6,465 research outputs found
The role of vitamin D supplementation in patients with rheumatic diseases
No full textVitamin D is a dietary vitamin that can also be synthesized in adequate amounts from cholesterol in most mammals exposed to sunlight. Vitamin D has classical roles in calcium and phosphate metabolism, and thus the skeleton; however, this molecule also has nonclassical effects that might influence the function of the immune, cardiovascular and endocrine systems. Vitamin D deficiency, due to insufficient sunlight exposure, dietary uptake and/or abnormalities in its metabolism, has been associated with rheumatic diseases, and both the classical and nonclassical effects of vitamin D might be of relevance to patients with rheumatic disease. However, conclusive data from intervention trials demonstrating the relationship between vitamin D levels and pathogenetic processes separate from classical effects of this molecule are lacking. Furthermore, the majority of studies linking vitamin D to health outcomes, harmful or beneficial, are observational in nature, linking clinical events to vitamin D exposure or serum levels of vitamin D metabolites. Evidence from high quality, prospective, double-blind, placebo-controlled, randomized trials should be obtained before vitamin D supplementation is recommended in the treatment of the many rheumatic conditions in which deficiency of this compound has been implicated. Herein, we review the evidence for vitamin D supplementation in the management of patients with rheumatic diseases
Vitamin D supplementation for musculoskeletal health outcomes in adults – The end of the beginning?
No full textGenom tron talar han alltjämt. Aspekter på Bo Giertz författarskap
No full textA previously printed summary of Bishop Bo Giertz as an author
Neonatal vitamin D status from archived dried spots and future risk of fractures in childhood - results from the D-tect study, a population-based case-cohort study
Full text linkBackground: Whether antenatal and neonatal vitamin D status have clinical relevance in fracture prevention has not been examined extensively, although observational studies indicate that fetal life may be a sensitive period in relation to bone growth and mineralization during childhood. Objective: We examined whether 25-hydroxyvitamin D3 [25(OH)D3] concentrations in stored neonatal dried blood spot (DBS) samples are associated with pediatric fracture risk. We hypothesized that in particular, low neonatal vitamin D status may be a risk factor for fracture incidence among children. Design: In a register-based case-cohort study design, the case group was composed of 1039 individuals who were randomly selected from a total of 82,154 individuals who were born during 1989–1999 and admitted to a Danish hospital with a fracture of the forearm, wrist, scaphoid bone, clavicle, or ankle at age 6–13 y. The subcohort was composed of 1600 individuals randomly selected from all Danish children born during 1989–1999. The neonatal 25(OH)D3 concentrations in DBS samples were assessed by using highly sensitive chromatography-tandem mass spectrometry. Results: The mean ± SD 25(OH)D3 concentration for all subjects was 27.7 ± 18.9 nmol/L [median (IQR): 23.5 nmol/L (13.3, 37.3 nmol/L)] and showed significant monthly variation (P < 0.0001) with the highest values in July and August. Individuals in the middle quintile of neonatal 25(OH)D3 had lower odds of sustaining a fracture than did those in the lowest quintile (adjusted OR: 0.75; 95% CI: 0.58, 0.96), but a global test did not show any significant overall association (adjusted P = 0.13). Conclusions: This study suggested that neonatal vitamin D status does not influence subsequent fracture risk in childhood. This is in accordance with studies that report no association between antenatal maternal vitamin D status and childhood fractures. Further studies are needed to examine fracture risk in relation to prenatal vitamin D status in a randomized controlled setting
Prenatal exposure to vitamin D from fortified margarine and risk of fractures in late childhood: period and cohort results from 222,000 subjects in the D-tect observational study
Get PDFPrenatal low vitamin D may have consequences for bone health. By means of a nationwide mandatory vitamin D fortification programme, we examined the risk of fractures among 10–18-year-old children from proximate birth cohorts born around the date of the termination of the programme. For all subjects born in Denmark during 1983–1988, civil registration numbers were linked to the Danish National Patient Registry for incident and recurrent fractures occurring at ages 10–18 years. Multiplicative Poisson models were used to examine the association between birth cohort and fracture rates. The variation in fracture rates across birth cohorts was analysed by fitting an age-cohort model to the data. We addressed the potential modification of the effect of vitamin D availability by season of birth. The risk of fractures was increased among both girls and boys who were born before the vitamin D fortification terminated in 1985 (rate ratio (RR) exposed v. non-exposed girls: 1·15 (95 % CI 1·11, 1·20); RR exposed v. non-exposed boys: 1·11 (95 % CI 1·07, 1·14). However, these associations no longer persisted after including the period effects. There was no interaction between season of birth and vitamin D availability in relation to fracture risk. The study did not provide evidence that prenatal exposure to extra vitamin D from a mandatory fortification programme of 1·25 µg vitamin D/100 g margarine was sufficient to influence the risk of fractures in late childhood, regardless of season of birth. Replication studies are needed
Bo Bennett, Author of The Ultimate Collection of Over 300 Logical Fallacies!
Full text linkInterview with Bo Bennett
Bo Bennett, Author of The Ultimate Collection of Over 300 Logical Fallacies!
Full text linkInterview with Bo Bennett
Massekhet Keritot. Text, Translation and Commentary. A Feminist Commentary on the Babylonian Talmud
No full textThe tractate Keritot of the Babylonian Talmud belongs to the Order of Qodashim in the Mishnah. It discusses the Temple and its rituals, especially sacrifices, but deals mostly with laws of incest, sexual transgressions, childbirth, and miscarriages. In this commentary, Federico Dal Bo provides a historical, philological and philosophical investigation on these gender issues. He discusses almost the entire tractate, referring to many other sources, Jewish (the Dead Sea Scrolls, the Sifra, and other rabbinic texts) as well as non-Jewish (Akkadian, Hittite, and Ugaritic). The author also provides accurate philological observations both on the Mishnah and the Gemara. Finally, he addresses gender issues by combining a reductionistic approach to Talmudic study (the so called "Brisker method") with philosophical deconstruction. Dal Bo shows that in nearly the entire tractate Keritot the rabbis discuss human sexuality in a tendentious and restrictive way, claiming that heterosexuality is the only proper sexual contact and progressively stigmatizing any other kind of sexual behavior
Social inequality and fractures - secular trends in the Danish population: a case-control study
No full textPurpose/ Introduction: we explored whether the risk of hip, humerus and wrist fracture was associated with markers of inequality using data from Danish health registries. Methods: all patients 50 years or older with a primary hip (ICD10: S720, S721, S722, and S729) humerus (ICD10: S422, S423, S424, S425, S426, and S427) or wrist (ICD10: S52) fracture were identified from 1/1/1995 to 31/12/2011. Fracture patients were matched 1:1 by age, sex and year of fracture, to a non-fracture control. Markers of inequality were: Income (fifths); marital status (married, divorced, widowed or unmarried); area of residence (remote, rural, intermediate or urban). Conditional logistic regression was used to investigate associations between these exposures, and risk of fracture, adjusting for covariates (smoking, alcohol and Charlson co-morbidity). Interactions were fitted between exposure and covariates where appropriate. Results: a total of 189,838 fracture patients (37,500 hip; 45,602 humerus; and 106,736 wrist) and 189,838 controls were included. Mean age was 73.9 years (hip), 67.5 years (humerus), and 65.3 years (wrist). High income (5th quintile) was significantly associated with a lower odds ratio of all three fractures, compared to average income (3rd quintile). Married subjects had a significantly decreased odds ratio across all three fractures. However, no overall secular difference was observed regarding the influence of the markers of inequality. Conclusion: in conclusion, we have demonstrated important, stable associations between social inequality, assessed using income, marital status, and area of residence, and fracture at the population level. These findings can inform approaches to healthcare, and suggest that much thought should be given to novel interventions aimed especially at those living alone, and ideally societal measures to reduce social inequality.<br/
Opportunistically identifiable vertebral fractures on routine radiological imaging predict mortality: observational cohort study
Full text linkUNLABELLED: In men and women with opportunistically identifiable vertebral fractures (VFs) on routine CT scans including the chest and/or abdomen, the risk of death is 51% higher than in those with no VF on the CT scan, and 325% higher than an age- and sex-matched general population cohort.PURPOSE: There is little knowledge about the risk of death in patients with VFs present on routine radiological imaging. We evaluated the risk of death in men and women aged 50 years or older with opportunistically identifiable VFs on routine CT scans and not treated with osteoporosis medications.METHODS: Thoracic and lumbar VFs were identified through a blinded, two-step approach on CT scans performed as part of normal clinical care in a Danish hospital in 2010 or later. Subjects with VF were matched on age and sex against those with no VF (1:2-ratio) and a general population cohort (1:3-ratio), respectively, and followed for up to 7 years through the national Danish registers. Subjects treated with an osteoporosis medication in the year prior to baseline were excluded.RESULTS: Subjects with VF had a significantly higher risk of death during follow-up as compared to subjects with no VF on the CT scan (adjusted hazard ratio [HR] 1.51 [95% confidence interval 1.27-1.79; p < 0.001]) and even more so when compared to the general population cohort (HR 4.25 [3.53-5.12; p < 0.001]). In subjects with versus without VF on the CT scan, the risk was higher in those with moderate or severe VF, in those with no malignancy prior to baseline, and in those with a lower Charlson comorbidity index score.CONCLUSION: Subjects with VF available for identification on routine CT scans face a substantially increased risk of death. Opportunistic identification and reporting of VF is important to identify these patients to allow intervention if indicated.</p
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