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Transfusion Medicine (Oxford, England) Aug 2022Frequent blood donors who contribute multiple times annually are important for maintaining an adequate blood supply. However, repeated donations exacerbate iron...
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.
Topics: Anemia, Iron-Deficiency; Blood Donors; Ferritins; Humans; Iron Deficiencies; Pica; Prevalence
PubMed: 35750589
DOI: 10.1111/tme.12890 -
Acta Neurochirurgica. Supplement 2021Aneurysms of the posterior inferior cerebellar artery (PICA) are uncommon. The complex anatomy of PICA and its intimate relationships with medulla, lower cranial nerves,... (Review)
Review
Aneurysms of the posterior inferior cerebellar artery (PICA) are uncommon. The complex anatomy of PICA and its intimate relationships with medulla, lower cranial nerves, and jugular tubercle makes the surgical treatment of these aneurysms fascinating. The reported is study aimed at a critical review of the overall results of a personal series of PICA aneurysms, treated by the senior author, R. Galzio. Demographics, charts, videos, outcome, and follow-up of a cohort of PICA aneurysms managed in the last 10 years were retrospectively analyzed, focusing only upon those treated with microneurosurgery. Twenty-five patients, harboring a single aneurysm, were operated on. Fifteen aneurysms were ruptured. Nineteen were proximal, all of these being been treated through a far-lateral approach. Trans-condylar or trans-tubercular variants were rarely necessary and however reserved to peculiar cases. Twenty-three aneurysms underwent direct treatment consisting of clip ligation. At 6-month follow-up, 60% of patients had a modified Rankin Score (mRS) of 0-2. Given the high anatomical variability of both PICA and patients' bony anatomy, a case-by-case meticulous preoperative imaging evaluation is mandatory for the choice of the most suitable and tailored surgical corridor which, in turn, is pivotal to achieve the best outcome.
Topics: Aneurysm, Ruptured; Cerebellum; Humans; Intracranial Aneurysm; Retrospective Studies; Treatment Outcome; Vertebral Artery
PubMed: 33973026
DOI: 10.1007/978-3-030-63453-7_5 -
Surgical and Radiologic Anatomy : SRA Jul 2023To demonstrate that occipital artery (OA)-p1 posterior inferior cerebellar artery (PICA) bypass can be an alternative for complex posterior circulation aneurysms.
PURPOSE
To demonstrate that occipital artery (OA)-p1 posterior inferior cerebellar artery (PICA) bypass can be an alternative for complex posterior circulation aneurysms.
METHODS
A far-lateral approach to craniotomy was performed on 20 cadaveric specimens, and the OA was obtained 'in-line.' Its length, diameter, and the number of p1/p2 and p3 segmental perforators were determined, and the relationship between the caudal loop and cerebellar tonsil position was also assessed. The distance between the PICA's origin and the cranial nerve XI (CN XI), the buffer length above the CN XI after dissection, the OA length required to complete the OA-p1/p3 PICA bypass, and the p1 and p3 segment diameters were all measured. A bypass training practical scale (TSIO) was used to evaluate the quality of the anastomosis.
RESULTS
All specimens underwent OA-p1 PICA end-to-end bypass and had favorable results for the TSIO score, 15 sides underwent OA-p3 PICA end-to-side bypass, and the other bypass protocols were less common. The buffer length above the CN XI after dissection, the distance between the PICA's origin and the CN XI, and the first perforator were all of sufficient length. The direct length of the OA needed to complete the OA-p1 PICA end-to-end bypass was significantly less than the available length and the OA-p3 PICA end-to-side bypass, with the OA matching the p1 segment diameter. The number of p1 perforators was less than that of p3, and the OA diameter was equal to that of the p1 segment.
CONCLUSION
OA-p1 PICA end-to-end bypass is a feasible alternative in cases in which p3 segment has high caudal loops or anatomic anomalies.
Topics: Humans; Feasibility Studies; Cerebral Revascularization; Cerebellum; Vertebral Artery; Intracranial Aneurysm; Cadaver
PubMed: 37173575
DOI: 10.1007/s00276-023-03160-5 -
Disability and Health Journal Jul 2021Pica, the repeated ingestion of nonfood items, can result in gastrointestinal (GI) outcomes. Children with autism spectrum disorder (ASD) and other developmental...
BACKGROUND
Pica, the repeated ingestion of nonfood items, can result in gastrointestinal (GI) outcomes. Children with autism spectrum disorder (ASD) and other developmental disabilities (DDs) are disproportionately affected by both pica and GI symptoms. Study of the inter-relationship between pica, GI symptoms, and ASD/DD is limited.
OBJECTIVE/HYPOTHESIS
We assessed associations between pica and GI symptoms in preschool-aged children with and without ASD and other (non-ASD) DDs in the Study to Explore Early Development.
METHODS
Our sample included children with ASD (n = 1244), other DDs (n = 1593), and population (POP) controls (n = 1487). Data to define final case-control status, pica, and GI symptoms were from standardized developmental assessments/questionnaires. Prevalence ratios, adjusted for sociodemographic factors (aPRs), and 95% confidence intervals were derived from modified Poisson regression.
RESULTS
Within each group (ASD, DD, POP) and for the total sample, pica was associated with vomiting (aPR for total sample 2.6 [1.7, 4.0]), diarrhea (1.8 [1.4, 2.2]), and loose stools (1.8 [1.4, 2.2]). In the DD group, pica was associated with constipation (1.4 [1.03, 1.9]) and pain on stooling (1.8 [1.2, 2.6]). In analyses of the subgroup without pica, increases in GI symptoms were still evident in the ASD and DD groups compared to POP group.
CONCLUSION
These findings highlight an important adverse effect of pica, GI symptoms, in children with and without ASD and DDs; nonetheless, pica does not fully explain the increased risk for GI symptoms among children with ASD and DDs. These findings inform the specialized healthcare needs of children with ASD and other DDs.
Topics: Autism Spectrum Disorder; Child; Child, Preschool; Disabled Persons; Gastrointestinal Diseases; Humans; Pica; Surveys and Questionnaires
PubMed: 33358227
DOI: 10.1016/j.dhjo.2020.101052 -
Epidemiology and Psychiatric Sciences Jun 2022Pica and rumination disorder are known as feeding disorder diagnoses in childhood, but little is known about their occurrence in adulthood. This study aimed to assess...
AIMS
Pica and rumination disorder are known as feeding disorder diagnoses in childhood, but little is known about their occurrence in adulthood. This study aimed to assess prevalence rates of one-time and recurrent pica and rumination behaviours (PB and RB) in adults, including sociodemographic subgroups, and to examine associations with other eating disorder and general psychopathology.
METHODS
The representative population sample ( = 2403) completed measures on PB and RB, symptoms of avoidant/restrictive food intake disorder (ARFID), body image and symptoms of depression and anxiety.
RESULTS
Any PB and RB were reported in 5.33 and 5.49%, respectively, while recurrent PB or RB occurred in 1.08 and 0.71%, respectively. Co-occurrence was high, with 35.29% of recurrent PB in RB, and 23.08% vice versa. Prevalence rates of recurrent PB or RB did not differ by gender, weight status, educational or migration history from those without recurrent behaviours. Adults with . without recurrent PB and RB showed more symptoms of ARFID, general eating disorders depression and anxiety, and behavioural symptoms of eating disorders (with the exception of compensatory behaviours in recurrent PB), and less positive body image. However, there were no differences regarding age and body mass index.
CONCLUSIONS
Our findings highlight the clinical significance of PB and RB in adults regarding both prevalence and associations with other psychopathological symptoms. In particular, associations with body image need to be investigated further, as in contrast to other eating disorders, body image disturbance is not yet represented in the diagnostic criteria for pica and rumination disorder. In sum, the findings highlight the need for clinical attention for these disorders and related behaviours in adults.
Topics: Adult; Feeding and Eating Disorders; Humans; Pica; Prevalence; Psychopathology; Rumination Syndrome
PubMed: 35678377
DOI: 10.1017/S2045796022000208 -
Neuropharmacology Nov 20215F-MDMB-PICA is a popular synthetic cannabinoid associated with analytically confirmed intoxications. In vitro studies show 5F-MDMB-PICA is a potent cannabinoid-1...
5F-MDMB-PICA is a popular synthetic cannabinoid associated with analytically confirmed intoxications. In vitro studies show 5F-MDMB-PICA is a potent cannabinoid-1 receptor (CB) agonist, but little information is available about in vivo pharmacokinetics and pharmacodynamics. To this end, the present study had three aims: 1) to develop a validated method for detection of 5F-MDMB-PICA and its metabolites in rat plasma, 2) to utilize the method for investigating pharmacokinetics of 5F-MDMB-PICA in rats, and 3) to relate 5F-MDMB-PICA pharmacokinetics to pharmacodynamic effects. 5F-MDMB-PICA and its metabolites were quantified using liquid chromatography tandem mass spectrometry (LC-MS/MS) and method validation followed forensic standards. Male Sprague-Dawley rats bearing surgically implanted jugular catheters and subcutaneous (s.c.) temperature transponders received 5F-MDMB-PICA (50, 100, or 200 μg/kg, s.c.) or its vehicle. Blood samples were drawn at 15, 30, 60, 120, 240, and 480 min post-injection, and plasma was assayed using LC-MS/MS. At each blood draw, body temperature, and catalepsy scores were recorded. Maximum plasma concentrations (C) of 5F-MDMB-PICA rose linearly with increasing dose (1.72-6.20 ng/mL), and plasma half-life (t) ranged from 400 to 1000 min 5F-MDMB-PICA-3,3-dimethylbutanoic acid and 5OH-MDMB-PICA were the only metabolites detected, and plasma concentrations were much lower than the parent drug. 5F-MDMB-PICA induced robust hypothermia and catalepsy-like symptoms that were significantly correlated with concentrations of 5F-MDMB-PICA. Radioligand binding in rat brain membranes revealed 5F-MDMB-PICA displays high affinity for CB (IC = 2 nM) while metabolites do not. In summary, 5F-MDMB-PICA is a potent CB agonist in rats whose pharmacodynamic effects are related to circulating concentrations of the parent drug and not its metabolites.
Topics: Animals; Cannabinoid Receptor Agonists; Cannabinoids; Catalepsy; Hypothermia; Male; Rats; Rats, Sprague-Dawley; Receptor, Cannabinoid, CB1
PubMed: 34547333
DOI: 10.1016/j.neuropharm.2021.108800 -
Clinical Neurology and Neurosurgery Jun 2023To assess the posterior inferior cerebellar artery (PICA)-PICA bypass possibility.
OBJECTIVE
To assess the posterior inferior cerebellar artery (PICA)-PICA bypass possibility.
METHODS
Fifteen adult cadaver heads were used for surgical simulation, and the far-lateral approach was used to expose the surgical field. The bilateral PICA course, diameter, and perforators were observed and measured to evaluate the possibility of a PICA-PICA bypass.
RESULTS
The PICA-PICA bypass was performed in seven (46.7 %) of the 15 specimens; the procedure was performed easily in three specimens, a little difficult in two, and was difficult in two specimens because of the relationship between the tonsil and the short parallel length of the bilateral tonsillomedullary (p3) segment. In eight (53.3 %) of the 15 specimens, PICA-PICA bypass was not feasible for reasons including 1) the caliber of the bilateral p3 was unmatched for bypass, 2) the distance of bilateral p3 in the midline was > 7 mm, 3) the middle segment of p3 perforating direct arteries limited the buffer length, and 4) single caudal loops.
CONCLUSION
The possibility of PICA-PICA bypass was determined by the proximity of the bilateral p3, caliber match, and mobilization of the bilateral caudal loop due to the perforators. The difficulty of the PICA-PICA bypass mainly depends on the relationship between the cerebellar tonsil and the parallel length of the bilateral PICA in the midline.
Topics: Adult; Humans; Cerebral Revascularization; Cerebellum; Vertebral Artery; Cadaver; Intracranial Aneurysm
PubMed: 37163930
DOI: 10.1016/j.clineuro.2023.107759 -
Clinical Neuroradiology Dec 2023Intracranial vertebral artery dissecting aneurysm (IVADA) is a rare type of aneurysm with high morbidity and mortality. Recently, the application of pipeline...
PURPOSE
Intracranial vertebral artery dissecting aneurysm (IVADA) is a rare type of aneurysm with high morbidity and mortality. Recently, the application of pipeline embolization devices (PEDs) has been extended to IVADAs. Here, we aim to investigate the safety and effectiveness of PEDs for IVADAs.
METHOD
We retrospectively reviewed the PLUS database to identify patients who had IVADAs and were treated with PEDs from 2014 to 2019 at 14 centers across China. Data including patient and aneurysm characteristics, procedure details, angiographic and clinical results, relationship with the ipsilateral posterior inferior cerebellar artery (PICA), and patency of the PICA following PED coverage were analyzed.
RESULTS
In this study 52 consecutive patients with 52 IVADAs were included. The mean age was 52.33 years and 82.7% were male. With a median follow-up of 10.5 months, the complete occlusion rate was 93.8% (45/48) and no recurrence or in-stent stenosis was detected. The total postoperative complication rate and mortality were 11.5% and 1.9%, respectively. Complications occurred in 9.6% (5/52) of patients within 30 days after the operation, including ischemic stroke in 3 and hemorrhagic stroke in 2. Another patient suffered an ischemic stroke at follow-up, 78.8% (41/52) PICAs were covered by PEDs, 1 case (2.4%) had a functional disability due to PICA occlusion, while 39.0% (16/41) had reduced flow during follow-up but hardly caused any obvious neurological deficits. Patients with IVADA involving PICA had a trend towards more complications (66.7% vs. 51.1%; P = 1).
CONCLUSION
Treating IVADAs with PEDs may be a safe and effective option, with favorable clinical and angiographic outcomes; however, complications associated with this treatment should not be ignored.
REGISTRATION
http://www.
CLINICALTRIALS
gov . Unique identifier: NCT03831672.
Topics: Humans; Male; Middle Aged; Female; Vertebral Artery; Treatment Outcome; Intracranial Aneurysm; Retrospective Studies; Embolization, Therapeutic; Cerebral Angiography; Vertebral Artery Dissection; Ischemic Stroke; Aortic Dissection
PubMed: 37380901
DOI: 10.1007/s00062-023-01318-7 -
Journal of Eating Disorders Sep 2021Pica as a scavenging behavior represents a serious health hazard to the care of patients with schizophrenia. Despite the rare comorbidity of pica eating disorder and...
Pica as a scavenging behavior represents a serious health hazard to the care of patients with schizophrenia. Despite the rare comorbidity of pica eating disorder and schizophrenia, pica behaviors are relatively common in this group of patients (1.5% vs. 14.3%). The risk of multiple clinical problems such as electrolyte disturbances, intestinal obstruction, and heavy metal poisoning has made pica behaviors an important research topic in patients with schizophrenia. However, few studies have examined the etiology, mechanisms, and treatment of pica behaviors in schizophrenia. This letter is a call for further research into discovering the biopsychopathology of these major clinical manifestations among patients with schizophrenia.
PubMed: 34530936
DOI: 10.1186/s40337-021-00472-y