Comparison of weight-based dosages of enteric-coated microtablet enzyme preparations in patients with cystic fibrosis.

Twenty-one stable hospitalized cystic fibrosis patients with malabsorption syndrome participated in an open-label crossover clinical trial to evaluate the efficacy of two-period dosing regimens of a pancreatic microtablet enzyme preparation in the treatment of steatorrhea. Standard dosing consisted of 500 U lipase/kg body weight/meal, 250 U lipase/kg body weight/snack; high dosing consisted of 1,500 U lipase/kg body weight/meal, 750 U lipase/kg body weight/snack. Doses were determined by units of lipase/kg body weight to provide dosing consistency among patients of varying size. Each patient was on a regular diet of approximately 100 g of fat per day. Two separate, 72-h stool collections were performed between markers. A significant difference in mean percentage fat absorbed between the standard dose and the high dose was found (86% versus 91%, p < 0.05). Subjects were then stratified into two groups, based on the grams of fecal fat eliminated (GFFE) as follows: Group 1 with < or = 7 GFFE/24 h on both dosages (n = 7) and Group 2 with > 7 GFFE/24 h on either dose (n = 14). A significant difference (p < 0.05) between Group 1 (96%) and Group 2 (88%) was noted in the percentage fat absorbed while on the high dose. Fat absorption improved from 81% to 88%, (p < 0.05) in Group 2. During the study period, the adverse reactions of constipation or elevated serum uric acid levels were not observed. The increased doses of pancreatic enzymes resulted in improved correction of steatorrhea.

Pulmonary parameters in children after laryngotracheal reconstruction.

Laryngotracheal reconstruction in children with autogenous rib cartilage has proved successful in relieving laryngotracheal stenosis. To date, no objective measurements have been available to assess the upper airway's functional ability in these children after decannulation. A pilot study analyzing pulmonary function in 18 children successfully decannulated after laryngotracheal reconstruction was performed. The children ranged in age from 24 months to 12 years and were several months postdecannulation at the time of testing. The results of this pilot study offer an objective assessment of functional capacity after laryngotracheal reconstruction in older children and serve as a basis for objective follow-up. In younger children, pulmonary function values were difficult to obtain and proved to be of no significant value to the overall assessment of functional capacity of the airway.