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Literature Review Proposal

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Introduction
Cystic fibrosis (CF) refers to an inherited problem of the mucus glands. Mucus is a substance that is usually slippery secreted by the body to cover the digestive system, lungs, and reproductive system as well as other tissues and organs. CF makes the body to release excessive mucus that is extremely thick and sticky, which can cause various health issues. Among these health issues are difficulty in coughing, chest repetitive infections, lengthy diarrhea and deprived gain of weight. If the condition is not treated it would cause extensive complications, which may lead to early death. Nevertheless, if the condition is identified early and the child is exposed to proper treatment, the symptoms of CF are controllable and children may live longer. Different authors have different views on CF as they all try to get into a conclusion on how the health condition should be resolved. Since CF is inherited, the defective gene must be passed from both the parents to the child in order to acquire the disease else if only a faulty gene is inherited, the child becomes a carrier. Actually carries of cystic fibrosis do not have the disease but can pass to other individuals. There are proposals on improvements as well as challenges in executing the CF treatment process. The paper discusses the proposal below.

Literature Review
According to Norm Brown (2009), the gene responsible for CF was identified and it was named Cystic Fibrosis Trans-membrane Conductance Regulator (CFTR). He introduced sweat testing which brought in the non-invasive diagnosis, which was considered as gold standard for CF testing. He suggested proper screening of children after birth to prevent the spread of the disease (Vanzo, 2009). Further, according to the research carried out by NBS Wilson et al, (2015) CF patients have better pulmonary function in later childhood than the patients diagnosed after clinical symptoms or for CF patients who had meconium ileus. The diagnosis is also carried out through the sweat chloride testing so as to rule out CF (Wilson et al, 2015). Although, Norm believes the disease is genetic (Peebles, 2005) argues that the disease apart from genetic may develop through lifestyle. Exposure to extremely cold and stuffy areas would cause the disease. Elborn et al (2000) suggest proper screening for children so as to avoid the conditions of the disease which may not be discovered from genetic identification.
In further discussion Giddings (2009) argues that CF is usually incurable if it is not treated early enough. At some point, the problem may not be noted very fast in a way that the family would call for first response by the doctor. He further argues that the accumulation of mucus in the lungs continue to increase making the situation worse. The argument is supported by Orenstein, Spahr & Weiner (2012) who say that the mucus becomes infectious once it is left to accumulate in the lungs and other organs. As a result, other complications may develop rendering the organs irresponsive to medication and the necessary treatment Wolter et al (2002). As such, the authors suggest that it is better to treat the disease much earlier, which calls for families to be on the look to the symptoms of the disease.
According to Munson & Traister (2005) there are a number of challenges that come with the CF condition. They argue that identifying the disease is a major hurdle, which many patients may not discover at early stages. It is a highly complicated disease whose test cannot be done on naked eyes. As such, they support the use of tests such as salt test, which is highly significant in identifying the problems attached to the CF condition. Further, Acton (2013) suggests that the challenge is not the test done but the identification of the condition when it is at early stage. He argues that it is easy to treat the disease at its early stage than when it advances to acute stages.
Pryor et al (1979) suggest that screening for cystic fibrosis should be done through proper evaluation of the postural drainage system. As such, the suggest use of forced expiration technique. The method is highly effective in screening and helps in identifying the least traces of mucus that may exist in the drainage. Further, Kerem, Eitan, et al. (2008) suggest that PTC124 could be a major treatment for cystic fibrosis. It is highly effective when the disease is detected at an early stage. Mutation is the major cause of the disease according to Kerem, Eitan, et al but it is highly effective at stage two. Therefore, proper screening is required as per the suggestion given by the authors. On the other hand, Hofmeyr et al (1986) suggested the use of positive expiratory pressure as the method of treatment. The method works closely with the chest physiotherapy to ensure excellent screening of the cystic fibrosis condition (Orenstein et al) Therefore, authors conclude that screening is the best solution to preventing the prevalence of cystic fibrosis.
Moss, Richard B., et al (2007) introduced an excellent research on the proper treatment for cystic fibrosis. They recommend repetitive aerosolized AAV-CFTR, which is usually controlled by the level of screening that one has been subjected to over the treatment period. The treatment is well known as it is able to eliminate a good percentage of the mucus found in the digestion system. (McAleer 2006) supports the process by defining it as a reliable technique to ensure the cystic fibrosis patients are healed. It is also supported as a therapy that may be practiced in a community setup. It is actual and highly reliable to offer the necessary knowledge concerning the existence of the disease. Further, (Conway 2003) had suggested that the screening process should be done immediately a child is born. It gives an opportunity to ensure the child is free from the condition. The screening process in this case is highly reliable and offers support to a number of treatments like AAV-CFTR and PTC124.
Frederiksen et al, (1997) offers possible prevention for cystic fibrosis. The method offered prevents chronic infection thus preventing the spread of the disease. It also cures the condition in its primary stages. However, the treatment cannot be extended to the family to prevent the occurrence of the disease. Aerts (2013), suggests that the treatment of the disease can be undertaken through practice for preventive measures that would ensure the disease does not survive in the body of a young one. McIlwaine et al (1997) suggests a reasonable process of treating the disease by ensuring proper methods are used in the treatment. As such, he suggests the postural drainage and percussion and positive expiratory pressure physiotherapy.

Works Cited
Acton, Ashton. Cystic Fibrosis: New Insights For The Healthcare Professional: 2013 Edition. Atlanta: Scholarly Editions, 2013. Print.
Aerts, Johannes Maria Franciscus Gerardus, and Rolf Gabriel Boot. "Treatment of cystic fibrosis." U.S. Patent No. 8,410,081. 2 Apr. 2013.
Conway, S. 'Osteoporosis Is Cystic Fibrosis'. Journal of Cystic Fibrosis 2.4 (2003): 161-162. Web.
Elborn, J. S., et al. "Elective versus symptomatic antibiotic treatment in cystic fibrosis patients with chronic Pseudomonasinfection of the lungs." Thorax 55.5 (2000): 355-358.
Frederiksen, Birgitte, Christian Koch, and Niels Høiby. "Antibiotic treatment of initial colonization with Pseudomonas aeruginosa postpones chronic infection and prevents deterioration of pulmonary function in cystic fibrosis." Pediatric pulmonology 23.5 (1997): 330-335.
Giddings, Sharon. Cystic Fibrosis. New York: Chelsea House, 2009. Print.
Hofmeyr, J. L., B. A. Webber, and M. E. Hodson. "Evaluation of positive expiratory pressure as an adjunct to chest physiotherapy in the treatment of cystic fibrosis." Thorax 41.12 (1986): 951-954.
Kerem, Eitan, et al. "Effectiveness of PTC124 treatment of cystic fibrosis caused by nonsense mutations: a prospective phase II trial." The Lancet372.9640 (2008): 719-727.
McAleer, R.D. '346 Community Physiotherapy For Newly Diagnosed Infants With Cystic Fibrosis (Newborn Screening)'. Journal of Cystic Fibrosis 5 (2006): S76. Web.
McIlwaine, P. Maggie, et al. "Long-term comparative trial of conventional postural drainage and percussion versus positive expiratory pressure physiotherapy in the treatment of cystic fibrosis." The Journal of pediatrics131.4 (1997): 570-574.
Moss, Richard B., et al. "Repeated aerosolized AAV-CFTR for treatment of cystic fibrosis: a randomized placebo-controlled phase 2B trial." Human gene therapy 18.8 (2007): 726-732.
Munson, Carol, and Rob Traister. Pathophysiology. Print.
Orenstein, David M, Jonathan E Spahr, and Daniel J Weiner. Cystic Fibrosis. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2012. Print.
Orenstein, David M., et al. "The effect of early diagnosis and treatment in cystic fibrosis: a seven-year study of 16 sibling pairs." American Journal of Diseases of Children 131.9 (1977): 973-975.
Peebles, Allison. Cystic Fibrosis Care. Edinburgh: Elsevier Churchill Livingstone, 2005. Print.
Pryor, J. A., et al. "Evaluation of the forced expiration technique as an adjunct to postural drainage in treatment of cystic fibrosis." BMJ 2.6187 (1979): 417-418.
Vanzo, Rena. 'Newborn Screening & Cystic Fibrosis'. U T A H D E P A R T M E N T O F H E A L T H — N E W B O R N S C R E E N I N G P R O G R A M 1.1 (2009): 1-5. Print.
Wilson, William, Christie Jett, and Deborah Froh. 'TWO-TIER NEWBORN SCREENING FOR CYSTIC FIBROSIS'. Department of Pediatrics, University of Virginia School of Medicine 1.1 (2015): 1-36. Print.
Wolter, J., et al. "Effect of long term treatment with azithromycin on disease parameters in cystic fibrosis: a randomised trial." Thorax 57.3 (2002): 212-216.

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