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

Marked weight loss is the major nutritional defect in chronic pancreatitis. Inadequate food intake owing to recurrent or near continuous pain usually accounts for the initial 10 to 20 per cent of loss of body weight, which decreases again with the onset of diabetes and is often precipitous with the development of steatorrhea. Treatment of pain, control of diabetes, and intensive pancreatic replacement therapy for steatorrhea usually causes weight gain, but seldom to ideal weight. It appears that the patient's body weight gets set at a new "weight-stat." Although isolated abnormalities of small bowel function tests can be elicited and deficiencies of fat-soluble vitamins, calcium, zinc, selenium, and so forth may be demonstrated, these rarely lead to clinical syndromes, as with demonstrable low B12 uptake in some 10 to 15 per cent of patients. In the late stage of the disease and particularly in NATP, extreme protein-calorie malnutrition may occur, which may not be correctable even by hyperalimentation. Although the mortality of the disease was reportedly higher in areas of socioeconomic deprivation, it appears from recent studies in Switzerland and other developed countries that mortality during a 12-year period may be in the region of 50 per cent worldwide.
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PMID:Nutritional deficiencies in chronic pancreatitis. 268 Sep 66

A case of necrotizing amebic pancolitis in a 6-year-old boy with asplenia, partial situs inversus, and cyanotic congenital heart disease is reported and the literature is reviewed briefly. Our patient was managed successfully by prompt colectomy, ileostomy, a Stamm gastrostomy, and extensive drainage of the peritoneal cavity with administration of metronidazole postoperatively and prolonged jugular vein Broviac catheter hyperalimentation. This child may be the first survivor of total colonic amebic necrosis in childhood. Necrotizing amebic colitis appears to be more hazardous in infancy and childhood than in adult years. Malnutrition and additional illnesses and malformations may produce greater immunocompromise in the very young, placing them at greater risk for the ultimate of amebic intestinal complications, total colonic necrosis and disintegration.
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PMID:Colectomy for necrotizing amebic pancolitis in early childhood with survival. 268 61

With the increased number of immunocompromised patients there has been a concomitant increase in patient morbidity and mortality due to fungi. The etiologic microorganisms vary depending upon the type of immune dysfunction. Patients with malignancies and chemotherapy-induced neutropenia commonly are infected with Candida and Aspergillus. Other ubiquitous fungi such as Rhizopus, Fusarium, and Trichosporon are more frequently implicated as agents of disease in these patients. Patients with cell-mediated immune dysfunction such as acquired immune deficiency syndrome (AIDS) are susceptible to mucocutaneous candidiasis and pulmonary and disseminated cryptococcosis. Histoplasmosis and coccidioidomycosis have been particularly lethal infections in AIDS patients. Contributing factors such as broad-spectrum antibiotic use, intravenous catheterization, malnutrition, hyperalimentation, multiple surgical procedures and/or trauma, and steroids used either singly or in combination may also predispose patients to invasive fungal disease. Definitive diagnosis is often difficult to establish and usually requires invasive biopsy. Delay of culture results due to the time required to process specimens and to allow the fungus to grow also contributes to the poor results of therapy. Biopsy of skin lesions represents a useful technique for making a diagnosis. Recent advances in antifungal therapeutics promise to change the current approach to treatment for several of the mycoses. The availability of new oral azoles with spectra of activity that include aspergillosis and cryptococcosis, which currently require treatment with parenteral amphotericin B, may prove practical for prolonged oral therapy of otherwise lethal mycoses.
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PMID:Fungal infections in the immunocompromised host. 268 23

In India, major social discrepancies linger despite major advances since 1947 with the result of overeating by the rich and undernutrition of the poor. Anemia affected 65% of pregnant women in Hyderabad hospitals, and in Calcutta it hovered around 88.5-90/1% for males and 96.5-96.7% for females aged 15-44. Malnutrition accounted for 15% of hospitalizations often because of infant diarrhea. Parasitic infestations leading to anemia and subsequent malnutrition also resulted in premature births and low birth weight. Weaning practices including its late initiation and prolongation of breast feeding for up to 12 months (or 18 months in rural areas) led to growth retardation. About 25,000 children become blind annually because of vitamin A deficiency, and 55% of women also suffer from it. Almost 120-170 million people suffer from endemic goiter. Socio economic and socio cultural factors are also associated with nutritional problems. Some Brahmin communities in South India avoid garlic and onions because they are considered taboo foods. The Tridosha Theory holds the there are heat-producing foods, cooling foods, and gas-producing foods that have to be avoided. Some of these are brown sugar, eggs, tomatoes, oranges, cereals, and vegetables. In West Bengal they believe that milk and fish can cause leprosy. The population nearing 800 million is another factor, as smaller families have better nutrition. Education by nurses should include the use of exhibits, songs, and plays to teach women proper nutrition. Nurses also have to change their attitudes to avoid commercial foods, identify harmful practices, and promote nutritional education. The project of the National Institute of Nutrition involving 23 villages combated vitamin A deficiency successfully by laying stress on available vegetables and fruits. If nurses participate if such primary health care programs the objectives of Health for All by 2000 will be achieved.
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PMID:Nutrition: an essential element of primary health care. 272 85

Destruction of the ventromedial hypothalamus produces hyperphagia, hyperinsulinemia and hypertriglyceridemia. These changes appear to be partly the result of increased firing rate of the vagus nerve and reduced firing rate of the sympathetic nerves. These reciprocal changes in the function of the autonomic nervous system appear to provide an adequate explanation for the hyperinsulinemia in this syndrome, and for the reduced heat expenditure. Destruction of the lateral hypothalamus, has effects opposite to those of the ventromedial hypothalamus with a reduction in food intake, a decrease in body fat, and an increase in the activity of the sympathetic nervous system. These reciprocal functions of the hypothalamus are associated with different adrenergic receptors. A medial hypothalamic alpha-adrenergic system mediates the epinephrine stimulation of feeding, and a beta-adrenergic system mediates the lateral hypothalamic inhibition of eating. Peptides from the endorphin family can stimulate food intake, but most other peptides are inhibitory. Growth hormone and thyroid hormone stimulate food intake under appropriate conditions. Insulin and adrenal steroids appear to play the most important role of all the hormones in regulating food intake. Deficiency of adrenal glucocorticoids is associated with decreased food intake and a wasting of body flesh. Increased levels of glucocorticoids, on the other hand, produce a variety of truncal obesity. In animals with ventromedial hypothalamic lesions and obesity, adrenalectomy will reverse the obesity. In genetically obese rats and mice, adrenalectomy will attenuate the progression of the syndrome. These effects appear to be through a reduction of food intake, and an increase in energy expenditure. Injections of insulin will stimulate food intake and may lead to obesity.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Autonomic and endocrine factors in the regulation of food intake. 286 66

Although abdominal candidiasis in critically ill surgical patients is becoming increasingly common, optimal management has not been defined. We treated 16 patients with abdominal candidiasis over a 36 month period. Violation of the gastrointestinal tract mucosa was the most common precipitating event (13 patients). Predisposing factors included: CVP catheters, broad spectrum antibiotics, and parenteral hyperalimentation in all patients, H2-blockers/antacids in 14 patients, as well as malnutrition (7 patients), DM (3 patients), alcoholism (3 patients), and steroids/chemotherapy (3 patients). Candida was isolated from an abscess in seven patients, peritoneal fluid in six patients and both in three patients. In four patients abdominal candidiasis was preceded by positive cultures from blood or two peripheral sites which had not been treated. All patients were treated with amphotericin B (146-4000 mg) without any major adverse effects. Fungal infection was eradicated in ten patients; three patients succumbed to candidiasis. Patients treated within seven days required less Amphotericin B and appeared to have a better outcome than those having delayed treatment. The authors conclude that abdominal candidiasis is a potentially lethal infection in critically ill surgical patients that should be aggressively treated. Amphotericin B can be safely administered and concurrent antibiotics need not be stopped.
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PMID:Abdominal candidiasis in surgical patients. 291 8

The cafeteria diet involves feeding experimental animals a choice of palatable human food items to stimulate energy intake, and has been used extensively to study diet-induced thermogenesis. In a recent commentary Moore has argued that this feeding regime is inappropriate for such studies because the nutrient composition cannot be controlled, many of the effects seen are due to protein or nutrient deficiency and accurate measurements of energy intake are difficult to achieve. We argue that all of these criticisms can be overcome by careful use of the feeding regime and well-controlled experiments. Gross nutrient composition of cafeteria diets can be modified over a wide range, and such studies demonstrate that the effects of protein deficiency can be clearly dissociated from those of hyperphagia. There is no experimental evidence for nutritional deficiency in cafeteria-fed animals even over very long periods of time. Furthermore, the alternatives suggested by Moore, i.e., presenting sucrose solutions to drink or high fat diets, suffer the same drawbacks of altered and often uncontrolled nutrient intake and yet produce little or no increase in energy intake. Criticism of the cafeteria diet is not justified simply because of its misuse by nutritionally naive experimenters. The value and validity of this feeding regime is further supported by the enormous impact it has made on our understanding of energy balance regulation and thermogenesis.
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PMID:The cafeteria diet as a tool for studies of thermogenesis. 304 31

Intravenous lipid emulsions are an efficient source of calories, and their use prevents essential fatty acid deficiency. Their use has resulted in prolonged survival in patients with short bowel syndrome and other causes of malnutrition. Serious adverse effects have been rare with the newer lipid emulsions. A case of multiple, partially organized pulmonary lipid-fibrin emboli associated with chronic hyperalimentation is reported.
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PMID:Pulmonary lipid emboli in association with long-term hyperalimentation. 308 Mar 66

The interactions of cancer and malnutrition are discussed with the focus on aging. To establish whether the elderly are more likely to develop cancer cachexia and its complications, this review encompasses the pathogenesis of malnutrition in cancer; the age-related alterations of appetite, gastrointestinal function, energy expenditure, and protein turnover; the diagnosis of malnutrition; and the effectiveness of nutritional support in the elderly. Although metabolic and physiologic changes induced by cancer and age appear synergistic in causing cachexia, more frequent complications of malnutrition have not been observed in the geriatric cancer patients. This may be due to only a small proportion of the elderly with cancer being enrolled in clinical studies or to a reduced cachexia-inducing ability of tumors in these patients. A limited number of studies indicate nutritional replenishment is obtainable in malnourished elderly by hyperalimentation. As restoration of the lean body mass may be slower in older patients, early institution of nutritional support is recommended in malnourished elderly or elderly at risk for malnutrition during neoplastic treatment.
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PMID:Nutrition, cancer, and aging: an annotated review. II. Cancer cachexia and aging. 308 18

Parenteral hyperalimentation or total parenteral nutrition has become an established therapy for patients with a wide variety of conditions that preclude oral feeding. Because pregnancy is an infrequent event in poorly nourished women with acute or chronic illness, total parenteral nutrition has not been widely used for pregnant patients. Some obstetricians believe that total parenteral nutrition entails risks in excess of its potential benefit to pregnancy and demands skills and knowledge that are either not available or are in limited supply. Sufficient favorable clinical experience has accumulated over the past 15 years so that total parenteral nutrition can be recommended in the management of malnutrition during pregnancy. The purpose of this report is to review the authors' experience and the literature about total parenteral nutrition during pregnancy.
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PMID:Total parenteral nutrition during pregnancy. 309 56


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