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Turkish Neurosurgery 2022To study the operative approaches for posterior inferior cerebellar artery (PICA) aneurysms or understanding the different pathologies that can affect this artery, and...
AIM
To study the operative approaches for posterior inferior cerebellar artery (PICA) aneurysms or understanding the different pathologies that can affect this artery, and to present detailed knowledge of this artery?s anatomy.
MATERIAL AND METHODS
The present study analyzed the different variations of the PICA?s first two segments, the anterior medullary and lateral medullary segments, regarding the number of trunks, their emergency site, and the presence or absence of hypoplasia of this artery, through microsurgical dissection of 23 fresh cadaver brains.
RESULTS
Some striking variations were found, such as the absence of the left vertebral artery in one of the brains and the emergence of any PICA in another two brains studied. Moreover, variations such as hypoplastic arteries, missing trunks on one side and double or triple trunks, different emergence sites, significant PICA emergence from the superior part of the vertebral artery (59% of the trunks), and asymmetries between the right and left sides were recorded. The double origins of non-hypoplastic PICAs were found in 17% (n = 4) of patients.
CONCLUSION
The results obtained in the present study indicated the great importance of the studies and reviews on the different topographies of PICA; these studies and reviews expand the knowledge and consensus on the characteristics and implications of PICA?s variations. The clinical implication of this knowledge and consensus is obtaining the best surgical strategies for clipping aneurysms and, in addition, the best choices for occlusion of the vessel affected if the territory of the main vessel has an adequate collateral circulation. From the results of the present study, it is evident that there was a significant PICA emergence from the superior part of the vertebral artery and that the double origin of non-hypoplastic trunks was also found in some patients; the latter is associated with a greater chance of aneurysms and other additional complications.
Topics: Cadaver; Cerebellum; Humans; Intracranial Aneurysm; Posterior Cerebral Artery; Vertebral Artery
PubMed: 34859823
DOI: 10.5137/1019-5149.JTN.33441-20.3 -
Evolutionary Anthropology Dec 2023Geophagy, the consumption of clay or similar substances, is known as an evolved behavior that protects vulnerable populations, such as pregnant women and children,... (Review)
Review
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.
Topics: Child; Humans; Female; Pregnancy; Pica; Illness Behavior; Anemia, Iron-Deficiency; Microbiota; Inflammation
PubMed: 37661330
DOI: 10.1002/evan.22004 -
Transfusion Jul 2021Pica is characterized as repeatedly eating or chewing a non-nutritious substance including, but not limited to ice, clay and dirt, starch, raw pasta, chalk, coal, paint,... (Comparative Study)
Comparative Study
BACKGROUND
Pica is characterized as repeatedly eating or chewing a non-nutritious substance including, but not limited to ice, clay and dirt, starch, raw pasta, chalk, coal, paint, or paper. Pica symptoms can be intense and addiction-like and disrupt quality of life. It is strongly linked to iron deficiency. Since substantial iron loss occurs during blood donation, blood donors may be susceptible to development of pica behaviors.
METHODS
We investigated demographic, clinical, hematological, and biochemical factors associated with pica using univariable and multivariable logistic regression analysis in a cohort of 11,418 racially diverse blood donors. Pica was defined 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 2.2% of the donors. The sensitivity and specificity of pica in iron-deficient donors were 36% and 82%, respectively. Lower ferritin (p = .001), non-Asian race (p < .001), higher red cell distribution width (p < .001), younger age, and restless legs syndrome (p = .008) were independently associated with pica. Female sex is associated with iron deficiency but was not an independent predictor of pica suggesting that iron deficient males and females were equally susceptible to the development of pica behaviors. Donors with normal ferritin levels also reported pica, reinforcing the role of non-iron related factors in its presentation.
CONCLUSIONS
We have identified demographic, clinical, and biochemical predictors of pica that help identify those most at risk for developing pica behaviors, and thereby assist in its clinical diagnosis and treatment.
Topics: Adolescent; Adult; Biomarkers; Blood Cell Count; Blood Donors; Body Mass Index; Connecticut; Disease Susceptibility; Erythrocyte Indices; Ethnicity; Feeding Behavior; Female; Ferritins; Humans; Ice; Iron Deficiencies; Male; Middle Aged; Pennsylvania; Pica; Racial Groups; Sensitivity and Specificity; Surveys and Questionnaires; Wisconsin; Young Adult
PubMed: 33913181
DOI: 10.1111/trf.16409 -
Translational Vision Science &... Aug 2023The purpose of this study was to examine the sensitivity of quantitative metrics of the retinal vasculature derived from optical coherence tomography angiography (OCT-A)...
PURPOSE
The purpose of this study was to examine the sensitivity of quantitative metrics of the retinal vasculature derived from optical coherence tomography angiography (OCT-A) images.
METHODS
Full retinal vascular slab OCT-A images were obtained from 94 healthy participants. Capillary loss, at 1% increments up to 50%, was simulated by randomly removing capillary segments (1000 iterations of randomized loss for each participant at each percent loss). Thirteen quantitative metrics were calculated for each image: foveal avascular zone (FAZ) area, vessel density, vessel complexity index (VCI), vessel perimeter index (VPI), fractal dimension (FD), and parafoveal intercapillary area (PICA) measurements with and without the FAZ (mean PICA, summed PICA, PICA regularity, and PICA standard deviation [PICA SD]). The sensitivity of each metric was calculated as the percent loss at which 80% of the iterations for a participant fell outside of two standard deviations from the sample's normative mean.
RESULTS
The most used OCT-A metrics, FAZ area and vessel density, were not significantly different from normative values until 27.69% and 16.00% capillary loss, respectively. Across the remaining metrics, metric sensitivity ranged from 6.37% (PICA SD without FAZ) to 39.78% (Summed PICA without FAZ).
CONCLUSIONS
The sensitivity of vasculature metrics for detecting random capillary loss varies substantially. Further efforts simulating different patterns of capillary loss are needed for comparison. Additionally, mapping the repeatability of metrics over time in a normal population is needed to further define metric sensitivity.
TRANSLATIONAL RELEVANCE
Quantitative metrics vary in their ability to detect vascular abnormalities in OCT-A images. Metric choice in screening studies will need to balance expected capillary abnormalities and the quality of the OCT-A images being used.
Topics: Humans; Tomography, Optical Coherence; Benchmarking; Retinal Vessels; Fluorescein Angiography; Macula Lutea
PubMed: 37531114
DOI: 10.1167/tvst.12.8.2 -
Toxicology and Applied Pharmacology Jul 2023Nowadays, more and more new synthetic cannabinoids (SCs) appearing on the illicit market present challenges to analytical, forensic, and toxicology experts. For a better...
Nowadays, more and more new synthetic cannabinoids (SCs) appearing on the illicit market present challenges to analytical, forensic, and toxicology experts. For a better understanding of the physiological effect of SCs, the key issue is studying their metabolomic and psychoactive properties. In this study, our validated targeted reversed phase UHPLC-MS/MS method was used for determination of urinary concentration of 5F-MDMB-PICA, 4F-MDMB-BICA, and their primary metabolites. The liquid-liquid extraction procedure was applied for the enrichment of SCs. The pharmacological characterization of investigated SCs were studied by radioligand competition binding and ligand stimulated [S]GTPγS binding assays. For 5F-MDMB-PICA and 4F-MDMB-BICA, the median urinary concentrations were 0.076 and 0.312 ng/mL. For primary metabolites, the concentration range was 0.029-881.02* ng/mL for 5F-MDMB-PICA-COOH, and 0.396-4579* ng/mL for 4F-MDMB-BICA-COOH. In the polydrug aspect, the 22 urine samples were verified to be abused with 6 illicit drugs. The affinity of the metabolites to CB1R significantly decreased compared to the parent ligands. In the GTPγS functional assay, both 5F-MDMB-PICA and 4F-MDMB-BICA were acting as full agonists, while the metabolites were found as weak inverse agonists. Additionally, the G-protein stimulatory effects of the full agonist 5F-MDMB-PICA and 4F-MDMB-BICA were reduced by metabolites. These results strongly indicate the dose-dependent CB1R-mediated weak inverse agonist effects of the two butanoic acid metabolites. The obtained high concentration of main urinary metabolites of 5F-MDMB-PICA and 4F-MDMB-BICA confirmed the relevance of their routine analysis in forensic and toxicological practices. Based on in vitro binding assays, the metabolites presumably might cause a lower psychoactive effect than parent compounds.
Topics: Tandem Mass Spectrometry; Drug Inverse Agonism; Guanosine 5'-O-(3-Thiotriphosphate); Cannabinoids
PubMed: 37182749
DOI: 10.1016/j.taap.2023.116548 -
MedRxiv : the Preprint Server For... Jun 2023Pica has been largely understudied in general population samples. Pica occurs most often in childhood and appears more prevalent in individuals with autism and...
OBJECTIVE
Pica has been largely understudied in general population samples. Pica occurs most often in childhood and appears more prevalent in individuals with autism and developmental delays (DD). Pica occurrence in the general population is poorly understood due to few epidemiological studies.
METHOD
Data on 10,109 caregivers from the Avon Longitudinal Study of Parents and Children (ALSPAC) study who reported pica behavior at 36, 54, 66, 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 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
Pica is an uncommon behavior in childhood; however, children with DD or autism may benefit from pica screening and diagnosis between ages 36-115 months. Children who exhibit undereating, overeating, and food fussiness may also engage in pica behaviors.
PubMed: 37333309
DOI: 10.1101/2023.06.04.23290951 -
Neuropsychopharmacology : Official... Mar 2022Synthetic cannabinoid receptor agonists (SCRAs) are an evolving class of new psychoactive substances found on recreational drug markets worldwide. The indole-containing...
Synthetic cannabinoid receptor agonists (SCRAs) are an evolving class of new psychoactive substances found on recreational drug markets worldwide. The indole-containing compound, 5F-MDMB-PICA, is a popular SCRA associated with serious medical consequences, including overdose and hospitalizations. In vitro studies reveal that 5F-MDMB-PICA is a potent agonist at cannabinoid type 1 receptors (CB), but little information exists regarding in vivo pharmacology of the drug. To this end, we examined the in vitro and in vivo cannabinoid-like effects produced by 5F-MDMB-PICA and related 5F-pentylindole analogs with differing composition of the head group moiety (i.e., 5F-NNEI, 5F-SDB-006, 5F-CUMYL-PICA, 5F-MMB-PICA). In mouse brain membranes, 5F-MDMB-PICA and its analogs inhibited binding to [H]rimonabant-labeled CB and displayed agonist actions in [S]GTPγS functional assays. 5F-MDMB-PICA exhibited the highest CB affinity (K = 1.24 nM) and functional potency (EC = 1.46 nM), but head group composition markedly influenced activity in both assays. For example, the 3,3-dimethylbutanoate (5F-MDMB-PICA) and cumyl (5F-CUMYL-PICA) head groups engendered high CB affinity and potency, whereas a benzyl (5F-SDB-006) head group did not. In C57BL/6J mice, all 5F-pentylindole SCRAs produced dose- and time-dependent hypothermia, catalepsy, and analgesia that were reversed by rimonabant, indicating CB involvement. In vitro K and EC values were positively correlated with in vivo ED potency estimates. Our findings demonstrate that 5F-MDMB-PICA is a potent SCRA, and subtle alterations to head group composition can have profound influence on pharmacological effects at CB. Importantly, measures of CB binding and efficacy in mouse brain tissue seem to accurately predict in vivo drug potency in this species.
Topics: Animals; Cannabinoid Receptor Agonists; Cannabinoids; Indazoles; Mice; Mice, Inbred C57BL; Receptor, Cannabinoid, CB1; Structure-Activity Relationship
PubMed: 34802041
DOI: 10.1038/s41386-021-01227-8 -
Cureus Jul 2020Pica is an unusual condition in which patients crave and chew substances with no nutritional value. Ice pica (pagophagia) is commonly seen in patient with iron...
Pica is an unusual condition in which patients crave and chew substances with no nutritional value. Ice pica (pagophagia) is commonly seen in patient with iron deficiency. People chew ice cubes or add ice to their drinks to cool or refresh themselves, and they may not consider this as an abnormal behavior. Excessive ice chewing/eating can have significant health risks, including electrolyte abnormalities and metabolic disorders. We report a patient admitted to our hospital with severe hyponatremia and seizures due to iron deficiency-associated pagophagia. Ice pica leading to hyponatremia and seizure is not commonly seen in clinical practice. It was a challenging case and the patient was seen and investigated at outpatient clinic for polyuria, though an underlying cause was not identified. Patients may be secretive or reluctant to mention their pica habit. Studies have also shown that most physicians are unaware of pica and most cases can be easily missed.
PubMed: 32742885
DOI: 10.7759/cureus.9330 -
The Medical Journal of Malaysia Nov 2021While specific bedside examinations are known to be sensitive in identifying stroke among acute vestibular syndrome patients, complementary quantitative vestibular... (Review)
Review
While specific bedside examinations are known to be sensitive in identifying stroke among acute vestibular syndrome patients, complementary quantitative vestibular function testing can be helpful to quantify vestibular loss due to stroke. In contrast to peripheral vestibular dysfunction, diagnosis of central vestibular dysfunction can be challenging for unskilful clinicians. This article presents a comprehensive overview of quantitative vestibular function test findings such as the video head impulse test (vHIT), cervical vestibular evoked myogenic potentials (cVEMPs), ocular vestibular evoked myogenic potentials (oVEMPs), videonystagmography (VNG) and caloric test among stroke patients. Vestibulo-ocular reflex (VOR) gain is usually found normal among posterior inferior cerebellar artery (PICA) stroke patients but varies among anterior inferior cerebellar artery (AICA) stroke patients. Abnormal contralesional posterior semicircular canal VOR gain can be observed due to lesions in the medial longitudinal fasciculus (MLF). AICA and PICA stroke can impair cVEMPs, oVEMPs, and VNG (i.e., smooth pursuit and saccade functions). Strokes, particularly those involving the vestibular nucleus, including both upper, lower brainstem and cerebellum, can result in various abnormalities of smooth pursuit, saccade or calorics testing. The combined evaluations of VNG, vHIT, and VEMPs can be accurately used to complement and quantify bedside vestibular evaluation in diagnosing central vestibular dysfunction. In addition, as most studies were conducted amongst acute vestibular syndrome (AVS) patients, future studies that investigate the prevalence of vestibular dysfunction in recovering stroke patients are required.
Topics: Head Impulse Test; Humans; Reflex, Vestibulo-Ocular; Stroke; Vestibular Evoked Myogenic Potentials; Vestibular Function Tests
PubMed: 34806680
DOI: No ID Found -
Journal of Ethnopharmacology Jan 2024Xiaobanxia Decoction (XBXD), a traditional antiemetic formula, is effective in preventing chemotherapy-induced nausea and vomiting (CINV), but its underlying mechanism...
ETHNOPHARMACOLOGICAL RELEVANCE
Xiaobanxia Decoction (XBXD), a traditional antiemetic formula, is effective in preventing chemotherapy-induced nausea and vomiting (CINV), but its underlying mechanism has not been fully clarified.
AIM OF THE STUDY
To investigate whether the antiemetic mechanisms of XBXD against CINV is associated with the reduction of GSDME-mediated pyroptosis and the alleviation of gastrointestinal inflammation induced by cisplatin.
MATERIALS AND METHODS
We established the in vivo pica rat model and the in vitro small intestinal epithelial cell (IEC-6 cell) injury model by cisplatin challenge. The levels of ROS, IL-1β, IL-18, HMGB1 were measured by ELISA. The histopathological changes of gastrointestinal (GI) tissues were examined by HE staining. The expression and localization of GSDME in GI tissues were determined by IHC. The GSDME mRNA expression in GI tissues was determined by RT-PCR. The IEC-6 cell viability was detected by CCK-8. The morphology of IEC-6 cells was observed by optical microscope and scanning electron microscopy. Pyroptosis was examined using Hoechst33342/PI staining. The intracellular ROS levels were measured with the fluorescent probe DCFH-DA. The expression levels of JNK, p-JNK, Bax, Bcl-2, caspase-9, caspase-3 and GSDME in GI tissues and IEC-6 cells were determined by WB.
RESULTS
We found that the cumulative kaolin intake (pica behavior, analogous to emesis) significantly increased in cisplatin-treated rats, accompanied by significant inflammatory pathological changes of GI tissues. XBXD decreased the cumulative kaolin intake and alleviated GI inflammation in cisplatin-treated rats by inhibiting the activation of the ROS/JNK/Bax signaling pathway and by reducing GSDME-mediated pyroptosis. Additionally, cisplatin damaged IEC-6 cells by activating GSDME-dependent pyroptosis. XBXD reduced GSDME-mediated IEC-6 cell pyroptotic death by regulating the ROS/JNK/Bax signaling pathway.
CONCLUSIONS
This study suggested that GSDME-mediated pyroptosis greatly contributes to the occurrence of CINV, and suppressing GSDME-mediated pyroptosis is the important antiemetic mechanism of XBXD.
Topics: Rats; Animals; Pyroptosis; Cisplatin; Antiemetics; bcl-2-Associated X Protein; Reactive Oxygen Species; Kaolin; Pica; Antineoplastic Agents; Vomiting; Nausea; Inflammation; Caspase 3
PubMed: 37516392
DOI: 10.1016/j.jep.2023.116970