The prevention of infection

2019 ◽  
Vol 101-B (1_Supple_A) ◽  
pp. 3-9 ◽  
Author(s):  
V. K. Alamanda ◽  
B. D. Springer
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Vitamin D ◽  
Glycaemic Control ◽  
Operating Room ◽  
Joint Infection ◽  
High Morbidity ◽  
Modifiable Risk Factors ◽  
Skin Preparation ◽  
Vitamin D Levels

AimsProsthetic joint infection (PJI) remains a serious complication that is associated with high morbidity and costs. The aim of this study was to prepare a systematic review to examine patient-related and perioperative risk factors that can be modified in an attempt to reduce the rate of PJI.Materials and MethodsA search of PubMed and MEDLINE was conducted for articles published between January 1990 and February 2018 with a combination of search terms to identify studies that dealt with modifiable risk factors for reducing the rate of PJI. An evidence-based review was performed on 12 specific risk factors: glycaemic control, obesity, malnutrition, smoking, vitamin D levels, preoperative Staphylococcus aureus screening, the management of anti-rheumatic medication, perioperative antibiotic prophylaxis, presurgical skin preparation, the operating room environment, irrigant options, and anticoagulation.ResultsPoor glycaemic control, obesity, malnutrition, and smoking are all associated with increased rates of PJI. Vitamin D replacement has been shown in preliminary animal studies to decrease rates of PJI. Preoperative Staphylococcus aureus screening and appropriate treatment results in decreased rates of PJI. Perioperative variables, such as timely and appropriate dosage of prophylactic antibiotics, skin preparation with chlorohexidine-based solution, and irrigation with dilute betadine at the conclusion of the operation, have all been associated with reduced rates of PJI. Similarly, aggressive anticoagulation and increased operating room traffic should be avoided to help minimize risk of PJI.ConclusionPJI remains a serious complication of arthroplasty. Surgeons should be vigilant of the modifiable risk factors that can be addressed in an attempt to reduce the risk of PJI.

A systematic review of modifiable risk factors in the progression of multiple sclerosis

2017 ◽  
Vol 23 (4) ◽  
pp. 525-533 ◽  
Author(s):  
Susanne Hempel ◽  
Glenn D Graham ◽  
Ning Fu ◽  
Elena Estrada ◽  
Annie Y Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multiple Sclerosis ◽  
Vitamin D ◽  
Meta Analysis ◽  
Clinical Manifestations ◽  
Rapid Decline ◽  
Modifiable Risk Factors ◽  
Presenting Symptoms ◽  
Increased Risk ◽  
Vitamin D Levels

Background: The presenting symptoms and rate of progression of multiple sclerosis (MS) are very heterogeneous. The diverse clinical manifestations and the clinical course of the disease may vary with modifiable risk factors. Objective: To systematically review modifiable risk factors and exposures associated with MS progression. Methods: We searched six databases till March 2015, reference-mined reviews, and consulted with experts (PROSPERO 2015:CRD42015016461). Two reviewers screened and extracted data. We used random meta-analysis models and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) to assess the quality of evidence. Results: In total, 59 studies met inclusion criteria. Lower vitamin D levels were associated with higher Expanded Disability Status Scale (EDSS) scores ( r = −0.22; confidence interval (CI) = −0.32, −0.12; 11 studies; I2 = 66%), smokers had an increased risk of MS progression (hazard ratio (HR) = 1.55; CI = 1.10, 2.19; I2 = 72%; seven studies), and there was no association of MS progression with the use of epidural analgesics during childbirth delivery (three studies). There was insufficient evidence to draw conclusions for 11 risk factors due to conflicting results or use of different predictor and outcome measures. Conclusion: MS progression was consistently associated with low vitamin D levels, and smoking was associated with a more rapid decline in MS disability. Studies used a variety of methods, predictors, and outcomes making it difficult to draw conclusions. Future studies should focus on prospective assessments.

Association of Vitamin D Levels and Other Risk Factors with Asthma Exacerbations in Children

2020 ◽  
Keyword(s):  
Risk Factors ◽  
Vitamin D ◽  
Serum Vitamin ◽  
Persistent Asthma ◽  
Food Allergies ◽  
P Value ◽  
Serum Vitamin D ◽  
Asthma Exacerbations ◽  
Vitamin D Levels ◽  
Animal Dander

Background: The risk factors for asthma exacerbations are well understood. However, the effect of vitamin D levels on number of asthma exacerbations per year is not clearly studied. The objective of the study was to find out the association of serum vitamin D levels and asthma risk factors on asthma exacerbations. Methods: In this study, ninety-nine subjects from 5 to 15 years of age were recruited at an episode of acute exacerbation. It was a cross sectional study and carried out from 2012 to 2015. Pulmonary function test was done by spirometry. Asthma exacerbation was labeled when forced expiratory volume/ forced vital capacity (FEV1/FVC) ratio was less than 80% (American Thoracic Society). Global Initiative for Asthma (GINA) guidelines were used to classify asthma into mild, moderate and severe persistent asthma. Serum vitamin D levels were measured by chemiluminescence method. Pearson Chi-square test was applied and p value (p<0.05) was considered as statistically significant. Results: Children who had exposure to animal dander had significantly lower asthma exacerbations per year (p-value <0.046). There was no significant association between vitamin D levels and number of exacerbations per years (p-value <0.099). Asthma was prevalent in girls of low socioeconomic status (SES) compared to males. However, there was no significant association between smoke, exercise, home environment, food allergies, weather, pollen and dust with asthma exacerbations. Conclusion: Low levels of vitamin D were not associated with increased number of asthma exacerbations per year. However, children exposed to animal dander had lesser number of exacerbations per year (p-value <0.046). Keywords: Asthma; Vitamin D; Children; Exacerbations, Risk factors.

scholarly journals Personal and Environmental Risk Factors at Birth and Hospital Admission: Direct and Vitamin D-Mediated Effects on Bronchiolitis Hospitalization in Italian Children

2021 ◽  
Vol 18 (2) ◽  
pp. 747
Author(s):  
Marco Zaffanello ◽  
Giuliana Ferrante ◽  
Salvatore Fasola ◽  
Michele Piazza ◽  
Giorgio Piacentini ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vitamin D ◽  
Hospital Admission ◽  
Environmental Risk ◽  
Gestational Age ◽  
Serum Vitamin ◽  
Spring Season ◽  
Serum Vitamin D ◽  
Mediated Effects ◽  
Vitamin D Levels

Seasonal variations in UV-B radiation may influence vitamin D status, and this, in turn, may influence the risk of bronchiolitis hospitalization. The aim of this study was using a causal inference approach to investigate, simultaneously, the interrelationships between personal and environmental risk factors at birth/hospital admission (RFBH), serum vitamin D levels and bronchiolitis hospitalization. A total of 63 children (<2 years old) hospitalized for bronchiolitis (34 RSV-positive) and 63 controls were consecutively enrolled (2014–2016). Vitamin D levels and some RFBH (birth season, birth weight, gestational age, gender, age, weight, hospitalization season) were recorded. The discovered RFBH effects on the risk ok bronchiolitis hospitalization were decomposed into direct and vitamin-D mediated ones through Mediation Analysis. Winter-spring season (vs. summer-autumn) was significantly associated with lower vitamin D levels (mean difference −11.14 nmol/L). Increasing serum vitamin D levels were significantly associated with a lower risk of bronchiolitis hospitalization (OR = 0.84 for a 10-nmol/L increase). Winter-spring season and gestational age (one-week increase) were significantly and directly associated with bronchiolitis hospitalization (OR = 6.37 and OR = 0.78 respectively), while vitamin D-mediated effects were negligible (1.21 and 1.02 respectively). Using a comprehensive causal approach may enhance the understanding of the complex interrelationships among RFBH, vitamin D and bronchiolitis hospitalization.

The Biochemical Parameters and Vitamin D Levels in ICU Patients with Covid-19: A Cross-Sectional Study

2021 ◽  
Vol 21 ◽  
Author(s):  
Hamed Abdollahi ◽  
Farahnaz Salehinia ◽  
Mostafa Badeli ◽  
Elmira Karimi ◽  
Hossein Gandomkar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vitamin D ◽  
Immune System ◽  
Liver Enzymes ◽  
Serum Vitamin ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Elevated Liver Enzymes ◽  
Vitamin D Levels

Background: In Covid-19 infection, leukopenia, inflammation, and elevated liver enzymes are found in most patients. Also, vitamin D deficiency attenuate the immune system and predispose a person more susceptible to infection. In this context, we aimed to evaluate vitamin D, Electrolytes, Complete blood count, Liver enzymes, Urea, Creatinine, Albumin, CRP and ESR levels in patients with Covid-19. Methods: We conducted a cross-sectional study on 118 patients with Covid-19 who were hospitalized from 2020/2/19 to 2020/4/3 in ICU. Serum levels of electrolytes, liver enzymes, blood factors, urea, creatinine, CRP and ESR as well as anthropometric parameters and serum vitamin D concentration were measured. Results: A total of 118 patients (80 male and 38 female) was enrolled in the study (65.05±15.75 years). Only 5.08% of patients had no risk factors and 55.9% had ≥ 2 risk factors. Diabetes (44.1%) and obesity (23.7%) were more common among patients. Laboratory finding showed that 80.50% of patients had hyponatremia, but other electrolytes included K, Mg, Ca and P were normal in majority of participants as well as CBC, Cr, Urea, Alb, ALT and ALKP. The AST concentration increased in most patients (66.94%). All patients had high levels of inflammatory factors such as CRP and ESR. The mean of 25-hydroxy-vitamin D levels in participants (25.95 ± 14.56 ng/mL) was lower than its levels in general papulation. However, it was not statistically significant (P= 0.88). A significant negative correlation found between vitamin D and ALT (P= 0.02, -0.21) as well as vitamin D and CRP (P= 0.05, -0.17). Conclusion: Regarding to the regulatory role of vitamin D in immune system and low levels of vitamin D in Covid-19 infected patients, the evaluation of vitamin D levels and prescribe supplements if necessary is suggested.

scholarly journals Vitamin D levels and cardiometabolic risk factors in Portuguese adolescents

2016 ◽  
Vol 220 ◽  
pp. 501-507 ◽  
Author(s):  
Maria Cabral ◽  
Joana Araújo ◽  
Joana Teixeira ◽  
Henrique Barros ◽  
Sandra Martins ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vitamin D ◽  
Cardiometabolic Risk ◽  
Cardiometabolic Risk Factors ◽  
Vitamin D Levels ◽  
Portuguese Adolescents

SEROSURVEY OF ANTI-TOXOCARA ANTIBODIES AND RISK FACTORS IN RELATION TO VITAMIN D LEVELS AMONG PREGNANT WOMEN OF DUHOK CITY –KURDISTAN REGION

2021 ◽  
Vol 15 (2) ◽  
pp. 52-62
Author(s):  
MANAL ADIL MURAD ◽  
◽  
SOUZAN HUSSAIN EASSA ◽  
SHEREEN ABDULLAH IBRAHIM ◽  
◽  
...  
Keyword(s):  
Risk Factors ◽  
Vitamin D ◽  
Pregnant Women ◽  
Kurdistan Region ◽  
Vitamin D Levels

scholarly journals Association of Vitamin D Status with Chronic Disease Risk Factors and Cognitive Dysfunction in 50–70 Year Old Adults

Nutrients ◽  
2019 ◽  
Vol 11 (1) ◽  
pp. 141 ◽  
Author(s):  
Japneet Kaur ◽  
Steven Ferguson ◽  
Eduardo Freitas ◽  
Ryan Miller ◽  
Debra Bemben ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Vitamin D ◽  
Chronic Diseases ◽  
Disease Risk ◽  
Serum Vitamin ◽  
Old Adults ◽  
Serum Vitamin D ◽  
Chronic Disease Risk ◽  
Vitamin D Levels

Vitamin D deficiency/insufficiency has been primarily associated with skeletal disorders, however, since vitamin D receptors are found on multiple types of cells, there is also a link to increased chronic disease risk and all-cause mortality. The aim of this study was to examine whether deficient/insufficient vitamin D levels are associated with risk factors of chronic diseases and cognitive dysfunction in 50 to 70 year old adults. Participants completed the health status, three-day dietary record and vitamin D food frequency, sun exposure, and international physical activity questionnaires. Cognitive function of the participants was assessed using the Automated Neuropsychological Assessment Metrics while body composition (percent body fat, android/gynoid ratio) was assessed using Dual Energy X-ray Absorptiometry. Applanation tonometry was used to obtain pressure wave forms at the radial artery to examine arterial stiffness and central pressures. A fasting blood draw was taken to measure vitamin D, blood lipid and glucose levels. Fifty percent of the participants (36/72) were vitamin D deficient/insufficient. Individuals in the low physical activity (PA) group had lower serum vitamin D concentration compared to those in the high PA group (p = 0.04). Moreover, serum vitamin D levels were negatively related to risk factors of chronic diseases; blood glucose (r = −0.38; p = 0.01), triglycerides (r = −0.27; p = 0.02), and android/gynoid ratio (r = −0.32; p = 0.01). Deficient/insufficient vitamin D levels are linked to the risk factors of chronic diseases in men and women aged 50 to 70 years.

Demographic Characteristics, Risk Factors, and Presenting Features of Children with Symptomatic Nutritional Rickets: A French Series

2020 ◽  
Vol 93 (5) ◽  
pp. 304-312
Author(s):  
Claire Flot ◽  
Valérie Porquet-Bordes ◽  
Justine Bacchetta ◽  
Anya Rothenbuhler ◽  
Anne Lienhardt-Roussie ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vitamin D ◽  
Pediatric Population ◽  
Vitamin D Supplementation ◽  
Demographic Characteristics ◽  
Total Serum ◽  
Nutritional Rickets ◽  
Total Serum Calcium ◽  
Vitamin D Levels ◽  
25 Hydroxy Vitamin D

<b><i>Aim:</i></b> To describe the demographic characteristics, risk factors, and presenting features of children with symptomatic nutritional rickets in France. <b><i>Methods:</i></b> This is a retrospective study of 38 children diagnosed with nutritional rickets from 1998 to 2019. <b><i>Results:</i></b> We observed a higher frequency of rickets in males (74 vs. 26%), in young children (median age at diagnosis: 23 months; 82% were younger than 5 years), and in children with a non-Caucasian ethnic background (89%). Most children were exclusively breastfed (78%) without adequate vitamin D supplementation (89%). The most common presentations were bowed legs (63%), hypocalcemic seizures (21%), and growth retardation (11%). Approximately half (62%) of the children were hypocalcemic. The children presenting with hypocalcemic seizures were significantly younger (0.8 vs. 2.2 years; <i>p</i> = 0.041) and had lower total serum calcium levels (1.44 vs. 2.17 mmol/L; <i>p</i> &#x3c; 0.0001), higher phosphatemia (1.43 vs. 1.23 mmol/L; <i>p</i> = 0.020), and lower 25-hydroxy vitamin D levels (3 vs. 7 ng/mL; <i>p</i> = 0.020) but similar parathyroid hormone levels (357 vs. 289 ng/mL; <i>p</i> = 0.940) compared to rickets cases who did not experience hypocalcemic seizures. A dilated cardiomyopathy was detected in 14% of the children who had undergone echocardiography. <b><i>Conclusion:</i></b> Nutritional rickets remains endemic in the pediatric population and its most severe forms can have life-threatening sequelae. Health practitioners need to be cognizant of these facts to raise awareness and screen high-risk populations.

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