scholarly journals Can screening for low vitamin D levels prevent bone health complications in paediatric oncology patients?

2021 ◽  
Author(s):  
Leonie Naeije ◽  
Mandy Pohlui de Silva ◽  
Paul Hofman
Keyword(s):  
Vitamin D ◽  
Bone Health ◽  
Paediatric Oncology ◽  
Oncology Patients ◽  
Vitamin D Levels ◽  
Health Complications

scholarly journals Impact of Chrysin on Vitamin D and Bone Health - Preclinical Studies

2020 ◽  
Author(s):  
Siva Swapna Kasarla ◽  
Sujatha Dodoala ◽  
Sunitha Sampathi ◽  
Narendra Kumar Talluri
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Bone Health ◽  
Low Dose ◽  
Active Vitamin ◽  
Deficient Diet ◽  
Bone Parameters ◽  
Active Vitamin D ◽  
Vitamin D Levels ◽  
The Impact

AbstractVitamin D deficiency is an endemic problem existing worldwide. Although several strategies were established to enhance vitamin D3 levels, studies specifically focussing inhibition of vitamin D metabolism which may prolong the availability of active vitamin D in pathological conditions are less explored. Studies also suggest that higher doses of vitamin D3 fail to achieve optimum vitamin D levels. In this context, we focussed on the enzyme CYP3A4 which promotes inactivation of active vitamin D. The current study was aimed to decipher the impact of chrysin, a proven CYP3A4 inhibitor as an intervention and its effects in combination with low dose vitamin D3 (40 IU) and bone health in vitamin D deficiency condition. The in-vivo activity of chrysin was evaluated on female Wistar albino rats fed with a vitamin D deficient diet to attain vitamin D deficiency for 28 days. Chrysin was given alone and in combination with calcium carbonate (CaCO3) and/or vitamin D3. All the therapeutic interventions were assessed for serum 25-OH-D3 by LC-MS, biochemical, urinary, and bone parameters. Animals treated with chrysin alone and in combination with low dose vitamin D3 and/or CaCO3 showed an eminent rise in serum 25-OH-D3 levels along with increased serum biochemical parameters. On contrary, a significant decrease in the urinary parameters followed by beneficial effects on bone parameters was noticed in contrast with the vitamin D deficient diet group. Our findings revealed that although chrysin alone showed a notable effect on 25-OH-D3 and osseous tissue, comparatively it showed intensified therapeutic effect in combination with vitamin D3 and CaCO3 which can be employed as a cost-effective option to improve bone health.Graphical Abstract

scholarly journals Characterizing the Assessment and Management of Vitamin D Levels in Patients with Osteoporosis in Clinical Practice: A Chart Review Initiative

2015 ◽  
Vol 2015 ◽  
pp. 1-7
Author(s):  
Jonathan D. Adachi ◽  
Jacques P. Brown ◽  
George Ioannidis
Keyword(s):  
Vitamin D ◽  
Clinical Practice ◽  
Bone Health ◽  
Chart Review ◽  
Serum Vitamin ◽  
Vitamin D Supplementation ◽  
Serum Vitamin D ◽  
Vitamin D Levels ◽  
25 Hydroxy Vitamin D ◽  
Vitamin D Supplements

Though vitamin D is important for bone health, little is known about the monitoring and management of vitamin D levels in patients with osteoporosis in clinical practice—a deficit this chart review initiative aimed to remedy. A total of 52 physicians completed profiles for 983 patients being treated for osteoporosis between November 2008 and April 2009. Information collected included demographics; fracture risk factors; availability and level of serum vitamin D measurements; and information on osteoporosis medications and calcium and vitamin D supplementation. Physicians also evaluated patients’ current regimens and detailed proposed changes, if applicable. Nearly 85% of patients were prescribed calcium and vitamin D supplements. Serum 25-hydroxy vitamin D levels were available for 73% of patients. Of these patients, approximately 50% had levels less than 80 nmol/L, which contrasts with the 37% thought to have “unsatisfactory” vitamin D levels based on physician perceptions. Physicians felt 26% of patients would benefit from additional vitamin D supplementation. However, no changes to the osteoporosis regimen were suggested for 48% of patients perceived to have “unsatisfactory” vitamin D levels. The results underscore the importance of considering vitamin D status when looking to optimize bone health.

scholarly journals P49 An audit of baseline vitamin D level tests for newly diagnosed paediatric haematology/oncology patients against trust guidelines

2020 ◽  
Vol 105 (9) ◽  
pp. e32-e33
Author(s):  
Lamia Samrin-Balch ◽  
Salma Mahmood
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
List Type ◽  
Oncology Patients ◽  
Hydroxyvitamin D ◽  
Treatment And Prevention ◽  
Health Report ◽  
Vitamin D Levels ◽  
25 Hydroxyvitamin D ◽  
Haematology Patients

Aim100% of patients should have their vitamin D levels checked at diagnosis’ as stated in the current trust guideline for the management of vitamin D deficiency Treatment and Prevention.100% of patients who had a baseline vitamin D level had these acted upon if necessary following the recommendations in the trust guideline.All of the patients who were given treatment had been prescribed were given an appropriate dose as stated in the trust guideline.These standards are supported by the recommendations in 2016 by Public Health England (PHE) that everyone (regardless of age and ethnicity) needs vitamin D equivalent to an average daily intake of 10 micrograms via supplementation.2 3MethodThis retrospective audit was conducted using internal clinical and prescribing programmes to access patient records and medical histories to retrieve data. The inclusion criteria for patients included in this audit were all new diagnoses of malignant haematological and oncological disease over a 6 month period, from April 2018-October 2018. The data collected for these patients were: if they had been tested for Vitamin D, the date of the test and their level of total vitamin D level Serum total 25-hydroxyvitamin D concentration. Patient data from the electronic prescribing system was utilised to check if patients had been prescribed vitamin D. Once data completed, patients with vitamin D levels, assessed against trust guidelines to determine if appropriately treated.ResultsA total of 78 patients met the inclusion criteria, where 56% of patients were tested for vitamin D during admission. Of the 78 patient, 43 were oncology patients and 33 haematology patients.In the oncology cohort (n=15) only 35% were tested whereas 83% of haematology patients (n=28) were tested. Of the haematology cohort of patients who were tested (83%): 69% had sufficient levels of vitamin D (serum total 25-hydroxyvitamin D concentration >50 nmol/L); 11% had insufficient levels (25–50 nmol/L) and 3% were deficient (< 25 nmol/L). Of the oncology cohort who were tested (35%): 28% had sufficient levels of vitamin D; 5% of patients had insufficient levels; 2% were deficient. 6% of haematology patients and 5% of oncology patients with sufficient levels of vitamin D received treatment that was not indicated. Furthermore, the 5% of oncology patients with insufficient levels of vitamin D did not receive any treatment.ConclusionThe standards set for this audit were not met. It is concerning that those with low levels were not treated effectively and are at risk of complications. Although the findings of this audit may not be a true reflection of the entire patient population due to the small cohort size; the insight into at risk patients suggests there is a need to improve practice and reach 100% for all the aims of this audit.To improve smart and efficient prescribing of medication, clinicians should adhere to the revised trust ‘Guideline for the Management of vitamin D deficiency’ to guide their decisions on initiating therapy. Pharmacists should check vitamin D levels for all new admissions and follow up as appropriate for any pending tests. Having a default test built into the current new prescribing system will also support in improving the results.ReferencesHolick, M. ( 2019). Vitamin D: importance in the prevention of cancers, type 1 diabetes, heart disease, and osteoporosis. [online]Available at: https://academic.oup.com/ajcn/article/79/3/362/4690120Public Health England. Statistical Summary: National Diet and Nutrition Survey: results from Years 1 and 9 (combined) of the Rolling Programme (2008/09 – 2016/17). https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/772430/NDNS_Y1-9_statistical_summary.pdfGOV.UK. ( 2019). SACN vitamin D and health report. [online]Available at: https://www.gov.uk/government/publications/sacn-vitamin-d-and-health-reportGreat Ormond Street Hospital Trust guideline for the management of Vitamin D deficiency Treatment and Prevention.

scholarly journals Vitamin D monitoring and management in the inpatient services – reaudit

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S86-S87
Author(s):  
Vasudevan Krishnan ◽  
Ciara Doyle ◽  
Maciej Rusilowicz
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Bone Health ◽  
Clinical Guideline ◽  
Scientific Advisory Committee ◽  
Inpatient Ward ◽  
Number Of Patients ◽  
Vitamin D Levels ◽  
Laboratory Results ◽  
Sufficient Vitamin

AimsTo survey the prevalence of monitoring of vitamin D on an inpatient ward.To audit the treatment if there is identified vitamin D deficiency or insufficiencyTo compare differences between findings in auditsMethodAll inpatients admitted to Milford centre between August 2019 and August 2020 were selected as part of the sample size.Data were collected by FY1 and FY2Patients’ laboratory results were accessed to determine vitamin D levels.E-notes were used to conclude who were vitamin D sufficient or deficient for treatmentThe standard for the audit were as per:Management of vitamin D deficiency or insufficiency in adults – CKS (2018)The above was based on National Osteoporosis Society (NOS) guideline Vitamin D and bone health: a practical clinical guideline for patient management [National Osteoporosis Society, 2013] and Scientific Advisory Committee on Nutrition (SACN) guidelineResult201748/188 patients had vitamin D levels measured36/48 patients had sufficient vitamin D levels12/48 patients were either deficient or insufficient12/12 patients were treated where found deficient or insufficient202090/115 patients had vitamin D levels measured47/90 patients had sufficient vitamin D Levels43/90 patients had either insufficient or deficient vitamin D levels22/43 patients had treatment documented in noted where found deficient or insufficientConclusionDifficult to make comparisons with previous audit due to difference in number of patients testedVitamin D is routinely tested on Milford ward on admission hence the large number compared to the last audit52% had noted to have sufficient levels of vitamin DConcerning were results that only 51% of those deemed to have insufficient or deficient were treated based on notesPotential reasons could be:Prescribed in medication card and not documented in notes.Vitamin D results checked in another ward, no supplementation given, and then transferred to Milford house.Patients refused treatment but not documented adequately.Patient discharged before results were received due to quick aroundResults were deemed insufficient in terms of the range but very close to normal hence decision made not to start supplementationResults to be disseminated with medical and nursing colleaguesRe-audit in September 2021

Vitamin D levels and predictors in Swiss elite athletes – recommandation for supplementation

2018 ◽  
Vol 66 (2) ◽  
Keyword(s):  
Vitamin D ◽  
Bone Health ◽  
Athletic Performance ◽  
Muscle Function ◽  
Elite Athletes ◽  
The Sun ◽  
Predicted Probability ◽  
Vitamin D Levels ◽  
Z Scores ◽  
To Come

Background: Vitamin D concentrations corresponding to 75 nmol/L of 25(OH)D or more have been related to maintained muscle function, growth and regeneration, to optimal bone health and immunology in athletes. The objective of this study was to investigate prevalence and predictors of insufficient 25(OH)D concentrations in athletes and to come up with recommendations for our Swiss athletes. Methods: 603 competitive Swiss athletes were assessed during their annual pre-participation examination. A standardized questionnaire was used to gather information about potential predictors for 25(OH)D concentrations. Results: One in 2 athletes showed insufficient 25(OH)D concentrations. Differences in predicted probability of insufficient 25(OH)D were found for those that were not substituted (56%) vs. those substituted (42%) versus unsubstituted (52%), for those performing indoor (58%) vs. outdoor (43%) sports and during the sun deprived seasons fall (49%), winter (70%) and spring (57%) as compared to summer (17%). An increase in BMI z-scores and age was associated with higher 25(OH)D. Implication: One in two Swiss athletes shows insufficient 25(OH)D concentrations. To prevent potential harmful consequences on athletic performance, muscular, skeletal and immunological health, we recommend a regular substitution in daily, weekly or monthly intervals with a daily equivalent dose of 600–2000 IE Vit D except perhaps in summer. Routine assessments of 25(OH)D concentrations are not necessary.

scholarly journals Vitamin D deficiency in adolescents in a tier 4 psychiatric unit

2017 ◽  
Vol 41 (3) ◽  
pp. 133-136 ◽  
Author(s):  
Neil F. Stewart ◽  
Simon N. Lewis
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Bone Health ◽  
Blood Test ◽  
Clinical Implications ◽  
Test Results ◽  
Psychiatric Unit ◽  
Severe Deficiency ◽  
Vitamin D Levels ◽  
Health Review

Aims and methodTo review the current clinical practice and guidelines for testing and treating vitamin D deficiency in adolescents admitted to a tier 4 adolescent psychiatric unit in north London. The blood test results of 56 patients admitted between 2012 and 2014 were examined to determine whether vitamin D levels had been tested. For those individuals who were tested for vitamin D, results were analysed by gender and ethnicity.ResultsOf 56 patients admitted, 48% were tested for vitamin D deficiency and in 81.5% of cases we uncovered deficiency or severe deficiency; 18.5% had the minimum levels of vitamin D for bone health as per our trust guidelines.Clinical implicationsAdolescents within tier 4 adolescent mental health services may be at higher risk of vitamin D deficiency and so assessment of vitamin D levels should be considered as part of a standard physical health review for this group of young people.

Sunshine and vitamin D

2015 ◽  
Vol 101 (2) ◽  
pp. 190-192 ◽  
Author(s):  
Vrinda Saraff ◽  
Nick Shaw
Keyword(s):  
Vitamin D ◽  
Bone Health ◽  
Sun Exposure ◽  
Ultraviolet B ◽  
Health Concern ◽  
The Past ◽  
Vitamin D Levels ◽  
Important Health ◽  
Solar Ultraviolet ◽  
Cutaneous Synthesis

Vitamin D is vital for bone health and its deficiency deemed as a disease of the past has re-emerged as an important health concern. Exposure of the skin to solar ultraviolet B radiation is the major source of vitamin D and only a small proportion is derived from dietary intake. We review the various factors that influence the cutaneous synthesis of vitamin D and the recommendations regarding safe sun exposure and dietary supplementation to achieve adequate vitamin D levels proposed for optimal bone health.

scholarly journals Vitamin D and bone health in adults: a systematic review and meta-analysis

2021 ◽  
Vol 26 (8) ◽  
pp. 3221-3244
Author(s):  
Kátia Josiany Segheto ◽  
Marcos Pereira ◽  
Danielle Cristina Guimarães da Silva ◽  
Cristiane Junqueira de Carvalho ◽  
Felipe Ribeiro Massardi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Vitamin D ◽  
Bone Mineral ◽  
Bone Health ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Serum Vitamin ◽  
Serum Concentrations ◽  
Vitamin D Levels

Abstract Low bone health is associated with vitamin D deficiency in older individuals; however, this association is not well established in adults. The aim of the study was to analyze the association between serum concentrations of 25-hydroxyvitamin D and bone health in adults by systematic review and meta-analysis. The search was carried out in the LILACS, PubMed, Scopus, Web of Science, ScienceDirect databases from March 2017 to October 2018 with adult individuals (20-59 years). Bone health was evaluation performed through dual X-ray absorptiometry and serum concentrations of 25(OH)D. The random effect model was used to analyze data from bone mineral content and bone mineral. Random effects models were used and the sources of heterogeneity were explored by means of meta-regression. Thirty-five articles were selected. There was positive correlation between vitamin D and bone health in most of the evaluated sites. Correlation was observed in the analysis of subgroups for lumbar spine among men. When stratified, the studies presented high heterogeneity, which was explained by the sample size, mean serum vitamin D levels and risk of bias. Vitamin D is positively correlated to bone health in adult individuals.

Bone Health Assesment in Patients Undergoing Hematopoietic Cell Transplantation

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 5886-5886
Author(s):  
Pablo Ramirez ◽  
Pablo Florenzano ◽  
Claudia Campusano ◽  
Veronica Jara ◽  
Pablo A Bertin ◽  
...  
Keyword(s):  
Vitamin D ◽  
Secondary Hyperparathyroidism ◽  
Cell Transplantation ◽  
Bone Health ◽  
Hematopoietic Cell Transplantation ◽  
Hematopoietic Cell ◽  
Main Diagnosis ◽  
Z Score ◽  
Vitamin D Levels ◽  
25 Oh Vitamin D

Abstract INTRODUCTION: The increased survival of hematological patients has required to widen the care of these patients, with emphasis in factors related to quality of life and late mortality. Among them, osteoporosis (OP) is a fundamental problem. Patients undergoing hematopoietic cell transplantation (HCT) are at great risk of OP, mainly due to prolonged exposure to chemotherapy, immunosuppresants and the hypogonadism frequently associated to these treatments. Despite this, there is lack of strong evidence on this matter and HCT guidelines are not clear on this problem. OBJECTIVES: To evaluate parameters related to bone health in patients undergoing HCT. To measure the frequency and severity of the alterations in this group of patients. PATIENTS AND METHODS: Observational and retrospective analysis of patients undergoing HCT at the Catholic University Hematology-Oncology Department. All patients undergoing HCT were recommended to have determination of 25-OH vitamin D, PTHi, Calcium, Phosphorus and bone densitometry (DXA). We included all patients with the evaluation before HCT (preHCT) and 1 year after HCT (postHCT). RESULTS: We obtained data from 20 patients preHCT and 22 patients postHCT. Main diagnosis were acute myeloid leukemia (n=13; 32%), multiple myeloma (n=11; 26%), acute lymphoblastic leukemia (n=9; 21%) and Hodgkin's Lymphoma (n=5; 12%). Mean age was 40 years (range: 17-67) and 67% were males. In the preHCT group, the median 25-OH vitamin D levels were 13,6 ng/ml (range: 4,9-26,7 ng/ml) and 100% of the patients were in the insuficiency range leveles (<30 ng/ml). Median PTHi levels were 62,6 pg/ml (range: 24,4-223,7 pg/ml), and 46% of the patients had secondary hyperparathyroidism. In the postHCT group, median 25-OH vitamina D levels were 11,4 ng/ml (range: 4-29,4 ng/ml) and 100% had insuficiency levels. Median PTHi levels were 68 pg/ml (range: 37,4-135,8 pg/ml), and 56% of the patients had secondary hyperparathyroidism. 12 patients had DXA before HCT and 3 (25%) of them had DXA lumbar Z score less than -2.0. In 19 patients postHCT, 4 (21%) had decreased DXA Z score < 2.0. No difference could be established between autologus or allogeneic HCT in any meassurement. CONCLUSIONS: HCT patients represent a high risk group of developing severe vitamin D deficiency, secondary hyperparathyrodism and decreased DXA levels. These data are a warning that this population of patients requiere early intervention to prevent long term complications. This report is the initial evaluation for the development and treatment of bone health in a prospective matter in HCT patients in our center. Disclosures No relevant conflicts of interest to declare.

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