morphine and Nasal-Polyps

It has long been recognized that the patient with chronic lung disease, malnutrition, vitamin K deficiency or electrolyte and blood gas disturbances presents a special problem for the surgeon. Patients with cystic fibrosis have all of these abnormalities. Until recently, the patient with cystic fibrosis was exclusively the domain of the pediatrician. Today, with the increasing number of patients over the age of 20 years, internists and surgeons have an increasingly important role in the care of these patients. In addition, since women with cystic fibrosis are capable of bearing children, the need for genetic, obstetric and gynecologic counseling is becoming more apparent. Although the patient with cystic fibrosis is generally at a much greater risk for the complications of surgical treatment than the normal patient, experience in the management of these patients has greatly improved the outlook. However, in most instances, surgical management of the patient with cystic fibrosis represents palliation, since these patients usually die of the medical complications of their disease. Further controlled studies are needed to fully evaluate the role of surgical treatment in the sequelas of cystic fibrosis.

Topics: Adolescent; Adult; Biliary Tract Diseases; Child; Child, Preschool; Cystic Fibrosis; Female; Hemoptysis; Humans; Hypertension, Portal; Infant; Infant, Newborn; Intestinal Obstruction; Meconium; Middle Aged; Mucocele; Nasal Polyps; Pneumothorax; Risk; Surgical Procedures, Operative

The clinical histories, chest X-ray appearances, skin prick test results, pulmonary function and IgE levels of 20 patients with cystic fibrosis (C.F.) complicated by nasal polyps have been compared with those of 97 C.F. controls. The patients who had developed polyps had a different clustering of symptoms to the controls with heavier birthweights, later presentations, milder gastrointestinal symptoms in infancy, less infection with Staphylococcus aureus and better vital capacities. There was no evidence on history, skin testing or IgE levels that the polyps patients were more allergic. It is likely, therefore, that nasal polyps in C.F. are due to a primary effect of the C.F. gene, although they could also be the effect of chronic nasal infection.

Topics: Birth Weight; Child, Preschool; Cystic Fibrosis; Humans; Hypersensitivity; Infant, Newborn; Intestinal Obstruction; Meconium; Nasal Polyps; Staphylococcal Infections; Vital Capacity

Topics: Abdomen, Acute; Aerosols; Anti-Bacterial Agents; Breathing Exercises; Cough; Cystic Fibrosis; Drainage; Heat Exhaustion; Humans; Intestinal Obstruction; Lung Diseases; Meconium; Mucus; Nasal Polyps; Physical Therapy Modalities; Pneumonia, Staphylococcal; Pneumothorax; Pulmonary Atelectasis; Rectal Prolapse; Respiratory Tract Infections; Sputum

Topics: Child; Cystic Fibrosis; Exhibitions as Topic; Humans; Hypertension; Hypertension, Portal; Infant; Infant, Newborn; Intestinal Obstruction; Intestines; Liver Cirrhosis; Meconium; Nasal Polyps; Osteoarthropathy, Secondary Hypertrophic; Pancreas; Pneumatosis Cystoides Intestinalis; Pneumothorax; Pulmonary Heart Disease; Radiography; Radiography, Thoracic; Sinusitis