Featured Cases: State-of-the-Art Treatment for CF Lung Disease

Volume 2, Issue 10.

Clinical practice guidelines have become a regular component of health care. The Cystic Fibrosis Foundation has supported the development of several recent clinical practice guidelines to review the evidence that endorses many of the therapies currently in use.

Although numerous clinical manifestations of cystic fibrosis (CF) exist, the principal causes of disease-related morbidity and mortality are due to pancreatic insufficiency and chronic airway infection. Recommendations are now available on the assessment and treatment of nutritional disease, use of airway clearance therapies, and use of chronic medications to maintain lung health. Acute complications of CF lung disease include pulmonary exacerbations, hemoptysis, and pneumothorax; guidelines on the management of these complications are currently available as well. Finally, as newborn screening for CF has become standard in all states, we can expect that most patients will be diagnosed in the absence of symptoms. Infant care guidelines should provide primary care physicians with the information needed for appropriate assessment and treatment of newly diagnosed patients.

In this podcast recording, Dr. Patrick Flume utilizes patient cases to summarize the clinical practice guidelines for individuals with CF, to aid clinicians in improving the quality and consistency of the care they provide.

Featured Cases: Vitamin D and Bone Health

Volume 2, Issue 8.

In 2002, the CF Foundation convened a consensus conference. This consensus conference developed specific recommendations for the prevention of bone disease and the optimal supplementation of vitamin D for patients with cystic fibrosis. The original consensus guidelines did not have any actual demonstration in cystic fibrosis patients, and most of this was expert opinion. And at this time we are actually trying to test these guidelines to see if they hold true in those with cystic fibrosis. Since patients with cystic fibrosis are living longer, they are developing more complications, such as bone disease, and insuring that vitamin D supplementation is adequate and figuring out new ways to prevent bone disease is becoming more and more important for CF patients. In the discussion today, Peter Mogayzel, MD and Dianna Green, MD, of the Johns Hopkins University School of Medicine, will focus on the basis of the current vitamin D recommendation for patients with cystic fibrosis, describe the potential for success of various strategies for treatment of vitamin D insufficiency, and compare the potential benefits and risks of using bisphosphonates for the treatment of osteoporosis in patients with cystic fibrosis.

Featured Cases: Cystic Fibrosis–Related Diabetes

Volume 2, Issue 2.

In September of 2009, the Cystic Fibrosis Foundation held a third CFRD consensus conference, co-sponsored by the American Diabetes Association and the Lawson Wilkins Pediatric Endocrine Society, providing a new set of recommendations for treating cystic fibrosis-related diabetes. Johns Hopkins provided evidence review so there can be evidence-based guidelines. Diagnostic & treatment criteria are presented in this podcast.