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

A patient with a history of diabetes, coronary artery disease, stroke, previous renal transplantation, and multiple hospital admissions for recurrent pancreatitis was transferred to the hospital from a chronic care facility because of fever and severe epigastric discomfort. At the time of admission, she was receiving hyperalimentation through a central venous TPN catheter. Multiple blood cultures obtained on the first and second hospital days yielded pure cultures of the yeast, Pichia ohmeri. The patient developed acute renal failure, and despite high-dose amphotericin B therapy, ultimately expired.
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PMID:Pichia ohmeri fungemia. 957 30

The clinical indications for and types of intravenous nutritional support are reviewed from the standpoint of their advantages and disadvantages. Total parenteral nutrition (TPN, also known as intravenous hyperalimentation) improves and maintains not only nutritional status but immunocompetence in patients with restricted food intake, because almost all essential nutritional substrates can be administered in the parenteral root alone to meet energy requirements. In surgical fields, TPN reduces perioperative risk and complication rates and enhances postoperative recovery of patients with severe stress such as those under going thoracic esophagectomy or pancreatoduodenectomy. In addition to calory administration, another type of parenteral nutrition a the disease-specific formulation has been attempted to improve directly such pathophysiologic conditions as renal failure, hepatic failure, or sever acute pancreatitis. Despite the great benefits of TPN, it is associated with several complications related to the indwelling catheter or to inadequate substrates administered, Disuse atrophy of the intestinal mucosa in patients receiving TPN to decreases the host defense against bacterial infection. To avoid the abuse of TPN, the indications for it should be selected rigorously. Moderate calory administration of a maximum of 15-20 cal/kg/day via a peripherally inserted catheter has been reevaluated in patients on short-term fasts.
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PMID:[Clinical significance and problems in parenteral nutritional care]. 961 95

Forty cases of total or near-total intestinal agangliosis (NTIA) were described to date in the English literature. Most cases had a lethal outcome. We describe the 41st case--a Beduin male neonate--who had only 30 cm of proximal hypoganglionic jejunum. He is presently almost one-year-old and thriving on home TPN, receiving one quarter of his caloric requirements orally using pregestamil, an MCT formula. The initial intricate course, diagnosis and several operative procedures, are elaborated. A review of the scant literature is discussed. The elusiveness of the correct diagnosis is pointed out and means to overcome these errors are described. Various surgical procedures have been suggested, none of which offer the perfect solution to the severe basic problem of short bowel. Long-term parenteral hyperalimentation is still the main modality of treatment. Based on our modest experience, we suggest saving every possible length of jejunum, even if hypoganglionic, since this bowel, following a few weeks of adaptation, starts to function fairly well, suggesting perhaps some neuro-muscular maturation. The best surgical approach is still pending. We present a report of a child with this disease and discuss the therapeutic dilemma.
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PMID:Near total intestinal aganglionosis with extreme short-bowel syndrome--a difficult surgical dilemma. 1053 70


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