Worldwide Interest in Vitamin D, Negative Effects on Kidneys, and Bone Density: Analysis of Google Trends Data

Background: Besides its role in calcium homeostasis and bone mineralization, vitamin D may also reduce the risk of cancer, cardiovascular and autoimmune diseases. Excessive vitamin D intake can lead to life-threatening hypercalcemia and toxicity, however. Here, we wanted to determine the relative search volume (RSV) of interest in vitamin D and its adverse biological effects (hypercalcemia, renal failure, kidney stones, bone density).Methods: We used data from Google Trends to assess changes in RSV trends across the world's regions. Data were extracted via the search terms "cholecalciferol", "ergocalciferol, "hypercalcemia", "acute renal failure", "kidney stones", and "bone density" from queries in English from 1 January 2004 to 1 October 2018 in the tool's related query database. Statistical analysis was performed using SPSS (R) 22.0 for Windows (IBM Inc., Armonk, NY, USA, 10504-1722).Results: There was a correlation between the RSV of cholecalciferol and ergocalciferol (Spearman's correlation) and the RSV of hypercalcemia, renal failure, kidney stones, and bone density. As measured by the change in RSV score, the trend for interest in kidney stones increased more rapidly than that for the other search terms. There was a positive correlation between the RSV score for cholecalciferol (or ergocalciferol) and renal failure and between the RSV score for cholecalciferol (or ergocalciferol) and kidney stones, whereas there was a negative correlation between cholecalciferol and hypercalcemia. The interest of ergocalciferol increased in parallel with the interest in bone density. The highest concentration of interest in cholecalciferol occurred in North America, Europe, India and Australia, whereas interest in ergocalciferol was greater in Central and South America, Spain, and Thailand. Interest in kidney stones was greater than cholecalciferol in North America, Brazil, India, and Australia, while interest in bone density was greater than cholecalciferol in North America, Brazil, Italy, Spain, South Africa, and Australia.Conclusions: In the pre-pandemic COVID-19 (COronaVIrus Disease 19) era, our preliminary results showed a positive correla-tion between global interest in cholecalciferol and kidney stones and renal failure, respectively. However, we found an unexpected negative correlation between global interest in cholecalciferol and hypercalcemia. Additionally, we found a positive correlation between global interest in ergocalciferol and bone density. These correlations can inform health interventions and education.

Pharmacological factors related to hospital admissions in polymedicated elderly patiens

6ER-022 Table 1Odds ratio results from logistic regression analysisFactor OR Lower 95% CI Upper 95%CI Factor OR Lower 95% CI Upper 95%CI A02B 1.46 0.427 4.991 N02B 0.814 0.513 1.291 A10B 1.246 0.816 1.904 N03A 0.715 0.443 1.154 A11C 0.875 0.535 1.431 N05A* 0.353 0.137 0.91 A12A 1.192 0.73 1.948 N05B 0.98 0.649 1.482 B01A* 1.95 1.004 3.824 N06A 1.002 0.671 1.497 C03C 1.088 0.72 1.642 R03A 0.997 0.628 1.583 C07A 1.206 0.8 1.818 R03B 0.881 0.541 1.435 C10A 0.988 0.626 1.561 Total prescribed drugs* 1.182 1.078 1.297 H02A 0.875 0.431 1.778 Gender 1.011 0.651 1.57 M05B 1.016 0.581 1.776 Age 1.022 0.991 1.054 N02A 0.819 0.524 1.279 CI, confidence interval;OR, odds ratio. *p<0.05.Conclusion and relevanceIn this preliminary analysis of 930 PEP, B01A (antithrombotic drugs) and a number of total prescribed drugs were SS factor associated with a higher risk of admission, meanwhile N05A (antipsychotics) showed a protective trend.References and/or acknowledgementsConflict of interestNo conflict of interest

The challenge of maintaining necessary vascular and endovascular services at a referral center in Northern Italy during the COVID-19 outbreak.

OBJECTIVES: The Padova Hospital Vascular Surgery Division is located in Veneto, one of the area of the Northern Italy most hit by the Coronavirus disease 2019 outbreak. The aim of this paper is to describe the protocols adopted and to evaluate their impact during the acute phase of Coronavirus spread, focusing on the management of elective and urgent/emergent surgery, outpatients activity, and also health staff preservation from intra-hospital Coronavirus disease 2019 infection. METHODS: Several measures were progressively adopted in the Padova University Hospital to front the Coronavirus disease 2019 outbreak, with a clear strong asset established by 9 March 2020, after the Northern Italy lockdown. Since this date, the Vascular Surgery Unit started a "scaled-down" activity, both for elective surgical procedures and for the outpatient Clinical activities; different protocols were developed for health preservation of staff and patients. We compared a two months period, 30 days before and 30 days after this time point. In particular, emergent vascular surgery was regularly guaranteed as well as urgent surgery (to be performed within 24 h). Elective cases were scheduled for "non-deferrable" pathology. A swab test protocol for COVID-19 was applied to health-care professionals and hospitalized patients. RESULTS: The number of urgent or emergent aortic cases remained stable during the two months period, while the number of Hospital admissions via Emergency Room related to critical limb ischemia decreased after national lockdown by about 20%. Elective vascular surgery was scaled down by 50% starting from 9 March; 35% of scheduled elective cases refused hospitalization during the lockdown period and 20% of those contacted for hospitalization where postponed due to fever, respiratory symptoms, or close contacts with Coronavirus disease 2019 suspected cases. Elective surgery reduction did not negatively influence overall carotid or aortic outcomes, while we reported a higher major limb amputation rate for critical limb ischemia (about 10%, compared to 4% for the standard practice period). We found that 4 out of 98 (4%) health-care providers on the floor had an asymptomatic positive swab test. Among 22 vascular doctors, 3 had a confirmed Coronavirus disease 2019 infection (asymptomatic); a total of 72 swab were performed (mean = 3.4 swab/person/month) during this period; no cases of severe Coronavirus disease 2019 (deaths or requiring intensive care treatment) infection were reported within this period for the staff or hospitalized patients. CONCLUSIONS: Elective vascular surgery needs to be guaranteed as possible during Coronavirus disease 2019 outbreak. The number of truly emergent cases did not reduce, on the other side, Emergency Room accesses for non-emergent cases decreased. Our preliminary results seem to describe a scenario where, if the curve of the outbreak in the regional population is flattened, in association with appropriate hospitals containment rules, it may be possible to continue the activity of the Vascular Surgery Units and guarantee the minimal standard of care.