scholarly journals The Impact of UV-dose, Body Surface Area Exposed and Other Factors on Cutaneous Vitamin D Synthesis Measured as Serum 25(OH)D Concentration: Systematic Review and Meta-analysis

2018 ◽  
Vol 38 (2) ◽  
Keyword(s):  
Systematic Review ◽  
Vitamin D ◽  
Surface Area ◽  
Body Surface Area ◽  
Body Surface ◽  
Meta Analysis ◽  
Uv Dose ◽  
The Impact

scholarly journals Vitamin D Status Is Associated with Modifiable Lifestyle Factors in Pre-Adolescent Children Living in Urban Kuala Lumpur, Malaysia

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2175
Author(s):  
Winnie Siew Swee Chee ◽  
Chung Yuan Chang ◽  
Kanimolli Arasu ◽  
Soon Yee Wong ◽  
Shu Hwa Ong ◽  
...  
Keyword(s):  
Vitamin D ◽  
Body Composition ◽  
Dietary Intake ◽  
Surface Area ◽  
Body Surface Area ◽  
Body Surface ◽  
Lifestyle Factors ◽  
Vitamin D Status ◽  
Kuala Lumpur ◽  
Modifiable Lifestyle Factors

Studies on vitamin D status and its determinants in growing children in countries with ample sunshine such as Malaysia have been limited. The aim of our study was to determine factors associated with serum 25(OH)D concentrations such as lifestyle, dietary intake, anthropometry, and body composition in 243 pre-adolescent Malaysian children from low-income families living in Kuala Lumpur. This cross-sectional study measured bone density and body composition using dual-energy X-ray absorptiometry (DXA), while serum 25(OH)D was measured using LC–MS/MS. Time spent outdoors, body surface area exposed to sunlight, dietary intake, and physical activity level were assessed using questionnaires. Multiple linear regression and stepwise analysis were performed to identify significant predictors for serum 25(OH)D. About 69.4% had 25(OH)D < 50 nmol/L, and 18.9% were vitamin-D-deficient with 25(OH)D < 30 nmol/L. Girls had a nine-fold higher prevalence of vitamin D deficiency than boys. Body surface area exposed to sunlight, Sun Index, and fat mass were significant predictors of 25(OH)D concentrations in this population. Modifiable lifestyle factors such as sun exposure and reducing obesity are important public health guidance to ensure optimal vitamin D status in these children.

scholarly journals Multimodal Analgesia and Discharge Opioid Requirements in Burn Patients

2020 ◽  
Vol 41 (5) ◽  
pp. 963-966
Author(s):  
Michael Wright ◽  
Jin A Lee
Keyword(s):  
Surface Area ◽  
Body Surface Area ◽  
Body Surface ◽  
Total Body Surface Area ◽  
Multimodal Analgesia ◽  
Burn Patients ◽  
Area Burned ◽  
Total Body ◽  
The Impact

Abstract Analgesia in burn patients is challenging given the complexity of burn pain and prolonged need beyond hospital admission. Given the risks of opioids, the impact of multimodal analgesia postdischarge needs to be further elucidated in this population. This retrospective, single-center cohort study evaluated adult burn patients who were consecutively admitted to the burn service with at least 10% total body surface area burned and subsequently followed in the burn clinic between February 2015 and September 2018. Subjects were separated into two cohorts based on discharge pain regimens: multimodal and nonmultimodal. The primary outcome was the change in opioid requirements (measured in oral morphine equivalents) between discharge and first follow-up interval. Secondary outcomes included the classes of multimodal agents utilized and a comparison of opioid requirements between the last 24 hours of admission and discharge. A total of 152 patients were included for analysis, 76 in the multimodal cohort and 76 in the nonmultimodal cohort. The multimodal cohort was noted to have increased total body surface area burned and prolonged number of days spent in the intensive care unit at baseline; however, the multimodal cohort exhibited a more significant decrease in opioid requirements from discharge to first follow-up interval when compared with the nonmultimodal cohort (106.6 vs 75.4 mg, P = .039).

scholarly journals The impact of vitamin D pathway genetic variation and circulating 25-hydroxyvitamin D on cancer outcome: systematic review and meta-analysis

2017 ◽  
Vol 116 (8) ◽  
pp. 1092-1110 ◽  
Author(s):  
P G Vaughan-Shaw ◽  
F O'Sullivan ◽  
S M Farrington ◽  
E Theodoratou ◽  
H Campbell ◽  
...  
Keyword(s):  
Systematic Review ◽  
Vitamin D ◽  
Genetic Variation ◽  
Meta Analysis ◽  
Hydroxyvitamin D ◽  
25 Hydroxyvitamin D ◽  
Cancer Outcome ◽  
The Impact

scholarly journals Impact of Age, Body Surface Area, and Body Mass Index on Pegaspargase Toxicity and Pharmacokinetics: A Report from the DFCI ALL Consortium

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 3396-3396
Author(s):  
Jonathan D. Paolino ◽  
Yael Flamand ◽  
Kristen E. Stevenson ◽  
Victoria Koch ◽  
Uma H. Athale ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Surface Area ◽  
Body Surface Area ◽  
Body Mass ◽  
Body Surface ◽  
Older Patients ◽  
Time Points ◽  
Induction Dose ◽  
Post Induction ◽  
The Impact

Abstract Introduction: Increased toxicity with pegaspargase (PEG) in older and higher body mass index (BMI) patients (pts) with acute lymphoblastic leukemia (ALL) has recently led to dose capping practices. We assessed the influence of age, body surface area (BSA), and BMI on PEG-related toxicity and pharmacokinetics from two consecutive DFCI ALL Consortium trials without dose capping. Methods: Patient (pts) aged 1 to &lt;19 years (DFCI 05-001) or 1 to &lt;22 years (DFCI 11-001) with newly diagnosed ALL were eligible for enrollment. Those who received PEG (2500 IU/m 2) were included in this analysis. Pts received 1 dose of IV PEG on day 7 of Induction and every 2 weeks for 15 doses post-induction. Serum asparaginase activity (SAA), considered therapeutic at &gt;0.1 IU/mL, was assessed 4, 11, 18, and 25 days after the Induction dose and nadir SAA was assessed before each Post-Induction dose. Asparaginase-related toxicities were prospectively assessed and graded by CTCAE version 3.0 (DFCI 05-001) or 4.0 (DFCI 11-001). Asparaginase toxicity for this analysis was defined as ≥1 of the following: pancreatitis, thrombosis, ≥grade 4 hyperbilirubinemia, ≥grade 4 hypertriglyceridemia. Allergy was analyzed separately (due to presumed dose independence). Height and weight at diagnosis were used for analyses. BMI categories were assigned using standard percentile ranges based on gender specific 2000 CDC growth charts. BSA was calculated using the Mosteller formula. Univariate analyses evaluated the relationship of age, BMI, and BSA with asparaginase toxicity. Comparisons of toxicity across BMI and BSA categories were performed using a Jonckheere-Terpstra test. Categorical comparisons for dichotomized BMI and BSA utilized a Fisher's exact test or chi square test. The relationships between BMI and BSA with toxicity were explored using multivariable models. Results: Between 4/2005-12/2011 802 pts enrolled on DFCI 05-001 and between 6/2012-6/2015 240 pts enrolled on DFCI 11-001. Both trials included random assignment of asparaginase formulation. In total 911 patients received pegaspargase during Induction and 351 during Post-Induction. During Induction, pts ≥15 years of age had higher asparaginase toxicity rates (17.1% vs 6.2%, p=0.0003) (Figure 1a). Toxicity differed significantly across BSA categories (&lt;1.5 m 2, 1.5 to &lt;2.0 m 2, ≥2.0 m 2, p= 0.007) with increased toxicity in those with BSA ≥2.0m 2 (22.7% vs. 6.8% for those &lt;2.0 m 2, p = 0.016) (Figure 1b). Age was highly correlated with BSA (Pearson r = 0.93, p &lt;0.0001). There was numerically higher toxicity in the BMI category of overweight vs. those underweight or normal weight (11.3% vs 6.5%) however this did not extend to the obese category, and overall, increasing BMI was not associated with statistically higher toxicity (p= 0.13, Figure 1c). Post-Induction, age ≥15 years was associated with increased asparaginase toxicity (57.1% vs 21%, p&lt;0.0001) (Figure 1d). Toxicity differed significantly across BSA categories (p&lt;0.0001) but was similar between BMI categories (p=0.19, Figure 1e-f). The impact of BSA was observed when dichotomized at thresholds of 1.5m 2 (54% vs. 19%, p&lt;0.0001) and 2.0m 2 (70% vs. 23%, p=0.003) (Figure 1e). Considering only those ≥10 years of age, trends for BSA/BMI and toxicity were similar. There was no significant association between BMI or BSA and allergy. In multivariable analysis, BSA was a significant predictor of Post-Induction toxicity (OR 4.21, p&lt;0.0001). Age was significant in the univariate setting (OR 1.14, p&lt;0.0001) however due to high correlation with BSA, was not included with BSA in the multivariable model. Post-Induction, median nadir SAA levels were ≥0.1IU/mL for all BSA and age categories. Median SAA was similar or lower at all time-points for those ≥15 years of age compared with younger children. Median SAA for pts with BSA ≥1.5m 2 were similar or lower compared to those with BSA &lt;1.5m 2 (Figure 2a-d). Conclusion: Age ≥15 years and BSA ≥2m 2 were each associated with significantly increased asparaginase toxicity. Older patients and those with higher BSA had similar or lower median SAA levels at all time-points. These results suggest that the differential toxicity seen in older patients and those with higher BSA is not explained by these patients having higher SAA levels. Prospective exploration of interventions to decrease toxicity in older patients and those with high BSA are needed. Figure 1 Figure 1. Disclosures Neuberg: Madrigal Pharmaceuticals: Other: Stock ownership; Pharmacyclics: Research Funding. Silverman: Takeda, Servier, Syndax, Jazz Pharmaceuticals: Current equity holder in publicly-traded company, Membership on an entity's Board of Directors or advisory committees.

scholarly journals Evaluation of Natalizumab Pharmacokinetics and Pharmacodynamics: Toward Individualized Doses

2021 ◽  
Vol 12 ◽  
Author(s):  
Jose M. Serra López-Matencio ◽  
Yaiza Pérez García ◽  
Virginia Meca-Lallana ◽  
Raquel Juárez-Sánchez ◽  
Angeles Ursa ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Weight ◽  
Plasma Concentration ◽  
Surface Area ◽  
Body Surface Area ◽  
Body Mass ◽  
Body Surface ◽  
Treatment Duration ◽  
Pharmacokinetics And Pharmacodynamics ◽  
The Impact

Background: Plasma concentration of natalizumab falls above the therapeutic threshold in many patients who, therefore, receive more natalizumab than necessary and have higher risk of progressive multifocal leukoencephalopathy.Objective: To assess in a single study the individual and treatment characteristics that influence the pharmacokinetics and pharmacodynamics of natalizumab in multiple sclerosis (MS) patients in the real-world practice.Methods: Prospective observational study to analyse the impact of body weight, height, body surface area, body mass index, gender, age, treatment duration, and dosage scheme on natalizumab concentrations and the occupancy of α4-integrin receptor (RO) by natalizumab.Results: Natalizumab concentrations ranged from 0.72 to 67 μg/ml, and RO from 26 to 100%. Body mass index inversely associated with natalizumab concentration (beta = −1.78; p ≤ 0.001), as it did body weight (beta = −0.34; p = 0.001), but not height, body surface area, age or gender Extended vs. standard dose scheme, but not treatment duration, was inversely associated with natalizumab concentration (beta = −7.92; p = 0.016). Similar to natalizumab concentration, body mass index (beta = −1.39; p = 0.001) and weight (beta = −0.31; p = 0.001) inversely impacted RO. Finally, there was a strong direct linear correlation between serum concentrations and RO until 9 μg/ml (rho = 0.71; p = 0.003). Nevertheless, most patients had higher concentrations of natalizumab resulting in the saturation of the integrin.Conclusions: Body mass index and dosing interval are the main variables found to influence the pharmacology of natalizumab. Plasma concentration of natalizumab and/or RO are wide variable among patients and should be routinely measured to personalize treatment and, therefore, avoid either over and underdosing.

scholarly journals Impact of Vitiligo on Quality of Life: A Cross-sectional Pilot Study from Western India

2020 ◽  
Vol 7 (2) ◽  
Author(s):  
Vasudha Abhijit Belgaumkar ◽  
Ravindranath Brahmadeo Chavan ◽  
Nitika S Deshmukh ◽  
Nupur Vasudeo Warke
Keyword(s):  
Quality Of Life ◽  
Surface Area ◽  
Correlation Coefficient ◽  
Body Surface Area ◽  
Body Surface ◽  
Western India ◽  
Care Hospital ◽  
Cross Sectional ◽  
The Impact

Background: Vitiligo is a common, acquired, mucocutaneous discoloration characterized by well-circumscribed depigmented macules. It has profound potential for cosmetic disfigurement and social stigma, which is an often neglected aspect of the disease. Objectives: To analyze the impact of vitiligo on the quality of life (Qol) of patients in western India and To determine the contributory factors. Methods: A cross-sectional, observational study was conducted at a tertiary care hospital on 60 patients with vitiligo (were enrolled after informed consent and ethical approval). Basic patient-related (age, gender, socioeconomic status, co-morbidities) and vitiligo-related variables (body surface area involved, stability, duration of disease, treatment modality) were noted. This information were collated with QoL using a standardized questionnaire, the Dermatology Life Quality Index (DLQI). Statistical analysis was performed using Spearman’s rank correlation coefficient, Pearson’s r, unpaired t-test (SPSS version 16). Results: Mean DLQI score of the study sample was 3.15 ± 4.2 (small effect on QoL). The mean DLQI score in females (3.97) was significantly higher than in males (1.92) (P = 0.046). Also, the DLQI demonstrated a significant positive correlation with body surface area involvement (Spearman’s correlation coefficient = 0.306) (P = 0.018). Other factors were not found to affect the DLQI. Conclusions: Various modifiable and non-modifiable factors influence the QoL of vitiligo patients. Gender- associated stigma may be alleviated by counseling and creating awareness, while the body surface area involvement may be addressed by instituting and appropriate treatment. The clinician must be vigilant for any subtle signs of impairment of QoL to enable timely intervention.

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