Are anemia, gastrointestinal disorders, and pregnancy outcome associated with pica behavior?

OBJECTIVE: This study was conducted to determine the relationship between pica and anemia, gastrointestinal disorders, as well as pregnancy outcomes in pregnant women. METHODOLOGY: This study was a prospective study carried out between January 2016 and June 2017 and was performed on 226 pregnant women who attended four different health care centers to receive routine prenatal care. Sampling was done considering the inclusion criteria, in two steps: cluster sampling and random sampling. Data collection was done using a researcher-made checklist. The significance level was set at p = 0.05. RESULTS: The average age of the participants was 26.10±6.27. The prevalence of pica in pregnant women in the first, second, and third trimesters was 9.3, 8, and 2.1%, respectively. The most common pica craving among pregnant women was for ice and frozen materials (68.2%). There was a statistically significant relationship between gastrointestinal disorders and anemia with pica (p < 0.001). There was also a significant relationship between birth weights of babies born to mothers with pica and those without pica (p = 0.005). CONCLUSION: Pica in pregnant women had a significant relationship with gastrointestinal disorders and anemia during pregnancy and pregnancy outcomes. Thus, in addition to providing healthcare services, health care professionals should consider patients' pica practices and make the necessary interventions.

Fatal gastric distension in a gold thioglucose mouse model of obesity.

This case report addresses the problem of underreporting negative results and adverse side effects in animal testing. We present our findings regarding a hyperphagic mouse model associated with unforeseen high mortality. The results outline the necessity of reporting detailed information in the literature to avoid duplication. Obese mouse models are essential in the study of obesity, metabolic syndrome and diabetes mellitus. An experimental model of obesity can be induced by the administration of gold thioglucose (GTG). After transcending the blood-brain barrier, the GTG molecule interacts with regions of the ventromedial hypothalamus, thereby primarily targeting glucose-sensitive neurons. When these neurons are impaired, mice become insensitive to the satiety effects of glucose and develop hyperphagia. In a pilot study for optimising dosage and body weight development, C57BL/6 mice were treated with GTG (0.5 mg/g body weight) or saline, respectively. Animals were provided a physiological amount of standard diet (5 g per animal) for the first 24 hours after treatment to prevent gastric dilatation. Within 24 hours after GTG injection, all GTG-treated animals died of gastric overload and subsequent circulatory shock. Animals developed severe attacks of hyperphagia, and as the amount of provided chow was restricted, mice exhibited unforeseen pica and ingested bedding material. These observations strongly suggest that restricted feeding is contraindicated concerning GTG application. Presumably, the impulse of excessive food intake was a strong driving force. Therefore, the actual degree of suffering in the GTG-induced model of hyperphagia should be revised from moderate to severe.

Soil eaten by chacma baboons adsorbs polar plant secondary metabolites representative of those found in their diet.

Geophagy, the deliberate consumption of earth materials, is common among humans and animals. However, its etiology and function(s) remain poorly understood. The major hypotheses about its adaptive functions are the supplementation of essential elements and the protection against temporary and chronic gastrointestinal (GI) distress. Because much less work has been done on the protection hypothesis, we investigated whether soil eaten by baboons protected their GI tract from plant secondary metabolites (PSMs) and described best laboratory practices for doing so. We tested a soil that baboons eat/preferred, a soil that baboons never eat/non-preferred, and two clay minerals, montmorillonite a 2:1 clay and kaolinite a 1:1 clay. These were processed using a technique that simulated physiological digestion. The phytochemical concentration of 10 compounds representative of three biosynthetic classes of compounds found in the baboon diet was then assessed with and without earth materials using high-performance liquid chromatography with diode-array detection (HPLC-DAD). The preferred soil was white, contained 1% halite, 45% illite/mica, 14% kaolinite, and 0.8% sand; the non-preferred soil was pink, contained 1% goethite and 1% hematite but no halite, 40% illite/mica, 19% kaolinite, and 3% sand. Polar phenolics and alkaloids were generally adsorbed at levels 10× higher than less polar terpenes. In terms of PSM adsorption, the montmorillonite was more effective than the kaolinite, which was more effective than the non-preferred soil, which was more effective than the preferred soil. Our findings suggest that HPLC-DAD is best practice for the assessment of PSM adsorption of earth materials due to its reproducibility and accuracy. Further, soil selection was not based on adsorption of PSMs, but on other criteria such as color, mouth feel, and taste. However, the consumption of earth containing clay minerals could be an effective strategy for protecting the GI tract from PSMs.

Pica in Pregnancy: An Unusual Presentation.

BACKGROUND: Pica is common in pregnancy and is often felt to be benign. The following case of severe pica presenting without anemia is unusual in its presentation, laboratory findings, and treatment. CASE: A 31-year-old multiparous woman at 37 0/7 weeks of gestation presented with esophagitis and gastritis secondary to laundry detergent consumption. She had borderline anemia (hemoglobin of 11 g/dL and hematocrit of 37%, mean corpuscular volume 80%) but was severely iron-deficient (serum ferritin 7 micrograms/dL). Parenteral iron infusion was associated with dramatic resolution of her cravings within 36 hours of treatment. CONCLUSION: Pica may be related to deficient iron stores in the absence of anemia and can result in serious morbidity. Parenteral iron may be associated with rapid pica resolution in symptomatic pregnant patients.

Esperance pica study.

BACKGROUND: Pica, the eating of non-foods, occurs particularly in children and pregnant women. It has been observed in communities all over the world. Pica is associated with iron deficiency and, in some environments, lead poisoning. This is the first time a study has assessed the prevalence of pica in Australia. METHODS: The study assessed the prevalence of pica in an Australian rural community, using a questionnaire given to parents of 223 children aged 2-10 years attending the five general practice surgeries in the shire. RESULTS: The prevalence of non-ice pica in the study group was 9.4%, and 3.6% of this group ate soil. DISCUSSION: The presence of pica should alert the treating clinician to consider iron deficiency and, in the case of polluted environments, lead exposure.

Running induces nausea in rats: Kaolin intake generated by voluntary and forced wheel running.

Three experiments were conducted showing rats' pica behavior (kaolin clay intake) due to running in activity wheels. The amount of kaolin consumed was a positive function of the available time of voluntary running (20, 40, or 60 min), although this relationship was blunted by a descending (i.e., 60 â†’ 40 â†’ 20 min) test series of execution (Experiment 1). Pica was also generated by forced running in a motorized wheel for 60 min as a positive function of the speed of wheel rotations at 98, 185, or 365 m/h, independent of the order of execution (Experiment 2). Voluntary running generated more pica than did forced running at 80 m/h, although the distance travelled in the former condition was 27% lesser than that in the latter condition (Experiment 3). Because kaolin intake is regarded as a reliable measure of nausea in rats, these results show that wheel running, either voluntary or forced, induces nausea in rats.

Characterization of pica and chewing behaviors in privately owned cats: a case-control study.

OBJECTIVES: The aim of this study was to characterize pica behavior in cats. METHODS: Cat owners were recruited to participate in a questionnaire survey on pica behavior exhibited by their cats. Emphasis was put on the type of item ingested. Questions on early history and environment, as well as general health and gastrointestinal signs, were asked. Owners of healthy cats not showing pica were also recruited into a control group. Associations between variables and groups were statistically tested. RESULTS: Pica was directed most commonly at shoelaces or threads, followed by plastic, fabric, other items, rubber, paper or cardboard and wood. Some cats ingested specific items but only chewed others. A significant positive association was found between sucking and ingesting fabric (P = 0.002). Ad libitum feeding was significantly lower in the pica group than the control group (P = 0.01). Prevalence of self-sucking behavior was significantly higher in the pica group than the control group (P = 0.001). Cats with pica vomited significantly more often than control cats (P = 0.01). CONCLUSIONS AND RELEVANCE: Pica, the ingestion of inedible items, does not seem to be the consequence of a suboptimal environment or early weaning. Cats with pica were less commonly fed ad libitum than healthy cats. As frequently reported, pica and vomiting were related, but the causative association is not well established and thus warrants further investigation.

Pagophagia improves neuropsychological processing speed in iron-deficiency anemia.

Pagophagia (compulsive ice chewing) has long been associated with iron deficiency anemia, but prior attempts to account for this craving have been unsatisfactory. We hypothesize that chewing ice triggers vascular changes that lead to preferential or increased perfusion of the brain. This would result in increased alertness and processing speed in anemic patients, but not in healthy controls who are already at ceiling, and would explain why anemic individuals crave ice. Preliminary support for this hypothesis was found in two studies. In Study 1, non-anemic subjects reported very low rates of pagophagia (only 4%) while anemic subjects reported significantly higher rates (56%). In Study 2, chewing ice dramatically improved response time on a neuropsychological test, but only for anemic individuals. In a small randomized controlled trial, iron deficient anemic subjects and healthy controls were assigned to chew ice or drink tepid water and then took a continuous performance test that measures response time, response time variability, errors of impulsivity and errors of inattention. In the water condition, anemic subjects performed significantly worse than healthy controls. Chewing ice had no effect on the performance of healthy controls, but significantly improved the performance of anemic patients. Potential explanations include activation of the dive reflex, which would lead to peripheral vasoconstriction and preferential perfusion of the brain or, alternatively, sympathetic nervous system activation, which would also increase blood-flow to the brain.

A test of three hypotheses of pica and amylophagy among pregnant women in Tamil Nadu, India.

OBJECTIVES: Pica has been studied in India and elsewhere for more than 100 years, yet no compelling and empirically well-supported explanation for it has emerged. Amylophagy, sometimes considered a type of pica and sometimes studied separately, is less frequently investigated and also lacks a convincing explanation. This study used a biocultural approach to test three hypotheses of pica and amylophagy: protection, hunger/nutrition, and psychological distress. METHODS: The research took place in Tamil Nadu, India. In study 1, a cultural investigation was carried out among nonpregnant, adult women (n = 54) to determine nonfood substances that are consumed in this region and perceptions of health consequences. Next, using the substances identified in Study 1, three hypotheses of pica and amylophagy were tested in a cross-sectional study of pregnant women (Study 2, n = 95). Logistic regression analysis was used to analyze the presence or absence of engaging in pica and amylophagy. A series of bivariate analyses were used to examine the variation in amount and frequency of consumption. RESULTS: Study 1 revealed that cultural attitudes strongly shape the selection of nonfood substances. In Study 2, the presence or absence of pica was not predicted by any of the variables included in the study, whereas the frequency and amount of consumption of pica substances were primarily explained by the psychological distress and hunger/nutrition hypotheses. Both the presence or absence of amylophagy as well as the frequency and amount of consumption were best explained by the protection hypothesis. CONCLUSIONS: This research provided partial support for the protection and hunger/nutrition hypotheses for amylophagy, and also provided some evidence for the role of psychological distress and hunger or nutrition in pica.

Oxidized trilinoleate and tridocosahexaenoate induce pica behavior and change locomotor activity.

Pica behavior, a behavior that is characterized by eating a nonfood material such as kaolin and relates to the degree of discomfort in animals, and the variations of locomotor activity of rats after eating deteriorated fat and oil extracted from instant noodles were examined in our previous study. The result shows that oxidized fat and oil with at least 100 meq/kg in peroxide value (PV) increase pica behavior and decrease locomotor activity. In the present study, the same two behaviors were measured using autoxidized trilinoleate (tri-LA) and tridocosahexaenoate (tri-DHA) as a model of vegetable and fish oil, respectively, to compare fatty acid differences against the induction of two behaviors. The oxidized levels of tri-LA and tri-DHA were analyzed with PV and p-anisidine value (AnV), the method to analyze secondary oxidized products. The oxidation levels of respective triacylglycerol (TAG) samples were carefully adjusted to make them having almost the same PV and AnV. As the results, 600 or more meq/kg in PV of both TAGs significantly increased the consumption of kaolin pellets compared to the control group. Furthermore, 300 or more meq/kg in PV of tri-LA and 200 or more meq/kg in PV of tri-DHA demonstrated significant decrease in locomotor activity compared to control group. These results would indicate that the oxidized TAG having the same PV and/or AnV would induce the same type of pica behavior and locomotor activity. Furthermore, that the structure of oxidized products might not be important and the amount of hydroperoxide group and/or aldehyde group in deteriorated fats and oils might affect the pica behavior and locomotor activity were thought.

Imatge radiològica amb petites densitats radioopaques abdominals en nen immigrant / No disponible

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Why on earth?: Evaluating hypotheses about the physiological functions of human geophagy.

Geophagy has been hypothesized to be an adaptive behavior, either as a means to allay nutrient deficiency or to protect against ingested pathogens and toxins. Others have proposed that geophagy is non-adaptive, occurring either to allay hunger or as an epiphenomenon of nutrient deficiencies. This paper evaluates these hypotheses using 482 published cultural-level accounts of human geophagy and 330 accounts of geophagy among 297 species of mammals, birds, and reptiles. Information was extracted from reports of human geophagy to permit statistical analysis; reports of non-human geophagy were tabulated. Human geophagy did not parallel changes in nutrient requirements, occurred most frequently among children and pregnant women and in tropical areas (where pathogen densities are highest), and was associated with ingestion of toxic substances and gastrointestinal distress. Earth ingested by humans was craved and carefully selected and prepared; it had high clay content, but few bioavailable mineral nutrients. In primates, geophagy was associated with both protection from toxins and obtaining nutrients, whereas in other vertebrates it was associated mainly with obtaining nutrients. Our results indicate that human geophagy is best explained as providing protection from dietary chemicals, parasites, and pathogens, whereas animal geophagy may involve both micronutrient acquisition and protection.

Effects of Korean ginseng root extract on cisplatin-induced emesis in a rat-pica model.

In the present study, we investigate the effect of Korean ginseng root extract (KG) on cisplatin-induced pica in a rat model. Rats were treated with KG before (25, 50, and 100 mg/kg) or after (12.5, 25, and 50 mg/kg) a single intraperitoneal injection of cisplatin (7 and 6 mg/kg, respectively). We examined intake of kaolin and normal food as an indicator of the emetic stimulus every 24 h for 120 h. Changes in body weight, haematology and histopathology were additionally assessed. Pre-treatment with KG (25 and 50 mg/kg) significantly attenuated cisplatin-induced kaolin intake (24, 48, and 72 h) and markedly improved intake of normal food by rats at 48, 72, 96, and 120 h. Cisplatin-induced kaolin intake was markedly decreased upon post-treatment of rats with KG (12.5, 25, and 50 mg/kg) at 24 h. Notably, post-treatment with the lowest KG dose resulted in a significant anti-pica effect and improved food intake until 72 h. The magnitude of body weight reduction was significantly diminished in rats pre-treated/post-treated with 25, 50, and 12.5 mg/kg KG. The anti-pica effects of KG were further confirmed with haematological and histopathological findings. Our findings collectively indicate that KG improves the resistance of rats against emesis.

Cisplatin-induced gastrointestinal dysmotility is aggravated after chronic administration in the rat. Comparison with pica.

BACKGROUND: Chemotherapy induces nausea/emesis and gastrointestinal dysmotility. Pica, the ingestion of non-nutritive substances, is considered as an indirect marker of nausea/emesis in non-vomiting species, like the rat. Cisplatin is the most emetogenic antitumoral drug. In the rat, acute cisplatin induces pica and gastric dysmotility in a temporally related manner, but the effects of chronic cisplatin are not well known. This study analyzed the effects of chronic cisplatin on pica and on gastrointestinal motor function in the rat, using radiographic, non-invasive methods. METHODS: Rats received saline or cisplatin (1-3 mg kg(-1), i.p.) once a week for four consecutive weeks. Serial X-rays were taken 0-8 h after administration of barium sulfate, which was given intragastrically immediately after the first and last cisplatin administrations and 1 week after treatment finalization. Pica (i.e., kaolin intake) was measured in isolated rats. KEY RESULTS: Cisplatin delayed gastric emptying and induced acute (during the 24 h following each administration) pica. Upon chronic administration, these effects were exacerbated. In addition, basal kaolin intake was enhanced (facilitated) and gastric distension induced. Delayed gastric emptying and gastric distension were not apparent 1 week after treatment, but basal kaolin intake was still elevated. CONCLUSIONS & INFERENCES: Whereas gastric dysmotility induced by cisplatin is parallel to the development of acute pica and might underlie facilitation of pica throughout chronic treatment, it does not explain its long-term maintenance. These findings should be taken into account in the search for new antiemetic strategies.