d. Dietary salt increased water intake and reduced weight gain and food conversion efficiency, but these variables were unaffected by lactose. Salt-supplemented rats exhibited a three- to fivefold increase in urinary calcium excretion and a small increase in urinary magnesium and phosphorus excretion, irrespective of dietary lactose content. In addition, salt supplementation reduced plasma alkaline phosphatase (EC 3.1.3.1) activity. Lactose increased urinary Ca and Mg excretion and plasma Ca and P concentrations. Salt reduced tibia mass but not tibia mass expressed relative to body-weight, but neither variable was affected by lactose. Both tibia Mg content and concentration were reduced by salt but unaffected by lactose, and neither tibia P content nor concentration was affected by salt or lactose. Tibia Ca content was reduced by salt but this was prevented by lactose. Tibia Ca concentration was unaffected by salt or lactose, although there was a reduction (not significant) in tibia Ca concentration in animals fed on the lactose-free diet. These results show that lactose had no independent effect on bone and that reduced accretion of bone mass and mineral content in rats fed on the high-salt diets was due, at least in part, to reduced growth. Failure to offset sodium-induced hypercalciuria by a compensatory increase in net Ca absorption may have contributed to reduced bone Ca accretion. The protective effect of lactose against reduced bone Ca accretion may be due to increased Ca absorption.
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Affiliation(s)
- C Shortt
- Department of Nutrition, University College, Cork, Republic of Ireland
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Shortt C. Micronutrients and health II: trace elements conference. Trends Food Sci Technol 1991. [DOI: 10.1016/0924-2244(91)90696-g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Affiliation(s)
- A Flynn
- Department of Nutrition, University College, Cork, Irish Republic
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Shortt C, Flynn A, Morrissey PA. Assessment of sodium and potassium intakes. Eur J Clin Nutr 1988; 42:605-9. [PMID: 3224604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The sodium, potassium and creatinine contents of three non-consecutive 24-h urine samples collected by 34 selected adult individuals (10 m; 24 f) living in Cork City were determined. The pooled mean 24-h excretion of sodium and potassium in collections adjudged to be complete were 152 mmol and 78 mmol, respectively. There was no significant difference between group average weekday and weekend-day excretion of Na or K, for either males or females. This suggests that weekend 24-h urinary collections, which most subjects find more convenient, are suitable for studies of sodium and potassium intakes of groups. The ratios of intra- to inter-individual variation for 24-h urinary sodium were 1.4 and 2.1 for males and females, respectively. The corresponding ratios for 24-h urinary potassium were 6.6 for males and 4.9 for females. These ratios indicated that there were large individual day-to-day variations in urinary sodium and potassium excretion in this group. It was estimated that a sample size of 35-60 individuals would be required to estimate group mean sodium and potassium intakes by means of single 24-h urine collections.
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Affiliation(s)
- C Shortt
- Department of Nutrition, University College, Cork, Ireland
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Shortt C, Madden A, Flynn A, Morrissey PA. Influence of dietary sodium intake on urinary calcium excretion in selected Irish individuals. Eur J Clin Nutr 1988; 42:595-603. [PMID: 3224603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The relationship between dietary sodium intake (as assessed by the 24-h urinary excretion of sodium) and urinary calcium excretion was examined in a selected group of free-living Irish individuals (n = 94), under conditions in which the completeness of urine collections was assessed. Results indicated that there was a significant positive correlation between 24-h urinary sodium and calcium excretion for males (r = 0.56, P less than 0.001) and females (r = 0.35, P less than 0.01). In addition, linear regression analysis indicated that mean 24-h urinary calcium excretion increased by 39 mg and 26 mg for a 1 g increment in sodium intake for males and females, respectively. The relationship between dietary sodium intake and urinary calcium excretion was also examined in 12 healthy young adults under controlled dietary conditions. Urinary sodium and calcium excretion values over 24 h were positively correlated for males (r = 0.44, P less than 0.05) and females (r = 0.80, P less than 0.001). However, the relationship was only statistically significant for 5 of the 12 subjects when the data were analysed on an individual basis. Results of this study suggest that salt intake may be an important determinant of urinary calcium loss in certain individuals and, as such, may be a risk factor in the development of osteoporosis. However, further studies are required to establish whether low salt intakes have a beneficial effect on calcium balance in free-living individuals.
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Affiliation(s)
- C Shortt
- Department of Nutrition, University College, Cork, Ireland
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