Premium
ORAL FAT EMULSIONS COMBINED WITH PROTEIN SUPPLEMENTS IN THE MANAGEMENT OF ACUTE POLIOMYELITIS
Author(s) -
Boines George J.
Publication year - 1952
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1111/j.1749-6632.1952.tb30208.x
Subject(s) - george (robot) , citation , general hospital , unit (ring theory) , medicine , library science , art , family medicine , psychology , art history , computer science , mathematics education
Recent developments in food supplements are contributing to improved clinical results in the treatment of poliomyelitis, which, by our concept, is a systemic disease of virus etiology. The various poliomyelitis or poliomyelitis-like viruses thus far identified have a special predilection for the central nervous system and for the voluntary muscles. Clinically, poliomyelitis is classified as either abortive, nonparalytic, or paralytic. The paralytic types may be spinal, bulbar, or encephalitic, in the order of their greatest frequency. Only in the abortive types is recovery spontaneous and apparently complete. The older therapeutic approach emphasizes immobilization and prolonged bed rest with no special nutritional care. Characteristic of the results are a high incidence of ankylosis, marked permanent muscle atrophy, prolonged malnutrition and a high incidence of orthopedic operations. The approach we use1 combines (1) early ambulation; (2) muscle relaxation by curarization2 and active exercise program, 3 ( 3) extended medical supervision; and ( 4) special nutrition. 4 In our opinion, this has given us superior clinical results, such as reduced severity of the acute phase, minimal weight loss, minimal disabling atrophy and ankylosis, accelerated convalescence, shorter hospitalization, reduced incidence of corrective surgery,5 and favorable results in functional restoration. In this presentation, I shall attempt to outline the special nutnt10n-one of the four important measures upon which our treatment of polio is based. During the past three years, we have used hyperproteinization6 with a high caloric intake to enhance utilization and to spare the body protein. At first, this high caloric intake was supplied by carbohydrates, but, during the last year, the extra calories have been supplied by oral fat emulsions7 which have the additional advantages of rapid assimilation and weight gain. Each patient's physical status was evaluated, and a diet was ordered consisting of easily assimilated protein preparations, protected by adequate caloric coverage, in quantities to attain a level of at least four grams of protein per kilo body weight, fortified with fat emulsion. In this way,. from 100 grams or more of protein, and 500 or more calories in fat were added to the diet. To do this effectively, it was necessary to give between-meal feedings. Vitamins and minerals were ordered as needed. High-caloric protein drinks were also utilized for supplementation, since the optimum