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

Malnutrition is associated with an increased susceptibility to infection by altering host defense mechanisms. A number of investigators have demonstrated restoration of in vitro immunocompetence following nutritional repletion with intravenous hyperalimentation. This study was designed to assess in vivo host defense mechanisms following protein depletion and repletion using a septic challenge. Female Fischer rats (150 gm) were fed a regular diet or a 2% agar protein depletion (DEP) diet for 14 days. The rats were then administered an infectious challenge with intraperitoneal injections of 7 ml/kg of a solution of 10(9) organisms/ml of E. coli with 4 gm% hemoglobin as red cells. Two additional organisms were repleted by regular diet (DEP-Oral) or by an intravenous solution (DEP-TPN) of dextrose-amino acid-lipid (D25 3.75% Aminosyn, 10% Intralipid) for an additional 2-week period, and given the experimental peritonitis challenge. Normal rats challenged with E. coli-hemoglobin adjuvant peritonitis had 66% survival as opposed to 15% survival of protein depleted rats. Protein-depleted (DEP-oral) rats refed with regular diets had a 60% survival which was comparable to normal controls. Rats repleted with intravenous hyperalimentation had a mortality comparable to protein-depleted controls. The data confirm that protein depletion is associated with loss of host defense mechanisms. Although refeeding by regular diet resulted in restoration of host defense, repletion by parenteral nutrition, in this model, did not improve survival.
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PMID:Malnutrition and immunocompetence: increased mortality following an infectious challenge during hyperalimentation. 678 58

An unusual etiology, probably iatrogenic, for chylothoraces in the newborn period was recently noted. Three tiny premature infants, all of whom subsequently died, developed massive bilateral chylothoraces. These infants had had prolonged hyperalimentation using jugular central venous catheters for severe gastrointestinal problems and malnutrition. All developed superior vena caval thrombosis, two with overt superior vena caval syndromes. Two had venograms that showed extension of thrombus into the innominate veins to the confluence of the jugular and subclavian veins, at the site of drainage of the lymphatic channels of the thorax. The relationship between superior vena caval an innominate vein thrombosis and chylothoraces in discussed and an important pitfall in the radiologic evaluation is emphasized.
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PMID:Lethal chylothoraces due to superior vena caval thrombosis in infants. 679 77

A study of specific and non-specific immune functions was performed in 14 children presenting with severe malnutrition, before and after parenteral hyperalimentation by central catheter. Anomalies of cellular functions (reduction of the percentage of E rosettes and deficient proliferation with mitogens) were rarely found. Measurements for serum immunoglobulins did not show any anomaly; however reduced percentages of EAC rosettes and important increase in "null" cells were found in about one third of the cases. The main finding was a decreased serum chemotactic activity following activation of the classic complement pathway. This was found in 12 children and returned to normal values in all cases after hyperalimentation.
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PMID:[Disturbances of chemotaxis in protein-calorie malnutrition (author's transl)]. 679 36

Tumor patients generally suffer from malnutrition which is still aggrevated by radiotherapy and its side effects. Therefore the accompanying alimentary guidance and treatment are very important factor. A plan comprising several degrees from dietary guidance, forced oral and enteral nutrition to intravenous hyperalimentation has proved to be practicable. For the ambulatory radiotherapy of our ORL-patients, we have recently been applying a Nutromat-Pfimmer, a promoter system operating according to the Bakery pump system and serving for continuous or discontinuous enteral nutrition therapy with formula or elementary diets. The authors describe principle and function of the device and present their first experiences. By using early and consequently this device for our irradiated patients, we hope to prevent or heal malnutrition, ameliorate the tolerance of tumor therapy, reduce the incidence of complications, re-establish the immunocompetence, and improve the life quality of the patients.
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PMID:[Nutromat-Pfrimmer, a new transporting system for the enteral nutrition therapy of tumor patients before, during and after radiotherapy (author's transl)]. 680 4

Nutrition and metabolism are vital functions just as respiration and cardio-vascular function which influence general well-being, physical and mental capacity, immunocompetence and wound healing. Malnutrition is a high-risk factor and carries a high morbidity and mortality. 30-50% of our patients nowadays are malnourished. Particularly tumor patients suffer from malnutrition which is still aggravated by radiotherapy and its side effects. Therefore the accompanying alimentary guidance and treatment are very important factors. A plan comprising several degrees from dietary guidance, forced oral and enteral nutrition to intravenous hyperalimentation has proved to be practicable. For the ambulatory radiotherapy of our ORL-patients, we have recently been applying a Nutromat, a promoter system operating according to the Bakey pump system and serving for continuous or discontinuous enteral nutrition therapy with formula or elementary diets. The authors describe principle and function of the device and present their first experiences. By using early and consequently this device for our irradiated patients, we hope to prevent or heal malnutrition, ameliorate the tolerance of tumor therapy and the patient's energy, increase the physical and psychical health, reduce the incidence of complications, reestablish the immunocompetence, and improve the survival and life quality of the patients.
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PMID:[Nutritional therapy of tumor patients before, during and after radiotherapy with a new promoter system--Nutromat]. 681 62

Protein calorie malnutrition is being recognized with greater frequency in the hospitalized patient. This report describes the clinical presentation and response to nutritional therapy in nine elderly malnourished patients ranging from 73 to 95 years. Clinical features of malnutrition include weight loss, confusion, hypoalbuminemia (mean 2.8 gm/dl), a low total iron binding capacity (TIBC) (mean 192 micrograms/dl), anergy, lymphocytopenia (mean 1 X 10(3) cells/microliter) and an anemia (mean 9.0 gm/dl). Our subjects were followed for 42 days. In two, hyperalimentation was achieved by voluntary food intake and polymeric dietary supplements. In seven, feeding for 21 days via nasogastric tube was required. After three weeks, weight gain, decreased confusion, improved appetite and mobility, and significant increases in serum albumin and TIBC were seen. At that time, no subject was anergic and lymphocyte counts increased significantly. Increase in the serum iron and percent saturation was noted, and by day 42, a significant elevation in the hemoglobin occurred. As a measure of stem cell function, the committed granulocyte/macrophage progenitor cell (CFU-C) was quantitated in four subjects prior to and following 21 days of nutritional support. A marked increase in CFU-C number from a mean of 0.1 X 10(7) cells/kg to a normal value of 0.85 X 10(7) cells/kg was seen. Thus in addition to correcting the nutritional deficit, hyperalimentation returned immune and hematopoietic abnormalities to near normal levels. While improvement could reflect recovery from an associated disease, it is just as likely that correction of malnutrition, a well-recognized cause of these immunologic and hematopoietic abnormalities, accounted for the response. These observations emphasize the importance of recognizing malnutrition in the elderly and highlight the need for a careful nutritional assessment prior to ascribing hematologic and immunologic abnormalities to the aging process.
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PMID:The correctability of the nutritional, immune, and hematopoietic manifestations of protein calorie malnutrition in the elderly. 682 Oct 77

Between October, 1969, and August, 1981, 125 pelvic exenterations were performed by gynecologic oncologists at the University of Alabama in Birmingham. One hundred twenty patients underwent an exenterative procedure that required urinary diversion and a gastrointestinal anastomosis. Gastrointestinal complications accounted for 60% of all nonmalignant indications for reoperation after exenteration. The common factor in the majority of gastrointestinal complications was the presence of an anastomosis in previously irradiated small bowel. Other preoperative factors, such as significant medical disease, previous laparotomy, or malnutrition, had little apparent effect on the rate of gastrointestinal complications. Avoidance of a small bowel anastomosis by means of a colon conduit, use of an omental pedicle to bring new blood supply into the pelvis, and hyperalimentation have reduced the risk of small bowel obstruction and fistula to 2.2%, while alteration in surgical technique has decreased the rectovaginal fistula rate to 5.3%.
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PMID:Gastrointestinal complications associated with pelvic exenteration. 682 22

Salmonellosis in older children and adults is usually a self-limited disease, but the risk of complications in infants is not well-defined. We performed a retrospective review of 52 patients. 90 days of age or less, seen at the St. Louis Children's Hospital between 1975 and 1981 with stool cultures positive for salmonella. Sixteen were 30 days old or less (neonates), 21 were 31- 60 days of age, and 15 were 61-90 days old. Among patients in whom blood cultures were done initially, bacteremia was most frequent in neonates: 5/11 (45%), compared to 2/18 (11%) in older infants. All seven infants presenting with bacteremia received 10 or more days of antibiotic therapy: yet complications (osteomyelitis, fatal meningitis or chronic diarrhea) developed in three of five neonates and one of two older infants. Complications also developed in seven of 22 patients who initially had negative blood cultures, including two infants in whom sepsis later developed and two infants who required intravenous hyperalimentation because of chronic diarrhea and malnutrition. The group of 23 patients who did not have blood cultures all did well. Salmonellosis is not necessarily a self-limited infection in young infants. Even in the absence of bacteremia, clinicans would appear to be justified in using antimicrobial therapy in infants 3 months of age or les with salmonella gastroenteritis, particularly neonates of older infants with symptoms of dysentery or failure to thrive.
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PMID:Salmonella gastroenteritis in the first three months of life. A review of management and complications. 714 Jan 21

Faecal fistula has been a challenging problem for every surgeon. It develops spontaneously, postoperatively or post-traumatically. Spontaneous faecal fistula develops following peritonitis. Tuberculous peritonitis is an important cause in developing countries. Postoperative faecal fistula develops after enteric perforation or appendicular diseases. Abdominal trauma-blunt, penetrating or perforating, isolated or part of multiple injuries--can lead to faecal fistula. Faecal fistula is more common after emergency surgery, especially in malnourished children. Faecal fistula leads to unnatural losses of fluid and electrolytes and malnutrition. Infection is generally a causative factor or the malnourished child with faecal fistula develops infection very fast. Assessment of the general condition of the child and the level of the fistula is very important in treating the child. Correction of fluid and electrolyte balance, control of infection and supplementation of nutrition is the basis of treatment. Improved parasurgical care and parenteral hyperalimentation has improved the survival rate and the spontaneous healing, reducing the need for surgical intervention.
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PMID:Faecal fistulae in children. 714 39

Candida albicans arthritis in the pediatric patient is rarely reported. In each instance, the patient has had one of the factors that predispose to fungal sepsis: broad spectrum antibiotic therapy, hyperalimentation, prematurity, abdominal surgery, corticosteroid or immunosuppressive therapy, malnutrition, maternal vaginal candidiasis, or lymphoproliferative disorders. To avoid the potentially fatal consequences of delayed treatment, early recognition of the disease is imperative. The patient usually refuses to use the affected joint and plain radiography shows a joint effusion with soft tissue swelling. Osteomyelitis develops in approximately half of the cases. Arthrocentesis with fungal cultures is the best method to make the diagnosis. Treatment is primarily chemotherapeutic and the drug of choice is the membrane inhibitor amphotericin B given intravenously. The antimetabolite 5-fluorocytosine is a second-line drug to be used if resistance develops. All cases before the present one involved the knee joint initially. The case presented involved the left hip and was successfully treated with intravenous amphotericin B.
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PMID:Pediatric Candida albicans arthritis: case report of hip involvement with a review of the literature. 714 47


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