Daniel S. Fleisher

Protein metabolism in cystic fibrosisof the pancreas

Metabolic balance studies were performed on 5 infants with cystic fibrosis of thepancreas. One of the subjects had hypoproteinemia and intermittent edema. Large quantities of nitrogen were excreted in the stools when the infants received a soybean formula. This was most marked in the hypoproteinemic patient and was considered to be the pathogenetic explanation of his hypoproteinemia. Nitrogen retention was significantly higher when the infants received an evaporated cows milk formula. A paracreatic enzyme preparation led to significant increase in nitrogen retention when added to soybean feedings but not when added to evaporated cows milk feedings. It is recommended that infants with cystic fibrosis of the pancreas should not be fed soybean milk preparations.

The Bi-Cycle Concept—Relating Continuing Education Directly to Patient Care

This excerpted article originally appeared in Stearns NS, Getchell ME, Gold RK. Continuing Medical Education in Community Hospitals: A Manual for Program Development. Boston: Postgraduate Medical Institute, 1971, 88–96; and was published by the Massachusetts Medical Society, as a supplement to The New England Journal of Medicine, Vol. 284; No. 20; May 20, 1971.