scholarly journals Relationship Between Degree of Obesity and Vitamin D Level in Obese Women Applying to A Family Medicine Outpatient Clinic

2021 ◽  
Vol 2 (2) ◽  
pp. 30-37
Author(s):  
Nazlı Hacıağaoğlu ◽  
Huseyin Cetin ◽  
Halim Omer Kasikci ◽  
Engin Ersin Simsek
Keyword(s):  
Vitamin D ◽  
Family Medicine ◽  
Outpatient Clinic ◽  
Obese Women

scholarly journals Outpatient clinic visits during heat waves: findings from a large family medicine clinical database

2018 ◽  
Vol 35 (5) ◽  
pp. 567-570 ◽  
Author(s):  
Devesh Vashishtha ◽  
William Sieber ◽  
Brittany Hailey ◽  
Kristen Guirguis ◽  
Alexander Gershunov ◽  
...  
Keyword(s):  
Family Medicine ◽  
Outpatient Clinic ◽  
Heat Waves ◽  
Large Family ◽  
Clinical Database ◽  
Clinic Visits

Management of bone metabolism in epilepsy

2021 ◽  
Vol 74 (7-8) ◽  
pp. 257-265
Author(s):  
Firdevs Ezgi Uçan Tokuç ◽  
Fatma Genç ◽  
Abidin Erdal ◽  
Yasemin Biçer Gömceli
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Bone Metabolism ◽  
Bone Mineral ◽  
Outpatient Clinic ◽  
Bone Mineralization ◽  
Mineral Density ◽  
Low Bone Mineral Density ◽  
Increased Risk ◽  
Significant Difference

Many systemic problems arise due to the side effects of antiepileptic drugs (AEDs) used in epilepsy patients. Among these adverse effects are low bone mineral density and increased fracture risk due to long-term AED use. Although various studies have supported this association with increased risk in recent years, the length of this process has not been precisely defined and there is no clear consensus on bone density scanning, intervals of screening, and the subject of calcium and vitamin D supplementation. In this study, in accordance with the most current recommendations, our applications and data, including the detection of possible bone mineralization disorders, treatment methods, and recommendations to prevent bone mineralization disorders, were evaluated in epilepsy patients who were followed up at our outpatient clinic. It was aimed to draw attention to the significance of management of bone metabolism carried out with appropriate protocols. Epilepsy patients were followed up at the Antalya Training and Research Hospital Department of Neurology, Epilepsy Outpatient Clinic who were at high risk for osteoporosis (use of valproic acid [VPA] and enzyme-inducing drugs, using any AED for over 5 years, and postmenopausal women) and were evaluated using a screening protocol. According to this protocol, a total of 190 patients suspected of osteoporosis risk were retrospectively evaluated. Four patients were excluded from the study due to secondary osteoporosis. Of the 186 patients who were included in the study, 97 (52.2%) were women and 89 (47.8%) were men. Prevalence of low bone mineral density (BMD) was 42%, in which osteoporosis was detected in 11.8% and osteopenia in 30.6% of the patients. Osteoporosis rate was higher at the young age group (18-45) and this difference was statistically significant (p=0.018). There was no significant difference between male and female sexes according to osteoporosis and osteopenia rates. Patients receiving polytherapy had higher osteoporosis rate and lower BMD compared to patients receiving monotherapy. Comparison of separate drug groups according to osteoporosis rate revealed that osteoporosis rate was highest in patient groups using VPA+ carbamazepine (CBZ) (29.4%) and VPA polytherapy (19.4%). Total of osteopenia and osteoporosis, or low BMD, was highest in VPA polytherapy (VPA+ non-enzyme-inducing AED [NEID]) and CBZ polytherapy (CBZ+NEID) groups, with rates of 58.3% and 55.1%, respectively. In addition, there was no significant difference between drug groups according to bone metabolism markers, vitamin D levels, and osteopenia-osteoporosis rates. Assuming bone health will be affected at an early age in epilepsy patients, providing lifestyle and diet recommendations, avoiding polytherapy including VPA and CBZ when possible, and evaluating bone metabolism at regular intervals are actions that should be applied in routine practice.

Diminished bone resorption in overweight/obese women despite vitamin D insufficiency

2017 ◽  
Vol 84 (1) ◽  
pp. 119-120
Author(s):  
Michel Laroche ◽  
Jean Michel Pouilles ◽  
Florence Trémollières ◽  
Marion Vallet ◽  
Slim Lassoued ◽  
...  
Keyword(s):  
Vitamin D ◽  
Bone Resorption ◽  
Vitamin D Insufficiency ◽  
Obese Women

Integrating pharmacogenetic testing via medication therapy management in an outpatient family medicine clinic

2021 ◽  
Author(s):  
Jacob T Brown ◽  
Danielle MacDonald ◽  
Ann Yapel ◽  
Tiana Luczak ◽  
Anna Hanson ◽  
...  
Keyword(s):  
Family Medicine ◽  
Prospective Study ◽  
Outpatient Clinic ◽  
Turnaround Time ◽  
Medication Therapy Management ◽  
Therapy Management ◽  
Medication Therapy ◽  
Patient Diagnosis ◽  
Included Patient ◽  
A Prospective Study

Introduction: Pharmacogenetic (PGx) implementation has lagged behind the development of drug/gene pair guidelines. Materials & methods: This was a prospective study assessing the integration of PGx through medication therapy management in an outpatient clinic. Variables collected included patient diagnosis, current medications, failed or discontinued medications, PGx results/recommendations, turnaround time and pre/post clinical ratings. Results: A total of 91 participants completed study procedures with an average enrollment of approximately one consult per week. Participants were referred for testing primarily for guidance for current and future medications. The average number of recommendations per participant was 0.93. Conclusion: Integrating PGx testing into medication therapy management is feasible with PGx results available in under a week resulting in clinical recommendations in over half of patients tested.

The vitamin D metabolites 25(OH)D and 1,25(OH)2D are not related to either glucose metabolism or insulin action in obese women

2016 ◽  
Vol 42 (6) ◽  
pp. 416-423 ◽  
Author(s):  
K.W. ter Horst ◽  
R.I. Versteeg ◽  
P.W. Gilijamse ◽  
M.T. Ackermans ◽  
A.C. Heijboer ◽  
...  
Keyword(s):  
Vitamin D ◽  
Glucose Metabolism ◽  
Insulin Action ◽  
Vitamin D Metabolites ◽  
Obese Women

Vitamin D level in a sample of Egyptian females of childbearing age attending a family medicine center

2020 ◽  
Author(s):  
Maivel Emile Soby Gerges ◽  
Ghada Essam Aldin Amin ◽  
Fady Andraous ◽  
Diaa Marzouk Abdel Hamid ◽  
Mohamed Farouk Allam
Keyword(s):  
Vitamin D ◽  
Family Medicine ◽  
Childbearing Age

scholarly journals Impact of Pharmacist-Physician Collaboration on Osteoporosis Treatment Rates

2018 ◽  
Vol 52 (9) ◽  
pp. 876-883 ◽  
Author(s):  
Brandi L. Bowers ◽  
Amy M. Drew ◽  
Christian Verry
Keyword(s):  
Vitamin D ◽  
High Risk ◽  
Family Medicine ◽  
Cohort Analysis ◽  
Osteoporotic Fractures ◽  
Osteoporosis Treatment ◽  
Economic Consequences ◽  
Collaborative Management ◽  
Medicine Physician ◽  
Risk Patients

Background: The vast majority of women at high risk for osteoporotic fractures are not treated, despite known significant clinical and economic consequences of this prevalent condition. To date, this is the first study of this size and duration to examine the role of pharmacists in management of osteoporosis in a family medicine clinic. Objective: To compare the initiation or continuation of prescription antifracture therapy in high-risk patients with collaborative pharmacist-physician to physician-only management; secondarily, to evaluate recommendation rates for antifracture therapy and calcium and vitamin D. Methods: This retrospective cohort analysis included women older than 65 years with a dual-energy X-ray absorptiometry (DXA) scan ordered by a family medicine physician. High risk was defined as T-scores ≤−2.5 at the lumbar spine, femoral neck, or 33% radius, or a FRAX 10-year fracture risk score ≥20% for major osteoporosis-related or ≥3% for hip fractures. Results: There were 466 (311 high-risk) pharmacist-physician and 549 (237 high-risk) physician-managed DXAs included. For high-risk DXAs, collaborative management resulted in increased rates of receiving antifracture therapy prescriptions over physician-only management (66% vs 34%, P < 0.001), advisement for antifracture therapy (87% vs 32%, P < 0.001), and calcium and vitamin D (97% vs 45%, P < 0.001). Collaborative management also improved calcium and vitamin D advisement among all DXAs (96% vs 46%, P < 0.01). There was no difference in adverse events documented in the pharmacist-physician compared with physician-only management (7.2% vs 3.7%, P = 0.32). Conclusion and Relevance: Pharmacist-physician collaboration is associated with higher treatment rates of osteoporosis. This study supports the pharmacist-physician partnership as one method of improving osteoporosis management.

scholarly journals Preliminary data about the influence of vitamin D status on the loss of body fat in young overweight/obese women following two types of hypocaloric diet

2008 ◽  
Vol 100 (2) ◽  
pp. 269-272 ◽  
Author(s):  
Rosa M. Ortega ◽  
Aránzazu Aparicio ◽  
Elena Rodríguez-Rodríguez ◽  
Laura M. Bermejo ◽  
José M. Perea ◽  
...  
Keyword(s):  
Vitamin D ◽  
Body Fat ◽  
Dietary Intervention ◽  
Experimental Period ◽  
Vitamin D Status ◽  
Obese Women ◽  
Childbearing Age ◽  
Hydroxyvitamin D ◽  
Loss Of Weight ◽  
25 Hydroxyvitamin D

The loss of weight was analysed in a group of sixty overweight/obese women of childbearing age (20–35 years) according to their initial vitamin D status. Subjects were randomly assigned to one of two slightly hypocaloric diets: Diet V, in which the consumption of vegetables was increased, or Diet C, in which the relative consumption of cereals (especially breakfast cereals) was increased. Dietetic, anthropometric and biochemical data were collected at the start of the study and again at 2 weeks after dividing the women into groups depending on their having an initial serum 25-hydroxyvitamin D (25(OH)D) concentration of < 50 nmol/l (LD) or ≥ 50 nmol/l (HD). Dietary intervention led to a reduction in energy intake, body weight and BMI in all groups. The HD women showed greater body fat losses during the study than the LD women (1·7 (sd 1·8) kg compared to 0·5 (sd 0·8) kg). A better vitamin D status therefore aided the loss of body fat over the experimental period (OR 0·462; CI 0·271, 0·785; P < 0·001). However, when the dietary groups were analysed separately, this effect was only seen in the C subjects (OR 0·300; CI 0·121, 0·748; P < 0·001). The present results suggest that women with a better vitamin D status respond more positively to hypocaloric diets and lose more body fat; this was especially clear among the C subjects who had a greater vitamin D supply during the experimental period.

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