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Query: UMLS:C0020505 (hyperphagia)
 6,116 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Haematological and biochemical parameters were monitored in six patients during Intralipid hyperalimentation. A mild anaemia was consistently observed, accompanied by morphological changes in red cells, granulocytes, and platelets. All patients demonstrated an abnormally high percentage of plasma cholesterol in the unesterified form and altered plasma cholesterol esterification, but red cells were not uniformly enriched in cholesterol. These findings stress the need for careful monitoring during Intralipid therapy.
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PMID:Haematological and biochemical abnormalities associated with intralipid hyperalimentation. 10 37

Serum zinc concentrations are decreased in patients with a variety of clinical disorders including cirrhosis, nephrotic syndrome and renal insufficiency. Urinary zinc excretions are increased in the first two disease states. Symptoms of acute zinc deficiency (anorexia, dysfunction of smell and taste, and mental and cerebellar disturbances) and chronic zinc deficiency (growth retardation, anemia, testicular atrophy, and impaired wound healing) are common in these patients. It remains unresolved whether these disease states are indicative of true symptomatic or asymptomatic zinc deficiency or merely reflect a decrease in available zinc binding proteins. The low serum zinc concentrations and high urinary zinc excretions in patients with nephrotic syndrome do not appear to be due to loss of zinc bound to urinary proteins. Studies in dogs indicate increased serum and urine concentrations of certain amino acids(cysteine, histidine) greatly increase urinary zinc excretions. Studies are now underway to determine if the hyperzincuria and hypozincemia of cirrhosis, nephrotic syndrome and hyperalimentation can be explained by an increase in these urinary amino acids.
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PMID:Zinc metabolism in renal disease and renal control of zinc excretion. 60 38

Ten episodes of Torulopsis glabrata fungemia occurring in nine patients with terminal illnesses are described. Eight patients had underlying malignancies and one patient had a plastic anemia. Two episodes of fungemia were considered transient since they were clearly related to the administration of intravenous hyperalimentation (IVH). Most patients were adult women and had solid tumors of the genitourinary tract. Contributory factors were: antibiotic therapy (100%), immunosuppressive drugs (75%), abdominal surgery (63%), IVH (50%), neutropenia (38%), and diabetes mellitus (13%). The clinical course was indistinguishable from a severe bacterial infection. However, endotoxic shock was not observed. The infection was rapidly fatal in four patients. In the remaining five patients, the infection was altered favorably by the discontinuation of infected intravenous hyperalimentation catheters. However, tissue invasion by T. glabrata was found in two of these patients who died shortly thereafter from tumor progression. At autopsy, T. glabrata was identified in tissue sections of the lungs, kidneys, and mucosas of the gastrointestinal and genitourinary tracts. In all cases there was tissue necrosis with a minor inflammatory response consisting of mononuclear cells. To our knowledge, this is the single largest series of T. glabrata fungemia ever reported.
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PMID:Fungemia due to Torulopsis glabrata in the compromised host. 82 17

The purpose of the paper is to demonstrate the usefulness of total parenteral hyperalimentation in a lactant, 4 months old patient with ulcerative colitis. At admission the lactant had diarrhea, dehydratation, anemia, malnutrition, and edema in the ankles. Proctoscopy and barium enema, and rectal biopsy were typical of ulcerative colities. Treatment included steroids and azulfidine. Evolution was poor and signs of perforation appeared. Total intravenous hyperalimentation was used and after one month the diarrhea disappeared and the patient gained weight. Ulcerative colitis is rare in lactants and usually appeares a chronic diarrhea. The diagnosis should be based on radiology, endoscopy, and biopsy. Parenteral hyperalimentation is the only treatment that permits to keep the colon at total rest while simultaneously maintaining nutrition.
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PMID:[Ulcertive colitis: clinical picture and treatment with total parenteral nutrition in a newborn]. 82 75

Five cases of malignant duodenocolic fistula seen at the Massachusetts General Hospital in the past thirty years are reviewed. Rarely encountered, these lesions are characterized by diarrhea, weight loss, abdominal pain, anemia, and sometimes feculent vomiting. Barium enemas are more likely to demonstrate the fistula tract than upper gastrointestinal series. Nutritional deficiencies may be profound, and the use of preoperative hyperalimentation is encouraged. Operations that accomplish only bypass of the fistula are of minimal palliative value, and the fistula should be divided or resected if possible. When feasible, wide resection is the procedure of choice, and a fourteen year survival is reported after this operation.
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PMID:Malignant duodenocolic fistulas. 86 13

Seven gastrocolic and five gastrojejunocolic fistulae were recorded at Charity Hospital between 1940 and 1970. Such fistulae occurred in males more often than females. In this series, as in others, the most common cause was gastric surgery for peptic ulcer disease. Pain, diarrhea, and weight loss were clinical findings in half the patients; anemia, leukocytosis, electrolyte disturbances and hypoalbuminemia were common laboratory findings. A fistula was demonstrated radiologically in nine of the twelve patients, management of these patients included no operation (3); two-stage procedure (2); and one-stage procedure (7); with a recent trend toward the one-stage procedure. A case report of a fistula resulting from postoperative complications of perforative appendicitis in which a successful combination of hyperalimentation and diverting colostomy was used is presented.
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PMID:Gastrocolic and gastrojejunocolic fistulae: report of twelve cases and review of the literature. 113 Aug 54

Thirty-one abdominal fascial wound dehiscences occurred in 2,761 patients undergoing major abdominal surgery during a 5-year period (1%). Twenty-two specific local and systemic risk factors were analyzed and compared with the risk factors of a control group of 38 patients undergoing similar procedures without dehiscence. Through multivariate analysis, each factor was assessed as an independent statistical variable. Significant factors (p less than 0.05) were found to include age over 65, wound infection, pulmonary disease, hemodynamic instability, and ostomies in the incision. Additional systemic risk factors that were found to be significant included hypoproteinemia, systemic infection, obesity, uremia, hyperalimentation, malignancy, ascites, steroid use, and hypertension. Risk factors not found to be important independent variables included sex, type of incision, type of closure, foreign body in the wound, anemia, jaundice, and diabetes. When dehiscence and control groups were combined, 30% of patients with at least five significant risk factors developed dehiscence, and all the patients with more than eight risk factors developed a wound dehiscence. There was an overall mortality of 29%, which was directly related to the number of significant risk factors. The co-existence of 9 risk factors portended death in one third of the patients, and all the patients with more than 10 risk factors died.
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PMID:Factors influencing wound dehiscence. 832 36

Deterioration in nutritional status occurs late in the progress of cancers at certain sites, but at all stages in patients with gastrointestinal cancer. Weight loss with decrease in body fat and muscle wastage, occurs to a varying degree. Superficially, the clinical condition resembles simple food deprivation. However, the derangements in metabolism are often and some patients show an elevated resting energy expenditure, disturbances of carbohydrate, fat and protein metabolism and generally, a failure to adapt to reduced food intake, which is characteristic of cachexia. Cancer cachexia then becomes characterized by signs of marked negative energy and protein balance, including hypoalbuminemia, weight loss, and anemia. On the other hand, toxohormone extracted from tumor tissues was considered as the main cause to produce cancer cachexia. However, it has become clearer that cytokines, e.g. cachectin/TNF, IL-1, LT and IFN gamma play an important role to produce cachexia. Patients who are malnourished have an incidence of postoperative complications double that seen in adequately nourished patients. The effectiveness of cancer-chemotherapy is also different in nutritional status of patients. Although in patients requiring hyperalimentation, enteral nutritional support may feasible and enteral feeding has a distinct metabolic advantage compared with parenteral feeding, there is a definite role for total parenteral nutrition in patients who have severe chronic radiation enteritis, side effect of chemotherapy, weight loss and malabsorption. Tentative weight gain and correction of hypoalbuminemia without improving patient survival may be expected by this intravenous hyperalimentation.
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PMID:[Palliative therapy in cancer 2. Nutrition control]. 169 91

Prematurity in Indian births is modeled, based on the hypothesis that reduced protein and glucose and aminoacids and maternal anemia and preeclampsia lead to placental dysfunction which is also affected by metabolic disturbance and fetal circulation related to cellular growth and questions about genetics. There may be an ethnic propensity for early maturation of the fetus which affects the higher stillbirth rates and perinatal mortality. It was observed that among, for instance, black and Indian racial groups there may be meconium release and fetal distress. The significance is that physicians should increase antenatal surveillance before 40 weeks. Maternal nutrition should be advanced and hyperalimentation by cordocentesis. Other interventions such as glucose, oxygen, and aspirin administration are still very experimental. The evidence that velocity of growth is different and low birth weight is due to abnormal growth and shortened gestation is currently being researched among different ethnic groups. The discussion is concerned with reports of ethnic variation among Indian and Malay babies in Singapore and babies of French or African ancestry in France. In these studies findings were that the Indians and Malays in Singapore vs. the Chinese had higher mortality, and black African ancestry in mixed ancestry babies was related to higher infant mortality. Another study on neonatal mortality in India led to the recommendation that 2000 gm be established as the limit for defining low birth weight. In the 1501- 2000 gm birth weight groups, 30-45% are preterm, and the remainder are term or postterm. Low birth weight may transcend generations in India even with emigration. Experimental studies show that intrauterine weight is related to placental volume. Reduced growth and lower fetal insulin/glucose ratio with elevated fetal glycine/valine ratio was found to be related to reduced glucose supply among fetuses with fetal hypertriglyceridemia. Fat seems to be lacking among low birth weight fetuses. Studies of somatomedin and somatostatin in metabolism are helping to provide greater understanding of fetal growth processes.
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PMID:The prematurity paradox of the small Indian baby. 180 Mar 24

In India, major social discrepancies linger despite major advances since 1947 with the result of overeating by the rich and undernutrition of the poor. Anemia affected 65% of pregnant women in Hyderabad hospitals, and in Calcutta it hovered around 88.5-90/1% for males and 96.5-96.7% for females aged 15-44. Malnutrition accounted for 15% of hospitalizations often because of infant diarrhea. Parasitic infestations leading to anemia and subsequent malnutrition also resulted in premature births and low birth weight. Weaning practices including its late initiation and prolongation of breast feeding for up to 12 months (or 18 months in rural areas) led to growth retardation. About 25,000 children become blind annually because of vitamin A deficiency, and 55% of women also suffer from it. Almost 120-170 million people suffer from endemic goiter. Socio economic and socio cultural factors are also associated with nutritional problems. Some Brahmin communities in South India avoid garlic and onions because they are considered taboo foods. The Tridosha Theory holds the there are heat-producing foods, cooling foods, and gas-producing foods that have to be avoided. Some of these are brown sugar, eggs, tomatoes, oranges, cereals, and vegetables. In West Bengal they believe that milk and fish can cause leprosy. The population nearing 800 million is another factor, as smaller families have better nutrition. Education by nurses should include the use of exhibits, songs, and plays to teach women proper nutrition. Nurses also have to change their attitudes to avoid commercial foods, identify harmful practices, and promote nutritional education. The project of the National Institute of Nutrition involving 23 villages combated vitamin A deficiency successfully by laying stress on available vegetables and fruits. If nurses participate if such primary health care programs the objectives of Health for All by 2000 will be achieved.
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PMID:Nutrition: an essential element of primary health care. 272 85


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