Samuel Spector

A 5 YEAR CLINICAL EVALUATION OF A THERAPEUTIC PROGRAM FOR PATIENTS WITH CYSTIC FIBROSIS.

A clinical evaluation of a comprehensive prophylactic therapeutic program for patients with cystic fibrosis is presented. Ninety-six consecutive patients were followed for 18 to 60 months (average 37 months) and evaluated with the use of a modification of the Shwachman scoring system. Eighty-two per cent of these patients showed improvement, 11% remained the same, 4% showed progression beyond their initial status, and only 3% died. None of the deaths occurred before 5 years of age. Evidence is presented supporting the desirability of early diagnosis and the early institution of an intensive prophylactic and therapeutic regimen.

A THERAPEUTIC REGIMEN FOR PATIENTS WITH CYSTIC FIBROSIS.

A comprehensive therapeutic regimen for patients with cystic fibrosis has been evolved, in part empirically, based on our understanding of the pathogenesis of the pulmonary lesion and in large part supported by the results of clinical and pulmonary function evaluations. The aims of this regimen are the maintenance of adequate pulmonary hygiene both prophylactically and therapeutically, effective control of the pulmonary infection, and comprehensive care of the patient. Prophylactic pulmonary therapy is instituted as soon as the diagnosis is made regardless of whether or not active pulmonary involvement is present. Pulmonary infection when present is treated specifically and intensively and is kept at a minimum by monthly clinical and laboratory evaluation of the patient.

An association of gastrointestinal allergy withthe celiac syndrome

Summary From the observations recorded, it seems that there is, at times, an association of gastrointestinal allergy with the celiac syndrome. Whether the allergy is secondary to a disturbance of absorption dependent on the celiac syndrome or whether the food sensitization precedes and is responsible for the symptomatology of celiac disease is not clear. The added observation that absorption from the gastrointestinal tract of a fat-soluble substance, vitamin A, may be impaired in conditions known to be due to allergy but in which gastrointestinal symptomatology is minimal suggests that degrees of impairment of absorption may occur on an allergic basis and that gastrointestinal allergy may bear a causal relationship to the celiac syndrome.