ABSTRACT
UNLABELLED: On September 29, 2011, acknowledged experts in the field of vitamin D, mainly European, were brought together in order to discuss the recent scientific advances in relation to vitamin D: the current requirements and associations with various health outcomes. In this article, the discussions resulting from the meeting are summarized. INTRODUCTION: Several groups at risk for developing vitamin D insufficiency have been identified. Accordingly, reviews indicate that a significant percentage of the population worldwide have serum 25-hydroxyvitamin D levels below 50 nmol/l. In addition to the role of vitamin D in bone health, recent studies suggest that it may play a pivotal role in other systems, e.g., the cardiovascular system, pancreas, muscle, immune system and brain. Most evidence, however, is obtained from observational studies and yet inconclusive. METHODS: To exchange and broaden knowledge on the requirements for vitamin D and its effect on various health outcomes, a workshop entitled "Vitamin D Expert Meeting: Do we get enough?", was organized. RESULTS: Despite low vitamin D levels worldwide, consensus on the definition of deficiency is not yet reached. In order to define cut-off points for vitamin D whilst taking into account extraskeletal health effects, randomized controlled trials in these fields are warranted. The experts do emphasize that there is evidence to suggest an important role for vitamin D in the maintenance of optimal bone health at all ages and that vitamin D supplementation, in most studies co-administered with calcium, reduces fracture risk in the senior population. CONCLUSION: To reach a serum 25-hydroxyvitamin D level of 50 nmol/l older adults aged ≥65 years are therefore recommended to meet a mean daily vitamin D intake of 20 µg (800 IU), which is best achieved with a supplement.
Subject(s)
Diet/standards , Dietary Supplements , Vitamin D Deficiency/diagnosis , Vitamin D/administration & dosage , Europe , Evidence-Based Medicine/methods , Global Health , Humans , Reference Values , Sunlight , Vitamin D/analogs & derivatives , Vitamin D/blood , Vitamin D Deficiency/bloodSubject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Neuroendocrine Tumors/therapy , Adult , Aged , Female , Fluorouracil/administration & dosage , Humans , Interferon alpha-2 , Interferon-alpha/administration & dosage , Leucovorin/administration & dosage , Male , Middle Aged , Neoplasm Metastasis , Recombinant Proteins , Treatment OutcomeABSTRACT
This article describes the technique for inserting cuffed polyurethane catheters under local anaesthesia. A very low complication rate is seen with these catheters and patients tolerate the catheters and Cadd infusional pumps for continuous chemotherapy very well.
Subject(s)
Ambulatory Care , Catheters, Indwelling , Drug Therapy/instrumentation , Infusion Pumps, Implantable , Polyurethanes , Ambulatory Care/methods , Anesthesia, Local , Drug Therapy/methods , Humans , ThoraxABSTRACT
During regular bacteriological surveillance of cardiac surgical equipment and patients, the Cell Saver apparatus (CSA) was prospectively evaluated to determine if it represented an additional risk for infection. Nineteen patients were studied. After each operation, the effluent from the CSA was sterilely sealed for subsequent culture. A total of 42 aerobic and 42 anaerobic cultures were made. Postoperatively all patients were evaluated daily for four days and before discharge for clinical evidence of infection. Four patients had positive CSA cultures without evidence of postoperative clinical infection. Five patients in whom postoperative infectious complications developed had negative CSA cultures. Ten patients had negative CSA cultures and no evidence of postoperative infection. We conclude that the CSA does not appear to contribute to the risk of infection in cardiac surgical patients and that it is a safe adjunct to cardiac surgery.