An Evidence-Based Review of Vitamin D for Common and High-Mortality Conditions.

BACKGROUND: Vitamin D is a fat-soluble vitamin available from food and sun exposure. Vitamin D receptors are present in cells throughout the body and cause it to act like a hormone. Observational studies document the association of low vitamin D levels with multiple health conditions. This article reviews the evidence for vitamin D in prevention and treatment in primary care. METHODS: We performed a literature review of randomized controlled trials, meta-analyses, systematic reviews, and large prospective trials looking at the role of vitamin D deficiency in the most common conditions seen in primary care and the top 10 causes of mortality since 2010. RESULTS: Vitamin D supplementation in patients with known cardiovascular disease does not reduce risk of stroke or heart attack. Vitamin D supplementation does not seem to have an effect in the treatment of hypertension or in cancer prevention. There is emerging evidence that supplementation reduces COVID-19 severity and risk of mechanical ventilation. Vitamin D at more moderate levels may reduce the risk of falls, but higher doses may cause increased fall risk. There does not seem to be a link between vitamin D supplementation and improved cognition. Vitamin D supplementation may be helpful in patients with major depression. High dose vitamin D may improve pain in people with fibromyalgia. Supplementing patients with prediabetes reduced the risk of progression to type 2 diabetes mellitus. Vitamin D supplementation in addition to standard emollient treatment helped to reduce symptoms in people with atopic dermatitis. CONCLUSION: Prospective studies of vitamin D supplementation demonstrate variable impact on disease specific and patient-oriented outcomes, suggesting a correlation but not a causal relationship between low vitamin D levels and disease pathogenicity. Future research should determine dosing standards and timing of vitamin D in treatment and prevention.

Therapeutic Efficacy of Yoga for Common Primary Care Conditions.

INTRODUCTION: Yoga is a popular form of exercise that uses body postures, meditation, and breathing techniques and has been shown to have many health benefits. OBJECTIVE/METHODS: Our goal for this review is to orient health professionals to the evidence-based uses of yoga most relevant to primary care. We conducted a PubMed search that included meta-analyses, reviews, systematic reviews, and randomized controlled trials. RESULTS: Results were limited to English language and publication between 2010 and 2020. Yoga was found to help decrease hypertension, relieve back pain, promote overall well-being, and improve mental health. CONCLUSIONS: Yoga is a relatively safe and effective option for patients interested in therapeutic lifestyle change to promote well-being and to help manage hypertension, back pain, and overall mental health.

Individually Tailored Yoga for Chronic Neck or Back Pain in a Low-income Population: A Pilot Study.

BACKGROUND: Low-income people are disproportionately affected by chronic back and neck pain. Yoga may be an effective therapy. AIMS: This feasibility pilot study evaluated an individualized yoga plan for the treatment of chronic spinal pain. RESULTS: Individuals showed a mean change of -2.4 from pre/post 10-cm pain scale recordings (P = 0.028, 95% confidence interval [CI]: -0.390--4.477) and a mean increase of 0.26 on the EQ-5D-3L (P = 0.029, 95% CI: 0.04-0.47). The intervention was well-received. CONCLUSIONS: An individually tailored yoga program was acceptable to these participants. Pain and quality of life scores appeared to improve.

A Qualitative Study of Undergraduate Racial and Ethnic Minority Experiences and Perspectives on Striving to Enter Careers in the Health Professions.

BACKGROUND: Diversification of the health care workforce by race and ethnicity offers a strategy for addressing health care disparities. This study explored the experiences with pathways programming and mentoring of minority undergraduates aspiring to health professions careers. METHODS: We interviewed 21 minority undergraduates in 4 focus groups. The interviews explored participants' backgrounds; perceptions of racial climate; exposure to health professions careers, mentors, and pathways programs; barriers to success; and desired support. RESULTS: Many participants described diminished confidence and feelings of isolation due to stereotyping and discrimination; some were empowered to pursue health care careers because of adversity. Common themes included desire for mentorship, earlier career exposure, and college readiness support. DISCUSSION: Minority students desire health career exposure, mentoring, pre-college advising, and a positive racial climate; unfortunately, these desires often go unmet.

Menopause.

The menopausal transition is a time when many physical and psychological changes are occurring for women. Women may experience irregular menses, vasomotor symptoms, sleep disruption, mood disorders as well as genitourinary symptoms. Despite irregular menstrual cycles, some women can still conceive. It is important to understand what is within normal physiologic changes and what may represent pathologic changes and how to further evaluate this. There are many options available to manage menopausal symptoms when they are impacting quality of life.

Nonpharmacologic treatment of chronic pain: What works?

Which therapies should you recommend for chronic low back pain, osteoarthritis, or fibromyalgia? This review-with 3 handy tables-summarizes the evidence.