[Scurvy, a serious and rare form of avitaminosis, easily
diagnosed and treated. Presentation of a case].
[Article in Spanish]
Gil Llano JR1, Grespo Rincn L, Ruiz Llano FC, Costo Campoamor A,
Mateos Polo L, Gonzlez MA.
Author information
1Servicios de Medicina Interna, Hospital San Pedro de Alcntara,
Cceres.
Abstract
We report a 66 years-old man case that was admitted with
abdominal wall hemorrhagic swelling ecchymosis on inferior
extremities and perifollicular purpura with hyperkeratosis of the
follicles, which gives it an appearance of palpable purpura,
together with gingival hemorrhage and moderate anemia. He was a
well-nourished sick man but who made a peculiar diet, practically
free from fruit and vegetables which developed a pure and serious
form of scurvy. We report this case because we consider that the
features which appear are illustrative to provide the immediate
clinical diagnosis of this uncommon disease, potentially mortal,
but easy to diagnose, if we think about it in the adequate clinical
contexts, and which it is quickly curable with the administration
of ascorbic acid.
Comment in
[Vitamin C deficiency: scurvy. Report of a case]. [An Med
Interna. 1996]
Prevalence of Vitamin D Insufficiency and Deficiency among Young
Physicians at University District Hospital in San Juan, Puerto
Rico.
Ramrez-Vick M1, Hernndez-Dvila L1, Rodrguez-Rivera N1,
Lpez-Valentn M2, Haddock L1, Rodrguez-Martnez R3, Gonzlez-Bossolo
A3.
Author information
1Endocrinology Division, Internal Medicine Department, School of
Medicine, University Hospital, University of Puerto Rico Medical
Sciences Campus, San Juan, PR.
2Puerto Rico Clinical and Translational Research Consortium,
School of Medicine, University of Puerto Rico Medical Sciences
Campus, San Juan, PR.
3Internal Medicine Department, School of Medicine, University
Hospital, University of Puerto Rico Medical Sciences Campus, San
Juan, PR.
Abstract
Vitamin D has been attracting increased attention because of
higher prevalences of vitamin D insufficiency and deficiency than
expected in areas with sufficient sun exposure. Even though
sunlight exposure and diet are the main determinants of vitamin D
status, other factors, such as age, race, the use (or not) of
sunscreen, medications, and malabsorptive conditions, also affect
vitamin D levels. Recent studies have found high prevalences of
vitamin D deficiency and insufficiency in different populations.
However, there are limited data regarding the prevalence of vitamin
D deficiency and insufficiency in Puerto Rico. To shed more light
on the subject, we evaluated a sample of 51 internal medicine
residents and research fellows, aged from 25 to 39 years at the
University District Hospital in San Juan, Puerto Rico, doing so by
means of a questionnaire that explored basic socio demographic and
lifestyle characteristics and collected anthropometric data; in
addition, we obtained blood samples in order to determine
25-hydroxyvitamin D levels. The median 25-hydroxyvitamin D level
was 21 ng/mL (range, 7-38 ng/mL). Forty-five participants (88.2%)
had 25-hydroxyvitamin D concentrations of lower than 30 ng/mL. We
found vitamin D deficiencies in 43.1% of the population and
insufficiencies in 45.1%. Contributory factors to our findings
include limited exposure to sunlight during periods of high sun
intensity, increased body mass index, and a limited area of the
body being exposed to sunlight. A relationship between reduced
physical activity levels and hypovitaminosis D was also found. Both
calcium intake and vitamin D intake, which were markedly below
recommended daily allowances, were positively correlated with
25-hydroxy vitamin D levels, but with a weak association.
KEYWORDS:
25-Hydroxyvitamin D/calcium; Dietary/sunlight exposure/physical
activity; Dietary/vitamin D
Clinical Trial of Vitamin D2 vs D3 Supplementation in Critically
Ill Pediatric Burn Patients.
Gottschlich MM1, Mayes T2, Khoury J3, Kagan RJ4.
Author information
1Department of Research, Shriners Hospitals for Children,
Cincinnati, Ohio Department of Nutrition, Shriners Hospitals for
Children, Cincinnati, Ohio Department of Surgery, University of
Cincinnati College of Medicine, Cincinnati, Ohio
[email protected].
2Department of Nutrition, Shriners Hospitals for Children,
Cincinnati, Ohio Cincinnati Children's Hospital Medical Center,
Cincinnati, Ohio.
3Cincinnati Children's Hospital Medical Center, Cincinnati,
Ohio.
4Department of Surgery, University of Cincinnati College of
Medicine, Cincinnati, Ohio Department of Surgery, Shriners
Hospitals for Children, Cincinnati, Ohio.
AbstractBACKGROUND:
Hypovitaminosis D exists postburn. However, evidence-based
guidelines for vitamin D repletion are unknown. This investigation
examined differences between D2 and D3 supplementation on outcome
in children with burn injuries.
METHODS:
Fifty patients with total body surface area burn of 55.7% 2.6%
and full-thickness injury of 40.8% 3.8% were enrolled, ranging in
age from 0.7-18.4 years. All participants received multivitamin
supplementation per standardized clinical protocol. In addition,
100 IU/kg D2, D3, or placebo was administered daily during
hospitalization using a randomized, double-blinded study design.
Assay of total 25-hydroxyvitamin D (D25), 1,25-dihydroxyvitamin D
(D1,25), 25-hydroxyvitamin D2 (25-OH-D2), 25-hydroxyvitamin D3
(25-OH-D3), and parathyroid hormone (PTH) was performed at 4
preplanned time intervals (baseline, midpoint, discharge, and 1
year postburn). Differences in vitamin D status were compared over
time and at each specific study interval.
RESULTS:
There were no significant differences in serum vitamin D levels
between groups, but >10% of patients had low D25 at discharge,
and percent deficiency worsened by the 1-year follow up for the
placebo (75%), D2 (56%), and D3 (25%) groups. There were no
statistical differences in PTH or clinical outcomes between
treatment groups, although vitamin D supplementation demonstrated
nonsignificant but clinically relevant decreases in exogenous
insulin requirements, sepsis, and scar formation.
CONCLUSIONS:
The high incidence of low serum D25 levels 1 year following
serious thermal injury indicates prolonged compromise. Continued
treatment with vitamin D3 beyond the acute phase postburn is
recommended to counteract the trajectory of abnormal serum levels
and associated morbidity.
2015 American Society for Parenteral and Enteral Nutrition.
KEYWORDS:
burn injury; pediatrics; vitamin D
Plasma vitamin D status in patients with type 2 diabetes with
and without retinopathy.
Reddy GB1, Sivaprasad M2, Shalini T2, Satyanarayana A2,
Seshacharyulu M2, Balakrishna N2, Viswanath K3, Sahay M4.
Author information
1Biochemistry, National Institute of Nutrition, Hyderabad,
India. Electronic address: [email protected].
2Biochemistry, National Institute of Nutrition, Hyderabad,
India.
3Pushpagiri Vitreo Retina Institute, Hyderabad, India.
4Nephrology, Osmania Medical College & Hospital, Hyderabad,
India.
AbstractOBJECTIVE:
Diabetic retinopathy (DR) is a common cause of blindness.
Although an association between hypovitaminosis D and type 1
diabetes is known, the association between vitamin D (VD) and type
2 diabetes (T2D) and its complications such as DR has been unclear.
The aim of this study was to investigate the status of VD in T2D
patients with and without DR.
METHODS:
A cross-sectional case-control study was conducted with 99
normal control (CN) participants and 164 patients with T2D, of
which 82 had retinopathy (DR) and 82 did not (DNR). After a
complete ophthalmic examination, inclusive of fundus fluorescein
angiography, the clinical profile and the plasma levels of VD and
calcium were analyzed.
RESULTS:
Although the mean plasma VD levels were significantly lower in
the DNR and DR groups compared with the CN group, no significant
differences were observed between the groups with diabetes.
Although the mean levels of VD in all three groups were below the
normal range, the prevalence of VD deficiency (VDD) was higher in
the DNR and DR groups (66% and 63%) than in the CN group (45%),
suggesting that the prevalence of VDD was higher in individuals
with diabetes, regardless of the presence or absence of
retinopathy. However, there were no group differences in the plasma
levels of calcium. Additionally, VDD did not seem to be related to
patient's age or body mass index, but was related to the duration
of diabetes.
CONCLUSION:
Results from this study suggest a possible association between
VDD and T2D, but not specifically with DR. Further investigations
are warranted.
Copyright 2015 Elsevier Inc. All rights reserved.
KEYWORDS:
Calcium; Diabetic complications; Diabetic retinopathy; Type 2
diabetes; Vitamin D
Vitamin D and tuberculosis: a review on a hot topic.
Facchini L, Venturini E, Galli L, Martino Md, Chiappini E.
Abstract
The aim of this study is to critically summarize the available
data on the correlation between vitamin D level and tuberculosis
(TB) infection. A literature search covering English language
articles published up to 20 October 2014 was conducted in MEDLINE
database. Three hundred ninety-seven articles were initially
identified, of which 147 studies were initially selected, and other
13 pertinent studies were included. A significant association
between low vitamin D levels and susceptibility to TB infection has
been found.
KEYWORDS:
Children,; Hypovitaminosis D,; Immunity; Mycobacterium
tuberculosis,; Tuberculosis,; Vitamin D,
[Is there vitamin D deficiency in children in a sunny
Mediterranean city?]
[Article in Spanish]
Togo A1, Espadas Maci D2, Blanes Segura S2, Siv Daz N2, Villalba
Martnez C3.
Author information
1Servicio de Pediatra, Hospital Clnico de Valencia, Valencia,
Espaa. Electronic address: [email protected].
2Servicio de Pediatra, Hospital Clnico de Valencia, Valencia,
Espaa.
3Laboratorio de Bioqumica Clnica y Patologa Molecular, Hospital
Clnico de Valencia, Valencia, Espaa.
AbstractINTRODUCTION:
Despite the increasing interest in vitamin D functions, new
cases of deficiency have been reported in sunny regions where
optimal levels are expected. The aim of this study was to analyze
25-hydroxivitamin D levels in children younger than 2 years
admitted for acute mild diseases in a tertiary hospital in Valencia
and its relationship with factors that can be associated with its
deficiency.
METHODS:
This one year prospective and observational study was conducted
on 169 children admitted for acute mild diseases. 25-hydroxivitamin
D levels were analyzed. A standardized physical examination and
structured interviews to the parents were performed. Children were
classified into two groups, according to 25-hydroxivitamin D levels
(cut-off 30ng/mL).
RESULTS:
A total of 169 children were included, with a median age of 9
months, being more prevalent Caucasians (75.7%) and youger than one
year old (79.3%). Almost one quarter (24.3%) of the children had
25-hydroxivitamin D levels
