The Impact of Vitamin D on Immune Function and Its Role in Hashimoto's Thyroiditis: A Narrative Review.

Vitamin D, an essential nutrient, plays a crucial role in numerous biological functions, acting as a hormone and being important for the proper functioning of the immune system. This review illustrates the interactions between adequate vitamin D levels and an appropriate immune response, highlighting the implications for Hashimoto's thyroiditis (HT), a chronic inflammation of the thyroid characterized by the production of autoantibodies. A comprehensive review of the existing literature shows that vitamin D inhibits the secretion of pro-inflammatory cytokines, leading to an improvement in the clinical picture in HT by switching from a pro-inflammatory to immune balance. Vitamin D supplementation has been shown to reduce elevated serum levels of thyroid peroxidase antibodies, a key marker of HT. Although the results are conflicting, the evidence suggests that an adequate vitamin D intake supports the immune function and counteracts autoimmune conditions such as HT by improving their symptoms. There is evidence of vitamin D's key role in supporting the immune system function and managing autoimmunity, such as in HT. An adequate vitamin D intake is crucial for improving the clinical picture and the symptoms of HT.

The use of the Limberg skin flap for closure of large lumbosacral myelomeningoceles.

Closure of the skin defect in myelomeningocele repair is an essential step that determines the quality of the surgical result. In large myelomeningoceles, however, adequate skin coverage may not be accomplished by direct closure or skin undermining. In such cases, the skin defect is best repaired using flaps. To evaluate whether the Limberg skin flap is effective for the repair of large round or oval lumbosacral myelomeningoceles, we studied the records of 25 children. Surgical repair was carried out within 24-36 hours of birth in all 25 patients, with the defect size ranging from 36-72 cm(2). Durable, stable soft tissue coverage of the defect was obtained in 23 of 25 patients, with a postoperative follow-up of at least 2 years. Reoperation became necessary in the remaining two patients, but flap necrosis occurred in only one. We suggest that Limberg flap repair may have some advantages in patients with large round or oval lumbosacral myelomeningoceles, including minimal invasivity, short hospitalization, and improved cosmetic results.