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)

Cancer patients are often extremely cachectic. Therefore, they become poor risks for adequate chemotherapy. Consequently, they are either excluded from antitumor therapy or receive only reduced dosage regimens. Since the patient's response to cancer chemotherapy depends on immunocompetence which, in turn, is related to the nutritional state, adequate nutrition is the key to effective treatment. Parenteral nutrition, which in the literature is often referred to as hyperalimentation, can overcome and prevent cachexia. We treated 19 patients with advanced malignancies of various kinds using aggressive chemotherapeutic regimens and parenteral nutrition. The tolerance for chemotherapy in our patients was improved and the patients gained weight.
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PMID:[Parenteral feeding during aggressive chemotherapy of various neoplasms]. 8 38

Elemental enteral alimentation (EEA) is an alternative to parenteral nutrition in patients with a functioning gastrointestinal tract and increased caloric requirements or in whom regular oral feeding is impossible or impractical. EEA is given by nasogastric, jejunostomy, or gastrostomy tube. It is useful in cases of short-gut syndrome, pancreatic disease, partial intestinal obstruction, colitis, neuropsychiatric cachexia, trauma, fistula, vascular insult, and renal and liver disease, as well as in patients being prepared for surgery or requiring hyperalimentation after surgery or abdominal irradiation. Strict attention must be paid to fluid and electrolyte status and to blood and urine glucose levels in patients receiving EEA. With use of a nasogastric tube, infection of the middle ear is a possible but uncommon complication.
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PMID:Meeting exceptional nutritional needs. 2. Elemental enteral alimentation. 10 Jul 74

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

If a patient is expected to respond optimally to one or more forms of oncologic therapy, he should simultaneously be in the best possible nutritional and metabolic condition. When the alimentary tract cannot be used effectively for feeding cancer patients, parenteral nutrition can be lifesaving. Moreover, patients who are poor candidates or noncandidates for any antineoplastic therapy because of their debility or cachexia can be converted to reasonable candidates following a course of i.v. hyperalimentation. This i.v. hyperalimentation can significantly reduce the morbidity and mortality of cancer patients without stimulating tumor growth when applied conscientiously according to the established principles and techniques and when integrated with specific tumor therapy. With the use of ambulatory or home hyperalimentation techniques, normal nutritional status can be restored or maintained during prolonged periods of antineoplastic therapy on a practical and relatively economical outpatient basis. It is anticipated that specific nutrient substrate formulas and parenteral therapy techniques will be developed to maintain optimal host nutrition while adversely affecting the neoplasm.
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PMID:Parenteral nutrition techniques in cancer patients. 40 99

Two groups of patients suffering from advanced neoplastic disease were fed parenterally for a period ranging from 1 to 16 weeks. The parameters considered were: weight change, serum albumin level, lymphocyte transformation test and serum immunoglobulin level. There were 23 patients in one group and 21 patients in the other. Regimens included for group I: saline solution (1000-1500 ml), glucose (100-150 g) and amino acids (15-30 g) per day; for group 2: 40-50 Cal/kg per day (dextrose about 15 g/kg per day), about 2 g of amino acids/kg/day and about 40-50 ml water/kg/day. In addition, 13 patients underwent both treatments sequentially. All the Group I patients lost weight (1.3 kg/week); while out of 23 patients in Group 2, 15 gained weight, 2 remained unchanged and 6 continued to lose weight, but to a lesser rate than before hyperalimentation (the average weight gain was 1.1 kg/week). Serum albumin levels decreased in 19 out of 25 patients in Group I and increased in 14 out of 26 patients of Group 2. Initial values of the lymphocyte blast transformation test were very low in both groups of patients, and an increase was observed only in patients treated by hyperalimentation. The increase was more evident in patients who were not under antiblastic treatment. Changes in serum immunoglobulin levels were not significant. The authors conclude that malnutrition plays a very important role in neoplastic cachexia and can be improved by parenteral hyperalimentation. Although it is possible that in the near future hyperalimentation and conventional neoplastic therapies will play complementary roles in treatment of advanced neoplastic disease, malnutrition is still the specific indication for intravenous hyperalimentation.
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PMID:[Parenteral hyperalimentation in patients with advanced neoplastic disease (author's transl)]. 82 82

Anorexia and cachexia are major problems in patients with cancer. Such measures as anti-cancer therapy, dietary counselling or hyperalimentation are not very successful in reversing this phenomenon in the vast majority of cancer patients. Thus, several drugs have been evaluated as agents to ameliorate cancer-associated anorexia/cachexia. Cyproheptadine is an antiserotonergic drug which appears to cause slight appetite stimulation in patients. A randomised clinical trial, however, was unable to demonstrate any weight gain from this agent. Corticosteroids are frequently used in clinical practice for appetite stimulation in patients with advanced malignancies. Supporting this practice, 4 randomised clinical trials showed that corticosteroid medications can stimulate the appetites of advanced cancer patients. However, these studies were not able to show any substantial nonfluid weight gain in treated patients. Megestrol acetate is a progestational agent which appears to be a relatively potent appetite stimulant. Randomised studies in advanced cancer patients have shown both substantial appetite stimulation and improvement in the nonfluid bodyweights of patients receiving this drug. Preliminary evidence also suggests that this drug has antiemetic properties. Several clinical studies are currently ongoing to determine the effect of various doses of megestrol acetate in patients with cancer. Efforts are also ongoing to evaluate both anabolic steroids and hydrazine sulfate as drugs for the treatment of patients with cancer anorexia/cachexia. The preliminary nature of these investigations, however, precludes recommendations for the use of either of these latter 2 drugs in routine clinical practice.
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PMID:Cancer-associated anorexia and cachexia. Implications for drug therapy. 137 16

A 15 year old boy with anorexia nervosa developed disseminated intravascular coagulation syndrome (DIC). Because of severe cachexia he had been admitted to the Shimane Prefectural Central Hospital. During his hospitalization he developed generalized massive ecchymosis. Laboratory data revealed not only DIC but also multiple organ complications. The patient was treated intravenously with FOY (gabexate mesilate, a protease inhibitor), heparin, a transfusion of fresh frozen plasma, antithrombin III concentrates and platelets. Intravenous hyperalimentation was also administered. The laboratory data, the general condition and the emotional state of the patient improved remarkably. We emphasize the importance of keeping in mind coagulopathy as a complication in anorexia nervosa.
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PMID:Disseminated intravascular coagulation syndrome in anorexia nervosa. 141 38

Cancer cachexia is characterized by progressive, involuntary weight loss in patients with cancer. Cachexia is a common cause of death in patients with cancer in the advanced stage. It is well known that cancer patients with significant weight loss are subject to a high risk of postoperative complications. Intravenous hyperalimentation (IVH) has been applied to anticancer treatment when patients are unable to take sufficient nutrients orally. It is mandatory to take efficacy of antineoplastic therapies into account in attempting to assess response to nutritional repletion in cancer patients. Nutritional support is effective in maintaining body weight of malnourished cancer patients, although it is difficult to maintain body cell mass expressed as intracellular water. In other words, there is a discrepancy between changes in body composition and weight loss in undernourished patients with cancer. It seems that intravenous hyperalimentation has no documented benefit to cancer patients undergoing antineoplastic treatment from the standpoint of improved patient survival in the prospective, randomized trials of nutritional support. Therefore, further studies are needed in order to improve tumor-bearing host survival by means of nutritional management, i.e., glutamine enriched solution, amino acid imbalance solution, and anticachectic drugs on the basis of the deranged metabolism in cancer.
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PMID:[Response to nutritional management in cancer patients]. 154 58

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

Weight loss and cachexia are common characteristics associated with the cancer patient. Although the wasted appearance seems the same in each person, the causes are varied. Studying a patient's history and identifying surgical causes to weight loss or weight loss as a result of treatment complications assists in the consideration of nutritional support. Nutritional parameters combined with the oncology nurse's knowledge of the patient, disease process, and treatment side effects place the nurse in the position to help identify options for nutritional support. The oncology nurse's expertise assists in the decision making process, since it is often not appropriate to institute nutritional support in the inpatient setting nor extend it to the home situation. Objective assessment parameters for home parenteral nutrition assist the nurse in making some of these decisions. The conflicts that arise within the decision making process are usually not clearcut nor easily resolvable. Home parenteral nutrition brings to the forefront requirements and variables that are often not consciously addressed when hyperalimentation is instituted in the inpatient setting.
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PMID:Nutrition support. Making the difficult decisions. 193 46


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