An Investigation of Vitamin D Status in Systemic Lupus Erythematosus - Its Relationship with Disease Activity, Bone Mineral Density and Quality of Life PDF Download
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Author: Leanne Catherine Breslin
Publisher:
ISBN:
Category :
Languages : en
Pages :
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Author: Leanne Catherine Breslin
Publisher:
ISBN:
Category :
Languages : en
Pages :
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Author:
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Languages : en
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Author: Ahmad Zaidi Othman
Publisher:
ISBN:
Category :
Languages : en
Pages : 132
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Author: U. S. Department Human Services
Publisher: CreateSpace
ISBN: 9781499500363
Category :
Languages : en
Pages : 358
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The University of Ottawa Evidence-based Practice Center (UO-EPC) reviewed and synthesized the published literature on five key questions. 1. Are specific circulating concentrations of 25 hydroxyvitamin D (25(OH)D) associated with bone health outcomes in: A. Children: rickets, bone mineral density (BMD), bone mineral content (BMC), fractures, or parathyroid hormone (PTH)? B. Women of reproductive age (including pregnant and lactating women): BMD, calcaneal ultrasound, fractures, PTH? C. Elderly men and postmenopausal women: BMD, fractures, falls? 2. Do food fortification, sun exposure, and/or vitamin D supplementation affect circulating concentrations of 25(OH)D? 3. What is the evidence regarding the effect of supplemental doses of vitamin D on bone mineral density and fracture or fall risk and does this vary with age groups, ethnicity, body mass index or geography? 4. Is there a level of sunlight exposure that is sufficient to maintain adequate vitamin D levels but does not increase the risk of non-melanoma or melanoma skin cancer? 5. Does intake of vitamin D above current reference intakes lead to toxicities (e.g., hypercalcemia, hypercalciuria, and calcification of soft tissue or major organs)? Osteoporosis-related fractures constitute an important socio-economic burden. The burden of fractures is expected to increase over the next two decades, with an expanding aging population. Effective treatment strategies that can be implemented on a population level are needed to decrease the burden of osteoporosis. Classical actions of vitamin D include the regulation of calcium homeostasis and the development and maintenance of the skeleton. Vitamin D's major biologic function is to maintain serum calcium and phosphorus concentrations within the normal range by enhancing intestinal absorption of calcium and release of calcium and phosphorus from bone. Low vitamin D status has been associated with the development of rickets and osteomalacia, and has been considered to lead to bone loss, fractures and falls. Vitamin D also has non-calciotropic autocrine and paracrine functions, for example, in the regulation of cell differentiation and proliferation. The enzyme 1-alpha hydroxylase is present in many tissues in addition to the kidney, resulting in extra-renal production of 1,25-dihydroxyvitamin D. There is also emerging evidence for immunomodulatory and anti-infective properties of vitamin D. The increased suggestions of nutritional vitamin D insufficiency in the general population and the potential impact of vitamin D status on bone health and chronic health conditions have highlighted the need to reassess current vitamin D reference intakes. Over the last few years, a number of large randomized trials have evaluated the effect of vitamin D supplementation on fractures, falls and harms. A systematic review was conducted to synthesize the most recent evidence and address the above questions.
Author: Paul Jarrett
Publisher:
ISBN:
Category :
Languages : en
Pages : 294
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Background There is a growing interest in the role of vitamin D beyond its effect on bone health. The vitamin D receptor is widely expressed in many different tissues, including the skin. Aim The aim was to investigate the association between 25-hydroxyvitamin D and cutaneous lupus erythematosus, and the effect of vitamin D on psoriasis. Two additional studies about the population prevalence of cutaneous lupus and the cardiovascular risk of psoriasis were undertaken. Methods Patients with cutaneous lupus were identified from multiple sources from both the hospital and the community. The database compiled was then used to clinically assess both the scarring and the activity of cutaneous lupus in association with 25-hydroxyvitamin D status. A randomised, placebo-controlled study of the effect of oral 100,000 IU monthly Vitamin D3 (cholecalciferol) was undertaken with participants who had psoriasis and had been recruited to a larger study called the Vitamin D assessment study. Results One hundred and forty-five patients with cutaneous lupus were identified. Māori and Pacific people were found to have a higher prevalence of all types of cutaneous lupus compared with the European population [relative risk 2.47 (95% CI: 1.67–3.67)] and especially discoid lupus [relative risk 5.96 (95% CI: 3.06–11.6)]. No relationship was found between cutaneous lupus (either active disease or scarring) and 25-hydroxyvitamin D levels. Sixty-five patients with mild psoriasis were recruited. The mean Psoriasis Area Severity Index was 3.0 and 3.3 in the placebo and active group respectively. No improvement in psoriasis was recorded by the addition of vitamin D3 when assessed by the Psoriasis Area Severity Index, Global Physician’s Assessment, Dermatology Life Quality Index or the Psoriasis Disability Index (p > 0.05). There was no increase in cardiovascular risk in the psoriasis participants (p > 0.05). Conclusions 25-hydroxyvitamin D status is not a significant factor for cutaneous lupus. Further research is needed to examine why Māori and Pacific peoples have high rates of cutaneous lupus. Oral vitamin D3 is not a therapeutic option for patients with mild psoriasis, and the low cardiovascular risk of a New Zealand patient cohort with mild psoriasis is confirmed.
Author: Karen Hertz
Publisher: Springer
ISBN: 3319766813
Category : Medical
Languages : en
Pages : 169
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This open access book aims to provide a comprehensive but practical overview of the knowledge required for the assessment and management of the older adult with or at risk of fragility fracture. It considers this from the perspectives of all of the settings in which this group of patients receive nursing care. Globally, a fragility fracture is estimated to occur every 3 seconds. This amounts to 25 000 fractures per day or 9 million per year. The financial costs are reported to be: 32 billion EUR per year in Europe and 20 billon USD in the United States. As the population of China ages, the cost of hip fracture care there is likely to reach 1.25 billion USD by 2020 and 265 billion by 2050 (International Osteoporosis Foundation 2016). Consequently, the need for nursing for patients with fragility fracture across the world is immense. Fragility fracture is one of the foremost challenges for health care providers, and the impact of each one of those expected 9 million hip fractures is significant pain, disability, reduced quality of life, loss of independence and decreased life expectancy. There is a need for coordinated, multi-disciplinary models of care for secondary fracture prevention based on the increasing evidence that such models make a difference. There is also a need to promote and facilitate high quality, evidence-based effective care to those who suffer a fragility fracture with a focus on the best outcomes for recovery, rehabilitation and secondary prevention of further fracture. The care community has to understand better the experience of fragility fracture from the perspective of the patient so that direct improvements in care can be based on the perspectives of the users. This book supports these needs by providing a comprehensive approach to nursing practice in fragility fracture care.
Author: Caroline Stone
Publisher:
ISBN:
Category :
Languages : en
Pages :
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Background: Osteoporosis is estimated to affect 200 million women in the world, affecting 10% of women aged 60, 20% of women aged 70, 40% of women aged 80 and 67% of women aged 90. Osteoporosis is characterized by low bone density and increases the risk for fractured bones; however, it may be prevented with modifiable factors such as supplements, diet, and physical activity. Vitamin D deficiency leads to bone mineral density loss, as Vitamin D3 is responsible for calcium absorption into the bones. Bone consolidation is believed to occur between 20 and 30 years old; thus, attaining peak bone mass is critical during pre-menopause. Methods: The relationship between vitamin D and bone mineral density has predominately been studied in postmenopausal populations. Therefore, we examined this association among 18-30 year old participants (n=271) in the cross-sectional UMass Vitamin D Status Study. The modified version of the Harvard Food Frequency Questionnaire was used to assess the average intake of vitamin D foods and supplements. Serum 25(OH)D3 concentrations were assayed from blood samples. Bone mineral content and bone area were measured by dual-energy X-ray absorptiometry scan. Bone mineral content (BMC), as measured in grams, provides a measure of bone mass. Bone area (BA), as measured in cm2, reflects a two-dimensional area, which is characterized by the periphery of a bone region. We used multivariable linear regression to model the relationship between bone mineral density and bone area with sources of vitamin D after adjusting for dietary and lifestyle factors. Results: In the present study, the mean and standard deviation of vitamin D is 372.7 IU and 285.8 IU, respectively. For vitamin D from supplements, the mean is 140.9 IU with a standard deviation of 232.3 IU. Finally, for vitamin D from food, the mean is 231.8 IU with a standard deviation of 182.0 IU. Compared to reference values of 600 IU, these data are below the recommended daily allowance. We did not observe an association between total vitamin D or vitamin D from foods sources with either BMC or BA. We also did not observe an association between serum 25-hydroxyvitamin D levels and BMC or BA. Conclusion: Future studies with larger sample sizes are warranted to validate this association among young premenopausal women.
Author: Hani Almoallim
Publisher: Springer Nature
ISBN: 9811583234
Category : Medical
Languages : en
Pages : 562
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This Open Access book presents practical approaches to managing patients affected by various rheumatological diseases, allowing readers to gain a better understanding of the various clinical expressions and problems experienced by these patients. Discussing rheumatology from an organ systems perspective, it highlights the importance ofdetailed musculoskeletal examinations when treating patients affected by rheumatological diseases. The book first explores the latest diagnostic approaches and offers key tips for accurate musculoskeletal examinations before addressing the various treatment modalities, with a particular focus on the most common joints involved in rheumatoid arthritis: the wrists and the metacarpophalangeal joints (2nd and 3rd). Featuring easy-to-understand flow diagrams and explaining the common medical problems associated with rheumatic disease, such as shortness of breath and anemia, it is not only a valuable resource to rheumatologists, but will also appeal to medical students, junior residents, and primary healthcare physicians.
Author: Emilia Pauline Liao
Publisher: Humana Press
ISBN: 3319737422
Category : Medical
Languages : en
Pages : 258
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While the skeletal effects of vitamin D are well-documented, the role and importance of vitamin D outside of bone health has not been well-established. Vitamin D receptors are located in nearly every tissue of the body, and low levels of vitamin D are associated with a range of various diseases. This book provides an in-depth examination of these extraskeletal effects of vitamin D and the associations between vitamin D deficiency and various disease states. Beginning with a review of the biochemistry and physiology of vitamin D, subsequent chapters investigate its relationship to autoimmune and infectious diseases, various forms of cancer, endocrine issues such as diabetes, obesity and reproductive function, cardiovascular disease and muscle weakness. Concluding chapters discuss the role of vitamin D in neurological disorders, including Alzheimer's Disease, and cognitive function. Focusing on extraskeletal effects only across a range of conditions, Extraskeletal Effects of Vitamin D will be an important resource for clinical endocrinologists and primary care physicians.
Author: Andrea Giustina
Publisher: Karger Medical and Scientific Publishers
ISBN: 3805572964
Category : Medical
Languages : en
Pages : 213
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Osteoporosis is one of the most clinically relevant disabling chronic disease encountered in clinical practice. A common cause of osteoporosis is glucocorticoid excess, as glucocorticoids may increase bone resorption, inhibit bone formation, have indirect actions on bone by decreasing intestinal calcium absorption and induce hypercalciuria. This book presents a comprehensive overview of the effects of glucocorticoids on bone metabolism and structure and on the diagnosis and treatment of glucocorticoid-induced osteoporosis. It aims at providing updated information on the pathogenesis, diagnosis and treatment of this often dramatic complication of glucocorticoid excess. Being one of the few publications completely devoted to glucocorticoid-induced osteoporosis it will heighten the awareness of specialists who prescribe glucocorticoids of the clinical relevance of this treatment complication. 'Glucocorticoid-Induced Osteoporosis' is addressed to clinical experts as well as to general practitioners who will both benefit from the comprehensive and integrative view of the management of patients exposed to glucocorticoids.
