title: Clinical, nutritional and spirometric evaluation of patients with cystic fibrosis after the implementation of multidisciplinary treatment.
abstract: OBJECTIVE
  Cystic fibrosis (CF) is a chronic multisystemic hereditary disease for which a multidisciplinary approach must be taken. The objective of this study was to show the evolution of a group of patients with CF after the implementation of multidisciplinary treatment.
  
  
  METHODS
  A retrospective study involving 19 patients (6-29 years of age) under clinical follow-up treatment at the University of São Paulo at Ribeirão Preto School of Medicine Hospital das Clínicas, located in the city of Ribeirão Preto, Brazil. The patients were divided into two groups: 6-12 (6-12 years of age) and 13+ (> 12 years of age). We collected data regarding body mass index (BMI), Z score, Shwachman score (SS), number of exacerbations/year, chronic colonization by Pseudomonas aeruginosa, and spirometric measurements (FVC, FEV1, FEV1%, and FEF25-75%). Data were collected at two different time points (before and after the implementation of the multidisciplinary treatment) and were analyzed with the Wilcoxon signed rank test.
  
  
  RESULTS
  The median age at the onset of symptoms was 10 months. In the 6-12 group, only BMI and FVC increased significantly. Although the other spirometric values increased, the differences were not significant. In the 13+ group, there were no significant differences between the two time points. There was a borderline significant decrease in SS and less than significant decreases in the spirometric measurements. However, the number of patients with alterations in volumes and flows decreased in both groups.
  
  
  CONCLUSIONS
  Although our patient sample was small, the lack of changes in the spirometric parameters might reflect clinical and functional stability. In all of the patients evaluated, clinical, functional, and nutritional parameters remained stable throughout the study period. The implementation of a multidisciplinary approach might have contributed to this result.
authors.affiliation: Departamento de Puericultura e Pediatria, Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil. lidiaagm@gmail.com
authors.forename: Lídia
authors.initials: L
authors.lastname: Torres
authors.forename: Jenny Libeth Jurado
authors.initials: JL
authors.lastname: Hernandez
authors.forename: Giseli Barbiero de
authors.initials: GB
authors.lastname: Almeida
authors.forename: Liana Barbaresco
authors.initials: LB
authors.lastname: Gomide
authors.forename: Valéria
authors.initials: V
authors.lastname: Ambrósio
authors.forename: Maria Inez Machado
authors.initials: MI
authors.lastname: Fernandes
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D002648:Child; D003550:Cystic Fibrosis / Q000473:pathology* / Q000503:physiopathology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009752:Nutritional Status / Q000502:physiology*; D010348:Patient Care Team / Q000592:standards; D012189:Retrospective Studies; D013147:Spirometry; D018709:Statistics, Nonparametric; D014797:Vital Capacity / Q000502:physiology*; D055815:Young Adult