scholarly journals Vitamin D and Postoperative Vasopressor Use in Cardiopulmonary Bypass

2018 ◽  
Vol 24 (8) ◽  
pp. 1322-1326 ◽  
Author(s):  
Michael J. Javorski ◽  
Mina M. Kerolos ◽  
Jawed Fareed ◽  
R. Anthony Perez-Tamayo
Keyword(s):  
Vitamin D ◽  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Vitamin D Deficiency ◽  
Low Cost ◽  
Vitamin D Levels ◽  
25 Hydroxy Vitamin D ◽  
The Mean ◽  
D 20 ◽  
Vasopressor Use

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.

scholarly journals Vitamin D assessment in perioperative medicine and critical care

2019 ◽  
Author(s):  
Paul Zajic ◽  
Stefan Heschl ◽  
Michael Schörghuber ◽  
Petra Srekl-Filzmaier ◽  
Tatjana Stojakovic ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
False Positive Rate ◽  
Fluid Loading ◽  
Vitamin D Levels ◽  
Positive Rate ◽  
25 Hydroxy Vitamin D ◽  
The Mean ◽  
Clinical Trials Registry ◽  
The Impact

Summary Background There is controversy about the impact of acute illness on vitamin D levels. This study was carried out to assess the influence of perioperative fluid loading on 25-hydroxy-vitamin D [25(OH)D] levels. The study evaluated the clinical utility of a commonly available chemiluminescence assay (ECLIA, IDS-iSYS) and liquid chromatography/mass spectrometry (LC-MS/MS) in the diagnosis of vitamin D deficiency in this setting. Methods In this prospective observational pilot study in adult patients undergoing cardiovascular surgery on cardiopulmonary bypass (CPB), blood samples drawn at preoperative baseline (t1), after weaning from CPB (t2), on intensive care unit (ICU) admission (t3) and on the first (t4) and second (t5) postoperative days were analyzed. Results A total of 26 patients (130 samples) were included in this study. Fluid loading by CPB led to a median reduction of 25(OH)D by −22.6% (range −54.5% to −19.5%) between t1 and t2. Cohen’s kappa (κ) for method agreement for vitamin D deficiency (tested cut-off values 20 ng/ml and 12 ng/ml), was κ = 0.291 (p < 0.001) and κ = 0.469 (p < 0.001), respectively. The mean difference between measurements by ECLIA and LC-MS/MS was 4.8 ng/ml (±5.7), Pearson’s r for correlation was 0.73 (p < 0.001). The biologically inactive C3-epimer did not contribute to 25(OH)D levels assessed by LC-MS/MS. Conclusion The 25(OH)D measurements by chemiluminescence assays can noticeably deviate from those measured by LC-MS/MS, which can be considered the unequivocal gold standard. These assays may still be acceptably reliable in the screening for vitamin D deficiency, especially in the setting of low vitamin D levels. Stricter definitions, e.g. serum 25(OH)D levels lower than 12 ng/ml, may be used to diagnose deficiency with low false positive rate. Trial Registration DRKS00009216, German Clinical Trials Registry (www.drks.de)

Serum 25-hydroxy vitamin D and nutritional status: Implications for vitamin D assessment and dietary supplementation in oncology

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 9638-9638
Author(s):  
K. Trukova ◽  
D. Gupta ◽  
P. G. Vashi ◽  
A. Adams ◽  
G. M. Lambert ◽  
...  
Keyword(s):  
Vitamin D ◽  
Nutritional Status ◽  
Serum Albumin ◽  
Vitamin D Deficiency ◽  
Cancer Survival ◽  
Case Series ◽  
Vitamin D Levels ◽  
Significant Difference ◽  
25 Hydroxy Vitamin D ◽  
The Mean

9638 Background: There is emerging evidence in the literature to suggest a protective role of vitamin D in cancer survival. Vitamin D status is not routinely assessed, despite the high prevalence of malnutrition in this population. We hypothesized that malnutrition could contribute to vitamin D deficiency, and therefore expected mean serum 25-hydroxy-vitamin D [25(OH)D] levels to be significantly lower in malnourished oncology patients. Methods: A consecutive case series of 737 cancer patients seen at Cancer Treatment Centers of America between Jan-June 08. Nutritional status was assessed using Subjective Global Assessment (SGA) and serum albumin. SGA categorizes patients into 3 distinct classes of nutritional status; well nourished (SGA-A), moderately malnourished (SGA-B) and severely malnourished (SGA-C). Serum albumin was divided into 2 groups: >=3.6 g/dl and <=3.5 g/dl. Mean serum 25(OH)D was compared across 3 categories of SGA using ANOVA and across 2 categories of serum albumin using 2 sample t test. Results: Of 737 patients, 302 were males and 435 females. The mean age at presentation was 55.7 years (SD = 10.2). The most common cancer types were lung (133, 18%), breast (131, 17.8%), colorectal (97, 13.2%), pancreas (86, 11.7%), prostate (44, 6%) and ovarian (38, 5.2%). The mean serum albumin and serum 25(OH)D was 3.5g/dl (SD = 0.6) and 21.9 ng/ml (SD = 13.5) respectively. There was no significant difference in the mean vitamin D levels across serum albumin (p = 0.76). The mean vitamin D levels across the 3 classes of SGA also showed no statistically significant difference ( Table ). Conclusions: Contrary to what we expected, vitamin D deficiency was found to be prevalent in cancer regardless of nutritional status. No significant differences were found across the 3 classes of SGA. Based on these results, screening for vitamin D deficiency and aggressive vitamin D repletion should be considered for all people with cancer. [Table: see text] No significant financial relationships to disclose.

scholarly journals 25-Hydroxyl Vitamin D Deficiency in Nasal Polyposis

2019 ◽  
Vol 24 (03) ◽  
pp. e308-e312
Author(s):  
Ankur Kumar Chandrakar ◽  
Arun Alexander ◽  
Medha R. ◽  
Kalaiselvi Rajendiran ◽  
Karthikeyan Ramasamy
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Disease Severity ◽  
Nasal Polyposis ◽  
Enzyme Linked Immunosorbent Assay ◽  
Cross Sectional ◽  
Vitamin D Levels ◽  
25 Hydroxy Vitamin D ◽  
The Mean ◽  
Hs Crp

Abstract Introduction Vitamin D is known to have immunomodulatory functions and has action on chronic inflammatory processes, such as nasal polyposis. Objective The present study assessed the levels of 25-hydroxy vitamin D and high-sensitivity C-reactive protein (hs-CRP) in patients with nasal polyposis, as compared with healthy control subjects, and identified their association with disease severity in nasal polyposis. It further assessed the levels of 25-hydroxyl vitamin D and hs-CRP in patients with nasal polyposis and atopy and compared it with patients with nasal polyposis without atopy. Methods This was a cross-sectional study involving 2 groups: 80 patients with nasal polyposis and 80 healthy subjects. In patients with nasal polyposis, the disease severity is assessed by the sino-nasal outcome test (SNOT20) and by the Lund & Mackay staging system. Levels of 25-hydroxy vitamin D and hs-CRP were measured by enzyme-linked immunosorbent assay (ELISA). Result The mean 25-hydroxyl vitamin D levels (ng/ml) was 12.01 ± 7.29 for cases and 22.87 ± 14.95 for controls, with p < 0.0001. The mean hs-CRP levels (mg/L) was 5.99 ± 2.74 in cases and 2.41 ± 1.95 in controls, with p < 0.0001. The severity of polyposis correlated negatively with serum levels of 25-hydroxy vitamin D and positively with hs-CRP. Conclusion The study has thus shown significant correlation between vitamin D deficiency and inflammation in patients with nasal polyps.

Prevalence of Vitamin-D Deficiency in Patients with Acute Coronary Syndrome in Syria

2016 ◽  
Vol 9 (6) ◽  
pp. 3544-3548
Author(s):  
Aya Hallak ◽  
Malhis Mahmoud ◽  
Yaser Abajy Mohammad
Keyword(s):  
Vitamin D ◽  
Acute Coronary Syndrome ◽  
Vitamin D Deficiency ◽  
Hypovitaminosis D ◽  
Control Group ◽  
Coronary Syndrome ◽  
Normal Individuals ◽  
Vitamin D Levels ◽  
25 Hydroxy Vitamin D ◽  
Coronary Syndromes

The objectives of this study were to estimate the prevalence of vitamin D deficiency in patients with acute coronary syndrome in comparison with normal individuals and study the correlation between these two conditions. We measured the plasma 25-hydroxy vitamin D (25-OH-D) levels in 60 patients with acute coronary syndromes (ACS) of both gender and in 30 age matched control individuals of both gender without any known cardiovascular or systemic diseases. The levels of 25-OH-D were measured by ELISA method and the results were statically analyzed to find out any possible correlation. We classified the cases according to their plasma 25(OH)D levels. 25(OH)D levels of ≥ 30 ng/ml were considered normal, levels < 30 and > 20 ng/ml were classified as insufficient, while levels of ≤ 20 ng/ml were classified as deficient. In the current study the prevalence of hypovitaminosis D in the patients group was much higher than it was in the control group. Vitamin D deficiency was observed in 80% and insufficiency in 13% of total patients of ACS, there by bringing the total count to 93%. Whereas only 7% of the patients had adequate vitamin D levels. Thus, these results indicate the existence of a significant correlation between the vitamin D deficiency and ACS in comparison to healthy controls

scholarly journals Correlation Between 25-hydroxy-Vitamin D and Parkinson's Disease:A Case-Control study

2020 ◽  
Author(s):  
ming xia ◽  
wenjuan Xiu ◽  
Xuliang Wang ◽  
Tingting Wu ◽  
Yingying Zheng ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Vitamin D ◽  
Parkinson's Disease ◽  
Vitamin D Deficiency ◽  
Case Control Study ◽  
Case Control ◽  
Lower Serum ◽  
Vitamin D Levels ◽  
25 Hydroxy Vitamin D ◽  
Control Study

Abstract Background: Previous cross-sectional studies have shown that Parkinson’s disease (PD) patients have lower serum 25- hydroxy vitamin D (25(OH)D) concentrations than controls. whether the research in other regions findings are generalizable to China populations remains untested in other studies. In this case-control study we examined the Correlation between 25-hydroxy-vitamin D and Parkinson's disease.Methods:We establish an association between deficiency of 25-hydroxy-vitamin D and PD in a case-control study of 100 PD patients and 100 control subjects free of neurologic disease in the First Affliated Hospital of Xinjiang Medical University.Results:Total 25-hydroxy-vitamin D levels, were deficient in 21% of patients with PD compared with 4% of controls. In univariate analyses Plasma levels of 25-hydroxy-vitamin D were associated with PD(p<0.001), respectively. In multivariate analyses, Vitamin D deficiency(25(OH)D <20 ng/mL) were significant associated with PD (p=0.008,OR=17.13,95% CI, 2.082-141.075). Individuals with levels in the lowest quartile of 25(OH)D values had the highest prevalence of PD(p =0.026,OR=11.786,95%CI,1.342-103.51)compared with individuals with values in the highest quartile.Conclusions:Our study reveals an association between 25-hydroxy-vitamin D and PD.Patients with incident PD had significantly lower serum 25(OH)D concentrations than age-matched controls, High-risk PD patients with vitamin D deficiency who have not yet developed exercise impairment, these populations should undergo vitamin D measurement and vitamin D treatment as soon as possible.

scholarly journals Vitamin D levels in children with COVID-19: a report from Turkey

2021 ◽  
Vol 149 ◽  
Author(s):  
Aysegul Alpcan ◽  
Serkan Tursun ◽  
Yaşar Kandur
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Statistical Significance ◽  
Serum Vitamin ◽  
University Hospital ◽  
Control Group ◽  
Serum Vitamin D ◽  
Vitamin D Levels ◽  
Normal Vitamin ◽  
The Mean

Abstract Several studies have demonstrated that higher levels of vitamin D are associated with better prognosis and outcomes in infectious diseases. We aimed to compare the vitamin D levels of paediatric patients with mild/moderate coronavirus disease 2019 (COVID-19) disease and a healthy control group. We retrospectively reviewed the medical records of patients who were hospitalised at our university hospital with the diagnosis of COVID-19 during the period between 25 May 2020 and 24 December 2020. The mean age of the COVID-19 patients was 10.7 ± 5.5 years (range 1–18 years); 43 (57.3%) COVID-19 patients were male. The mean serum vitamin D level was significantly lower in the COVID-19 group than the control group (21.5 ± 10.0 vs. 28.0 ± 11.0 IU, P < 0.001). The proportion of patients with vitamin D deficiency was significantly higher in the COVID-19 group than the control group (44% vs. 17.5%, P < 0.001). Patients with low vitamin D levels were older than the patients with normal vitamin D levels (11.6 ± 4.9 vs. 6.2 ± 1.8 years, P = 0.016). There was a significant male preponderance in the normal vitamin D group compared with the low vitamin D group (91.7% vs. 50.8%, P = 0.03). C-reactive protein level was higher in the low vitamin D group, although the difference did not reach statistical significance (9.6 ± 2.2 vs. 4.5 ± 1.6 mg/l, P = 0.074). Our study provides an insight into the relationship between vitamin D deficiency and COVID-19 for future studies. Empiric intervention with vitamin D can be justified by low serum vitamin D levels.

Vitamin D levels in children with otitis media with effusion

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ahmed Adly Mohamed ◽  
Marwa Mohamed EL-Begermy ◽  
Ahmed Abdelmoneim Teaima ◽  
Mohamed Ali Abdelghafar
Keyword(s):  
Vitamin D ◽  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Serum Vitamin ◽  
Control Group ◽  
University Hospitals ◽  
Serum Vitamin D ◽  
Vitamin D Levels ◽  
25 Hydroxy Vitamin D ◽  
The Mean

Abstract Objective To investigate the relationship between otitis media with effusion (OME) and serum vitamin D level in children. Methods This prospective case control study was conducted at Ain Shams University Hospitals between February 2018 and May 2019. The study population included 50 children with OME confirmed by tympanometry type (B) who will undergo adenotonsillectomy and grommet tube insertion compared to 50 children without OME confirmed by tympanometry type (A) who will undergo adenotonsillectomy. Measurement of serum 25-hydroxy vitamin D using electrochemiluminescence technique from a blood sample (3cm) taken from them on the day of surgery. Results In this study, the mean age of the cases was 4.24 ± 0.80 and 5.34 ± 1.19 years for the controls besides 23 (46%) of the OME group were boys and 27 (54%) were girls, compared with 29 (58%) boys and 21 (42%) were girls in the control group. The mean levels of vitamin D in children with OME was 16.24 ± 7.14 ng/mL and in children in the control group was 15.89 ± 5.84 ng/mL (P = 0.815) and it was statistically non significant. Conclusion There was no significant relation between vitamin D serum level and the incidence of OME in children.

The Prevalence of 25-Hydroxyvitamin D Deficiency in Post-HSCT Pediatric Patients.

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 2139-2139
Author(s):  
Christine Duncan ◽  
Lynda Vrooman ◽  
Lori Bechard ◽  
Elly Barry ◽  
Leslie E. Lehmann
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Pediatric Patients ◽  
Bone Marrow Failure ◽  
Long Term Effects ◽  
Hydroxyvitamin D ◽  
Vitamin D Levels ◽  
25 Hydroxyvitamin D ◽  
The Mean ◽  
25 Oh Vitamin D

Abstract Children undergoing HSCT are at risk for vitamin D deficiency due to lack of sun exposure, the recommended use of sunscreen, dietary insufficiency, and the effects of medications such as glucocorticoids and calcineurin inhibitors. We assessed the prevalence of 25-hydroxyvitamin D (25-OH vitamin D) deficiency in pediatric post-HSCT patients in an outpatient oncology clinic during 4 weeks in May 2008. Patients found to have low 25-OH vitamin D levels were referred for dietary counseling and given supplementation or repletion as needed. 25-OH vitamin D and parathyroid hormone (PTH) levels were measured in 62 (88.6%) of 70 eligible patients. 83.8% of patients had a 25-OH vitamin D level less than the institutional lower limit of normal, 30 ng/mL. 29% of patients were 25-OH vitamin D insufficient with levels 20–29 ng/mL (range of 20–29). 54.8% of patients were 25-OH vitamin D deficient with levels &lt;20 ng/mL (range 5–19). The prevalence of insufficiency and deficiency was similar between male (87.8%; 57.6%) and female patients (57.6%; 55.2%).The mean duration of days following transplant was 532.6 days (median 251.5 days). The mean age at transplant was 3.7 years (median 3.5 years). 47% of patients were female. 75.8% were Caucasian. 90.3% received allogeneic transplants. The underlying diseases were as follows: ALL (27.4%), AML/MDS (24.2%), bone marrow failure (11.3%), nonmalignant hematologic diagnosis (8.1%), solid tumor (8.1%), immunodeficiency (6.5%), lymphoma (6.5%), and other diagnoses (8.1%). 8 patients regularly took either an over-the-counter multivitamin or vitamin D supplement and all 8 patients had 25-OH levels less than 30 ng/mL. There was a negative inverse correlation of (r= −0.3, p=0.029) between PTH and 25-OH vitamin D. There were no significant associations between 25-OH vitamin D level and any of the following: corticosteroid or calcineurin inhibitor use in the preceding year, time from transplant, age at transplant, current age, or graft-versus-host disease. 25-OH vitamin D insufficiency and deficiency are common following pediatric HSCT. We recommend vitamin D screening for all post-HSCT pediatric patients. Further investigation is needed to identify potential risk factors for vitamin D deficiency and the long-term effects of deficiency on bone health and development.

scholarly journals Vitamin D status in adults and children in Transcarpathia, Ukrainein 2019

2020 ◽  
Author(s):  
Khrystyna Shchubelka
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Adult Population ◽  
Winter Season ◽  
Epidemiological Data ◽  
Adult Women ◽  
Vitamin D Levels ◽  
Significant Difference ◽  
Adults And Children ◽  
The Mean

Abstract Background: Vitamin D deficiency is a global health problem, it is assessed by measuring serum 25-hydroxivitamin D (25(OH) D), nevertheless epidemiological data for many countries remains underreported.Objectives:To study the prevalence of vitamin D deficiency throughout the calendar year in a large cohort recruited ina multiethnic Transcarpathian region of Ukraine.Methods: In this retrospective study 25(OH)D serum concentration was measured during all 12 months of the year 2019 by electrochemoluminescent assay on the automatic analyzer Cobas e411 in 1,823 subjects, including both children and adults (1551 females (85.03%) and 273 males (14.97%)). ResultsThe mean 25(OH) D concentration in adults demonstrates significantly lower levels compared to children (22.67±8.63 ng/ml vs. 26.00±10.72 ng/ml respectively, p<0.001). Adult women expressed significantly lower mean annual serum 25 (OH) D concentrations in comparison to men (22.29±8.46 ng/ml vs. 25.75±9.38 ng/ml respectively, p< 0.001). In contrast, children did not show a significant difference between sexes (girls 24.98±10.38 ng/ml vs. boys 27.01±11.01 ng/ml, p=0.2003). In the winter months, 25(OH)D levels fell below 20 ng/ml in 51,74 % of adult population of Thranscarpathia, and in 12.91%, - below 12 ng/ml.ConclusionsThe results of this study contradict the previously reported evaluations of the vitamin D levels in Ukraine which were assessed by measuring serum 25(OH) D. Specifically, only approximately half of the studied population is vitamin D deficient during winter season. This study features the most representative sample size in Ukraine to date.

scholarly journals Prevalence and Correlation of Laryngopharyngeal Reflux in Females with Vitamin D Deficiency in a Multi-Specialty Polyclinic in New Delhi, India

2020 ◽  
Vol 8 (2) ◽  
Author(s):  
Sachin Saini ◽  
Rahul Pandey ◽  
Navdeep Singh ◽  
Surendra Kumar Pandey ◽  
Inam Danish Khan
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Tissue Injury ◽  
Laryngopharyngeal Reflux ◽  
New Delhi ◽  
Female Population ◽  
Severe Vitamin ◽  
Vitamin D Levels ◽  
The Mean ◽  
Study Participants

Background: Laryngopharyngeal Reflux (LPR) is a condition in which gastric content reflux into the larynx and pharynx. It is one of the extraesophageal manifestations of gastroesophageal reflux disease (GERD), involving the laryngeal regio. The laryngopharyngeal epithelium is more susceptible to reflux-related tissue injury than the esophageal epithelium. Objectives: This study aimed to test the hypothesis of whether severe vitamin D deficiency results in increased Laryngopharyngeal reflux (LPR) symptoms in Indian females. The objective was to find out the prevalence of LPR in the severe vitamin D deficient Indian female population. Methods: A descriptive observational study was done at a multispecialty polyclinic in New Delhi, India, over a period of one year. Based on a pilot study, a sample size of 185 individuals was taken. All females referring to the general outpatient department (OPD) with vitamin D levels below 20 ng/ml were included. The frequency of LPR symptoms in the study participants was assessed using the reflux symptom index (RSI) and reflux finding score (RFS) given for all symptomatic patients using a validated scoring system. The data were analyzed descriptively with Microsoft Excel and SPSS version 21 using appropriate tests. Results: In this study, 92% of the subjects aged more than 25 years, and the mean vitamin D level was 9.87 (± 3.425) ng/ml. Moreover, 74% of study participants had severe vitamin D deficiency (≤ 10 ng/ml). The mean RSI for our study participants was 14.54 (± 10.353). Also, the mean RFS was 1.77 (± 3.069). No significant correlation was established between the severity of vitamin D deficiency and RSI as well as RFS. The prevalence of LPR was 43%. Conclusions: Hypovitaminosis D does not have any effect on LPR in the Indian female population.

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