Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0020505 (hyperphagia)
 6,116 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The provision of adequate nutrition to hospitalized patients with exceptional caloric requirements has been a problem until the recent advent of intravenous hyperalimentation. With total parenteral nutrition (TPN), the nutritional needs of any patient can be met by infusion. TPN solution is hypertonic, and administration requires central venous cannulation. The subclavian vein is usually chosen as route of access to the superior vena cava. Strict aseptic technique must be used in inserting the catheter and making up and administering the solution. TPN is not without risk. Infection is always a possibility, as are metabolic alterations, such as electrolyte imbalance, fluid overload, osmotic dehydration, and essential fatty acid deficiency.
 ...
PMID:Meeting exceptional nutritional needs. 1. Total parenteral nutrition. 9 43

Twenty-seven patients treated for pancreatic and/or biliary-cutaneous fistulas have been reviewed. Four patients died mainly because of cardiopulmonary and septic complications. Spontaneous sealing of the fistula occurred in 81% of the conservatively treated cases (48% of all cases). All the LO fistulas but only 68% of the HO fistulas treated conservatively sealed spontaneously. Eleven patients were treated surgically. There were three deaths and three failures (reappearance of fistula). All the patients who died had been operated on within three months after the appearance of HO fistulas. There was no mortality among the patients with LO fistulas or among patients operated on at a later stage. We have reached the following conclusions: 1. There is a significant difference in prognosis between low output and high output fistulas. 2. In LO fistulas, there is no need for a surgical intervention aimed to close the fistula unless it persists for at least one year. 3. In HO fistulas, if a corrective operation is necessary, it should be withheld for at least three months whenever possible. 4. Roux-en-Y fistulojejunostomy is considered to be the procedure of choice. 5. Infection and premature colsure of the external part of the fistulous tract should be avoided by insertion of drains and repeated surgical drainage, where necessary. 6. High caloric feeding, elemental diet and intravenous hyperalimentation are very important factors that enhance recovery in the surgically and conservatively treated patients.
 ...
PMID:External biliary-pancreatic fistulas. 40 66

Candida parapsilosis is rarely isolated from blood cultures. Our hospital surveillance detected an increased rate of isolation of C parapsilosis during a four month period. Fourteen postoperative patients receiving intravenous (IV) hyperalimentation and eight burn patients receiving IV albumin were involved. Hectic fever, the major clinical manifestation, was seen in 61% of cases. Therapy in the postoperative patients consisted merely of discontinuing IV catheters and hyperalimentation, while amphotericin B was needed in five of eight burn patients to control persistent fungemia. Epidemiologic analysis identified a source of the organism in the IV-additive preparation room where C parapsilosis was found contaminating a vacuum system. Organisms apparently refluxed into IV bottles when aliquots were removed to accommodate additives. Of 103 patients who received fluids prepared with the contaminated system, 21% became infected with C parapsilosis. Infection surveillance was instrumental in detection and control of the outbreak. Routine guideline should be established to insure the sterility of IV fluids containing additives.
 ...
PMID:Nosocomial outbreak of Candida parapsilosis fungemia related to intravenous infusions. 41 74

The present paper described the technique of intravenous hyperalimentation applied to a group of 100 surgical patients. A specially prepared diet supplying a high amount of calories, using hypertonic glucose and supplying nitrogen, using polypeptides or aminoacid solutions, was infused into the superior vena cava. The inhibition of digestive secretions, during the period of hyperalimentation, was used in the management of 19 patients with intestinal and pancreatic fistulae. The general conclusion reached after wide clinical experience was that by supplying energy and nitrogen to a patient in a severe catabolic state, a significant and sometimes dramatic capacity could be developed which allowed him to overcome difficult conditions and even initiated a reversal of the metabolic balance in the direction of anabolism. The regimen should be adopted in the preoperative preparation of debilitated patients; in hypercatabolic states (post-trauma, post-surgery or burns); in gastrointestinal, granulomatous or infectious diseases; in acute pancreatitis; in digestive fistulae; in oncological conditions, and so on. The metabolic and infective complications can be pregressively decreased and eventually prevented by proper handling and strict metabolic monitoring. The use of this hyperalimentation was extremely encouraging, and on many occasions we had the impression that it was life saving.
 ...
PMID:Intravenous hyperalimentation in the management of the critically ill patient, with special reference to abdominal fistulae. 82 16

Thirty-one patients underwent hemodialysis for renal failure as a complication of major cardiovascular surgery at the University of Minnesota (1968-1973). Only eight patients (26%) survived. A review of the literature shows that since the beginning of hemodialysis the mortality of those patients has not improved. Infection was the overwhelming cause of death. The infections were difficult to diagnosis because they were frequently associated with abdominal abscesses that were almost uniformly overlooked. Several possible ways of improving these patients survival are: 1) the use of early operative interventions of second look type; 2) improved hygenic measures in the care of these patients; 3) more selective antibiotic treatment based on frequent reculturing; and 4) daily short dialysis in association with hyperalimentation.
 ...
PMID:Acute renal insufficiency complicating major cardiovascular surgery. 113 Aug 53

Hepatic disorder during long-term intravenous hyperalimentation (IVH) in adults was studied. Fifty-one patients (30 males and 21 females) in whom IVH was performed for more than 60 days at Tenri Hospital from 1975 to 1984, were divided into 3 groups by change of indices which showed hepatic cellular injury (CII) and bile stasis (BSI). Namely, type I patients (33 cases) showed transient abnormality of indices, type II patients (14 cases) has continuous abnormal indices during IVH and type III patients (4 cases) were lethal due to hepatic failure. There were no differences in clinical feature among 3 groups. Incidence of metabolic complications during IVH in type II was significantly higher than in type I (p less than 0.05). All patients of type III were complicated by severe infectious diseases. Chief histological findings from 13 specimens (6 biopsies and 7 autopsies) were fatty degeneration of hepatocytes and fibrosis in the portal area with proliferation of bile ducts. Change of the portal area had closer relationship to the clinical severity of hepatic disorder than change of hepatocytes. BSI was more important than CII in inspection of clinical course and estimation of prognosis on hepatic disorder during IVH.
 ...
PMID:[Hepatic disorder during long-term intravenous hyperalimentation in adults]. 309 24

To determine risk factors for infection of hyperalimentation catheters, we prospectively studied 169 catheter systems (88 patients) by using a semiquantitative culture technique. Infection occurred in 24 (14%) catheters (16 patients), was inversely proportional to the number of previous catheters inserted by the operator (P less than .02), and was proportional to the interval between admission and catheter insertion (P less than .0005). Catheter replacement over a guidewire was no more likely to be associated with infection than was a de novo percutaneous insertion at another site (P = .6). Using a proportional hazards model, we estimated the risk of infection per day to be 1.3 times greater for a catheter if the patient had been hospitalized 50 days instead of seven days, and 3.8 times greater if the patient had a Swan-Ganz catheter at the time of insertion.
 ...
PMID:Prospective study of catheter replacement and other risk factors for infection of hyperalimentation catheters. 309 37

Infection, particularly that involving the respiratory tract, is commonly seen in the patient with ARDS. It can be either an etiologic factor leading to the syndrome or a complicating factor leading to a high likelihood of mortality. Pneumonia develops in up to 70% of individuals with ARDS, and when present, converts the syndrome to its most severe and mortal form. In addition, when systemic injury coexists with any type of infection, ARDS will develop with an increased frequency. Nosocomial pneumonia results when upper and lower respiratory tract defenses fail and these sites are overwhelmed by bacteria. Colonization of the oropharynx and tracheobronchial tree, both of which are common in critically ill patients, precedes the development of pneumonia. In the patient with ARDS, all levels of host antibacterial defenses may be impaired, thus accounting for the high incidence of both colonization and pneumonia. These impairments result from the acute lung injury itself, coexisting systemic illnesses, therapeutic interventions, and acquired malnutrition. Once pneumonia develops in the course of acute lung injury, diagnosis is exceedingly difficult and potentially inaccurate. With proper application of the protected specimen brush, inserted bronchoscopically, diagnostic accuracy may improve. Therapy must be undertaken early and with agents directed at likely pathogens, particularly P. aeruginosa and other gram-negative bacilli. In the future, preventive efforts against pneumonia may be effective for the ARDS patient. Strategies that may be effective include hyperalimentation, judicious use of all pharmacotherapy, active and passive antibacterial vaccines, airway microenvironment manipulation, and the use of aerosolized antibiotics.
 ...
PMID:The interaction of infection and the adult respiratory distress syndrome. 333 58

Infection of DBA/2N male mice with encephalomyocarditis virus resulted in a diabeteslike syndrome characterized by hyperglycemia, glycosuria, hypoinsulinemia, polydipsia, and polyphagia. Blood glucose levels were elevated within 4 days after infection and reached a maximum mean level of 320 mg/100 ml within 12 days. Approximately 60-80% of the animals developed a transient hyperglycemia while 10-15% of the animals remained hyperglycemic for well over 6 mo. The remaining animals failed to become hyperglycemic but many had abnormal glucose tolerance curves. Hyperglycemia was most pronounced when animals were allowed free access to food, and the incidence of byperglycemia was related both to the strain and sex of the animals, with few females developing hyperglycemia. The amount of immunoreactive insulin in the plasma of infected hyperglycemic mice was significantly lower than in appropriate controls, and injection of exogenous insulin resulted in a rapid drop in the blood glucose levels. Despite the fact that certain animals were hyperglycemic for many months, virus could not be recovered from the pancreas after the first 10 days of the infection.
 ...
PMID:Virus-induced diabetes mellitus. I. Hyperglycemia and hypoinsulinemia in mice infected with encephalomyocarditis virus. 434 51

Faecal fistula has been a challenging problem for every surgeon. It develops spontaneously, postoperatively or post-traumatically. Spontaneous faecal fistula develops following peritonitis. Tuberculous peritonitis is an important cause in developing countries. Postoperative faecal fistula develops after enteric perforation or appendicular diseases. Abdominal trauma-blunt, penetrating or perforating, isolated or part of multiple injuries--can lead to faecal fistula. Faecal fistula is more common after emergency surgery, especially in malnourished children. Faecal fistula leads to unnatural losses of fluid and electrolytes and malnutrition. Infection is generally a causative factor or the malnourished child with faecal fistula develops infection very fast. Assessment of the general condition of the child and the level of the fistula is very important in treating the child. Correction of fluid and electrolyte balance, control of infection and supplementation of nutrition is the basis of treatment. Improved parasurgical care and parenteral hyperalimentation has improved the survival rate and the spontaneous healing, reducing the need for surgical intervention.
 ...
PMID:Faecal fistulae in children. 714 39


1 2 Next >>