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Objectives: To evaluate the impact of cholecalciferol (D3) supplementation using clinical and paraclinical variables in patients with RA and vitamin D insufficiency and deficiency. Methods: A randomized, double-blind, placebo-controlled study included patients from 5 to 40 years with a diagnosis of RA and vitamin D insufficiency and deficiency. They were supplemented for 8 weeks with 4000 or 5000 IU, depending on age. Total nasal symptoms score (TNSS) was measured monthly and 25(OH)D3 levels at baseline and at the end of the study. Results: A total of 31 patients were included, with a mean age of 18.19 years. In the active group, there was a significant improvement in symptomatology with respect to the TNSS score and an increase in serum vitamin D levels (p < 0.01). There were no adverse reactions with cholecalciferol or placebo. Conclusions: Supplementing patients with vitamin D3, at the evaluated dose, together with conventional treatment for allergic rhinitis results in symptoms and quality of life improvement in patients with this disease. [ABSTRACT FROM AUTHOR]

Background: Vitamin D deficiency in critically ill patients is associated with poor outcomes, and vitamin D supplementation is recommended for patients with chronic kidney disease. Whether acute kidney injury (AKI) is associated with altered Vitamin D metabolism is unknown. We aimed to compare the longitudinal profiles of serum 25(OH)D and 1,25(OH)2D concentrations in critically ill patients with and without moderate to severe AKI and explore the impact of renal recovery and parathyroid hormone (PTH). Methods: In this prospective, observational study in two centres in the UK, critically ill patients with and without AKI underwent serial measurement of serum 25(OH)D and 1,25(OH)2D and plasma PTH concentrations for 5 days. Linear mixed model analysis and sensitivity analyses were performed. Results: Serial data of 137 patients were analysed. Seventy-one patients had AKI stage II/III of whom 23 recovered kidney function during the 5-day study period; 66 patients did not have AKI at enrolment of whom 14 developed new AKI. On day of enrolment, patients' serum 25(OH)D concentrations were low (median 18 nmol/L) but there was no significant difference between patients with and without AKI. Median serum 1,25(OH)2D levels were significantly lower in patients with AKI II/III (41 pmol/L [IQR 26, 58]) compared to similarly unwell patients without AKI (54 pmol/L [IQR 33, 69]) during the 5-day period. Recovery of kidney function in patients with AKI was associated with a rise in 1,25(OH)2D concentrations. Plasma PTH results were impacted by serum calcium and magnesium levels but not associated with 1,25(OH)2D levels. Conclusions: Critically ill patients with moderate-to-severe AKI have significantly lower serum 1,25(OH)2D concentrations than similarly sick patients without AKI but there was no difference in serum 25(OH)D concentrations. Recovery of AKI was associated with a rise in serum 1,25(OH)2D concentrations. More research is needed to investigate the health benefits and safety of supplementation with active vitamin D in critically ill patients with moderate-to-severe AKI. Trial registration Clinicaltrials.gov (NCT02869919), registered on 16 May 2016. [ABSTRACT FROM AUTHOR]

Objetivos: Evaluar el impacto de la suplementación con colecalciferol (D3) mediante variables clínicas y paraclínicas en pacientes con RA e insuficiencia y deficiencia de vitamina D. Métodos: Estudio aleatorio, doble ciego, placebo controlado, en el que se incluyeron pacientes de 5 a 40 años, con diagnóstico de RA e insuficiencia y deficiencia de vitamina D. Fueron suplementados con 4000 o 5000 UI, dependiendo de la edad, durante 8 semanas. Mensualmente se midió la puntuación total síntomas nasales (TNSS) y las concentraciones de 25(OH)D3 al inicio y al final del estudio. Resultados: Se incluyeron 31 pacientes, con una edad promedio de 18.19 años. En el grupo activo existió una mejoría significativa en la sintomatología respecto a la puntación de TNSS y un incremento en los niveles séricos de vitamina D (p < 0.01). No se presentaron reacciones adversas con la ingesta de colecalciferol o placebo. Conclusiones: Suplementar a los pacientes con vitamina D3, a la dosis evaluada, junto con el tratamiento convencional para la rinitis alergica resulta en una mejoría sintomática y en la calidad de vida de los pacientes con esta enfermedad. Palabras clave: Rinitis alérgica, Vitamina D, Placebo, Colecalciferol, Suplementación.

Introduction: Vitamin D is a fat-soluble vitamin used by the body for bone development and maintenance through the increased absorption of calcium, magnesium, and phosphate. Vitamin D deficiency, or insufficiency, has been identified as a global problem that affects at least one billion people worldwide. The presence of muscle weakness, falls, and fractures associated with vitamin D deficiency is frequent in the elderly; however, its impact on young people is little known. Clinical Case: We present the case of a 34-year-old male with no sun exposure and a history of consuming alcoholic beverages, presenting with progressive muscle weakness and a non-traumatic bilateral humeral fracture associated with vitamin D deficiency. We also describe the diagnostic-therapeutic approach as well as review the literature and its current importance. Conclusions: Vitamin D deficiency is common and often unrecognized, yet it can play an important role in exacerbating underlying pathologies, especially in vulnerable populations. Proximal humerus fractures are common among elderly patients, but not in young people, and less in the absence of trauma. In low-energy fractures without obvious traumatic mechanisms, greater prevalence has been observed in patients with low vitamin levels.

Introdução: A vitamina D é uma hormona que atua diretamente na saúde óssea, no crescimento celular saudável, na imunidade, na musculatura, no metabolismo e noutros sistemas, como o sistema cardiovascular e o sistema nervoso. A sua formação implica uma primeira hidroxilação no fígado, pela 25-hidroxilase, a 25-OHD. Assim, o nível sérico de 25-OHD é o melhor indicador do conteúdo corporal de vitamina D. Um número crescente de estudos tem vindo a associar a insuficiência de vitamina D com aumento do risco para diversas patologias, como doenças cardiovasculares. Objetivos: Analisar os valores de Vitamina D de indivíduos provenientes de diferentes ambientes – espaços Urbanos e espaço de Ocupação Predominantemente Rural – e estudar o impacto da zona demográfica nos níveis dessa vitamina. Material e Métodos: Foi realizado um estudo descritivo transversal, com registos de 31208 indivíduos, dos quais 583 são habitantes de zonas rurais e 30625 de zonas urbanas. Em todas as amostras foi determinado o nível sérico de 25-OHD no período do inverno (entre 1 de janeiro a 31 de março de 2022). Posteriormente, analisaram-se os resultados e estratificaram-se por sexo, idade, proveniência e valor de Vitamina D. Resultados: No total, em ambiente urbano, 54,9% dos indivíduos apresentavam níveis deficientes de vitamina D e 27,9% níveis insuficientes. Em ambiente rural, 62,0% dos indivíduos apresentaram níveis deficientes e 25,4% níveis insuficientes. Na classe dos 19-30 anos, os níveis normais de vitamina D corresponderam a 7,07% 7,0% em meio rural e urbano, respetivamente, aumentando para 8,2% e 10,4%, respetivamente, em indivíduos entre os 31-50 anos. Já dos 51-65 anos, os níveis normais corresponderam a 9,3% em ambiente rural e 12,8% em ambiente urbano. Conclusões: Conclui-se que os défices de vitamina D ocorrem maioritariamente na população jovem, quer em ambiente rural, quer em ambiente urbano. O facto da população a partir dos 50 anos ter níveis normais poderá estar relacionado o uso de suplementação, dado que os valores inferiores aos normais são considerados como um obstáculo ao envelhecimento saudável.

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction. Modern studies indicate the therapeutic effect of vitamin D (VD) in chronic pain conditions, but there is no data on the use of VD in chronic tension type headache (CTTH) treatment.Objective: comparative evaluation of the effectiveness of various options for preventive treatment of CTTH: the use of colecalciferol, standard therapy of the disease and a combination of these methods.Materials and methods. 125 women with CTTH and hypovitaminosis D were treated in the study. The frequency, duration and intensity of headache (HF, HD and HI, respectively), HIT index, frequency of analgesics taking, pericranial muscle dysfunction were evaluated. The VD level was measured by the concentration of 25-hydroxyvitamin D [25(OH)D]. The patients received differentiated therapy for 16 weeks: group 1 – colecalciferol, group 2 – amitriptyline, group 3 – a combination of these medicines. Results. In group 1, HF, HD, HIT-index and the frequency of analgesics taking decreased, all p ≤ 0.001. In groups 2 and 3, the values of all CTTH-parameters decreased, all p

Objetivo: Proporcionar recomendaciones basadas en la evidencia sobre la prevención y el tratamiento del déficit de vitamina D. Métodos: Un grupo de trabajo multidisciplinar formado por 10 miembros de la Sociedad Española de Investigación Ósea y del Metabolismo Mineral (SEIOMM), formuló las preguntas clínicas de interés. Posteriormente, se realizó una revisión sistemática de la literatura en MEDLINE (PubMed), EMBASE y Cochrane sobre la evidencia disponible para cada una de las preguntas planteadas. Se incluyeron artículos publicados en inglés o español entre el 15 julio 2016 y 31 de diciembre de 2020. Para establecer la fuerza de las recomendaciones y el grado de evidencia se empleó el sistema Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). Tras la formulación de las recomendaciones, estas se discutieron de manera conjunta en el grupo de trabajo y fueron ratificadas por todos los socios de la SEIOMM. Resultados y conclusiones: El presente documento establece una serie de recomendaciones sobre las concentraciones óptimas y cribado del déficit de 25-hidroxivitamina D, los requerimientos de vitamina D en diferentes poblaciones, la exposición solar, y las estrategias de suplementación en pacientes con déficit.

Aims: The prevalence of vitamin D deficiency is high in children with chronic kidney disease (CKD). However, current dosing recommendations are based on limited pharmacokinetic (PK) data. This study aimed to develop a population PK model of colecalciferol that can be used to optimise colecalciferol dosing in this population. Methods: Data from 83 children with CKD were used to develop a population PK model using a nonlinear mixed effects modelling approach. Serum creatinine and type of kidney disease (glomerular vs. nonglomerular disease) were investigated as covariates, and optimal dosing was determined based on achieving and maintaining 25‐hydroxyvitamin D (25(OH)D) concentration of 30–48 ng/mL. Results: The time course of 25(OH)D concentrations was best described by a 1‐compartment model with the addition of a basal concentration parameter to reflect endogenous 25(OH)D production from diet and sun exposure. Colecalciferol showed wide between‐subject variability in its PK, with total body weight scaled allometrically the only covariate included in the model. Model‐based simulations showed that current dosing recommendations for colecalciferol can be optimised using a weight‐based dosing strategy. Conclusion: This is the first study to describe the population PK of colecalciferol in children with CKD. PK model informed dosing is expected to improve the attainment of target 25(OH)D concentrations, while minimising the risk of overdosing. [ABSTRACT FROM AUTHOR]

An increasing number of studies are analyzing the relationship between serum vitamin D levels and the development of sensitization and allergic diseases in genetically predisposed individuals, as well as the impact of vitamin D supplementation. This article reviews the literature on this subject. Clinical trials, meta-analyses and systematic reviews consulted in PubMed, EMBASE, Scopus, Ovid, Wiley Online Library, Springer, Cochrane and manual resources were included, with the keywords: vitamin D, 25 hydroxyvitamin D, cholecalciferol, asthma, rhinitis, allergy, 25-OH-D, 1,25 hydroxyvitamin D, supplementation. The results show a positive linear trend, however, differ. We should keep in mind that in the studies there is heterogeneity of population groups and associated factors, which may modify such studies. It is necessary to increase research to clarify this relationship and to have successful interventions from the patient's approach to the strengthening of pharmacological and immunological treatment of allergic patients with these diseases. [ABSTRACT FROM AUTHOR]

Objetivo: A vitamina D tem muitos efeitos pleiotrópicos cardiovasculares e o seu défice parece estar associado a múltiplas doenças cardiovasculares. É controversa a relação entre a suplementação de vitamina D e os valores tensionais de doentes hipertensos. O objetivo desta revisão é conhecer a evidência da associação entre a suplementação de vitamina D em adultos hipertensos e controlo dos seus valores tensionais. Fontes de dados: National Guideline Clearinghouse, National Institute for Health and Care Excellence, Canadian Medical Association Practice Guidelines Infobase, The Cochrane Library, Database of Abstracts of Reviews of Effectiveness, Bandolier, Evidence-Based Medicine Online e PubMed. Métodos de revisão: Foi realizada uma pesquisa de meta-análises (MA), revisões sistemáticas, ensaios clínicos aleatorizados e controlados (ECA) e normas de orientação clínica publicados entre junho de 2010 e junho de 2020, em português e inglês, utilizando os termos MESH Cholecalciferol, Blood pressure e Vitamin D. Para estratificar o nível de evidência dos estudos e força de recomendação foi utilizada a Strength of Recommendation Taxonomy, da American Academy of Family Physicians. Resultados: Foram encontrados 123 artigos e selecionados, por cumprirem os critérios de inclusão, duas MA e quatro ECA. As MA apresentam resultados concordantes: não houve evidência de diminuição da PA com significância estatística aquando de suplementação com colecalciferol; no entanto, esta foi demonstrada quando se ajustaram as intervenções para grupos específicos, como doentes com mais de 50 anos, obesidade ou doses de suplementação elevadas (> 800UI/dia). Relativamente aos ECA, apenas dois deles encontraram relações com significância estatística, enquanto os restantes dois não conseguiram demonstrar uma relação causal. Conclusões: A evidência da associação entre suplementação com colecalciferol a doentes hipertensos e o melhor controle tensional não é clara. Alguns estudos conseguiram demonstrar que em populações específicas parece atuar como adjuvante no tratamento da HTA (SORT C).

Cada vez son más los trabajos que analizan la relación de los niveles séricos de vitamina D y el desarrollo de sensibilizaciones y enfermedades alérgicas en los individuos con predisposición genética, así como el impacto de su suplementación. El presente artículo efectúa una revisión de la literatura acerca de este tema. Se incluyeron ensayos clínicos, metaanálisis y revisiones sistemáticas consultadas en PubMed, EMBASE, Scopus, Ovid, Wiley Online Library, Springer, Cochrane y recursos manuales, con las palabras clave: vitamina D, 25 hidroxivitamina D, colecalciferol, asma, rinitis, alergia, 25-OH-D, 1,25 hidroxivitamina D, suplementación. Los resultados muestran una tendencia lineal positiva; sin embargo, algunos difieren. Debemos tener en mente que en los estudios existe heterogeneidad de los grupos poblacionales y los factores asociados, lo que puede modificarlos. Es necesario incrementar las investigaciones para clarificar esta relación y tener intervenciones exitosas desde el abordaje del paciente hasta el fortalecimiento del tratamiento farmacológico e inmunológico de los pacientes alérgicos con estas enfermedades.

Genital endometriosis (GE) is a widespread multifactorial disease thus making it necessary to carry on studying its pathogeny in order to work out target therapy techniques. Studying vitamin D role in GE pathogeny is a new promising research trend. 25(ОН)D level was determined in peripheral blood (PB) of 440 patients with GE and in peritoneal fluid (PF) – in 49 GE patients; the same test in PB was performed in 30 patients of the control group with the ovulatory menstrual cycle and no gynecologic pathology. 129 patients with GE, as well as 82 women of the control, underwent examination of vitamin D receptor (VDR) polymorphism gene in BsmI, FokI, and TaqI polymorphic locus. We examined vitamin D receptor expression in the eutopic and ectopic endometrium in 32 women with GE and in the endometrium of 20 women from the control group. We also compared the efficacy of combined therapy involving colecalciferol to the standard hormone modulating therapy. It was established that the prevalent GE forms are characterized by lower 25(ОН)D levels both in PB and in PF. It was also found that G/G genotype of VDR BsmI gene polymorphic variant 1.9 times increases GE occurrence risk. VDR expression was authentically lower in the ectopic endometrium compared to the eutopic endometrium. Patients with GE show no VDR expression cyclic variations in the endometrium which is contrary to the control. Therapy in combination with colecalciferol promotes a more expressed decrease of endometriosis-associated pain syndrome and psycho-emotional stabilization of GE patients compared to the standard hormone modulating therapy. Vitamin D deficiency plays a significant role in the pathogenesis of GE and Vit D may be applied as its targeted therapy. [ABSTRACT FROM AUTHOR]

Background: The lack of a unified approach to the treatment of deficiency and vitamin D deficiency stimulated a detailed study of the dynamics of indicators of phosphorus-calcium metabolism, parathyroid hormone, 25(OH)D (calcidiol). Aim: To evaluate the pharmacokinetic properties of colecalciferol at a dosage of 150 000 IU, from the standpoint of its efficacy and safety in clinical practice. Materials and methods: Observational, single-center, prospective, selective, uncontrolled study of a comprehensive assessment of the pharmacokinetic properties of a single saturating dose of 150 000 IU of colecalciferol. To assess the pharmacokinetic properties of colecalciferol at a dosage of 150 000 IU, we set efficacy and safety criteria. The criterion for the effectiveness of treatment was to achieve an adequate level of vitamin D (more than 30 ng / ml at the initial insufficient level and more than 20 ng / ml for patients with vitamin D deficiency). The safety criteria for the correction of vitamin D deficiency or deficiency were the absence of patient complaints, adverse events and / or serious adverse events, as well as the preservation of the main laboratory parameters of phosphorus-calcium metabolism within the reference values. Results: When studying the efficacy of a dose of 150 000 IU in patients with vitamin D deficiency and insufficiency, it was found that the level of calcidiol was significantly higher in the group after treatment with colecalciferol compared with the group before treatment (p 0.05). The peak of the maximum value for patients with deficiency was established on the 14 day from the moment of administration of colecalciferol and was 37.1 6.28 ng / ml, and for patients with initial vitamin D deficiency 40.1 3.71 ng / ml. In the study of the safety of colecalciferol in a bolus dose of 150 000 IU, there were no statistically significant differences in the laboratory parameters of calcium-phosphorus metabolism, both in the group before treatment and after correction of deficiency and vitamin D insufficiency in both groups. Conclusion: Colecalciferol in the form of a single bolus dose of 150 000 IU demonstrated its efficacy and safety in real clinical practice.

Introducción: Los bifosfonatos son considerados como un grupo de fármacos de gran utilidad en el tratamiento de enfermedades del tejido óseo ya que promueven su resorción. Han sido la primera línea para el tratamiento de la osteoporosis, enfermedad de Paget, mieloma múltiple e hipercalcemia maligna. Por su parte, la vitamina D es un nutriente esencial cuya función principal es la homeostasis de calcio (Ca+2) y fosfato (P43-). Objetivo: Describir los aspectos moleculares y farmacológicos de la acción de un bifosfonato (alendronato sódico) y la vitamina D, por los cuales potencian mutuamente sus efectos en enfermedades óseas. Métodos: Fueron seleccionadas las referencias más actualizadas que abordaran aspectos relevantes acerca del alendronato y la vitamina D. Se consultaron las bases de datos de PubMed, Uniprot y Protein Databank. Conclusiones: El sinergismo entre alendronarto y vitamina D generan efectos benéficos en el tejido óseo. Sin embargo, existen efectos colaterales que pueden afectar a otros tejidos, por lo que su uso debe ser controlado.

Vitamin D (calciferol), measured by maternal serum 1,25-dihydroxyvitamin D, is important for the fetal-placental unit development. Decidua and trophoblast cells express vitamin D receptor and 1α-OHase, suggesting an autocrine or paracrine role for 1,25(OH)2D3 for fetal and placental development. During pregnancy, maternal circulating levels of 1,25(OH)2D3 double with the advancing gestation age, resulting in a concomitant increase in calcium uptake by the maternal intestine, with a concomitant decrease in calcium serum levels. In this narrative review, we want to highlight the current knowledge regarding vitamin D and pregnancy. A literature research was performed. The significant data were extracted and summarized in tables. It remains to validate whether the measurement of vitamin D levels and vitamin D supplementation (and calcium) during pregnancy should be recommended. Further studies are recommended to demonstrate any connection between the 25-OH-D level and prematurity, gestational diabetes and low birth weight, and, if present, to specify when and how vitamin D level should be dosed. [ABSTRACT FROM AUTHOR]

Profissionais de saúde tem prescrito cada vez mais vitamina D, visto que sua deficiência representa um problema de saúde coletiva mundial. Adicionalmente, indivíduos têm utilizado esta substância para outros fins além daqueles ligados ao metabolismo mineral, apesar da escassez de dados científicos sobre seu papel na prevenção de outras doenças. Este trabalho analisou a prescrição, manipulação e uso do colecalciferol em apresentações magistrais e comerciais nacionais. Farmácias magistrais de Recife, PE informaram as formas farmacêuticas manipuladas contendo colecalciferol para administração oral; consultas eletrônicas ao site da Anvisa e ao software INTUITIVE®, utilizado pela Farmácia Escola Carlos Drummond de Andrade (FECDA), permitiram que as apresentações comerciais/manipuladas, no período do estudo, fossem elencadas e analisadas. Foram realizadas consultas a bases de dados visando estabelecer uma análise crítica e atual diante dos achados. Foi verificada uma ampla preocupação no estabelecimento dos níveis sanguíneos adequados desta vitamina na população por parte dos profissionais de saúde habilitados, visto que 29 diferentes especialistas prescreveram colecalciferol manipulado. Também foi constatada uma maior quantidade de dosagens e formas farmacêuticas magistrais quando comparadas com as apresentações comerciais do mercado nacional. No mais, garantir que estas prescrições estejam embasadas nas necessidades de cada paciente, requer exames sanguíneos e utilização de guias reconhecidos, o que, associado ao acompanhamento farmacoterapêutico, poderá contribuir para o sucesso terapêutico.

Deficitul de vitamină D reprezintă o problemă globală de sănătate publică, la toate grupele de vârstă, provocată în principal de expunerea insuficientă la lumina soarelui, diete necorespunzătoare, absorbție şi utilizare ineficiente, cerințe crescute sau pierderi mai mari. Cunoscând implicațiile vitaminei D în organism şi perioadele sensibile de creştere şi dezvoltare, este important să se efectueze determinări biologice, pentru o profilaxie adecvată şi pentru a interveni prompt când apar modificări. Grupele de vârstă la care se recomandă administrarea vitaminei D sunt sugarii (indiferent dacă sunt alimentați natural, cu formulă sau alimentație complementară) şi adolescenţii. În afară de rolul binecunoscut al vitaminei D în metabolismul fosfo-calcic, se discută din ce în ce mai mult de implicarea vitaminei D în patogenia bolilor non-musculo-scheletice.

Introduction: Human vitamin D levels have been increasingly related to a wide range of clinical outcomes. There is a large amount of reports on its associations, especially with obstetric complications, including preeclampsia and gestational diabetes. These results are scarcely consistent and there is still a lack of quality intervention studies to confirm the role of vitamin D in those outcomes. Objective: To review the available scientific evidence on the role of maternal vitamin D in the development of preeclampsia. Materials and methods: The methodology used followed the recommendations of the Cochrane guide for the preparation of systematic reviews, and for metaanalysis, the Guide of the Metaanalysis of Observational Studies in Epidemiology group (MOOSE). The search included both observational studies and controlled clinical trials. Results: Low vitamin D levels, measured by the 25-hydroxyvitamin D test, are common in pregnancy. The results of this systematic review and metaanalysis suggest an inverse ratio between vitamin D levels and the development of preeclampsia. There was heterogeneity among the studies with regard to the design, population, geographic location, definitions of exposure, and the outcome. We excluded randomized controlled trials from this meta-analysis. Conclusion: The inverse association we found suggests that the higher the levels of vitamin D the lesser the probability of developing preeclampsia, in spite of the heterogeneity of the global measurement in this type of analysis.

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Purpose: The purpose of this study was to determine the proportion of patients admitted to a major tertiary teaching hospital in Australia aged 50 years and older with a confirmed neck of femur or vertebral minimal trauma fracture, who are commenced on colecalciferol supplementation by discharge, and to describe the doses prescribed. Methods: A subanalysis of a retrospective audit of electronic medical files for patients admitted with a minimal trauma fracture of the hip or vertebra between January 1, 2016, and June 30, 2016, was conducted. Results: A total of 406 patients were screened and 64 patients were included in the audit. In this subanalysis of these 64 patients eligible for inclusion, 38 were not on any vitamin or mineral supplementation at admission. Of these, 26 patients (68.4%) had their serum colecalciferol levels measured, and 21 patients (55.2%) overall were initiated on colecalciferol. Conclusion: Over half of patients with a minimal trauma fracture were commenced on colecalciferol therapy, but a noteworthy proportion of patients remain untreated. Patients with colecalciferol levels are more likely to be initiated on therapy compared with those of whom levels were not taken during admission. This is a missed opportunity for intervention that may place patients at a higher risk of subsequent fracture; therefore, effective strategies should be implemented to address this treatment gap in the future. [ABSTRACT FROM AUTHOR]

Copyright of Pediatrie pro Praxi is the property of SOLEN sro and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

S Calabria,1 E Cinconze,2 M Rossini,3 E Rossi,2 AP Maggioni,1,4 A Pedrini,1 M De Rosa2 1CORE, Collaborative Outcome Research, Bologna, Italy; 2Health Care Systems Department, CINECA, Interuniversity Consortium, Bologna, Italy; 3Rheumatology Unit, University of Verona, Verona, Italy; 4ANMCO Research Center, Firenze, ItalyPurpose: Osteoporosis is a chronic disease and an important health and social burden due to its worldwide prevalence. Literature and clinical experience report incomplete adherence to the therapy. This retrospective observational study aimed at assessing the adherence to first-line antiosteoporosis drugs (AODs; reimbursed by the National Health System, according to the Italian Medicine Agency recommendation number 79), alendronate or risedronate, with or without calcium and/or vitamin D supplements, in a real, Italian clinical setting.Patients and methods: Analyses were carried out on data present in the ARNO Observatory, a population-based patient-centric Italian database. From a population of 5,808,832 inhabitants with available data, a cohort of 3.3 million of patients aged ≥40 years was selected. New users of first-line AODs as monotherapy (accrual period, 2007–2009) were followed up over 3 years to assess adherence at 6, 12, and 36 months to AODs and to supplements and related determinants.Results: Approximately 40,000 new users were identified: mostly women, aged on average (standard deviation) 71±10 years. Alendronate was the most prescribed (38.2% of patients), followed by risedronate (34.9%) and alendronate with colecalciferol as a fixed-dose combination (25.8%). Adherence at the 6-month follow-up was 54%, and this constantly and significantly decreased after 1 year to 46%, and after 3 years to 33% (P50 years were more likely to adhere to treatment regimen (P5 drugs), cardiovascular, and neurological therapies were significantly associated with low adherence throughout the follow-up period.Conclusion: In a huge clinical practice sample, this study highlights suboptimal adherence to first-line AODs and to supplements and important determinants, such as concomitant therapies.Keywords: osteoporosis, adherence, determinants, bisphosphonates, colecalciferol

A osteoporose é uma característica extra-articular bem estabelecida da artrite reumatoide (AR). A inflamação sistêmica parece ser essencial para causar uma alteração em múltiplos sistemas homeostáticos implicados na saúde óssea, como as vias RANK/RANKL/osteoprotegerina e Wnt/β catenina; vários outros fatores causais têm sido implicados, como o uso crônico de corticosteroides. Como a vitamina D exerce funções imunorreguladoras importantes, tem-se afirmado que o desarranjo do sistema vitamina D/hormônio paratireóideo (HPT), um determinante bem conhecido da saúde óssea, pode desempenhar um papel patogênico na autoimunidade; estudos com animais e dados clínicos apoiam essa hipótese. Além disso, os pacientes com AR parecem ser relativamente refratários à supressão de HPT induzida pela vitamina D. Portanto, a ligação entre a AR e a osteoporose pode ser em parte causada por alterações no sistema vitamina D/HPT. Uma melhor compreensão da fisiopatologia desse sistema pode ser crucial para prevenir e curar a osteoporose em pacientes com doenças inflamatórias/autoimunes. A maior evidência da correlação clínica de cooperação e interdependência entre a vitamina D e o HPT é que a correção da deficiência de vitamina D, pelo menos nas doenças autoimunes, deve ser orientada para a supressão do HPT.

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The supplementation with 1,25-dihydroxycholecalciferol (1,25(OH)2D3) has been evaluated as an alternative to reduce dietary concentrations of calcium (Ca) and phosphorus (P). Thus, the objective of this study was to determine the best level of dietary supplementation of 1,25(OH)2D3 from plant source (Solanum glaucophyllum) to female broiler chickens restricted in Ca and available P (aP). A total of 684 day-old chicks were weighted and equally distributed in a completely randomized design with six treatments and six replications of 19 birds. Treatments consisted of a positive control (PC): corn- and soybean-meal diet formulated to reach animals' nutritional requirements; a negative control (NC): PC diet with 15% reduction in dietary Ca and aP concentrations; and four NC diets supplemented with 0.5, 1.0, 1.5 or 2.0 μg/kg of 1,25(OH)2D3. Growth performance was evaluated at 42 days; bone mineralization characteristics, at 21 and 33 days. Broilers fed NC decreased feed intake (P<0.05), but not weight gain and feed conversion ratio. At day 21, the supplementation of NC with 1,25(OH2)D3 did not return tibiotarsus ash to the same level as that observed in broilers fed PC, but it kept other bone characteristics at simmilar values. At day 33, broilers fed NC supplemented with 1,25(OH2)D3 showed higher bone weight. Overall, broilers fed 2.0 μg/kg of 1,25(OH)2D3 had higher ash content than those fed PC. [ABSTRACT FROM AUTHOR]

Deficitul de vitamină D reprezintă o problemă globală de sănătate publică, la toate grupele de vârstă, provocată în principal de expunerea insuficientă la lumina soarelui, diete necorespunzătoare, absorbție şi utilizare ineficiente, cerințe crescute sau pierderi mai mari. Cunoscând implicațiile vitaminei D în organism şi perioadele sensibile de creştere şi dezvoltare, este important să se efectueze determinări biologice, pentru o profilaxie adecvată şi pentru a interveni prompt când apar modificări. Grupele de vârstă la care se recomandă administrarea vitaminei D sunt sugarii (indiferent dacă sunt alimentați natural, cu formulă sau alimentație complementară) şi adolescenţii. În afară de rolul binecunoscut al vitaminei D în metabolismul fosfo-calcic, se discută din ce în ce mai mult de implicarea vitaminei D în patogenia bolilor non-musculo-scheletice. [ABSTRACT FROM AUTHOR]

There is clinical uncertainty as to the testing of serum 25-Hydroxy vitamin D (25[OH]D) concentrations and when to use high-dose supplementation. Data show that there has been a rapid increase in the number of tests performed within the Northumbria Healthcare NHS Foundation Trust over the past 8 years and an increase in high-dose supplementation over the past 5 years. We performed a retrospective analysis of the 25(OH)D test requests over the period from January to October 2017. A total of 17,405 tests were performed in this time period. The overall average concentration was 57.5 nmol/L and this figure was similar across age groups, although a larger proportion of patients aged over 75 had a concentration <25 nmol/L. Test requests were classified into 'appropriate', 'inappropriate' and 'uncertain' categories based on current expert opinion. We found that between 70.4% and 77.5% of tests could be inappropriate, depending on whether the 'uncertain' categories of falls and osteoporosis are considered to be justified. Tiredness, fatigue or exhaustion was the reason for testing in 22.4% of requests. We suggest that a more rational approach to testing, and subsequent treating, could lead to reductions in costs to the healthcare system and patients. [ABSTRACT FROM AUTHOR]

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Los niveles séricos de vitamina D bajos se han asociado con un riesgo elevado de preeclampsia, una de las principales causas de mortalidad materna en Colombia y el mundo. La asociación parte del papel de la vitamina D en la inflamación y de su relación con el eje renina-angiotensina-aldosterona. El Instituto de Salud de los Estados Unidos sugiere que la vitamina D debe suplementarse de forma rutinaria durante el control prenatal; sin embargo, la Organización Mundial de la Salud, respaldada en medicina basada en la evidencia, sugiere la no suplementación de rutina de esta vitamina. En Colombia, no se conoce la prevalencia de la deficiencia o insuficiencia de vitamina D y los puntos de corte de normalidad aún son objeto de discusión. El objetivo del presente artículo es el de presentar una revisión desde la bases de la biología molecular a la clínica, dilucidando el papel de la vitamina D en la gestación y en su relación con la preeclampsia, así como el de invitar al desarrollo de programas de investigación en temas relacionados con la vitamina D en el país. Abstract The low serum levels of vitamin D have been associated with the risk of preeclampsia, a leading cause of maternal mortality in Colombia. The biological plausibility of the association is the vitamin D role in inflammation and its relationship with the renin-angiotensin-aldosterone axis. The Institute of Medicine of the United States suggests that vitamin D should be supplemented routinely during antenatal care, however, the World Health Organization, supported by evidence-based medicine, suggests not supplement it. In Colombia, the prevalence of deficiency or insufficiency of vitamin D is not known and even normal break- points are discussed. The aim of this article is to review from the molecular biology to the clinic, elucidating the role of vitamin D during pregnancy and in the genesis of preeclampsia, and to encourage research in this field in the country.

Os efeitos da suplementação da vitamina D3 e de seus diferentes metabólitos foram avaliados na resposta imune e na morfometria intestinal de frangos de corte. Foram utilizados 952 frangos de corte de um dia de idade, distribuídos em um delineamento inteiramente casualizado, com quatro tratamentos, sete repetições e 34 aves por unidade experimental. Os tratamentos foram constituídos por quatros diferentes fontes de vitamina D3: colecalciferol (D3), 25-hidroxicolecalciferol (25(OH)D3), 1,25-dihidroxicolecalciferol (1,25(OH)2D3) e 1α-hidroxicolecalciferol (1α(OH)D3). As diferentes fontes foram incluídas na dieta, fornecendo 2000 e 1600 UI de vitamina D, nas fases pré-inicial, inicial e de crescimento, respectivamente. O peso relativo do intestino delgado diferiu entre os tratamentos aos 7, 21 e 42 dias e o peso relativo do fígado somente aos 42 dias de idade. Os demais órgãos e parâmetros imunológicos avaliados (peso dos órgãos linfóides, reação de hipersensibilidade cutânea basofílica, avaliação da atividade de macrófagos, dosagem de nitrito e perfil heterofilo: linfócito foram similares entre os animais alimentados com os diferentes metabólitos. Houve efeito (P0,05) dos tratamentos. Os parâmetros imunológicos não foram afetados pelos diferentes metabólitos de vitamina D. Os diferentes metabólitos de vitamina D afetaram positivamente a morfometria intestinal na altura de vilo na fase inicial, sendo os melhores resultados obtido pelos animais alimentados com 1,25(OH)2D3, contudo os parâmetros imunológicos foram similares entre os metabólitos estudados.

Inborn metabolism errors of newborn babies are diseases that require early intervention since timely management allows the prevention of severe or fatal consequences. However, its diagnosis is difficult due to multiple non-specific clinical manifestations that accompany it and to various metabolic alterations that affect the reading of routine clinical laboratory studies. However, a systematic approach that takes into account the variations of the intermediate metabolism interpreted through basic laboratory tests allows reaching, in most cases, a correct diagnosis. The approach proposed here is based on the interpretation of three metabolic states: metabolic acidosis, hyperammonemia, and hypoglycemia and their relation to the results of laboratory tests that are available in most neonatal units. Various recommendations are presented regarding normal values, diagnostic flowcharts, and recommendations on taking and conservation of the samples. [ABSTRACT FROM AUTHOR]

The analysis of the biologically active forms of vitamin D has increased in the last decades, becoming a relevant tool in the clinical practice and investigation. Vitamin D plays an essential role in regulating the metabolism of calcium and phosphorous. In addition, this vitamin is considered a potential preventive factor in a wide range of chronical diseases such as cardiovascular and autoimmune diseases, different kinds of cancer, type 2 diabetes, chronical obstructive pulmonary disease, and pre-eclampsia. Due to the possible role that vitamin D has in these diseases and the few existing comparative studies which have been conducted between these diseases and the vitamin D levels, clinicians and researchers are interested in using reliable and specific techniques to quantify the concentrations of vitamin D in plasma. Nevertheless, in the scientific literature reviewed have not been established which is the best biomarker that indicates the sufficiency and function of vitamin D nor which is the most appropriate technique for adequate quantification. The goal of this review is to briefly describe the metabolism of vitamin D and the current challenges for its proper quantification and use in translational research. [ABSTRACT FROM AUTHOR]

Introducción: La carencia de vitamina D produce una mineralización ósea inadecuada, debilidad muscular de predominio proximal, alteración de la marcha y aumento del riesgo de caídas y de fracturas. Por otra parte, en estudios epidemiológicos, se ha asociado al aumento en el riesgo de cáncer, enfermedades autoinmunes, diabetes tipo 1 y 2, artritis reumatoide, esclerosis múltiple; así como, enfermedades infecciosas, cardiovasculares y depresión. Cuando no es posible la síntesis cutánea a través de la exposición solar y el paciente no puede ingerir alimentos por vía oral, como ocurre en las fases avanzadas de diversas enfermedades neurológicas, el aporte de vitamina D ha de hacerse mediante la nutrición enteral. Objetivos: El objetivo del presente estudio es revisar el papel de la vitamina D en un grupo frecuente de enfermedades neurológicas que precisan nutrición artificial y analizar si el contenido de vitamina D de las diferentes fórmulas de nutrición enteral es adecuado para cubrir las necesidades de este grupo de pacientes. Resultados: Numerosos estudios han puesto en evidencia la asociación entre el déficit de vitamina D y el aumento en la incidencia de demencia, ictus y otras enfermedades neurodegenerativas. Las intervenciones encaminadas a incrementar los niveles de vit. D y sus efectos sobre objetivos funcionales (caídas, dolor, calidad de vida) y cardiovasculares (muerte de origen cardiovascular, ictus, infarto de miocardio, factores de riesgo cardiovascular) han obtenido como dato más destacado una clara reducción de caídas y fracturas, mientras que la evidencia para el resto de parámetros estudiados todavía es escasa y poco consistente. El contenido de calcio y vitamina D de las distintas fórmulas completas de nutrición enteral está regulado en nuestro país. La cantidad total de vitamina D para un aporte diario de 1.500-2.000 kcal oscila entre 300 y 1.600 UI/d (media ± SD: 32,9 ± 8,5 mg/100 kcal) en las fórmulas completas de nutrición enteral de uso más común. El 50% de las dietas estudiadas, para una ingesta de 2.000 kcal/d, y el 90%, para una ingesta de 1.500 kcal/d, aportan menos de 600 UI/d de vitamina D. Discusión: Algunas guías publicadas recientemente han revisado las recomendaciones de ingesta diaria de vitamina D. El documento publicado por el Instituto de Medicina de EE.UU recomienda para los adultos, entre 19 y 70 años, 600 UI/d y, por encima de los 70 a, se proponen 800 UI/d de vitamina D. Estas cantidades son consideradas insuficientes por otras sociedades científicas que establecen que para conseguir unos niveles sanguíneos de 25(OH)D iguales o superiores a 30 ng/ml puede requerirse un aporte diario de 1.500-2.000 UI y una cantidad dos o tres veces mayor si existe deficiencia previa. Conclusiones: Se necesitan más estudios controlados para averiguar cual es la dosis adecuada de vitamina D en fases avanzadas de la enfermedad neurológica, donde es difícil e improbable la exposición solar. Sugerimos que el contenido en vitamina D probablemente debería ser reconsiderado en las fórmulas de nutrición enteral, que, a la luz de las publicaciones recientes, aparecen como claramente insuficientes para aportes energéticos estándar (1.500-2.000 kcal).Introduction: Vitamin D deficiency produces inadequate bone mineralization, proximal muscle weakness, abnormal gait and increased risk of falls and fractures. Moreover, in epidemiological studies, has been associated with increased risk of cancer, autoimmune diseases, type 1 and 2 diabetes, rheumatoid arthritis, multiple sclerosis, infectious diseases, cardiovascular diseases and depression. When synthesis through the skin by sun exposure is not possible and the patient can not eat by mouth, as in the advanced stages of various neurological diseases, the supply of vitamin D has to be done by enteral nutrition. Objectives: The aim of this study is to review the role of vitamin D in a common group of neurological conditions that often require artificial nutrition and analyze whether the vitamin D of different enteral nutrition formulas is adequate to meet the needs of this group of patients. Results: Numerous studies have shown the association between vitamin D deficiency and increased incidence of dementia, stroke and other neurodegenerative diseases. Interventions aimed to increase levels of vit. D and its effects on functional (falls, pain, quality of life) and cardiovascular goals (cardiovascular death, stroke, myocardial infarction, cardiovascular risk factors) have obtained as highlight data a clear reduction of falls and fractures, while the evidence for the other parameters studied is still limited and inconsistent. The content of calcium and vitamin D of enteral formulas is legislated in our country. The total amount of vitamin D for a daily intake of 1,500-2,000 kcal ranges between 300 and 1,600 IU/d (mean ± SD: 32.9 ± 8.5 mg/100 kcal) in the complete formulas for enteral nutrition most commonly used. 50% of the diets studied, for an intake of 2,000 kcal/d, and 90% for an intake of 1,500 kcal/d, provide less than 600 IU/d of vitamin D. Discussion: Some revised recently guidelines published recommendations of daily intake of vitamin D. The document published by the U.S. Institute of Medicine recommended for adults between 19 and 70 years, 600 IU/d and up from 70, proposes 800 IU/d of vitamin D. These amounts are deemed insufficient by other scientific societies to state that to achieve blood levels of 25 (OH) D equal or greater than 30 ng/ml may be required a daily intake of 1,500-2,000 IU and a number two or three times higher if previous deficiency exists. Conclusions: Further controlled studies are needed to ascertain which is the appropriate dose of vitamin D in advanced stages of neurological disease, where sun exposure is difficult and unlikely. We suggest that the vitamin D content should probably be reconsidered in enteral nutrition formulas, which, in light of recent publications appear as clearly insufficient for standard energy intakes (1,500-2,000 kcal).

The paper deals with the problem of osteoporosis (OP) in patients with chronic somatic diseases. It gives the data available in the literature and the authors' findings on the prevalence of OP. Particular attention is paid on the pathogenetic aspects of a relationship between OP and cardiovascular diseases. The extraskeletal effects of vitamin Dз deficiency and the results of a 24-month follow-up of patients receiving various antiresorptive agents are described.

The objective of this research was to evaluate the performance of birds and the quality and enrichment of eggs from quails fed diets supplemented with vitamins A, D and E. Three experiments were performed, one for each vitamin, under completely randomized experimental design, with six replicates and eight birds per plot, totaling 192 quails. Performance of birds was evaluated by the daily feed intake, egg weight, laying percentage (%) and food conversion, per kg and dozen of eggs. It was also evaluated the internal quality (Haugh unit, yolk index and yolk and albumen percentages) and external quality (eggshell percentage, egg specific gravity, eggshell thickness and weight) and the concentration of vitamins in egg yolk by using the high performance liquid chromatography method. Vitamins supplementation did not improve productive performance neither the internal and external quality of the eggs, except for vitamin D supplementation, which increased intake. Incorporation of vitamin A in yolk increased 536.27% at level 30,000 UI/kg, vitamin D increased 13.43% at 1,500 UI/kg and vitamin E increased 479.05% at 600 UI/kg, and these results evidence that the nutritional value of eggs, related to vitamins, can be increased through supplementation of diets for quails.Objetivou-se nesta pesquisa avaliar o desempenho das aves e a qualidade e o enriquecimento de ovos de codornas sob suplementação com vitaminas A, D e E. Foram realizados três experimentos, um para cada vitamina, em delineamentos inteiramente casualizados, com seis repetições e oito aves por parcela, totalizando 192 codornas. O desempenho das aves foi avaliado pelo consumo diário de ração, peso dos ovos, porcentagem de postura e conversão alimentar, por kg e dúzia de ovos. Também foram avaliadas a qualidade interna (unidade Haugh, índice gema e porcentagens de gema e albúmen) e externa (porcentagem de casca, peso específico, espessura e peso da casca) e a concentração das vitaminas na gema dos ovos, mediante o método de cromatografia líquida de alta eficiência. A suplementação das vitaminas não melhorou o desempenho produtivo nem a qualidade interna e externa dos ovos, com exceção da suplementação de vitamina D, que elevou o consumo. A incorporação de vitamina A na gema aumentou 536,27% no nível de 30.000 UI/kg, a de vitamina D 13,43% no nível de 1.500 UI/kg e a de vitamina E 479,05% no nível de 600 UI/kg, e isso evidencia que o valor nutricional dos ovos, relacionado à vitamina, pode ser aumentado com a suplementação na dieta das codornas.

Copyright of Revista da Associação Brasileira de Nutrição is the property of Associacao Brasileira de Nutricao and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

São descritos aspectos toxicológicos, clínico-patológicos e ultraestruturais de coelhos intoxicados iatrogênica e experimentalmente por vitamina D por via subcutânea. Clinicamente, os animais evidenciaram sinais de insuficiência cardiovascular como ascite e edema pulmonar, hiporexia, anorexia, diarréia mucosa, emagrecimento e apatia. As clássicas alterações de mineralização e, por vezes, osseificação, do sistema cardiovascular, bem como as alterações de rins, pulmões, estômago, entre outros órgãos, foram reproduzidas com administrações subcutâneas de solução oleosa de colecalciferol (vitamina D3 não-ativada).Toxicological, clinic-pathological and ultrastructural aspects of iatrogenic and experimental subcutaneous poisoning in rabbits by vitamin D are described. Clinically the animals showed signs of cardiovascular insufficiency, as ascite and lung edema, hyporexia, anorexia, mucous diarrhoea, loss of weight and apathy. The classical alterations of minera-lization and, occasionally, ossification of the cardiovascular system, as well the lesions of kidneys, lungs, stomach, among other organs, were reproduced by the subcutaneous administration of an oily solution of cholecalciferol (non-activated vitamin D3).