Vitamin D status and obesity in children from Chile

Background Vitamin D [25(OH)D] is essential for normal bone development and maintenance. Furthermore, its deficiency has been associated with obesity, cardiovascular diseases, insulin resistance, autoimmune diseases, and certain cancers. Objective To determine the incidence of serum 25(OH)D deficiency (<20 ng/ml) among apparently healthy Chilean children (4–14 years old) from three Chilean geographic areas during May–September 2018. Materials and methods Serum 25(OH)D levels were measured by a competitive protein-binding ELISA assay in 1134 children, and correlations between serum 25(OH)D levels, BMI, and geographic area were calculated. Individuals were grouped according to their serum 25-hydroxyvitamin D levels (ng/ml): severe deficiency: <5; moderate deficiency: 5–10.9; mild deficiency: 11–20.9; insufficiency: 21–29.9 and sufficiency: 30–100. Results We found 80.4% of children had serum 25(OH)D deficiency, with 1.7% severe, 24.6% moderate, and 54.1% mild. In the three cities, the percentage of serum 25(OH)D deficit was increased when comparing overweight or obesity with a healthy weight. Additionally, an interaction effect was observed between geographic area, nutritional status, and serum 25(OH)D levels using the factorial ANOVA test (p = 0.038). In Antofagasta, there were more overweight children and also a higher percentage of children with VitD deficiency (<30 ng/ml) compared to Santiago or Concepción. Conclusion This study revealed a high prevalence of serum 25(OH)D deficiency in children between 4 and 14 years old in Chile (80.4%) during May–September 2018. Obese and overweight children had the highest prevalence of serum 25(OH)D deficiency.

Vitamin B12 Deficiency in Eastern India: A Hospital Based Cross-sectional Study

Introduction: The prevalence of vitamin B12 deficiency is common (around 40%) in people older than 65 years of age and in people who are strict vegetarians. The major sources of Viamin B12 are meat, fish, dairy products and fortified cereals. Aim: To study the prevalence and common types of presentations of vitamin B12 deficiency among 20-80 years aged, non-vegetarian people attending a tertiary care hospital in a state of Eastern India. Materials and Methods: This hospital based cross-sectional study was conducted at IPGME&R and SSKM Hospital between July 2018 to December 2019. Serum samples were collected from 478 adult patients presenting with different symptoms like pallor, fatigue, numbness and tingling sensation in limbs, memory loss, alopecia etc., which may be related to vitamin B12 deficiency. These samples were screened for serum vitamin B12 level by chemiluminescence method in ADVIA, Centaur CP (SIEMENS). Data were analysed statistically by graph pad prism 8 software. Significance of the difference between means were detected using Student’s unpaired t-test and calculating the p-value (p-value <0.05 were considered as significant). Results: Among 184 females, 50 (27.17%) were found to be Vitamin B12 deficient (VBD). Among them, 18 (36%) had mild deficiency (serum vitamin B12 level 201-220 pmol/L), 22 (44%) had moderate (serum vitamin B12 level 150-200 pmol/L) and 10 (20%) had severe deficiency (serum vitamin B12 level <150 pmol/L). A total of 35 (70%) of the VBD females were of <50 years of age. Among 294 males, 83 (28.23%) were found to be VBD. Among them, 34 (41%) had mild deficiency (serum vitamin B12 level 201-220 pmol/L), 36 (43%) had moderate (serum vitamin B12 level 150-200 pmol/L) and 13 (16%) had severe deficiency (serum vitamin B12 level <150 pmol/L). Total 43 (51.8%) of VBD male persons were of <50 years age. Among VBD female patients, 24 (48%) had neuropathy and among VBD male patients, 54 (65%) had neuropathy. Conclusion: So, it can be concluded that if regular screening is done for serum vitamin B12 in symptomatic patients irrespective of age, a number of problems can be reduced or cured by diagnosing VBD patients and treating them with vitamin B12 either by dietary modification or medicinal supplementation.

Vitamin D – contrary to vitamin K – does not associate with clinical outcome in hospitalized COVID-19 patients

SARS-CoV-2 causes remarkably variable disease from asymptomatic individuals to respiratory insufficiency and coagulopathy. Vitamin K deficiency was recently found to associate with clinical outcome in a cohort of COVID-19 patients. Vitamin D has been hypothesized to reduce disease susceptibility by modulating inflammation, yet little is known about its role in disease severity. Considering the critical interaction between vitamin K and vitamin D in calcium and elastic fiber metabolism, we determined vitamin D status in the same cohort of 135 hospitalized COVID-19 patients by measuring blood 25(OH)D levels. We found no difference in vitamin D status between those with good and poor outcome (defined as intubation and/or death). Instead, we found vitamin D sufficient persons (25(OH)D >50 nmol/L) had accelerated elastic fiber degradation compared to those with mild deficiency (25(OH)D 25-50 nmol/L). Based on these findings, we hypothesize that vitamin D might have both favorable anti-inflammatory and unfavorable pro-calcification effects during COVID-19 and that vitamin K might compensate for the latter.

Presence and absence of carbohydrate metabolism disorders as a factor influencing development of vitamin B12 deficiency

Objective. To study the significance of the presence and absence of carbohydrate metabolism disorders as a factor affecting the development of vitamin B12 deficiency. Materials and methods. The data of 206 subjects, forming two main groups were analyzed: the group of carbohydrate metabolism disorders (CMDs), which included 76 women and 71 men (n = 147); the control group, which included 33 women and 26 men (n = 59). The inclusion criteria were the following: age over 35, availability of anamnestic data on pharmacotherapy, availability of data to clarify the state of carbohydrate metabolism, availability of data on vitamin B12 and some other biochemical indices. Vitamin B12 levels 221 pmol / l were considered normal, vitamin B12 levels from 148 pmol / l to 221 pmol/l were considered borderline (or mild deficiency), and levels of 148 pmol / l or less were considered severe vitamin B12 deficiency. Results. The group of absent carbohydrate metabolism disorders included 59 persons and the group of carbohydrate metabolism disorders (CMDs) included T2DM patients (n = 123) and individuals with prediabetes (n = 24), i.e. the total number of the examined persons in CMD group was equal to 147. The average level of vitamin B12 in the control group (n = 59) was 401.6 and 138.06 pmol / l, and in CMD group (n = 147) it was equal to 342.1 133.10 pmol/l. The differences between the groups were statistically significant (p 0.01), that suggested the significance of CMDs as a risk factor for vitamin B12 deficiency. Vitamin B12 deficiency was combined with the presence of CMDs in 32 (21.8 %) cases. In 115 cases (78.2 %), the presence of CMDs was combined with the absence of vitamin B12 deficiency. In 8 cases (13.5 %), there were no CMDs, but there was vitamin B12 deficiency. In 51 cases (86.4 %), no CMDs and vitamin B12 deficiency was noted. Conclusions. Despite the presence of a statistically significant decrease in vitamin B12 levels in CMD group (342.1 133.10 pmol / l vs 401.6 and 138.06 pmol/ l; p 0.01) and a high incidence rate of vitamin B12 deficiency in CMD group (21.8 % and 13.5 %, respectively), the study results do not allow us to consider the presence of CMDs to be the risk factor for vitamin B12 deficiency.

Comparison of Umbilical Cord Serum Vitamin D Levels between Infants with Transient Tachypnea of the Newborn and those without Respiratory Distress

Background: Transient tachypnea of the newborn (TTN) is one of the most frequent causes of respiratory distress in neonates. A relationship has been shown between vitamin D deficiency and respiratory disorders in neonates. This research was carried out to evaluate the serum level of vitamin D in TTN newborns and their mothers compared to the control group. Methods: This case-control research was conducted during 2016-2019 in a general hospital affiliated with Mashhad University of Medical Sciences, Iran. Thirty-four infants with TTN and 82 neonates in the control group as well as their mothers were investigated. The levels of umbilical cord serum vitamin D in infants with TTN and also their mothers were compared to the control group. Results: The mean levels of serum vitamin D in infants with TTN and their mothers were 8.11 ± 4.32 and 12.6 ± 10.12 ng/mL, respectively (P<0.001), whereas they were 19.21 ± 12.71 and 25.96 ± 16.6 ng/mL in the newborns of the control group and their mothers, respectively (P<0.001). The mean differences (95% CI) of neonatal and maternal vitamin D level between the two groups were 11.10 (7.92–14.28) and 13.36 (7.90–18.08), respectively. In the TTN group, 100% of the infants had vitamin D levels less than 30 ng/mL (79.4% had severe, 17.6% had moderate and 2.9% showed mild deficiency). However, vitamin D levels lower than 30 ng/mL were observed in 76.4% of the neonates in the control group (28.8% had severe, 31.1% showed moderate and 16.3% had a mild deficiency) (P<0.001). Conclusion: The serum vitamin D levels of infants with TTN and their mothers were significantly lower than the control group. Therefore, TTN in infants may be reduced through the treatment of vitamin D deficiency in mothers.

NEUROPSYCHOLOGICAL CHARACTERISTIC OF COGNITIVE DISORDERS IN PATIENT WITH CLIPPERS SYNDROME

Chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS) is a novel inflammatory central nervous system disorder. The diagnosis is made on the basis of the radiological, neurological, neuropathological data and responsiveness to steroids treatment. The aim of this paper is to present a neuropsychological characteristic of cognitive, executive and linguistic symptoms characteristic for patient with CLIPPERS disease. In this paper we present the case of a 42-year-old woman with hyperintense punctate foci in the pons, cerebellum, midbrain, thalamus, white matter of occipital lobes, with a short-term verbal memory deficits, mild deficiency in verbal and procedural learning, executive dysfunctions, hand-eye coordination impairment, psychomotor speed disabilities and dysarthria, associated with a chronic lymphocytic inflammation. In this challenging diagnosis of CLIPPERS, neuropsychological analysis of cognitive functions can be important to optimize the diagnosis and treatment.

Understanding vitamin B12 and folate deficiency

Vitamin B12 and folate deficiencies are common and have a big impact on sufferers' lives. Margaret Perry provides an overview of the causes of, and treatments for, these conditions Vitamin B12 and folate are essential for a number of physiological functions in the body. Deficiency of vitamin B12 is relatively common and prevalence increases with age. Folate deficiency is less common, but still clinically significant. Diagnosis can often be problematic as many of the symptoms patients present with are shared with other conditions and can easily be attributed to other causes. Mild deficiency of B12 may cause no symptoms until it has progressed to be more severe. Interpretation of B12 levels is extremely difficult as there is no clinically normal level. Diagnosis can be easily overlooked, but correct treatment has the ability to transform sufferer's lives in terms of improving energy levels and preventing further complications.

Assessment of the efficiency of prevention of iodine deficiency among the children’s population of the city of Mezhdurechensk of the Kemerovo region

In the article there are presented results of a study of indices of ioduria in preschool kids and school children of the city of Mezhdurechensk (south of the Kemerovo region). 411 children aged of 3-17 years participated in the study. The median of ioduria on preschooler kids was 97,0 pg/l, and the proportion of urine samples with iodine levels less than 50 pg/l - 1,0%. The median of ioduria in school children is 98,0 pg/l, the percentage of urine samples with iodine levels less than 50 pg/l accounts for 1,3%. On average, on the population of children there was established that the percentage of urine samples with iodine levels from 50-100 pg/l (mild deficiency) was detected in 53,5% of children. Comparative analysis of indices of the level of ioduria according to data obtained in 2008 and 2014 in a group of school children showed that the measures taken to prevent diseases caused by iodine deficiency (the use of iodized salt in the diet of children and adolescents from organized groups on a regular basis) have given positive results.

Fight Song on Mute: University Pep Band Member Noise Dosages and Noise-Induced Hearing Loss Knowledge

The occurrence of noise-induced hearing loss (NIHL) can be detrimental to the future careers of student musicians. Few studies have focused on the noise exposure of student musicians within an indoor pep band as they performed during university basketball games. The purpose of this longitudinal study was to assess: (a) the status of noise dosages acquired via personal noise dosimeters from two pep band players as they performed over nine men’s basketball games spanning three seasons, (b) perceived effectiveness of earplugs on the primary participants, and (c) the status of all band members’ (n=72) knowledge of hearing loss and hearing loss prevention. The noise dosages accrued by primary participants in each game over the three seasons greatly exceeded the National Institute for Occupational Safety and Health’s (NIOSH) recommendation regarding safe daily noise exposure time. Participants occasionally reported that the earplugs did not provide sufficient protection from noise or contributed to communication and intonation issues. Questionnaire responses from band members demonstrated a mild deficiency in hearing loss knowledge. Two-thirds of pep band members reported that they did not always wear hearing protection at pep band functions. Exceeding standard noise dosage recommendations without hearing protection potentially leaves these individuals at a high risk for permanent hearing loss.