Pica as obsessive-compulsive disorder.
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Changes in eating and weight are not uncommon in dementia although they have yet to be systematically studied. These changes are of clinical importance since they can seriously affect patients' physical health and they are often a major problem for carers. These changes are also of theoretical interest since certain abnormalities may be a direct expression of specific brain pathology. Studying these changes in eating and weight may therefore further our understanding of certain of the pathological processes underlying dementia and suggest new approaches to the management of these problems.
A 74-year-old man who had been institutionalized for severe multiinfarct dementia was found dead in bed. He had a history of compulsive ingestion of food and other materials, including feces. At autopsy, a 65-g bolus of fecal material was impacted within the laryngopharynx, occluding the inlet of the larynx. This case demonstrates an unusual coprophagic variant of cafe coronary syndrome and emphasizes that demented individuals with pica are at risk of sudden death from ingestion of a wide variety of materials, including, but not limited to, food.
The daily rearrangement of a profoundly retarded child's routine shower was effective in eliminating his low-frequency faeces smearing and coprophagic behaviour during the late afternoon/early evening part of the day. The effects appeared to generalise such that both types of behaviour were reduced at other times of the day and night. These results are discussed in terms of a social learning framework. A model for analysing the motivations and reinforcing conditions for rectal digging, coprophagy, and smearing faeces is also presented.
This paper presents the case of a female patient in a special hospital who engaged in faecal smearing whilst in seclusion. A management investigation followed a complaint by a Nurse Manager regarding the reluctance of staff to clean the room whilst the patients remained disturbed. The investigation team adopted a triangulated method of interviews, literature review, survey and case presentations to study the issues involved. The results presented here suggest the emergence of similar issues from both the interview commentary and the tabulated data from the survey. There appears an intricate and complex dilemma facing those managing situations involving scatolic behaviour. There are issues of concern from diverse organizational settings that overlap between those persons who engage in scatolia who may be deemed mentally impaired, psychiatrically disordered, or protest behaviour.
Dental patients with severe and profound mental impairments may engage in behaviors that adversely affect their oral health. Based on experience in a residential care facility, this report sensitizes dental practitioners, who are unfamiliar with the problems of these patients, to consequences of these behaviors.
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Whereas food has always received much attention in conversation, commerce, and the literature, the subject of feces has been comparatively neglected. To fill this lacuna, a small book on comparative coprology was recently published (Lewin 1999). The present article aims to supplement this book with a review of overlooked or new items relating to biological and medical aspects of coprology, notably chemical and microbial components of human and animal feces, their uses as fertilizers, and a few other sociological impacts.
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As part of a longitudinal, community-based study of diarrhoeal morbidity in a peri-urban community in Lima, Peru, a household survey was administered to ascertain possible risk factors, based on transmission routes, for diarrhoeal incidence. Socioeconomic information was also obtained in the survey and a composite socioeconomic status (SES) indicator was created based on four variables: income (wealth), ownership of 4 functioning electrical household appliances, community participation, and house construction. Both transmission factors and the SES indicator were analysed for their effects on diarrhoeal incidence using both bivariate and multivariate methods. The SES indicator, method of water storage, if the child was seen eating faeces or soil were all significantly associated with diarrhoeal incidence. In a final logistic model, water storage, location of defecation for children, child eating soil or faeces, and age, demonstrated significant results. Children in households with water stored in containers without a faucet were twice as likely to have a high incidence of diarrhoea (greater than 7 episodes/child/year). The SES indicator was not significant in the logistic model, but high SES was associated with whether or not the child was reported as having been seen eating faeces or soil and with non-use of latrines by adults. Also low SES households were more likely to have better water storage methods. Therefore, it would seem that (SES) does not independently determine diarrhoeal incidence, but rather may be functioning through these transmission factors to affect diarrhoeal incidence.
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