Sweat test and cystic fibrosis: overview of test performance at public and private centers in the state of São Paulo, Brazil
Autor(a) principal: | |
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Data de Publicação: | 2017 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Jornal Brasileiro de Pneumologia (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1806-37132017000200121 |
Resumo: | ABSTRACT Objective: The sweat test (ST) measures chloride levels in sweat and is considered the gold standard for the diagnosis of cystic fibrosis (CF). However, the reliability of a ST depends on their being performed by experienced technicians and in accordance with strict guidelines. Our aim was to evaluate how sweat stimulation, sweat collection, and chloride measurement are performed at 14 centers (9 public centers and 5 private centers) that routinely perform STs in the state of São Paulo, which has the highest frequency of CF in Brazil. Methods: This was a cross-sectional cohort study, using a standardized questionnaire administered in loco to the staff responsible for conducting STs. Results: No uniformity regarding the procedures was found among the centers. Most centers were noncompliant with the international guidelines, especially regarding the collection of sweat (the samples were insufficient in 10-50% of the subjects tested); availability of stimulation equipment (which was limited at 2 centers); modernity and certification of stimulation equipment (most of the equipment having been used for 3-23 years); and written protocols (which were lacking at 12 centers). Knowledge of ST guidelines was evaluated at only 1 center. Conclusions: Our results show that STs largely deviate from internationally accepted guidelines at the participating centers. Therefore, there is an urgent need for standardization of STs, training of qualified personnel, and acquisition/certification of suitable equipment. These are essential conditions for a reliable diagnosis of CF, especially with the increasing demand due to newborn screening nationwide, and for the assessment of a possible clinical benefit from the use of modulator drugs. |
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Jornal Brasileiro de Pneumologia (Online) |
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Sweat test and cystic fibrosis: overview of test performance at public and private centers in the state of São Paulo, BrazilCystic fibrosis/diagnosisCystic fibrosis/prevention & controlSweatABSTRACT Objective: The sweat test (ST) measures chloride levels in sweat and is considered the gold standard for the diagnosis of cystic fibrosis (CF). However, the reliability of a ST depends on their being performed by experienced technicians and in accordance with strict guidelines. Our aim was to evaluate how sweat stimulation, sweat collection, and chloride measurement are performed at 14 centers (9 public centers and 5 private centers) that routinely perform STs in the state of São Paulo, which has the highest frequency of CF in Brazil. Methods: This was a cross-sectional cohort study, using a standardized questionnaire administered in loco to the staff responsible for conducting STs. Results: No uniformity regarding the procedures was found among the centers. Most centers were noncompliant with the international guidelines, especially regarding the collection of sweat (the samples were insufficient in 10-50% of the subjects tested); availability of stimulation equipment (which was limited at 2 centers); modernity and certification of stimulation equipment (most of the equipment having been used for 3-23 years); and written protocols (which were lacking at 12 centers). Knowledge of ST guidelines was evaluated at only 1 center. Conclusions: Our results show that STs largely deviate from internationally accepted guidelines at the participating centers. Therefore, there is an urgent need for standardization of STs, training of qualified personnel, and acquisition/certification of suitable equipment. These are essential conditions for a reliable diagnosis of CF, especially with the increasing demand due to newborn screening nationwide, and for the assessment of a possible clinical benefit from the use of modulator drugs.Sociedade Brasileira de Pneumologia e Tisiologia2017-04-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1806-37132017000200121Jornal Brasileiro de Pneumologia v.43 n.2 2017reponame:Jornal Brasileiro de Pneumologia (Online)instname:Sociedade Brasileira de Pneumologia e Tisiologia (SBPT)instacron:SBPT10.1590/s1806-37562016000000076info:eu-repo/semantics/openAccessServidoni,Maria FátimaGomez,Carla Cristina SouzaMarson,Fernando Augusto LimaToro,Adyléia Aparecida Dalbo ContreraRibeiro,Maria Ângela Gonçalves de OliveiraRibeiro,José DirceuRibeiro,Antônio Fernandoeng2017-05-16T00:00:00Zoai:scielo:S1806-37132017000200121Revistahttp://www.jornaldepneumologia.com.br/default.aspONGhttps://old.scielo.br/oai/scielo-oai.php||jbp@jbp.org.br|| jpneumo@jornaldepneumologia.com.br1806-37561806-3713opendoar:2017-05-16T00:00Jornal Brasileiro de Pneumologia (Online) - Sociedade Brasileira de Pneumologia e Tisiologia (SBPT)false |
dc.title.none.fl_str_mv |
Sweat test and cystic fibrosis: overview of test performance at public and private centers in the state of São Paulo, Brazil |
title |
Sweat test and cystic fibrosis: overview of test performance at public and private centers in the state of São Paulo, Brazil |
spellingShingle |
Sweat test and cystic fibrosis: overview of test performance at public and private centers in the state of São Paulo, Brazil Servidoni,Maria Fátima Cystic fibrosis/diagnosis Cystic fibrosis/prevention & control Sweat |
title_short |
Sweat test and cystic fibrosis: overview of test performance at public and private centers in the state of São Paulo, Brazil |
title_full |
Sweat test and cystic fibrosis: overview of test performance at public and private centers in the state of São Paulo, Brazil |
title_fullStr |
Sweat test and cystic fibrosis: overview of test performance at public and private centers in the state of São Paulo, Brazil |
title_full_unstemmed |
Sweat test and cystic fibrosis: overview of test performance at public and private centers in the state of São Paulo, Brazil |
title_sort |
Sweat test and cystic fibrosis: overview of test performance at public and private centers in the state of São Paulo, Brazil |
author |
Servidoni,Maria Fátima |
author_facet |
Servidoni,Maria Fátima Gomez,Carla Cristina Souza Marson,Fernando Augusto Lima Toro,Adyléia Aparecida Dalbo Contrera Ribeiro,Maria Ângela Gonçalves de Oliveira Ribeiro,José Dirceu Ribeiro,Antônio Fernando |
author_role |
author |
author2 |
Gomez,Carla Cristina Souza Marson,Fernando Augusto Lima Toro,Adyléia Aparecida Dalbo Contrera Ribeiro,Maria Ângela Gonçalves de Oliveira Ribeiro,José Dirceu Ribeiro,Antônio Fernando |
author2_role |
author author author author author author |
dc.contributor.author.fl_str_mv |
Servidoni,Maria Fátima Gomez,Carla Cristina Souza Marson,Fernando Augusto Lima Toro,Adyléia Aparecida Dalbo Contrera Ribeiro,Maria Ângela Gonçalves de Oliveira Ribeiro,José Dirceu Ribeiro,Antônio Fernando |
dc.subject.por.fl_str_mv |
Cystic fibrosis/diagnosis Cystic fibrosis/prevention & control Sweat |
topic |
Cystic fibrosis/diagnosis Cystic fibrosis/prevention & control Sweat |
description |
ABSTRACT Objective: The sweat test (ST) measures chloride levels in sweat and is considered the gold standard for the diagnosis of cystic fibrosis (CF). However, the reliability of a ST depends on their being performed by experienced technicians and in accordance with strict guidelines. Our aim was to evaluate how sweat stimulation, sweat collection, and chloride measurement are performed at 14 centers (9 public centers and 5 private centers) that routinely perform STs in the state of São Paulo, which has the highest frequency of CF in Brazil. Methods: This was a cross-sectional cohort study, using a standardized questionnaire administered in loco to the staff responsible for conducting STs. Results: No uniformity regarding the procedures was found among the centers. Most centers were noncompliant with the international guidelines, especially regarding the collection of sweat (the samples were insufficient in 10-50% of the subjects tested); availability of stimulation equipment (which was limited at 2 centers); modernity and certification of stimulation equipment (most of the equipment having been used for 3-23 years); and written protocols (which were lacking at 12 centers). Knowledge of ST guidelines was evaluated at only 1 center. Conclusions: Our results show that STs largely deviate from internationally accepted guidelines at the participating centers. Therefore, there is an urgent need for standardization of STs, training of qualified personnel, and acquisition/certification of suitable equipment. These are essential conditions for a reliable diagnosis of CF, especially with the increasing demand due to newborn screening nationwide, and for the assessment of a possible clinical benefit from the use of modulator drugs. |
publishDate |
2017 |
dc.date.none.fl_str_mv |
2017-04-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1806-37132017000200121 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1806-37132017000200121 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/s1806-37562016000000076 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira de Pneumologia e Tisiologia |
publisher.none.fl_str_mv |
Sociedade Brasileira de Pneumologia e Tisiologia |
dc.source.none.fl_str_mv |
Jornal Brasileiro de Pneumologia v.43 n.2 2017 reponame:Jornal Brasileiro de Pneumologia (Online) instname:Sociedade Brasileira de Pneumologia e Tisiologia (SBPT) instacron:SBPT |
instname_str |
Sociedade Brasileira de Pneumologia e Tisiologia (SBPT) |
instacron_str |
SBPT |
institution |
SBPT |
reponame_str |
Jornal Brasileiro de Pneumologia (Online) |
collection |
Jornal Brasileiro de Pneumologia (Online) |
repository.name.fl_str_mv |
Jornal Brasileiro de Pneumologia (Online) - Sociedade Brasileira de Pneumologia e Tisiologia (SBPT) |
repository.mail.fl_str_mv |
||jbp@jbp.org.br|| jpneumo@jornaldepneumologia.com.br |
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1750318346794958848 |