ETS can reduce concentrations of ascorbate, an important blood antioxidant, even when the amount of smoke exposure is minimal. Children exposed to ETS should be encouraged to consume increased amounts of foods rich in vitamin C or should be given the equivalent amount of this vitamin as a supplement.

The generally accepted concept that metabolic acidosis in infant diarrhea results from the loss of buffer base in the stool has been based on the common observation that inorganic cations predominate over inorganic anions in diarrheal stools (1)(2)(3)(4)(5). This predominant loss of inorganic cations has been taken as evidence of loss of bicarbonate. On the other hand, Teree, Mirabal-Font, Ortiz, and Wallace (6) have shown by direct measurements that the pH of the stool water in infant diarrhea is frequently acidic (almost always below the pH of the blood) and that HCO3-is very low or absent. On the basis of the observed differences between Na+ + Ki and Cl-, these authors have suggested that there is a high concentration of organic anions in diarrheal stools of infants and have advanced several hypotheses to explain the origin of these substances (7).The effect of fecal loss of organic anion on acidbase balance will depend upon several factors. These include the origin of the organic anions (i.e., whether ingested preformed, or generated within the body) and the nature of, the cations accompanying them (8). Those organic acids generated in the intestinal lumen or elsewhere in the body change the H+ concentration of the body fluids, depending upon the degree of ionization of

Iron-deficiency anemia may be a clinical presenting sign of pouchitis. Hemoglobin levels may be considered as surveillance tools for pouchitis in patients with IPAA.

This study was designed to determine among various personal, socioeconomic, and environmental factors those which had the greatest influence on exposure to environmental tohacco smoke (ETS) in a population of children residing in a tropical environment and to compare these results with those obtained in the literature of tobacco exposed children in temperate climates. Urine specimens were collected from 606 healthy Puerto Rican children (2-12 years) living in an industrial area and analyzed for cotinine, a quantitative hiomarker for exposure to ETS. Parents completed a questionnaire covering smoking hahits and socioeconomic information. Seventy per cent of the children were reported to be exposed to ETS, 50% resulting from exposure to smoke from either or both parents. Major determinants to ETS exposure were found to be presence of smoker, numher of smokers, identity of smoker, numher of cigarettes smoked in the household and child age with the youngest children suffering twice the exposure of older children. Non-determinants were exposure to smoke other than from the parent, sex of the child, season of the year and several socioeconomic factors including civil and employment status ofthe mother, mother's age and educational background and whether food stamps were being received. Results of a muitiple regression analysis showed that our predictors accounted for 40% of cotinine appearing in the urine. Reasons for this relatively low value may be due in part to precision of our analytic method und lower levels of ambient smoke in our population vs. others that reported higher R^ values. Predictions from questionnaire information for high ETS exposure were not always the same as those indicated by urinar>' cotinine emphasizing that the bioindicator, which indicates the actual inhalation of ETS, is a better predictor of exposure than responses from a questionnaire.

Increased stool losses of water, solute, and organic acids after the ingestion of milk during acute diarrhea of infancy have been related to impaired absorption of carbohydrate (1). We have observed that the osmolality of diarrheal stool water is usually high during periods of milk intake. Furthermore, we have demonstrated that carbohydrate comprises most of the solute content of the stool water and that there exists a reciprocal relationship between the concentration of this compound and that of Cl-, Na+, and K+. On the other hand, there is a direct relationship between the concentration of carbohydrate and total organic anions. Similar effects of carbohydrate on stool volume and acidity have been described when specific disaccharidases are deficient (2-9) or when monosaccharide absorption is impaired (10-13). An obvious assumption is that unabsorbed carbohydrate exerts an osmotic effect in the bowel and constitutes substrate for the generation of organic acids. However, studies directed at verifying these assumptions and determining the characteristics of these processes at different levels of the small and large bowel have not been performed. Our present studies demonstrate that the absorption of glucose by the jejunum is impaired in acute diarrhea of infancy. The studies also show that the associated net movement of fluid into