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1.
Br J Med Med Res ; 2014 Nov; 4(31): 5053-5061
Artigo em Inglês | IMSEAR | ID: sea-175648

RESUMO

Background: Vitamin D deficiency is linked to several musculoskeletal conditions including nonspecific low back pain, autoimmune diseases. Data regarding to vitamin D deficiency and low back pain are not consistent across various studies. The objective of this case-control study was to determine association of vitamin D deficiency and lowback pain in women. Methods: Eighty-one women with nonspecific low back pain and 101 age-matched controls entered the study. Serum vitamin D was assessed by quantitative determination of serum 25-hydroxyvitamin D (25-OHD) by electerochemiluminecence method, and levels <20ng/ml were considered as vitamin D deficiency. Mann-Whitney U test and chi square test was used for analysis. Results: Mean age of patients and controls was 35.1±8.14 and 37.4±7.9 years respectively. Median serum 25-OHD concentration in patients was significantly lower than control group (p=0.003). Serum 25-OHD deficiency was observed in 57(70.4%) patients versus 47(46.5%) controls (p=0.001). There was a significant association between serum 25-OHD deficiency and low back pain (OR=2.72, 95%CI, 1.47-5, p=0.001). 25-OHD deficiency was significantly correlated with low back pain (r=0.239, p=0.001). Conclusion: This study indicates a significant association between vitamin D deficiency and nonspecific LBP in women and justifies serum 25-OHD assessment in women with low back pain.

2.
Br J Med Med Res ; 2014 June; 4(16): 3031-3041
Artigo em Inglês | IMSEAR | ID: sea-175236

RESUMO

Aims: To investigate the impact of supplemental vitamin D on pulmonary function in patients with stable chronic obstructive pulmonary disease (COPD). Study Design: Case-control study Place and Duration of Study: Department internal medicine, Rouhani hospital, Babol university of medical sciences, Babol, Iran. Over six months from September 2011 through February 2012 Methodology: Patients with COPD allocated to the treatment or control group intermittently. Thirty patients in the treatment group received 50.000 IU oral cholecalciferol weekly for two months plus routine treatment and 28 patients who served as controls received only their usual medications. The serum 25-hydroxyvitamin D (25-OHD) and FEV1% was measured at baseline and two months later. The primary objective was to determine treatment response defined as 5% or greater increase from baseline in FEV1% and the secondary objective was to determine the association between vitamin D supplementation and treatment response. In statistical analysis Spearman's correlation coefficient was used to determine correlation and logistic regression analysis with calculation of odds ratio (OR) was used to determine association. Results: Mean age of the patients and controls was 67.1±10.5 years and 66.±12.2 years respectively (P=0.83).Thirteen patients (43.3%) versus 3 (10.7%) controls responded to treatment (P=0.009). Treatment response was positively correlated with mean serum 25- OHD changes from baseline (Spearman's correlation coefficient = 0.358, P=0.026). Mean 25-OHD change from baseline in the responders was significantly higher than in no responders (P = 0.031). Mean 25-OHD changes were positively correlated with FEV1% (P = 0.013).Vitamin D supplementation increased the treatment response by OR = 6.37 (95% CI, 1.57-25.8). After adjustment for inhaled bronchodilator, corticosteroid therapy, age, weight, smoking, ESR and CRP the odds of treatment response in vitamin D group increased to 17.1 (95%CI, 2.39-122, P= 0.005). Conclusion: The findings of this study indicate that, two months vitamin D supplement to the drug regimen of COPD confers small pulmonary function improvement as compared with controls and justify serum 25-OHD measurement in COPD. Raising serum 25-OHD to sufficient levels with longer duration of treatment may exert further benefits.

3.
Annals of Saudi Medicine. 2009; 29 (6): 467-470
em Inglês | IMEMR | ID: emr-102553

RESUMO

The utility of anticyclic citrullinated peptide [anti-CCP] antibody in the diagnosis of rheumatoid arthritis [RA] varies across different studies. We determined the diagnostic performance and predictive ability of anti-CCP for RA. We studied 201 patients with RA and compared them with 208 non-RA patients as controls. RA patients included in the study fulfilled the American College of Rheumatology revised criteria and patients with other diseases as well as those with undifferentiated arthritis [UIA] were used as controls. Anti-CCP was measured by enzyme-linked immunosorbent assay [ELISA] and rheumatoid factor [RF] by the agglutination method. The optimal cutoff value and diagnostic accuracy were determined using receiver operating characteristics [ROC] curve and area under the curve [AUC].The sensitivity and specificity were determined by comparison of RA patients with non-RA controls. The anti-CCP test was positive in 164 patients with RA for a sensitivity of 81.6%, specificity of 87.5%, and overall accuracy of 84.6%. The respective values for RF were 75.6%, 86.5% and 84.4%. The anti-CCP test discriminated RA from non-RA patients with high accuracy [AUC=0.889 [0.017] 95% CI, 0.856-0.952, P=.001], and predicted progression of UIA to RA with moderate accuracy [AUC=0.733 [0.069], 95% CI 0.60-0.87, P<.006] at a sensitivity of 75% and a specificity of 68.1%. Among 60 UIA patients, in 16 [26.7%] who differentiated to RA, the mean [standard deviation] for anti-CCP was significantly higher than in 24 [40%] patients who progressed to non-RA [134.8 [172] vs 46 [86] U/mL, P<.01]. These findings indicate that anti-CCP yields higher sensitivity and overall accuracy, but slightly greater specificity than RF for diagnosis of RA. Anti-CCP positivity, particularly a higher level of serum antibody in patients with UIA, may be a predictor of subsequent RA


Assuntos
Humanos , Masculino , Feminino , Peptídeos Cíclicos , Peptídeos Cíclicos/imunologia , Prevalência , Anticorpos/sangue , Valor Preditivo dos Testes , Ensaio de Imunoadsorção Enzimática , Fator Reumatoide
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