ABSTRACT
Pain is a potential complication of cystic fibrosis (CF), but its consequences in daily life and other issues of pain management are not yet clearly understood. We undertook a comparative study of children and adults with CF to assess the prevalence of pain symptoms, their characteristics and treatment, their impact on daily quality of life, and the occurrence of procedural pain. The study included 73 children (1-18 years) and 110 adults (18-52 years); 59% of the children and 89% of the adults reported at least one episode of pain during the previous month. Pain was significantly more intense and lasted significantly longer among adults, but its rate and recurrence did not differ significantly between the two populations and were not related to the severity of CF. The most prevalent locations were the abdomen for children, and the back, head, and chest for adults. Although pain significantly limited physical activity, only 15% of patients reported that it caused absenteeism, and 27% reported that it negatively affected their family life. The mean pain intensity rates on a visual analog scale for the episode that had caused the greatest pain during the past month were 4.9 (2) (mean [SD]) for children and 6 (2) for adults; however, only 40% and 50%, respectively, of those with pain reported the use of analgesic treatment, mainly paracetamol (acetaminophen). At least one episode of procedural pain during the previous month was reported by 85% of children and 78% of adults. Our study demonstrates the high incidence of undertreated pain in CF patients throughout their lives.
Subject(s)
Cystic Fibrosis/complications , Pain/etiology , Adult , Age Factors , Child , Cystic Fibrosis/epidemiology , Cystic Fibrosis/psychology , Female , Humans , Male , Pain/epidemiology , Pain/psychology , Quality of Life , Surveys and QuestionnairesABSTRACT
OBJECTIVES: In cystic fibrosis (CF) children, we investigated the predictive impact of glutathione S-transferases (GST) activity and genotypes P1, M1 and T1, and antioxidant levels on stage-severity of Pseudomonas aeruginosa lung infection. METHODS: GST activity was determined in whole blood by spectrophotometry, and GST genotypes by multiplex PCR RFLP for 36 CF and 9 control children. Levels of glutathione in erythrocyte and vitamins A, E and C in plasma were measured by HPLC. RESULTS: No difference in GST activity and no relationship between GST activity and antioxidant levels were observed in CF children as compared to controls. However, GST activity was lower in CF children with severe clinical status and infection, and the frequency of GSTP1 wild type genotype AA, prevalent in uninfected CF children (75%), decreased in infected ones (33%). CONCLUSION: GST activity and genotype could play an important role in modulating P. aeruginosa lung infection in CF patients.
Subject(s)
Cystic Fibrosis/enzymology , Cystic Fibrosis/microbiology , Glutathione Transferase/metabolism , Pseudomonas Infections/physiopathology , Pseudomonas aeruginosa/pathogenicity , Adolescent , Ascorbic Acid/blood , Child , Child, Preschool , Chromatography, High Pressure Liquid , Erythrocytes/metabolism , Female , Genotype , Glutathione/metabolism , Glutathione Transferase/genetics , Humans , Male , Polymerase Chain Reaction , Polymorphism, Restriction Fragment Length , Vitamin A/blood , Vitamin E/blood , Young AdultABSTRACT
Children affected with sickle-cell disease experience painful crises that may be life threatening, or felt as if they were. We evaluated by semistructured interviews and questionnaires the presence of posttraumatic stress disorder in 11 children affected by sickle-cell disease and having suffered at least one hospitalization for a painful crisis, and in their parents (10 mothers, 1 father). Three children (27%) and four parents (40%) were diagnosed with the disorder. It was not correlated to the disease severity but, in parents, to a feeling of powerlessness over the child's illness (P = 0.04).
