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Query: UMLS:C0000737 (abdominal pain)
31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Subacute lead encephalopathy due a chronic poisoning was present in a 6 year-old child. Neurologic features (coma, seizures, CSF abnormalities) began after 2 weeks of vomiting, abdominal pain and constipation. Diagnosis was confirmed by studies of porphyrin metabolism. Lead poisoning following pica in childhood has rarely been reported in France. Its pathogenesis, main features, diagnosis and treatment are reviewed.
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PMID:[Lead poisoning revealed by severe encephalopathy : pica does exist in France (author's transl)]. 731 73

Visceral larva migrans is a syndrome characteristically involving children with a history of pica, and usually presents with fever, abdominal pain, tender hepatomegaly, and hypereosinophilia. Hepatic granulomas of visceral larva migrans are rare in adults. We describe three adult patients with hepatic lesions which on histopathology demonstrated characteristic granulomas of visceral larva migrans. All patients had abdominal sonograms and two had additional MR scans of the liver. Both ultrasound and magnetic resonance imaging demonstrated characteristic appearances which have not been described previously (viz., ill-defined central necrotic areas surrounded by concentric thick walls and perifocal edema in the liver parenchyma).
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PMID:Hepatic granulomas due to visceral larva migrans in adults: appearance on US and MRI. 801 56

To determine the prevalence of intestinal parasitic infections in the residents of four Italian psychiatric institutions, we examined the stool specimens collected in triplicate from 238 residents, enrolled between May 1995 and May 1996. Besides, physician and staff nurses provided data about each resident by standardized questionnaires. Parasites were detected in the fecal samples from 128 patients (53.8%). However, in the stool specimens from 106 residents only non-pathogenic protozoa were found (82.8%). Trichuris trichiura ova, Giardia lamblia cysts and trophozoites, Cryptosporidium parvum oocysts, and Balantidium coli cysts were found in the fecal samples from 22 residents (9.2%). B. hominis was the most prevalent parasite. It was detected in the fecal specimens from 97 residents (40.8%). The so-called nonpathogenic amebae were detected in the fecal specimens from 65 residents, though, at the same time, there was no evidence of Entamoeba histolytica infection. Twelve residents (5.0%) showed intestinal colonization by nonpathogenic flagellates. All the subjects with T. trichiura infection were housed in the facility of Ancona. Parasites were found in fecal samples from all the 11 residents with behavioural aberrations, but only three of those suffering from intestinal pathogen infection associated to diarrhea. Statistical analyses revealed that the presence of pathogenic parasites in fecal specimens was significantly associated with diarrhea, nausea, vomiting, abdominal pain, fever, behavioural aberrations and nonpathogenic protozoa (p < 0.01), but did not demonstrate any other significant associations between these parasites and the other variables, such as pruritus, mucus or blood in the stools and presence of fecal leukocytes. On the other hand, the presence of nonpathogenic protozoa was significantly related to aberrations such as pica, geophagia, phytophagy, coprophagy, coprophilia and pathogenic parasites (p < 0.01). Data analyses revealed that both pathogenic and nonpathogenic parasites were significantly more common in institutionalized patients than in controls. The rare presence of clinical signs and symptoms in colonized patients represents an important public health problem, since the presence of asymptomatic carriers among residents with low hygienic conditions, raises concern of transmission of parasitic infections to professional staff and other residents. Since the eradication of parasitic colonization in residential facilities is hard to reach, an effective prevention is the only measure to deal with this public health problem.
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PMID:Epidemiologic features of intestinal parasitic infections in Italian mental institutions. 938 73

1. Blood lead measurements in samples collected from 660 London schoolchildren during 1991 to 1992 suggest that the blood lead values in children in the U.K. are decreasing. 2. Geometric mean values for blood lead were 0.18 (range 0.05-0.71) micromol/l [3.7 (1. 0-15.0) microgram/dl]. Analysis of variance showed differences between ethnic groups, sex and schools. An age-matched subset of 148 children was compared with 136 children from an earlier study in 1986 and 1987. Trend analysis of the geometric mean lead values showed a negative slope (b=-0.484, P<0.0001), with maximum values of 0.81, 1.00, 0.71 and 0.43 micromol/l (17, 21, 15 and 9 microgram/dl) for the years 1986, 1987, 1991 and 1992 respectively. 3. It is recommended that children in the U.K. being investigated for anaemia, pica, recurrent abdominal pain or a high-risk environment should have blood lead values measured and that the action level for blood lead in children should be decreased from 1.19 micromol/l to 0.48 micromol/l (from 25 microgram/dl to 10 microgram/dl). 4. Guidance is offered to clinicians and other health professionals investigating excessive lead exposure.
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PMID:Blood lead in U.K. children--time for a lower action level? 986 45

A seroepidemiology study using TES-ELISA was carried out in 1,020 children aged 1-12 years in the Hindagala Community Health Project, Sri Lanka. Toxocariasis seroprevalence was 43% with 16.6% showing high antibody levels. Unconditional logistic regression analysis showed 7-9 year olds to be at the highest risk (OR 3.0820; CI = 1.95-4.87). Dog ownership, especially puppies (OR 29.28; CI = 7.40-116.0), and geophagia-pica (OR 6.3732; CI = 3.87-10.50), were significant risk factors. Family clustering of toxocariasis was significant (chi2 = 88.000; p = 0.0001). Abdominal pain (45%), cough (30%), limb pain (23%) and skin rashes (20%) were significantly associated with seropositivity indicating that toxocariasis causes covert morbidity. These findings are, overall, applicable to other areas in Sri Lanka. However, in the dry zone, survival of infective eggs in the soil could be affected by the climate while more importantly, in agricultural areas with a high buffalo population, Toxocara vitulorum could account for human toxocariasis. Using a species specific double sandwich ELISA based on 57 kDa protein of T. canis ES antigen, it is demonstrated that 91% of the seropositives were due to T. canis. Thus along with rabies and dirofilariasis, toxocariasis is an important zoonotic health hazard from dogs in Sri Lanka and prevention is indicated.
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PMID:A seroepidemiological study of toxocariasis and risk factors for infection in children in Sri Lanka. 1297 8

Whereas small gastric bezoars may be removed endoscopically, large bezoars traditionally are removed at laparotomy. We describe a 33-year-old mentally retarded woman with pica syndrome who had experienced episodes of upper abdominal pain and distension of 10 months duration. Gastroscopy showed a large bezoar in the stomach, and attempted endoscopic removal was unsuccessful. The patient underwent laparoscopic extraction of the bezoar, which proved to be an ingested glove. She made an uneventful recovery and was discharged home on postoperative day 1. She had no wound complications, and her symptoms had not recurred at a 3-month follow up assessment. The operative technique is described, and the merits of the laparoscopic approach are discussed.
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PMID:Laparoscopic removal of a large gastric bezoar in a mentally retarded patient with pica. 1576 58

A 37-year-old man was admitted to hospital after complaining of abdominal pain for the past two weeks. On admission the abdominal radiograph showed multiple radio-opaque flecks dispersed throughout the gastrointestinal tract. Blood testing showed hemoglobin level 8.7 g/dL and a blood lead level of 112.4 microg/dL. The family interview revealed that the patient had pica-like behavior since childhood. He was a site foreman and had been ingesting pieces of roofing plates for a few weeks. The patient was treated with laxatives and CaNa(2)EDTA therapy was initiated. The blood lead level then dropped to 69.9 microg/dL. The patient received two subsequent courses of oral succimer and the blood lead level decreased to 59 microg/dL 21 days after the first course. The follow-up abdominal X-ray 20 days after the first examination was normal. Four months later, an outpatient follow-up visit showed a blood lead level within normal limits (14.5 microg/dL) and a psychiatric follow-up was initiated. Lead poisoning following the ingestion of lead-containing foreign bodies is particularly rare in adults, while it is sometimes observed in children. Pica behavior is a well-identified risk factor of lead intoxication in children but is quite exceptional in adults, where it is usually considered to be a psychiatric condition. Other unusual sources of lead poisoning include the ingestion of lead bullets, ceramic lead glaze or glazed earthenware, lead-contaminated candies, ethnic or herbal remedies.
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PMID:Lead poisoning following ingestion of pieces of lead roofing plates: pica-like behavior in an adult. 1790 91

The aim of this study was to assess the seroprevalence of human toxocariasis in three Andean communities from the Northeast of Lima, Peru. A total of 303 subjects including children and adults were studied and blood samples were collected to detect anti-Toxocara antibodies by ELISA-IgG test and by hematological examination; stool samples were collected also for parasitological examination. The overall seroprevalence of toxocariasis observed in the total population was 20.46%, with a significant high proportion in children from one to 10 years old (p = 0.034). Among the subjects with positive serology, 32.26% of them had respiratory disturbances, 22.58% hepatomegaly, 17.74% ocular signs or symptoms, 14.51% abdominal pain, 9.68% neurological involvement, and 4.84% cutaneous signs, but none of these clinical features were associated to a positive serology by multivariate analysis. Furthermore, 79.03% of seropositive subjects also harbored at least one intestinal parasite, which was associated to a positive serology (p < 0.05). The presence of pets within the houses, a previous history of pica or geophagia and the use of public places were also present in this population, but only the latter was associated to the serology (p < 0.05). In conclusion, clinical, serological, and epidemiological evidences for larval Toxocara infection were found in the studied population.
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PMID:Seroprevalence of human toxocariasis in Andean communities from the Northeast of Lima, Peru. 2030 52

The etiology of pica, the purposive consumption of non-food substances, is not understood, despite its ubiquity among gravidae. We examined correlates of pica in a representative obstetric population (n = 2,368) on Pemba Island, Zanzibar, Tanzania to examine proposed etiologies. Cross-sectional data were collected on socioeconomic characteristics, food intake, geophagy (earth consumption), amylophagy (raw starch consumption), anthropometry, iron status, parasitic burden, and gastrointestinal morbidities. Amylophagy was reported by 36.3%, geophagy by 5.2%, and any pica by 40.1%. There was a strong additive relationship of geophagy and amylophagy with lower hemoglobin (Hb) concentration and iron deficiency anemia. By multivariate logistic regression, any pica was associated with Hb level (odds ratio [OR] = 0.76, 95% confidence interval [CI] = 0.72-0.81), nausea (OR = 1.45, 95% CI = 1.20-1.73), and abdominal pain (OR = 1.22, 95% CI = 1.01-1.48). These striking results indicate that the nature of the relationship between pica, pregnancy, gastrointestinal distress, and iron deficiency anemia merits further investigation.
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PMID:Association of pica with anemia and gastrointestinal distress among pregnant women in Zanzibar, Tanzania. 2059 93

We report a classical presentation of trichobezoar in an 8 year old girl who was referred for consultation querying a probable abdominal neoplasm in the left upper quadrant. A large mobile mass was palpable in the left upper quadrant extending toward the umbilicus. Of note, she also had symptoms of recurrent abdominal pain, nausea, vomiting and halitosis. Although a rare occurrence, trichobezoar must be considered as a differential diagnosis in a patient who had a history of pica, presenting with an abdominal mass.
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PMID:Hairball--a case of mistaken identity. 2084 2


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