pica and Weight-Gain

Nutrition assessment and counseling are integral components of preconception and prenatal care. The average-size woman should gain between 11.25 and 15.75 kg (25 and 35 lb) during a normal pregnancy. Some factors identify the pregnant woman with a nutrition risk. Vitamin and mineral supplementation should be based on a dietary assessment. Common discomforts of pregnancy frequently can be managed with dietary modification and safe pharmacotherapeutics. The coordinated efforts of health care providers, registered dietitians, the Women, Infants, and Children (WIC) nutrition program, local health departments and Cooperative Extension Service offices can provide appropriate nutrition assessment, education and intervention.

Topics: Caffeine; Constipation; Female; Humans; Lactose Intolerance; Nausea; Nutrition Assessment; Nutritional Physiological Phenomena; Pica; Pregnancy; Pregnancy Complications; Sodium, Dietary; Substance-Related Disorders; Vomiting; Weight Gain

Buprenorphine is commonly used as (part of) postoperative analgesic treatment with dosage dependent side-effects such as pica behaviour. No strict consensus exists about the optimal dosing interval of buprenorphine, as its duration of action has been described as being in the range of 6-12 h. In this study, dosing intervals of 8 h (thrice-a-day) and 12 h (twice-a-day) for buprenorphine in a multimodal analgesic strategy (concurrent administration of a non-steroidal anti-inflammatory drug) were compared on food intake, weight and side-effects (gnawing on plastic Petri dishes and growth rate, indicative of pica behaviour) in rats. The food intake and weight of both intervals were comparable, as the animals from the twice-a-day group did not lose more weight or consumed less food during the analgesic period. The rats from the thrice-a-day group suffered from more side-effects, as the growth rate was decreased and more plastic was gnawed on. It is recommended to carefully evaluate analgesic and side-effects when using buprenorphine. When side-effects are observed, the possibility of increasing the dosing interval of buprenorphine should be explored. In this study, increasing the dosing interval of buprenorphine in a multimodal analgesic regimen resulted in reduced unwanted side-effects, without increasing weight loss or decreasing food intake. Although this is suggestive of provision of comparable analgesia, future studies including more pain-related readout parameters to assess the effect of the dosing interval on analgesic efficacy are recommended.

Topics: Analgesics, Opioid; Animals; Anti-Inflammatory Agents, Non-Steroidal; Buprenorphine; Drug Therapy, Combination; Electrodes, Implanted; Feeding Behavior; Injections, Subcutaneous; Male; Meloxicam; Neurosurgical Procedures; Pain, Postoperative; Pica; Postoperative Care; Rats; Rats, Wistar; Thiazines; Thiazoles; Time Factors; Weight Gain

Maintaining fluid balance in haemodialysis patients is important because of the adverse effects of excessive interdialytic weight gain. This often requires fluid restriction that patients often struggle with. We report a case of a 31-year-old female diabetic patient on haemodialysis with repeated excessive interdialytic weight gains despite fluid restriction and dry weight adjustment. It was subsequently discovered that she devised an unusual, albeit unsuccessful, strategy of eating the polyurethane foam from her dialysis chair while increasing her fluid intake hoping that it would absorb excess water in the gut! This under-diagnosed phenomenon known as pica has been reported in renal patients with substances such as ice, clay and baking soda.

Topics: Adult; Diabetes Mellitus, Type 1; Female; Humans; Pica; Polyurethanes; Renal Dialysis; Weight Gain

Soil intake may be the most prominent source of environmental contaminants for free range and organic hens, but there are no quantitative data concerning soil intake by domestic hens. Consumption of soil of 14-32 g a day can be estimated from literature, but such a dilution of nutrient intake seems incompatible with high productivity. In this study laying hens were fed pelleted diets with 0%, 10%, 20%, 25% and 30% of sand addition to determine its effect on productivity. Feed intake, feed and nutrient (feed minus sand) conversion ratio, egg production, egg weight and body weight gain were measured over a 4-week period. Acid insoluble ash concentration in the faeces was measured to determine the accuracy of estimating the soil ingestion by the soil-ingestion equation for wildlife as a way to determine soil ingestion of free range and organic hens under practical circumstances. The hens were able to compensate the dilution of the diet with 20%, 25% and 30% of sand by increasing their feed intake. Feed intake increased significantly and feed to egg conversion ratio decreased significantly with increasing sand levels in the diet. The nutrient to egg conversion ratio of the diet without sand tended to be worse than for the diets with sand, presumably due to the total absence of coarse material in the diet. There were no differences in egg production and egg weight between hens fed the different diets but body weight gain was significantly lower for the hens fed the diets with 20%, 25% and 30% of sand. Estimation of sand ingestion was done by the soil-ingestion equation for wildlife. Provided that the actual dry matter digestibility coefficient of the nutrient part of the diet is taken into account, estimating the soil ingestion according to the soil-ingestion equation for wildlife seems an appropriate way to determine soil ingestion for free range and organic hens under practical circumstances.

Topics: Animal Feed; Animal Nutritional Physiological Phenomena; Animals; Chickens; Digestion; Dose-Response Relationship, Drug; Eating; Female; Oviposition; Pica; Random Allocation; Silicon Dioxide; Weight Gain