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

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.
Cancer 1976 Oct
PMID:Fungemia due to Torulopsis glabrata in the compromised host. 82 17

Forty-eight esophagastric resections performed for cancer of the esophagus and cardia resulted in a five-year survival rate of four per cent. An operative mortality rate of 23%, comparable to that reported by others, diminishes the value of esophagogastrectomy even for palliation. Nutritional depletion, commonly found in these patients, contributes significantly to the unacceptably high mortality. A review of the recent literature indicates that the routine use of preoperative hyperalimentation and prophylactic antibiotics can significantly reduce morbidity in these high-risk patients and thereby result in better palliation.
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PMID:Mortality and morbidity after esophagogastrectomy for cancer of the esophagus and cardia. 83 5

A 61-year-old woman was admitted to our hospital because of hoarseness and abnormal shadow on chest X-ray. We diagnosed this patient as large cell carcinoma of the right upper lobe of the lung; T3N3M1 Stage IV. She was treated with OK-432, CDDP and CQ. On the 6th day after 2nd cycle chemotherapy, she was confused, and we diagnosed her as a case of hyperosmolar nonketotic coma (HNC) on the 7th day. Unfortunately, she died on the 8th day, after 20 hours of treatment for HNC. She suffered from chronic dehydration due to trouble with left recurrent nerve palsy. Although continuous intravenous hyperalimentation was used, she had severe HNC. HNC might be one complication in chemotherapy for patients with malignancy.
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PMID:[A case of hyperosmolar nonketotic coma occurring during chemotherapy in lung cancer]. 132 54

Anorexia and cachexia are major problems in patients with cancer. Such measures as anti-cancer therapy, dietary counselling or hyperalimentation are not very successful in reversing this phenomenon in the vast majority of cancer patients. Thus, several drugs have been evaluated as agents to ameliorate cancer-associated anorexia/cachexia. Cyproheptadine is an antiserotonergic drug which appears to cause slight appetite stimulation in patients. A randomised clinical trial, however, was unable to demonstrate any weight gain from this agent. Corticosteroids are frequently used in clinical practice for appetite stimulation in patients with advanced malignancies. Supporting this practice, 4 randomised clinical trials showed that corticosteroid medications can stimulate the appetites of advanced cancer patients. However, these studies were not able to show any substantial nonfluid weight gain in treated patients. Megestrol acetate is a progestational agent which appears to be a relatively potent appetite stimulant. Randomised studies in advanced cancer patients have shown both substantial appetite stimulation and improvement in the nonfluid bodyweights of patients receiving this drug. Preliminary evidence also suggests that this drug has antiemetic properties. Several clinical studies are currently ongoing to determine the effect of various doses of megestrol acetate in patients with cancer. Efforts are also ongoing to evaluate both anabolic steroids and hydrazine sulfate as drugs for the treatment of patients with cancer anorexia/cachexia. The preliminary nature of these investigations, however, precludes recommendations for the use of either of these latter 2 drugs in routine clinical practice.
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PMID:Cancer-associated anorexia and cachexia. Implications for drug therapy. 137 16

Eighty-four patients with fungemia were analyzed. Fungi had been isolated by culture of blood samples, including blood from the catheter for intravenous hyperalimentation, between 1986-1990. Candida albicans (39.3%), Candida parapsilosis (20.2%), Candida tropicalis (11.9%), Candida glabrata (10.7%), Candida guilliermondii (4.8%) and Trichosporon beigelii (4.8%) were the most frequently isolated fungal pathogens. Four patients' blood yielded two different fungal species. Fifty-nine cases were male, and 25 cases were female. Forty-six of the 84 patients died (54.8%), but there were no differences in the overall mortality rate as a function of the fungal species or sex. All patients had underlying diseases: solid cancer, 37 cases; cardiovascular diseases, 9 cases; gastrointestinal diseases excluding gastrointestinal cancer, 8 cases; central nervous system diseases, 7 cases; premature infants and congenital abnormality, 7 cases; leukemia, 6 cases and miscellaneous, 10 cases. Twenty-four of the 46 dead cases were autopsied, and eight cases showed systemic fungal lesions. However, in one case of pulmonary cryptococcosis and one case of pulmonary penicilliosis, there was no correlation between the isolation of C. glabrata by blood culture and the pathological findings. A fungus-positive blood culture was surmised to be a result of contamination of the sample in 33 cases, and the mortality rate for those cases was 72.2% (24 cases). For 6 of the corpses, fungal lesions observed at autopsy were compatible with the types of lesions found by the fungi which had been isolated before death. Removal of the catheter reduced the mortality rate to 41.7%. Fungal endophthalmitis was diagnosed in six cases.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Analysis of 84 cases with fungemia]. 140 94

Marrow transplantation is now an accepted form of therapy for patients with aplastic anemia, genetic diseases, and a variety of malignant diseases. Intensive chemotherapy and radiotherapy regimens are necessary to eradicate cancer cells and allow engraftment of the transplanted marrow. Patients undergoing such treatment suffer prolonged marrow aplasia and immunosuppression and experience significant nonmarrow toxicities. This requires maximum supportive care including hyperalimentation, fluid and blood transfusions, antibacterial and antiviral prophylaxis, and measures to reduce organ toxicities and accelerate engraftment. The use of drugs to suppress the production of antitumor necrosis factor-alpha has shown promise in reducing the nonmarrow toxicities of the conditioning regimen. Prophylactic antibiotics that reduce gastrointestinal colonization with aerobic bacteria yet preserve anaerobic flora may more effectively reduce not only systemic bacteria but fungal infections as well. The impact of infections due to cytomegalovirus has been reduced by more effective prevention in patients who are cytomegalovirus negative and reactivation in patients who are cytomegalovirus positive. The use of recombinant growth factors will significantly reduce morbidity after transplantation by reducing the period of marrow aplasia.
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PMID:Supportive care in marrow transplantation. 151 Oct 18

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

Cancer cachexia is characterized by progressive, involuntary weight loss in patients with cancer. Cachexia is a common cause of death in patients with cancer in the advanced stage. It is well known that cancer patients with significant weight loss are subject to a high risk of postoperative complications. Intravenous hyperalimentation (IVH) has been applied to anticancer treatment when patients are unable to take sufficient nutrients orally. It is mandatory to take efficacy of antineoplastic therapies into account in attempting to assess response to nutritional repletion in cancer patients. Nutritional support is effective in maintaining body weight of malnourished cancer patients, although it is difficult to maintain body cell mass expressed as intracellular water. In other words, there is a discrepancy between changes in body composition and weight loss in undernourished patients with cancer. It seems that intravenous hyperalimentation has no documented benefit to cancer patients undergoing antineoplastic treatment from the standpoint of improved patient survival in the prospective, randomized trials of nutritional support. Therefore, further studies are needed in order to improve tumor-bearing host survival by means of nutritional management, i.e., glutamine enriched solution, amino acid imbalance solution, and anticachectic drugs on the basis of the deranged metabolism in cancer.
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PMID:[Response to nutritional management in cancer patients]. 154 58

Long-term indwelling central venous catheters have eased the administration of drugs, blood products, and hyperalimentation to patients with cancer. However, their use is associated with thrombotic complications. We report here on the thrombotic complications prospectively observed in 46 patients with refractory lymphoma (22 Hodgkin's disease, 24 non-Hodgkin's lymphoma) who had placement of one or more catheters in preparation for autologous stem cell transplantation (ASCT). Thrombosis of 26 catheters in 19 patients was observed. Specific abnormalities of hemostasis were equally common in patients who developed thrombosis and in those who did not. Thrombotic complications were more common in patients with Hodgkin's disease (13/22) than in patients with non-Hodgkin's lymphoma (6/24, p = 0.04). Although more patients with Hodgkin's disease had received prior splenectomy and/or irradiation to the area involved by thrombosis than patients with non-Hodgkin's lymphoma, the incidence of splenectomy and irradiation was similar for patients with Hodgkin's disease who developed thrombosis and those who did not. Therefore, although the etiology remains unexplained, patients with Hodgkin's disease undergoing intensive chemotherapy and ASCT appear to have a higher incidence of catheter-related thrombosis than patients with non-Hodgkin's lymphoma undergoing similar therapy.
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PMID:Catheter-related thrombosis in patients with refractory lymphoma undergoing autologous stem cell transplantation. 167 22

Two pain-ridden patients in the terminal stage of a malignancy of the head and neck were treated with high-dose morphine which was administered as a continuous IV infusion along with a hyperalimentation solution using a pump. Good pain relief and a lessening of anxiety were achieved after failure to control pain in spite of the use of the analgesic ladder recommended by the WHO.
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PMID:Treatment of cancer pain of the head and neck by continuous intravenous infusion of high-dose morphine: report of two cases. 169 Feb 76


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