What is new in recommendations on ophthalmological screening in patients treated with chloroquine and hydroxychloroquine? Update and literature review.

Based on the present literature, in March 2016, new recommendations of the American Academy of Ophthalmology for ophthalmic screening tests in patients treated with chloroquine and hydroxychloroquine were published. These recommendations emphasized the fact that toxicity is related to the dose calculated by real weight. The recommended hydroxychloroquine and chloroquine doses have been limited. It is no longer recommended to calculate the cumulative dose of chloroquine to establish the risk of toxicity. Kidney failure and the use of tamoxifen are proven risk factors of ocular complications in these patients. The screening agenda was established and available diagnostic methods were evaluated. Screening in patients treated with chloroquine derivatives may prevent an irreversible complication-toxic retinopathy. The present recommendations warn against making premature decision on medicine withdrawal, especially in the light of the most recent studies on their beneficial systemic influence. This paper systematizes the information on ophthalmological screening in chloroquine derivatives users.

Menopause and age-driven changes in blood level of fat- and water-soluble vitamins.

OBJECTIVE: The purpose of this cross-sectional study was to assess the association of the menopausal transition with changes in vitamins. METHODS: The study group comprised women aged 17-85 years from the Third National Health and Nutrition Examination Survey (NHANES), which was conducted between 1988 and 1994, and from the NHANES surveys conducted between 1999 and 2006. Menopausal status was defined using the time since the last period, < 2, 2-12, and > 12 months, for the pre-, peri-, and postmenopause, respectively. The data-cleaning technique employing serum follicle stimulating hormone activity resulted in pre-, peri- and postmenopausal samples encompassing the following age brackets: 17-50, 42-51, and 46-85 years. Statistical inferences were analyzed using non-parametric techniques. RESULTS: Significant increases in vitamin A and vitamin E concentrations across all phases of the menopausal transition were observed. There was a gradual decrease in the vitamin C concentration across all stages of the menopause but a fairly stable concentration of vitamin B12. There was a statistically significant increase in vitamin D between the pre- and postmenopause. Body mass index correlated negatively with serum vitamin concentration in the pre- and postmenopause. CONCLUSIONS: Vitamin A should be supplemented in postmenopausal women to decrease the risk of bone fracture. The daily diet should be supplemented with vitamin B12, to avoid possible neurological symptoms due to vitamin B12 deficiency, and with vitamin D to decrease the risk of developing secondary hyperparathyroidism. Due to an adverse influence on serum vitamin concentration, body mass index should be monitored in pre- and postmenopausal women.

Selenium supply and glutathione peroxidase activity in breastfed Polish infants.

Selenium (Se) concentration in human milk in Poland is below 10 ng ml-1 and the Se intake by breastfed infants is about 6 micrograms day-1. Supplementation of lactating mothers with selenium-enriched yeast increases rapidly and significantly the Se concentration and glutathione peroxidase activity in maternal blood components. Se concentration in milk is also significantly elevated. After 1 month the mean Se intakes by breastfed infants were greater than the recommended dietary allowance of 10 micrograms day-1 for infants from birth to 6 months of age.