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)

A review of the clinical course of gastroenteritis in 274 hospitalized children revealed a severe form of the disease. Eight-eight per cent were aged 12 months or under and 20% had severe associated malnutrition. The commonest clinical manifestations were diarrhoea (100%), dehydration (98.9%), vomiting (81.4%) and fever (77.7%). Pathogens were isolated from 75.2% of cases (rotavirus 24.5%, Escherichia coli 20.8%, salmonellae 20%, shigellae 6.2%, campylobacter 2.2% and Yersinia enterocolitica in 1.5%). Septicaemia was confirmed in 12 patients (4.4%) and strong clinical evidence of septicaemia was present in 36 more cases (13%). Dehydration was isonatraemic in 68%, hyponatraemic in 21% and hypernatraemic in 11% of cases. There was a clear association between septicaemia and hyponatraemia. The overall mortality rate was 1.8%. Data from our study show that the use of intravenous hyperalimentation, and/or antibiotics in the management of gastroenteritis in selected patients, can significantly reduce morbidity and mortality.
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PMID:Gastroenteritis in a regional hospital in Kuwait: some aspects of the disease. 619 27

A three-year-old boy with severe aplastic anemia (HLA-A1,B8(Bw6), Cw7,DR3, MB2, MT2, SB4/A1,B8 (Bw6), Cw7,DR3,MB2,MT2,SB-) received a bone marrow transplant from a phenotypically HLA-identical, SB-compatible female unrelated donor. This donor was selected from eighteen HLA-A1,-B8,-blood donors after extended serotyping, mixed leukocyte culture testing and secondary proliferation assays with primed lymphocyte typing reagents specific for SB. Although patient cells proliferated well as responders in MLR, their stimulatory capability was greatly impaired. Because the patient had inherited the same serological HLA-D haplotype from each parent, it was concluded that a compatible unrelated donor must be homozygous for the same HLA-D antigens as the patient. This HLA-D homozygosity was demonstrated by the lack of MLR responses of both parents to stimulators from the donor. The SB typing results suggested SB compatibility because both the patient and the donor typed as SB4,-. Following bone marrow transplantation, there was rapid hematopoietic engraftment. The patient developed severe diarrhea caused by graft-versus-host disease of the gastrointestinal tract, which necessitated hyperalimentation. He is currently eighteen months posttransplant with full hematopoietic reconstitution and moderate chronic skin graft-versus-host disease.
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PMID:Bone marrow transplantation for severe aplastic anemia using a phenotypically HLA-identical, SB-compatible unrelated donor. 622 16

The immediate onset of hypermetabolism after a major burn dictates that nitrogen and calories be supplied as early as possible to such patients to prevent the well-documented catabolic state. However, intravenous hyperalimentation is not always possible, and enteral feeding is not usually attempted in the early resuscitative period. Twelve patients with major burns (40% to 70%) were fed nasoduodenally in the early postburn period with a new solution (3.5% Aminosyn, 25% Polycose, and appropriate additions of electrolytes and vitamins). All patients reached positive nitrogen balance in 9.8 +/- 2.3 days, tolerated the feeding extremely well, and had no distention or diarrhea. Metabolic assessment showed remarkable stability. The characteristic signs of hypermetabolism, such as hyperglycemia and hypoinsulinemia or hyperinsulinemia, were absent. Furthermore, there was no persistent neutrophilia or leukocytosis and there was a significant (p less than .01) decrease in the percentage of juvenile neutrophils and a significant (p less than 0.001) increase in absolute lymphocytes between days 0 and 14 of the study. These data indicate that early enteral feeding of Polycose-Aminosyn is safe and well tolerated, and that the small intestine absorbs nutrients readily in the early postburn period, leading to positive nitrogen balance, preventing loss of serum protein, assisting in the maintenance of normal carbohydrate metabolism, and restoring granulocytes and lymphocytes to normal ratios.
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PMID:Early enteral feeding of patients with major burns: prevention of catabolism. 644 Apr 66

During a 9-year period, 204 infants younger than 12 months of age had 294 Broviac central venous hyperalimentation catheters inserted. Fifty-nine adult-size and 235 infant-size Broviac catheters were used. Catheter insertion was via the saphenous vein (267), external jugular (7), internal jugular (16), cephalic (2), and transthoracic right atrial veins (2). General anesthesia was used for all internal jugular, but for only 11 saphenous catheters. Catheter function ranged from 6 to 925 days (mean, 112 days). Forty-four infants had malabsorption syndromes, 36 had short bowel syndrome, 38 had intractable diarrhea, and 86 required nutritional support for a variety of other conditions. Fifteen of the 204 infants developed inferior (10) or superior vena caval thrombosis (2), or both (3). Thrombosis occurred in 13 of the 267 infants with saphenous catheters (4.9%), and five of the 25 with jugular or cephalic venous catheters (20.0%). Obstruction to normal catheter infusion was the first sign of caval occlusion. Transient mild leg edema (4) and prominent venous pattern over the legs (3) were present with inferior vena caval (IVC) occlusion, but no patient had renal vein obstruction or died as a direct result of this condition. Each of the two patients with superior vena caval (SVC) occlusion experienced mild to moderate edema and venous suffusion of the head and upper extremities, and one developed a pleural effusion. Each of the three infants with combined superior and inferior vena caval thrombosis died from pulmonary insufficiency within six months after SVC occlusion.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Complications of superior versus inferior vena cava occlusion in infants receiving central total parenteral nutrition. 644 Sep 68

Positive nitrogen balance and preservation of body weight and total proteins were demonstrated in 26 patients undergoing extensive upper gastrointestinal operations who were randomized to receive elemental diet by a needle catheter jejunostomy. Infusions were started immediately after operation and continued for 10 days. In 26 patients receiving enteral feedings and 22 intravenous control patients, mean cumulative 10 day nitrogen balance was +11.7 +/- 5.4 and -44.7 +/- 6.5 g, respectively (p = 0.0001). Enterally fed patients lost only 0.02 +/- 0.5 kg of weight compared with 3.8 +/- 0.3 kg in control patients. The only complications were diarrhea in 34 percent of the study patients and one broken catheter. It is probable that the nitrogen and body weight preservation provided by enteral hyperalimentation equals or exceeds that demonstrated for total parenteral nutrition in postoperative patients.
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PMID:Nutritional benefits of immediate postoperative jejunal feeding of an elemental diet. 676 49

Previous reports have described a syndrome of paresthesias, weakness, seizures and hypophosphatemia in patients and animals receiving intravenous hyperalimentation. In this report we describe a group of five patients who developed this syndrome while on oral caloric intake and three patients who received only modest amounts of hyperalimentation therapy. As an experimental corollary, studies were performed in starved and normal dogs with calories infused via an intragastric catheter. The serum inorganic phosphorus (Pi) fell slightly in normal animals from 4.8-2.5 mg. %. In the starved dogs with diarrhea or vomiting the Pi fell gradually from 4.8-1.6. In starved dogs without gastrointestinal symptoms the Pi fell precipitously from 3.7-1.4 mg % on the first day of infusion and remained at that level. Approximately 50% of the starved animals developed the neurological syndrome; none of the normal animals had neurological symptoms.
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PMID:Hypophosphatemia and neurological changes secondary to oral caloric intake: a variant of hyperalimentation syndrome. 677 12

Seven patients developed severe zinc deficiency with acrodermatitis during hyperalimentation. Several of them had other problems such as diarrhea, poor wound healing and mental changes, which may also have been related to zinc deficiency. Three patients were on hyperalimentation for 2 weeks or less when skin lesions first developed, and most patients were receiving regular infusions of plasma. All patients responded to enteral administration of zinc. We conclude that: 1) severe zinc deficiency with acrodermatitis is not a rare complication of hyperalimentation; 2) even short-term hypralimentation may be complicated by severe zinc deficiency with acrodermatitis; 3) plasma is not an appropriate way to provide zinc supplementation; 4) if intravenous zinc preparations are not available, oral supplementation is usually effective; and 5) all patients undergoing hyperalimentation should receive zinc supplementation and have regular monitoring of their serum zinc level.
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PMID:Severe zinc deficiency presenting with acrodermatitis during hyperalimentation: diagnosis, pathogenesis, and treatment. 677 23

During a five year period at UCLA Hospital, 118 Silastic, Broviac, central venous hyperalimentation catheters were inserted into 94 infants who were less than one year of age. The indications for total parenteral nutrition were malabsorption syndrome in 26, short bowel syndrome in 24, diarrhea in 15, nutritional support following operation in 11 and miscellaneous in 18. One hundren and two catheters were placed into the vena cava by way of the saphenous vein at the groin, and 16 were inserted through the external or internal jugular veins. The duration of catheter use varied from six to 925 days, a mean of 104 days. In six infants, obstruction of the vena cava developed, five in the inferior vena cava and one in the superior vena cava. Swelling of the extremity was minimal, and the thrombosis was insidious in each patient. None of the patients had pulmonary emboli. Although two of the six patients eventually died, in neither was thrombosis of the cava believed to be related. Thrombosis of the vena cava is a frequent sequela of long term central venous hyperalimentation in infants, but it is rarely fatal and produces remarkably few serious complications.
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PMID:Occlusion of the vena cava in infants receiving central venous hyperalimentation. 680 43

A 6 1/2 month old male infant presented a week after his birth with secretory diarrhea of unknown etiology. He was sustained by central hyperalimentation for the rest of his life, and treated for presumed sepsis with a wide variety of antibiotics. The brain showed vacuolation in the diencephalic nuclei and white matter of the brain stem. There were also many clusters of enlarged Purkinje cell dendrites in the molecular layer. In Golgi preparations the primary and secondary dendrites showed segmental swellings and absent tertiary branchlets. The swellings were due to remarkable accumulations of mitochondria. The pathogenesis of the dendritic changes is discussed, and 'dying back' phenomenon is proposed to explain the changes.
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PMID:'Dystrophic' Purkinje cell dendrites in an infant. 712 43

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


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