Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020505 (hyperphagia)
 6,116 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sixty-six patients with locally advanced or diffuse gastrointestinal cancer or suffering from major complications due to surgery or radiation therapy, were treated with continuous parenteral hyperalimentation at the Istituto Nazionale Tumori of Milan for a cumulative period of 2101 study-days. Patients were divided into 4 groups: Group 1, malnourished patients with advanced gastrointestinal malignancy; Group 2, patients with gastrointestinal fistulae due to simple surgical complications or to radiation injury of the bowel; Group 3, patients with major postoperative complications; Group 4, surgical patients with gastric or colo-rectal carcinoma treated preoperatively. Mean infusional regime for the various groups included 42-56 Cal/kg/day and 1.5 to 2.4 g amino acid/kg/day, and the duration of the treatment ranged from 7 to 144 days. The results obtained show that protein calorie depletion of cancer patients may depend on malnutrition and that it can be reversed by parenteral nutrition, in patients, that are candidates for surgical treatment or those who qualify for chemotherapy and/or radiotherapy. Parenteral nutrition has a fundamental role in patients with fistulae, even if much attention must be paid to the external care of the fistula and the wound. In addition, nutritional support by intravenous feeding has proven essential for a successful outcome of patients with major postoperative complications. Preoperative protein repletion and central venous nutrition in patients who require gastrintestinal surgery represent a modern advance in the field of cancer surgery.
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PMID:Parenteral hyperalimentation in patients with gastrointestinal cancer. 9 80

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

The renewal of the digestive mucosa is the most efficient process assuming the maintenance of the gastrointestinal barrier. The mucous and absorptive cells, born in the proliferative zone, are migrating to the surface and they extrude duirng meals, living 4 to 6 days. Hyperphagia, pregnancy, lactation and intestinal resection induce a hypertrophic state. Fasting, ageing, germ free status provoke a hypoplasia. The ulcerogenic and antimitotic drugs decrease the proliferative activity. The gastrointestinal cell renewal is controlled by hormonal, vitaminic and nervous agents. Gastrin and growth hormone are the major trophic factors, secretom amd cprtocpsteroids act as antitrophic agents. The vitamins A, D and B12, and the nervous transmittors participate in the feed back control assuming a steady state between proliferation and extrusion. Chalones and immunologic factors are probably the most important but unknown inhibitors. The pathological events concerned with abnormal renewal are peptic ulcer, atrophic gastritis, intestinal villous atrophy and digestive cancer.
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PMID:[Regulation of cell renewal in the gastrointestinal mucosa (author's transl)]. 32 43

Eighty-four patients with fungemia were analyzed. Fungi had been isolated by culture of blood samples, including blood from the catheter for intravenous hyperalimentation, between 1986-1990. Candida albicans (39.3%), Candida parapsilosis (20.2%), Candida tropicalis (11.9%), Candida glabrata (10.7%), Candida guilliermondii (4.8%) and Trichosporon beigelii (4.8%) were the most frequently isolated fungal pathogens. Four patients' blood yielded two different fungal species. Fifty-nine cases were male, and 25 cases were female. Forty-six of the 84 patients died (54.8%), but there were no differences in the overall mortality rate as a function of the fungal species or sex. All patients had underlying diseases: solid cancer, 37 cases; cardiovascular diseases, 9 cases; gastrointestinal diseases excluding gastrointestinal cancer, 8 cases; central nervous system diseases, 7 cases; premature infants and congenital abnormality, 7 cases; leukemia, 6 cases and miscellaneous, 10 cases. Twenty-four of the 46 dead cases were autopsied, and eight cases showed systemic fungal lesions. However, in one case of pulmonary cryptococcosis and one case of pulmonary penicilliosis, there was no correlation between the isolation of C. glabrata by blood culture and the pathological findings. A fungus-positive blood culture was surmised to be a result of contamination of the sample in 33 cases, and the mortality rate for those cases was 72.2% (24 cases). For 6 of the corpses, fungal lesions observed at autopsy were compatible with the types of lesions found by the fungi which had been isolated before death. Removal of the catheter reduced the mortality rate to 41.7%. Fungal endophthalmitis was diagnosed in six cases.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Analysis of 84 cases with fungemia]. 140 94

Deterioration in nutritional status occurs late in the progress of cancers at certain sites, but at all stages in patients with gastrointestinal cancer. Weight loss with decrease in body fat and muscle wastage, occurs to a varying degree. Superficially, the clinical condition resembles simple food deprivation. However, the derangements in metabolism are often and some patients show an elevated resting energy expenditure, disturbances of carbohydrate, fat and protein metabolism and generally, a failure to adapt to reduced food intake, which is characteristic of cachexia. Cancer cachexia then becomes characterized by signs of marked negative energy and protein balance, including hypoalbuminemia, weight loss, and anemia. On the other hand, toxohormone extracted from tumor tissues was considered as the main cause to produce cancer cachexia. However, it has become clearer that cytokines, e.g. cachectin/TNF, IL-1, LT and IFN gamma play an important role to produce cachexia. Patients who are malnourished have an incidence of postoperative complications double that seen in adequately nourished patients. The effectiveness of cancer-chemotherapy is also different in nutritional status of patients. Although in patients requiring hyperalimentation, enteral nutritional support may feasible and enteral feeding has a distinct metabolic advantage compared with parenteral feeding, there is a definite role for total parenteral nutrition in patients who have severe chronic radiation enteritis, side effect of chemotherapy, weight loss and malabsorption. Tentative weight gain and correction of hypoalbuminemia without improving patient survival may be expected by this intravenous hyperalimentation.
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PMID:[Palliative therapy in cancer 2. Nutrition control]. 169 91

The malnourishing effects of cancer and its treatments haveprovided a strong clinical incentive for the nutritional support of cancer patients with intravenous hyperalimentation (IVH), but potential enhancement of tumor growth by additional substrate provision has generated concern. Twenty-five patients undergoing surgical treatment for gastrointestinal cancer were studied on one of two preoperative dietary regimens: ad libitum oral diet or intravenous hyperalimentation. Using a stable isotope tracer, N-glycine, in vivo tissue fractional protein synthesis rates were determined from operative specimens of tumor and normal gastrointestinal tissue. Despite substantial advantage in caloric and protein intake, and nitrogen retention, tumors in IVH-fed patients were synthesizing protein no faster (14.2%/day) than those in orally fed patients (15.1/day). Tumor fractional protein synthesis rates (PSRs) correlated (r = + 0.708, P less than 0.005) with the PSR of the tissues from which they arose. IVH maintained gut PSR at the level occurring in the orally fed patients. Parenteral nutritional support in cancer patients does not maintain protein synthesis rates at levels greater than those present with regular oral diets. Although not a direct measure of tumor growth, these data provide preliminary evidence that optimal nutritional support of the cancer patient may be possible without undesirable stimulation of tumor growth.
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PMID:Protein synthesis dynamics in human gastrointestinal malignancies. 676 89