Topics

Can a pregnant physiotherapist continue working with chronically infected CF-Patients?
Ladies and Gentlemen, I work as physiotherapist with CF-patients. Currently, I am in my 3rd week of pregnancy. Some of my patients are chronically infected with CF-pathogens like MRSA and Burkholderia cepacia. My present MRSA precautions are mouth protection, smock, hood, and gloves; with Cepacia smock and gloves. My questions are: Can I carry on working with chronically infected CF-Patients, are those precautions sufficient and are there specific recommendations to protect mother and embryo child? I would be pleased to receive a clear answer to this very delicate affair ASAP. Thank you in advance, Michaela
07.01.2008
Travelling with CF
CF- Patients frequently ask if there is specific medical concern for them to travel to foreign countries. Question 1: Is there a list available that tells CF-patients which areas/countries they should avoid to visit? Question 2: If so, to which particular risks/species is a patient exposed in such countries?
07.01.2008
Cystic Fibrosis, Lung Transplantation
My nephew suffers from cystic fibrosis since he was born. In the meantime he is 40 years old. He suffers from respiratory troubles, diabetes and is terribly plugged with mucus continuously. Meanwhile he can only live with supplemental oxygen supply. His weight has fallen to a mere 56 kgs. His doctor in charge has confronted him with the question to have a lung transplantation. My nephew already had a preliminary talk in the university hospital in Hannover. The appointment at which he has to decide in favour or against a transplantation is getting closer. Now, I read an article in a doctor's magazine that I quote here: New lung rather does harm Transplantation in case of cystic fibrosis raises mortality risk SALT LAKE CITY (eb.). For most children with cystic fibrosis a lung transplantation rather raises the risk to die young, this is what researchers of the University of Utah in the USA report. In the scope of the analysis of 248 minor patients who have been lung transplanted during a period of eleven years the scientists asserted a clear benefit through this therapy for one single patient only. For 162 others the transplantation raised the mortality risk – in some cases up to sevenfold. For the 85 remainding children a clear advantage or disadvantage could not be identified. The authors of the study strongly request to select candidates for a transplantation very rigidly. Also in my nephew's interest it means a lot to me to learn about how you assess the situation. Are you in the position to write a comment on this or, if not, – who should I contact in your opinion?
25.12.2007
Alcaligenes / Achromobacter xylosoxidans
Dear expert team, Is there any new knowledge / therapeutic strategies concerning this bacterium (last question/answer 18.09.04)? The first identification of this bacterium was on the 15.02.03 and again on the 08.12.03. Almost at the same time Pseudomonas has been identified for the last time (30.01.04). Since then, Alcaligenes could be identified in the sputum during all controls – however not causing any problems (FEV1 = 87,2% / 24 years) – Pseudomonas could not be detected anymore since then. Do you probably see a connection between these two findings – does Alcaligenes probably cause such unfavourable circumstances that Pseudomonas can not / does not like to colonize anymore? Alcaligenes is not treated – all oral antibiotics are not effective according to laboratory findings. In addition, the following bacteria can be identified in the sputum sample: staphylococcus again and again (cefuroxim sensitive) / aspergillus + hämophilus from time to time. Many thanks in advance, Yours sincerely, ….
25.12.2007
PSA (prostate-specific antigen)
Hello, are there any hints/investigations/statistics for increased PSA-levels in male CF patients? CF patient 46 years old PSA-level increased from 3.6 to 7.1 in 21 months, first biopsy 14 stamps negative.
25.12.2007
Pregnancy after lung transplantation
Dear expert team, I have been lung transplanted due to CF 6 years ago. As a am living in a stable relationship, I am feeling again the desire to have a baby by the course of time. I do not have any children yet and I am in a good condition. I did not have any rejections for many years and I had only 3 rejections altogether in the whole time. Furthermore there had not been any complications either. Is it possible for me to give birth to a baby? I would strongly desire that. In case you do not know anything about this, I would appreciate if you could give me an advice to whom I can ask this question. Best regards,
14.12.2007
Several children suffering from CF in the kindergarten
Dear expert team, I got the question from a kindergarten, if there is no risk in having two children suffering from CF (one 3 years old, the other one 5 years old, not related) in the same kindergarten (different groups, but no strict separation). Parents and nursery school teachers are worrying about a possible reciprocal infection with germs. At this time-point, none of the children has an infection with a problematic germ (which can, however, change of course). Can I give the advice with a good conscience that this situation is quite safe or should I advise the parents to give the children to different institutions? Many thanks for your answer,
14.12.2007
CF out-patient department Frankfurt
Does the CF out-patient depatment in Frankfurt/M. (Germany) take also children for treatment? For some time I am thinking of changing the out-patient department... Could you give me some information?
14.12.2007
Pneumococcal vaccine
Dear expert-team, We would like to have our son (4 ½ years old, diagnosis of CF 1 ½ years ago) vaccinated against Streptococcus pneumoniae, what has not been done until now. The paediatrician is of the opinion that it is advisable to use the polysaccharide vaccine and the conjugate vaccine. I thought that the conjugate vaccine is only used in babies and small children and you do not need this kind of vaccine anymore as soon as the polysaccharide vaccine can be used (which covers a border spectrum of S. pneumoniae anyhow). Please give me some information what is advisable to do. Many thanks!
14.12.2007
Uric acid
Dear ladies and gentlemen, I have an increase of the uric acid for sometime. Are there any general recommendations for CF, at what amount of the uric acid this should be treated and which drugs can be used? Is this also a typical finding in CF? I have heard once, that the digestion enzymes (Kreon, Panzytrat etc.) contain a very high amount of purine. Surely you can not allow yourself a low-purine diet in CF, because additionally you also have to pay attention that the weight is not decreasing rapidly… Many thanks in advance.
14.12.2007
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