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

Recipients of autologous bone marrow transplantation (ABMT) for solid tumors need nutritional support to maintain their body weight (BW). Severe BW-reduction (9.9%) was noticed retrospectively in ten ABMT patients fed orally, despite intensive counseling or occasional tube feeding. A prospective, randomized study of hyperalimentation (25 g nitrogen (N) and 3400 nonprotein kilocalories) with total parenteral nutrition (TPN) or partial parenteral plus enteral nutrition by tube feeding (PPN/EN) was done in 22 patients. Nutritional assessment included balance measurements of N, Na, K, Cl, P, Ca, Mg, Cu, and Zn, and serial measurements of BW, serum albumin, prealbumin, and transferrin. Both regimens were effective in maintaining BW (maximum percent of change, 2.5) and N-balance. Blood products accounted for an additional N-intake of 13% in both groups. The TPN group had a higher dietary N-intake versus PPN/EN, a positive K balance but negative Ca, Mg, Cu, and Zn balances. More mineral supplementation was given in the PPN/EN group where positive K, Mg, and Zn balances were seen. Visceral proteins and IgG, IgA, and IgM levels were decreased on days 7, 14, and 21. Creatinine clearance increased significantly in both groups. Compared with TPN, the PPN/EN group showed a twofold number of patients with a positive blood culture, although this observation did not reach statistical significance and patients had fewer days of diarrhea (31.1% versus 54.3%, P less than 0.01). Hyperalimentation with PPN/EN is an acceptable alternative to TPN in the nutritional support of ABMT recipients.
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PMID:Hyperalimentation in autologous bone marrow transplantation for solid tumors. Comparison of total parenteral versus partial parenteral plus enteral nutrition. 250 64

From 1980-1986 intestinal mucosal lymphangiectasia was diagnosed histologically in eight patients (6 weeks to 16 years; four males/four females; seven white). The presenting features were diarrhea (six/eight), vomiting (four/eight), and growth deficit (seven/eight). Additional conditions in these patients included asthma, urinary tract infection, esophageal atresia, hydrops fetalis, inflammatory bowel disease, malabsorption syndrome, and thymic hypoplasia. Hypoalbuminemia and edema (four/eight) were more prominent in those patients under 5 years of age. Two had systemic lymphangiectasia and lymphopenia. The patients responded variably to hyperalimentation and dietary supplements, depending on the extent of their lymphangiectasia and the age at onset of symptoms. Dilated lymphatics were seen in the small intestinal mucosa under the surface epithelium. Lesions were often focal, requiring several biopsies or serial sections for detection. Other common findings were mild to moderate lymphoplasmacytic inflammation and mild to moderate villous injury with blunting and edema. Mild inflammation without lymphangiectasia was also present in esophageal, gastric, or colonic biopsies. Diagnosis should be made on the basis of endoscopic findings or in small-intestinal inflammatory conditions even in the absence of a classic clinical picture. Histologic confirmation may require more than one serially sectioned biopsy. This study confirms the diversity of disorders that may be associated with intestinal lymphangiectasia and shows that the disease in infants is more severe and generalized.
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PMID:Intestinal lymphangiectasia in children: a study of upper gastrointestinal endoscopic biopsies. 274 90

Urinary incontinence affects up to 43 per cent of acute care patients. Toileting is a function of intact bladder, sphincters, and nervous system. Five types of incontinence are stress, urge, reflex, total, and functional. Problems affecting patients in acute care are: 1. Diagnostic studies 2. Treatments--for example, intravenous fluids, hyperalimentation, medications, catheters 3. Bedrest 4. Restraints 5. Pain 6. Iatrogenic conditions 7. Environment Assessment includes a specific history and physical examination, focused on previous episodes of incontinence, functional ability, and cognitive status. Management includes scheduled fluid intake and toileting, manipulation of the environment, and attention to orientation and psychological factors. The treatment of fecal incontinence in the hospital elderly includes: 1. Assessment of incontinence and contributing factors; 2. Bowel regimen and environmental assists for persons with periodic incontinence; 3. Treatment of diarrhea or constipation; and 4. Protection of perineal skin from stool exposure.
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PMID:Continence issues in acute care. 277 95

The effect of combination chemotherapy on human small intestinal morphology and disaccharidase activities and their relation with clinical and chemical (fecal wet weight and K-excretion) parameters for gastrointestinal toxicity were evaluated in patients with disseminated malignant melanoma receiving enteral normoalimentation (NA). Also evaluated were the supposed protective effects on gastrointestinal toxicity of enteral hyperalimentation (HA) with an elemental diet. After chemotherapy, a comparable decrease in villus height, total mucosal height, and mitotic index was found in jejunal biopsy specimens of both groups. However, in the NA group, the crypt depth decreased (in contrast to the HA group), whereas the disaccharidase activities in the HA group deteriorated to lower values than in the NA group. The authors found no correlation between disaccharidase levels and mucosal morphology, nor was there a correlation between these variables, fecal parameters and clinical diarrhea, suggesting that diarrhea occurring after chemotherapy was not due to loss of mucosal tissue or decrease in enzyme activities. A protective effect of HA with an elemental diet on gastrointestinal toxicity could not be established.
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PMID:Gastrointestinal toxicity of chemotherapy and the influence of hyperalimentation. 309 54

We studied 54 patients who, after small intestinal resection, developed a massive protracted diarrhea with a daily fecal loss greater than 2 kg, status we defined as the "overwhelmed intestine syndrome" (OIS). Median length of residual small bowel was 120 cm, 19 patients had a definitive stoma (jejunostomy, n = 9; colostomy, n = 10), 26 patients had a provisional jejunostomy. Fecal weight greater than 2 kg was related to enteral hyperalimentation (greater than 3,500 Kcal) in 19 patients (induced OIS) and was clearly independent in 16 others who had fecal weight over 3 kg while receiving approximately 2,000 Kcal (obligatory OIS); the last 19 patients had fecal weight between 2 and 3 kg during normoalimentation. Hypocalcemia and hypomagnesemia were common in the three groups. The other complications were seen mostly in patients with obligatory OIS: in those patients, parenteral nutrition was maintained in 9 cases out of 16 (vs. 0 in other groups), nutritional gain was scanty, sodium equilibrium was difficult to obtain in spite of a large sodium intake (380 mmol/day), hospitalization lasted several months and autonomy via the enteral route could not be achieved in 7 out of the 9 patients with definitive short bowel (vs. 0 in other groups). This study shows that the OIS is an unique functional entity. Complications and prognosis are dependent on the obligatory or induced pattern of the syndrome. Only patients with obligatory OIS require definitive home parenteral nutrition.
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PMID:[The overwhelmed intestine syndrome]. 313 76

The hypermetabolic state observed in thermally injured patients warrants aggressive nutritional management. Enteral support is the preferred route of nutrient delivery, however diarrhea is reported to be a persistent complication of continuous nasogastric or nasoduodenal hyperalimentation. Diarrhea adds to problems in patient care, disturbs fluid and electrolyte balance, and worsens nutritional status. There has been the impression that tube feeding hyperosmolality, antibiotics, and low serum albumin induce diarrhea. However, in view of the sparsity of published work, a prospective study was undertaken to determine the incidence of diarrhea and to define factors associated with its cause. Of the 50 patients studied, 16 (32%) developed diarrhea. Stool cultures were negative for pathogenic organisms. Although the risk of diarrhea was associated with antibiotics (p less than 0.005), several nutrients also had an impact. Results demonstrated a significant relationship between dietary lipid content (p less than 0.05) or vitamin A intake (p less than 0.001) and diarrhea. Implementation of tube feeding within 48 hrs postburn was also associated with a decreased incidence of diarrhea (p less than 0.001). This paper describes a modular tube feeding program in which diarrheal frequency is lessened (p less than 0.0001). Surprisingly, tube feeding osmolality, drugs used to prevent stress ulcers, or hypoalbuminemia did not have an adverse effect on intestinal absorption. The cause of diarrhea in burn patients is obviously multifactorial. It is concluded that a low fat (less than 20% of caloric intake), vitamin A enriched (greater than 10,000 IU/day), early enteral support program maximizes conditions which promote tube feeding tolerance while minimizing nutrient malabsorption during the nutritional rehabilitation of thermal injury.
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PMID:Diarrhea in tube-fed burn patients: incidence, etiology, nutritional impact, and prevention. 313 42

We studied the effect of early postoperative enteral hyperalimentation on the nutritional state and hormones in digestive organs in twenty patients who underwent resection of thoracic esophageal carcinoma and reconstruction of new esophagus. Following results were obtained. 1. Although enteral hyperalimentation was started in the early postoperative period (postoperative 3 day), the incidence of complications including diarrhea was decreased dramatically and satisfactory nutritional effect was obtained due to the development of many excellent chemically defined enteral nutrients. 2. Gut hormones including CCK showed the same response as in the preoperative period to the loading of enteral nutrients. And that, it is suggested that the response of CCK is affected by the lipid content in the nutrients and that this response was effective to prevent the postoperative biliary stasis. 3. Enteral nutrition made it possible to self-regulate water absorption from digestive organs, to control body fluid volume and to prevent over hydration or hypovolemia to comparison with parenteral nutrition.
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PMID:[Nutritional management following resection of esophageal cancer--effect of early postoperative enteral hyperalimentation]. 314 65

The case of a 4 month old Irish setter bitch is reported in the present paper, which showed a recurrent diarrhoea, polyphagia from the purchase of the dog at the age of two months. The dog was severely emaciated and treatment with Pancreon was not followed by any improvement. The total information acquired from the history of the dog and laboratory studies was clearly indicative of exocrine pancreatic deficiency. In spite of the satisfactory response to treatment with Tryplase (the faeces were restored to normal, but polyphagia and coprophagia continued to be present), it was decided to perform euthanasia. Atrophy of the pancreas and small groups of undifferentiated cells situated in the adipose tissues were observed at autopsy. Pseudoductules, excretory ducts and blood vessels were clearly identifiable. Islands of Langerhans were not detected, only a few scattered B cells being present. The microscopic findings in the Irish setter were obviously similar to the type 1 atrophy as described by Prentice et al. (11). The age (of this dog), at which exocrine atrophy of the pancreas became apparent may be described as exceptionally young.
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PMID:[A rare case of juvenile atrophy of the pancreas]. 338 Dec 16

In order to evaluate the effects of an unrestricted, compensatory, enteral hyperalimentation in patients with short bowel syndrome, we retrospectively selected from 128 consecutive patients with extensive small bowel resection a group of 25 who developed under this regimen a massive protracted diarrhea (fecal weight 2005-6188 g/day). All the patients but one were weaned from parenteral nutrition by the eighth day after admission. Although fecal weight increased in relation to the increase of the enteral intake, there was a significant gain of body weight, serum-albumin, and creatinine-height index and an improved fluid and electrolyte balance through the period of hospitalization. By contrast, 18 of the 25 patients developed hypocalcemia and/or hypomagnesemia. After discharge (median follow-up, three years), most patients resumed normal social activity. It is concluded that exclusively enteral hyperalimentation can stabilize most patients with severe short bowel syndrome even in the case of massive fecal losses.
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PMID:Compensatory enteral hyperalimentation for management of patients with severe short bowel syndrome. 392 12

We report about a 76 years old patient with Cronkhite-Canada syndrome. The diagnosis has been found with the following clinical symptoms: diarrhea, anorexia, alopecia, and onychotrophia. Laboratory values: severe hypoproteinemia (total serum protein 4.3 g/dl, albumin 2.4 g/dl); endoscopical and radiological findings: a generalized polyposis which involved the whole intestine except the oesophagus. As far as we saw in our literature-overview of 55 patients with Cronkhite-Canada syndrome, this patient had for the first time a carcinoma of the urinary bladder and a Bricker operation 17 years before the onset of his disease. Further we remarked a lack in the resorption of the enterally administered thyroidal hormones. The progress was fatal despite a parenteral hyperalimentation and a treatment with antibiotics and glucocorticoids.
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PMID:[New observations in a case of Cronkhite-Canada syndrome]. 396 97


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