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

A 36-year-old man with prolonged confusion developed after psychomotor status was reported. He had no past history of epileptic seizures or psychotic disorders. The status continued for 20 hours, and twilight state and a slight fever lasted for about 10 days. Thereafter gross impairment of memory and disorientation became remarkable, and, in addition, strong psychic and autonomic disturbances developed, such as visual and auditory hallucinations, excessive excitement, disturbance of sleep, polyphagia, polydypsia, polyuria and hyperhidrosis. The CT scan, carotide angiography, CSF examination, and complement fixation tests for viruses were all within normal limits. The EEGs showed a slowing of the background activity, 0.6--0.8 Hz periodic high voltage wave discharges and random spikes in each temporal area. The clinical symptoms and EEG findings gradually improved without remarkable damage.
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PMID:A case of prolonged confusion after temporal lobe psychomotor status. 52 Sep 42

Phosphate depletion occurring during total parenteral nutrition has been frequently reported during the part 4 years. Hypophosphatemia may be associated with confusion, hyperventilation, and neuromuscular irritability, suggesting a total body phosphate deficiency. If inorganic phosphate levels fall below 1.0 mg %, diminished red cell glycolysis occurs with low erythrocyte levels of 2,3 diphosphoglycerate and adenosine triphosphate. Lowered red cell organic phosphates are associated with increased hemoglobin oxygen affinity. If severe hypophosphatemia occurs, hemolytic anemia, which is correctible by phosphate infusion, may result. In addition, leucocyte function is impaired by low levels of serum inorganic phosphate. While recognized as a needed additive, recommended phosphate supplements vary. Different infusion regimens have been suggested over the past 4 years, based primarily on assumed daily requirements. In the 19 trauma patients described who received hyperalimentation as part of their treatment, phosphate administration was calculated retrospectively and prospectively as a function of non-protein calories infused. Four different groups were studied. Group A received no phosphate additive and quickly became severely hypophosphatemic. Group B received from one to 15 meg of potassium acid phosphate per 1,000 K cal and developed a more gradual lowering of serum inorganic phosphate levels. Group C received 15 to 25 meg of potassium acid phosphate per 1,000 K cal and maintained normal phosphate levels throughout the course of treatment. Group D received greater than 25 meq of potassium acid phosphate per 1,000 K cal and gradually increased their serum inorganic phosphate levels. A significant positive correlation was found between serum inorganic phosphate levels, 2,3 diphosphoglycerate levels, adenosine triphosphate levels, and P50 of the oxy-hemoglobin dissociation curve. No patients developed hemolytic or neuromuscular syndromes which were attributable to hypophosphatemia. This study describes a simple method for the maintenance of adequate phosphate levels in patients whose dextrose-protein solutions may vary from day to day, by relating it to non-protein calories. Provision of 20 to 25 meq of potassium dihydrogen phosphate per 1,000 K cal will maintain normal serum levels of inorganic phosphate during total parenteral nutrition.
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PMID:Phosphate depletion and repletion: relation to parenteral nutrition and oxygen transport. 81 Nov 82

The hypothalamus, in addition to regulating the anterior and posterior pituitary, controls water balance through thirst, regulates food ingestion and body temperature, influences consciousness, sleep, emotion and other behaviors. Much has been learned of these effects in human disease through the clinical manifestations that occur with hypothalamic lesions. This study reviews the clinical pathologic correlations that have been made in recent years showing that regions of the hypothalamus exert functions in humans that are similar to those identified in experimental animals. Clinical pathologic correlations have not always provided precise analysis of hypothalamic function. The hypothalamus is small and often lesions that come to clinical attention achieve considerable size before their recognition, making local anatomic dissections of the effects of the lesions difficult. Nevertheless, the use of modern non-invasive techniques including CT scans and magnetic resonance imaging (MRI) have provided new information not previously available. This paper reviews several cases of hypothalamic disorder recognized recently. (1) A 33-year-old black man with hypothalamic sarcoidosis. Manifestations of hypothalamic dysfunction included panhypopituitarism, aggressive hyperphagia, polydipsia (partially due to hyperglycemia secondary to diabetes mellitus), drowsiness, depression, and irritability. (2) A 37-year-old woman with a large intrahypothalamic tumor (biopsy showed pituitary adenoma), with drowsiness, poikilothermia, lack of satiety, confusion, and memory loss. She becomes depressed when she is transiently more alert (as after hypertonic contrast-dye infusion). (3) A 60-year-old man with hypothalamic compression by a pituitary tumor, associated with syndrome of inappropriate ADH (SIADH), severe anorexia, memory loss, but preserved thirst. After surgical decompression of the tumor his appetite acutely recovered, but he developed severe hypo(poikilo)thermia. (4) A 45-year-old woman with a suprasellar craniopharyngioma presented with severe drowsiness, hyperphagia, depression, and memory loss post-operatively, which responded to antidepressants (except for the memory loss). She had extremely labile blood pressures and serum Na for about 1 week post-operatively.
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PMID:Neurologic manifestations of hypothalamic disease. 148 Jul 55

Bulimia is an eating disorder characterized by episodic, uncontrollable overeating and frequently by purging after binges. It appears to afflict approximately 5 percent of female college students in the United States. Most sufferers are high-achieving but passive and unassertive young women from similarly high-achieving but disorganized families. Confusion over social roles for women is common in bulimic patients. Bulimia shows a strong association with affective disorders; depression is common in both bulimic patients and their close family members. Bulimic patients seem to have a pronounced affective vulnerability to rejection, loss, and failure. Bulimia presents a special diagnostic challenge to the primary care physician because of the paucity of clues provided by a typical review of systems and a physical examination, even a very thorough one. Making the diagnosis requires persistent and thorough history-gathering and is best accomplished through special attention to the psychosocial history (particularly history of depression and substance abuse, family dynamics, and recent stressors) as well as pointed questioning regarding eating behavior. Because of the severe, potentially lethal complications that may attend bulimia (including fluid and electrolyte imbalance, cardiac conduction abnormalities, gastric rupture, pneumonia), diagnosis and appropriate referral by the primary care physician may have a critical impact on the patient's life and health.
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PMID:Bulimia: diagnosis and management in the primary care setting. 354

Protein calorie malnutrition is being recognized with greater frequency in the hospitalized patient. This report describes the clinical presentation and response to nutritional therapy in nine elderly malnourished patients ranging from 73 to 95 years. Clinical features of malnutrition include weight loss, confusion, hypoalbuminemia (mean 2.8 gm/dl), a low total iron binding capacity (TIBC) (mean 192 micrograms/dl), anergy, lymphocytopenia (mean 1 X 10(3) cells/microliter) and an anemia (mean 9.0 gm/dl). Our subjects were followed for 42 days. In two, hyperalimentation was achieved by voluntary food intake and polymeric dietary supplements. In seven, feeding for 21 days via nasogastric tube was required. After three weeks, weight gain, decreased confusion, improved appetite and mobility, and significant increases in serum albumin and TIBC were seen. At that time, no subject was anergic and lymphocyte counts increased significantly. Increase in the serum iron and percent saturation was noted, and by day 42, a significant elevation in the hemoglobin occurred. As a measure of stem cell function, the committed granulocyte/macrophage progenitor cell (CFU-C) was quantitated in four subjects prior to and following 21 days of nutritional support. A marked increase in CFU-C number from a mean of 0.1 X 10(7) cells/kg to a normal value of 0.85 X 10(7) cells/kg was seen. Thus in addition to correcting the nutritional deficit, hyperalimentation returned immune and hematopoietic abnormalities to near normal levels. While improvement could reflect recovery from an associated disease, it is just as likely that correction of malnutrition, a well-recognized cause of these immunologic and hematopoietic abnormalities, accounted for the response. These observations emphasize the importance of recognizing malnutrition in the elderly and highlight the need for a careful nutritional assessment prior to ascribing hematologic and immunologic abnormalities to the aging process.
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PMID:The correctability of the nutritional, immune, and hematopoietic manifestations of protein calorie malnutrition in the elderly. 682 Oct 77

It has been suggested that a new diagnostic category be added to the section on eating disorders in DSM-IV. This new diagnosis has been termed binge eating disorder. In this article we argue that for two main reasons it would be a mistake to include binge eating disorder in DSM-IV: first, too little is known about binge eating and other related forms of recurrent overeating to justify its inclusion in DSM-IV; and second, its inclusion would be a source of diagnostic confusion. We argue that it is premature to crystallize this specific subgroup from amongst those who recurrently overeat and that to do so would impede the acquisition of knowledge rather than enhance it. We advocate a research strategy that involves studying broad samples of those with recurrent overeating rather than narrow ones.
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PMID:The classification of recurrent overeating: the "binge eating disorder" proposal. 847 85

Hospitalized women with anorexia nervosa and/or bulimia nervosa and dietarily restrained and unrestrained, clinically normal women were provided with a multi-item breakfast meal. Eating patterns and hunger and satiety ratings were assessed. Subjects were offered three foods which varied in fat and carbohydrate contents. Anorectic-restrictors differed most from the control subjects: they had a longer meal duration, a slower overall rate of eating, more frequent pauses during the meal, and more short bouts of eating. They also displayed abnormal ratings of hunger and satiety: they were generally less hungry, had less urge to eat, and were more full than controls of bulimics. Both anorectic and bulimic patients showed more variability in total energy intake than did the controls. Patients usually displayed one of two patterns - either severe restriction or overeating. Abnormal hunger and satiety patterns indicating confusion typified the responses of bulimics; additionally, they showed more urge to eat in the post-meal period than did the controls. A higher proportion of fat in the initial part of the breakfast was related to a larger meal size for the bulimics. It is suggested that these techniques may be useful in evaluating the outcome of treatment for eating disorder patients.
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PMID:Micro- and macroanalyses of patterns within a meal in anorexia and bulimia nervosa. 866 30

A 28-year-old woman with inoperable gastric carcinoma was given continuous infusion of 5-fluorouracil (5-FU) and low-dose cisplatin (CDDP) for 4 weeks while receiving intravenous hyperalimentation (IVH). Eleven days after her last treatment, she developed acute diplopia, deafness and gait ataxia, followed by severe confusion. She became markedly acidotic and hypotensive with a systolic blood pressure of 60 mmHg, necessitating intubation, dopamine treatment and hemodialysis for 7 h. She was also given thiamine. Thereafter, her blood pressure stabilized, the acidosis improved, and her deafness, diplopia, and confusion were resolved. This case suggests that FP (5-FU/CDDP) therapy toxicity, manifested as acute metabolic acidosis and Wernicke's encephalopathy, may be associated with IVH and thiamine deficiency.
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PMID:Severe acute metabolic acidosis and Wernicke's encephalopathy following chemotherapy with 5-fluorouracil and cisplatin: case report and review of the literature. 876 81

The study objectives were to gain insight into how the terms "dieting" and "binge eating" are understood and used by adolescents and to assess whether interpretations of these terms are consistent across age and gender. Twenty-five focus groups were conducted with 203 adolescents (138 girls and 65 boys) in urban public junior and senior high schools. Respondents were asked questions about dieting and binge eating behaviors. In the majority of groups (n=19), healthful eating behaviors, such as eating less fat or more fruits and vegetables, were mentioned in reference to dieting. However, in many of the groups (n=13) unhealthful eating behaviors, such as skipping meals or "starvation," were also described. Dieting was frequently described as an umbrella term for different behaviors aimed at weight control (ie, physical activity) or in nonbehavioral terms (ie, as a desire or plan for weight loss). Although binge eating was described as overeating by many participants, often it was not clear if youth were referring to uncontrolled overeating. In nearly half of the groups, participants indicated unfamiliarity with the term "binge eating." There was some confusion between binge eating and other forms of disordered eating. The findings suggest that prevalence rates of self-reported dieting and binge eating behaviors should be interpreted with caution and it should not be assumed that the majority of adolescents who self-report dieting are engaging in unhealthful behaviors. In providing nutrition counseling to youth, and in assessing dieting and binge eating behaviors in clinical settings and in research studies, specific behaviors should be defined.
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PMID:Dieting and binge eating among adolescents: what do they really mean? 955 Jan 69

The Kleine-Levin syndrome (KLS) is characterized by periodic, sudden-onset episodes of hypersomnia, compulsive hyperphagia, and behavioral-emotional disorders (typically indiscriminate hypersexuality, irritability, impulsive behaviors), lasting from a few days to a few weeks, with almost complete remission in the intercritical periods. Depression, confusion, and thought disorders are frequently associated with the critical symptomatology, and they may suggest other psychiatric diagnoses (schizophrenia, mood disorder, conversion disorder) or a substance abuse. A diencephalic-hypothalamic dysfunction is suspected, even if this composite symptomatology cannot easily be linked to a simple mechanism. The aim of this article is to illustrate problems in differential diagnosis, using a case approach. History, course, and therapeutic intervention in a 21-year-old patient with KLS, associated with a clear psychiatric symptomatology and a critical affective pattern, is reported. Psychiatric correlates of KLS are discussed, including the relationship with affective disorders and the possible emotional impact of the attacks. Implications regarding a combined psychological and pharmacological treatment are also discussed.
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PMID:The Kleine-Levin syndrome as a neuropsychiatric disorder: a case report. 1085 65


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