Introduction: Vitamin D acts on the immune system and lung response. Patients with cystic fibrosis (CF) may be deficient in this vitamin. The aims of the study were to evaluate vitamin D levels and severity of lung disease in infants and preschoolers diagnosed with CF, and to compare them to a group of children without pancreatic insufficiency (PI).
Methods: Patients with CF up to 4 years old were included, and compared to an agematched group of children without diagnosis of CF. CF group had medical records and High Resolution Thorax Computed Tomography (HRCCT) evaluated in order to verify the severity of lung disease. Information on demographic data, sun exposure habits, supplemental vitamin D therapy, and on the season at the time of vitamin D sampling were collected for both groups.Results: This study included 45 patients in the CF group and 102 in the non-CF group, with no differences in age (P = 0.327) between them. There was no association between vitamin D levels and markers of lung disease in the CF group. The non-CF group had lower daily sun exposure (P = 0.034), and lower supplementation than the CF group (P < 0.001). Supplementation and seasonality were the determinant variables for vitamin D levels, which were lower for non-supplemented children and for assessments during fall/winter.
Conclusion:There was no association between lung disease severity and vitamin D levels in CF group. Supplementation and seasonality were associated to higher vitamin levels.
K E Y W O R D Scystic fibrosis, infants and preschoolers, lung disease, neonatal screening, vitamin D
A Faculdade de Ciências Médicas da Unicamp implantou uma ampla reforma curricular, que antecedeu as Diretrizes Curriculares Nacionais (DCN) de 2001. Analisou-se a trajetória profissional e o impacto da reforma curricular na formação pela percepção dos egressos. Alunos concluintes de 1991-2005 compuseram o grupo pré-reforma e os de 2006-2012, o grupo pós-reforma, que receberam um questionário semiestruturado on-line por e-mail e redes sociais. Obtiveram-se 213 (15,8%) respostas do grupo pré e 126 (16,1%) do pós-reforma. Os dados apontaram pouca dispersão geográfica dos ex-alunos, ocupação de 2,4 postos de trabalho por médico, entendimento da residência como necessária, maior frequência a cursinhos preparatórios no grupo pós-reforma e sugestão de inclusão de administração/gestão em saúde no currículo. A integração entre áreas básicas/clínicas apresentou significante melhora pós-reforma. A percepção sobre a graduação foi altamente positiva. O estudo contribuiu para implantar o acompanhamento sistemático de egressos no curso de Medicina.
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