Vitamin D Alleviates Anxiety and Depression in Elderly People with Prediabetes: A Randomized Controlled Study.

Older people are prone to frailness, present poor adherence to pharmacotherapy, and often have adverse drug effects. Therefore, it is important to develop effective and safe interventions to mitigate the burden of anxiety and depression disorders in this population. The aim of this study was to investigate the effect of vitamin D supplementation on the anxiety and depression status of elderly people with prediabetes. Participants were randomly assigned a weekly dose of vitamin D3 of 25,000 IU (n = 45, mean age 73.10 ± 7.16 years) or nothing (n = 45, mean age 74.03 ± 7.64 years), in addition to suggested lifestyle measures. The State-Trait Anxiety Inventory subscales (STAI-T and STAI-S) and the Patient Health Questionnaire-9 (PHQ-9) were used to evaluate anxiety and depression levels, respectively, at baseline, 6, and 12 months. A total of 92.68% of the participants in the vitamin D group and 97.14% of the controls exhibited vitamin D deficiency (<20 ng/mL) at baseline. Mean STAI-T scores were lower in supplemented individuals than in the control group at 6 (38.02 ± 9.03 vs. 43.91 ± 7.18, p = 0.003) and 12 months (32.35 ± 7.77 vs. 44.97 ± 7.78, p < 0.001). The same pattern was evident for STAI-S scores at 6 (37.11 ± 7.88 vs. 43.20 ± 9.33, p = 0.003) and 12 months (32.59 ± 6.45 vs. 44.60 ± 9.53, p < 0.001). Supplemented participants demonstrated lower mean PHQ-9 scores compared to controls at 6 (15.69 ± 6.15 vs. 19.77 ± 8.96, p = 0.021) and 12 months (13.52 ± 5.01 vs. 20.20 ± 8.67, p < 0.001). Participants with deficiency and insufficiency at baseline experienced equal benefits of supplementation in terms of anxiety and depression scores. In conclusion, in a high-risk population, a weekly vitamin D supplementation scheme was effective in alleviating anxiety and depression symptoms. More studies are needed to elucidate the relevant mechanisms.

The effect of vitamin D supplementation on glycemic status of elderly people with prediabetes: a 12-month open-label, randomized-controlled study.

BACKGROUND: Data on the efficacy of vitamin D in improving the glycemic status of elderly people with prediabetes are scarce. This open-label, randomized-controlled trial investigated the effect of vitamin D supplementation on glycemic markers of Greek people with prediabetes aged 60 years or above, over 12 months. RESEARCH DESIGN AND METHODS: Participants were randomized to a weekly vitamin D3 dose of 25,000 IU (n = 45) or nothing (n = 45), on top of lifestyle measures. Anthropometric and glycemic markers were assessed at baseline, 3, 6, and 12 months. RESULTS: Supplemented participants demonstrated a significant increase in 25(OH)D concentrations at 3,      6,      and 12 months     compared to baseline    . In the intervention group, fasting glucose was decreased at 6 months compared to baseline (96.12 ± 5.51 vs 103.40 ± 12.05 mg/dl, p < 0.01) and glycated hemoglobin was significantly lower at 6 and 12 months compared to baseline [5.82 ± 0.21% vs 5.87 ± 0.21%, p = 0.004 and 5.80 ± 0.23% vs 5.87 ± 0.21%, p < 0.001, respectively]. CONCLUSIONS: Vitamin D could be complementary to lifestyle change strategy for the management of prediabetes in the elderly. CLINICAL TRIAL REGISTRATION: ISRCTN51643592.

Cholethorax with biliopleural communication detected on [99mTc]mebrofenin hepatobiliary scintigraphy.

Bilious pleural effusion or cholethorax is a rare type of exudative pleural effusion. Here is presented a case of right-sided cholethorax, in which the direct communication between the pleural effusion with the biliary duct was visible only on the posteriori images of dynamic hepatobiliary scintigraphy with [99mTc]mebrofenin.

The diagnostic performance of (99m)Tc-HMPAO radiolabeled leucocytes scintigraphy in the investigations of infection. A single center experience.

OBJECTIVE: This study aims to evaluate the diagnostic efficacy of (99m)Tc-HMPAO-labeled white blood cells scintigraphy (RL-WBC scan) in a variety of infectious processes. Despite the technical difficulties of labeling WBCs without altering their viability/pathophysiologic integrity and the lengthy imaging procedure, the RL-WBC scan has gained an evolving role in the detection of occult infection. METHODS: Retrospective review of 66 patient files (34 males and 32 females) that underwent this functional imaging test from September 2013 until September 2015. Their mean age was 58.39±18.63 (range: 11-84) years. Twenty seven of them were investigated for fever of unknown origin, 6 with suspicion of inflammatory bowel disease, 9 with aneurysm of celiac artery before or after abdominal endovascular aortic repair, 6 with joint prostheses, 5 with diabetic angiopathy, and 13 had rather undefined symptoms. RESULTS: The mean labeling yield of the leukocytes with the lipophilic complex (99m)Tc-HMPAO was 57.4±8.6. The RL-WBC scan was positive in 39/66 patients, including 16/27 patients with fever of unknown origin and 8/9 patients with aortic aneurysm/graft infection. It showed expected/suspected localization of radioactivity in 23 patients, whereas 11 of them had equivocal signs of infection. In 16 patients, a significant change in patients' management was conferred, as non-suspected locations of inflammatory process were detected, based on early functional alterations derived from leukocyte recruitment. CONCLUSION: The RL-WBC scan (i) is extremely useful in the diagnosis of perigraft tissue infection and osteomyelitis (except for spine) with high rate of sensitivity and specificity (≈90%) when timely used, and (ii) may provide valuable information in patients with fever of unknown origin, inflammatory bowel disease or vague symptoms. False positive results have been noticed mainly due to artifacts, co-existent skeletal lesions or in the early postoperative course because of the nonspecific radionuclide uptake in the healing tissue. On the other hand, false negative results may appear in delayed aortic graft infection, etc. Difficulties arise in the discrimination between infection and sterile inflammatory lesions accompanying atheromatosis or grafts/prostheses. Our experience shows that there should take place a closer co-operation between nuclear medicine physicians and clinicians to ensure the rational selection of the patients that would benefit from this complex diagnostic procedure, in order to get the optimal results concerning in vivo inflammation/abscess visualization.

A case of non-malignant multifocal lesions on the methyl diphosphonate technetium-99m bone scan with enteropathy. SAPHO syndrome.

This is a case of a 24-year-old man with non-malignant multifocal bone lesions on the methyl diphosphonate technetium-99m bone scan, that may represent a variant of synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome. The patient complained for diffuse osseous pain, focused mainly in the hip joints. X-rays of the hips were normal but X-rays of the shoulders showed hyperostosis of the right clavicle with no erosions. SAPHO is a rare syndrome of unknown aetiology with no more than a hundred cases reported during the last 10 years. Its typical form consists of characteristic painful osteoarticular manifestations and dermatological findings. In a variant of this syndrome, such as in our case, dermatological manifestations may be absent, but hyperostosis with osseous hypertrophy and enteropathy are present. No other malignant or benign disease was diagnosed. All routine laboratory tests for an inflammatory rheumatoid disease were negative. Treatment with non steroid anti-inflammatory agents was successful and after six months, there were no clinical symptoms and lesions on the bone scan faded. Four years later the patient remained free from symptoms. We discuss the scintigraphic, radiological laboratory clinical findings, the therapeutic criterion and the exclusion of any malignant or other benign bone disease that suggest the diagnosis of SAPHO syndrome. In conclusion, although we were unable to perform a bone biopsy, we suggest that no other diagnosis but an enteropathic variant of SAPHO syndrome may better describe the above clinical and laboratory findings. Bone scan findings have a principal diagnostic role in SAPHO syndrome.