Between 1967 and 1973 15 women with ulcerative colitis had 20 pregnancies. 14 ended with normal deliveries, 4 with spontaneous abortions, and 2 with therapeutic abortions. Fertility was normal. Malformations in the children were not observed. In the case of conception during remission or a latent phase of the disease in general a normal pregnancy is to be expected (12 out of 14). On the other hand conception during an active phase can lead to an unpredictable threat to the life of mother and child. Therapeutic abortion should be seriously considered when ulcerative colitis and pregnancy begin simultaneously. In the same period of time in 15 comparable patients with Crohn's disease (12 with ileo-colitis and 3 with terminal ileitis) who were not taking ovulation inhibitors 4 pregnancies were observed. Fertility is not significantly reduced in terminal ileitis whereas in ileo-colitis it is highly significantly reduced (bilateral tubal irritation). As in ulcerative colitis a normal pregnancy can be expected after conception in an inactive phase (2 out of 4).
Urea production rate and cellular Immune reactivity measured by skin stamp tests were used to determine the extent of protein catabolism in 30 surgical patients with histologically diagnosed gastrointestinal carcinoma. All patients received high‐caloric total parenteral nutrition (TPN) preoperatively. In those patients with an urea production rate of less than 15 g/day (according to definition a non‐catabolic state) TPN was discontinued and the operation performed immediately, whereas the remaining 13 patients with an urea production rate exceeding 15 g/day (accordiong to definition a catabolic state) were given TPN a total of 10 days prior to operation. Nine of the 13 patients could be converted from a catabolic to a non‐catabollc state. Only one of these patients died, whereas of the remaining 4 patients who – according to the definition – remained in a catabolic state, two died. The course of nutrition positively influenced the serum levels of IgG, IgA and IgM. The skin stamp test was positive in only three of the 13 patients. Obviously, a positive skin test reaction occurred only in those patients who could be returned to a non‐catabolic state during the course of TPN. By means of preoperative TPN catabolic patients can be converted into a non‐catabolic state which is associated with a reduction in morbidity and mortality. Moreover, high caloric parenteral nutrition rich in amino acids seems to improve the prognosis for patients with negative skin test reactivity.
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