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)

Numerous studies have estimated the frequency of bulimia nervosa among high school girls and college women, but population-based trends in incidence in a community have not been reported. In this study we determined the incidence of bulimia nervosa by identifying persons residing in the community of Rochester, Minnesota, who had the disorder initially diagnosed during the 11-year period from 1980 to 1990. Using our comprehensive population-based data resource (the Rochester Epidemiology Project), we identified cases by screening 777 medical records with diagnoses of bulimia; feeding disturbance; rumination syndrome; adverse effects of cathartics, emetics, or diuretics; polyphagia; sialosis; or vomiting. We identified 103 Rochester residents (100 female and 3 male) who fulfilled DSM-III-R diagnostic criteria for bulimia nervosa during the 11-year study period. Mean +/- S.D. age for females at the time of diagnosis was 23.0 +/- 6.1 years (range, 14.4 to 40.2 years). Yearly incidence in females rose sharply from 7.4 per 100000 population in 1980 to 49.7 in 1983, and then remained relatively constant around 30 per 100000 population. The annual age-adjusted incidence rates were 26.5 per 100000 population for females and 0.8 per 100000 population for males. The overall age- and sex-adjusted annual incidence was 13.5 per 100000 population. Bulimia nervosa is a common disorder in adolescent girls and young women from 15 to 24 years of age. Histories of alcohol or drug abuse, depression, or anorexia nervosa were higher than expected in the general population.
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PMID:Bulimia nervosa in Rochester, Minnesota from 1980 to 1990. 858 3

We have retrospectively reviewed the ability to safely deliver total body irradiation (TBI) in the outpatient setting in 10 pediatric patients undergoing stem cell transplantation. Patients had a median age of 14 years (range 9-17 years) with diagnoses that included ALL in second remission, AML in second remission, myelodysplastic syndrome, Ewing's sarcoma, and rhabdomyosarcoma. Patients received a total of 1375 cGy or 1440 cGy given in a hyperfractionated schedule (11 or 12 fractions) over a 4-day period. All children were seen in the outpatient clinic daily during TBI and all were housed within a 20 mile radius of our institution during this period. Eight patients achieved good control of nausea and emesis with ondansetron alone while two patients required ondansetron and diphenhydramine. Nine patients received some form of intravenous hydration during this period (hyperalimentation, fluid boluses in clinic, or night-time intravenous fluids). One patient maintained good hydration with oral intake alone. Only one child required admission during this period for persistent nausea and vomiting despite antiemetics and intravenous fluids. A cost approximation suggests that TBI delivered in the outpatient setting resulted in a saving of approximately $2400 per patient. We conclude that TBI administered to children and adolescents in the outpatient setting can be a safe and cost-effective practice.
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PMID:Outpatient total body irradiation for pediatric patients undergoing stem cell transplantation. 919 47

A 12-year-old boy had been treated with multiagent chemotherapy for acute mixed lineage leukemia and with intravenous hyperalimentation due to persistent diarrhea and vomiting for 2 months. He suddenly complained of horizontal nystagmus and gait disturbance followed by oculomotor palsy and disorientation within a few days. Blood tests revealed low serum vitamin B1 and high serum pyruvate. Magnetic resonance imaging in T2-weighted axial image revealed a high signal inside the bilateral thalami, mamillary bodies and periaquaductal gray matter. He was diagnosed as Wernicke's encephalopathy and successfully treated with vitamin B1. Careful observation and adequate treatment are emphasized in the management of this preventable and curable disease.
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PMID:Successful treatment of Wernicke's encephalopathy in a boy with acute mixed lineage leukemia. 969 4

Cyproheptadine hydrochloride was administered to 20 presumed or proven allergic cats to determine its efficacy in controlling pruritus. Each cat received 2 mg, orally, every 12 h. The pruritus was satisfactorily controlled in 9 cats. Side effects were seen in 8 cats, and included polyphagia, sedation, vocalization, affectionate behavior, and vomiting.
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PMID:Observations on the use of cyproheptadine hydrochloride as an antipruritic agent in allergic cats. 978 74

It has been proposed that teenage girls often smoke cigarettes to protect themselves from the impulse to binge eat, with its feared weight-gain consequences, particularly when other measures such as greater dietary restraint have failed. The present study looked at the relationship between body mass index and standardised questionnaire responses concerning smoking, alcohol consumption, moods, weight changes, attitudes to body weight and shape, dietary patterns and menstruation in 1936 British (London) and 832 Canadian (Ottawa) schoolgirls. Data analysis revealed links between cigarette smoking and body weight/shape concerns, and awareness by subjects of these links; there was also a tendency for smokers in these two populations to be overweight but not grossly obese. Smoking was also related at all ages to being postmenarchal. The London population in particular revealed an association between smoking and a weight loss of 7 kg or more at some stage since puberty. Smoking was also linked, in a minority, with regular vomiting undertaken as a further defence against weight gain when overeating had occurred. These associations existed alongside the major and predictable association found between alcohol consumption and smoking. Similarities between the British and Canadian schoolgirls were striking in respect of rank order of reasons given for smoking and consequences of giving it up. Since smoking amongst older women is reportedly associated with below-average body weight it may indeed be effective in helping to curb weight gain. Our study provided little evidence of association between smoking and generalised anxiety or social anxiety (in either population), or depression (in the British cohort). We suggest that any preventive psychological approach to teenage female smoking should include attention to weight gain anxiety and consequent pursuit of thinness.
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PMID:Smoking and pursuit of thinness in schoolgirls in London and Ottawa. 1044 86

A 63-year-old woman who started to have polyarthralgia in December 1993 has been diagnosed as rheumatoid arthritis (RA) and treated with muscular injection of gold sodium thiomalate. She began to have nausea, vomiting, anorexia and watery diarrhea in October 1995. A year later, she had to receive intravenous infusion on admission since more frequent watery diarrhea occurred more than ten times within a day. On admission in our hospital in December 1996, she had proteinuria in addition to gastrointestinal symptoms. The biopsy specimen from stomach, duodenum and kidney proved systemic amyloidosis associated with RA. In spite of steroid-pulse, dimethyl sulfoxide (DMSO) and colchicine therapy, profound proteinuria in nephrotic syndrome was continued in association with hypoproteinemia, anasarca and renal failure. She was treated on hemodialysis and intravenous hyperalimentation (IVH) until November 1997 when A-V shunt operation on left forearm was performed. However, the shunt was not available for HD and she suffered from septicemia and died on December 1997. This patient was a rare case of secondary systemic amyloidosis associated with RA in early clinical course.
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PMID:[A case of secondary systemic amyloidosis associated with rheumatoid arthritis after 3-year disease duration]. 1033 14

METHODS: Evaluated are surgical difficulties, management problems and weight loss in patients with distal gastric bypass as a revisionary procedure. Eighty patients were followed up to 3 years; four were lost to follow-up. Mean age was 43; mean prebariatric surgery weight 134 kg; height 1.65 meters; body mass index 40.1; ideal body weight 62.7 kg; excess weight 70.5 kg; per cent excess weight 214%. A 250 cm stomach-to-ileocecal valve segment of small bowel was used, and the biliopancreatic secretions were brought into the terminal ileum 100 6 in from the ileocecal valve. Mean pouch size was 63 cc; length of hospital stay 5 days; operative blood loss 616 cc; operative time 130 min. RESULTS: Intraoperative complications included three splenic injuries (without splenectomy). Early complications included one deep vein thrombosis, two marginal ulcers, one GI hemorrhage, one wound dehiscence, one pouch outlet obstruction and one pancreatitis. Late complications included: one death from protein malnutrition/ ARDS; 21 hypoproteinemia; six protein malnutrition, and of these, three had hyperalimentation; three cholecystitis; 27 anemia; 22 incisional hernia; two staple-line disruption (reoperated); 26 low serum iron; 11 prolonged (>6 months) diarrhea; three prolonged frequent vomiting; and two unrelated deaths (chronic myelogenous leukemia and amyotrophic lateral sclerosis). Mean excess weight loss was 83% at 12 months; 89% at 24 months; and 94% at 36 months. CONCLUSION: The distal gastric bypass is fraught with the operative and immediate post-operative complications experienced in any revisionary bariatric surgery. Distal gastric bypass is very effective in producing long-term weight loss. Nutritional problems are common but usually easily corrected. The most serious nutritional complication is protein malnutrition, which must be identified and corrected early. Success of this procedure is dependent upon patient compliance with proper nutrition and supplements, and regular office follow-up with monitoring of laboratory data. Patients who are noncompliant are at significant risk for complications.
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PMID:The Gastric Bypass for Failed Bariatric Surgical Procedures. 1072 55

BACKGROUND: Comparing primary vertical banded gastroplasty (VBG) and distal gastric bypass (DGBP) patients might assist decision-making based on patient profiles and desired outcomes. METHODS: A prospective study of 81 vertical banded gastroplasty and 60 distal gastric bypass patients. Technical aspects, complications, weight loss, post-op compliance and satisfaction are reported. Length of follow-up is 48 months (VBG) and 36 (DGBP). Lost-to-follow-up 41% (VBG) and 22% (DGBP). Ten per cent of VBGs were revised, with 1% takedown. Three percent DGBPs were converted to proximal GBPs. Demographics are comparable. RESULTS: Operative time was 40 min VBG and 88 DGBP; blood loss 187 cc vs 335 cc; and hospital stay 3 versus 4 days. Exclusive VBG complications include: 1% staple-line leak, 4% intra-abdominal abscess, 1% respiratory failure, 5% pneumonia, 1% intra-abdominal bleed, 1% small bowel obstruction, 2% infected incision, 2% fistula, 2% stenotic or obstructed obstructed stoma, and 1% bezoar. Exclusive DGBP complications include: 2% GI bleed, 12% marginal ulcer, 5% reflux esophagitis, 13% hypocalcemia, 23% hypovitaminosis A and D (12% requiring B12 therapy). Shared complications include hypoproteinemia 6% VBG versus 40% DGBP; excess vomiting (>6 months post-op), 7% versus 10%, excess diarrhea 2% versus 20%, dehydration 1% versus 8%, re-hospitalization 4% versus 15% (hyperalimentation), post-op cholecystectomy 1% versus 5%, weight regain 48% versus 1%. VBG experienced an average of 64% excess weight loss at 36 months versus DGBP 89% excess weight loss. VBG follow-up compliance is generally poor but good for DGBP. Compliance with diet and supplements is equivalent (50%). Satisfaction is 85% and 93% respectively. CONCLUSION: The DGBP provides better long-term weight loss, but nutritional deficiencies occur more often and require close follow-up. The surgery is more complex, but as a primary procedure there are few major complications.
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PMID:Vertical Banded Gastroplasty and Distal Gastric Bypass as Primary Procedures: A Comparison. 1072 88

The prognosis of spontaneous esophageal rupture of the esophagus worsens over time from disease onset to treatment and, in severe cases, may require surgery to save the patient's life. Patients appearing at the hospital considerably after esophageal perforation have no appropriate surgical alternatives and face poor prospects. We conservatively treated a severe case following 2-day lapse of after disease onset, managing a favorable outcome. A 58-year-old man who developed upper abdominal and back pain after vomiting from drinking was transferred to our institute in an emergency due to pain intensifying 2 days after the symptom onset. Chest X-ray revealed a large quantity of bilateral pleural effusion similar to gastrointestinal content, which we withdrew through intrathoracic drainage. Esophagography showed perforation of the esophagus. The patient's poor general condition, including septic shock and adult respiratory distress syndrome, contraindicated radical surgery, so we instituted conservative therapy such as continuous thoracic drainage hyperalimentation. Oral intake was started in month 4 after admission. The patient was discharged in good general condition 7 months after onset.
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PMID:Spontaneous esophageal rupture treated by conservative therapy. 1096 24

We studied a wide variety of medical publications to find out whether late-nineteenth-century nervous or hysterial vomiting was clinically consistent with modern bulima nervosa. Since modern diagnostic criteria of bulimia nervosa my be time- and culture-bound, we made use of adapted criteria, focusing on the more overt, physical and behavioural features of the syndrome. In retrospect, it became obvious that only some of these specific diagnostic requirements were met. Indeed, late-nineteenth-century nervous or hysterical vomiters most likely have been non-organically-ill neurotics. However, their disorder was more closely associated with food abstinence in general and anorexia nervosa in particular than with overeating. Only in a few cases doctors made mention of recurrent episodes of binge eating, but there was no convincing evidence of any concern for body shape and weight. Obviously, late-nineteenth-century nervous or hysterial vomiting was still located at the crossing between classic hysteria, the 'new' clinical entity of anorexia nervosa, and forms of psychogenic vomiting.
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PMID:Was late-nineteenth-century nervous vomiting an early variant of bulimia nervosa? 1163 51


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