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CLINICIAN'S CORNER
Clinical Concerns About Reduced-Osmolarity Oral Rehydration Solution
David R. Nalin, MD;
Norbert Hirschhorn, MD;
William Greenough III, MD;
George J. Fuchs, MD;
Richard A. Cash, MD
JAMA. 2004;291:2632-2635.
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Demonstration of the benefits of oral therapy for cholera in 19681 soon led to application of the method to all forms of infectious diarrheal diseases.2 The original oral rehydration solution (ORS) formulation developed by the World Health Organization (WHO) (Table 1) struck a compromise between the ideal solutions for these diverse disorders to meet the programmatic goal of a single formulation and packaging for global use in cholera and noncholera diarrheas, in both adults and children. Recently, WHO recommended a new oral solution (Table 1) for all acute diarrheas, including cholera. This new formula would replace the original ORS, which saved millions of lives, with a new formulation containing less sodium and glucose.3 This change was ostensibly to reduce gross stool volume and use of . . . [Full Text of this Article]Consequence of a Lower-Sodium Solution
Author Affiliations: Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Conn (Dr Hirschhorn); Johns Hopkins School of Medicine, Baltimore, Md (Dr Greenough); University of Arkansas Medical School, Little Rock (Dr Fuchs); and Harvard School of Public Health, Camrbidge, Mass (Dr Cash).
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Scientific Rationale for a Change in the Composition of Oral Rehydration Solution
Christopher Duggan, Olivier Fontaine, Nathaniel F. Pierce, Roger I. Glass, Dilip Mahalanabis, Nur Haque Alam, Maharaj K. Bhan, and Mathuram Santosham
JAMA. 2004;291(21):2628-2631.
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Symptomatic hyponatremia during treatment of dehydrating diarrheal disease with reduced osmolarity oral rehydration solution.
Alam et al.
JAMA 2006;296:567-573.
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