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1.
Goiânia; SES-GO; 14 maio 2021. 1-15 p. fig, ilus, tab.
Non-conventional in Portuguese | ColecionaSUS, LILACS, ColecionaSUS, CONASS, SES-GO | ID: biblio-1224471

ABSTRACT

O termo vitamina D engloba um grupo de moléculas secosteroides derivadas do 7- deidrocolesterol (7-DHC ou provitamina D) interligadas através de uma cascata de reações fotolíticas e enzimáticas que acontecem em células de diferentes tecidos. (CASTRO, 2011). Nos seres humanos, apenas 10% a 20% da vitamina D necessária à adequada função do organismo provém da dieta. (CASTRO, 2011). O restante, cerca de 80%, da vitamina D é produzida na pele após a exposição à radiação ultravioleta B ­ UVB (HOLICK, 2008)


The term vitamin D encompasses a group of secosteroid molecules derived from 7- dehydrocholesterol (7-DHC or provitamin D) interconnected through a cascade of photolytic and enzymatic reactions that occur in cells of different tissues. (CASTRO, 2011). In humans, only 10% to 20% of the vitamin D needed for proper body function comes from the diet. (CASTRO, 2011). The remainder, about 80%, of vitamin D is produced in the skin after exposure to ultraviolet radiation B ­ UVB (HOLICK, 2008)


Subject(s)
Humans , Male , Female , Pregnancy , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Vitamin D/administration & dosage , Vitamin D/biosynthesis
2.
Rev. chil. endocrinol. diabetes ; 14(4): 159-165, 2021. tab, ilus
Article in Spanish | LILACS | ID: biblio-1344801

ABSTRACT

La diabetes Tipo 1 (DT1) es una compleja enfermedad autoinmune con una etiología aún desconocida. La vitamina D ha sido ampliamente estudiada debido a su potencial terapéutico en los potenciales nuevos casos de DT1. Por otra parte, los microARNs (miRs) han sido propuestos como posibles biomarcadores en diversos procesos biológicos como en la apoptosis e inflamación. El objetivo de este estudio fue evaluar el efecto de la suplementación con vitamina D sobre el perfil de expresión del miR-21 y marcadores de apoptosis tales como: BCL2, STAT3, TIPE2 y DAXX, en células mononucleares periféricas provenientes de pacientes con DT1 y sujetos controles. RESULTADOS: El perfil de expresión de miR-21 se encontró disminuido en los pacientes con DT1 en comparación con los controles. La expresión relativa de BCL2 se encontró aumentada en controles al comparar con pacientes DT1 en todas las condiciones experimentales. La expresión relativa de DAXX mostró un perfil de expresión diferencial al comparar pacientes con DT1 versus controles (p=0.006). CONCLUSIÓN: El estímulo con vitamina D parece tener un posible efecto regulador sobre los genes BCL2 y DAXX.


Type 1 diabetes (T1D) is a complex chronic autoimmune disease. Vitamin D has been one of the most studied therapeutic potential outbreaks related to T1D. Specific miRNAs have been proposed as potential biomarkers in several biological processes as apoptosis and inflammation. The aim of this study was to evaluate the effect of vitamin D on the expression profiles of miR-21 and apoptotic markers BCL2, STAT3, TIPE2 and DAXX, in PBMCs from T1D patients and control subjects. RESULTS: miR-21 expression was increased in controls regarding T1D patients. BCL2 was increased in controls compared to T1D patients in all experimental conditions. DAXX showed different expression patterns between T1D patients and controls (p=0.006). CONCLUSION: Vitamin D showed a possible regulation effect on apoptosis markers mainly through the regulation of BCL2 and DAXX


Subject(s)
Humans , Child , Adolescent , Vitamin D/administration & dosage , Apoptosis , Diabetes Mellitus, Type 1/metabolism , Vitamin D/metabolism , Biomarkers , Molecular Chaperones/drug effects , Molecular Chaperones/genetics , Molecular Chaperones/metabolism , Proto-Oncogene Proteins c-bcl-2/drug effects , Proto-Oncogene Proteins c-bcl-2/genetics , Proto-Oncogene Proteins c-bcl-2/metabolism , MicroRNAs/drug effects , MicroRNAs/genetics , MicroRNAs/metabolism , STAT3 Transcription Factor/drug effects , STAT3 Transcription Factor/genetics , STAT3 Transcription Factor/metabolism , Co-Repressor Proteins/drug effects , Co-Repressor Proteins/genetics , Co-Repressor Proteins/metabolism , Glucose/administration & dosage
3.
Rev. chil. pediatr ; 91(5): 684-690, oct. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1144266

ABSTRACT

INTRODUCCIÓN: El primer año de vida es un periodo de riesgo de deficiencia de vitamina D (VD). La administración de 400 UI diarias de VD no tiene una adherencia del 100%, en cambio dosis únicas de 100.000 UI de VD oral son seguras en recién nacidos. OBJETIVO: Comparar el efecto de la suplementación oral de VD en dosis única de 100.000 UI al mes de edad vs dosis diarias de 400 UI sobre las concentraciones séricas de VD, a los 6 meses de vida. SUJETOS Y MÉTODOS: Ensayo clínico aleatorizado, sin enmascaramiento. Se incluyeron 84 lactantes sanos de 1 mes de vida, asignados al azar al grupo de estudio (GE) que recibió una dosis única de VD de 100.000 UI oral o al grupo control (GC), que recibió dosis diarias de VD de 400 UI oral del 1er al 6to mes de vida. A los 6 meses de edad se determinó la concentración sérica de VD. RESULTADOS: 65 lactantes terminaron el estudio, 36 en GE y 29 en GC. No se encontró deficiencia de VD. La insuficiencia de VD fue de 5,5% y 6,8% en el GE y GC, respectivamente. La concentración sérica de VD a los 6 meses de vida, fue de 38,8 ± 5,2 ng/ml y 39,7 ± 6,3 ng/ml para GE y GC, respectivamente (NS). CONCLUSIONES: La suplementación con 100.000 UI de VD única al mes de edad logra concentraciones séricas de VD a los 6 meses de vida, similares a dosis diarias de 400 UI de VD, del 1er al 6to mes.


INTRODUCTION: Infants are a group at risk of vitamin D (VD) deficiency. The administration of 400 IU of VD per day during the first year of life does not achieve 100% adherence. A single dose of 100,000 IU of oral VD is safe in newborns. OBJECTIVE: To compare the effect of oral administration of VD between a single dose of 100,000 IU at one month of age vs daily doses of 400 IU on serum concentrations of VD, at 6 months of age. SUBJECTS AND METHOD: Randomized clinical trial, without masking. 84 healthy infants were included at 1 month of age, randomized to the study group (SG) receiving a single oral dose of 100,000 IU or to the control group (CG), who received daily oral doses of VD of 400 IU from the 1st to the 6th month of life. At 6 months of life, the serum concentration of VD was determined. RESULTS: 65 infants completed the study, 36 in SG and 29 in CG. No VD deficiency was found. VD insufficient was 5.5% and 6.8% in the SG and CG, respectively. The serum concentration of VD at six months of age was 38.8 ± 5.2 ng/ml and 39.7 ± 6.3 ng/ml for the SG and CG, respectively (NS). CONCLUSIONS: Supplementation of 100,000 IU of VD at one month age achieves serum concentrations of VD at 6 months of life similar to the administration of daily doses of 400 IU of VD from the 1st to the 6th month.


Subject(s)
Humans , Male , Female , Infant , Vitamin D/administration & dosage , Vitamin D Deficiency/prevention & control , Vitamins/administration & dosage , Dietary Supplements , Vitamin D/analogs & derivatives , Vitamin D/blood , Vitamin D/therapeutic use , Vitamin D Deficiency/diagnosis , Vitamin D Deficiency/blood , Vitamins/therapeutic use , Drug Administration Schedule , Biomarkers/blood , Nutritional Status , Administration, Oral , Follow-Up Studies , Treatment Outcome , Dose-Response Relationship, Drug
4.
Rev. cuba. endocrinol ; 31(2): e183, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1138902

ABSTRACT

RESUMEN Introducción: La vitamina D, considerada más que una vitamina, una prohormona, se le atribuye múltiples e importantes funciones que van más allá de la homeostasis cálcica. El creciente interés por la vitamina D está relacionado con el descubrimiento de sus receptores y de la expresión de la enzima 1α-hidroxilasa en diferentes tejidos del organismo. Esto ha generado la descripción de un gran número de efectos de la vitamina D en diferentes tejidos y en diversos procesos fisiológicos como: actividad antitumoral, reparación del ácido desoxirribonucleico (DNA), control de la apoptosis, estrés oxidativo, inmunomodulación, adhesión celular y metabolismo y otras funciones aún por esclarecer, y aunque los estudios no son concluyentes, los mismos proponen una relación entre niveles bajos de la vitamina y algunas enfermedades crónicas, autoinmunes y oncológicas. Objetivo: El propósito del presente artículo es describir las funciones extraesqueléticas de la vitamina D y su relación con algunas enfermedades a partir de información actualizada. Método: Se utilizó como buscador de información científica el Google Académico. Se revisaron 101 artículos provenientes de diferentes bases de datos: PubMed, SciELO y páginas web en general; de los cuales fueron referenciados 74 documentos. Conclusiones: Existe evidencia del efecto extraóseo de la hormona vitamina D, así como de la influencia biológica desfavorable de sus bajos niveles, sin embargo, no existe consenso relativo al efecto beneficioso de la suplementación con esta hormona(AU)


ABSTRACT Introduction: Vitamin D, considered, more than a vitamin, a prohormone, is attributed multiple and important functions beyond calcium homeostasis. The growing interest in vitamin D is related to the discovery of its receptors and the expression of the 1α-hydroxylase enzyme in different body tissues. This has generated the description of a large number of effects of vitamin D in different tissues and it involvement in various physiological processes such as antitumor activity, DNA repair, control of apoptosis, oxidative stress, immunomodulation, cell adhesion, and metabolism, as well as other functions still to be clarified; and, although studies are not conclusive, they suggest a relationship between low levels in the vitamin and some chronic, autoimmune and oncological diseases. Objective: The purpose of this article was to describe, based on updated information, the extraskeletal functions of vitamin D and its relationship with some diseases. Methods: Google Scholar was the search engine used to retrieve scientific information. We reviewed 101 articles from different databases, such as PubMed, SciElo, and web pages in general. Out of this number, 74 were chosen as referents. Conclusions: There is evidence about the extra-bone effect of the hormone known as vitamin D, as well as about the unfavorable biological influence of its low levels; however, there is no consensus regarding the beneficial effect of supplementation with this hormone(AU)


Subject(s)
Humans , Vitamin D/administration & dosage , Homeostasis/drug effects , Review Literature as Topic , Databases, Bibliographic/trends
5.
Actual. osteol ; 16(2): [116]-[131], mayo.-ago. 2020. ilus
Article in Spanish | LILACS | ID: biblio-1129745

ABSTRACT

"Los coronavirus pertenecen a una gran familia de virus (Coronaviridae) que infectan aves y varios mamíferos. El coronavirus actualmente denominado SARS-CoV-2, fue descubierto en diciembre de 2019 en Wuhan, provincia de Hubei, China, y es el agente causal de la epidemia de neumonía atípica actual" (COVID-19; Coronavirus Disease 2019). Los casos más graves presentan un síndrome de dificultad respiratoria aguda que puede conducir a la muerte. La vitamina D (VD), además del efecto bien conocido y positivo sobre la salud ósea y la homeostasis del calcio, tiene efecto pleiotrópico en varios órganos, con distribución casi universal del receptor de VD y de las enzimas de metabolización de 25 hidroxivitamina D (25OHD) en las células del organismo. Estas acciones extraesqueléticas dependen de la síntesis en dichas células del metabolito activo 1,25 dihidroxivitamina D por regulación paracrina y autocrina, dependiente de niveles circulantes óptimos de 25OHD. Por sus acciones inmunomoduladora, antiinflamatoria, antimicrobiana, reguladora del sistema renina-angiotensina-aldosterona, favorecedora de la indemnidad del epitelio respiratorio y la homeostasis redox celular, la VD podría tener efecto protector en la infección por COVID-19. Entre los grupos de riesgo para COVID-19 figuran los adultos mayores, obesos, diabéticos, hipertensos, con afecciones cardiovasculares, patologías con mayor incidencia en individuos con hipovitaminosis VD. La suplementación con VD, para alcanzar niveles óptimos de 25OHD de 40-60 ng/ml, podría reducir la incidencia, severidad y riesgo de muerte en la actual pandemia por COVID-19, como medida complementaria mientras se desarrollan la vacuna y otras medicaciones específicas. (AU)


Coronaviruses belong to a large family of viruses (Coronaviridae) that infect birds and various mammals. The novel coronavirus currently known as SARS-CoV-2 was discovered in December 2019 in Wuhan, Hubei province, China and is the causal agent of the current atypical pneumonia epidemic (COVID-19: Coronavirus Disease 2019); The most severe cases present with acute respiratory distress syndrome that can lead to death. Vitamin D (VD) has a pleiotropic effect on several organs, in addition to its wellknown and positive effect on bone health and calcium homeostasis, with an almost universal distribution of the VD receptor and the metabolites of 25hydroxyvitamin D (25OHD) in all cells of the body. These extra-skeletal actions depend on the synthesis of the active metabolite 1,25dihydroxyvitamin D in the cells depending on the optimal circulating levels of 25OHD and though paracrine and autocrine regulation. Due to its immunomodulatory, anti-inflammatory, antimicrobial, and regulatory actions on the renin angiotensin aldosterone system, which favors the compensation of the respiratory epithelium and cellular redox homeostasis, the VD could have a protective effect on COVID-19 infection. Among the risk groups for COVID-19 are obese, diabetic, and hypertensive patients, subjects with cardiovascular conditions, and elderly people. All these pathologies show a higher incidence in individuals with VD hypovitaminosis. VD supplementation, to achieve optimal 25OHD levels of 40-60 ng/ml, could reduce the incidence, severity, and risk of death in the current COVID-19 pandemic, as a complementary measure while the vaccine and other specific therapies are being developed. (AU)


Subject(s)
Humans , Pneumonia, Viral/prevention & control , Vitamin D/immunology , Coronavirus Infections/prevention & control , Pneumonia, Viral/immunology , Vitamin D/administration & dosage , Vitamin D/biosynthesis , Vitamin D/physiology , Vitamin D/therapeutic use , Vitamin D Deficiency/complications , Calcifediol/biosynthesis , Coronavirus Infections/immunology , Pandemics , Betacoronavirus
6.
Buenos Aires; IECS; 28 jul. 2020.
Non-conventional in Spanish | LILACS, BRISA | ID: biblio-1119361

ABSTRACT

CONTEXTO CLÍNICO: La enfermedad por el Coronavirus 2019 (COVID-19), por su sigla en inglés Coronavirus Disease 2019) es una enfermedad respiratoria de humanos por un nuevo Coronovirus identificado con la sigla SARS-CoV-2. TECNOLOGÍA: La vitamina C o ácido ascórbico es una vitamina soluble en agua con una función conocida sobre la síntesis de colágeno en tejidos conectivos y actúa como antioxidante. La vitamina D no solo es un nutriente sino también una hormona, que puede sintetizarse en nuestro cuerpo con la ayuda de la luz solar. El zinc es un oligoelemento dietético y es importante para el mantenimiento y el desarrollo de las células inmunes del sistema inmunitario innato y adaptativo. La deficiencia de Zinc resulta en la disfunción de la inmunidad humoral y mediada por células y aumenta la susceptibilidad a enfermedades infecciosas. OBJETIVO: El objetivo del presente informe es evaluar la evidencia disponible acerca de la eficacia, seguridad y aspectos relacionados a las políticas de cobertura del uso de suplementos vitamínicos (Vit. C, D) y Zinc en la infección por COVID-19. MÉTODOS: Se realizó una búsqueda en las principales bases de datos bibliográficas, en buscadores genéricos de internet, financiadores de salud. Se priorizó la inclusión de revisiones sistemáticas (RS), ensayos clínicos controlados aleatorizados (ECAs), evaluaciones de tecnologías sanitarias (ETS), evaluaciones económicas, guías de práctica clínica (GPC) y recomendaciones de diferentes organizaciones de salud. RESULTADOS: Se incluyeron una RS con MA, un protocolo de RS, un estudio observacional retrospectivo y ocho recomendaciones de sociedades científicas. No se hallaron estudios que evalúen la suplementación con vitaminas C y D para la prevención o tratamiento de la infección por COVID-19. Para Zinc, se halló un solo estudio que lo utiliza combinado con tratamientos discontinuados para esta patología por alertas en su seguridad. CONCLUSIONES: No hallaron estudios que evalúen la suplementación con las vitaminas C y D, solas o combinadas con otros tratamientos, en la prevención o tratamiento de la infección por COVID-19. Tampoco se encontraron estudios preventivos que evaluén el uso de Zinc. En el caso de su uso terapéutico, evidencia de muy baja calidad no permite determinar los efectos de la suplementación con Zinc en pacientes hospitalizados por COVID-19. Aunque se desconoce el efecto preventivo en relación al COVID-19, se halló evidencia de alta calidad de estudios realizados durante la era pre- COVID-19 que muestra que, en población general, la suplementación con vitamina D reduce el riesgo de infecciones respiratorias agudas. La incertidumbre actual podría reducirse a corto o mediano plazo debido a que se encuentran en curso aproximadamente 90 estudios que evaluarán el efecto de la administración C y D, y Zinc, solas o en combinación con otros tratamientos, para la prevención o tratamiento de la infección por COVID-19.


Subject(s)
Humans , Ascorbic Acid/administration & dosage , Vitamin D/administration & dosage , Zinc/administration & dosage , Coronavirus Infections/prevention & control , Betacoronavirus/drug effects , Technology Assessment, Biomedical , Health Evaluation , Cost-Benefit Analysis
7.
Arch. argent. pediatr ; 118(2): 95-101, abr. 2020. tab, ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1099857

ABSTRACT

Introducción. El objetivo fue evaluar la concentración de vitamina D en niños sanos de 12 a 24 meses suplementados con vitamina D (400 UI/día) durante el primer año.Métodos. Estudio descriptivo transversal entre junio de 2015 y mayo de 2016 en Estambul. Se incluyó a niños de 12 a 24 meses en seguimiento en la clínica del niño sano y con suplementación con vitamina D durante el primer año. Se midió calcio, fósforo, fosfatasa alcalina, hormona paratiroidea y 25-hidroxivitamina D [25(OH)D]. Se definió suficiencia (>20 ng/ml), insuficiencia (15-20 ng/ml) y deficiencia (<15 ng/ml) de vitamina D.Resultados. El estudio incluyó 197 niños. El 26,9 % (n = 53) siguió recibiendo suplementación después del año (dosis media: 491 ± 267 UI/día). La concentración media de 25(OH)D fue 38,0 ± 13,9 ng/ml. La ingesta regular de vitamina D en menores de un año (p = 0,008) y la continuación de suplementación después del año (p = 0,042) aumentaron la concentración de 25(OH)D en niños de 12 a 24 meses. Hubo deficiencia en 4,1 % e insuficiencia en 7,1 %. El nivel educativo materno (p = 0,009) y la leche maternizada (p = 0,012) fueron factores protectores contra deficiencia o insuficiencia.Conclusiones. La concentración de 25(OH)D era suficiente en el 88,8 % de los niños de 12 a 24 meses con suplementación con vitamina D (400 UI/día) durante el primer año. Los niños sanos de 12 a 24 meses con una suplementación correcta de vitamina D en el primer año podrían no requerir suplementación.


Introduction. The aim of this study was to evaluate vitamin D levels between 12-24 month-old healthy children supplemented with vitamin D (400 IU/day) during the first year.Methods. Descriptive-sectional study conducted between June 2015, and May 2016, in Istanbul (latitude 41ºN). Children aged 12-24 months followed up by the well-child clinic who had vitamin D supplementation in the first year were included in the study. The levels of calcium, phosphorus, alkaline phosphatase, parathyroid hormone and 25-hydroxyvitamin D [25(OH)D] were measured. Vitamin D status was defined as >20 ng/mL: sufficiency, 15-20 ng/mL: insufficiency and <15 ng/mL: deficiency.Results. The study was completed with 197 children. 26.9 % of children (n = 53) went on receiving supplementation after one year (mean dose 491 ± 267 IU/day). The mean 25(OH)D level was 38.0 ± 13.9 ng/mL. It was found that regular vitamin D intake under one year of age (p = 0.008) and continued support after one year of age (p = 0.042) increased level of 25(OH)D in children aged 12-24 months. Vitamin D deficiency was found in 4.1 % and vitamin D insufficiency in 7.1 %. Mother's education (p = 0.009) and use of formula (p = 0.012) were protective factors in relation to development of vitamin D deficiency or insufficiency.Conclusions. The level of 25(OH)D was sufficient in 88.8 % of children aged 12-24 months receiving 400 IU/day vitamin D supplementation in the first year. Vitamin D supplementation could not be required in healthy children aged 12-24 months who received properly vitamin D supplementation in the first year.


Subject(s)
Humans , Male , Female , Infant , Vitamin D/blood , Dietary Supplements , Turkey , Vitamin D/administration & dosage , Vitamin D/therapeutic use , Vitamin D Deficiency , Epidemiology, Descriptive , Cross-Sectional Studies , Statistical Analysis
8.
Neumol. pediátr. (En línea) ; 14(4): 205-209, dic. 2019. ilus, tab
Article in Spanish | LILACS | ID: biblio-1087949

ABSTRACT

The main source of Vitamin D is the bioconversion of 7-dehydrocholesterol to cholecalciferol, however, the level of sun exposition has been drastically reduced during the last decades, so it is not unusual to find a high deficit of Vitamin D in the population. There is evidence to suggest that the deficit of Vitamin D is associated with a worse evolution of asthma and a greater risk of serious exacerbations. Possibly prenatal Vitamin D supplementation to pregnant mothers reduces the risk of wheezing and asthma in the offspring, and supplementation to asthmatic children could improve the evolution of the disease.


La principal fuente de Vitamina D es la bioconversión del 7-dehidrocolesterol a colecalciferol, sin embargo, el nivel de exposición solar se ha reducido drásticamente durante las últimas décadas, por lo que no es extraño encontrar un déficit elevado de Vitamina D en la población. Existe evidencia que sugiere que el déficit de Vitamina D se asocia a peor evolución del asma y mayor riesgo de exacerbaciones graves. Posiblemente la suplementación prenatal de Vitamina D a madres embarazadas reduzca el riesgo de sibilancias y asma en los hijos que nacerán, y la suplementación a niños asmáticos podría mejorar la evolución de la enfermedad.


Subject(s)
Humans , Child , Asthma/therapy , Vitamin D/administration & dosage , Asthma/etiology , Asthma/prevention & control , Vitamin D Deficiency/complications , Dietary Supplements
9.
Rev. méd. Chile ; 147(11): 1415-1422, nov. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1094171

ABSTRACT

Background Sun exposure is the main source of 25-hydroxy-vitamin D. Since anesthesiologists work inside operating rooms, they are identified as a deficiency risk group. As medical activity in general occurs indoors, added to the work excess and sedentary lifestyle, physicians in general have low sun exposure. Aim To investigate the determinants of vitamin D levels in physicians. Material and Methods Anesthesiologists and physicians not working in operating rooms were included. A survey that comprised working hours, diet, skin color, sunscreen use and outdoor activities was also applied. Measurements of vitamin D and parathormone levels in blood were performed. Results We analyzed samples from 81 volunteers. Median vitamin D values of the whole sample were in the range of insufficiency (25.3 [interquartile range 12.4] ng/ml). Multiple linear regression analysis detected no differences between anesthesiologists and non-anesthesiologists. A higher body mass index was a risk factor for vitamin D deficiency, (p = 0.025). The only protective factor was the intake of a vitamin D supplement (p < 0.01). Conclusions Anesthesiologists and other specialists were both at risk for vitamin D deficiency. Obesity was a risk factor and the use of a vitamin D supplement was the only protective factor.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Parathyroid Hormone/blood , Vitamin D/analogs & derivatives , Vitamin D/blood , Vitamin D Deficiency/diagnosis , Dietary Supplements , Anesthesiologists/statistics & numerical data , Vitamin D/administration & dosage , Vitamin D Deficiency/blood , Body Mass Index , Cross-Sectional Studies , Risk Factors
10.
Actual. osteol ; 15(2): 94-102, mayo - ago. 2019. tab.
Article in Spanish | LILACS | ID: biblio-1048478

ABSTRACT

El propósito de la terapia en el desorden del metabolismo óseo mineral asociado a la enfermedad renal crónica (IRC) consiste en restaurar el balance mineral, y, en la osteoporosis, mantener o aumentar la masa ósea. Ambas terapias tratan de evitar la fractura ósea. La mayoría de los osteoactivos están contraindicados en la insuficiencia renal crónica avanzada (estadios 4 y 5), y las terapias son empíricas. Algunos autores opinan que sin anomalías bioquímicas del desorden del metabolismo óseo mineral asociado a la enfermedad renal crónica avanzada se podría intentar el tratamiento estándar para la osteoporosis. Antes de intentar la terapia osteoactiva se debe corregir el desorden mineral óseo que pudiera presentarse asociado a la IRC, y en la indicación del tipo de osteoactivo se sugiere seleccionar al paciente según su estado óseo. Se aconseja que la administración de los antirresortivos se realice a dosis menores con respecto a los que tienen mejor función renal junto con aportes adecuados de calcio y vitamina D, antes y durante el tratamiento para prevenir el riesgo de severas hipocalcemias y un efecto óseo excesivo. Se presenta el caso clínico de una mujer de 65 años, con diagnóstico de osteoporosis de etiología multifactorial, fractura de pelvis, múltiples fracturas vertebrales e insuficiencia renal crónica avanzada, entre otras comorbilidades, y probable enfermedad ósea adinámica. Recibió inicialmente terapia con teriparatide y luego con denosumab, complicándose con hipocalcemia asintomática. (AU)


The purpose of therapy for the bone mineral metabolism disorder associated with chronic kidney disease is to restore the mineral balance; and to maintain or increase bone mass in osteoporosis. The goal of both types of therapy is to avoid bone fractures. Most antiosteoporotic drugs are contraindicated in advanced chronic renal failure (CRF) stages 4 and 5, and the therapies are empirical. Some authors believe that without biochemical abnormalities of the mineral bone metabolism disorder associated with advanced chronic kidney disease, standard treatment for osteoporosis could be attempted. Before attempting antiosteoporotic therapy, the bone mineral disorder that may be associated with CRF must be corrected, and in the indication of the type drug it is suggested that the patient be selected according to their bone status. It is advised that the administration of anti-resorptives be performed at lower doses in individuals with poor renal function compared to those with better renal function together with adequate calcium and vitamin D, before and during treatment to prevent the risk of severe hypocalcemia, and an excessive bone effect. We present the clinical case of a 65-year-old woman with a diagnosis of osteoporosis of multifactorial etiology, pelvic fracture, multiple vertebral fractures and advanced chronic renal failure, among other comorbidities and probable adynamic bone disease. The patient received initial therapy with teriparatide and followed by denosumab administration and exhibited asymptomatic hypocalcemia. (AU)


Subject(s)
Humans , Female , Aged , Chronic Kidney Disease-Mineral and Bone Disorder/drug therapy , Fractures, Bone/prevention & control , Osteoporosis/therapy , Chronic Kidney Disease-Mineral and Bone Disorder/complications , Chronic Kidney Disease-Mineral and Bone Disorder/metabolism , Chronic Kidney Disease-Mineral and Bone Disorder/therapy , Vitamin D/administration & dosage , Vitamin D/therapeutic use , Calcium/administration & dosage , Calcium/therapeutic use , Alendronate/therapeutic use , Teriparatide/administration & dosage , Teriparatide/adverse effects , Teriparatide/therapeutic use , Diphosphonates/administration & dosage , Diphosphonates/adverse effects , Diphosphonates/therapeutic use , Cinacalcet/therapeutic use , Risedronic Acid/therapeutic use , Denosumab/administration & dosage , Denosumab/adverse effects , Denosumab/therapeutic use , Hypocalcemia/prevention & control
12.
Prensa méd. argent ; 105(4): 228-234, jun 2019. tab
Article in English | LILACS, BINACIS | ID: biblio-1046179

ABSTRACT

Introduction. With age, there is a growing risk of vitamin D deficiency and cognitive impairment. Maintaining the older people's health is socially relevant to health systems in the light of the population ageing trend. The study was aimed at identifying the relationship of vitamin D levels and symptoms of moderate cognitive impairment in older people. Methods. The authors conducted a cross-sectional screening of vitamin D status and cognitive impairment using the memory impairment screen (MIS) questionnaire, as well as the clinical, placebo-controlled study of vitamin D intake at a dose of 2,000 IU/day for 6 months. Results. The frequency of vitamin D deficiency in older patients with signs of cognitive impairment totaled 90.91 %, which was significantly more frequently compared with the group without cognitive impairment, where vitamin D deficiency was found only in 11.36 % of cases. In the dynamics on the background of the vitamin D intake for 6 months, the concentration in the intervention group amounted to 52.34 ± 2.43 ng/ml vs 14.71 ± 1.54 ng/ ml in the placebo group. The results of the study of cognitive impairment using MIS for the treatment group were 3.63 ± 0.01 points, which was significantly higher compared with the placebo group ­ 1.78 ± 0.22 points. A correlation analysis of vitamin D levels and MIS points showed a strong positive relationship, with a correlation coefficient of 0.92. Conclusion. The study identified a positive relationship of increasing vitamin D levels and reducing the symptoms of mild cognitive impairment in older people. Achieving vitamin D levels of over 40 ng/ ml greatly reduces the symptoms of cognitive impairment identified by the MIS questionnaire, however, the issue of treatment of impaired cognitive functions with vitamin D remains debatable.


Subject(s)
Humans , Aged , Aged, 80 and over , Vitamin D/administration & dosage , Vitamin D Deficiency/drug therapy , Cross-Sectional Studies , Treatment Outcome , Outcome Assessment, Health Care , Controlled Clinical Trial , Cognitive Dysfunction/therapy
13.
Int. braz. j. urol ; 45(2): 340-346, Mar.-Apr. 2019. tab, graf
Article in English | LILACS | ID: biblio-1002204

ABSTRACT

ABSTRACT Purpose: Hypercalciuria is one of the risk factors for calcium kidney stone formation (the most common type of urinary stones). Although vitamin D deficiency is prevalent among urolithiasis patients, the effect of vitamin D supplementation on urine calcium in these patients is still unclear. Materials and Methods: In this retrospective study, medical and laboratory tests records of 26 patients with recurrent calcium kidney stones and vitamin D deficiency treated with 50000IU vitamin D per week for 8-12 weeks were analyzed. The changes in 24-hour urine calcium (24-h Ca), serum 25-hydroxyvitamin D (25 (OH) D), serum parathormone (PTH), other 24-hour urine metabolites and calculated relative supersaturations of calcium oxalate (CaOxSS), calcium phosphate (CaPSS) and uric acid (UASS) were assessed. Moreover, correlations between changes in 24-h Ca and other aforementioned variables were assessed. Results: Serum 25 (OH) D and 24-h Ca increased after vitamin D supplementation, while serum PTH decreased (p < 0.001, for all analyses). The levels of 24-hour urine sodium and urea increased significantly (p = 0.005 and p = 0.031, respectively). The levels of CaOxSS and CaPSS increased, but the changes were not significant (p = 0.177, and p = 0.218, respectively). There were no correlations between the changes in 24-h Ca and serum 25 (OH) D or PTH. Conclusions: The result of current study suggests that although urine Ca increased in vitamin D supplemented patients, this increase was not associated with the increase in serum vitamin D and may be due to other factors such as dietary factors. Further randomized clinical trials considering other factors associated with urine Ca are warranted.


Subject(s)
Humans , Male , Female , Aged , Vitamin D/therapeutic use , Vitamin D Deficiency/etiology , Vitamin D Deficiency/drug therapy , Vitamins/therapeutic use , Calcium/urine , Urolithiasis/urine , Parathyroid Hormone/blood , Vitamin D/administration & dosage , Vitamin D/blood , Retrospective Studies , Dietary Supplements , Hypercalciuria/complications , Middle Aged
14.
Int. j. morphol ; 37(1): 87-92, 2019. tab, graf
Article in English | LILACS | ID: biblio-990010

ABSTRACT

SUMMARY: This study aimed to investigate the toxic effects of cigarette smoke exposure on lung and the protective role of Omega 3 and Vitamin D against these toxic effects biochemically and histologically. 28 pregnant Wistar Albino rats were divided into four groups. The first group was control group; the second group was exposed to smoke of 10 cigarette by puff device 2 hours/day after pregnancy; the third group was exposed to cigarette smoke together with Omega 3 (0.5 mg/kg/day) and the fourth group was exposed to cigarette smoke together with vitamin D (42 microgram/kg/day). Finally, lung tissue sections of the newborn rats were stained with Hemotoxilen eosine and Masson tricromite. Malondialdehyde (MDA) and Fluorescent Oxidation Products (FOU) levels were measured. Fetal weights and the number of fetuses were significantly lower in the group received only cigarette smoke (both p<0.001). Histopathologically, pulmonary volume, number of developed alveols and parenchyma elasticity decreased significantly, meanwhile interstitial tissue increased, elastin and collagen did not develop adequately. Histopathologic changes significantly decreased in the group given Omega 3 and Vitamin D. Statistically, MDA and FOU levels were found to be higher in the group exposed to cigarette smoke compared to the control group, and MDA and FOU levels were lower in the group given Omega 3 along with cigarette smoke (p<0.001). Cigarette smoke caused histologically significant damage to fetal lung tissue, oxidative stress and increased MDA and FOU levels. This damage was significantly reduced with Omega 3 and Vitamine D supplementation. Omega 3 is an important antioxidant; vitamin D has no significant antioxidant effect.


RESUMEN: Este estudio tuvo como objetivo investigar los efectos tóxicos de la exposición al humo de cigarrillo en el pulmón, y el papel protector de Omega 3 y la Vitamina D contra esos efectos. 28 ratas Wistar albino preñadas fueron separadas en cuatro grupos. El primer grupo grupo control; el segundo grupo estuvo expuesto al humo de 10 cigarrillos por dispositivo de inhalación 2 horas / día después de la preñez; el tercer grupo se expuso al humo del cigarrillo junto con Omega 3 (0,5 mg / kg / día) y el cuarto grupo se expuso al humo del cigarrillo junto con vitamina D (42 microgramos / kg / día). Secciones de tejido pulmonar de las ratas recién nacidas se tiñeron con Hematoxilina Eosina y tricrómico de Masson. Se midieron los niveles de malondialdehído (MDA) y productos de oxidación fluorescente (POF). Los pesos fetales y el número de fetos fueron significativamente más bajos en el grupo que recibió solamente humo de cigarrillo (ambos p <0,001). Histopatológicamente, el volumen pulmonar, el número de alveolos desarrollados y la elasticidad del parénquima disminuyeron significativamente; mientras que el tejido intersticial aumentó y la elastina y el colágeno no se desarrollaron adecuadamente. Los cambios histopatológicos disminuyeron significativamente en el grupo que recibió Omega 3 y Vitamina D. Estadísticamente, se encontró que los niveles de MDA y POF eran más altos en el grupo expuesto al humo de cigarrillo en comparación con el grupo control, además los niveles de MDA y POF fueron más bajos en el grupo que recibió Omega 3 junto con el humo del cigarrillo (p <0,001). El humo del cigarrillo causó daños histológicamente significativos en el tejido pulmonar fetal, el estrés oxidativo y el aumento de los niveles de MDA y FOU. Este daño se redujo significativamente con los suplementos de Omega 3 y Vitamina D. El omega 3 es un importante antioxidante; la vitamina D no tiene ningún efecto antioxidante significativo.


Subject(s)
Animals , Female , Pregnancy , Rats , Vitamin D/administration & dosage , Fatty Acids, Omega-3/administration & dosage , Maternal Exposure/adverse effects , Lung Injury/prevention & control , Nicotine/toxicity , Smoke/adverse effects , Analysis of Variance , Rats, Wistar , Oxidative Stress , Lung Injury/chemically induced , Lung Injury/pathology , Fetus/drug effects , Fluorescence , Animals, Newborn , Malondialdehyde/analysis
15.
Arch. argent. pediatr ; 116(6): 736-743, dic. 2018. tab
Article in English, Spanish | LILACS, BINACIS | ID: biblio-973688

ABSTRACT

Introducción.La vitamina D afecta la eritropoyesis.Objetivo: evaluar, en niños de 6 meses a 5 años, la asociación entre concentraciones de 25-hidroxi vitamina D (25-OHD) en la madre/niño, ferropenia y anemia ferropénica (AF). Población y métodos. Se incluyeron los niños que asistieron a la consulta entre septiembre de 2014 y enero de 2016. Se excluyeron aquellos con infección aguda/crónica, desnutrición, enfermedades crónicas y prematuros. Se realizó hemograma, hierro sérico, capacidad fijación del hierro, ferritina y 25-OHD. Se investigó suplemento con hierro y vitamina D durante lactancia y embarazo.Resultados. Se incluyeron 117 niños: 67 tenían ferropenia/AF [Grupo 1, edad (años): 2,05 ± 1,24 (0,5-5)] y 50 niños sanos [Grupo 2, edad (años): 1,87 ± 1,12 (0,58-5)]. Más niños y madres tuvieron deficiencia de vitamina D en Grupo 1 que en Grupo 2 (niños, 49,3 % vs 20 %, p = 0,002, y madres: 94 % vs 64 %; p= < 0,001, respectivamente). Hubo correlación positiva entre la hemoglobina en niños y la 25-OHD en madres/niños. Factores independientes de riesgo de AF fueron más tiempo de lactancia (OR: 0,35; IC 95 % [0,155-0,789]; p = 0,011), más breve suplementación con hierro durante la lactancia (OR: 1,69; IC 95 % [1,148-2,508]; p = 0,008) y embarazo (OR: 1,39; IC 95 % [1,070-1,820]; p = 0,014) y concentraciones < 25-OHD en madres (OR: 1,16; IC del 95 % [1,034-1,292]; p = 0,011). Conclusiones. La deficiencia de vitamina D en madres/niños está asociada con ferropenia/AFen los niños.


Introduction. Vitamin D (VitD) affects the erythropoiesis. The aim of this study was to evaluate the association between maternal/child 25-OH VitD (25-OHD) levels and iron deficiency (ID) and anemia (IDA) in children aged 6 months-5 years. Population and methods. Between September 2014 and January 2016 children who were admitted to outpatient clinic were included to study. We excluded the children with acute or chronic infection, malnutrition, chronic disease and preterm birth history. Complete blood count, serum iron, total iron binding capacity, ferritin, 25-OHD levels were examined from children and their mothers. Iron and VitD supplementation during infancy and pregnancy and breastfeeding history were questioned.Results. The study included totally 117 children. There were 67 children with ID/IDA [Group 1, mean age (years):2.05±1.24 (0.5-5)] and 50 normal children [Group 2, mean age (years): 1.87±1.12 (0.58-5)]. There were more VitD deficient children and mothers in Group 1 than in Group 2 (respectively, children 49.3 % vs. 20 % p=0.002; mothers 94 % vs.64 %, p=<0.001). There was a positive correlation between hemoglobin levels of children and maternal/child 25-OHD. The independent risk factors for IDA in children were longer exclusively breastfeeding time (odds ratio [OR], 0.35; 95 % confidence interval [CI], 0.155-0.789; p=0.011), shorter duration of regular iron supplementation during infancy and pregnancy (infancy: OR,1.69; 95 % CI 1.148-2.508; p=0.008. pregnancy: OR,1.39; 95 % CI,1.070-1.820; p=0.014) and lower maternal 25-OHD level (OR,1.16; 95 % CI,1.034-1.292; p=0.011). Conclusions. Maternal/child VitD deficiency is associated with ID/IDA in children aged 6 months-5 years.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Vitamin D/blood , Vitamin D Deficiency/complications , Anemia, Iron-Deficiency/epidemiology , Iron/deficiency , Time Factors , Vitamin D/administration & dosage , Vitamin D Deficiency/epidemiology , Breast Feeding/statistics & numerical data , Hemoglobins/analysis , Pregnancy , Risk Factors , Dietary Supplements , Ferritins/blood , Iron/blood
16.
Arch. argent. pediatr ; 116(3): 445-450, jun. 2018. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-950024

ABSTRACT

La hipertensión endocraneana idiopàtica se asocia infrecuentemente con la hipovitaminosis A y D. Se presenta el caso de una paciente femenina de 8 años con visión borrosa de 24 horas y papiledema bilateral. Resonancia magnética nuclear normal. Presión de apertura de líquido cefalorraquídeo: 260 mm^O. Presentó déficit de vitamina A y D, e inició un tratamiento sustitutivo. El segundo caso corresponde a un paciente masculino de 12 años con fiebre y odinofagia de 3 días. Con antecedente de glomerulonefritis y sobrepeso. Presentaba edema bipalpebral y papiledema. Tomografia axial computada de la órbita: aumento de líquido en la vaina de ambos nervios ópticos. Resonancia magnética nuclear: aracnoidocele intraselar. Presión de apertura de líquido cefalorraquídeo: 400 mm^O. Presentó déficit de vitamina D y B6, e inició el tratamiento sustitutivo. La elevación de la presión intracraneal desencadena mecanismos de compensación que, al fallar, pueden comprometer la vida o provocar graves discapacidades neurológicas. Reconocer la causa para un enfoque terapéutico preciso es clave para disminuir la morbimortalidad asociada a esta patología.


Idiopathic endocranial hypertension is infrequently associated with hypovitaminosis A and D. The case of an 8-year-old female with 24-hour blurred vision and bilateral papilledema is presented. Nuclear magnetic resonance was normal. Opening pressure of cerebrospinal fluid: 260 mm^O. She presented vitamin A and D deficiency and started replacement therapy. The second case corresponds to a 12-year-old male with fever and odynophagia of 3 days. History of glomerulonephritis and overweight. He had bipalpebral edema and papilledema. Computed tomography scan of the orbit: increase of fluid in the sheath of both optic nerves. Nuclear magnetic resonance: intrasellar arachnoidocele. Opening pressure of cerebrospinal fluid: 400 mmH2O. He presented vitamin D and B6 deficiency and started replacement treatment. The elevation of intracranial pressure triggers compensation mechanisms that, when they fail, can compromise life or cause serious neurological disabilities. Recognizing the cause for an accurate therapeutic approach is key to reduce the morbidity and mortality associated with this pathology.


Subject(s)
Humans , Male , Female , Child , Vitamin B 6 Deficiency/complications , Vitamin A Deficiency/complications , Vitamin D Deficiency/complications , Pseudotumor Cerebri/diagnosis , Vitamin B 6 Deficiency/drug therapy , Vision Disorders/etiology , Vitamin A/administration & dosage , Vitamin A Deficiency/drug therapy , Vitamin D/administration & dosage , Vitamin D Deficiency/drug therapy , Pseudotumor Cerebri/etiology , Magnetic Resonance Imaging , Tomography, X-Ray Computed/methods , Papilledema/etiology , Intracranial Hypertension/diagnosis , Intracranial Hypertension/etiology , Vitamin B 6/administration & dosage
17.
Actual. osteol ; 14(1): 22-29, Ene - Abr. 2018. graf
Article in Spanish | LILACS | ID: biblio-1116628

ABSTRACT

Las estatinas son fármacos habitualmente seguros y bien tolerados, muy eficaces para la prevención de trastornos cardiovasculares. La presencia de mialgias, poco frecuente, pero con incidencia dispar en diversos reportes, es una de las causas de abandono de su uso. También las distintas denominaciones (mialgia, miopatía, rabdomiólisis) y la subjetividad de cada paciente para referirlas han creado confusión en el tema. Se ha comenzado a reportar asociación entre niveles de vitamina D sérica disminuida y mayor riesgo de miopatía, por un lado, y trabajos donde pacientes que las abandonaban a causa de mialgias, con deficiencia de vitamina D, pueden tolerarlas una vez que se suplementa la vitamina hasta valores deseables. La presencia de polimorfismos en genes de enzimas que metabolizan o transportan a las estatinas es otro factor claramente relacionado con miopatía. Es posible que el déficit de vitamina D deba ser considerado un factor de riesgo para desarrollar miopatía por estatinas, como lo serían también la administración simultánea de fármacos que se metabolizan por la misma vía de citocromo P450, o la presencia de los polimorfismos mencionados. En conclusión, el hallazgo de tener deficiencia de vitamina D se asocia a miopatía por estatinas, o que es un factor de riego para desarrollarla, abre nuevas perspectivas para un gran número de pacientes que abandonan este tratamiento debido a esta patología. (AU)


Statins are usually safe and well tolerated drugs, very effective for preventing cardiovascular complications. The rare presence of myalgia, with different incidence as reported by several studies, is one of the causes of lack of drug compliance. Also the different symptoms referred (myalgia, myopathy, rhabdomyolysis) and the lack of objetivity of each patient when referring to the symptoms, have created confusion in this matter. Associations between decreased vitamin D levels and increased risk of myopathy has been reported. Indeed, studies describing patients with vitamin D deficiency who are not compliant due to myalgia show that they become tolerant to the drugs once the vitamin is supplemented to desirable values. The presence of gene polymorphisms for enzymes that metabolize or transport statins is another factor clearly related to myopathy. Therefore, we should consider vitamin D deficiency and other conditions such as the simultaneous administration of drugs that are metabolized by the same cytochrome P450 pathway, or the presence of mentioned polymorphisms as a risk factor for developing myopathy due to statins. In conclusion, the finding that vitamin D deficiency is associated with statin myopathy, or is a risk factor its develpoment, opens new perspectives for a large number of patients who leave this treatment due to this condition. (AU)


Subject(s)
Humans , Male , Female , Vitamin D Deficiency/complications , Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects , Myalgia/chemically induced , Myotoxicity/diagnosis , Polymorphism, Genetic/drug effects , Vitamin D/administration & dosage , Risk Factors , Hydroxymethylglutaryl-CoA Reductase Inhibitors/pharmacology , Drug Interactions , Myalgia/diagnosis , Cytochrome P-450 CYP3A Inhibitors/administration & dosage , Fruit and Vegetable Juices/adverse effects , Treatment Adherence and Compliance , Mevalonic Acid/pharmacology , Muscular Diseases/physiopathology
18.
Actual. osteol ; 13(3): 198-206, Sept - DIc. 2017. graf, tab
Article in Spanish | LILACS | ID: biblio-1117027

ABSTRACT

La osteoporosis afecta al 6-7% de la población masculina. Es alta la proporción de pacientes con fracturas sin diagnóstico previo de esta enfermedad. La mortalidad luego de una fractura es mayor en hombres que en población femenina; a pesar de esto, la mayoría de los pacientes no reciben tratamiento. Los fármacos aprobados, en nuestro medio, para tratar la osteoporosis masculina son: bifosfonatos, teriparatida y ranelato de estroncio. El objetivo de este estudio fue evaluar el efecto del ranelato de estroncio sobre la densidad mineral ósea en hombres después de 1 año de tratamiento. Se incluyeron los registros de 20 hombres de 67,8±3,0 años, tratados con ranelato de estroncio (2 g/día) durante 1 año. Todos los pacientes presentaban un T-score inferior a -2,5 en cadera o columna vertebral o un T-score inferior a -2,0 y factores de riesgo de fractura. No hubo modificación de parámetros de laboratorio luego del tratamiento (calcemia, calciuria, fósforo sérico, parathormona, 25(OH)vitamina D, fosfatasa alcalina y desoxipiridinolina) en relación a los basales. Luego del tratamiento con ranelato de estroncio se observó incremento de la densidad mineral ósea en columna lumbar: 0,953±0,029 versus 0,997±0,030 g/cm2 (p=0,0068), cuello femoral: 0,734±0,013 versus 0,764±0,016 g/cm2 (p=0,0084) y cadera total: 0,821±0,02 versus 0,834±0,02 g/cm2 (p=0,0419). Conclusión: el tratamiento con ranelato de estroncio produjo un incremento significativo de la densidad mineral ósea en columna lumbar y fémur proximal en hombres con osteoporosis. (AU)


Osteoporosis affects 6-7% of the male population. The proportion of patients with fragility fractures but without diagnosis of the disease is high. Mortality after hip fracture is higher in men than in women; in spite of this, most patients are left without treatment for osteoporosis. Drugs approved, for the treatment of osteoporosis in our country are bisphosphonates, teriparatide, and strontium ranelate (SrR). The objective of this study was to evaluate the effect of SrR on axial BMD in men after one year of treatment. We obtained pertinent data from medical registries of 20 men aged 67,8±3,0 years, treated with oral SrR (2 g/day) for 12 months. All patients had a T-score below -2,5 at the hip or the lumbar spine, or a T-score below -2,0 and one or more risk factors for fracture. The levels of serum calcium, phosphate, alkaline phosphatase, 25-hydroxyvitamin D, or PTH, or urinary calcium and desoxipyridinoline remained unchanged following SrR administration. After treatment with SrR there were significant increases in BMD at the lumbar spine: 0,953±0,029 versus 0,997±0,030 g/cm2 (p=0,0068), femoral neck: 0,734±0,013 versus 0,764±0,016 g/cm2 (p=0.0084), and total hip: 0,821±0,02 versus 0,834±0,02 g/cm2 (p=0,0419). Conclusion: in osteoporotic men, treatment with SrR significantly increases BMD in the lumbar spine and the proximal femur. (AU)


Subject(s)
Humans , Male , Aged , Osteoporosis/drug therapy , Strontium/chemistry , Bone Diseases, Metabolic/drug therapy , Bone Density/drug effects , Organometallic Compounds , Osteoporosis/diagnosis , Argentina , Strontium/administration & dosage , Testosterone/therapeutic use , Thiophenes , Vitamin D/administration & dosage , Bone Diseases, Metabolic/metabolism , Bone Diseases, Metabolic/blood , Body Mass Index , Sex Factors , Calcium/administration & dosage , Retrospective Studies , Risk Factors , Bone Density Conservation Agents/therapeutic use , Osteoporotic Fractures , Hypogonadism/complications
19.
Säo Paulo med. j ; 135(5): 497-507, Sept.-Oct. 2017. tab
Article in English | LILACS | ID: biblio-904102

ABSTRACT

ABSTRACT CONTEXT AND OBJECTIVE: Despite the high prevalence of vitamin D supplementation, its use remains controversial. The objective of this review was to identify and summarize the evidence from Cochrane systematic reviews regarding vitamin D supplementation for preventing ortreating any clinical condition. DESIGN AND SETTING: Review of systematic reviews, conducted in the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo. METHODS: A search was conducted to identify all Cochrane systematic reviews that fulfilled the inclusion criteria. Titles and abstracts were screened by two authors. RESULTS: We included 27 Cochrane systematic reviews: 10 assessing use of vitamin D for prevention and 17 for treatment. The reviews found moderate to high quality of evidence regarding the benefit of vitamin D for pregnant women (prevention of adverse events: preterm birth risk [rate ratio, RR 0.36; 95% confidence interval, CI 0.14 to 0.93] and low birthweight risk [RR 0.40; 95% CI 0.24 to 0.67]) and for asthma patients (reduction of severe exacerbations [RR 0.63; 95% CI 0.45 to 0.88]). No benefit was found regarding vitamin D supplementation alone (without calcium) for preventing hip or any new fracture. For all other outcomes assessed under various conditions, the current quality of evidence is low or unknown, and therefore insufficient for any recommendation. CONCLUSION: Based on moderate to high quality of evidence, the Cochrane systematic reviews included here showed that there were some benefits from vitamin D supplementation for pregnant women and asthma patients and no benefits for preventing fractures.


Subject(s)
Humans , Vitamin D/administration & dosage , Vitamin D Deficiency/complications , Review Literature as Topic , Evidence-Based Medicine , Dietary Supplements , Fractures, Bone/prevention & control , Vitamin D Deficiency/prevention & control , Vitamins/administration & dosage
20.
Braz. j. infect. dis ; 21(3): 270-275, May-June 2017. tab
Article in English | LILACS | ID: biblio-839222

ABSTRACT

ABSTRACT Background: The increase in life expectancy for patients living with human immunodeficiency virus (HIV) infection has resulted in health complications related to a chronic disease. Objectives: To evaluate the prevalence of bone mineral density (BMD) alterations and vitamin D concentrations in HIV-infected children and adolescents and to verify the variations in those parameters during a 12-month interval. Methods: A prospective cohort study with a dual period of evaluation was conducted in 57 patients perinatally HIV-infected and one patient with sexual abuse in early infancy. Demographic, anthropometric, pubertal stage, viral load, T CD4+ cell count and antiretroviral therapy were evaluated. Biochemical tests and total body (TB) and lumbar spine (L1-L4) bone density evaluations by dual X-ray absorptiometry (DXA) were performed. Calcium or vitamin D supplements were prescribed if reduction in BMD or deficiency for vitamin D was detected. Results: 58 patients (ages 5.4-18.3 years; 60.3% girls) were included (T0); 55 patients were reevaluated after 12 (±3) months (T1). Low bone mass for chronological age was found in 6/58 (10.4%) and 6/55(10.9%) patients at T0 and at T1, respectively. There was no statistical relationship between z-scores for BMD (BMD z-score) and the variables sex, fracture history, family history of osteoporosis, physical activity and pubertal stage. There was a relation between BMD z-score alterations for TB and HIV viral load at T1 (p = 0.016). There was no association between duration or classes of antiretroviral therapy and bone density. The mean value of vitamin D in T0 was 23.43 ng/mL ± 2.015 and in T1 22.1 ng/mL ± 0.707 and considered insufficient levels for this population. Conclusion: Patients infected with HIV are at risk for BMD alterations and lower vitamin D serum concentrations; both of these variables should be evaluated at routine examinations in order to improve both prevention and therapeutic planning.


Subject(s)
Humans , Male , Female , Child , Adolescent , Vitamin D/blood , Bone Density/physiology , HIV Infections/complications , Calcium/administration & dosage , Vitamin D/administration & dosage , Absorptiometry, Photon , HIV Infections/physiopathology , HIV Infections/blood , Prevalence , Prospective Studies , CD4 Lymphocyte Count , Viral Load
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