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

HLA-DR antigens in small and large intestinal epithelia were examined in Crohn's disease (CD). Seventy-two biopsy specimens (10 from the duodenum, 18 from the terminal ileum, and 44 from various sites of the large intestine) were obtained from 5 patients with CD chronologically; before treatment, during elemental diet (ED) treatment, and during home elemental enteral hyperalimentation (HEEH). HLA-DR antigens on the intestinal epithelia were identified by the indirect immunoperoxidase staining method using two mouse anti-HLA-DR monoclonal antibodies. In the small intestine, HLA-DR antigens were expressed differently from normal controls in macroscopically or microscopically pathological areas, but not in macro- or microscopically normal areas. In the large intestine, when the disease was in full vigor before treatment, HLA-DR antigens were always aberrantly expressed even in the macroscopically uninvolved areas, as well as in macroscopically involved areas. However, when the disease was suppressed after ED followed by HEEH treatment, the antigens were not always expressed in the macroscopically uninvolved areas, or in the macroscopically involved areas. These findings suggest that HLA-DR antigens are not merely expressed as a non-specific response to inflammation, but may be expressed as a primary change which results in macroscopic lesions. The possible role of HLA-DR antigens in the immunological mechanism in CD is proposed.
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PMID:HLA-DR antigen expression in macroscopically uninvolved areas of intestinal epithelia in Crohn's disease. 267 7

A patient with Crohn's disease who required placement of a right external jugular vein central catheter for total hyperalimentation is presented. Catheter-induced thrombosis and catheter-associated bacteremia and sepsis subsequently developed. Following the description of the case is a brief discussion of the complications inherent in central line placement, the mechanisms by which thrombosis and sepsis occur, and the measures that can be taken to decrease the incidence of thrombosis and sepsis in central line placement. The management of central venous thrombosis and sepsis is medical and not surgical in nature, and consists of catheter removal, antibiotics, and anticoagulation.
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PMID:Unusual case of central vein thrombosis and sepsis. 309 Aug 81

Aminoacid and oligopeptide formulas of low molecular weight have frequently been used in the past on an empirical basis for nutritional support of patients with Crohn's disease. Improvement of intestinal symptoms and laboratory parameters reflecting the inflammatory process have been demonstrated. Only a few controlled therapeutic trials have compared elemental diets with conventional drug therapy. In small bowel involvement, therapeutic efficiency in active disease is as good as salazosulfapyridine combined with corticosteroids. Elemental diet is less effective in large bowel disease. In the therapeutic application of elemental diets in active disease these formulas should be the only nutritional source for the patient. Particularly in small bowel disease the growth retarding side effects of corticosteroids can markedly be reduced by elemental diets. Children with moderate disease and additional growth retardation may benefit from either supplemental elemental diet and/or high molecular weight formula or from parenteral hyperalimentation. --Crohn-specific fistulas seem to close rarely on elemental diets while favourable results are seen in postoperative fistulas.
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PMID:[Significance of elemental diets in the therapy of Crohn disease in childhood]. 331 3

Six patients with hyperphagia (ingestion of 5-11 000 Kcals/day) associated with severe malabsorption and steatorrhoea are described. The cause of the malabsorption was coeliac disease in three patients, Crohn's disease with ileal resection in two, and carcinoma of the pancreas in one patient. There was no evidence of neurological or endocrine disease (apart from mild diabetes mellitus in the patient with carcinoma of the pancreas) but three patients suffered from severe depression. This association may be commoner than previously realized and be revealed in patients with steatorrhoea of unexplained severity by careful dietary assessment. Its detection has therapeutic implications since restriction of caloric and fat intake decreased steatorrhoea without weight loss in several of the patients described.
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PMID:Hyperphagia in intestinal disease. 453 69

Causal therapy of Crohn's disease up to now cannot be achieved due to the unknown etiology. However, randomized multicenter cooperative trials have demonstrated that adrenocorticoids and sulfasalazine are the most efficient basic therapeutics. In the acute attack additional supportive measures like hyperalimentation, transfusions or substitution of vitamins may become necessary. In contrast to former times a maintenance treatment is no longer justified. About 60% of all patients with Crohn's disease have to be operated because of complications of their disease. The knowledge of absolute and relative indications for surgery in Crohn's disease facilitates the decision. Therapy in Crohn's disease has to be differentiated in relation to severity of the disease and disease location.
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PMID:[Differentiated therapy in Crohn's disease]. 611 4

Thirty-six patients (27 with ulcerative colitis and 9 with Crohn's disease) completed a prospective controlled therapeutic trial of intravenous hyperalimentation (IVH) and total bowel rest in acute colitis. All patients received prednisone 40 mg/day which was reduced every 3 days or more depending on the response to treatment. The trial was completed either when the prednisone was reduced to 10 mg/day or when the patient came to colectomy. In the control group (5 males, 12 females; mean age 44.7 yr), 6 came to surgery and 11 responded medically in a mean time of 23.7 days. In the IVH group (8 males, 11 females; mean age 37.4 yr) 9 came to surgery and 10 responded medically in a mean time of 21.2 days. The results of this trial show that IVH with total bowel rest has no primary therapeutic effect in acute colitis.
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PMID:Controlled trial of intravenous hyperalimentation and total bowel rest as an adjunct to the routine therapy of acute colitis. 677 33

A 23-year-old man suffering from Crohn's disease developed a bilateral maculopathy simulating 'cherry-red spot' with vision impairment and normal electroretinogram during total parenteral hyperalimentation, when copper and zinc serum levels were considerably decreased. The maculopathy rapidly subsided after cessation of the parenteral hyperalimentation and the addition of cooper and zinc. The cause of this maculopathy may be ocular involvement as part of the systemic disease owing to storage of the supplementary free amines and intravenous lipids, and the deficiency of zinc and copper.
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PMID:Bilateral maculopathy simulating 'cherry-red spot' in a patient with Crohn's disease. 678 47

Total parenteral nutrition (TPN) carried out by the patient at home is a new concept in the treatment of intestinal failure. We describe a patient with Crohn's disease who has extensive involvement of the small intestine with resultant severe malabsorption, and who was therefore treated with 'home' TPN for 4 months. During this treatment there were no serious complications. The disabling symptoms present before hyperalimentation was commenced disappeared, and overall clinical improvement has been maintained for a further 6 months after TPN therapy. This case illustrates the feasibility of safe TPN at home in selected patients who have access to specialized hyperalimentation units.
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PMID:Home parenteral nutrition in a patient with Crohn's disease. A case report. 680 19

Since specific treatment has not yet been decided on for Crohn's disease, the immediate target is the induction of remission and its maintenance. We examined the effects of an elemental diet (ED) in Crohn's disease with special reference to the maintenance of remission. Eighty-four patients received total enteral nutrition with the ED (35 to 40 kcal/kg ideal body weight/day) and/or conventional drug treatment for induction of remission. Sixty-one patients in remission were then followed-up with prolonged ED therapy (home elemental enteral hyperalimentation, HEEH) and/or drugs. During the follow-up periods the course of patients receiving HEEH was better than those of patients without HEEH, namely the cumulative continuous remission rates after one, 2 and 4 years were, 94%, 63% and 63% in the group receiving HEEH, 75%, 66% and 66% in the group receiving HEEH and drugs, 63%, 42% and 0% in the group receiving drugs, and 50%, 33% and 0% in the group receiving no maintenance therapy, respectively. In particular, when more than 30 kcal/kg ideal body weight/day of the ED was given, the maintenance of remission was successful in 95% of the patients. These results indicated that ED therapy was effective not only for the induction of remission but also for the maintenance of remission in Crohn's disease.
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PMID:Home elemental enteral hyperalimentation (HEEH) for the maintenance of remission in patients with Crohn's disease. 810 7

Short-bowel syndrome is a state of severe malabsorption secondary to extensive bowel resection. The most common reasons for extensive bowel resection are Crohn's disease and mesenteric infarction. The pathophysiological consequences depend on extent and site of resection, integrity and adaptation of the remaining bowel, and secondary effects on other organs. Most extensively bowel resected patients can be adequately nourished by mouth, especially since they develop compensatory hyperphagia. For patients with colon in function a high-carbohydrate low-fat diet is beneficial compared to a diet with a normal fat content, because it results in decreased diarrhoea, decreased faecal mineral losses, and increased energy assimilation. The relative amount of dietary fat does not influence stool mass or energy assimilation in jejunostomy patients. Patients with jejunostomy have a high faecal output of water, sodium, and divalent cations, and they often need permanent parenteral supply of saline as well as calcium and magnesium if their small intestinal remnant is < 200 cm and parenteral nutritional support if they retain < 100 cm small bowel. In contrast, 50 cm of the jejunum often suffices for adequate oral nutrition if most of the colon is preserved. The majority of patients needing long-term intravenous supply are trained to administer parenteral nutrition at home (HPN). Most patients on HPN obtain a good or fair quality of life with hospital readmissions corresponding to an average of 10% of the HPN duration and an overall HPN related mortality of about 4%.
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PMID:Nutrition in short-bowel syndrome. 872 85


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