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)

Zinc, copper, iron, magnesium, and chromium were analyzed in commercially prepared total parenteral nutrition solutions of amino acid/protein hydrolysate, dextrose, lipid, and water from several manufacturers. Concentrations of each varied with both the manufacturer and the solution lot number, with the greatest differences observed for zinc (0.026 to 4.04 mg/liter) and iron (0.025 to 1.370 mg/liter). Since the consequences of prolonged total parenteral nutrition with trace-metal-deficient solutions are dependent upon the physical state of the patients, the duration of hyperalimentation and problems associated with trauma, it is recommended that the endogenous concentrations described be supplemented as needed for each patient. This need is difficult to determine, however, because little is known about the clinical effect of any trace-metal-deficiency state developing in patients receiving long-term total parenteral nutrition.
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PMID:Trace metal profile of parenteral nutrition solutions. 41 17

Patient L.A. (f., 20 yrs), affected by bulimia and self-induced vomiting, was hospitalized because of severe malnutrition (BMI 13.1), hypopotassemia (2.8 mEq/l) and prolonged QTc interval (0.469"). Intensive care treatment aimed to normalize mineral balance mainly serum potassium, consisted of administering e.v. potassium (mg 2346/day), magnesium (mg 72/day), calcium (mg 80/day), phosphorus (mg 769/day), chloride (mg 710/day), iron (mg 40/day). Dietary treatment was deliberately chosen to be slightly above minimum energy requirements in order to avoid possible side effects of forced hyperalimentation. The patient, immediately after hospitalization, interrupted vomiting and 2 wks later weight increased by 5 kg (from 34.9 kg to 40.0 kg). On the other hand normalization of serum potassium levels was slow and QTc interval reached normal range only after the 10th day of treatment (0.447"). This case supports the hypothesis that major ECG abnormalities may be present in severe malnutrition due to anorexia nervosa or bulimia with self-induced vomiting. The dangers of these complications were substantiated by the fact that intensive care treatment allowed prompt body weight recovery but normalization of electrolytic balance and cardiac function was very slow. For such patients, electrocardiographic monitoring should be routine.
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PMID:[Hypopotassemia and prolongation of the Q-T interval in a patient with severe malnutrition caused by bulimia and post-prandial vomiting]. 237 4

The effect of central iv hyperalimentation (IVH) as an adjunct to aggressive antineoplastic therapy for small cell carcinoma of the lung was evaluated in a randomized trial with 119 evaluable patients. IVH was given over a 28-day period with higher caloric and protein intake for patients nutritionally depleted on entry in the study; all patients were escalated in caloric and protein intake to maximize nutritional repletion. Combination chemotherapy and radiation therapy induced a 45.5% complete response rate and an overall response rate of 92.8%. Median survival for patients with limited disease was 18 months; median survival for patients with extensive disease was 11 months. Patients randomized to receive IVH did not have a better response rate (P = 0.97) or survival (P = 0.78) than control patients. IVH did not significantly alter the survival for patients who at baseline had greater than 5% pretreatment weight loss, low caloric intake, decreased serum albumin, or reduced total iron-binding capacity. Significantly more febrile episodes were seen in IVH patients than in control patients (P less than 0.001). Short-term IVH to patients with this malignancy who are capable of enteral alimentation cannot be routinely recommended as adjunctive therapy.
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PMID:Effect of adjuvant central iv hyperalimentation on the survival and response to treatment of patients with small cell lung cancer: a randomized trial. 298 91

Reduced serum concentrations of nutrients like iron, zinc and folates and of albumin and cholesterol are found, as well as emaciation, both in malnutrition and in cancer. In patients with leukemia, a depletion of intracellular potassium and hypo-potassemia are found in addition. The use of hyperalimentation in cancer was originally based on the concept that too little food is the cause of these disturbances in the nutrition state. However, there is also a disturbed metabolism of nutrients in patients with tumors and inflammatory disease. In the case of folic acid, the disturbed metabolism could not be normalized by hyperalimentation. The more advanced the disease, the more pronounced is the disturbed nutrient metabolism, and this disturbance is related to the macrophage activity. It is not self-evident, therefore, that hyperalimentation can normalize the nutritional state in cancer. Emaciation in cancer patients is not caused exclusively by malnutrition.
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PMID:Folate and iron metabolism in patients with tumors and inflammations. 406 5

Copper deficiency has been described in premature infants on hyperalimentation. The bony abnormalities are generalized and are usually associated with anemia and neutropenia. These changes present with normal serum levels of iron, ascorbic acid, calcium, phosphorus, and magnesium, as well as with depressed levels of copper and ceruloplasmin. They appear at about three to nine months of age in infants with a low birth weight who are receiving total parenteral nutrition, but can be prevented by greater than normal maintenance levels of copper supplements. Established bone changes improve rapidly after the administration of therapeutic supplements.
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PMID:Skeletal changes associated with copper deficiency. 680 88

Protein calorie malnutrition is being recognized with greater frequency in the hospitalized patient. This report describes the clinical presentation and response to nutritional therapy in nine elderly malnourished patients ranging from 73 to 95 years. Clinical features of malnutrition include weight loss, confusion, hypoalbuminemia (mean 2.8 gm/dl), a low total iron binding capacity (TIBC) (mean 192 micrograms/dl), anergy, lymphocytopenia (mean 1 X 10(3) cells/microliter) and an anemia (mean 9.0 gm/dl). Our subjects were followed for 42 days. In two, hyperalimentation was achieved by voluntary food intake and polymeric dietary supplements. In seven, feeding for 21 days via nasogastric tube was required. After three weeks, weight gain, decreased confusion, improved appetite and mobility, and significant increases in serum albumin and TIBC were seen. At that time, no subject was anergic and lymphocyte counts increased significantly. Increase in the serum iron and percent saturation was noted, and by day 42, a significant elevation in the hemoglobin occurred. As a measure of stem cell function, the committed granulocyte/macrophage progenitor cell (CFU-C) was quantitated in four subjects prior to and following 21 days of nutritional support. A marked increase in CFU-C number from a mean of 0.1 X 10(7) cells/kg to a normal value of 0.85 X 10(7) cells/kg was seen. Thus in addition to correcting the nutritional deficit, hyperalimentation returned immune and hematopoietic abnormalities to near normal levels. While improvement could reflect recovery from an associated disease, it is just as likely that correction of malnutrition, a well-recognized cause of these immunologic and hematopoietic abnormalities, accounted for the response. These observations emphasize the importance of recognizing malnutrition in the elderly and highlight the need for a careful nutritional assessment prior to ascribing hematologic and immunologic abnormalities to the aging process.
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PMID:The correctability of the nutritional, immune, and hematopoietic manifestations of protein calorie malnutrition in the elderly. 682 Oct 77

The Prader-Willi Syndrome shortens the life of patients due to the morbid obesity which it entails. The compulsive hyperphagia associated with it makes a dietetic treatment or a gastroplasty difficult. This study presents the case histories of three patients suffering from the Prader-Willi syndrome who were operated on by means of a Scopinaro's bilio-pancreatic diversion. Following a marked reduction the first year, the weight loss stabilized and then tended to diminish. The observation of three cases which continued for two and a half to six years did not reveal any considerable metabolic problems. The deficiency of iron, vitamins D and B12 as well as folic acid had to be made up by supplementation. These results are comparable with the most favorable ones in the literature. Even if the effect on the weight loss is not spectacular, the operation manages to hold off the development of the obesity, inexorable for those with the Prader-Willi syndrome, and prevents lethal complications, without having notable side effects. Lifting coercive dietary measures improves the quality of life.
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PMID:Long-term Result of Treatment of Prader-Willi Syndrome by Scopinaro's Bilio-pancreatic Diversion. Study of Three Cases and the Effect of Dextrofenfluramine on the Postoperative Evolution. 1071 67

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

Although the Mexican population has traditionally been malnourished, the prevalence of obesity in children and adults has increased by almost 50 % in the last 10 years. Recent studies show substantial changes in the nutritional status of Mexicans, especially in the pediatric population. Among the factors associated with the development of obesity are overeating, sedentariness, and genetics. The apparent economic development in Mexico, as well as the influence of dietary patterns from other countries, have contributed to modifying lifestyle. Despite measures taken by the health system, iron- and zinc-deficiency anemia continue to be prevalent. The present review aims to describe the changes that have taken place in Mexico in the last few decades leading to a generation of short and obese children, as well as to determine the associated factors in order to promote healthier eating patterns among the Mexican population.
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PMID:[Dietary changes in Mexico]. 1278 Nov 13

According to the DSM IV, pica is a trouble of alimentary behavior, which is characterized by the ingestion of non-nutriment substances during at least on the month. The main objective of this study conducted at the Clermont-de-l'Oise Interdepartmental Medical Center is to evaluate pica's prevalence for hospitalized patients. Secondary objectives are to describe clinical characteristics, complications and outcome upon the different therapeutic approaches. The patients hospitalized in the Adult and/or Pediatric Department of Psychiatry, which fulfilled the 4 criteria of the DSM IV, were considered eligible for the study. In order to better evaluate the severity of behavioral troubles evoked by item D of DSM IV definition, we elaborated specific severity and preoccupation scales. The severity scale reflects the complications due to the ingestion of the non-nutriment substances, the encountered risks in the case of persistence of these troubles as well as the patient's management. The preoccupation scale reflects the medical team's involvement towards the patient in order to prevent life-threatening complications. The two scales are graded from 0 to 5 according to the severity or to the degree of preoccupation, respectively. Only patients with scores 3 were considered as fulfilling the severity criteria. Among the 943 hospitalized patients at a selected time period, 23 adult patients have been considered eligible. According to these data, prevalence of pica was estimated at 2.44%. This value may seem an underestimation when compared to the values reported in the medical literature, which range from 9 to 25%. Additionally, among the 108 hospitalized infant patients, none fulfilled DSM IV criteria, which is surprising, as pica is relatively common in childhood. These results may be explained by the use of the more restrictive criteria of the DSM IV and also by the difficulties encountered in considering pica as an independent medical condition. Indeed, pica is often a secondary diagnosis associated with other psychiatric conditions characterized by profound mental deterioration. Two pathogenic factors were constantly searched in the medical records: iron-deficiency anemia and psychopathology. Cultural factors can be a priori eliminated, as most of these patients are in rupture with their family environment since low ages. Only two patients presented with iron-deficiency anemia and its correction did not result in pica's improvement. These findings do not support the -studies presenting pica as an iron-deficiency anemia induced trouble, which regress after a well-conducted iron replacement. Most patients were found to have precocious lack of affect in their medical history. All patients presented other associated psychiatric troubles including severe mental impairment (48%) and dysharmonic development (26%), as well as autistic troubles and schizophrenia. These data concur with other studies, which associate pica to other psychiatric disorders. Gluttony is a widely represented symptom in our study population (87%) and predisposes to food aspiration. It is the mark of frenetic orality and concerns comestible as well as non-comestible compounds. The ingestion of non-nutriment compounds could therefore be considered as an incapacity of discerning among different mouth-introduced substances. Auto- and hetero-aggressive disorders have been reported in 77% of the patients. These behaviors arise mostly in the phase of seeking of substances, especially if these are particularly attractive. The enhancement of the -anxiety, which often arises in the eventuality of hindering of the act, as well as the soothing effect of the ingestion, suggests a compulsive activity. This compulsive activity could be related to an addictive conduct. Pica could therefore be related to obsessive-compulsive disorders and benefit from its specific therapy, either behavioral or chemotherapy with serotonin-recapture inhibitors. The most common clinical forms of pica were phytophagia and geophagia, probably due to the facility of access to these substances. However, 31 distinct substances have been identified in our study. Pica's evolution often implies severe complications, which are sometimes life threatening in spite of a well-conducted treatment. Severity factors include the iteration of medical and surgical complications, as well as the type of ingested products. Our results show a high incidence of surgical complications, essentially gastro-intestinal. Due to the elevated incidence of complications and to the high rate of mortality, some authors proposed systematical search of pica for any gastro-intestinal troubles arising in patients suffering from mental disorders. For these patients for whom anamnesis is often difficult, a standard X-ray of the abdomen is an essential imaging study. Respiratory complications come in second position and infectious complications are seen mostly for the geo- and coprophagia-suffering patients, which contract intestinal parasitosis. Because of its multifactor causality, treatment of pica is complex, and results are often deceiving. Symptomatic neuroleptic therapy results in transient improvement and is indicated especially in delirious patients. Psychotherapy with behavioral approaches and different institutional approaches can be proposed. Indeed, pica could be considered as an acquired behavior, which could benefit from cognitive and behavioral therapies. Institutional management including supportive and compassionate care, restoration of self-confidence is interesting for these patients. Some authors even suggest that pica might be considered as a good indicator of the institution's care quality.
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PMID:[Pica: a descriptive study of patients in a speciality medical center]. 1461 90


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