scholarly journals Assessing Biomarkers of Breast Cancer Risk in Underserved Women in a Midwestern County

2021 ◽  
Vol 12 ◽  
pp. 215013272110177
Author(s):  
Marla A. DeWitt ◽  
Ivana T. Croghan ◽  
Celine M. Vachon ◽  
Thomas D. Thacher ◽  
Marcia R. Venegas Pont ◽  
...  
Keyword(s):  
Vitamin D ◽  
Mammographic Density ◽  
Small Sample Size ◽  
Vitamin D Insufficiency ◽  
Screening Mammography ◽  
Small Sample ◽  
Vitamin D Status ◽  
Small Pilot Study ◽  
Unexpected Findings

Objective: The primary aim of this study was to evaluate the feasibility of collecting risk factor information and accessing digitized mammographic data in a medically marginalized population. A secondary aim was to examine the association between vitamin D status and mammographic density. Methods: Breast-screening examinations were provided for age-appropriate patients, and a referral for no-cost screening mammography was offered. Study participants were asked to undergo 25-hydroxyvitamin D testing at mammography and 1-year follow-up. Results: Of 62 women approached, 35 (56%) consented to participate. Of 32 participants who had baseline mammography, the median mammographic density measured by VolparaDensity (Volpara Solutions Limited) was 5.7%. After 1 year, 9 women obtained follow-up mammograms, with a median density of 5.7%. Vitamin D status was measured for 31 participants at baseline and 13 participants in the following year. Insufficient vitamin D status (<30 ng/mL) was noted in 77% at each time point. Mammographic density was not significantly correlated with vitamin D status ( P = .06). Conclusions: On the basis of this small pilot study, vitamin D insufficiency is common in this study population. Owing to the small sample size, an association between vitamin D insufficiency and breast density was not clear. Additional unexpected findings included substantial barriers in initial access to care and longitudinal follow-up in this population. Further study of these issues is needed.

Does vitamin D status predict weight gain or increase in waist circumference? Results from the longitudinal Health 2000/2011 Survey

2020 ◽  
Vol 23 (7) ◽  
pp. 1266-1272 ◽  
Author(s):  
Tuija Jääskeläinen ◽  
Satu Männistö ◽  
Tommi Härkänen ◽  
Katri Sääksjärvi ◽  
Seppo Koskinen ◽  
...  
Keyword(s):  
Vitamin D ◽  
Risk Factor ◽  
Weight Gain ◽  
Waist Circumference ◽  
Healthy Lifestyle ◽  
Adult Population ◽  
Population Based ◽  
Vitamin D Insufficiency ◽  
Vitamin D Status

AbstractObjective:To investigate whether vitamin D status predicts weight gain or increase in waist circumference during the 11-year follow-up in general adult population.Design:A population-based longitudinal study.Setting:The study was conducted using data from the nationally representative Health 2000/2011 Survey. The analyses were based on regression models adjusted for sociodemographic and lifestyle factors.Participants:Weight, waist circumference and vitamin D status (serum 25-hydroxyvitamin D concentration analysed with radioimmunoassay) were measured from 2924 participants aged 30–64 years at baseline.Results:In men, low vitamin D status at baseline predicted ≥10 % increase in waist circumference during the follow-up when adjusted for age only (OR for sufficient v. deficient S-25(OH)D 0·41; 95 % CI 0·25, 0·67; P for trend <0·01), but the association with weight gain was only borderline significant. After adjustment for potential confounders, low vitamin D status remained a significant predictor of increase in waist circumference, but the association with weight gain was further attenuated. In women, vitamin D status at baseline did not predict weight gain or increase in waist circumference.Conclusions:Our results suggest that vitamin D insufficiency may be a risk factor of abdominal obesity among men but not among women. In men, it may also increase the risk of weight gain. Further studies are required to confirm these findings and examine potential mechanisms behind them. There is also a possibility that vitamin D is a biomarker of healthy lifestyle rather than an independent risk factor for obesity.

P51 NUTRITIONAL DEFICIENCY POST OESOPHAGO-GASTRIC SURGERY IN CANCER PATIENTS

2019 ◽  
Vol 32 (Supplement_2) ◽  
Author(s):  
Veeralakshmanan Ji Chung Tham Pushpa ◽  
Wadhawan Himanshu ◽  
Wright Amy ◽  
Bolter Marilyn ◽  
Berrisford Richard ◽  
...  
Keyword(s):  
Vitamin D ◽  
Nutritional Status ◽  
Vitamin B12 ◽  
Small Sample Size ◽  
Pancreatic Insufficiency ◽  
Gastric Surgery ◽  
Small Sample ◽  
Nutritional Deficiencies ◽  
Nurse Specialist

Abstract Aim Postoperative nutritional status is an important prognostic factor in patients undergoing oesophagectomy or gastrectomy for malignant tumours. The deterioration in nutritional status post oesophagectomy is seen more profoundly after 6 months of surgery [1]. In our unit, we successfully implemented Allied Health Professionals (AHP) led clinics consisting of cancer nurse specialist and specialist dietician to conduct routine follow-up for 5 year duration post oesophago-gastric surgery to help identify and manage nutritional deficiencies. Background & Methods AHP led outpatient clinic was established in February 2017. Between February 2017 and February 2018, all patients who were eligible and who attended the AHP clinic at our tertiary unit were included in the study. All patients who attended the clinic, had micronutrient screening in particular ferritin, folate, vitamin B12 and vitamin D. Patients were screened for exocrine pancreatic insufficiency (EPI) through series of questions related to symptoms of EPI including steatorrhea, flatulence, loose stools and urgency to defecate. All patients included in the study were started on A-Z multivitamin tablets from their first visit. Patients reporting symptoms indicative of EPI were started on Creon. Patients found deficient in any micronutrients were invited for a follow-up measurement of the respective deficiency. Results A total of 52 patients were included in the study period with a median follow-up of 17 months post oesophago-gastric cancer surgery. Proportion of patients with deficiency in ferritin, folate, vitamin B12 and vitamin D were 51.92%, 11.54%, 7.69% and 42.31% respectively. Proportion of patients identified with symptoms indicative of EPI was 36.54%. At re-test follow-up, 64.71% patient noticed settlement of symptoms of EPI and 85.91% of patients improved their ferritin levels at retest. Folate, Vitamin B12 and D levels significantly improved post initial AHP follow-up (significance level p<0.05). Conclusion Despite the study’s limitation of a small sample size of 52, it highlights that nutritional deficiencies post oesophago-gastric surgeries are prevalent. AHP run follow-up clinics in our unit helps identify these deficiencies and manage them accordingly. Study shows statistically significant improvement in deficiencies thereby making AHP led follow-up clinics to be cost effective and improve patient outcome.

scholarly journals Effect of Vitamin D level on growth velocity of RHGH treated children

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
W A Mouharam ◽  
A A Saab ◽  
D A Soliman
Keyword(s):  
Growth Hormone ◽  
Vitamin D ◽  
Short Stature ◽  
Growth Velocity ◽  
Statistical Significance ◽  
Vitamin D Insufficiency ◽  
Vitamin D Status ◽  
Rhgh Therapy ◽  
Single Blood Sample

Abstract Objective Recent studies have shown a relationship between vitamin D status, growth hormone and insulin-like growth factor 1 axis. Aims of the study are: 1- To evaluate the vitamin-D blood level in children on substitution treatment with rhGH. 2. To find out correlation between the vitamin D level and growth velocity with rhGH therapy, height, height SDS, height/height SDS after 1 year of treatment Methods The study included 173 prepubertal children, with short stature on treatment with rhGH (90 girls and 81 boys), aged between 2 and 10.3 years. To determine vitamin D status we measured serum 1,25-OH vitamin D by taking a single blood sample in the morning, in a fasting stage. Growth velocity over the year of observation, starting height, height SDS, height at the end of the year and its SDS all were calculated and correlated to vitamin D level. Results In the present study: 56 patients had vitamin D deficiency (&lt;10 ng/ml); 54 had vitamin D insufficiency (10–20 ng/ml) and 63 had vitamin D sufficiency (&gt;20 ng/ml). No statistical significance correlation was found between vitamin D level and height, height SDS, follow up height, and follow up height SDS (P.09, .066, .455, .927 respectively) Significant positive correlation was found between vitamin D and growth velocity (r .445 and P.0001). Conclusions Optimizing vitamin D level in patients with short stature under growth hormone therapy may improve growth velocity and response to growth hormone.

Role of multiparametric MRI in long-term surveillance following focal laser ablation of prostate cancer

2021 ◽  
pp. 20210414
Author(s):  
Mark Paxton ◽  
Eitan Barbalat ◽  
Nathan Perlis ◽  
Ravi J Menezes ◽  
Mark Gertner ◽  
...  
Keyword(s):  
Laser Ablation ◽  
Recurrent Disease ◽  
Small Sample Size ◽  
Focal Therapy ◽  
Outcome Data ◽  
Small Sample ◽  
Restricted Diffusion ◽  
Treatment Site ◽  
Imaging Characteristics

Objective: Determine the multiparametric magnetic resonance imaging (mpMRI) appearance of the prostate following focal laser ablation (FLA) for PCa and to identify imaging characteristics associated with recurrent disease. Methods: Retrospective analysis of patients who underwent FLA for low-intermediate risk PCa between 2010 and 2014 was performed. Early (median 4 months) and late mpMRI (median 49 months) follow-up were qualitatively assessed for T2-weighted, dynamic contrast enhanced (DCE) and diffusion weighted imaging (DWI) appearances and also compared to corresponding PSA values and biopsy results. Results: 55 cancers were treated in 54 men (mean age 61.0 years). Early mpMRI was performed in 30 (54.5%) patients while late follow-up mpMRI in 42 (84%). Ill-defined scarring with and without atrophy at the treatment site were the most common appearances. In patients with paired MRI and biopsy, one of four patients with clinically significant PCa on biopsy (≥GG2 or≥6 mm GG1) showed hyperenhancement or restricted diffusion at early follow-up. At late follow-up, positive biopsies were seen in 5/8 (63%) cases with hyperenhancement and 5/6 (83%) cases with restricted diffusion at the treatment site. PSA change was not associated with biopsy results at either time point. Conclusion: mpMRI is able to document the morphological and temporal changes following focal therapy. It has limited ability to detect recurrent disease in early months following treatment. Late-term mpMRI is sensitive at identifying patients with recurrent disease. Small sample size is, however, a limitation of the study. Advances in knowledge: Implementing MRI in follow-up after FT may be useful in predicting residual or recurrent PCa and therefore provide reliable outcome data.

Serum levels of vitamin D are not associated with future risk of venous thromboembolism

2013 ◽  
Vol 109 (05) ◽  
pp. 885-890 ◽  
Author(s):  
Gunhild Lerstad ◽  
Guri Grimnes ◽  
Sigrid K. Brækkan ◽  
Anders Vik ◽  
Jan Brox ◽  
...  
Keyword(s):  
Vitamin D ◽  
Venous Thromboembolism ◽  
Statistical Power ◽  
Cox Regression ◽  
Multivariable Analysis ◽  
Indirect Evidence ◽  
Serum Levels ◽  
Vitamin D Status ◽  
Future Risk

SummaryPrevious studies have provided indirect evidence for a possible association between vitamin D status and risk of venous thromboembolism (VTE). However, no study has so far investigated the association between serum levels of 25-hydroxyvitamin D (25(OH)D), the biomarker of vitamin D status, and risk of VTE. The aim of our study was to investigate whether high levels of 25(OH)D were associated with decreased risk of VTE in a prospective population-based study. Serum levels of 25(OH)D were measured in 6,021 men and women, aged 25–84 years, who participated in the Tromsø Study in 1994–1995. Incident VTE-events were registered from date of inclusion through the end of follow-up, September 1, 2007. Cox-regression models were used to calculate hazard ratios (HR) with 95% confidence interval (CI) for VTE. There were 201 incident VTE-events during a median of 10.7 years of follow-up. The risk of VTE did not decrease per one standard deviation (SD) (19.8 nmol/l) increase in serum 25(OH)D (multivariable HR 1.02; 95% CI 0.91–1.22). Moreover, subjects with serum 25(OH)D ≥ 70 nmol/l (upper quartile) did not have decreased risk of VTE compared to those ≤ 44 nmol/l (lower quartile) in age- and sex-adjusted analysis (HR 0.91, 95% CI: 0.60–1.37, p for trend across quartiles 0.9) or multivariable analysis adjusted for age, sex, body mass index, smoking, and physical activity (HR 0.76, 95% CI: 0.45–1.28, p for trend across quartiles 0.9). Subgroup analyses showed no associations between serum levels of 25(OH)D and unprovoked or provoked VTE. In conclusion, in our study, normal serum levels of 25(OH)D were not associated with future risk of VTE, suggesting that vitamin D status does not play an important role in the pathogenesis of VTE. However, our findings did not apply to subjects with vitamin D deficiency (< 30 nmol/l) due to lack of statistical power among these subjects.

scholarly journals Effects of Age and Serum 25-OH-Vitamin D on Serum Parathyroid Hormone Levels

2012 ◽  
Vol 97 (11) ◽  
pp. 3989-3995 ◽  
Author(s):  
A. Valcour ◽  
F. Blocki ◽  
D. M. Hawkins ◽  
Sudhaker D. Rao
Keyword(s):  
Vitamin D ◽  
Calcium Absorption ◽  
Small Sample Size ◽  
International Workshop ◽  
Large Population ◽  
Small Sample ◽  
Reference Laboratory ◽  
Population Database ◽  
Age Related ◽  
Serum Pth

Context: Several studies define optimal serum 25-hydroxyvitamin D (25-OHD) levels based on serum PTH level reaching an asymptote. However, results differ widely, ranging from 25-OHD levels of 12–44 ng/ml: many studies are constrained by small sample size. Objective: The objective of the study was to determine the relationship between serum PTH and 25-OHD levels and age in a very large reference laboratory database. Design: This was a detailed cross-sectional analysis of 312,962 paired serum PTH and 25-OHD levels measured from July 2010 to June 2011. Results: Median PTH levels and the proportion of patients (PTH &gt; 65 pg/ml), from 63 successive 25-OHD frequency classes of 5000 patients, provide smooth, exceptionally well-fitted curves (R2 = 0.994 and R2 = 0.995, respectively) without discernible inflection points or asymptotes but with striking age dependencies. Serum 25-OHD was below the recent Institute of Medicine sufficiency guidance of 20 ng/ml in 27% (85,000) of the subjects. More importantly, 40 and 51% of subjects (serum 25-OHD &lt;20 and 10 ng/ml, respectively) had biochemical hyperparathyroidism (PTH &gt; 65 pg/ml). Conclusions: This analysis, despite inevitable inherent limitations, introduces several clinical implications. First, median 25-OHD-dependent PTH levels revealed no threshold above which increasing 25-OHD fails to further suppress PTH. Second, the large number of subjects with 25-OHD deficiency and hyperparathyroidism reinforces the Third International Workshop on Asymptomatic Primary Hyper parathyroidism's recommendations to test for, and replete, vitamin D depletion before considering parathyroidectomy. Third, strong age dependency of the PTH-25-OHD relationship likely reflects the composite effects of age-related decline in calcium absorption and renal function. Finally, this unselected large population database study could guide clinical management of patients based on an age-dependent, PTH-25-OHD continuum.

scholarly journals Maternal Vitamin D Status and Risk of Gestational Diabetes: a Meta-Analysis

2018 ◽  
Vol 45 (1) ◽  
pp. 291-300 ◽  
Author(s):  
Lingmin Hu ◽  
Yue Zhang ◽  
Xing Wang ◽  
Lianghui You ◽  
Pengfei Xu ◽  
...  
Keyword(s):  
Vitamin D ◽  
Gestational Diabetes ◽  
Observational Studies ◽  
Meta Analysis ◽  
Vitamin D Insufficiency ◽  
Significant Heterogeneity ◽  
Vitamin D Status ◽  
Maternal Vitamin ◽  
Increased Risk ◽  
Maternal Vitamin D Status

Background/Aims: Whether maternal vitamin D deficiency is associated with gestational diabetes remains controversial. This meta-analysis aimed to systematically evaluate published evidence on the association between maternal vitamin D status and the risk of gestational diabetes. Methods: We retrieved relevant articles from the PubMed, Medline and Embase databases up to May 2017 for observational studies investigating the association between vitamin D status and the risk of gestational diabetes. Odds ratios (OR) or risk ratios (RR) from individual studies were pooled using the fixed and random effect models. Results: The meta-analysis of 29 observational studies included 28,982 participants, of which 4,634 were diagnosed with gestational diabetes, and showed that maternal vitamin D insufficiency was associated with a significantly increased risk of gestational diabetes by 39% (pooled OR = 1.39, 95%CI = 1.20-1.60) with moderate heterogeneity (I2 = 50.2%; P = 0.001). Moreover, the 25(OH)D level was significantly lower in gestational diabetes cases than in controls with a pooled effect of -4.79 nmol/L (95% CI = -6.43, -3.15). Significant heterogeneity was also detected (I2 = 65.0%, P < 0.001). Further subgroup analysis indicated that this association was also evident in most subpopulations. Conclusion: This meta-analysis indicated a significant association between vitamin D insufficiency and increased risk of gestational diabetes. Further well-designed large-scale clinical trials are essential to verify this association.

Utility of chemotherapy given before and/or after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for appendiceal adenocarcinoma with peritoneal metastases.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e16276-e16276
Author(s):  
Tyler Friedrich ◽  
Junxiao Hu ◽  
Robert William Lentz ◽  
Alexis Diane Leal ◽  
Sunnie S. Kim ◽  
...  
Keyword(s):  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Small Sample Size ◽  
Peritoneal Metastases ◽  
Small Sample ◽  
Histologic Grade ◽  
Low Grade ◽  
Appendiceal Adenocarcinoma

e16276 Background: Appendiceal adenocarcinoma is relatively rare and often diagnosed incidentally during operations for acute appendicitis. It is commonly associated, either at time of initial presentation or upon recurrence, with peritoneal metastases. A typical treatment strategy for patients with peritoneal disease includes cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC). Extrapolating largely from literature in colorectal cancer, chemotherapy is frequently given before and/or after CRS/HIPEC though high-level evidence to support this is lacking. We sought to evaluate the effect of systemic chemotherapy on survival. Methods: Utilizing a database of CRS/HIPEC procedures at University of Colorado Hospital from 2008 to present we retrospectively reviewed cases of appendiceal adenocarcinoma. Data collected included staging, histologic grade, chemotherapy given, surgical outcomes, and time to disease recurrence. Patients without adequate information regarding treatment, or without at least 1 year of clinical follow-up, were excluded. Associations between administration of chemotherapy or histologic grade and 1-year DFS were analyzed using Fisher’s exact test, and logistic regression was used to assess whether 1-year DFS were different in chemotherapy-treated patients when adjusted for histologic grade. Results: In total, 117 cases reviewed indicated an appendiceal pathology. Of these, 54 cases in a total of 51 patients met the specified criteria for pathology and completeness and length of follow-up information. The average age was 58 years (range 26-81 years). Adenocarcinoma was graded as low in 15 (28%) cases, intermediate in 18 (33%) cases, and high in 21 (39%) cases. 23 (43%) patients received no chemotherapy while 31 (57%) received chemotherapy before and/or after surgery. In the overall population, there was no significant effect of chemotherapy on survival, with 1-year DFS demonstrated in 74.2% of patients receiving some chemotherapy and 70% in patients not receiving chemotherapy (p = 0.765). One-year DFS was achieved in 86% of low-grade cases, 61% of intermediate-grade cases, and 71% of high-grade cases, though this was also not statistically significant (p = 0.254). Furthermore, when 1-year DFS between chemotherapy and non-chemotherapy patients was adjusted for grade, there was again no significant interaction (odds ratio = 0.48, 95% C.I. (0.13-1.64), p = 0.763). Conclusions: In this small, single-institution experience of patients with peritoneal appendiceal adenocarcinoma, there was no significant effect of chemotherapy administration on 1-year DFS. These findings are likely affected by significant confounding with the small sample size and retrospective nature of the data. Further investigation on a larger scale is warranted.

scholarly journals Role of pregnancy and obesity on vitamin D status, transport, and metabolism in baboons

2019 ◽  
Vol 316 (1) ◽  
pp. E63-E72
Author(s):  
Eugenia Mata-Greenwood ◽  
Hillary F. Huber ◽  
Cun Li ◽  
Peter W. Nathanielsz
Keyword(s):  
Vitamin D ◽  
Maternal Obesity ◽  
Subcutaneous Fat ◽  
Placental Tissue ◽  
Vitamin D Insufficiency ◽  
Primate Species ◽  
Vitamin D Status ◽  
Vitamin D Levels ◽  
25 Hydroxy Vitamin D ◽  
Kidney Liver

Human studies show that obesity is associated with vitamin D insufficiency, which contributes to obesity-related disorders. Our aim was to elucidate the regulation of vitamin D during pregnancy and obesity in a nonhuman primate species. We studied lean and obese nonpregnant and pregnant baboons. Plasma 25-hydroxy vitamin D (25-OH-D) and 1α,25-(OH)2-D metabolites were analyzed using ELISA. Vitamin D-related gene expression was studied in maternal kidney, liver, subcutaneous fat, and placental tissue using real-time PCR and immunoblotting. Pregnancy was associated with an increase in plasma bioactive vitamin D levels compared with nonpregnant baboons in both lean and obese groups. Pregnant baboons had lower renal 24-hydroxylase CYP24A1 protein and chromatin-bound vitamin D receptor (VDR) than nonpregnant baboons. In contrast, pregnancy upregulated the expression of CYP24A1 and VDR in subcutaneous adipose tissue. Obesity decreased vitamin D status in pregnant baboons (162 ± 17 vs. 235 ± 28 nM for 25-OH-D, 671 ± 12 vs. 710 ± 10 pM for 1α,25-(OH)2-D; obese vs. lean pregnant baboons, P < 0.05). Lower vitamin D status correlated with decreased maternal renal expression of the vitamin D transporter cubulin and the 1α-hydroxylase CYP27B1. Maternal obesity also induced placental downregulation of the transporter megalin (LRP2), CYP27B1, the 25-hydroxylase CYP2J2, and VDR. We conclude that baboons represent a novel species to evaluate vitamin D regulation. Both pregnancy and obesity altered vitamin D status. Obesity-induced downregulation of vitamin D transport and bioactivation genes are novel mechanisms of obesity-induced vitamin D regulation.

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