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Kisamo, Ombeni, Manase Kilonzi, Wigilya P. Mikomangwa, George M. Bwire, Hamu J. Mlyuka, Alphonce I. Marealle, and Ritah F. Mutagonda. "The magnitude of prescribing medicines by brand names at Muhimbili National Hospital, Tanzania." Medicine Access @ Point of Care 4 (January 2020): 239920261990014. http://dx.doi.org/10.1177/2399202619900148.
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Background: Tanzania National Treatment Guidelines and National Therapeutic Committee circular of 2012 requires prescribers to prescribe medicines using their generic names as recommended by the World Health Organization. The implementation of the aforementioned recommendations by prescribers is not well documented in our settings. Therefore, this study aimed to explore the compliance on the use of generic names by prescribers at Muhimbili National Hospital. Methods: A descriptive cross-sectional study was conducted at Muhimbili National Hospital from January to May 2019 in both inpatient and outpatient pharmacy units. Data were analyzed using SPSS, version 23. Chi-square test was used to analyze proportions between the different variables of the study. A p-value for significance was <0.05. Results: Of 1001 prescriptions analyzed, 71.6% contained medicines prescribed using brand names. The mean (±standard deviation (SD)) number of medicines per prescription was 2.98 (±1.5). The most frequently prescribed medicines by brand names were a combination of vitamin and mineral supplements (34.4%) followed by antibiotics (26.7%). Medical doctors (25.6%) and medical specialists (21.6%) prescribed ⩾2 medicines using brand names per prescription compared to interns (15.0%) and residents (6.9%) ( p < 0.001). Conclusion: Prescribing medicines using brand names was highly observed in this study. Supplements and antibiotics were among the products that were highly prescribed using their brand names. Qualitative studies to explore reasons for brand name prescribing practices are recommended.
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Mwita, Julius Chacha, Albertino Damasceno, Pilly Chillo, Okechukwu S. Ogah, Karen Cohen, Anthony Oyekunle, Endale Tefera, and Joel Msafiri Francis. "Vitamin K-dependent anticoagulant use and level of anticoagulation control in sub-Saharan Africa: protocol for a retrospective cohort study." BMJ Open 12, no. 2 (February 2022): e057166. http://dx.doi.org/10.1136/bmjopen-2021-057166.
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BackgroundGiven that vitamin K-dependent anticoagulants (VKAs) will continue to be the primary anticoagulant in Africa for a long time, understanding the quality of anticoagulation services in the continent is vital for optimising the intended benefits. Notably, a few small studies have assessed the quality of anticoagulation in sub-Saharan Africa (SSA) countries. This study will describe the current VKA use and anticoagulation control among patients in selected SSA countries.Methods and analysisWe plan to review the 2019 anticoagulation data of a cohort of 800 random patients from 19 selected clinics in Botswana, the Democratic Republic of Congo, Ethiopia, Gambia, Ghana, Mozambique, Nigeria, Tanzania and South Africa. We expect at least one participating site to enrol 100 participants in each country. Eligible participants will be those on VKAs for at least 3 months and with at least four international normalised ratio (INR) results. We will document the indications, type and duration of VKA use, sociodemographic factors, coexisting medical conditions, concurrent use of drugs that interact with warfarin and alcohol and tobacco products. The level of anticoagulation control will be determined by calculating the time-in-therapeutic range (TTR) using the Rosendaal and the Percent of INR in TTR methods. A TTR of less than 65% will define a suboptimal anticoagulation control.Ethics and disseminationThis study was approved by the Ministry of Health and Wellness Ethics Committee (HPDME13/8/1) in Botswana and local research ethics committees or institutional review boards of all participating sites. As the study collects data from existing records, sites applied for waivers of consent. We will disseminate research findings through peer-reviewed scientific publications.
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Haile, Zelalem T., Asli K. Teweldeberhan, Bhakti Chavan, and John Francescon. "Hormonal contraceptive use and vitamin A deficiency among women in Tanzania." International Journal of Gynecology & Obstetrics 141, no. 1 (December 15, 2017): 20–25. http://dx.doi.org/10.1002/ijgo.12396.
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M. Fletcher, Jean, Sharee A. Basdeo, Aideen C. Allen, and Padraic J. Dunne. "Therapeutic Use of Vitamin D and its Analogues in Autoimmunity." Recent Patents on Inflammation & Allergy Drug Discovery 6, no. 1 (January 1, 2012): 22–34. http://dx.doi.org/10.2174/187221312798889239.
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Zbinden, Gerhard. "THERAPEUTIC USE OF VITAMIN B1 IN DISEASES OTHER THAN BERIBERI." Annals of the New York Academy of Sciences 98, no. 2 (December 15, 2006): 550–61. http://dx.doi.org/10.1111/j.1749-6632.1962.tb30576.x.
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Carazo, Alejandro, Kateřina Macáková, Kateřina Matoušová, Lenka Kujovská Krčmová, Michele Protti, and Přemysl Mladěnka. "Vitamin A Update: Forms, Sources, Kinetics, Detection, Function, Deficiency, Therapeutic Use and Toxicity." Nutrients 13, no. 5 (May 18, 2021): 1703. http://dx.doi.org/10.3390/nu13051703.
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Vitamin A is a group of vital micronutrients widely present in the human diet. Animal-based products are a rich source of the retinyl ester form of the vitamin, while vegetables and fruits contain carotenoids, most of which are provitamin A. Vitamin A plays a key role in the correct functioning of multiple physiological functions. The human organism can metabolize natural forms of vitamin A and provitamin A into biologically active forms (retinol, retinal, retinoic acid), which interact with multiple molecular targets, including nuclear receptors, opsin in the retina and, according to the latest research, also some enzymes. In this review, we aim to provide a complex view on the present knowledge about vitamin A ranging from its sources through its physiological functions to consequences of its deficiency and metabolic fate up to possible pharmacological administration and potential toxicity. Current analytical methods used for its detection in real samples are included as well.
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Donaldson, CJ, and DJ Harrington. "Therapeutic warfarin use and the extrahepatic functions of vitamin K-dependent proteins." British Journal of Biomedical Science 74, no. 4 (June 28, 2017): 163–69. http://dx.doi.org/10.1080/09674845.2017.1336854.
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Thabet, Romany H., Adel A. Gomaa, Laila M. Matalqah, and Erin M. Shalaby. "Vitamin D: an essential adjuvant therapeutic agent in breast cancer." Journal of International Medical Research 50, no. 7 (July 2022): 030006052211138. http://dx.doi.org/10.1177/03000605221113800.
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Low serum levels of vitamin D have been reported as a risk factor for breast cancer. This narrative review provides an update on the impact of vitamin D on hormone receptors, notably estrogen receptor subunits, and gives insights on possible therapeutic interventions to overcome breast cancer. In addition, evidence that supports the beneficial use of vitamin D as adjuvant treatment of breast cancer is summarized. Vitamin D deficiency is significantly widespread in patients with triple-negative tumors. Several studies have observed a possible modulatory effect of vitamin D or its analogues on the expression of different hormone receptors in breast cancer and increased sensitivity to tamoxifen. Vitamin D possesses anti-inflammatory and immunomodulatory effects in patients with breast cancer, and the mechanism of action of vitamin D in patients with breast cancer is discussed. In conclusion, vitamin D appears to have a beneficial role in the prevention and management of breast cancer, however, large-scale, randomized controlled trials are needed to confirm the effects of vitamin D in breast cancer prevention or treatment.
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Ræder, Helge, Nick Shaw, Coen Netelenbos, and Robert Bjerknes. "A case of X-linked hypophosphatemic rickets: complications and the therapeutic use of cinacalcet." European Journal of Endocrinology 159, suppl_1 (December 2008): S101—S105. http://dx.doi.org/10.1530/eje-08-0383.
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In hypophosphatemic rickets, there are both inherited and acquired forms, where X-linked dominant hypophosphatemic rickets (XLH) is the most prevalent genetic form and caused by mutations in the phosphate-regulating endopeptidase (PHEX) gene. XLH is associated with growth retardation and bone deformities. The renal tubular cells have an important role in calcium and phosphate metabolism, where the 1α-hydroxylase enzyme metabolizes the conversion of 25 (OH)-vitamin D to potent 1,25 (OH)2-vitamin D, whereas the sodium–phosphate transporter controls tubular phosphate reabsorption. The pathophysiological defect in XLH is speculated to cause an increase in a circulating phosphate regulating hormone termed phosphatonin (fibroblast growth factor 23 is the primary phosphatonin candidate), which leads to inhibition of 1α-hydroxylase, and simultaneously to inhibition of the sodium–phosphate transporter domain NPT2c leading to parathyroid hormone-independent phosphaturia. Hence, current treatment of XLH is 1,25 (OH)2-vitamin D or the vitamin D analog alfacalcidol and elementary phosphorus. Unfortunately, patients with XLH may develop nephrocalcinosis, secondary or tertiary hyperparathyroidism, and in some situations also hypertension and cardiovascular abnormalities. We describe a patient with XLH caused by a novel missense mutation in the PHEX gene, who on treatment with alfacalcidol and oral phosphate had normal growth and minimal bone deformities, but who subsequently developed moderate nephrocalcinosis, significant hyperparathyroidism, hypercalcemia, renal failure, and hypertension. We also report the use of the calcimimetic drug cinacalcet in the successful treatment of hypercalcemia and hyperparathyroidism.
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Kurushina, O. V., A. E. Barulin, and O. I. Agarkova. "Use of parenteral vitamin B complexes in treatment of polyneuropathy." Medical Council, no. 18 (November 17, 2018): 62–66. http://dx.doi.org/10.21518/2079-701x-2018-18-62-66.
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The article considers the ethiological factors for the formation of such a widespread disease of the peripheral nervous system as polyneuropathy. The classification, modern approaches to the diagnosis of various types of diseases are presented. The authors emphasize on the therapeutic approaches to the treatment of such common forms as diabetic and alcoholic polyneuropathies. Particular attention is paid to the complex of B vitamins. The effectiveness and safety of the injectable form of vitamins for the therapy of polyneuropathies are demonstrated.
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Nalyotov, Andrew V., Tatjana I. Shapchenko, and Dmitrij I. Masjuta. "The efficiency of vitamin D using in the formation of food tolerance to cow’s milk protein in children with food allergy." Pediatrician (St. Petersburg) 10, no. 4 (December 5, 2019): 25–29. http://dx.doi.org/10.17816/ped10425-29.
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The problem of vitamin D deficiency is one of the most actual today, because, according to the results of numerous studies, its deficiency is registered in half the worlds population. The article presents the results of a study on the level of vitamin D in children of first year of life, suffering from cows milk proteins allergy, as well as in children who have formed a secondary food tolerance to this allergen. In the article was evaluated the effectiveness of the additional use of vitamin D against the background of the therapeutic dairy-free diet use. It was found that the 57.1 4.8% children of first year of life with cows milk proteins allergy have vitamin D insufficiency. Normal vitamin D level was found in only 36.2 4.7% of patients. In turn, vitamin D deficiency was found in 6.7 2.4% children, suffering from cows milk proteins allergy. It was found that the additional daily intake of vitamin D on the background of the use of therapeutic dairy-free diet may reduce the time of development of food tolerance to cows milk proteins and achieve the formation of secondary food tolerance for the three years in 92.0 3.8% of children with cows milk proteins allergy. It was found, that the use of only therapeutic dairy-free diet allows to achieve the formation of secondary food tolerance only in 76.0 6.0% children (p 0.05). The normal level of vitamin D were established in 97.6 1.7 % children, formed a secondary food tolerance to cows milk proteins.
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Banks, Mindy, and Stuart M. Sprague. "Vitamin D and Peritoneal Dialysis." Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis 28, no. 2_suppl (March 2008): 33–37. http://dx.doi.org/10.1177/089686080802802s06.
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Chronic kidney disease – mineral and bone disorder (CKD–MBD) is a cause of significant morbidity and mortality in patients with long-standing kidney disease. Management of secondary hyperparathyroidism includes the use of phosphorus-binding agents and treatment with activated vitamin D compounds, better referred to as vitamin D receptor agonists (VDRAs). In an effort to maximize the therapeutic response while reducing the adverse effects of calcitriol, the naturally synthesized hormone, the use of intravenous administration and several selective VDRAs have been developed. Recently, oral preparations of these selective VDRAs have become available, enabling their use in the peritoneal dialysis (PD) population. The present report reviews the data concerning the use of oral VDRAs for the treatment of hyperparathyroidism in PD patients. The data, although limited, appear to support the use of oral paricalcitol as the VDRA in PD patients. In addition, traditional teaching focuses only on therapy with VDRAs, ignoring vitamin D replacement in CKD stage 5. However, given the potential benefits of calcidiol (25-OH-D) repletion and the rampant 25-OH-D deficiency in the PD population, our opinion is that screening for and treating that deficiency should extend beyond early CKD and also include PD patients.
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Brossaud, J., V. Pallet, and J.-B. Corcuff. "Vitamin A, endocrine tissues and hormones: interplay and interactions." Endocrine Connections 6, no. 7 (October 2017): R121—R130. http://dx.doi.org/10.1530/ec-17-0101.
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Vitamin A (retinol) is a micronutrient critical for cell proliferation and differentiation. In adults, vitamin A and metabolites such as retinoic acid (RA) play major roles in vision, immune and brain functions and tissue remodelling and metabolism. This review presents the physiological interactions of retinoids and endocrine tissues and hormonal systems. Two endocrine systems have been particularly studied. In the pituitary, retinoids target the corticotrophs with a possible therapeutic use in corticotropinomas. In the thyroid, retinoids interfere with iodine metabolism and vitamin A deficiency aggravates thyroid dysfunction caused by iodine-deficient diets. Retinoids use in thyroid cancer appears less promising than expected. Recent and still controversial studies investigated the relations between retinoids and metabolic syndrome. Indeed, retinoids contribute to pancreatic development and modify fat and glucose metabolism. However, more detailed studies are needed before planning any therapeutic use. Finally, retinoids probably play more minor roles in adrenal and gonads development and function apart from their major effects on spermatogenesis.
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Azevedo, Fernanda Reis de, and Bruno Caramelli. "Hypovitaminosis D and Obesity—Coincidence or Consequence?" US Endocrinology 09, no. 01 (2013): 40. http://dx.doi.org/10.17925/use.2013.09.01.40.
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Vitamin D has attracted much scientific interest in recent years, mostly due to its newly described roles in metabolism regulation and cell proliferation. Along with hypovitaminosis D, the incidence of obesity has risen and has become a public health concern. The association between these two conditions is not merely coincidence and is being deeply investigated regarding its prevalence, mechanism, and even a possible causal relation. The data are still inconclusive but there is important evidence indicating that vitamin D is involved with fat accumulation, the responsible mechanism however still the principal question. The three main hypotheses are: adipose tissue sequestration, genetic modulation, such as polymorphism of the vitamin D receptor (VDR), or an organism evolutionary adaptation to cold weather. In conclusion, more evidence is needed to determine what the correct direction of this connection is and the possible therapeutic strategies of vitamin D replenishment and obesity control.
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Richard, Seidu A., Marian Sackey, and Nii Korley Kortei. "Exploring the Pivotal Neurophysiologic and Therapeutic Potentials of Vitamin C in Glioma." Journal of Oncology 2021 (December 14, 2021): 1–12. http://dx.doi.org/10.1155/2021/6141591.
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Gliomas represent solely primary brain cancers of glial cell or neuroepithelial origin. Gliomas are still the most lethal human cancers despite modern innovations in both diagnostic techniques as well as therapeutic regimes. Gliomas have the lowest overall survival rate compared to other cancers 5 years after definitive diagnosis. The dietary intake of vitamin C has protective effect on glioma risk. Vitamin C is an essential compound that plays a vital role in the regulation of lysyl and prolyl hydroxylase activity. Neurons store high levels of vitamin C via sodium dependent-vitamin C transporters (SVCTs) to protect them from oxidative ischemia-reperfusion injury. Vitamin C is a water-soluble enzyme, typically seen as a powerful antioxidant in plants as well as animals. The key function of vitamin C is the inhibition of redox imbalance from reactive oxygen species produced via the stimulation of glutamate receptors. Gliomas absorb vitamin C primarily via its oxidized dehydroascorbate form by means of GLUT 1, 3, and 4 and its reduced form, ascorbate, by SVCT2. Vitamin C is able to preserve prosthetic metal ions like Fe2+ and Cu+ in their reduced forms in several enzymatic reactions as well as scavenge free radicals in order to safeguard tissues from oxidative damage. Therapeutic concentrations of vitamin C are able to trigger H2O2 generation in glioma. High-dose combination of vitamin C and radiation has a much more profound cytotoxic effect on primary glioblastoma multiforme cells compared to normal astrocytes. Control trials are needed to validate the use of vitamin C and standardization of the doses of vitamin C in the treatment of patients with glioma.
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Noor, Ramadhani A., Ajibola I. Abioye, Anne Marie Darling, Ellen Hertzmark, Said Aboud, Zulfiqarali Premji, Ferdinand M. Mugusi, et al. "Prenatal Zinc and Vitamin A Reduce the Benefit of Iron on Maternal Hematologic and Micronutrient Status at Delivery in Tanzania." Journal of Nutrition 150, no. 2 (October 16, 2019): 240–48. http://dx.doi.org/10.1093/jn/nxz242.
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ABSTRACT Background Zinc and vitamin A supplementation have both been shown to affect iron status, hemoglobin (Hb) concentration, and anemia in animal and human studies. However, evidence on their combined use in pregnancy, in the context of iron–folic acid (IFA) supplementation, remains limited. Objective This study determined the effects of prenatal zinc, vitamin A, and iron supplementation on maternal hematologic and micronutrient status at delivery in Tanzania. Methods We analyzed 2 large randomized controlled trials, using generalized estimating equations, and examined the effect of daily zinc (25 mg) and vitamin A (2500 IU) supplementation starting in the first trimester of pregnancy compared with placebo (n = 2500), and separately evaluated the safety and efficacy of daily iron (60 mg) supplementation among iron-replete pregnant women (n = 1500). Blood samples from baseline and delivery were tested for Hb, serum ferritin, soluble transferrin receptor, plasma zinc, and zinc protoporphyrin. Results Zinc and vitamin A supplementation were associated with lower Hb concentrations at delivery of −0.26 g/dL (95% CI: −0.50, −0.02 g/dL) and −0.25 g/dL (95% CI: −0.49, −0.01 g/dL), respectively. Vitamin A increased mean ferritin concentrations at delivery (14.3 μg/L, 95% CI: 1.84, 29.11 μg/L), but was associated with increased risk of severe anemia (RR: 1.41; 95% CI: 1.06, 1.88). Among women who were iron replete at baseline, iron supplementation reduced the risk of iron depletion at delivery by 47% (RR: 0.53; 95% CI: 0.43, 0.65). There was no effect of zinc or iron supplements on plasma zinc concentrations. Conclusions Our findings support existing WHO guidelines on prenatal iron, vitamin A, and zinc supplementation among pregnant women. In this setting, scaling uptake of prenatal iron supplements is warranted, but prenatal zinc and vitamin A supplementation did not benefit maternal hematologic status at delivery. In settings where vitamin A deficiency is endemic, the efficacy and safety of the WHO recommended prenatal vitamin A supplementation require further evaluation.
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Vorobyova, М. Р., and E. Р. Karpova. "Use of vitamin D to prevent recurrent otitis media in children." Medical Council, no. 2 (February 16, 2019): 259–63. http://dx.doi.org/10.21518/2079-701x-2019-2-259-263.
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This article addresses the problem of recurrent otitis media (ROM) in children. The study was aimed to increase the clinical efficacy of prophylactic treatment of ROM in children. The study showed that the children diagnosed with ROM had significantly lower serum 25(OH) vitamin D levels as compared to the healthy children. The follow-up observation and treatment of children with ROM allowed for the conclusion that all children at risk of ROM required the systemic examination of serum 25(OH) vitamin D and further therapeutic and prophylactic management.
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Perumpail, Brandon, Andrew Li, Nimy John, Sandy Sallam, Neha Shah, Waiyee Kwong, George Cholankeril, Donghee Kim, and Aijaz Ahmed. "The Role of Vitamin E in the Treatment of NAFLD." Diseases 6, no. 4 (September 24, 2018): 86. http://dx.doi.org/10.3390/diseases6040086.
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There has been a growing interest in the role of vitamin E supplementation in the treatment and/or prevention of nonalcoholic fatty liver (NAFLD). We performed a systematic review of the medical literature from inception through 15 June 2018 by utilizing PubMed and searching for key terms such as NAFLD, vitamin E, alpha-tocopherol, and nonalcoholic steatohepatitis (NASH). Data from studies and medical literature focusing on the role of vitamin E therapy in patients with NAFLD and nonalcoholic steatohepatitis (NASH) were reviewed. Most studies assessing the impact of vitamin E in NAFLD were designed to evaluate patients with NASH with documented biochemical and histological abnormalities. These studies demonstrated improvement in biochemical profiles, with a decline in or normalization of liver enzymes. Furthermore, histological assessment showed favorable outcomes in lobular inflammation and hepatic steatosis following treatment with vitamin E. Current guidelines regarding the use of vitamin E in the setting of NAFLD recommend that vitamin E-based treatment be restricted to biopsy-proven nondiabetic patients with NASH only. However, some concerns have been raised regarding the use of vitamin E in patients with NASH due to its adverse effects profile and lack of significant improvement in hepatic fibrosis. In conclusion, the antioxidant, anti-inflammatory, and anti-apoptotic properties of vitamin E accompanied by ease-of-use and exceptional tolerability have made vitamin E a pragmatic therapeutic choice in non-diabetic patients with histologic evidence of NASH. Future clinical trials with study design to assess vitamin E in combination with other anti-fibrotic agents may yield an additive or synergistic therapeutic effect.
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Latham, Michael C., Deborah M. Ash, Diklar Makola, Simon R. Tatala, Godwin D. Ndossi, and Haile Mehansho. "Efficacy Trials of a Micronutrient Dietary Supplement in Schoolchildren and Pregnant Women in Tanzania." Food and Nutrition Bulletin 24, no. 4_suppl_1 (January 2003): S120—S128. http://dx.doi.org/10.1177/15648265030244s109.
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Traditionally, the main strategies used to control micronutrient deficiencies have been food diversification, consumption of medicinal supplements, and food fortification. In Tanzania, we conducted efficacy trials using a dietary supplement as a fourth approach. These were randomized, double-blind, placebo-controlled efficacy trials conducted separately first in children and later in pregnant women. The dietary supplement was a powder used to prepare an orange-flavored beverage. In the school trial, children consumed 25 g per school day attended. In the pregnancy trial, women consumed the contents of two 25-g sachets per day with meals. This dietary supplement, unlike most medicinal supplements, provided 11 micronutrients, including iron and vitamin A, in physiologic amounts. In both trials we compared changes in subjects consuming either the fortified or the nonfortified supplement. Measures of iron and vitamin A status were similar in the groups at the baseline examination, but significantly different at follow-up, always in favor of the fortified groups. Children receiving the fortified supplement had significantly improved anthropometric measures when compared with controls. At four weeks postpartum, the breast milk of a supplemented group of women had significantly higher mean retinol content than did the milk of mothers consuming the nonfortified supplement. The advantages of using a fortified dietary supplement, compared with other approaches, include its ability to control several micronutrient deficiencies simultaneously; the use of physiologic amounts of nutrients, rather than megadoses that require medical supervision; and the likelihood of better compliance than with the use of pills because subjects liked the beverage used in these trials.
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Налетов, А. В., Т. И. Шапченко, and И. В. Коктышев. "ЭФФЕКТИВНОСТЬ ИСПОЛЬЗОВАНИЯ ВИТАМИНА D В ЛЕЧЕНИИ ДЕТЕЙ С АЛЛЕРГИЕЙ К БЕЛКАМ КОРОВЬЕГО МОЛОКА." Университетская клиника, no. 3(32) (October 1, 2019): 40. http://dx.doi.org/10.26435/uc.v0i3(32).340.
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The article presents the results of a study on the level of vitamin D in children of first year with cow's milk proteins allergy. The aim of the work is to evaluate the effectiveness of using an aqueous solution of vitamin D in addition to a therapeutic elimination diet in children who are allergic to cow's milk proteins. It was found that the 57.1±4.8 % children of first year with cow's milk proteins allergy have vitamin D insufficiency. Normal vitamin D levels were found in only 36.2±4.7 % % patients. In turn, vitamin D deficiency were found in 6,7±2,4 % children. The additional intake of vitamin D on the background of the use of elimination therapeutic dairy-free diet can reduce the time of development of tolerance to cow's milk proteins and achieve tolerance for three years in 92 % of children with allergies to cow's milk proteins were found.
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Pestova, V. Yu. "Alfacalcidol use in complex therapy of atopic dermatitis." Kazan medical journal 96, no. 6 (December 15, 2015): 952–58. http://dx.doi.org/10.17750/kmj2015-952.
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Aim. To study clinical course of atopic dermatitis and improve dermatosis therapeutic tactics in vitamin D deficiency. Study design - comparative observational open-label study.
Methods. 67 patients with a verified «atopic dermatitis» diagnosis were selected to study. Serum calcidol level below 75 nmol/l was observed in 32 patients what was the basis to division of the observed patients into two groups. Conventional therapy (local glucocorticoids and moistening agents, systemic administration of non-specific anti-inflammatory and desensitizing agents) was administered to all patients. Vitamin D active form - alfacalcidol (Alpha D3-Teva) was administered to patients of the second group as a part of complex therapy.
Results. Good clinical results have been achieved amid the treatment, in 21 days SCORAD index decreased by 86.56% in the first group, in the second - by 93.63%, with the clinical remission achievement in over 75% of patients in both groups. Atopic dermatitis complex therapy using alfacalcidol contributed to the normalization of the vitamin D concentration (from 42.92±2.87 to 79.26±4.92 nmol/l) and total calcium level (from 1.97±0.4 to 2, 21±0,8 mmol/l), reduced TEWL measurement and increased corneometry results. The therapy did not contribute to the sebometry data change in both groups.
Conclusion. Vitamin D deficiency leads to more severe atopic dermatitis course; complex treatment of this disease with alfacalcidol facilitated normalization of serum vitamin D level and tendency to the epidermal barrier recovery, what opens new possibilities in the treatment of atopic dermatitis.
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Locantore-Ford, Patricia, Ronak Mistry, Evani Patel, Sarah Chen, and Robert C. Goodacre. "Use of an Antifibrinolytic Agent and Vitamin K As Alternative to Platelet Transfusions in Autologous Hematopoietic Cell Transplantation." Blood 138, Supplement 1 (November 5, 2021): 2916. http://dx.doi.org/10.1182/blood-2021-149823.
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Abstract Background Managing thrombocytopenia with a prophylactic strategy was previously recommended for patients with impaired bone marrow function, hematological malignancies, and recipients of HCT when platelet counts declined to under 10,000/uL. However, the updated 2018 ASCO guidelines now suggest a place for a therapeutic i.e., after a bleeding event rather than a prophylactic platelet transfusion strategy for patients with hematologic malignancies undergoing autologous HCT. Studies show a lack of significant difference between trial groups in hemostatic outcomes, such as the number of WHO grade 2-4 bleeds, and number of days with bleeding events. Platelet transfusions increase risks of infectious and non-infectious complications as well as inducing a platelet refractory state. Our Transfusion Free Medicine Program has now performed over 200 autologous hematopoietic stem cell transplants (HCT) in Jehovah's Witnesses who due to religious convictions, do not accept red cell or platelet transfusions. Vitamin K is a fat-soluble vitamin that is required for normal blood clotting. Autologous HCT patients are at risk for vitamin K deficiency from multiple reasons including malnutrition, frequent use of antibiotics, chemotherapy induced gastrointestinal toxicity leading to malabsorption and colitis. The prothrombin test lacks the sensitivity and specificity to detect mild deficiency. A mild vitamin K deficiency may be underdiagnosed in our transplant patients adding to bleeding risk. With the effective use of antifibrinolytic agents and Vitamin K as an alternative to platelet transfusions we believe this may enhance hemostasis and prove a valuable adjunct to a therapeutic approach. Methods Patients in our study were those who were of the Jehovah's Witness faith undergoing autologous HCT for Multiple Myeloma and Lymphoma. Patients received aminocaproic acid as an alternative to platelet transfusion to enhance hemostasis at a dose of 1 g every 4 hours or prophylactically for platelet counts less than 30,000 /uL. Titration to 4 g every 4 hours intravenously was required for platelet counts less than 10,000/ul or clinical bleeding. Vitamin K 10 mg orally or subcutaneous was also started at this time. Results Table 1 illustrates the low number of bleeding events especially grade 3 or 4 that occurred. There were no Grade 3 or 4 bleeding events in patients with platelet counts above 5000/uL. No patient had residual long term effects nor was there an increase in thromboembolic events. Conclusions These data add to the body of literature supporting a therapeutic platelet transfusion strategy in an experienced center for autologous HCT patients and challenges the prophylactic platelet count of 10,000 /uL suggesting instead 5000/uL. The safety and efficacy of antifibrinolytic agents and Vitamin K as an alternative to platelet transfusions to enhance hemostasis in autologous stem cell transplant patients may prove beneficial not only in JW patients but also in those transplant centers wishing to offer a therapeutic platelet transfusion approach and as a strategy to manage platelet refractoriness. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare. OffLabel Disclosure: Aminocaproic Acid is an antifibrinolytic agent approved for treatment of bleeding in surgical patients and hematological bleeding disorders. Vitamin K is approved for use in reversal of anticoagulation from Warfarin, vitamin K deficiency without liver disease and in the newborn.
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Javorski, Michael J., Mina M. Kerolos, Jawed Fareed, and R. Anthony Perez-Tamayo. "Vitamin D and Postoperative Vasopressor Use in Cardiopulmonary Bypass." Clinical and Applied Thrombosis/Hemostasis 24, no. 8 (May 6, 2018): 1322–26. http://dx.doi.org/10.1177/1076029618772357.
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The use of cardiopulmonary bypass (CPB) in cardiac surgery often leads to a systemic inflammatory response. Up to 25% of patients undergoing CPB for cardiac surgery are reported to develop vasoplegic syndrome in the acute postoperative period, in which the patients are refractory to vasopressors. The purpose of this study is to assess vitamin D deficiency as a risk factor for vasoplegia after using CPB. We performed a retrospective review of 1322 patients undergoing adult cardiac surgery requiring CPB. Forty-six patients with previously recorded 25-hydroxy vitamin D (25(OH)D) levels within 6 months of surgery met the conditions of this study. The mean level of 25(OH)D was 32.7 ng/mL (standard deviation [SD] = 15.1). The mean age of patients was 67 (SD = 10.1) years old, most were male (63%) and white (78%). Average CPB time was 140 ± 44 minutes. Postoperative vasopressor use was compared to individual preoperative 25(OH)D levels. As a secondary end point, postoperative vasopressor use and vasoplegia were analyzed between 3 groups: Vitamin D deficient defined as 25(OH)D ≤20 ng/mL (n = 7), vitamin D insufficient defined as 25(OH)D between 20 and 29 ng/mL (n = 15), and vitamin D sufficient defined as 25(OH)D ≥30 ng/mL (n = 24). There was no correlation between vitamin D levels and postoperative vasopressor use. The mean doses of postoperative vasopressor use were 0.088 µg/kg/min (standard error of the mean [SEM] = 0.032), 0.085 µg/kg/min (SEM = 0.037), and 0.072 µg/kg/min (SEM = 0.024) of norepinephrine equivalents for the vitamin D deficient, insufficient, and sufficient groups, respectively. Incidence of vasoplegia for each group was the following: 0.143 for vitamin D deficient, 0.067 for vitamin D insufficient, and 0.125 for vitamin D sufficient. In this pilot study, there does not appear to be a relationship between vitamin D and vasopressor use following cardiac surgery utilizing CPB; however, there appears to be a trend toward an increased vasopressor usage in patients with decreased vitamin D levels. A larger sample size and a prospective analysis are warranted to further assess the significance of the relationship between vasoplegia and vitamin D deficiency. With further investigation, vitamin D has the potential to become a low-cost, low-risk therapeutic for improving outcomes in CPB surgery.
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Moustiés, Célia, Claire Bourlieu-Lacanal, Youna M. Hemery, Bruno Baréa, Pierre Villeneuve, Adrien Servent, Pascaline Alter, et al. "Nutritional quality of Ready-to-Use Therapeutic Foods: focus on lipid composition and vitamin content." OCL 29 (2022): 13. http://dx.doi.org/10.1051/ocl/2022007.
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Severe Acute Malnutrition (SAM) is still a public health issue in many low-income and middle-income countries. Its management has changed with the development of Ready-to-Use Therapeutic Foods (RUTF) that are energy-dense, lipid-based, micronutrient-enriched foods. The purpose of the present study was to define some aspects of the nutritional profile (in particular, lipid content, fatty acids profile, lipophilic vitamin content), oxidative status, and mycotoxin content of three RUTF products (of which two manufactured in Asia and one in Europe), at different time points during their storage. All RUTF displayed good lipid stability, with peroxide values < 10 meqO2/kg lipids, acidity index < 0.6 g/100 g lipids, and very low amounts of secondary oxidation volatile compounds. Only the one produced in Europe complied with the international recommendations on vitamin A and E contents. Lipid content ranged from 28.7 ± 0.5 to 41.2 ± 2.4 g/100 g. Oleic acid, palmitic acid, and linoleic acid (47.2 ± 7.4%, 26.8 ± 2.1%, and 12.4 ± 3.9% of total lipids, respectively) were the main fatty acids. Only one of the samples made in Asia exceeded the regulatory limit of mycotoxins. The RUTF lipid phase was rather stable at ambient temperature from 9 to 12 months, and appropriate packaging may have contributed to a major stability.
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Badawy, Ingy, Mahmoud Mohsen, Alaa Ahmed, Shrouk Mahmoud, Amany Saeed, Amr Atef, AlTaher Rabea, Marina Mauric, and Baher Zlat. "NOVEL THERAPEUTIC USE OF INSULIN AND VITAMIN E IN (NAFLD) USING FATTY LIVER INDUCED RATS." International Journal of Advanced Research 6, no. 5 (May 31, 2018): 927–31. http://dx.doi.org/10.21474/ijar01/7113.
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Dias, Bina F., and Aparna Dilip Nimkar. "Effect of medical nutrition therapy on vitamin C and malondialdehyde in HIV positive malnourished children." International Journal of Research in Medical Sciences 5, no. 11 (October 27, 2017): 4822. http://dx.doi.org/10.18203/2320-6012.ijrms20174927.
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Background: The objective is to assess the effect of medical nutrition therapy on biochemical parameters like Vitamin C and Malondialdehyde by estimating oxidative stress in HIV positive malnourished childrens’ sample. Any alteration in the antioxidant markers can help to assess the effectiveness of MNT as a therapeutic agent. There is limited data on the use of Ready to Use Therapeutic Food (RUTF) in India. Therefore, the study was conducted to determine the effect of prepared Ready to Use Therapeutic Food (RUTF) also termed as Medical Nutrition Therapy (MNT) in HIV positive malnourished children.Methods: In this prospective comparative study, pre MNT and post MNT sample as well as the parameters-Malondialdehyde and Vitamin C were analyzed in 19 HIV positive malnourished children in the age group of 6-12 years at L.T.M.M. College. HIV positive malnourished children showed adverse effects on nutrition as well as immune system. Thus, to supply adequate micronutrients and macronutrients, the subjects were treated with Medical Nutrition Therapy (MNT).Results: The post MNT HIV positive malnourished childrens’ samples revealed significant results than pre MNT HIV positive malnourished childrens’ samples.Conclusions: The level of antioxidant marker (vitamin C) increased and peroxidation marker (MDA) decreased post medical nutrition therapy. The increased post levels of vitamin C activity helped in the eradication of excess free radicals, thereby reducing oxidative stress and hence the oxidative damage to cells as well as inhibiting lipid peroxidation (which is indicated by decreased post level MDA).
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Grant, Frederick, Robert Ackatia-Armah, Haile Okuku, and Rogers Kakuhenzire. "Association Between Nutrition Social Behavior Change Communication and Improved Caregiver Health and Nutrition Knowledge, Attitudes and Practices in Rural Tanzania." Current Developments in Nutrition 4, Supplement_2 (May 29, 2020): 193. http://dx.doi.org/10.1093/cdn/nzaa043_044.
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Abstract Objectives Efforts to improve infant and young child (IYC) feeding practices include the use of nutrition social behaviour change communication (SBCC) among caregivers of children under 5y. We assessed the association between monthly participation in community-level nutrition group meetings on caregiver health and nutrition knowledge, attitudes and practices (KAPs). Methods Data from community-based cross-sectional survey conducted in Eastern and Southern Highland Zones of Tanzania, were used. Indices were developed for caregivers’ knowledge on nutrition, health-and-childcare, household and young child dietary diversity, and vitamin A intakes. Impact of the number of nutrition meeting attendance on caregiver knowledge and practices scores were examined using multiple regression analyses controlling for potential caregiver socio-demographic confounders such as maternal age, marital status, education, employment, household size, and household wealth index. Results Out of 547 caregivers surveyed, 49.7% attended nutrition group meetings and received information on nutrition SBCC while 50.3% did not. Overall, 28% of participating women had a moderate level of nutrition knowledge, 62% had high level of vitamin A knowledge, and 57% had high level of health-and-childcare knowledge. Participation in nutrition group meetings was significantly associated with health-and-childcare knowledge score, household and young child dietary diversity scores, and household and young child vitamin A intake; magnitude of the associations were greater for caregivers who attended at least four meetings. Conclusions Our findings emphasize the need for programmes that seek to address the issues present in the use of nutrition SBCC at community level to improve maternal/caregiver KAPs and subsequently to improve nutrition status of infant and young children. Funding Sources UKAID.
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Begum, Sartaz, Derick R. Mwakimbwala, Gideon Sangiwa, and Valence M. K. Ndesendo. "Chemical Analysis, Antibacterial Activities and Uses of Leaves and Calyces of Hibiscus sabdariffa Grown in Dodoma, Tanzania." Tanzania Journal of Science 48, no. 4 (December 30, 2022): 785–92. http://dx.doi.org/10.4314/tjs.v48i4.6.
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Preliminary phytochemical screening of aqueous and ethanolic extracts of Hibiscus sabdariffa grown in Tanzania revealed the presence of secondary metabolites like steroids, tannins, saponins, glycosides, terpenoids, flavonoids along with L-ascorbic acid (vitamin C) and iron(II). Furthermore, both leaves and calyces showed antibacterial activities (agar well diffusion method) against selected bacterial species (Escherichia coli, Staphylococcus aureus, Salmonella typhi and Shigella sonnei), but calyces possessed potent antibacterial activities compared to leaves. The results also supported the claimed traditional uses of this plant. When interrogated during the cross-sectional study in Dodoma region, 54% of the respondents claimed the plant is used to treat anaemia (supposedly as it increases haemoglobin levels), 23% claimed it is used in the preparation of local wine and the remaining respondents stated use in both areas. Furthermore, the intake of H. sabdariffa leaves and calyces on regular basis can boost the immunity system and helps in preventing bacterial and viral infections as the plant is loaded with flavonoids and vitamin C. Thus, the results observed for the plant H. sabdariffa that is grown in Dodoma in small scale for traditional uses, paves a way for consideration of future large scale production of pharmaceutical and neutraceutical products in Tanzania.
Keywords: Phytochemical screening, Hibiscus sabdariffa, antibacterial activity, L-ascorbic acid and iron(II)
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Petrushina, A. D., Daria M. Slashcheva, N. S. Brynza, N. D. Pirogova, S. V. Sosnovskaya, and A. P. Chernova. "VITAMIN D AND LATENT TUBERCULOSIS INFECTION IN SCHOOLCHILDREN." Russian Pediatric Journal 22, no. 6 (December 15, 2019): 344–48. http://dx.doi.org/10.18821/1560-9561-2019-22-6-344-348.
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The World Health Organization has adopted the global TB strategy for the period of 2016-2035. To achieve its targets, it is necessary to propose and introduce new approaches for the prevention and treatment of latent tuberculosis infection (LTBI) in children and adolescents, as a potential source of active tuberculosis development. In this regard, the use of vitamin D (cholecalciferol) may become promising in combating tuberculosis, since most researchers suppose an adequate level of cholecalciferol to have a positive preventive and therapeutic effect in children with active and latent tuberculosis. So far the use of vitamin D may be appropriate, especially in children not adequately provided with vitamin D. The paper presents the results of the vitamin D levels study before and after prescribing cholecalciferol, as well as the dynamics of the tuberculin skin tests in school-age LTBI children receiving preventive treatment with anti-TB drugs. At the initial examination, a normal level of 25-hydroxycholecalciferol (25(OH)D) was not detected in any child. After 3 months of administration of vitamin D in therapeutic doses, a normal concentration of 25(OH)D was observed in 52% of the children examined repeatedly. Analysis of the tuberculin skin test dynamics showed 47.6% of children to have a negative/doubtful test result after 3 months of treatment with anti-TB drugs and vitamin D. In 9.5% of patients, the size of the papule did not change during treatment. It is important to note that in these children, the 25(OH)D level also did not increase. А vitamin D intake at a therapeutic dosage did not cause hypercalcemia or hypercalciuria in any child. LTBI children are inadequately provided with cholecalciferol. There fore it is necessary to determine the level of vitamin D in the blood, then to prescribe the vitamin D, regardless of the time of year, along with standard therapy for a more effective outcome of LTBI treatment and prevention of active forms of tuberculosis in the future.
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Shen, Hongwei, and Bingyan Zhan. "Effect of vitamin E on stroke-associated pneumonia." Journal of International Medical Research 48, no. 9 (September 2020): 030006052094965. http://dx.doi.org/10.1177/0300060520949657.
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Objective To study the role of vitamin E in stroke-associated pneumonia. Methods We selected 183 patients with stroke-related pneumonia who were divided into different nutrition groups according to the Mini Nutritional Assessment score. Patients were then administered different doses of vitamin E. Results CD55 and CD47 levels in patients taking vitamin E across different nutrition score groups were better than those in patients who did not use vitamin E. The levels of CD55 and CD47 and the duration of hospitalization were better in the high-dose vitamin E group than in the low-dose vitamin E group. Conclusion Vitamin E may have an auxiliary therapeutic effect in patients with stroke-associated pneumonia.
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Hassan, Syed Hafeez ul. "Malnutrition Challenge Therapeutic Strategy." Journal of Aziz Fatimah Medical & Dental College 1, no. 2 (November 19, 2019): 77–78. http://dx.doi.org/10.55279/jafmdc.v1i2.58.
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SUMMARYMalnutrition is a broad term which describes nutritional related diseases caused by over and under nutrition, found in the hospitals or in famines. Therefore malnutrition can be categorized as over nutrition and obesity resulting into metabolic syndrome characterized by hyperglycemia, hypertension, dyslipidemia, hyperuricemia and decreased vitamin D in some cases. Whereas under nutrition with inflammation can be as a result of chronic illness, acute illness/injury or simply decreased dietary intake when there is no inflammation. The initial assessment can be done by simple clinical measures such as recording weight and BMI and serum albumin estimation. The adjusted nutrition plan during sickness involves assessment of calories requirement under the circumstances and then to use appropriate nutrition or premade nutrition formulas to meet the new requirements during disease or after surgery. The therapeutic strategy which also includes nutrition assessment and treatment may result in decrease in complications hence decreased hospital stay and cost of treatment having better hospital outcomes.
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Khodjaeva, Zulfiya A. "THERAPEUTIC APPROACH TO THE TREATMENT OF PATIENTS WITH INFLAMMATORY DORSALGIA." Oriental Journal of Medicine and Pharmacology 02, no. 02 (April 1, 2022): 1–12. http://dx.doi.org/10.37547/supsci-ojmp-02-02-01.
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After analyzing the effectiveness of SWT and vitamin D in the complex treatment of patients with dorsalgia, we came to the conclusion that the use of SWT is safe and effective, has an analgesic systemic effect, which normalizes local microcirculation and makes it possible to reduce the dose of prescribed drugs, reducing the risk of side effects of NSAIDs. in patients with dorsalgia of inflammatory origin.
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Gatera, Vesara Ardhe, Rizky Abdulah, Ida Musfiroh, Raden Tina Dewi Judistiani, and Budi Setiabudiawan. "Updates on the Status of Vitamin D as a Risk Factor for Respiratory Distress Syndrome." Advances in Pharmacological Sciences 2018 (September 30, 2018): 1–6. http://dx.doi.org/10.1155/2018/8494816.
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To update the guidelines regarding vitamin D status in respiratory distress syndrome, we reviewed recent human and animal studies on the benefits of vitamin D in respiratory distress. We searched PubMed and ProQuest for studies on the use of vitamin D from 2009 to 2017. The common parameters in these studies included the use of lung tissue, phospholipids, blood, and plasma to assess the effects of vitamin D on respiratory syndrome. The metabolized form of vitamin D used in these studies was 1,25(OH)2D3 in animal studies and 25(OH)D in human studies. Vitamin D supplementation decreases the risk of respiratory distress syndrome, improves the quality of life, and is relatively effective and safe for preterm neonates as well as during lung maturation. However, although vitamin D supplementation may offer benefits for respiratory distress syndrome, the optimal dosing strategies for specific types of risk factors in the lungs must be clarified to confirm the therapeutic efficacy.
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Knepper, J., E. Ramacciotti, and T. W. Wakefield. "Novel anticoagulants: a discussion of clinical use in the treatment and prevention of venous thromboembolism." Phlebology: The Journal of Venous Disease 26, no. 1 (January 14, 2011): 3–7. http://dx.doi.org/10.1258/phleb.2010.010023.
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Traditional therapeutic oral anticoagulation strategies often require invasive dosing or monitoring. Vitamin K antagonists (VKAs) have a large number of interactions, delayed onset requires frequent dose monitoring, and they have a small margin between therapeutic dose and bleeding complications. Novel oral anticoagulants, such as dabigatran, rivaroxaban and apixaban, are being developed to prevent those VKAs drawbacks. Besides oral bioavailability, those compounds are designed to require minimal to no monitoring and have a favourable safety profile. This review reports efficacy and safety data of these compounds throughout clinical development, as well as new approaches for oral pharmacological management of venous thromboembolism.
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Kashiouris, Markos G., Michael L’Heureux, Casey A. Cable, Bernard J. Fisher, Stefan W. Leichtle, and Alpha A. Fowler. "The Emerging Role of Vitamin C as a Treatment for Sepsis." Nutrients 12, no. 2 (January 22, 2020): 292. http://dx.doi.org/10.3390/nu12020292.
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Sepsis, a life-threatening organ dysfunction due to a dysregulated host response to infection, is a leading cause of morbidity and mortality worldwide. Decades of research have failed to identify any specific therapeutic targets outside of antibiotics, infectious source elimination, and supportive care. More recently, vitamin C has emerged as a potential therapeutic agent to treat sepsis. Vitamin C has been shown to be deficient in septic patients and the administration of high dose intravenous as opposed to oral vitamin C leads to markedly improved and elevated serum levels. Its physiologic role in sepsis includes attenuating oxidative stress and inflammation, improving vasopressor synthesis, enhancing immune cell function, improving endovascular function, and epigenetic immunologic modifications. Multiple clinical trials have demonstrated the safety of vitamin C and two recent studies have shown promising data on mortality improvement. Currently, larger randomized controlled studies are underway to validate these findings. With further study, vitamin C may become standard of care for the treatment of sepsis, but given its safety profile, current treatment can be justified with compassionate use.
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Sartori, Alexandrina, SofiaFernanda Gonçalves Zorzella-Pezavento, LuizaAyumi Nishiyama Mimura, MarinaBonifácio Denadai, WilliamDanilo Fernandes de Souza, and ThaisFernanda de Campos Fraga-Silva. "Is there a window of opportunity for the therapeutic use of vitamin D in multiple sclerosis?" Neural Regeneration Research 17, no. 9 (2022): 1945. http://dx.doi.org/10.4103/1673-5374.335139.
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Bania, Angelina, Konstantinos Pitsikakis, Georgios Mavrovounis, Maria Mermiri, Eleftherios T. Beltsios, Antonis Adamou, Vasiliki Konstantaki, et al. "Therapeutic Vitamin D Supplementation Following COVID-19 Diagnosis: Where Do We Stand?—A Systematic Review." Journal of Personalized Medicine 12, no. 3 (March 8, 2022): 419. http://dx.doi.org/10.3390/jpm12030419.
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Vitamin D has known immunomodulatory activity and multiple indications exist supporting its potential use against SARS-CoV-2 infection in the setting of the current pandemic. The purpose of this systematic review is to examine the efficacy of vitamin D administered to adult patients following COVID-19 diagnosis in terms of length of hospital stay, intubation, ICU admission and mortality rates. Therefore, PubMed and Scopus databases were searched for original articles referring to the aforementioned parameters. Of the 1376 identified studies, eleven were finally included. Vitamin D supplements, and especially calcifediol, were shown to be useful in significantly reducing ICU admissions and/or mortality in four of the studies, but not in diminishing the duration of hospitalization of COVID-19 patients. Due to the large variation in vitamin D supplementation schemes no absolute conclusions can be drawn until larger randomized controlled trials are completed. However, calcifediol administered to COVID-19 patients upon diagnosis represents by far the most promising agent and should be the focus of upcoming research efforts.
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Janjusevic, Milijana, Alessandra Lucia Fluca, Giulia Gagno, Alessandro Pierri, Laura Padoan, Annamaria Sorrentino, Antonio Paolo Beltrami, Gianfranco Sinagra, and Aneta Aleksova. "Old and Novel Therapeutic Approaches in the Management of Hyperglycemia, an Important Risk Factor for Atherosclerosis." International Journal of Molecular Sciences 23, no. 4 (February 20, 2022): 2336. http://dx.doi.org/10.3390/ijms23042336.
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Hyperglycemia is considered one of the main risk factors for atherosclerosis, since high glucose levels trigger multiple pathological processes, such as oxidative stress and hyperproduction of pro-inflammatory mediators, leading to endothelial dysfunction. In this context, recently approved drugs, such as glucagon-like-peptide-1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter-2 inhibitors (SGLT2i), could be considered a powerful tool for to reduce glucose concentration and cardiovascular risk. Interestingly, many patients with type 2 diabetes mellitus (T2DM) and insulin resistance have been found to be deficient in vitamin D. Recent studies pointed out the unfavorable prognostic values of T2DM and vitamin D deficiency in patients with cardiac dysfunction, either when considered individually or together, which shed light on the role of vitamin D in general health status. New evidence suggests that SGLT2i could adversely affect the production of vitamin D, thereby increasing the risk of fractures, which are common in patients with T2DM. Therefore, given the biological effects of vitamin D as an anti-inflammatory mediator and a regulator of endothelial function and calcium equilibrium, these new findings should be taken into consideration as well. The aim of this review is to gather the latest advancements regarding the use of antidiabetic and antiplatelet drugs coupled with vitamin D supplementation to control glucose levels, therefore reducing the risk of coronary artery disease (CAD).
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Lordi, Alexis, Nida Ansari, Michael Maroules, and Anusha Manjegowda. "Splenomegaly in a Patient with a History of Pernicious Anemia; the Potential Therapeutic Effects of B12 Therapy." Case Reports in Hematology 2022 (April 11, 2022): 1–3. http://dx.doi.org/10.1155/2022/2854520.
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Splenomegaly is manifested by a variety of etiologies, one of which is macrocytic anemia. Macrocytic anemia has multiple causes in itself that include; folate (Vitamin B9) and Cobalamin (vitamin B12) deficiencies. In this case report, we present a patient with a history of pancytopenia, macrocytic anemia and vitamin B12 deficiency, who underwent a splenectomy. The differential diagnoses for the cause of the patient’s splenomegaly included: lymphoma, infiltrative disease, and idiopathic splenomegaly. The pathology report from the splenectomy did not reveal any evidence of lymphoma or infiltrative disease, however, it did mention vascular congestion of the spleen. In theory, vascular congestion, due to extramedullary hematopoiesis in the spleen or sequestration of blood cell lineages, could lead to pancytopenia. In prior visits to the hospital this patient was diagnosed with: splenomegaly, and macrocytic anemia due to pernicious anemia. A splenectomy puts one at increased risk for infection by encapsulated organisms, and is to be avoided if possible. There are few case reports and studies that show vitamin B12 therapy can potentially cause a reversal in the splenomegaly as well as a reversal in the pancytopenia and macrocytic anemia. We hope to show that the least invasive treatment for vitamin B12, vitamin therapy, can be of use and effective.
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Pedraza-Chaverri, José, Laura G. Sánchez-Lozada, Horacio Osorio-Alonso, Edilia Tapia, and Alexandra Scholze. "New Pathogenic Concepts and Therapeutic Approaches to Oxidative Stress in Chronic Kidney Disease." Oxidative Medicine and Cellular Longevity 2016 (2016): 1–21. http://dx.doi.org/10.1155/2016/6043601.
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In chronic kidney disease inflammatory processes and stimulation of immune cells result in overproduction of free radicals. In combination with a reduced antioxidant capacity this causes oxidative stress. This review focuses on current pathogenic concepts of oxidative stress for the decline of kidney function and development of cardiovascular complications. We discuss the impact of mitochondrial alterations and dysfunction, a pathogenic role for hyperuricemia, and disturbances of vitamin D metabolism and signal transduction. Recent antioxidant therapy options including the use of vitamin D and pharmacologic therapies for hyperuricemia are discussed. Finally, we review some new therapy options in diabetic nephropathy including antidiabetic agents (noninsulin dependent), plant antioxidants, and food components as alternative antioxidant therapies.
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Bender, David A. "Non-nutritional uses of vitamin B6." British Journal of Nutrition 81, no. 1 (January 1999): 7–20. http://dx.doi.org/10.1017/s0007114599000082.
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Vitamin B6is a water-soluble vitamin, and is readily metabolized and excreted, so it has generally been assumed to have negligible toxicity, although at very high levels of intake it can cause peripheral nerve damage. Nutritional deficiency disease is extremely rare, although a significant proportion of the population shows biochemical evidence of inadequate status, despite apparently adequate levels of intake. The vitamin has been used to treat a wide variety of conditions, which may or may not be related to inadequate intake. In some conditions use of vitamin B6supplements has been purely empirical; in other conditions there is a reasonable physiological or metabolic mechanism to explain why supplements of the vitamin many times greater than average requirements may have therapeutic uses. However, even in such conditions there is little evidence of efficacy from properly conducted controlled trials.
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GARG, RAVENDRA, NIRPENDRA SINGH, and ANURADHA DUBE. "Intake of nutrient supplements affects multiplication ofLeishmania donovaniin hamsters." Parasitology 129, no. 6 (November 18, 2004): 685–91. http://dx.doi.org/10.1017/s0031182004006055.
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The role of the essential nutrients, vitamins A,B (complex), C and E and iron, as prophylactic as well as supportive therapy in experimental visceral leishmaniasis (VL), was studied in hamsters. Prophylactic administration of vitamin C (50, 100 and 250 mg/kg) from day15 to day 0 (15 doses) significantly reduced the intake ofLeishmania donovaniin hamsters but had no therapeutic effect. In contrast, vitamins A,B complex and E and iron, whether used prophylactically or therapeutically, promoted parasite multiplication. The efficacy of sodium stibogluconate, a reference antileishmanial drug, was appreciably improved in animals administered prophylactically with vitamin C. However, supplementation of vitamin C during established infections resulted in reduced drug action. The results show that the prophylactic use of vitamin C may prevent the onset of leishmania infection and cautions against the indiscriminate use of nutrient supplements such as vitamin A, B complex, and E and iron in VL endemic areas.
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Haamit Abba-Kabir, Claude-Audrey Meguieze, Esther Voundi Voundi, Eric Nseme Etouckey, Carlin Ntoukem Mbakop, and Paul Koki Ndombo. "Therapeutic use and covid-19 in a pediatric population in Yaoundé." World Journal of Advanced Research and Reviews 15, no. 1 (July 30, 2022): 311–16. http://dx.doi.org/10.30574/wjarr.2022.15.1.0657.
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Introduction: The COVID-19 pandemic is an airborne or hand borne viral respiratory disease. Its treatment is not yet totally codified. Objective: The aim of this study was to describe the therapeutic remedies of COVID-19 in a paediatric population in Yaoundé. Materials and methods: A cross sectional descriptive study was conducted in Nkolndongo health district from January to May 2021 for a duration of 5 months. All patients aged 0 to 19 years, tested COVID-19 by RT-PCR and managed in the Nkolndongo health district were included. Results were analysed using IBM SPSS.23.0 software and data expressed as frequencies and percentages. Results: This study revealed that among the 48 patients tested positive 100%have received drugs as instructed by the national protocol 2020. The molecules involved included: introychloroquine, azithromycin, zinc and vitamin C. At the same time, 39.6% have received paracetamol and 4.16% have received oxygen. In addition of the national protocol drugs 43.75% have used Zingiber officinale and Citrus limon, 33.33% have used Cinchona officinalis, 25% have consumed Allium sativum, 22.92% Allium cepa, 8.33% honey, 6.25% Moringa oleifera and 10.41% mint crystals. Conclusion: The treatment was according to the national COVID-19 protocol 2020. A high proportion of children has used traditional pharmacopoeia.
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Iamsawat, Supinya, Anusara Daenthanasanmak, and Xue-Zhong Yu. "Vitamin C Stabilizes CD8iTregs and Enhances Their Therapeutic Potential in Controlling GvHD and Leukemia Relapse." Blood 132, Supplement 1 (November 29, 2018): 4532. http://dx.doi.org/10.1182/blood-2018-99-117036.
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Abstract Graft-versus-host disease (GvHD) remains a leading cause of non-relapse mortality after allogeneic hematopoietic cell transplantation (allo-HCT). The imbalance between T effector (Teffs) and regulatory cells (Tregs) is a defined characteristic of GvHD. Therefore, promoting Tregs for controlling GvHD has drawn an intense interest in preclinical and clinical studies of allo-HCT. Although CD4 Tregs (CD4+Foxp3+) have been shown to effectively prevent GvHD, they impaired graft-versus-leukemia (GVL) effect. Our lab has previously demonstrated that CD8 iTregs (CD8+Foxp3+) not only suppressed allogeneic T-cell responses, but also possessed the GVL activity themselves. However, instability of Foxp3 in CD8 iTregs is a major obstacle to translate this Treg population into clinic application. Vitamin C has been reported to promote Foxp3 stability by accelerating its demethylation. In the current study, we asked whether vitamin C could stabilize CD8 iTregs and enhance their therapeutic potential in controlling GvHD. Addition of vitamin C in the culture significantly increased the generation of allo-reactive CD8 iTregs in vitro (Fig. 1A). These CD8 iTregs generated with vitamin C had strikingly increased demethylation on Foxp3 CpGs (Fig. 1B) and superior suppressive activity (data not shown) compared to control-treated CD8 iTregs. We further evaluated the capability of vitamin C-treated CD8 iTregs in preventing GvHD in allo-HCT. Using a MHC-mismatched murine BMT model, vitamin C-treated CD8 iTregs could significantly alleviate GvHD reflected by a marked reduction of recipient mortality (Fig. 1C) and clinical scores (data not shown). To determine the Foxp3 stability in vivo, we analyzed the transferred CD8 iTregs and allogeneic Teffs in recipient spleens 7 days after allo-HCT. Vitamin C-treated CD8 iTregs (Ly5.2+) remarkably suppressed Teff (Ly5.1+) expansion and maintained higher Foxp3 expression compared to the control iTregs (Fig. 1D). To address a critical question whether vitamin C-treated CD8 iTregs can preserve the GVL activity, we performed a haploidentical transplant with a leukemia relapse model, and found that vitamin C-treated CD8 iTregs not only attenuated GvHD severity, but also prevented recipients from tumor relapse (Fig. 1E). In conclusion, our studies provide a rationale and mean to use stabilized CD8 iTregs with vitamin C for controlling GvHD and leukemia relapse in the clinic. Disclosures No relevant conflicts of interest to declare.
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Jeetendra, Singh, and Baheti Tushar. "Metformin Use and Vitamin B12 Deficiency in Patients with Type-2 Diabetes Mellitus." MVP Journal of Medical Sciences 3, no. 1 (February 29, 2016): 67. http://dx.doi.org/10.18311/mvpjms/2016/v3/i1/731.
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Metformin is commonly used oral hypoglycaemic agent in the treatment of type-2 Diabetes Mellitus (DM). One of the important side effect of long term metformin therapy is malabsorption of vitamin B<sub>12</sub> which could lead to megaloblastic anemia and peripheral neuropathy. Therefore annual screening of serum vitamin B<sub>12</sub> level or serum methylmalonic acid (MMA)/serum homocysteine level should be done in cases taking metformin for more than four to five years with average dose of >1g per day, even in the absence of haematological or neurological abnormalities. However, as the incidence of type-2 DM is increasing, cost of annual measurement of vitamin B<sub>12</sub> level also increases. Considering cost factor for annual screening, vitamin B<sub>12</sub> supplementation appears to be more cost effective approach rather than annual screening for routine prophylaxis. Routine vitamin preparations available in the market may contain less amount of B<sub>12</sub> and hence are not of much therapeutic use in treatment of B<sub>12</sub> deficiency due to Metformin. Hence there is a need to look for higher doses of approximately 500-2000μg/day.
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Simonetti, Sérgio Henrique, Gustavo Bernardes de Figueiredo Oliveira, Fabiana Cristina Lourenço, and França João Ítalo Dias. "Accuracy of an adherence score and time in therapeutic range among patients on chronic use of vitamin K antagonists." Research, Society and Development 10, no. 8 (July 16, 2021): e59510816523. http://dx.doi.org/10.33448/rsd-v10i8.16523.
Full textAbstract:
To validate and analyze the accuracy of the Simonetti adherence score among patients on chronic use of vitamin K antagonists and their time in therapeutic range (TTR) of the international normalized ratio as a measure of quality of anticoagulation. A prospective cohort study with a nonrandomized intervention in patients from an anticoagulation center of a public hospital. Baseline data were collected from May to September 2017, and follow-up data were obtained eight months after a nurse-led educational intervention, which was given to all patients after consent form and after applying the adherence score (N=205). The intervention was undertaken through 30-40 min conversation about relevant factors that had been previously identified in the score derivation study, which comprised drug-drug interactions, inadequate OAC use, comorbidities, effects of food on vitamin K absorption, and invasive procedures. A receiver operating characteristic (ROC) curve was applied to validate the adherence score in terms of prediction of INR out of recommended therapeutic range. At baseline, mean adherence score was 44.69 and standard deviation (SD) was 18.37, and mean TTR was 41.07 (SD 15.40). Patients were reassessed after 8 months. At follow-up, there were significant improvements in mean adherence score 54.28 (SD 13.13), and in mean TTR 50.99 (SD 26.10). The Simonetti adherence score yielded high performance and accuracy in clinical practice among patients on chronic use of vitamin K antagonists. Our data indicate that nurse led educational intervention yielded favorable impact in terms of adherence score and TTR improvements.
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Farahmand, P., and J. D. Ringe. "Therapeutic options in male osteoporosis." Osteologie 22, no. 04 (2013): 271–76. http://dx.doi.org/10.1055/s-0038-1630134.
Full textAbstract:
SummaryOsteoporosis in men is increasingly recognized as an important public health problem but affected patients are still under-diagnosed and -treated. As in women the diagnostic and therapeutic strategy has to be adapted to the individual case. In the practical management it is very important to detect possible causes of secondary osteoporosis, to explain the possibilities of basic therapy counteracting individual risk factors and communicate that osteoporosis is a chronic disease and adherence to a long-term treatment is crucial. In established severe osteoporosis a careful analgesic therapy is important to avoid further bone loss related to immobility. In elderly men with increased risk of falling insufficient Vitamin D supply or impaired activation of Vitamin D due to renal insufficiency must be taken into consideration. Specific medications available today for the treatment of male osteoporosis comprise among antiresorptive drugs the bis phosphonates alendronate, risedronate and zoledronic acid. Denosumab, the first biological therapy is approved for men with androgen deprivation therapy for prostate cancer. An important advantage of this potent antiresorptive drug is the increased adherence due to the comfortable application by sixmonthly subcutaneous injections. Study results from the 2-year multi-center randomized controlled ADAMO-Study will very soon allow the use of denosumab in all types of male osteoporosis. Teriparatide, the 34 N-terminal amino acid sequence of parathyroid hormone was approved for men with osteoporosis as an anabolic agent based on proven efficacy by different studies. Among drugs with other modes of action the D-hormone pro-drug alfacalcidol can be used in men alone or in combination with the advantage of pleiotropic effects on calcium absorption, parathyroids, bone and muscle. Recently also Strontium-ranelate was approved for male patients with the limitation to exclude men with clinical relevant cardiovascular risk factors. In general the possibilities to treat male osteoporosis have considerably improved during recent years. Today there is a choice of a spectrum of drugs from mild to strong potency with different modes of action on bone turnover to design strategies for individual male patients.
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Bode, C., and M. Moser. "Antikoagulation bei Vorhofflimmern." Hämostaseologie 32, no. 01 (2012): 37–39. http://dx.doi.org/10.5482/ha-1186.
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SummaryAtrial fibrillation is one of the most frequent reasons for therapeutic anticoagulation in everyday practice. Oral vitamin K antagonists such as Marcumar have been state of the art anticoagulants to prevent thrombembolic events in patients with atrial fibrillation and additional risk factors. But these drugs are accompanied by disadvantages such as increased bleeding risk and impaired quality of life caused by interactions with food or other medications as well as frequent controls of INRs.The new anticoagulants apixaban, rivaroxaban and dabigatran are direct antagonists of coagulation factors (FXa or FIIa) and demonstrate a promising risk/benefit profile in large clinical trials compared with vitamin K antagonists.Their approval for clinical use will open up new therapeutic perspectives for patients with atrial fibrillation and indication for anticoagulation.
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Brum, Doralina Guimarães, Elizabeth Regina Comini-Frota, Claúdia Cristina F. Vasconcelos, and Elza Dias-Tosta. "Supplementation and therapeutic use of vitamin D in patients with multiple sclerosis: Consensus of the Scientific Department of Neuroimmunology of the Brazilian Academy of Neurology." Arquivos de Neuro-Psiquiatria 72, no. 2 (February 2014): 152–56. http://dx.doi.org/10.1590/0004-282x20130252.
Full textAbstract:
Multiple sclerosis (MS) is an inflammatory, autoimmune, demyelinating, and degenerative central nervous system disease. Even though the etiology of MS has not yet been fully elucidated, there is evidence that genetic and environmental factors interact to cause the disease. Among the main environmental factors studied, those more likely associated with MS include certain viruses, smoking, and hypovitaminosis D. This review aimed to determine whether there is evidence to recommend the use of vitamin D as monotherapy or as adjunct therapy in patients with MS. We searched PUBMED, EMBASE, COCHRANNE, and LILACS databases for studies published until September 9 th , 2013, using the keywords “multiple sclerosis”, “vitamin D”, and “clinical trial”. There is no scientific evidence up to the production of this consensus for the use of vitamin D as monotherapy for MS in clinical practice.
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Sun, Hui, Xiaoshuai Zhu, Dan Li, and Tao Cheng. "Effects of a compound vitamin B mixture in combination with GeneTime® on radiation-induced oral mucositis." Journal of International Medical Research 47, no. 5 (April 2, 2019): 2126–34. http://dx.doi.org/10.1177/0300060519831171.
Full textAbstract:
Objective Both compound vitamin B mixtures and GeneTime® have been used in treatment of oral inflammation. This study aimed to assess the therapeutic effects of a compound vitamin B mixture combined with GeneTime® on radiation-induced oral mucositis. Methods A total of 100 patients with radiation-induced oral mucositis were randomly divided into a control group (vitamin B alone; n = 50 patients) and an observation group (vitamin B plus GeneTime®, n = 50 patients). Clinical outcomes were compared between the two groups for the following 3 weeks. Results The observation group had a significantly greater number of grade 0–I patients and significantly fewer grade II–IV patients than the control group. Among patients in the observation group, a significantly greater number of ulcers healed within 1–2 weeks, compared with those in patients in the control group. Significantly fewer ulcers healed among patients in the observation group at 3 weeks; notably, there were fewer ulcers to heal in the observation group, compared with the control group. Conclusions Use of a compound vitamin B mixture combined with GeneTime® exerted obvious therapeutic effects on radiation-induced oral mucositis and markedly shortened ulcer healing time. Therefore, this strategy may be useful in clinical applications.