Changes in handgrip strength in children with cystic fibrosis compared to children without cystic fibrosis.

BACKGROUND & AIMS: Cystic Fibrosis (CF) may impact nutritional status. Handgrip strength (HGS) may be used for nutrition assessment. The objective of the study was to evaluate changes in HGS over time in children with CF compared to children without CF. A secondary purpose was to analyze the relationship of clinical characteristics of CF with HGS. METHODS: A prospective, longitudinal study was conducted. The non-CF group (n = 76) was recruited from a school and the CF group (n = 75) from an accredited CF center. Height, weight, mid-upper arm circumference, triceps skinfold, and HGS were measured at baseline and approximately three and six months in both groups. Data for pulmonary function, nutrition risk, enteral supplementation, CF transmembrane conductance regulator modulator, steroids, antibiotics, vitamin levels, CF related diabetes (CFRD), and recent hospitalization were collected for the CF group. A mixed model determined the difference in the change in HGS between the CF group and the non-CF group. For all analyses, p=<0.05 was significant. RESULTS: The rate of change in HGS z-score in the CF-group (0.18 ± 0.05) versus the non-CF group (0.06 ± 0.06) was not significant (p = 0.15). Initial mean dominant HGS z-score was significantly lower (p = 0.02) in those with vitamin D deficiency (-1.35 ± 0.09) versus those without (-1.02 ± 0.11). HGS z-score significantly (p = 0.02) decreased over time in children with CFRD (-0.19 ± 0.22) versus children without CFRD (0.32 ± 0.14), p = 0.02. CONCLUSION: Serial measurements of HGS may help detect changes in muscle function related to CFRD and vitamin D deficiency. Further investigation is warranted to elucidate HGS's role in nutrition assessment of children with CF.

Prefilled syringe needles versus standard removable needles for intravitreous injection.

PURPOSE: To investigate differences in the scleral resistance between standard disposable 27 gauge (G) needle versus the Macugen prefilled syringe needle. METHODS: Observational study at one eye center. One injecting physician performed 46 intravitreous injections using standard Becton Dickinson 27 G needles and 71 intravitreous injections using Macugen needles during January to May 2005. The procedure in two patients was videotaped and analyzed frame by frame. Microphotographs of used needles were analyzed. RESULTS: There were no complications during the injection procedure in either group. Microphotographic analysis after injection revealed 3 and 5 facets on standard 27 G needle and Macugen needles, respectively. The bevel forming the tip of the 27 G needle was steeper and longer than that of the Macugen needle. The inside diameter in the standard 27 G needle was 220 microm versus 210 microm in the Macugen needle. CONCLUSION: There are differences in needle design between commonly used disposable 27 G needles and 27 G Macugen needles which result in higher resistance to penetration with Macugen needle. Careful needle design is an important concern in manufacturing prefilled syringes with needles attached to them.