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

Wernicke's encephalopathy is an uncommon disorder caused by a thiamine deficiency which is clinically characterized by the triad of ophthalmoplegia, ataxia and disturbances of consciousness, each finding being variably present. The disease is caused by malnutrition or malabsorption, and is often associated with prolonged alcohol intake, neoplasm and extensive inflammatory processes of the digestive tract and parenteral hyperalimentation-induced gastrointestinal mucosal atrophy. Clinical diagnosis can be elusive and MRI may be the only imaging technique able to detect the cerebral lesions, whose type and distribution are characteristic of the Wernicke's encephalopathy, whereas CT is positive only in exceptional cases. We report a case of a 56-year-old woman who developed a Wernicke's encephalopathy 1 month after a colonic resection with signal intensity changes located in the mammillary bodies and in the medial thalamic nuclei.
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PMID:Magnetic resonance imaging in a case of Wernicke's encephalopathy. 968 4

During 1977, M.D. Anderson Hospital and Tumor Institute used 270,575 g of human serum albumin (HSA) at a patient cost of $1.1 million. For a 1-month period in early 1978, a survey of HSA usage was conducted in the 440-bed hospital. Patients who were started on albumin during the study period were included and monitored for the duration of their therapy. The largest groups of patients receiving albumin were those with gynecological tumors (30%) and gastrointestinal tumors (16%). Two-thirds of all patients receiving HSA were also receiving intravenous hyperalimentation (IVH); 80% of all HSA used was given to IVH patients. Although the IVH patients received a smaller daily dose of HSA, the average length of their therapy was about three times longer than that of the non-IVH patients. The mean total dose for the IVH patients was 344 g as compared to 180 g for non-IVH patients. For all patients, the mean total dose of HSA was 289 g at a patient cost of $1212. Of the patients, 66% had an initial serum albumin level determined before therapy was begun, 43% had a serum albumin level run at the termination of therapy, 16% had neither, and 28% had only one serum albumin level during their HSA therapy. Ninety percent of the patients had at least one period of 4 days or longer without a serum albumin level being obtained.
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PMID:Human serum albumin usage in a comprehensive cancer center. 1024 69

Cachexia is common in patients with advanced neoplastic disease, and beyond certain levels, is associated with decreased survival. Depletion of vitamins and minerals may co-exist with protein-calorie undernutrition. The causes of the cancer cachexia syndrome may include decreased food intake, increased fecal and urinary nutrient losses, and abnormal metabolic pathways in both the host and the tumor. The complex nature of weight loss in cancer makes restoration of lean body mass more difficult in cancer than in non-cancer undernutrition. Non-volitional feeding (hyperalimentation) frequently causes cancer patients to gain weight, but this weight may be more fat and water than lean body mass. Hyperalimentation has not yet been shown to prolong survival in cancer, but additional nutritional support studies are in progress.
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PMID:Nutritional support of the cancer patient. 1031 14

Ten dogs with pituitary-dependent hyperadrenocorticism (PDH) received 2 mg/kg of L-Deprenyl once daily for 6 months. Monthly patient assessment consisted of evaluation of the owner's daily observation protocol, a standardized owner questionnaire, physical examination, CBC, biochemical profile, determination of the urine cortisol/creatinine ratio (UC/C), low-dose dexamethasone suppression (LDDS) test, corticotropin releasing hormone (CRH) test, and adrenal ultrasonography. At the beginning and the end of the study, an adrenocorticotropic hormone (ACTH) stimulation test and computed tomography also were performed. Two dogs developed neurologic signs and 2 dogs developed acute pancreatitis. An increase in activity, decrease in polyphagia, and decrease in panting were reported by 6, 4, and 2 owners, respectively. Seven owners believed that water intake decreased, but this was confirmed in only 3 dogs. Water intake increased in 2 dogs and remained unchanged in 5 dogs. The condition of the hair coat and skin improved in 2 dogs, worsened in 3, and remained unchanged in 5. Urine specific gravity, urine osmolality, ACTH test results, UC/C, and adrenal gland size did not change significantly throughout the study. In 4 of 8 dogs, LDDS was abnormal at the start of the study but normal at the end of the study, and in 2 dogs, the opposite occurred. Marked individual variation was noted in the CRH test, with a tendency for smaller increases in ACTH toward the end of the study. A marked increase in hypophyseal tumor size occured in 4 dogs. Treatment with L-Deprenyl resulted in improvement, deterioration, and stagnation of clinical signs in 2, 4, and 4 dogs, respectively. The results of this study indicate that L-Deprenyl cannot be recommended as the sole treatment for canine PDH.
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PMID:The efficacy of L-Deprenyl in dogs with pituitary-dependent hyperadrenocorticism. 1044 18

Home anti-cancer chemotherapy was performed for patients with advanced cancer of the digestive plantable venous port placed beneath the skin via the subclavian vein. 128 patients under 75 years old (enrolled: 6 patients with esophageal, 65 with gastric, 44 with colorectal, 5 with cholangio, 5 with pancreatic, one with hepatic and one with ileal cancer) were treated. Continuous intravenous infusion of 5-FU (300-400 mg/body/day) combined with low-dose injection of cisplatin (5 mg/body/day) was continued for 10 days, and repeated 3 times for 6 weeks. The response rate was 23.6% in 72 patients with valuation of tumor mass. In 83 patients for whom a tumor marker evaluation was also performed, an effect was seen in 30.1%. No severe side effects such as renal dysfunction were observed, and no special infusions were needed. Therefore, a quality of life was maintained in which bathing was possible and patients were released from the hospital. Hyperalimentation through the venous port, and palliation during the terminal stage, is easily accomplished. It is useful method for surgery, chemotherapy and palliative therapy in the treatment of cancer.
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PMID:[Home anti-cancer chemotherapy with continuous infusion of 5-FU combined with low-dose cisplatin injection via implantable venous port with portable balloon pump]. 1063 Feb 41

We report herein the case of an 80-year-old woman with insulinoma who was regarded as an unsuitable candidate for immediate surgery due to her advanced age and obesity, for whom octreotide, a long-acting analogue of somatostatin, was used to improve her hypoglycemia and hyperinsulinemia without hyperalimentation. Administering a minimal dose of octreotide for a long period resulted in the improvement of leg edema, weight control, and cardiopulmonary function, and resection of the pancreatic tumor was safely carried out without any complications.
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PMID:The effectiveness of administering a minimal dose of octreotide long-term prior to surgery for insulinoma: report of a case. 1088 68

A 54-year-old man presented with visual disturbance and polydipsia. Magnetic resonance imaging disclosed a cystic mass which extended from the intrasellar to the suprasellar region. Bifrontal craniotomy was performed and the tumor was totally removed. Histological findings confirmed the diagnosis of craniopharyngioma. Postoperatively, the patient suffered from transient disorientation. About one month after the operation the patient manifested hyperphagia and he gained 15 kg in one month. Mazindol, a non-amphetaminergic anorectic agent, was administered for 3 weeks. His appetite normalized and his weight fell and stabilized even after mazindol administration was ceased.
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PMID:Mazindol administration improved hyperphagia after surgery for craniopharyngioma--case report. 1138 81

Data from both rodent models and humans suggest that intact neuronal melanocortin signaling is essential to prevent obesity, as mutations that decrease the melanocortin signal within the brain induce hyperphagia and excess body fat accumulation. Melanocortins are also involved in the pathogenesis of disorders at the opposite end of the spectrum of energy homeostasis, the anorexia and weight loss associated with inflammatory and neoplastic disease processes. Studies using melanocortin antagonists (SHU9119 or agouti-related peptide) or genetic approaches (melanocortin-4 receptor null mice) suggest that intact melanocortin tone is required for anorexia and weight loss induced by injected lipopolysaccharide (an inflammatory gram-negative bacterial cell wall product) or by implantation of prostate or lung cancer cells. Although the precise mechanism whereby peripheral inflammatory/neoplastic factors activate the melanocortin system remains unknown, the proinflammatory cytokines (interleukin-1, interleukin-6, and tumor necrosis factor-alpha) that are produced in the hypothalamus of rodents during both inflammatory and neoplastic disease processes likely play a role. The data presented in this paper summarize findings that implicate neuronal melanocortin signaling in inflammatory anorexia.
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PMID:Melanocortin signaling and anorexia in chronic disease states. 1285 26

A 42-year-old woman with locally advanced breast cancer developed headache just after completing adjuvant chemotherapy. Magnetic resonance imaging revealed a mass located in the left subthalamic nucleus (STN) and involving the posterior part of the thalamus and the hypothalamus. The patient refused a radiologically guided biopsy and gamma knife treatment was not financially possible. Palliative whole brain radiotherapy with hormonal therapy was administered. The patient gained 19 kg body weight during 4 months follow up because of hyperphagia. This solitary tumor, either a breast cancer metastasis or a primary tumor, involving the STN is extremely unusual.
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PMID:Subthalamic nucleus tumor causing hyperphagia--case report. 1456 Aug 52

Although nutritional support using nutrient enemas was recorded almost 3,500 years ago, the modern era of clinical dietetics commenced with the development of intravenous hyperalimentation by Dudrick et al. and the development of the chemically defined diet by Greenstein et al. Thereafter, clinical nutritional support became widely accepted as one of the basic tools of patient care, and knowledge of the metabolism of nutrients has been extended. In particular, the significance of micronutrients in systemic function, importance of gut function on the systemic metabolism and immune system, and involvement of amino acids and fat elements in the development and amelioration of specific disease status such as renal and hepatic failure have been recognized, and specific nutritional support has been created as a treatment strategy. In addition to knowledge of renal and hepatic failure or metabolic disorders, accumulated information on tumor metabolism and pathophysiology in cancer cachexia has also enabled cancer treatment using a nutritional approach. An enteral diet containing certain amino acids such as arginine or glutamate, omega-3 unsaturated fatty acids, and nucleic acids has been developed, and its clinical application under the new concept of "immunonutrition" has demonstrated reduction of the incidence of infection and shortening of hospital stay. Many questions on Immunonutrition remain to be answered such as its mechanism or optimal composition, although it is a promising field for future evolution. Currently, the assessment of nutritional status and gut function is required through lifelong education of medical doctors as well as the popularization of nutritional support teams. In the near future, tailor-made nutritional support will be required based on gene polymorphisms.
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PMID:[Advance and perspective of clinical nutrition]. 1502 60


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