Prevalence and recurrence of pica behaviors in early childhood within the ALSPAC birth cohort.

OBJECTIVE: The present study examined prevalence and correlates of pica behaviors during childhood using data from the Avon Longitudinal Study of Parents and Children (ALSPAC) study. METHOD: Data on 10,109 caregivers from the ALSPAC study who reported pica behavior at 36, 54, 65, 77, and 115 months on their child were included. Autism was obtained through clinical and education records, while DD was derived from the Denver Developmental Screening Test. RESULTS: A total of 312 parents (3.08%) reported pica behaviors in their child. Of these, 19.55% reported pica at least at two waves (n = 61). Pica was most common at 36 months (N = 226; 2.29%) and decreased as children aged. A significant association was found between pica and autism at all five waves (p < .001). There was a significant relationship between pica and DD, with individuals with DD more likely to experience pica than those without DD at 36 (p = .01), and 54 (p < .001), 65 (p = .04), 77 (p < .001), and 115 months (p = .006). Exploratory analyses examined pica behaviors with broader eating difficulties and child body mass index. DISCUSSION: This study enhances understanding of childhood pica behaviors, addressing a significant gap in knowledge. Pica occurrence in the general population is poorly understood due to few epidemiological studies. Findings from the present study indicate pica is an uncommon behavior in childhood; however, children with DD or autism may benefit from pica screening and diagnosis between ages 36 and 115 months. Children who exhibit undereating, overeating, and food fussiness may also engage in pica behaviors.

A Rare Presentation of Pica Disorder in Soap Ingestion Variant: Case Report and Review.

ABSTRACT: Pica indicates the persistent ingestion of inedible substances over a period of at least 1 month, being discordant to the individual's cognitive development level and not directly attributable to cultural or social normative practices. The literature suggests that the prevalence of pica varies significantly according to the social and clinical context. It can co-occur with psychiatric disorders, with its etiology being poorly understood and most likely multifactorial. In this article, we report the case of a patient in her 50s with a clinical setting compatible with soap ingestion variant of pica disorder. In addition to the variety of ingested substances, pica can be associated with heterogeneous behavior, mainly of the obsessive-compulsive spectrum. Despite recent research, this condition is still a target of much speculation. This is a very rare and challenging presentation of a soap ingestion variant of pica with very few similar cases described to date.

Causes and management of Pica disorder among central Iraqi peoples.

OBJECTIVE: Aim: To find the causes and factors behind the Pica disorder, which helps in early diagnosis and appropriate treatments.. PATIENTS AND METHODS: Materials and Methods: A retrospective cross-section study was carried out between July 1, 2022, and April 20, 2023, enrolling 300 patients from different provinces of central and south Iraq with Pica disease whose diagnosis depended on specialized physicians according to WHO guidelines. The participants were following up for three to six months in private clinics. RESULTS: Results: 92.4% of the patients were female, and 41% of patients were under 20 years old, with low ferritin, HB, and vitamin D levels (80% of cases), and these markers showed a negative correlation with the number of Pica. Chowing of ice and clay were the common types of Pica, which represent about 30% each, while 34% of cases had multiple types, which had signs and symptoms of fever, palpitation, vomiting, abdominal pain, paleness, headaches, and hair loss. Six-month flows were better than three months. CONCLUSION: Conclusions: Pica was a disorder that could lead to behavior and emotional abnormalities that caused the patients to eat some things that were eaten by healthy people. This may be, as concluded from our results, due to reduced levels of ferritin, hemoglobin (Hb), and vitamin D that caused these psychological problems.

First record of geophagy in Jungle Babbler (Turdoides striata) prior to egg-laying: an instinct for calcium supplement.

Geophagy has been documented in different animal taxa including Aves and particularly in Passeriformes. However, no geophagic activity has been reported in the genus Turdoides of the family Leiothrichidae belonging to the passerine order. Studies reveal the behaviour of geophagy to be aiding in nutrient supplementation, toxin neutralisation, cytoprotection, gut pH stabilisation and parasite liberation. Here, we provide a record of geophagy in Jungle Babbler Turdoides striata in a peri-urban area of Berhampur city in India. Although this species, being insectivorous, was thought to be feeding on insects, nevertheless, close observations confirmed the activity to be a case of geophagy, which was followed up by nest-building, egg-laying and hatching. The soil samples from the geophagic sites (Ca = 2415 mg/kg) contained 130% more Ca than that of the non-geophagic sites (Ca = 1050 mg/kg). The biochemical requirement of calcium throughout the reproductive phase of Turdoides sp. may corroborate the soil consumption instinct, which was also extrapolated from the reproductive success observed, because the demand for calcium in birds remains high during the egg-laying time. Although the possible explanations for geophagy, reported for the first time in this species, were oriented specifically towards Ca supplement, the present findings provide impetus for furthering research in this domain.

Revisiting geophagy: An evolved sickness behavior to microbiome-mediated gastrointestinal inflammation.

Geophagy, the consumption of clay or similar substances, is known as an evolved behavior that protects vulnerable populations, such as pregnant women and children, against gastrointestinal injury. However, perplexing questions remain, like the presence of geophagy in the absence of overt gastrointestinal infection and the potential causal relationship between geophagy and iron deficiency anemia. In this review, we hypothesize that geophagy is an inflammation-mediated sickness behavior regulated via the vagus nerve. We further hypothesize that the gut microbiome plays a critical role in mediating the relationship between inflammation and geophagy. By including inflammation and the microbiome within the existing protection hypothesis, we can explain how subclinical gastrointestinal states induce geophagy. Furthermore, we can explain how gastrointestinal inflammation is responsible for both geophagy and iron-deficiency anemia, explaining why the two phenomena frequently co-occur. Ultimately, defining geophagy as a sickness behavior allows us to integrate the gut-brain axis into geophagy research.

Entopallium Lost GFAP Immunoreactivity during Avian Evolution: Is GFAP a "Condition Sine Qua Non"?

INTRODUCTION: The present study demonstrates that in the same brain area the astroglia can express GFAP (the main cytoskeletal protein of astroglia) in some species but not in the others of the same vertebrate class. It contrasts the former opinions that the distribution of GFAP found in a species is characteristic of the entire class. The present study investigated birds in different phylogenetic positions: duck (Cairina moschata domestica), chicken (Gallus gallus domesticus), and quails (Coturnix japonica and Excalfactoria chinensis) of Galloanserae; pigeon (Columba livia domestica) of a group of Neoaves, in comparison with representatives of other Neoaves lineages, which emerged more recently in evolution: finches (Taeniopygia guttata and Erythrura gouldiae), magpie (Pica pica), and parrots (Melopsittacus undulatus and Nymphicus hollandicus). METHODS: Following a perfusion with 4% buffered paraformaldehyde, immunoperoxidase reactions were performed with two types of anti-GFAP: monoclonal and polyclonal, on floating sections. RESULTS: The entopallium (formerly "ectostriatum," a telencephalic area in birds) was GFAP-immunopositive in pigeon and in the representatives of Galloanserae but not in songbirds and parrots, which emerged more recently in evolution. The lack of GFAP expression of a brain area, however, does not mean the lack of astroglia. Lesions induced GFAP expression in the territory of GFAP-immunonegative entopallia. It proved that the GFAP immunonegativity is not due to the lack of capability, but rather the suppression of GFAP production of the astrocytes in this territory. In the other areas investigated besides the entopallium (optic tectum and cerebellum), no considerable interspecific differences of GFAP immunopositivity were found. It proved that the immunonegativity of entopallium is due to neither the general lack of GFAP expression nor the incapability of our reagents to detect GFAP in these species. CONCLUSION: The data are congruent with our proposal that a lack of GFAP expression has evolved in different brain areas in vertebrate evolution, typically in lineages that emerged more recently. Comparative studies on GFAP-immunopositive and GFAP-immunonegative entopallia may promote understanding the role of GFAP in neural networks.

Prenatal arsenic and mercury levels among women practicing geophagy in areas with artisanal and small-scale gold mining activities, Northwestern Tanzania.

BACKGROUND: Artisanal and small-scale gold mining (ASGM) areas potentially pose increased exposure to arsenic and mercury through community contamination, occupations at gold mines, and/or geophagy when soil is locally sourced. This study examined the effects of geophagy, a deliberate soil eating practice, along with community and occupational exposures in ASGM areas on urinary arsenic and blood mercury levels among pregnant women in the Mining and Health Longitudinal Cohort in northwestern Tanzania. METHODS: Data on maternal arsenic and mercury levels were captured for 1056 pregnant women using an unprovoked morning urine samples and dried blood spots respectively. We used a step-wise generalized linear regression model to retain the most relevant covariates for the model. A generalized linear regression model with identity link function was used to predict the effect of geophagy practices on arsenic and mercury levels separately. The model was adjusted using sociodemographic correlates, including maternal age, education level, whether respondents lived in mining or non-mining area, years of residence, marital status, maternal occupation, individual partner's education, and occupational, and socioeconomic status. RESULTS: In the adjusted regression model, eating soil during pregnancy increased arsenic concentration by almost 23% (ß = 1.229, 95% CI: 1.094, 1.38, p < 0.001) and living in mining areas had a 21.2% (ß = 1.212; 95% CI: 1.039,1.414, p = 0.014) increased risk. Geophagy significantly increased mercury levels by 13.3% (ß = 1.133, 95% CI: 1.022, 1.257, p = 0.018). Living in areas with ASGM activities was associated with a 142% (ß = 2.422, 95% CI: 2.111, 2.776, p < 0.0001) increase in blood mercury. CONCLUSION: Geophagy practices increased urinary arsenic and blood mercury levels in pregnant women, which was especially true for arsenic when living in areas with ASGM activities. Working in mining = increased risk for blood mercury levels. Community-based environmental health policies should address reductions in occupational and community exposures, along with strategic geophagy reduction interventions.

Morishitium polonicum (Machalska, 1980) is a junior synonym of Morishitium dollfusi (Timon-David, 1950) (Trematoda: Cyclocoeliidae).

Species of the genus Morishitium Witenberg, 1928 are parasites of the body cavity, air sacs, and lungs of birds. At least 14 species are considered valid, but molecular confirmation of their status is lacking. Here, we provide the first molecular data on Morishitium dollfusi isolated from their type host Pica pica, compared them with previously reported molecular data from Morishitium polonicum isolated from their type and paratype hosts, Turdus merula and Turdus philomelos, and performed extensive measurements of 511 individuals of Morishitium spp. across a broad host spectrum, at multiple infection intensities, and year-round. We analyzed the molecular phylogenetics of Morishitium spp. adults isolated from bird hosts of Czech origin and provide comparative measurements of the analyzed specimens. Based on the molecular examination of morphologically identified specimens of M. dollfusi and M. polonicum (CO1, ND1, and ITS2 markers), we propose synonymization of Morishitium dollfusi (Timon-David, 1950) with Morishitium polonicum (Machalska, 1980) (isolates of European origin). The three markers were either identical (CO1, ITS2) or formed haplotypes shared by the two species (ND1). Morphological analyses revealed a continuum of key identification features for the two above-named species, although we used specimens matching the original descriptions and isolated them from the type hosts. Therefore, Morishitium polonicum is a junior synonym of Morishitium dollfusi. Attention is needed regarding the status of East Asian isolates identified previously as M. polonicum (or M. polonicum malayense). The molecular analysis revealed that these isolates form a distinct clade, and further research is needed to produce data allowing the likely separation of the malayense clade as a separate species.

Geochemical composition and potential health risks of geophagic materials: an example from a rural area in the Limpopo Province of South Africa.

Geophagy is a common practice among rural population of the Fetakgomo Tubatse Local Municipality area in the Limpopo Province of South Africa. Although, the practice might be beneficial to the health of the consumers, its negative effects could overshadow the positive effects and might lead to detrimental health issues. The present work sought to investigate the geochemical composition as well as pH and organic matter (OM) content of geophagic materials commonly consumed in the study area. Furthermore, assessment of the potential health risk of the materials on geophagic individuals was also considered. Twelve samples were collected in the study area and analysed by X-ray Fluorescence (XRF) and Inductively Coupled Plasma-Mass Spectrometry (ICP-MS) for major and trace elements composition. The results showed higher concentrations of non-essential elements (e.g., As, Cr, Pb) than the proposed recommended daily standards intake, suggesting a potential health risk. The alkaline nature (pH 6.80 to 9.22) of the studied samples might affect the bioacessibility of some essential elements. Furthermore, the OM content (> 0.7%) observed in some of the studied samples may retain pathogenic micro-organisms detrimental to health. Although As and Cr presented a low bioaccessible fraction (< 16.0%), health risk assessment revealed that their concentrations represented a hazard (HQ > 1) and might induce non-carcinogenic health threats to geophagic individuals. Based on the geochemical analysis, pH and OM content as well as health risk assessment findings, the studied geophagic materials are not considered suitable for human consumption. The practice should therefore be discouraged amongst the population in the study area to avoid possible detrimental health issues.

In vitro release of aluminum from the geophagic clay "Chacco" in the Peruvian highlands: Chemical characterization and health risk assessment.

In the altiplano zone of Latin America, "Chacco" is one of the clays widely consumed as part of geophagy. The objectives of the study were to chemically characterize "Chacco", determine the zero charge point, evaluate the release of aluminum in vitro, perform the kinetic study and evaluate the health risk. The results by ICP-OES showed that the elements with the highest concentration were Al, Ba, Ca, Fe, K, Mg, Mn, Na, Si, Sr, Ti and Zn. ATR-FTIR analysis showed the presence of Si-O (693 and 990 cm-1), Al-O (790 cm-1), Al-Al-OH bending vibration (912 cm-1), Si-H bond stretching (2100 to 2500 cm-1) and free -OH groups (3629 cm-1). SEM-EDX results indicate that Al is one of the main constituents of "Chacco" (7.35 wt%). The pHzpc of "Chacco" was 6.83. In the dissolution profiles, the highest Al release occurred at pH 6.8 and in intestinal juice simulated with pseudo-second order dissolution kinetics. The EDIAl and EWIAl were 20.24 and 142.66 respectively, comparing EWIAl with the PTWI established by JECFA (2 mg/kg bw), it is concluded that the weekly intake of "Chacco" represents an appreciable health risk. There are no reports of the carcinogenic factor of Al, so TRAl was not calculated.

Prevalence of Pica amongst Pregnant Women attending Antenatal Clinic of a Tertiary Clinic in South-East, Nigeria.

BACKGROUND: The eating of non-food substances during pregnancy is called pica. It is commonly practised by pregnant women worldwide, including in Nigeria, and has been reported to have a mixed impact on their health. AIM: This study sought to determine the prevalence of pica amongst pregnant women attending the antenatal clinic in Nnamdi Azikiwe University Teaching Hospital (NAUTH), Anambra State, South East, Nigeria. MATERIALS AND METHODS: After obtaining approval from the Ethics And Research Committees in Nnamdi Azikiwe University Teaching Hospital, a cross-sectional survey of 326 consenting pregnant women who met the eligibility criteria was conducted. They were selected by systematic random sampling from 5th September to 5th of November 2022. Data was obtained by interview-based questionnaires and analyzed using the statistical package for Social Sciences (SPSS) version 25.0. The level of significance for this study was set at P < 0.05 for all analyses. RESULTS: The prevalence of pica among this population was 25.8%, and their mean age was 29.3 ± 4.8. The majority identified smell 45 (53.6%) and taste 40 (47.6%) as the reasons for pica practice. Geophagy dominated other forms of pica as white clay was the most consumed item 60 (72.6%). CONCLUSION: This study showed that pica practice was common among pregnant women in this study and geophagy was the dominant form of pica. There is a need to step up health education on the effects of pica in pregnancy.

CONTEXTE: La consommation de substances non alimentaires pendant la grossesse est appelée pica. Il est couramment pratiqué par les femmes enceintes dans le monde entier, y compris au Nigéria, et il a été signalé qu'il avait un impact mitigé sur leur santé. OBJECTIF: Cette étude visait à déterminer la prévalence du pica chez les femmes enceintes fréquentant la clinique prénatale du Nnamdi Azikiwe University Teaching Hospital (NAUTH), dans l'État d'Anambra, dans le sud-est du Nigeria. MATÉRIEL ET MÉTHODES: Après avoir obtenu l'approbation des comités d'éthique et de recherche du Nnamdi Azikiwe University Teaching Hospital, une enquête transversale a été menée auprès de 326 femmes enceintes consentantes qui répondaient aux critères d'éligibilité. Elles ont été sélectionnées par échantillonnage aléatoire systématique du 5 septembre au 5 novembre 2022. Les données ont été obtenues à l'aide de questionnaires basés sur des entretiens et analysées à l'aide du progiciel de statistiques pour les sciences sociales (SPSS) version 25.0. Le niveau de signification de cette étude a été fixé à P < 0,05 pour toutes les analyses. RÉSULTATS: La prévalence du pica dans cette population était de 25,8 % et l'âge moyen était de 29,3 ± 4,8 ans. La majorité a identifié l'odeur 45 (53,6%) et le goût 40 (47,6%) comme les raisons de la pratique du pica. La géophagie domine les autres formes de pica, l'argile blanche étant l'élément le plus consommé (60, soit 72,6 %). CONCLUSION: Cette étude a montré que la pratique du pica était courante chez les femmes enceintes et que la géophagie était la forme dominante de pica. Il est nécessaire de renforcer l'éducation sanitaire sur les effets du pica pendant la grossesse. Mots-clés: Pica, Pratiques de pica, Phagie, Femmes enceintes, Clinique prénatale, Nigeria.

Allotriophagy And Allotriodipsia In Endocrinology.

Allotriophagy is defined as food cravings that are different from the expected or the norm. It gives clinical pointers to an underlying diagnosis. We propose a new term, allotriodipsia which suggests a preference for beverages that are different from the norm. Taken together, these two entities may point towards certain endocrinological abnormalities and iatrogenic sequelae. In this communication we highlight the clinical relevance of allotriophagy and allotriodipsia.

Effect of niacin supplementation on nausea-like behaviour in an isoniazid-induced mouse model of pellagra.

Niacin deficiency causes pellagra, the symptoms of which include dermatitis, diarrhoea and dementia. Investigating the mechanism underlying these phenotypes has been challenging due to the lack of an appropriate animal model. Here, we report a mouse model of pellagra-related nausea induced by feeding mice a low-niacin diet and administering isoniazid (INH), which is thought to induce pellagra. Mice fed a normal or low-niacin diet received INH (0·3 or 1·0 mg/mg per animal, twice daily, 5 d), and nausea was evaluated based on pica behaviour, which considered the rodent equivalent of the emetic reflex. Furthermore, the effect of therapeutic niacin administration on nausea was evaluated in this model. Urinary and hepatic metabolite levels were analysed by LC coupled with MS. INH-induced pica was observed in mice fed a low-niacin diet but not in those fed a normal diet. Levels of urinary metabolites, such as 1-methyl-2-pyridone-5-carboxamide, kynurenic acid and xanthurenic acid, were significantly reduced in the mice treated with INH compared with those that did not receive INH. Furthermore, niacin supplementation prevented pica and restored the levels of some metabolites in this mouse model. Our findings suggest that INH-related nausea is pellagra-like. We also believe that our newly established method for quantifying pica is a useful tool for investigating the mechanisms of pellagra-related nausea.

Effects of Rikkunshi-To, a Japanese kampo medicine, on donepezil-induced gastrointestinal side effects in mice.

Donepezil, an acetylcholinesterase inhibitor, is associated with gastrointestinal symptoms, such as nausea, vomiting, and anorexia, which may affect adherence to continuous therapy. Since Rikkunshi-To, a Japanese herbal medicine, activates the ghrelin signaling pathway and promotes gastrointestinal function, it is administered to prevent gastrointestinal symptoms. We herein investigated whether donepezil-induced gastrointestinal side effects in mice are ameliorated by Rikkunshi-To and if its therapeutic efficacy is mediated by ghrelin. Since pica behavior, the ingestion of kaolin, correlates with nausea and vomiting in humans, donepezil was intraperitoneally administered with or without Rikkunshi-To daily to mice, and food and kaolin intakes were monitored. The effects of donepezil on intestinal motility and a ghrelin receptor antagonist on donepezil-induced pica behavior, anorexia, and changes in intestinal motility were examined in mice treated with Rikkunshi-To. Pica behavior and anorexia were significantly induced by donepezil and significantly inhibited by Rikkunshi-To. Intestinal motility was significantly suppressed by donepezil and promoted by Rikkunshi-To. Furthermore, the therapeutic effects of Rikkunshi-To were antagonized by the ghrelin receptor antagonist. The present results support the therapeutic efficacy of Rikkunshi-To against donepezil-induced gastrointestinal side effects.

The Neurology and Psychopathology of Pica.

PURPOSE OF REVIEW: Pica is defined by the American Psychiatric Association's Diagnostic and Statistical Manual, 5th edition (DSM 5) as the ongoing ingestion of materials with no nutritive or food value. More specifically such ingestions must be unremitting for at least 1 month and occur at a developmentally inconsistent age for such behavior. This article reviews the association of pica with pregnancy, micronutrient deficiencies, psychiatric disorders, dementia, and developmental disorders with emphasis on autism spectrum disorders (ASD). RECENT FINDINGS: Some variants of non-nutritive consumption are prevalent behavioral norms in non-western cultures, so not all picas should be considered pathological. However, the strong association of pica with iron deficiency anemia (IDA) lends credence to the hypothesis that dopamine transmission may be disrupted in this disorder. Picas associated with ASD are resistant to medications but can be treated with applied behavioral analysis therapy (ABA). Etiological hypotheses for pica are explored with a focus on neurobiological, neuroimaging, and psychiatric correlations. Pharmacological management and behavior modification strategies are also discussed. The possibility that pica is a form of addiction analogous to food cravings is introduced and suggested as an area for further research pursuits.

The factor structure and validity of a diagnostic interview for avoidant/restrictive food intake disorder in a sample of children, adolescents, and young adults.

OBJECTIVE: There is a paucity of validated diagnostic interviews for avoidant/restrictive food intake disorder (ARFID) to aid identification and classification of cases for both clinical and research purposes. To evaluate the factor structure, construct validity, and criterion validity of the Pica ARFID and Rumination Disorder Interview (PARDI; ARFID module), we administered the PARDI to 129 children and adolescents ages 9-23 years (M = 16.1) with ARFID (n = 84), subclinical ARFID (n = 11), and healthy controls (n = 34). METHOD: We used exploratory factor analysis to examine the factor structure of the PARDI in children, adolescents, and young adults with an ARFID diagnosis, the Kruskal-Wallis analysis of variance and Spearman correlations to test the construct validity of the measure, and non-parametric receiver operating characteristic curves to evaluate the criterion validity of the PARDI. RESULTS: Exploratory factor analysis yielded a 3-factor structure: (1) concern about aversive consequences of eating, (2) low appetite/low interest in food, and (3) sensory sensitivity. Participants with ARFID demonstrated significantly higher levels of sensory sensitivity, low appetite/low-food interest, and concern about aversive consequences of eating symptoms relative to control participants. The construct validity for each PARDI subscale was supported and clinical cutoffs for the low appetite/low interest in food (1.1) and sensory sensitivity subscales (0.6) were established. DISCUSSION: These data present evidence for the factor structure and validity of the PARDI diagnostic interview for diagnosing ARFID in children, adolescents, and young adults, supporting the use of this tool to facilitate ARFID clinical assessment and research. PUBLIC SIGNIFICANCE: Due to the paucity of validated diagnostic interviews for avoidant/restrictive food intake disorder (ARFID), we evaluated the factor structure and validity of the Pica ARFID and Rumination Disorder Interview (ARFID module). Findings suggest that the interview assesses 3 components of ARFID: concern about aversive consequences of eating, low-appetite, and sensory sensitivity, and that clinical threshold scores on the latter two subscales can be used to advance ARFID assessment.

Demographic, clinical, and biochemical predictors of pica in high-intensity blood donors.

BACKGROUND: Frequent blood donors who contribute multiple times annually are important for maintaining an adequate blood supply. However, repeated donations exacerbate iron deficiency, which can lead to pica, a condition characterised as repeated eating or chewing of a non-nutritious substance such as ice, clay and dirt. Understanding characteristics of frequent donors that are associated with increased risk for developing pica will help to identify them and prevent this adverse consequence of blood donation. METHODS: Demographic, clinical, haematological, and biochemical factors associated with pica were investigated using univariable and multivariable logistic regression analysis in a cohort of 1693 high-intensity donors who gave nine or more units of whole blood in the preceding 2 years. Pica was classified by questionnaire responses as consuming at least 8 oz of ice daily and/or consumption of non-ice substances regardless of the amount and frequency. RESULTS: Pica was present in 1.5% of the high-intensity donors, and only occurred in those with ferritin <50 ng/ml. Of 16 candidate variables, only haematocrit (OR = 0.835, p = 0.020) was independently associated with pica. Although severe iron deficiency was more prevalent in high-intensity donors, pica behaviours were less prevalent than in less frequent donors (2.2%). CONCLUSION: We have uncovered predictors of pica in high-intensity donors, which further emphasises the need to continue to implement iron replacement programs to reduce the prevalence of pica and maintain a robust pool of frequent donors.

Localisation of the petrous internal carotid artery relative to the vidian canal on computed tomography: a case-control study evaluating the impact of petroclival chondrosarcoma.

BACKGROUND: The vidian canal (VC) is normally a reliable anatomical landmark for locating the petrous internal carotid artery (pICA). This study determined the influence of petroclival chondrosarcoma on the relationship between the VC and pICA. METHODS: Nine patients (3 males, 6 females; median age 49) with petroclival chondrosarcoma, and depiction of the pICA on contrast-enhanced CT, were retrospectively studied. CT-based measurements were performed by two observers, both in the presence of the petroclival chondrosarcoma (case) and on the contralateral control side. The antero-posterior (AP) and craniocaudal (CC) measurements from the posterior VC to the pICA, whether the pICA was in the trajectory of the VC, and the coronal relationship of the pICA anterior genu with the VC were recorded. RESULTS: Chondrosarcoma usually displaced the pICA anteriorly (8/9 cases) and superiorly (6/9 cases) relative to the normal side with mean AP and CC measurements of 3.9 mm v 7.2 mm (p = 0.054) and 4.4 mm v 1.4 mm (p = 0.061). The VC trajectory less frequently intersected the pICA cross-section in the presence of chondrosarcoma however it was in the line of the eroded dorsal VC in one case. The anterior genu of the pICA was displaced more laterally by chondrosarcoma but usually remained superior to the VC. CONCLUSION: Petroclival chondrosarcoma variably influences the anatomical relationship between the VC and the pICA, hence requiring an individualised approach. The pICA is usually anterosuperiorly displaced, and the anterior genu remains superior to the VC, however it may be located in the line of the canal.

Arsenic Toxicity From the Ingestion of Terracotta Pottery.

BACKGROUND: Symptomatic arsenic toxicity has not been associated with terracotta pottery despite thousands of years of use in food storage and preparation. We describe a case of chronic arsenic toxicity from undiagnosed pica involving the ingestion of terracotta pots. CASE REPORT: A 49-year-old woman with a history of anemia and abnormal uterine bleeding presented to the Emergency Department complaining of lower extremity pain. She was also noted to have chronic lower extremity paresthesia, constipation, and fatigue. She admitted to ingesting glazed and unglazed terracotta pots for the past 5 years. This unusual craving was thought to be a manifestation of pica in the setting of chronic anemia. The patient was found to have an elevated urinary arsenic concentration of 116 µg/24 h. An abdominal radiograph showed opacifications throughout her bowel, and she received whole bowel irrigation. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Pica is a common behavior in certain populations. Practicing clinicians should be familiar with the complications of pica, including chronic arsenic toxicity and its associated array of nonspecific symptoms.

Landscape REE anomalies and the cause of geophagy in wild animals at kudurs (mineral salt licks) in the Sikhote-Alin (Primorsky Krai, Russia).

To test the "rare earth" hypothesis of geophagy, geological and hydrogeochemical studies unparalleled anywhere in the world were carried out at kudurs (salt licks) in two districts in the Primorsky Krai, Russia. The mineral and chemical compositions of geophagic earth consumed by animals, the chemical composition of surface waters and vegetation, and the chemical composition of biological tissues of red deer (Cervus elaphus) were studied in this research. It was found that ultra-fresh surface and fontinal waters in the studied areas contain anomalously high concentrations of rare earth elements (REE), the sums of which exceeded the average values in the Primorsky Krai and worldwide by tenfold, and more. The presence of landscape REE anomalies is confirmed by elevated concentrations of these elements in vegetation. Using electron microscopy, it was determined that the sources of REE in landscape components are rocks containing secondary, readily soluble, REE minerals (hydrophosphates and fluorocarbonates). The study of the chemical composition of animal tissues showed the presence of significant concentrations of heavy REE (HREE) in the blood and brain, which indirectly indicates a high probability of animals developing stress reactions against the background REE-elementosis. Eaten earthy substances in both areas are represented by mixtures of smectite clays and zeolites with high ion-exchange properties. In the digestive tract of animals, such sorbents actively interact with the biological electrolyte, saturating it with sodium ions and absorbing HREE. The main meaning of geophagy is regulation of the concentration and proportion of REE in the body. Sometimes it manifests itself in intake of significant amounts of Na.