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

We measured the serum GH responses to GHRH (1 micrograms/kg) in six normal men who had been rendered hyperinsulinemic and hypolipidemic by 10 days of total parenteral nutrition (TPN subjects) with a 25% dextrose-amino acid solution. The men underwent GHRH testing after 3 h of infusion of NaCl or Met-human (h) GH (2 micrograms/kg.h). The results of these tests were compared with those of five men tested in the post-absorptive state (PA subjects). The serum GH response to GHRH during NaCl infusion was significantly lower in the TPN subjects than in the PA subjects. During the Met-hGH infusion, the serum GH response to GHRH in the PA subjects was significantly lower than that after the NaCl infusion, whereas in the TPN subjects the response was similar to that during the NaCl infusion. The mean integrated areas under the GH response-time curve after GHRH treatment were 3963 +/- 2086 min/micrograms.L following NaCl infusion and 413 +/- 64 min/micrograms.L following Met-hGH infusion in PA subjects; they were 1127 +/- 500 min/micrograms.L following NaCl infusion and 1456 +/- 682 min/micrograms.L during Met-hGH infusion in the TPN subjects. The Met-hGH infusions resulted in a significant increase in serum FFA concentrations in the PA, but not the TPN, subjects. These results suggest that hyperalimentation induces a metabolic background which inhibits GH secretion, as manifested by a diminished serum GH response to GHRH administered after NaCl infusion. The absent FFA response to Met-hGH infusion in the TPN subjects may explain why the Met-hGH infusion in them did not result in a reduced serum GH response to GHRH as occurred in the PA subjects. Hence, FFA may play an important role in the effects of short term Met-hGH infusion on GH secretion.
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PMID:Intravenous refeeding blocks growth hormone (GH)-provoked rises in serum free fatty acids and blunting of somatotroph response to GH-releasing hormone in normal men. 250 53

Diet therapy is an important factor in overall care of most GI patients. Historically, diets have been used unscientifically in many of these patients without positive results. Nutritional care and diet therapy are critical for two reasons. First, malnutrition is an expected sequelae to most, if not all, GI diseases or disorders. Failure to eat, digest, or assimilate nutrients can provoke malnutrition in just a few weeks, although careful assessment of anthropometric, clinical, biochemical, and nutritional history by a trained professional can protect against this. Diet therapy through the elimination of offending foods such as wheat gluten or lactose, or inclusion of specialized products such as medium chain triglycerides or elemental formulas, can sustain nutritional status. Dietary components such as insoluble fiber appear to have physiologic effects, while soluble fibers may have metabolic effects important to diabetes and cardiovascular disease. There is a high potential for malnutrition in Crohn's disease during active and remittent phases. Elemental enteral formulas or TPN are used during the active phase to ensure optimal nutritional status and bowel rest. Hyperalimentation using the GI tract during remittent stage maintains this. Avoiding offending foods by Crohn's patients is an acceptable practice as long as entire categories of foods are not deleted. Avoiding all foods containing gluten from wheat, rye, barley, and oats, however, is a crucial prerequisite to recovery from celiac disease. Gluten is commonly used as a stabilizer, emulsifier, and extender in the food industry and is not always shown on food labels. Careful consultation with a registered dietitian can identify hidden sources of gluten in the diet.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Dietary therapy in gastrointestinal disease. 264 90

Most patients receiving chronic IVH therapy adjust well, not only to their treatment, but also to their underlying illness. Depression, organic mental syndromes, and encapsulated delusions occur with sufficient frequency to educate staff, patients, and families as to their possible occurrence. Discussing their possible development before they appear reduces anxiety and makes the patient feel less alien. Advance knowledge makes management easier and permits families to discuss problems before they become major sources of conflict. Multidisciplinary hyperalimentation teams of medical, surgical, and psychiatric physicians, psychiatric and specially trained TPN nurses, social workers, pharmacists and dietitians are useful in providing a comprehensive program for long-term hyperalimentation patients. The elements of a TPN program should include: 1) medical services available 24 hours a day; 2) a comprehensive educational program for staff, patients, and family members; 3) psychiatric support on both a routine and an as-needed basis; 4) patient participation in treatment planning; 5) easy access to needed supplies; and 6) and assistance with financial planning.
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PMID:Psychiatric factors in the management of long-term hyperalimentation patients. 312 43

Patients who receive hyperalimentation undergo prolonged periods of fasting which may alter bile composition and lead to gallbladder stasis, both important factors in gallstone formation. Therefore, we tested the hypothesis that patients who receive long-term TPN are at increased risk for cholelithiasis by performing cholecystosonography on adult patients who had received a minimum of 3 months of intravenous hyperalimentation during 1981. Seventy-one patients whose mean age was 41.9 years, 41 percent of whom were men, met these criteria. Gallstones had been diagnosed in 11 of the 71 patients (15 percent) before the initiation of parenteral nutrition. Twenty-one of the remaining 60 at risk patients (35 percent) were discovered to have cholelithiasis after hyperalimentation was started. The 45 percent prevalence of gallstones in our 71 patients was significantly higher (p less than 0.001) than predicted from autopsy data. In addition, the 49 percent prevalence of cholelithiasis in our 53 patients with ileal disorders was significantly greater (p less than 0.02) than predicted from a study of patients with similarly defined ileal disorders. This analysis strongly suggests that patients who receive long-term TPN are at increased risk for the development of cholelithiasis.
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PMID:Increased risk of cholelithiasis with prolonged total parenteral nutrition. 640 11

We studied on 66 patients with esophageal cancer with preoperative enteral hyperalimentation by elemental diet, comparing with 64 patients without it, and the following results were obtained; Items such as TP, Alb, etc. in surviving patients, as well as those who died within 3 months, were worse immediately before operation than those at the time of admission when neither TPN nor ED was yet in use. In 35 of 66 patients, there were significant differences between the patients with or without postoperative complications, and who were died after surgery, in arm circumference (AC), triceps skinfold (TSF), arm muscle circumference (AMC), albumin (Alb), prealbumin (PA), retinol-binding protein (RBP) and PPD skin test. From the studies of about 60 items with the computer, the index as follow were obtained. Nutritional Assessment Index (NAI) = 2.64 AC + 0.6 PA + 3.76 RBP + 0.017 PPD - 53.8 Nutritional status of the patients was divided retrospectively broadly to three groups, good (NAI greater than or equal to 60), intermediate (60 greater than NAI greater than or equal to 40), and poor (40 greater than NAI) in preoperative period. The incidence of postoperative complications and mortality rates were reflected significantly in NAI. NAI would be useful to know prospectively the probability of all kinds of postoperative complications as well as estimating the nutritional assessment.
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PMID:[Nutritional assessment of patients with esophageal cancer. "Nutritional Assessment Index (NAI)" to estimate nutritional conditions in pre-and postoperative period]. 642 34

Intravenous hyperalimentation which consisted of 30% hypertonic glucose solution and 10% amino acid solution via central venous catheterization and 10% lipid solution via peripheral venous lines has been applied to the postoperative patients with esophageal cancers since 10 years ago. sixty-five percent of the patients who underwent surgical treatment showed abnormal signs of the glucose tolerance function test. Positive application of insulin for these patients was performed according to the algorism of continuous insulin infusion method devised by us. Serum glucose levels have been kept within the normal range during the postoperative days. Non-protein Calorie per nitrogen (Cal/N) was optimal at 190, and 10% of the total Calorie administered should be obtained as lipid solution. Postoperative changes of glucose synthase I and D, and phosphorylase a and b of leukocytes were analysed periodically. Chemiluminescence of leukocytes were also checked. Postoperative combined therapies were actively performed under the nutritional support of TPN. The cases of n (-), n1(+) and n2(+) were treated with radio-chemoimmunotherapy (4000 R, Bleomycin 80 mg, Tegaful 500-750 mg/day, PSK or OK-432). The cases of n3(+) and n4(+) were treated with aggressive chemotherapy (Adriamycin, Mitomycin and Pepleomycin). Remarkable improvement of the prognosis in these patients was obtained.
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PMID:[Progress in postoperative care and postoperative combined therapy of esophageal carcinoma by total parenteral nutrition (TPN)]. 643 83

Malnutrition is associated with an increased susceptibility to infection by altering host defense mechanisms. A number of investigators have demonstrated restoration of in vitro immunocompetence following nutritional repletion with intravenous hyperalimentation. This study was designed to assess in vivo host defense mechanisms following protein depletion and repletion using a septic challenge. Female Fischer rats (150 gm) were fed a regular diet or a 2% agar protein depletion (DEP) diet for 14 days. The rats were then administered an infectious challenge with intraperitoneal injections of 7 ml/kg of a solution of 10(9) organisms/ml of E. coli with 4 gm% hemoglobin as red cells. Two additional organisms were repleted by regular diet (DEP-Oral) or by an intravenous solution (DEP-TPN) of dextrose-amino acid-lipid (D25 3.75% Aminosyn, 10% Intralipid) for an additional 2-week period, and given the experimental peritonitis challenge. Normal rats challenged with E. coli-hemoglobin adjuvant peritonitis had 66% survival as opposed to 15% survival of protein depleted rats. Protein-depleted (DEP-oral) rats refed with regular diets had a 60% survival which was comparable to normal controls. Rats repleted with intravenous hyperalimentation had a mortality comparable to protein-depleted controls. The data confirm that protein depletion is associated with loss of host defense mechanisms. Although refeeding by regular diet resulted in restoration of host defense, repletion by parenteral nutrition, in this model, did not improve survival.
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PMID:Malnutrition and immunocompetence: increased mortality following an infectious challenge during hyperalimentation. 678 58

The indications for total parenteral nutrition are compared with those for enteral alimentation. The indications for parenteral nutrition (nutrition support and hyperalimentation) in gastro-intestinal surgery, traumatology and burn care are discussed. Prophylactic TPN, supplemental TPN and therapeutic TPN are covered as well as their merit in the treatment of surgical complications.
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PMID:[Indications for total parenteral nutrition in surgery (author's transl)]. 679 74

Intestinal mucosa and muscularis/serosa prostaglandin (PG) biosynthesis was compared in sham control female rats and rats subjected to mild hemorrhage (hemorrhage to 80 mm Hg for 60 min), blood reperfusion, and maintenance on hyperalimentation (TPN) for 5 days. Tissue PG synthesis was analyzed by radiochromatographic analysis of microsomal membrane fractions prepared from mucosa and muscularis/serosa removed from the duodenum, jejunum, and ileum. Individual PG synthesis in the mucosa and muscularis/serosa sham group was modest, with low levels of synthesis of 6-keto-PGF1 alpha, PGE2, PGF2 alpha, and thromboxane B2. Hemorrhage, reperfusion, and maintenance on TPN for 5 days did not alter PG synthesis in the mucosa, whereas muscularis/serosa synthesis of 6-keto-PGF1 alpha and PGE2 was increased five-fold or more in each tissue studied. These data suggested that the muscularis/serosa could serve as a major source for the elevated PG, previously shown to occur following long-term resuscitation after acute hemorrhage.
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PMID:Long-term hyperalimentation following hemorrhage/reperfusion injury induces intestinal prostanoid synthesis. 850 20

In this paper, we present a preterm infant with acute focal lung edema due to central venous catheter migration into the right pulmonary vein. The substances aspirated from the endotracheal tube contained the parenteral nutrition fluid. Thus, parenteral nutrition fluid extravasation into the lung or a vasculopulmonary fistula was suspected. The course of complication was smooth after the catheter was withdrawn into the right atrium. This unusual presentation during TPN hyperalimentation was described in order to prevent a potentially dangerous event.
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PMID:Migration of a central venous catheter into pulmonary vein complicated with lung edema in a premature infant. 929 34


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