Crohn's disease involving the colon: an audit of clinical management

This paper describes the clinical management of 204 patients with Crohn's disease involving the colon who have been reviewed regularly for many years. The results have been analyzed to define the morbidity, mortality, and long term prognosis of the disorder. Despite a high morbidity, the long term prognosis is good. Although the mean interval since the onset of symptoms is more than 13 years, 77% of the patients are symptom-free and 60% have normal laboratory indices. This analysis suggests that until the etiology of Crohn's disease is established and a specific therapy is developed, good results can be obtained with regular medical review and appropriate surgical treatment with the limited use of immunosuppressive agents or total parenteral nutrition.

Current trends in diet and drug therapy for the dialysis patient

It is virtually impossible to discuss diet and drug therapy separately in the treatment of the hemodialysis patient. Drugs and dialysis techniques often necessitate changes in dietary care, just as dietary indiscretions call for changes in drug therapy and dialysis. In order to coordinate the various facets when ordering diets, several factors must be considered. The physician plans the drug therapy with input from the dialysis nurses, especially for dialysis effects on salt, water, K+, and protein balance, and the dietitian coordinates the diet with drug and dialysis therapy. It is therefore essential that all personnel must interact as a team if the patient is to receive the maximum benefit of hemodialysis. To maintain this delicate, constantly changing approach, a balance of teamwork is essential.