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

Essential to the management of the head and neck cancer patient is carefully monitored nutritional support. Traditionally, enteral alimentation, using the nasogastric feeding tube, has been the mainstay of treatment. Tube feedings should provide ample amounts of essential nutrients, minerals, vitamins, and adequate calories and protein. Knowledge of the tube feedings available and problems associated with their administration helps to avoid the pitfalls which limit their effectiveness. The inadequacies of enteral alimentation preclude its use in selected circumstances of severe nutritional depletion. Parenteral hyperalimentation, as a primary or adjuvant mode of therapy, may be capable of rapidly reversing deficits, improving postoperative morbidity and increasing tolerance to radiation and chemotherapy. Postoperative deglutition abnormalities may prolong the nutritional problems of head and neck cancer patients as well.
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PMID:Nutritional concepts in the management of the head and neck cancer patient. II. Management concepts. 10 13

The greatly increased nutritional demands of the severely burned patient frequently require the use of tube feeding for enternal hyperalimentation. At a time when general patient morale is low and motivation needs to be maximally maintained, there is nothing so dispiriting as the distress of a painful perianal region and uncontrollable liquid stools. Attempts to control the diarrhea which frequently accompanies tube feeding by changing the formula or the method of administration or a wide variety of constipating drugs have all met with very limited success. Based on the clinical observation of a noted gastroenterologist (Bockus), we have administered a mucilagenous hydrophilic colloid bulk laxative (Metamucil) to patients on tube feeding formulae. The dosage and frequency are adjusted to individual patient needs, but average 7 g per liter of liquid formula. The results have been dramatic; namely, the virtual elimination of the diarrhea problem in our burn patients on enteral hyperalimentation by gastric tube feeding. Colonic transit time increases. The stools become formed but soft, cohesive but not adhesive. Perianal irritation does not occur. Neither does soilage of wound, dressings, or bed. No rebound constipation or obstructive symptoms have been encountered. We attribute this response to the same water binding mechanism that allows these colloids to prevent chronic constipation. Our patients may be given as much as 5,000 to 6,000 calories of tube feeding per day. Our patients are not distressed by diarrhea. Our nursing staff is relieved of the burden that entails.
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PMID:Successful use of a bulk laxative to control the diarrhea of tube feeding. 10 11

Eight patients with intrathoracic esophageal disruptions were managed nonoperatively and without pleural drainage. Criteria for nonoperative treatment included the following: disruption contained in the mediastinum or between the mediastinum and visceral lung pleura; drainage of the cavity back into the esophagus; minimal symptoms; and minimal signs of clinical sepsis. Cause of the esophageal perforation was pneumostatic dilatation (1 patient), vomiting (2), and a leak following esophageal operation (5). Antibiotics were administered intravenously to all patients; hyperalimentation was accomplished intravenously in 5, and nasogastric suction was used in only 1. The cavities contracted and the esophageal leaks sealed in all instances. Time before oral intake was resumed ranged from 7 to 38 days (average, 18 days). Days until discharge ranged from 15 to 52 days (average, 28 days).
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PMID:Selective nonoperative management of contained intrathoracic esophageal disruptions. 11 Feb 75

We studied four patients with high-output end jejunostomies (greater than 3,000 mL/day) who were receiving home hyperalimentation. With knowledge of urine and stoma output, standard total parenteral nutrition fluid was infused and titrated according to individual needs, first during the hospital stay and then on follow-up office visits. Mean daily stoma output for the group was 3,556 mL/day. With oral fluid intake restricted to 1,500 mL/day, average daily stoma output dropped to 2,892 mL. The mean daily volume of nutrient fluid required to achieve stabel biochemistries and weight was 3,550 mL. Daily caloric requirements ranged from 23 kcal/kg to 44 kcal/kg, with a mean of 32.5 kcal/kg. Amino acid requirements averaged 1.6 g/kg. With 65 patient months of continuous overnight catheter infusion, there have been no serious metabolic derangements or deaths. The program of home hyperalimentation can maintain a satisfactory metabolic state in patients with high-output jejunostomies.
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PMID:Maintenance of home hyperalimentation in patients with high-output jejunostomies. 11 Feb 88

In a pilot study, the distribution of lymphocyte subpopulations in the peripheral blood and skin tests with recall antigens have been examined in 42 patients with gastrointestinal cancer before and during a perioperative parenteral hyperalimentation. Concerning the calories and the concentrations of amino acids and carbohydrates, two different solution regimens were applied. During parenteral nutrition with 2400 and 2200 kcal especially the absolute numbers of lymphocyte subpopulations increase reflecting the changes of total lymphocyte count. There was no marked difference between the 2 groups. Both solutions are qualified to balance the preoperative catabolic situation indicated by preoperative lymphopenia. This kind of parenteral nutrition did not influence the patient's cellular immunological status which was tested by 3 recall antigens. It must, however, be considered that the physical i.e. nutritional situation of the patients was not reduced to an extent where the immunological status was impaired. Our results suggest that in the perioperative period cancer patients should be supported by hypercaloric parenteral nutrition. On the other hand more sensitive immunological tests such as DNCB for skin testing and functional assays for in vitro tests are necessary to assess the effects of this kind of therapy.
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PMID:[The effect of parenteral nutrition on cellular immune status in patients with gastrointestinal cancer]. 11 May 58

A 17-year-old male with Crohn's disease involving the terminal ileum and cecum developed an umbilical fistula in the absence of previous surgery. While on intravenous hyperalimentation he developed an enterovesical fistula and was successfully treated by surgical resection. This combination of an enterovesical and umbilical fistula has not been previously reported. An aggressive approach to treatment is suggested.
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PMID:Crohn's disease with spontaneous ileoumbilical and ileovesical fistulae. 11 May 69

Hematogenous Candida osteomyelitis is described in a two-month-old infant, as a complication of Candida septicemia which occurred during a parenteral hyperalimentation regimen. Treatment with flucytosine led to full recovery. The scarcity of reports on hematogenous Candida osteomyelitis in infants, despite an increased incidence of Candida septicemia, and the non-specific symptomatology which the disease may assume in this age group, indicate the need for greater awareness of this complication. Flucytosine is an antifungal drug which can also be given by mouth and carries relatively low toxicity. We found flucytosine to be extremely effective in the treatment of disseminated infantile Candida osteomyelitis.
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PMID:Candida osteomyelitis as a complication of parenteral nutrition in an infant. Successful treatment with flucytosine. 11 Jul 30

Home hyperalimentation is now recognized as a technique which allows patients with severe short bowel syndrome or inflammatory bowel disease to return to a near normal life style. The success of this program is dependent on the longterm use of a catheter through which intravenous fluids are infused. In the past 20 months, we have inserted 32 catheters into 22 patients for purposes of home parenteral nutrition. In a 1 to 20-month follow-up, the average duration of catheter insertion was 6 months, the longest has been 19 months in 2 patients. One patient with superior vena cava thrombosis has had a catheter inserted via a femoral vein which has been functioning well for 5 months. Thirteen catheters have been removed: 3 for obstruction, 2 for sepsis, 1 due to breakage of the catheter, 4 for slippage (3 were pulled out by the patient, and 1 was removed because of inability to psychologically accept the presence of the catheter). The removal of 6 of these 13 catheters was necessitated by breaks in the proper techniques of catheter care, which include daily dressing changes and heparinization of the catheter at least once daily. Techniques of catheter insertion and catheter care will be presented
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PMID:Exerience with the Broviac catheter for prolonged parenteral alimentation. 11 Sep 52

A computer program has been developed to allow the generation of written orders for the logical progression of enteral hyperalimentation by the technique of continuous nasogastric infusion. Data required for entry include name, age, sex, height, usual and current weights, degree of stress, and if indicated, restrictions of nitrogen, fluids, sodium and potassium. A specific formulation may be requested, or the computer will pick a single nutrient solution or combination of two solutions that will best meet the requested constraints. Output includes entered data with English and Metric interconversion, surface area, and estimates of basal energy expenditure, protein wastage, protein and caloric requirements. If requested, daily orders are written to include a reasonable progression of infusion rates and concentrations of the solutions(s). Daily values are printed for the total amounts to be infused of fluid, calories, protein, sodium, potassium, and mOsm. The programs have been demonstrated to run in either on-line or batch mode. The system is easily accessible by physician, dietician, nurse, or other interested professionals.
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PMID:Computer optimization of enteral hyperalimentation. 11 Sep 60

Chemotherapeutic agents, blood products and hyperalimentation solutions have been administered and recurrent diabetic ketoacidosis has been treated via vascular access procedures in 13 patients during the period from 1972 through 1977. Bovine heterograft, saphenous vein graft and the direct arteriovenous fistulae have been successfully utilized in the construction of arteriovenous fistulae in patients requiring vascular access for nonhemodialysis purposes. Operative techniques and therapeutic usefulness are discussed.
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PMID:Nondialysis uses for vascular access procedures. 11 35


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