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)

This feasibility report is based on the fact that malnutrition has been recognized but too little understood in connection with surgical risk. Patients with cardiac cachexia are remarkably similar to many patients with cachexia of the aged. Cachectic patients generally go through an operation well, but their condition often deteriorates slowly and they die a few days later; they behave as if they are running out of energy reserves. Malnourished people can be divided into three categories: kwashiorkorlike, marasmic, and marasmic-kwashiorkorlike. Recognition and classification of protein/calorie malnutrition into these categories directs treatment. Recognition is based on the usual physical and laboratory tests, plus triceps skinfold/arm circumference observations; leukocyte counts, with absolute and relative lymphocyte counts; serial transferrin, globulin, and albumin assessments; and, particularly, Candida and mumps skin testing to identify the anergic state. Intravenous and oral hyperalimentation can bring about conspicuous improvement in the appearance, attitude, and ability to withstand stress--including major heart surgery--of malnourished patients. However, astute clinical balance is essential, since either oral or intravenous hyperalimentation may cause renal nitrogen overload; moreover, if intravenous delivery is too rapid, congestive heart failure may be precipitated.
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PMID:Malnutrition: a poorly understood surgical risk factor in aged cardiac patients. 40 3

Candida parapsilosis is rarely isolated from blood cultures. Our hospital surveillance detected an increased rate of isolation of C parapsilosis during a four month period. Fourteen postoperative patients receiving intravenous (IV) hyperalimentation and eight burn patients receiving IV albumin were involved. Hectic fever, the major clinical manifestation, was seen in 61% of cases. Therapy in the postoperative patients consisted merely of discontinuing IV catheters and hyperalimentation, while amphotericin B was needed in five of eight burn patients to control persistent fungemia. Epidemiologic analysis identified a source of the organism in the IV-additive preparation room where C parapsilosis was found contaminating a vacuum system. Organisms apparently refluxed into IV bottles when aliquots were removed to accommodate additives. Of 103 patients who received fluids prepared with the contaminated system, 21% became infected with C parapsilosis. Infection surveillance was instrumental in detection and control of the outbreak. Routine guideline should be established to insure the sterility of IV fluids containing additives.
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PMID:Nosocomial outbreak of Candida parapsilosis fungemia related to intravenous infusions. 41 74

Using intravenous saline as a control, the kinetics of insulin in protein hydrolysate (hyperalimentation) solutions in glass bottles with and without the addition of albumin were studied using double radioisotope tags. Albumin is not a necessary additive to the solution. A technique for providing constant, predictable delivery of insulin is described. Albumin, when added to hyperalimentation and saline solutions with insulin, does not protectively coat plastic tubing or glass bottle surfaces to prevent insulin adsorption; some other mechanism is responsible for the increased insulin concentrations in intravenous solutions with added albumin.
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PMID:Insulin kinetics in hyperalimentation solution and routine intravenous therapy. 41 62

On the basis of recent pathophysiological data and clinical observations in three patients, this paper draws attention to the commonly neglected importance of postoperative hypoproteinemia as the cause of an edema of the intestinal wall with a consequent "interstitial" paralytic ileus. The characteristic features of this syndrome are its onset between the third and the eighth postoperative day; the absence of other known causes of intestinal hypomotility; the benign, but protracted course without treatment; and the therapeutic success achieved by the correction of a hypoproteinemic fluid overload with concentrated albumin and a diuretic. In addition, parenteral hyperalimentation and Rheomacrodex-Sorbit may be indicated, but the hypoproteinemia should at any rate be corrected.
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PMID:[Hypoproteinemia causing postoperative "interstitial" paralytic ileus]. 58 62

A young man with severe multiple injuries following a motorcycle accident was admitted with head and mandible fractures, coma, fracture dislocation at C5-C6 resulting in total leg paralysis, partial paralysis of the right arm and intercostal muscles, and closed chest injury with possible pulmonary contusion. On the fourth day he developed fulminating mediastinitis and massive empyema, and was found to have a ruptured esophagus. Recovery became possible with surgical drainage of the pleural cavity and mediastinum, proximal and distal decompression of the esophagus, antimicrobial therapy, irrigation of the pleural cavity, complete intravenous hyperalimentation, and infusions of salt-poor albumin. The patient was discharged after 95 days, and 7 months after injury is neurologically intact except for a partial right wrist drop. This rare esophageal rupture should be suspected in any chest injury patients, especially those characterized by extreme cyanosis, dyspnea, shock, and prostration incompatible with thoracic cage injury.
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PMID:Rupture of the thoracic esophagus from blunt trauma. 59 47

Albumin synthesis was measured, in vivo, in rats 16 hours after partial hepatectomy or after sham operation. When albumin synthesis was expressed in terms of whole body weight, partially hepatectomized rats synthesized significantly less than sham-operated rats. However, when albumin synthesis was expressed as a function of dry liver weight, the two groups synthesized similar amounts. Intragastric hyperalimentation with amino acids significantly increased albumin synthesis in partially hepatectomized rats.
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PMID:Stimulation of albumin synthesis by amino acids following partial hepatectomy in the rat. 80 3

Forty patients with a mean age of 56 yrs, all of whom required hemodialysis therapy, for mean of 32 days, were treated with a minimum of 2000 kilocalories of I.V. glucose, potassium orthophosphate with mulit-vitamins and 25 Gm of I.V. albumin. Patients were initially dialyzed daily and then every other day or 3 times/wk. Complications including pneumonia, GI bleeding, gram negative septicemia, shock, the need for tracheostomy and ventialtory assist were high. Overall survival rate was 33%. This survival rate we beleive to be high considering the complicated type of illness these patients had as well as our clinical experience prior to the use of total parenteral nutrition in the manner described in this report. Essential L-amino acids were not used based on our experience in 3 patients with hepatic and renal failure who developed worsening neurological findings with the use of this substance. We believe further that I.V. glucose and albumin may be preferred mode of hyperalimentation.
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PMID:Total parenteral nutrition in acute renal failure. 82 19

Because of its capacity to form a deposit on thrombus fibrin, 99mTc-macroaggregated albumin can be used to detect intracardiac thrombus by routine imaging. The authors report a case of right ventricular thrombus diagnosed antemortem on a routine lung study in a patient with an intracardiac hyperalimentation catheter in place.
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PMID:Diagnosis of intracardiac thrombus by 99mTc-MAA scintiscanning. 83 Mar 33

Twenty-eight patients underwent pelvic exenterations for gynecologic malignancies between June 1986 and June 1989. The postoperative fluid and electrolytes were managed by one of two regimens. One group of 10 patients was given concentrated 25% albumin infusion for the first 16 hr after surgery in addition to maintenance intravenous crystalloid solution according to ideal body weight. The second group of 18 patients received only a standard crystalloid solution. The albumin infusion group was found to have a more stable postoperative course as evidenced by less fluid boluses (P less than 0.01), fewer electrolyte bolus requirements (P less than 0.01), and easier management of blood pressure and urine output. There was a 50% decrease in total fluid requirement, a higher mean right atrial pressure (P less than 0.05), and a lower maintenance intravenous fluid rate (P less than 0.01). As a consequence, central hyperalimentation was started earlier (P less than 0.01) and the albumin infusion group left the Intensive Care Unit sooner than the non-albumin infusion group. There was not a single instance of clinical fluid overload with this slow infusion technique. Thus, concentrated albumin infusion was beneficial in the acute fluid management of these difficult patients.
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PMID:Concentrated albumin infusion as an aid to postoperative recovery after pelvic exenteration. 175 98

The aggressive radiotherapy and chemotherapy used in conditioning regimens for children with leukaemia undergoing bone marrow transplantation (BMT) cause a severe catabolic state. Total parenteral nutrition (TPN) is indispensable in the management of these patients. 25 children with leukaemia undergoing BMT were studied to evaluate the efficacy of TPN and the value of anthropometric parameters and biochemical variables (albumin, retinol-binding protein and prealbumin) in monitoring nutritional status in the critical post-BMT phase. The complications of TPN were mainly metabolic, generally mild and easily controlled. The hyperalimentation solution and infusion line were not responsible for infection in any patient. The marked variations in anthropometric parameters and albumin expected in such patients were not observed in our children due to the nutritional support given. Prealbumin and retinol-binding protein showed statistically significant, positive variations (P less than 0.01), thus proving sensitive indices of the response to nutritional repletion.
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PMID:Total parenteral nutrition and nutritional assessment and leukaemic children undergoing bone marrow transplantation. 182 20


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