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1.
Rev Assoc Med Bras (1992) ; 65(9): 1151-1155, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31618329

RESUMO

This report describes the post-bariatric-surgery evolution of an obese patient who had low adherence to the diet and micronutrient supplementation. Four years after two bariatric surgeries, the patient was admitted due to transient loss of consciousness, slow thinking, anasarca, severe hypoalbuminemia, in addition to vitamin and mineral deficiencies. She had subcutaneous foot abscess but did not present fever. Received antibiotics, vitamins A, D, B12, thiamine, calcium, and parenteral nutrition. After hospitalization (twenty-eight days), there was a significant body weight reduction probably due to the disappearance of clinical anasarca. Parenteral nutrition was suspended after twenty-five days, and the oral diet was kept fractional. After hospitalization (weekly outpatient care), there was a gradual laboratory data improvement, which was now close to the reference values. Such outcome shows the need for specialized care in preventing and treating nutritional complications after bariatric surgeries as well as clinical manifestations of infection in previously undernourished patients.


Assuntos
Cirurgia Bariátrica , Desnutrição Proteico-Calórica/complicações , Infecções Estreptocócicas/complicações , Adulto , Deficiência de Vitaminas/complicações , Deficiência de Vitaminas/terapia , Cirurgia Bariátrica/efeitos adversos , Feminino , Humanos , Nutrição Parenteral , Complicações Pós-Operatórias , Desnutrição Aguda Grave/complicações , Desnutrição Aguda Grave/etiologia , Desnutrição Aguda Grave/terapia , Cooperação e Adesão ao Tratamento
2.
Int. j. cardiovasc. sci. (Impr.) ; 32(5): 508-516, Sept-Oct. 2019. tab, ilus
Artigo em Inglês | LILACS | ID: biblio-1040105

RESUMO

The study is based on the fact that left atrial (LA) volume measurement is a marker of the presence of diastolic dysfunction and that Vitamin D deficiency may be associated with ventricular remodeling, worsening of left ventricular (LV) diastolic and systolic function, and activation of the renin-angiotensin-aldosterone system. Objective: To evaluate whether LAV changes are related to vitamin D deficiency. Method: A cross-sectional, population-based, unicentric study in which 640 patients over 45 years of age enrolled in the Niterói's Médico de Família program, RJ, were evaluated. Patients were submitted to tissue Doppler echocardiography to evaluate the parameters of diastolic and systolic function and vitamin D dosage. The presence or absence of hypovitaminosis D associated with structural and functional cardiac changes was compared between each group. A p < 0.05 value was considered as an indicator of statistical significance. Results: Of the 640 individuals analyzed, hypovitaminosis D was confirmed in 39.2% of the patients, of whom 34.8% had diastolic dysfunction. The most relevant echocardiographic parameters that were statistically significant were non-indexed AEDs and LAV, E'/A' and E wave deceleration time, which were associated with the presence of hypovitaminosis D (P < 0.01). Conclusion: The study of the association of hypovitaminosis D and the appearance of structural and functional cardiac abnormalities may contribute to the discussion of the adoption of one more criterion to select individuals at risk of developing clinical cardiac insufficiency in primary care since, with the use of echocardiography, the subclinical condition of cardiac involvement, with prognostic and treatment implications for the referred patients with hypovitaminosis D, can be identified early


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Atenção Primária à Saúde/métodos , Vitamina D , Função do Átrio Esquerdo , Átrios do Coração , Deficiência de Vitaminas/complicações , Deficiência de Vitamina D/complicações , Pressão Sanguínea , Ecocardiografia/métodos , Estudos Transversais , Análise Estatística , Insuficiência Cardíaca , Frequência Cardíaca
3.
Toxicol Lett ; 315: 96-106, 2019 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-31386889

RESUMO

We investigate the long-term effect of very-low dose exposure to a mixture of six pesticides associated with hydrophilic vitamin deficiency on the neurobehavioral outcomes of rats. Two hundred Wistar rats were divided into four groups, two control groups, a vitamin sufficient control group and a vitamin deficiency control group and 2 test groups, a vitamin sufficient test group, and a vitamin deficiency group. The test groups were exposed for 9 months to a mixture of diquat, imazamox, imazethapyr, tepraloxydin, bentazone and acifluorfen in doses of 0.01xNOAEL (mg/kg bw/day). After 9 months of exposure, the behavior changes were evaluated by open field test and elevated plus maze test and the memory was assessed by passive avoidance test. Chronic vitamin deficiency decreased locomotor and special orientation activity and increased anxiety-like behavior in rats. Exposure to very low doses of a mixture of 6 pesticides caused central nervous effects, manifested as decreased locomotor activity, and increased anxiety levels. Vitamin deficiency and low dose chronic pesticides mixture exposure thus affected the central nervous system, especially long-term memory.


Assuntos
Deficiência de Vitaminas/complicações , Deficiência de Vitaminas/fisiopatologia , Aprendizagem da Esquiva/efeitos dos fármacos , Aprendizagem em Labirinto/efeitos dos fármacos , Doenças do Sistema Nervoso/induzido quimicamente , Doenças do Sistema Nervoso/fisiopatologia , Praguicidas/toxicidade , Animais , Modelos Animais de Doenças , Masculino , Ratos , Ratos Wistar
4.
Ter Arkh ; 91(4): 122-129, 2019 May 16.
Artigo em Inglês | MEDLINE | ID: mdl-31094486

RESUMO

The review discusses thesteps of vitamin B12 metabolism and its role in maintaining of neurological functions. The term "vitamin B12 (cobalamin)" refers to several substances (cobalamins) of a very similar structure. Cobalamin enters the body with animal products. On the peripherу cobalamin circulates only in binding with proteins transcobalamin I and II (complex cobalamin-transcobalamin II is designated as "holotranscobalamin"). Holotranscobalamin is absorbed by different cells, whereas transcobalamin I-binded vitamin B12 - only by liver and kidneys. Two forms of cobalamin were identified as coenzymes of cellular reactions which are methylcobalamin (in cytoplasm) and hydroxyadenosylcobalamin (in mitochondria). The main causes of cobalamin deficiency are related to inadequate intake of animal products, autoimmune gastritis, pancreatic insufficiency, terminal ileum disease, syndrome of intestinal bacterial overgrowth. Relative deficiency may be seen in excessive binding of vitamin B12 to transcobalamin I. Cobalamin deficiency most significantly affects functions of blood, nervous system and inflammatory response. Anemia occurs in 13-15% of cases; macrocytosis is an early sign. The average size of neutrophils and monocytes is the most sensitive marker of megaloblastic hematopoiesis. The demands in vitamin B12 are particularly high in nervous tissue. Hypovitaminosis is accompanied by pathological lesions both in white and gray brain matter. Several types of neurological manifestations are described: subacute combined degeneration of spinal cord (funicular myelinosis), sensomotor polyneuropathy, optic nerve neuropathy, cognitive disorders. The whole range of neuropsychiatric disorders with vitamin B12 deficiency has not been studied well enough. Due to certain diagnostic difficulties they are often regarded as "cryptogenic", "reactive", "vascular¼ origin. Normal or decreased total plasma cobalamin level could not a reliable marker of vitamin deficiency. In difficult cases the content of holotranscobalamin, methylmalonic acid / homocysteine, and folate in the blood serum should be investigated besides carefully analysis of clinical manifestations.


Assuntos
Deficiência de Vitaminas/complicações , Doenças do Sistema Nervoso/etiologia , Complexo Vitamínico B/metabolismo , Animais , Biomarcadores , Transcobalaminas , Deficiência de Vitamina B 12/diagnóstico , Deficiência de Vitamina B 12/etiologia , Deficiência de Vitamina B 12/terapia
5.
J Altern Complement Med ; 25(6): 567-577, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30912673

RESUMO

Objective: The pathophysiology of atopic dermatitis (AD) involves a complex interplay between immune system dysfunction, genetics, and environmental factors. It is well known that nutritional status is essential to a proper functioning immune system, leading to a highly debated question regarding the role of dietary factors in the pathogenesis of AD. Food allergies and elimination diets have been broadly studied in atopy; however, less consideration has been given to how vitamins, minerals, and other micronutrients influence the risk for AD and severity of symptoms. This systematic review discusses evidence on how various micronutrients, including vitamins (C, E, and D) and trace minerals (zinc, selenium, iron, copper, magnesium, and strontium) are associated with AD, and how supplementation influence disease severity. Design: A systematic search was conducted to identify the role that oral micronutrients have on AD. The authors reviewed 49 studies herein. Results: While there are weak associations between vitamins C or E and AD, there is sufficient evidence to suggest that vitamin D supplementation provides benefit in AD patients. Deficiency of selenium and zinc may exacerbate AD. Current reports are not sufficient to confidently discern the role of other vitamins and trace minerals on AD. Conclusions: Though oral micronutrients may play a role in AD, the current literature is limited, and there is a need for more comprehensive randomized controlled trials (RCTs) to truly decipher the role between oral micronutrients and AD.


Assuntos
Dermatite Atópica/tratamento farmacológico , Suplementos Nutricionais , Minerais/uso terapêutico , Estado Nutricional , Oligoelementos/uso terapêutico , Vitaminas/uso terapêutico , Deficiência de Vitaminas/complicações , Dermatite Atópica/complicações , Humanos , Selênio/uso terapêutico , Índice de Gravidade de Doença , Oligoelementos/deficiência , Vitamina D/uso terapêutico , Zinco/uso terapêutico
6.
Nutrients ; 11(2)2019 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-30764587

RESUMO

As microbiological diagnostic techniques improve and the frequency of nontuberculous mycobacterial pulmonary disease (NTM-PD) infection increases worldwide, NTM-PD is becoming increasingly important to clinicians and researchers. Vitamin activity has been associated with the host immune response in tuberculosis; however, such information is very limited in NTM-PD. We performed a case-control study in 150 patients with NTM-PD and 150 healthy controls to investigate serum vitamin status. We measured concentrations of vitamins A, D, and E along with homocysteine and methylmalonic acid (MMA) as indicators of vitamin B12 deficiency, using high-performance liquid chromatography (HPLC) or HPLC-tandem mass spectrometry. The serum concentrations of vitamins A and E were significantly lower in patients with NTM-PD than in healthy controls (1.5 vs. 2.1 µmol/L, p < 0.01 for vitamin A; and 27.3 vs. 33.1 µmol/L, p < 0.01 for vitamin E). In contrast, the serum concentrations of vitamin D and homocysteine were not significantly different between the two groups. Vitamin A deficiency (< 1.05 µmol/L) was significantly more prevalent in patients with NTM-PD than in healthy controls (p < 0.01) and was associated with an 11-fold increase in risk of NTM-PD. Multiple vitamin deficiencies were only observed in patients with NTM-PD (7.3% of all NTM-PD patients). Positive correlations were observed among vitamins (vitamins A and D; r = 0.200, p < 0.05; vitamins D and E, r = 0.238, p < 0.05; vitamins A and E, r = 0.352, p < 0.05). Serum vitamin status, demographic variables, and biochemical indicators were not associated with treatment outcomes. Vitamin A deficiency was strongly associated with patients with NTM-PD. Our study suggests that altered vitamin status is associated with mycobacterial disease. Future well-designed prospective studies with large patient cohorts addressing these issues are needed to clarify the significance of vitamins in NTM-PD.


Assuntos
Deficiência de Vitaminas/complicações , Pneumopatias/microbiologia , Infecções por Micobactéria não Tuberculosa/complicações , Idoso , Estudos de Casos e Controles , Feminino , Humanos , Pneumopatias/complicações , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Vitaminas/sangue
7.
Osteoporos Int ; 30(3): 593-599, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30483849

RESUMO

The associations of multiple vitamin deficiencies on incident fractures were uncertain, the relationships between serum vitamin markers and incident bone fractures were investigated in Japanese postmenopausal women. The number of deficiencies was additively associated with incident fracture after adjustment for possible confounding factors including the treatment of osteoporosis. INTRODUCTION: To evaluate the associations of multiple vitamin deficiencies on incident fractures, the relationships between serum vitamin markers and incident bone fractures were investigated in Japanese postmenopausal women. METHODS: This analysis used a subset of the ongoing cohort maintained by a primary care institution. Inclusion criteria of the present study were postmenopausal women aged ≥ 50 years, without vitamin supplementation and secondary osteoporosis. Baseline serum concentrations of 25-hydroxyvitamin D (25(OH)D), undercarboxylated osteocalcin (ucOC), and homocysteine (Hcy) were measured to assess vitamin D, vitamin K, and vitamin B, respectively. Since 25(OH) D positively relates to vitamin D, ucOC and Hcy negatively relate to vitamin K and vitamin B nutrients, respectively, the subjects with lower (25(OH)D) or higher (ucOC or Hcy) values than each median value was defined as subjects with the corresponding vitamin deficiency. Subjects were divided into four groups according to the number of deficiency: no deficiency, single deficiency, double deficiencies, and triple deficiencies. Relationships between the vitamin deficiencies and incident fractures were evaluated by Cox regression analysis. RESULTS: A total of 889 subjects were included in this analysis; their mean and SD age was 68.3 ± 9.5 years, and the follow-up period was 6.3 ± 5.1 years. The numbers of subjects in the four groups were 139 (15.6%), 304 (34.2%), 316 (35.5%), and 130 (14.6%) for the groups with no, single, double, and triple deficiencies, respectively. Incident fractures were observed in 264 subjects (29.7%) during the observation period. The number of deficiencies was significantly associated with incident fracture (hazard ratio 1.25, 95% confidence interval 1.04-1.50, P = 0.018) after adjustment for possible confounding factors including the treatment of osteoporosis. CONCLUSION: Accumulation of vitamin deficiencies was related to incident fractures.


Assuntos
Deficiência de Vitaminas/complicações , Osteoporose Pós-Menopausa/etiologia , Fraturas por Osteoporose/etiologia , Absorciometria de Fóton/métodos , Idoso , Deficiência de Vitaminas/sangue , Deficiência de Vitaminas/epidemiologia , Densidade Óssea/fisiologia , Feminino , Homocisteína/sangue , Humanos , Incidência , Japão/epidemiologia , Pessoa de Meia-Idade , Osteocalcina/sangue , Osteoporose Pós-Menopausa/sangue , Osteoporose Pós-Menopausa/epidemiologia , Fraturas por Osteoporose/sangue , Fraturas por Osteoporose/epidemiologia , Fatores de Risco , Deficiência de Vitaminas do Complexo B/sangue , Deficiência de Vitaminas do Complexo B/complicações , Deficiência de Vitaminas do Complexo B/epidemiologia , Vitamina D/análogos & derivados , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/complicações , Deficiência de Vitamina D/epidemiologia , Deficiência de Vitamina K/sangue , Deficiência de Vitamina K/complicações , Deficiência de Vitamina K/epidemiologia
8.
Med Sante Trop ; 28(4): 439-442, 2018 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-30499448

RESUMO

INTRODUCTION: Among the 1.4 million blind children in the world, 300,000 live in Africa. The causes of blindness vary from one country to another. The purpose of our study was to report the causes of childhood blindness and visual impairment in children attending the only school for the blind in Mali (National Institute for the Blind in Mali, INAM). MATERIALS AND METHODS: All children attending the INAM were examined. Blindness was defined as visual acuity less than 3/60 (20/400 or 0.05). Visual impairment was moderate when the visual acuity was less than 6/18 (20/70 or 0.30), but greater than or equal to 6/60 (20/200 or 0.1), and severe when visual acuity was less than 6/60 (20/200 or 0.1), but greater than or equal to 3/60 (20/400 or 0.05). RESULTS: The study included a total of 104 children. The average age of our patients was 12 years with a M/F sex-ratio of 1.12. In all, 85.6 % of the children were blind and 14.4 % visually impaired. The main causes of blindness were corneal opacities (26 %), and whole globe lesions and conditions (19.2 %). Ametropia accounted for 60 % of visual impairment. DISCUSSION: According to WHO, corneal and retinal damage are the leading cause of blindness (50.6 %) in children. In our series, corneal diseases were the leading cause, following by damage to the whole globe. CONCLUSION: The results of our study indicate that avoidable and treatable causes of childhood blindness are the leading causes of blindness of children at INAM.


Assuntos
Cegueira/etiologia , Adolescente , Deficiência de Vitaminas/complicações , Catarata/congênito , Criança , Pré-Escolar , Doenças da Córnea/complicações , Feminino , Humanos , Lactente , Masculino , Mali , Sarampo/complicações , Estudos Prospectivos , Erros de Refração/complicações
9.
Dtsch Med Wochenschr ; 143(20): 1450-1454, 2018 10.
Artigo em Alemão | MEDLINE | ID: mdl-30286493

RESUMO

Hospital mortality of severe sepsis and septic shock is still around 40 % according to recent studies. In accordance to the current sepsis definition, sepsis is a life-threatening organ dysfunction caused by a dysregulated response of the organism to infection. Septic shock is defined by vasopressor-dependent circulatory failure and lactic acidosis. Patients with sepsis and septic shock are often old and/or characterized by severe comorbidities, e. g. tumor or liver disease. These factors also predispose to malnutrition and hence to a corresponding deficiency of essential nutritional components e. g. vitamins. A number of recent studies and reviews have addressed the question whether deficiencies in certain vitamins may facilitate the transition from infection to septic shock. In addition, studies have investigated the effect of high-dose vitamin therapies on sepsis mortality and sepsis-associated organ dysfunctions. This article would like to summarize this current discussion with a focus on vitamin B1 (thiamine), vitamin C and vitamin D.


Assuntos
Deficiência de Vitaminas , Sepse , Ácido Ascórbico/administração & dosagem , Ácido Ascórbico/uso terapêutico , Deficiência de Vitaminas/complicações , Deficiência de Vitaminas/fisiopatologia , Humanos , Sepse/complicações , Sepse/tratamento farmacológico , Sepse/mortalidade , Sepse/fisiopatologia , Vitamina D/administração & dosagem , Vitamina D/uso terapêutico , Vitamina K/administração & dosagem , Vitamina K/uso terapêutico
10.
Nutr Hosp ; 35(Spec No6): 60-63, 2018 Sep 07.
Artigo em Espanhol | MEDLINE | ID: mdl-30351164

RESUMO

Metabolic syndrome is the name given to a set of risk factors that increases the risk of cardiovascular disease and other health problems, such as diabetes and stroke. There are different cut-off points to establish the definition of metabolic syndrome according to various international organizations, although in all definitions are considered four main data related to: 1) obesity; 2) alteration of glucose metabolism; 3) alteration of lipid metabolism; and 4) hypertension. Strategies for the treatment of the metabolic syndrome include changes in lifestyle (diet and physical activity), along with pharmacological treatment in certain cases. There is little evidence of the effect of different micronutrients in this syndrome, although there are many investigations in this line.


Assuntos
Deficiência de Vitaminas/complicações , Síndrome Metabólica/complicações , Micronutrientes/administração & dosagem , Minerais/uso terapêutico , Vitaminas/uso terapêutico , Deficiência de Vitaminas/tratamento farmacológico , Humanos , Estilo de Vida , Síndrome Metabólica/tratamento farmacológico , Síndrome Metabólica/terapia , Micronutrientes/uso terapêutico , Fatores de Risco
11.
Nutr. hosp ; 35(n.extr.6): 60-63, sept. 2018. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-181737

RESUMO

El síndrome metabólico es el nombre que se da a un conjunto de factores de riesgo que aumenta el riesgo de enfermedad cardiovascular y otros problemas de salud, como diabetes y accidente cerebrovascular. Existen diferentes puntos de corte para establecer la definición de síndrome metabólico según diversos organismos internacionales, si bien en todas las definiciones se consideran cuatro pilares básicos: 1) obesidad; 2) alteración del metabolismo de la glucosa; 3) alteración del metabolismo de los lípidos; e 4) hipertensión arterial. Las estrategias para el tratamiento del síndrome metabólico incluyen cambios en el estilo de vida (dieta y actividad física) junto con tratamiento farmacológico en determinados casos. Se tiene poca evidencia sobre el efecto de diferentes micronutrientes en dicho síndrome, aunque existen múltiples investigaciones en esta línea


Metabolic syndrome is the name given to a set of risk factors that increases the risk of cardiovascular disease and other health problems, such as diabetes and stroke. There are different cut-off points to establish the definition of metabolic syndrome according to various international organizations, although in all definitions are considered four main data related to: 1) obesity; 2) alteration of glucose metabolism; 3) alteration of lipid metabolism; and 4) hypertension. Strategies for the treatment of the metabolic syndrome include changes in lifestyle (diet and physical activity), along with pharmacological treatment in certain cases. There is little evidence of the effect of different micronutrients in this syndrome, although there are many investigations in this line


Assuntos
Humanos , Deficiência de Vitaminas/complicações , Micronutrientes/administração & dosagem , Minerais/uso terapêutico , Vitaminas/uso terapêutico , Deficiência de Vitaminas/tratamento farmacológico , Estilo de Vida , Síndrome Metabólica/terapia , Micronutrientes/uso terapêutico , Fatores de Risco
13.
Obes Surg ; 28(9): 2727-2736, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29754386

RESUMO

BACKGROUND: Nutritional deficiencies have been reported in bariatric surgery patients with inconsistent results. However, scarce data exist for Chinese patients. We aimed to assess nutritional deficiencies in Chinese patients undergoing Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG), and to identify predictors of postoperative nutritional status. METHODS: A retrospective review of a prospectively collected database was conducted in the patients undergoing RYGB and SG in our hospital between June 2013 and January 2017. Anthropometric data and nutritional data were collected before surgery, at 6 and 12 months postoperatively. RESULTS: This study enrolled 269 patients (120 RYGB, 149 SG). Nutritional deficiencies were common in Chinese bariatric candidates, with vitamin D deficiency the most serious (78.8%), followed by vitamin B1 (39.2%), vitamin B6 (28.0%), folate (26.8%), vitamin C (18.0%) albumin (13.4%), transferrin (11.6%), and phosphorus (11.5%). Despite postoperative routine multivitamin and calcium supplements, nutritional deficiencies were still obvious for RYGB and SG patients. The prevalence of hemoglobin and vitamin B12 deficiencies increased remarkably in the RYGB group; the levels of hemoglobin, globin, vitamin B12, and ferritin decreased significantly (P < 0.05). Preoperative hemoglobin, vitamin B12, and ferritin levels were independently associated with postoperative decrease, respectively. Deficiencies of vitamin D, vitamin B1, vitamin B6, vitamin C, and albumin before surgery were predictors for deficiencies 1 year after surgery, respectively. CONCLUSION: Nutritional deficiencies are common in Chinese bariatric surgery candidates. Similar deficiencies were also seen after RYGB and SG. Routine evaluation and related corrections of preoperative nutritional abnormity could contribute to postoperative nutrient balance.


Assuntos
Deficiência de Vitaminas , Gastrectomia/estatística & dados numéricos , Derivação Gástrica/estatística & dados numéricos , Obesidade , Deficiência de Vitaminas/complicações , Deficiência de Vitaminas/epidemiologia , China/epidemiologia , Humanos , Obesidade/complicações , Obesidade/epidemiologia , Obesidade/cirurgia , Prevalência , Estudos Retrospectivos
14.
Nefrología (Madrid) ; 38(1): 41-47, ene.-feb. 2018. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-170080

RESUMO

Introducción: El déficit de 25-OH-vitamina D (25-OH-D) es común en los pacientes en hemodiálisis (HD). Por otra parte, es bien conocida la elevada incidencia de hiperparatiroidismo secundario en este grupo de pacientes, y lo importante que es su adecuado control. La 25-OH-D está implicada en la regulación de la homeostasis del calcio, por lo que tener niveles adecuados puede contribuir en el control del metabolismo óseo-mineral. Objetivos: Evaluar el efecto de la repleción de 25-OH-D en pacientes en HD con déficit vitamínico (niveles<20ng/ml), en el control del hiperparatiroidismo secundario y en el estado de microinflamación. Pacientes y métodos: Estudio observacional, prospectivo en el que se trataron pacientes estables en HD con déficit de 25-OH-D (<20ng/ml), con calcifediol 0,266mcg/15 días vía oral durante 3 meses. Los datos de HD, parámetros bioquímicos y las dosis de fármacos administrados fueron analizados antes y después de la corrección del déficit. Resultados: Un total de 45 pacientes estables en HD con edad media 74,08±12,49 años completaron el tratamiento. Del total, 27 pacientes (60%) alcanzaron niveles de 25-OH-D>20ng/ml (en 23 fueron>30ng/ml, y 4 entre 20-30ng/ml). Las cifras de hormona paratiroidea descendieron en 32 de los 45 pacientes, alcanzando en 23 (51% de tratados) un descenso>30% respecto al valor basal. En cuanto al tratamiento concomitante, se objetivó un descenso significativo de la dosis de activador selectivo del receptor de vitamina D; sin evidenciarse cambios en la dosis de calcimimético ni de quelantes. Respecto al estado de malnutrición-inflamación, destaca un descenso de la proteína C reactiva, aunque no se modificaron otros parámetros de microinflamación como los monocitos activados (CD14+/CD16+ y CD 14++/CD16+). Tampoco se observaron cambios en los niveles de FGF-23. Conclusiones: La corrección del déficit de 25-OH-D en pacientes en HD se asocia a un mejor control del hiperparatiroidismo secundario con menores dosis de análogos de vitamina D y a una mejoría en el estado inflamatorio de estos pacientes. Nuestros resultados apoyan la recomendación de determinar niveles de 25-OH-D y corregir el déficit en pacientes en HD (AU)


Introduction: Patients on haemodialysis (HD) have a high prevalence of 25-OH-vitamin D (25-OH-D)deficiency. Secondary hyperparathyroidismis a common condition in these patients, which is very important to control. 25-OH-D is involved in regulating calcium homeostasis. As such, appropriate levels of this vitamin could help to control bone mineral metabolism. Objective: To evaluate the effect 25-OH-D repletion in HD patients with 25-OH-D deficiency (<20ng/ml) on the control of secondary hyperparathyroidism and microinflammation status. Patients and methods: Prospective observational study in which stable patients on HD with 25-OH-D deficiency (<20ng/ml) were treated with oral calcifediol 0.266mcg/every 2 weeks for three months. Dialysis characteristics, biochemical parameters and drug doses administered were analysed before and after the correction of the deficiency. Results: Forty-five stable HD patients with a mean age of 74.08±12.49 years completed treatment. Twenty-seven patients (60%) achieved 25-OH-D levels above 20ng/ml (23 with levels>30ng/ml and 4 between 20-30ng/ml). Parathyroid hormone levels decreased in 32 of the 45 patients, 23 of which (51%) achieved a>30% decrease from baseline. In terms of concomitant treatment, we observed a significant reduction in the selective vitamin D receptor activator dose, but no changes in calcimimetic or phosphate binders administration. In terms of malnutrition-inflammation status, a decrease in C-reactive protein was noted, although other microinflammation parameters, such as activated monocytes (CD14+/CD16+ and CD 14++/CD16+) were unchanged. No changes were observed in the levels of FGF-23. Conclusions: Correcting 25-OH-D deficiency in HD patients is associated with better secondary hyperparathyroidism control with lower doses of vitamin D analogues, as well as an improvement in inflammatory status. Our results support the recommendation to determine 25-OH-D levels and correct its deficiency in these patients (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Diálise Renal/instrumentação , Diálise Renal/métodos , Hiperparatireoidismo/complicações , Hiperparatireoidismo/tratamento farmacológico , Deficiência de Vitamina D/complicações , Ergocalciferóis/uso terapêutico , Vitamina D/uso terapêutico , Reação em Cadeia da Polimerase , Ferro/uso terapêutico , Darbepoetina alfa/uso terapêutico , Estudos Prospectivos , Deficiência de Vitaminas/complicações , Deficiência de Vitaminas/terapia
15.
Clin Dermatol ; 36(1): 54-61, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29241753

RESUMO

Hair loss is a common condition that affects most people at some point in their lives. It can exist as an isolated problem or with other diseases and conditions. Androgenetic alopecia (AGA) and its association with the metabolic syndrome (MetS) have received increasing interest since 1972, when the first link between cardiovascular risk factors and hair loss was raised. We have reviewed studies concerning the relationship between alopecia and MetS. Many studies have investigated the relationship among AGA and MetS and its individual components, particularly in men, where a disproportionately large number of these studies supports this association. AGA has also been associated with other metabolic-related conditions, including coronary artery disease, polycystic ovary syndrome, and Cushing syndrome, as well as several nutritional deficiencies, all of which have led to many clinicians advocating for the screening of MetS and cardiovascular risk factors in patients who present with AGA.


Assuntos
Alopecia/complicações , Síndrome Metabólica/complicações , Deficiência de Vitaminas/complicações , Cirurgia Bariátrica , Doenças Cardiovasculares/etiologia , Síndrome de Cushing/complicações , Feminino , Humanos , Masculino , Síndrome do Ovário Policístico/complicações , Fatores de Risco
16.
Cad Saude Publica ; 33(12): e00136616, 2017 12 18.
Artigo em Português | MEDLINE | ID: mdl-29267687

RESUMO

The study's objective was to investigate the association between inadequate dietary consumption of micronutrients and indicators of general and abdominal obesity. Cross-sectional analysis of the second wave of the EpiFloripa Adults longitudinal study, including 1,222 individuals, aged 22-63 years and residing in Florianópolis, Santa Catarina State, Southern Brazil. Food consumption data was obtained from two 24-hour food recalls, and habitual consumption and prevalence rates of inadequate consumption of calcium, iron, zinc, and vitamins A, C, D, and E were estimated according to the Institute of Medicine and National Research Council guidelines. General obesity was defined based on the body mass index (BMI) values and abdominal obesity was based on waist circumference (WC) values. For most of the micronutrients investigated (calcium and vitamins A, C, D, and E), consumption levels were below the recommendations, with high prevalence of inadequate consumption in the sample as a whole. Only inadequate vitamin C intake was higher among obese individuals (general or abdominal). In addition, there was an inverse association between lower consumption of calcium and iron and higher BMI and WC, and between lower consumption of vitamins A and D and higher WC levels (ß = -0.92cm; 95%CI: -1.76; -0.08 and ß = -0.69 cm; 95%CI: -1.32; -0.06, respectively), especially in young adults. The study showed an inverse association between inadequate dietary consumption of micronutrients and general and abdominal obesity in a sample of adults in Southern Brazil.


Assuntos
Índice de Massa Corporal , Inquéritos sobre Dietas/estatística & dados numéricos , Obesidade/epidemiologia , Obesidade/etiologia , Oligoelementos/metabolismo , Vitaminas/metabolismo , Circunferência da Cintura/fisiologia , Adulto , Fatores Etários , Deficiência de Vitaminas/complicações , Brasil/epidemiologia , Estudos Transversais , Dieta/efeitos adversos , Ingestão de Energia , Feminino , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Obesidade/metabolismo , Prevalência , Valores de Referência , Fatores Sexuais , Fatores Socioeconômicos , Oligoelementos/deficiência , Adulto Jovem
17.
Gastroenterol Clin North Am ; 46(4): 797-808, 2017 12.
Artigo em Inglês | MEDLINE | ID: mdl-29173522

RESUMO

Indiscriminate use of multivitamin/mineral supplements in the general population may be misguided, but patients with chronic Inflammatory Bowel Diseases (IBD) should be monitored and compensated for nutritional deficiencies. Mechanistic links between vitamin/mineral deficiencies and IBD pathology has been found for some micronutrients and normalizing their levels is clinically beneficial. Others, like vitamin A, although instinctively desirable, produced disappointing results. Restoring normal levels of the selected micronutrients requires elevated doses to compensate for defects in absorptive or signaling mechanisms. This article describes some aspects of vitamin and mineral deficiencies in IBD, and summarizes pros and cons of supplementation.


Assuntos
Deficiência de Vitaminas/complicações , Deficiência de Vitaminas/tratamento farmacológico , Doenças Inflamatórias Intestinais/complicações , Ferro/uso terapêutico , Vitaminas/uso terapêutico , Anemia Ferropriva/complicações , Animais , Biotina/uso terapêutico , Cálcio/uso terapêutico , Colecalciferol/uso terapêutico , Suplementos Nutricionais , Ácido Fólico/uso terapêutico , Humanos , Doenças Inflamatórias Intestinais/tratamento farmacológico , Tiamina/uso terapêutico , Vitamina A/uso terapêutico , Vitamina B 12/uso terapêutico , Vitamina B 6/uso terapêutico , Vitamina K/uso terapêutico , Zinco/deficiência , Zinco/uso terapêutico
19.
J Clin Gastroenterol ; 51(10): 878-889, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28858940

RESUMO

BACKGROUND: Vitamin deficiency is frequently associated with inflammatory bowel disease (IBD). Supplementation of vitamins could thus serve as an adjunctive therapy. The present meta-analysis reviews the deficiencies and alterations in serum fat-soluble vitamins (A, D, E, and K) reported in IBD patients. MATERIALS AND METHODS: PubMed database search was performed to identify all primary studies up to January 2015 that evaluated the serum concentrations of fat-soluble vitamin levels in IBD patients compared with healthy individuals. We estimated pooled mean differences between groups and estimated their relations with some compounding variables (age, disease duration, C-reactive protein, albumin), using a meta-regression analysis. RESULTS: Nineteen case-control studies met selection criteria. In patients with Crohn's disease (CD), vitamin A, D, E, K status was lower than in controls [D=212 µg/L.92; 95% confidence interval (CI), 95.36-330.48 µg/L, P=0.0002; D=6.97 nmol/L, 95% CI, 1.61-12.32 nmol/L, P=0.01; D=4.72 µmol/L, 95% CI, 1.60-7.84 µmol/L, P=0.003; D=1.46 ng/mL, 95% CI, 0.48-2.43 ng/mL, P=0.003, respectively]. Patients with ulcerative colitis had lower levels of vitamin A than controls (D=223.22 µg/L, 95% CI, 44.32-402.12 µg/L, P=0.01). Patients suffering from CD for a longer time had lower levels of vitamins A (95% CI=7.1-67.58 y, P=0.02) and K (95% CI, 0.09-0.71 y, P=0.02). Meta-regression analysis demonstrated statistically significant associations between the levels of inflammatory biomarkers: C-reactive protein (P=0.03, 95% CI, -9.74 to -0.6 mgl/L) and albumin (P=0.0003, 95% CI, 402.76-1361.98 g/dL), and vitamin A status in CD patients. CONCLUSION: Our meta-analysis shows that the levels of fat-soluble vitamins are generally lower in patients with inflammatory bowel diseases and their supplementation is undoubtedly indicated.


Assuntos
Deficiência de Vitaminas/complicações , Colite Ulcerativa/etiologia , Doença de Crohn/etiologia , Deficiência de Vitaminas/terapia , Colite Ulcerativa/sangue , Colite Ulcerativa/terapia , Doença de Crohn/sangue , Doença de Crohn/terapia , Humanos , Vitamina A/administração & dosagem , Vitamina A/sangue , Vitamina D/administração & dosagem , Vitamina D/sangue , Vitamina E/administração & dosagem , Vitamina E/sangue , Vitamina K/administração & dosagem , Vitamina K/sangue
20.
Clin Dermatol ; 35(5): 441-452, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28916025

RESUMO

Nutritional deficiencies occur when body metabolic requirements are not matched by intake and absorption. Reasons for this discrepancy are numerous, but often social, economic, medical, and even psychiatric factors may play a role. Vitamins and minerals are required for appropriate rapid cell turnover of the oral mucosa. The oral cavity is a unique anatomic environment that may manifest early signs of nutritional disorders as well as other indicators of systemic disease. Knowledge of these oral manifestations and associated findings will allow a practitioner to consider a nutritional disorder when evaluating oral changes and, in turn, initiate appropriate therapy. A systematic approach to examination of the mouth and perioral skin is suggested. A detailed medical and social history complements the physical examination in identifying patients at risk for nutritional disorders and heightening the clinical suspicion to warrant additional nutritional screening. The rising prevalence of anorexia and bulimia, as well as fad diets, add to the population of patients at risk for vitamin and mineral deficiencies that a clinician must now consider.


Assuntos
Doenças da Boca/etiologia , Transtornos Nutricionais/complicações , Deficiência de Vitaminas/complicações , Humanos , Minerais/administração & dosagem , Mucosa Bucal/fisiologia , Transtornos Nutricionais/diagnóstico , Vitaminas/administração & dosagem
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