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)

Pneumothorax, hydrothorax, hydromediastinum, and cardiac tamponade are uncommon, although not unusual, complications of central venous catheter placement. We report a case of hydromediastinum with bilateral pleural and pericardial effusions, occurring in a patient after placement of a Silastic double-lumen central venous catheter for hyperalimentation.
 ...
PMID:Bilateral pleural and pericardial effusions because of mediastinal placement of a central venous catheter. 176 59

Small-bore Silastic feeding tubes are being used with increasing frequency for short- and long-term enteral hyperalimentation. We present three cases where these flexible tubes were passed into the tracheobronchial tree and then out into the pleural space. The result in each case was a pneumothorax or hydropneumothorax. These cases were collected at one community hospital over a 6-month period. A review of the current literature reveals reports of 10 similar cases. We conclude that, although the exact incidence of pleural complications of small-bore feeding tubes is unknown, it is not insignificant. The traditional methods of assessing proper nasogastric tube placement are inadequate when applied to these small tubes. Only a chest roentgenogram can assure placement in the stomach. Education of hospital staff on methods to avoid malposition of feeding tubes has resulted in an absence of pulmonary complications over a subsequent 1-year period.
 ...
PMID:Pneumothorax complicating small-bore feeding tube placement. 174 6

Sixty-eight semipermanent subclavian catheters were placed in 61 patients with gynecologic malignancies. The principal indicator for placement was chemotherapeutic administration. Other uses included blood transfusion, antibiotic infusion, and hyperalimentation. The minor complication rate of 21% included exit site infections and clotted, broken, and dislodged catheters. There were no acute surgical complications; i.e., bleeding or pneumothorax, but there was a 6% major complication rate, which included four cases of sepsis and a case of a broken intravascular catheter.
 ...
PMID:Evaluation of subclavian catheters in gynecologic cancer patients. 212 89

Nutritional supplements administered through flexible small caliber feeding tubes are an increasingly popular substitute for parenteral hyperalimentation. Small and large caliber nasogastric tubes can inadvertently pass into the tracheobronchial tree, even in the presence of an endotracheal tube with an inflated cuff. We report three patients who had small caliber feeding tubes passed through the tracheobronchial tree perforating into the pleural space. Potential complications include immediate or delayed pneumothorax, tension pneumothorax, hydropneumothorax, and empyema. Prompt post-insertion chest radiography is required to verify correct placement of small caliber feeding tubes.
 ...
PMID:Iatrogenic bronchopleural fistula caused by feeding tube insertion. 392 Feb 21

Patients who have cystic fibrosis (CF) are frequently hospitalized for long-term intravenous (IV) treatment. We evaluated clinical effectiveness of the Drum-Cartridge Catheter (Abbott Laboratories) for such patients. The catheter is placed peripherally under local anesthesia via an antecubital vein into the superior vena cava or right atrium. Patients who were more than 10 years of age and who were hospitalized for IV antibiotic therapy and/or IV hyperalimentation were studied. All but 2 patients had CF. Using an aseptic technique the catheters were inserted into the basilic or cephalic vein. Chest radiographs were used to confirm the final location of the catheter. Catheters were used to administer IV antibiotics, hyperalimentation, and lipids. There were 38 catheterizations in 23 patients; several patients had repeated insertions at later admissions. The success rate of insertion was 86% with 31 of the 38 insertions initially located either in the superior vena cava or right atrium. Mean duration of catheterization was 15.4 days (range 5-49 days). No major complications such as sepsis, catheter or clot embolism, pneumothorax, vascular perforation, or hemorrhage occurred in the patients who had DF. Complications that required displacement of catheter into the axillary vein (1 patient), and cracked catheter hub (1 patient). This study shows that the Drum-Cartridge Catheter can be used easily for IV therapy of patients who have CF for a long duration, repeatedly, and with no major complications.
 ...
PMID:Peripherally inserted central venous catheters for treatment of cystic fibrosis. 393 8

Fifteen cases of gunshot wounds of the esophagus seen between the years 1970 and 1978 were reviewed, eight involving the cervical esophagus and seven involving the thoracic portion. Most common symptoms were pain, neck tenderness, dyspnea, and dysphagia. Signs observed were subcutaneous emphysema, crepitations, fever, and leukocytosis. Plain X-rays showed pneumomediastinum, hydrothorax, and pneumothorax. Perforations were confirmed by barium studies in 12 patients. Injuries in the cervical portion were treated by prompt exploration, closure of the defect, and drainage. There were no deaths in this group. Thoracic injuries were treated by prompt thoracotomy except in one patient, for whom the diagnosis was not made until 22 hours after the injury; his was the only death in this series. Because of the extensive tissue involvement in gunshot wounds, primary repairs of thoracic esophageal perforations have a high incidence of failure. Defunctionalization of the esophagus, through ligation of the distal esophagus, gastrostomy, and cervical esophagostomy, has provided a safer method. Use of a double strand of absorbable Dexon to ligate the distal esophagus made a second thoracotomy for removal of the ligature unnecessary. We have adopted routine use of hyperalimentation, avoiding the need for feeding jejunostomy.
 ...
PMID:Perforations of the esophagus from gunshot wounds. 670 55

Surgeons are frequently called upon to place central venous catheters for various purposes. With the increasing used of central vein hyperalimentation, these catheters have become quite widely used. Often, critically ill patients require simultaneous infusions of vasopressors, fluids, blood and/or blood products, and hyperalimentation. In patients who have had peripheral intravenous catheters indwelling for long periods, often no peripheral access routes are available. Central venipuncture carries a definite risk of pneumothorax, hemothorax, and arterial puncture. The technique presented here allows the placement of multiple centra venous catheters via a single venipuncture. Each catheter is a completely separate venous conduit and may be used to infuse any number of substances alone or concurrently with others. Materials needed for this technique are: One 18-gauge Thinwall needle Two 20-cc Luer tip syringes Two 16-gauge 8" or 12" intravenous catheters* Two separate bags of infusion fluids and tubings One bottle 1% xylocaine Two .035" floppy end spring guidewires, 40 cm long One 8 French percutaneous dilator-introducer kit One 11 knife blade One mosquito curved hemostat Sterile towels, gauze sponges, sutures of choice, antiseptic *(This equipment is required for the placement of only two catheters).
 ...
PMID:A single venipuncture technique for placement of multiple central venous catheters. 685 77

Recent attempts to reduce weight by patients with anorexia nervosa have sometimes led to life-threatening hematologic complications. This report describes an instance in which a patient with anorexia nervosa and pancytopenia drastically improved with treatment that included administration of granulocyte colony-stimulating factor. The patient had lost 27 kg of body weight within 8 months. Even after admission, the blood cell count continued to decrease rapidly as follows: platelet, from 244 x 10(3)/microliters to 44 x 10(3)/microliters; erythrocyte, from 4.04 x 10(6)/microliters to 2.58 x 10(6)/microliters; and leukocyte, from 4.8 x 10(3)/microliters to 1.6 x 10(3)/microliters (granulocyte, 0.8 x 10(3)/microliters). Complications included pneumomediastinum, pneumothorax, purpura, petechiae, hepatomegaly, fever, gangrenous stomatitis, and somnolence. Bone marrow aspiration disclosed absence of fat cells, marrow hypoplasia, and infiltration of the mature lymphocytes. Intravenous hyperalimentation, blood transfusion, gamma-globulin, and antibiotics were administered, but leukopenia and fever remained. However, administration of recombinant human granulocyte colony-stimulating factor dramatically reversed the leukopenia and fever. With careful nutrition therapy, the patient's blood cell count and bone marrow normalized by the time of discharge. It was concluded that severe hematologic disorders may occur in patients with anorexia nervosa, and advanced treatment may be required to save the patient's life.
 ...
PMID:Case report: reversal of severe leukopenia by granulocyte colony-stimulating factor in anorexia nervosa. 768 51

Increased chest drainage, a higher incidence of pleural effusions in the postoperative period, and more chest tube drainage was found after harvesting the internal thoracic artery (ITA). Patients with these complications required thoracocentesis, or prolonged chest tube drainage. But these methods may be painful and make a limitation to activity of daily life (ADL) in these patients. We therefore sought an effective procedure for these patients, and applied pleural placement of intravenous hyperalimentation catheter. This technique could drain the effusion completely, conveniently and painlessly without a limitation to ADL. Pneumothorax, infections and other complications occurred in no patients. We concluded that this method might be useful in these patients with prolonged post operative pleural effusion after harvesting the ITA who have failed other modes of therapy.
 ...
PMID:[Use of intravenous hyperalimentation catheter to drainage prolonged postoperative pleural effusion after harvesting the internal thoracic artery]. 774 59

One hundred ten women with gynecologic malignancies underwent 116 subclavian vein Groshong catheter insertions at the bedside under local anesthesia and intravenous sedation. Three (2.6%) additional patients had unsuccessful insertions because of an inability to access the subclavian vein or thread the guidewire. Fluoroscopy was not used. There was one delayed pneumothorax and no insertion-related infections. The 111 single-lumen catheters used primarily for the administration of chemotherapy are the subject of this report. The mean age of patients was 60 (range 13 to 89) years and their average Gynecologic Oncology Group performance score was 1.1 (range, 0 to 3). Diagnoses include 74 ovarian, 19 cervical, 13 uterine, and 5 other gynecologic malignancies. Hyperalimentation was administered in 16 (14%) patients. Grade IV neutropenia occurred in 57 (51%) patients and 44 (40%) received granulocyte colony-stimulating factor during therapy. The average lifespan of catheters was 247 (range, 37 to 703) days, and 39 (35%) women died from disease with their catheter in situ at a mean time of 288 days. Thirty-seven (33%) catheters were removed after completion of chemotherapy at an average time of 239 (range, 78 to 448) days. As of 1/1/94, 22 patients continued to use their catheters at a mean of 313 (range, 182 to 509) days. The remaining 13 (11.7%) catheters were removed due to complications (7 episodes of bacteremia, 3 tunnel infections, 2 catheter migration/thromboses, and 1 catheter laceration). Twenty episodes of fever in 17 (15.3%) patients were evaluated with blood cultures in the absence of a tunnel infection. None of the 10 culture negative cases resulted in catheter removal, whereas 7 of 10 patients with bacteremia had catheters removed. Exit site infections occurred in 23 (21%) patients and were resolved with local measures and oral antibiotics. The risk of exit site cellulitis was 3.3% per month. When compared to placement of permanent central venous access devices at our institution in the operating room or radiology suite, bedside placement of Groshong catheters resulted in a savings of $1448 and $231 per case, respectively.
 ...
PMID:An evaluation of Groshong central venous catheters on a gynecologic oncology service. 789 88


1 2 Next >>