Improvement of fecal fat excretion after addition of omeprazole to pancrease in cystic fibrosis is related to residual exocrine function of the pancreas.

Pancreatic function tests were performed in 11 adult cystic fibrosis (CF) patients with a fecal fat excretion of more than 10% during treatment with pancrease 2 capsules three times a day. These tests included urinary p-aminobenzoic acid (PABA) excretion, fasting serum trypsin and pancreatic polypeptide (PP), and glucose and insulin in fasting and postprandial serum. Subsequently, the patients entered a double-blind placebo-controlled crossover study to assess the effect of gastric acid inhibition by 20 mg omeprazole on fecal fat excretion.

Bilateral hydronephrosis with urosepsis due to neglected pessary. Case report.

In an 86-year-old woman a neglected pessary and extreme coprostasis gave rise to anuria, urosepsis and bilateral ureteropelvic dilatation with an empty bladder. This seems to be the first reported case of its kind.

Nutritional state and lung disease in cystic fibrosis.

The life expectancy of patients with cystic fibrosis (CF) is largely dependent on the severity and progress of the pulmonary involvement associated with the disease. Many data support the view that malnutrition and deterioration of lung function are closely interrelated and interdependent, with each affecting the other, leading to a spiral decline in both. The occurrence of malnutrition appears to be associated with poor lung function and poor survival, and conversely prevention of malnutrition appears to be associated with better lung function and improved survival.

New modalities in the treatment of exocrine pancreatic insufficiency in cystic fibrosis.

Pancreatic insufficiency is the second most important pathophysiological expression of cystic fibrosis (CF) and occurs in the majority of patients. It leads to fat malabsorption and high energy losses in the stools and is one of the major causes of malnutrition often seen in CF. Although the development of enteric-coated enzyme preparations offers a dramatic improvement in therapy, it is still difficult to achieve complete correction of fat malabsorption.

Recognition and prevention of two cases of erroneous haemocytometry counts due to platelet and white blood cell aggregation. The use of acid citrate dextrose as an auxiliary anticoagulant.

Two cases of anticoagulant-induced platelet-white blood cell aggregation are described, which resulted in erroneous haemocytometry counts. Aggregation was avoided by the use of acid citrate dextrose (ACD) as an auxiliary anticoagulant, thus enabling quantification of platelets and white blood cells.

Pharmacokinetics of ranitidine in a homogeneous population of intensive care unit patients during intermittent and continuous administration.

The pharmacokinetics of ranitidine during two different modes of intravenous administration was studied in a homogeneous group of postoperative intensive care unit patients (n = 18). Patients at risk of developing stress-related lesions were randomized to receive repeated injections, 50 mg every 6 h (group A), or a continuous infusion, 50-mg bolus followed by 0.125 mg/kg/h (group B).

Shelf life of prepared Bordet-Gengou and Regan-Lowe agar plates for isolation of Bordetella pertussis.

The shelf life of prepared agar plates used for the isolation of Bordetella pertussis was studied. They contained Bordet-Gengou agar, Bordet-Gengou agar with cephalexin, Regan-Lowe agar, Regan-Lowe agar with cephalexin, or Regan-Lowe agar with both cephalexin and amphotericin B. Plates stored were compared to freshly prepared control plates for up to a maximum of 18 weeks.

Omeprazole enhances the efficacy of pancreatin (pancrease) in cystic fibrosis.

We studied the effect of the addition of omeprazole (20 mg once a day) to treatment with pancreatin (Pancrease, Cilag, Herentals, Belgium), two or four capsules three times a day, on fecal fat excretion in a double-blind, crossover fashion in nine patients with cystic fibrosis having persistent steatorrhea while taking Pancrease, two capsules three times a day (mean fecal fat excretion, 22.3%; range, 12% to 44%). Neither doubling of the dose of Pancrease nor addition of omeprazole to the lower dose of Pancrease significantly reduced fecal fat excretion (mean, 19.

Quinidine treatment of chronic lone atrial fibrillation.

Patients with chronic lone atrial fibrillation (LAF) were treated with quinidine according to a special schedule to establish sinus rhythm and prevent recurrences. Twenty-seven patients following this schedule were identified retrospectively. To prevent relapses, quinidine had been continued in 25 patients in doses 100 mg quid lower than those used for conversion.

Efficacy of different doses of cimetidine in the treatment of reflux esophagitis. A review of three large, double-blind, controlled trials.

Four different cimetidine dosage regimens--800 mg u.i.d.

Prevention of stress ulcer bleeding: a review.

The pathophysiology of stress ulcers is complex. There is either too much acid and pepsin or inadequate mucosal defenses. The incidence of upper GI bleeding due to stress ulcers in the ICU is 5-25% depending upon the minimum criterion of bleeding.

Ranitidine compared with the dimethylprostaglandin E2 analogue enprostil as adjunct to pancreatic enzyme replacement in adult cystic fibrosis.

In a double-blind cross-over randomized study adjunct therapy with ranitidine (2 x 150 mg) was compared with enprostil (2 x 35 micrograms) in eight adult cystic fibrosis (CF) patients receiving a fixed dose of enteric-coated microsphere capsules of pancreatin (Pancrease). The study consisted of two consecutive 14-day treatment periods. All patients kept a fixed daily fat intake during the last 5 days of each treatment period and performed 72-h faecal collections during the last 3 days of each treatment period.

Should the Cytobrush be used in routine screening for cervical pathology?

In 632 women visiting a family planning clinic, paired cervical smears were taken using a wooden spatula and a Cytobrush. Of the spatula smears 7.8% were unreliable with too little or scanty material to allow a cytologic diagnosis (class 0); 17.

CD-1 (T6), HLA-DR-expressing cells, presumably Langerhans cells, in nasal mucosa.

In the skin, epidermal Langerhans cells (LC) constitute a major population of antigen-presenting cells. These cells are characterized by the expression of both CD-1 (T6) and HLA-DR on the cell membrane. We wanted to know whether similar CD-1/HLA-DR-positive cells occur in the nasal mucosa of patients with an isolated grass pollen allergy and in non-allergic controls.

Urological complications following aorto-iliac reconstructive surgery.

The incidence of urological complications after aorto-iliac graft surgery was prospectively studied in 49 patients and retrospectively in 35 other patients operated on more than five years before. Follow-up of all 49 patients was one year. In one patient a mild asymptomatic hydronephrosis was discovered after four months.

Efficacy and transdermal absorption of permethrin in scabies patients.

The clinical efficacy and transdermal absorption of permethrin, a new synthetic insecticide was investigated in ten scabies patients. All patients were successfully treated with one application of a cream, containing 5% permethrin. Apart from mild postscabies dermatitis no side-effects were observed.

Pneumoperitoneum without peritonitis.

Usually, pneumoperitoneum is due to perforation of a hollow abdominal organ. In the absence of peritoneal symptoms, pneumoperitoneum may be due to other causes. Two patients with an unnecessary laparotomy for pneumoperitoneum without peritonitis are presented.

Recognition and prevention of pseudothrombocytopenia and concomitant pseudoleukocytosis.

Unrecognized anticoagulant-induced platelet (PLT) aggregation, leading to pseudothrombocytopenia and concomitant pseudoleukocytosis, can have serious clinical consequences. It can be readily recognized by inspecting conventional blood smears or the white blood cell histograms generated by modern blood cell counters. Blood specimens from twenty patients with known EDTA-induced platelet aggregation were consecutively drawn into three other anticoagulants (using Vacutainer tubes) and processed in a three-part differential Coulter Counter S Plus IV.

Performance of the Cytobrush in patients at risk for cervical pathology: does it add anything to the wooden spatula?

In 130 high-risk patients for cervical pathology paired smears were obtained with a wooden spatula and a Cytobrush. The Cytobrush was useful in lowering the amount of inadequate smears (2 vs 22%, p less than or equal to 0.01), and detected more abnormal cytology in combination with the spatula compared to the spatula smear alone (27 vs 35%, p less than or equal to 0.