SUMMARY Nine weU-motirated adults, knowledgeable about nutrition, kept food records, sared food portions equal to what had been eaten, and collected 24-hour urine samples for 3 consecutive days. Estimates of sodium and potassium intake were calculated from food table analyses of written food records and from flame photometric analyses of food portions. For each subject the mean of the estimates for each of the 3 days was compared with the mean of urine analyses for sodium and potassium for each of the 3 days. For the group of nine subjects, the average estimate of sodium intake from analyses of food records was 11% lower than the average estimate of urinary sodium excretion; the average estimate of sodium intake from analysis of food portions was 2% higher than urinary sodium excretion. For individuals, there were large differences between estimates of intake and measurement of sodium excretion. For the group of nine subjects, the average estimate of potassium intake from analysis of food records was less than 1% lower than the average estimate of potassium urinary excretion; the average estimate of potassium intake from analysis of food portions was 13% higher than potassium urinary excretion. For individuals, as with sodium, there were large differences between estimates of intake and measurement of potassium excretion. (Hypertension 2: 695-699, 1980) KEY WORDS * sodium • potassium • urinary excretion measurements T HE PURPOSE of this study was to determine whether in free living adults measurement of sodium and potassium from food ingested yields a valid estimate of sodium and potassium excreted in the urine. This is of interest because 24-hour urinary excretion, which is believed to provide the best estimate of sodium intake, cannot be measured in free living infants and is difficult to measure in free living adults. In a prior study of 6-month-old infants, sodium intake was assessed from food records, and a positive association was found between sodium intake and systolic blood pressure.1 When the infants were reexamined at 15 months of age, the association between sodium intake and systolic pressure was no longer present. We wondered whether the more complex food intakes of 15-month-old infants rendered the assessment of sodium intake from food records invalid.
The effect of 32 split ileostomies on 29 patients with severe symptomatic perianal Crohn's disease is reported. The perianal disease improved or healed after 23 (72 per cent) split ileostomies, although it relapsed in 2 patients while diverted and in 6 after closure of split ileostomy. Seven of 12 rectovaginal fistulas healed initially but only remained healed in those patients without rectal involvement with disease. At the time of review 6 patients have normal bowel continuity, 8 have had proctocolectomies and 15 are still defunctioned. Split ileostomy should be considered as an initial step in the management of intractable perianal disease.
Isolation of the large bowel by means of an end ileostomy was first tried by Brown' in the treatment of ulcerative conditions of the colon, but the results were disappointing. Truelove2 showed that corticosteroid enemas improved rectal inflammation in ulcerative colitis and this led to the suggestion that an external diversionary operation would not only defunction the colon, but would also allow administration of topical corticosteroids to the whole colon in patients with acute exacerbations. Preliminary results of this combined treatment showed that the 26 patients with ulcerative colitis who had failed to respond to medical treatment had no improvement after diversion.3 Five patients with Crohn's colitis who were included in the study, however, showed a marked improvement in general health which warranted further assessment of this method of treatment. This paper reports our long-term experience with the technique, and although our aim was to use it only for patients with Crohn's colitis, in some patients the diagnosis was found eventually to be ulcerative colitis.The original aims of the operation were: (1) To facilitate limited resection. In patients with a segment of severe colonic disease in association with
The long-term outcome of Crohn's disease was reviewed in 139 patients who were treated at the Cleveland Clinic for a minimum of 15 years. At the time of diagnosis, 38 (27 percent), 39 (28 percent) and 62 (43 percent) patients had small-bowel, large-bowel, and ileocolic patterns of disease, respectively. The disease progressed with time and, eventually, 104 (75 percent) patients had ileocolic disease. One hundred twenty-two patients (88 percent) underwent at least one definitive operation for the disease. Forty-four (32 percent) patients had proctocolectomies and 65 (47 percent) have ileostomies. Associated manifestations of Crohn's disease occurred in a high proportion of patients; perianal disease in 78 (56 percent), intestinal fistulas in 45 (32 percent), extraintestinal disease in 49 (35 percent). Six patients died of causes directly related to the disease. Specific complications tend to occur at definite times in the course of the disease. Crohn's disease is not a benign condition. There is a relentless progression of the disease and a high incidence of complications when patients are followed over a long period.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.