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Pregnancy
Published in Judy More, Infant, Child and Adolescent Nutrition, 2021
Changes in taste, cravings and appetite may also be related to hormonal changes or due to the removal of energy substrates from maternal blood by the fetus. Unless they alter the balance of a nutritious diet they do not present a problem. Pica is a term given to the craving of non-food substances, such as soap, chalk and coal.
Answers
Published in Samar Razaq, Difficult Cases in Primary Care, 2021
Lead poisoning is rare in the UK. Whereas acute poisoning is an emergency, chronic lead poisoning may present with non-specific symptoms such as constipation, irritability, headaches, behavioural problems and abdominal pain. The most common sources of lead exposure in children are deteriorating paint in old houses, contaminated dust and soil and lead pipes in unrefurbished old houses. A history of pica should be sought where lead toxicity is suspected, although blood lead concentrations of 20 µg/dL or greater can be achieved without frank pica. The aim is to bring the blood lead level to below 10 µg/dL. However, recent opinion (Binns, et al., 2007) seems to suggest that harm to the child may occur at lower levels also. For blood lead concentrations below 45 µg/dL, treatment is not always necessary and may just involve regular review and removal of the hazardous source of lead. Higher levels necessitate oral or parenteral chelation therapy.
Feeding/Eating Problems in Young Children
Published in Cathy Laver-Bradbury, Margaret J.J. Thompson, Christopher Gale, Christine M. Hooper, Child and Adolescent Mental Health, 2021
Liz McCaughey, Sue Evans, Margaret J.J. Thompson
It is normal for infants and young children to mouth, and occasionally eat, strange things, but pica is when a child regularly and excessively eats inappropriate substances, e.g. soil, paper, wood, cloth or paint. Pica has many causes, including adverse environmental circumstances and emotional distress. It may be associated with distorted developmental patterns and learning difficulty. Iron-deficiency anaemia may result, and lead levels may be elevated. This used to be associated with lead-containing paints, but fortunately this is seen much less frequently now. Lead levels should be measured to exclude lead poisoning and its sequelae. Management of pica will depend on the nature of the problems but should never be ignored
Ameliorative effects of nutritional minerals on lead-induced hematological alterations in male Wistar albino rats
Published in Drug and Chemical Toxicology, 2022
Herman Sunil Dsouza, Geraldine Menezes, Venkatesh Thuppil
Lead inhibits δ-ALAD resulting in the accumulation of its substrate δ-ALA. The majority of lead in erythrocytes, binds to δ-ALAD, explaining several phenomena observed in lead toxicity (Bergdahl et al.1997, Gonick 2011). The urinary δ-ALA can be used as a biological marker for lead exposure, however, it is a relatively insensitive measure of the early biological effect of lead toxicity since its level of excretion does not increase drastically until the PbB exceeds 40 µg/dl (Makino et al.2000). In addition to lead inhibiting the δ-ALAD activity, even gene polymorphism can cause certain individuals to be more susceptible to the toxic effects of lead. ALAD-2 allele has been reported to show higher susceptibility for the retention lead in the blood (Mani et al.2018). Rats receiving 50 mg/kg lead nitrate intraperitoneally for 5 consecutive days once daily reported a 50% reduction in δ-ALAD activity (Pande et al.2001). Jangid et al. (2012) reported a decrease in δ-ALAD activity in individuals with an increase in PbB levels. A significant increase in the δ-ALAU excretion was reported in workers occupationally exposed to lead (Oishi et al. 1996, Ahmed et al.2008, Kalahasthi and Barman 2018). Abraham et al. (2002) reported a 24% increase in δ-ALAU levels in a 1-year-old child, lead-poisoned due to pica.
An Evaluation of Differential Reinforcement in the Treatment of Pica
Published in Developmental Neurorehabilitation, 2020
Colin Muething, Nathan A. Call, Seth Clark
Pica is defined as the persistent eating of nonnutritive, nonfood substances1 including soil, fibers, plastic, pencils, cigarette butts, and toiletries.2–6 This behavior may cause intestinal obstruction or perforation, toxicity, infection, and malnutrition7 such that even a single instance of pica has the potential to be fatal.8,9 Prevalence estimates suggest that 21.8% of individuals with developmental disabilities engage in pica.10
Rapunzel syndrome (gastric trichobezoar), a rare presentation with generalised oedema: case report and review of the literature
Published in Paediatrics and International Child Health, 2019
Islam Nour, Mona Abd Alatef, Ahmed Megahed, Sohier Yahia, Yahya Wahba, Abd Elazeez Shabaan
Trichobezoars are commonly found in adolescent females, with only four case reports in males [2,4–6]. Of the 78 reports of paediatric RS, only five were ≤4 years old [4,7–10]. Classically, trichobezoars are formed owing to trichophagia which can be related to psychiatric conditions [11] and mental retardation [12], which was not the case in this patient. Pica owing to iron deficiency anaemia and childhood neglect are possible explanations [13].