Seasonal and sex-related variation in vitamin D status and its association with other biochemical markers in young individuals: A cross-sectional study

BACKGROUND

While several studies have investigated the association between vitamin D deficiency and biochemical parameters, the results are still inconsistent and mostly overlook seasonal variations. This study explored the relationships between 25-hydroxy-vitamin D (25(OH)D) concentrations, biochemical markers, and seasonal variation among young males and females.

METHODS

A cross-sectional study was conducted among 203 individuals aged 18-24 years of both sexes residing in Brasilia, Brazil (latitude: 15°S). Sociodemographic variables, season of blood collection, and serum levels of 25(OH)D, total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, glycated hemoglobin (HbA1c), glucose, insulin, hs-CRP, parathyroid hormone, ionized calcium, and alkaline phosphatase were included. Descriptive statistics and differences among groups, correlations, and linear regression tests were performed.

RESULTS

The mean age of the participants was 21.17±1.7 years, and the mean serum 25(OH)D level was 25.76±7.0 ng/mL. Of the participants, 50.7% had vitamin D insufficiency (20 to 29.9 ng/mL), and 23.2% were vitamin D deficient (≤20 ng/mL). Vitamin D deficiency was higher in the spring (53.2%) and among females (29.5%). In young men with vitamin D insufficiency/deficiency (≤29.9 ng/mL) (n = 49), 25(OH)D levels were inversely correlated with HOMA-β (r = -0.234, p = 0.032) and triglyceride (r = -0.415, p = 0.003) levels. However, there were no significant correlations between 25(OH)D concentrations and biochemical markers among women with insufficient and deficient vitamin D levels.

CONCLUSION

This study found a high prevalence of vitamin D insufficiency/deficiency among young individuals living in Brasília, Brazil, particularly women and during the spring season. Our findings suggest that lower 25(OH)D levels (≤29.9 ng/mL) may be associated with insulin resistance and an increased risk of cardiovascular disease in young men studied. However, further studies with larger representative samples are needed to explore the mechanisms underlying the association between vitamin D and biochemical parameters.

Determinant factors of bone health after long-term of Roux-en-Y gastric bypass surgery: A cross-sectional study

OBJECTIVES

The aim of this study was to evaluate bone health and the potential influencing factors of bone metabolism disorders in adults ≥5 y after Roux-en-Y gastric bypass (RYGB) surgery.

METHODS

In this cross-sectional study, patients who were ≥5 y post-RYGB were invited. Bone health considered as bone mineral content (BMC) and bone mineral density (BMD) in this study was assessed by dual x-ray absorptiometry. We also assessed 25-hydroxy-vitamin D concentrations, individual ultraviolet B radiation levels, serum ionized calcium, alkaline phosphatase, parathyroid, anthropometric, and body composition.

RESULTS

The study evaluated 104 adults (90% women; 49.6 ± 9.1 y old; postoperative period 8.7 ± 2.2 y). Lumbar and femoral BMC and BMD were positively correlated to body mass index (BMI), appendicular lean mass (ALM), and negatively to %excess of weight loss (EWL). Femoral BMD was negatively correlated to age, and both femoral BMD and BMC were positively correlated to weekly exposed body part score. Sex, age, BMI, ALM, and weekly exposed body part score explained 35% and 54% of the total variance of femoral BMD and BMC, respectively.

CONCLUSIONS

The present findings suggested that older age, lower BMI, higher %EWL, lower ALM, and lower weekly body part exposure score are important determinants in lowering BMD and BMC parameters in long-term post-bariatric surgery individuals, rather than serum 25-hydroxy-vitamin D and parathyroid.

Vitamin D and musculoskeletal health: outstanding aspects to be considered in the light of current evidence

Vitamin D enhances calcium absorption and bone mineralisation, promotes maintenance of muscle function, and is crucial for musculoskeletal health. Low vitamin D status triggers secondary hyperparathyroidism, increases bone loss, and leads to muscle weakness. The primary physiologic function of vitamin D and its metabolites is maintaining calcium homeostasis for metabolic functioning, signal transduction, and neuromuscular activity. A considerable amount of human evidence supports the well-recognised contribution of adequate serum 25-hydroxyvitamin D concentrations for bone homeostasis maintenance and prevention and treatment strategies for osteoporosis when combined with adequate calcium intake. This paper aimed to review the literature published, mainly in the last 20 years, on the effect of vitamin D and its supplementation for musculoskeletal health in order to identify the aspects that remain unclear or controversial and therefore require further investigation and debate. There is a clear need for consistent data to establish realistic and meaningful recommendations of vitamin D status that consider different population groups and locations. Moreover, there is still a lack of consensus on thresholds for vitamin D deficiency and optimal status as well as toxicity, optimal intake of vitamin D, vitamin D supplement alone as a strategy to prevent fractures and falls, recommended sun exposure at different latitudes and for different skin pigmentations, and the extra skeletal effects of vitamin D.

Frequency of Vitamin D Deficiency and Associated Factors in Long-term Bariatric Surgery Patients: a Cross-sectional Study

BACKGROUND

Vitamin D deficiency is a common consequence of bariatric surgery (BS). However, few studies have evaluated influential factors and to date there are no studies investigating individual ultraviolet B (UVB) radiation levels in BS patients. This study aimed to evaluate vitamin D deficiency and its associated factors, including UVB radiation, in Roux-Y gastric bypass (RYGB) patients.

METHODS

This study included 104 adults (90.4% female) at least 5 years after RYGB. Patients underwent surgery in private hospitals (Private; n = 47) or in two public hospitals, one with ongoing outpatient care (Active; n = 17), and the other with discontinued service for BS (Discontinued; n = 40). 25-hydroxyvitamin D (25(OH)D) concentrations were analyzed by chemiluminescence, individual UVB radiation levels by dosimeter badges. Vitamin D intake, anthropometric, skin phototype, sociodemographic and lifestyle patterns were also assessed.

RESULTS

Mean age was 49.6 ± 9.1 years and post-operative period 8.7 ± 2.2 years. The prevalence of 25(OH)D deficiency and insufficiency was 25.0% and 51.9% respectively. 25(OH)D concentration differed among the hospitals (private = 26.2 ± 8.5; active = 28.7 ± 11.4; discontinued = 23.5 ± 6.5 ng/mL; p = 0.038). A total of 26.2% of the variance observed in 25(OH)D concentrations was explained by daily UVB radiation levels (β = 0.224; p = 0.032) and vitamin D intake (β = 0.431; p < 0.001), controlling for age and BMI.

CONCLUSION

A quarter of the evaluated patients presented vitamin D deficiency, which was associated with the discontinuation of the health care, higher BMI, lower vitamin D intake, and lower individual UVB radiation levels.

Association between vitamin D status and lifestyle factors in Brazilian women: Implications of Sun Exposure Levels, Diet, and Health

BACKGROUND

Vitamin D deficiency has been documented to be prevalent, even in low latitude regions; and this may be related to sun exposure behaviors. The aim of the current study was to assess the association between serum 25-hydroxyvitamin D [25(OH)D] concentrations and lifestyle-related factors in a sample of Brazilian women living at latitude 21º 8' S.

METHODS

A cross-sectional study was undertaken in 101 women aged 35 years or older in July 2019 to assess the association between 25(OH)D concentration and level of exposure to ultraviolet radiation (UVR), smoking habits, alcohol consumption, and physical activity levels. Age, body mass index (BMI), and postmenopausal status were investigated.

FINDINGS

According to the slope coefficient for individual daily UVR levels, the concentration of 25(OH)D increased by 5 nmol / L for each extra Standard Erythema Dose of UVR, regardless of age and BMI (p < 0·001). Postmenopausal women had a significantly higher mean concentration of 25(OH)D (p = 0·01), higher UVR exposure (p = 0·01) and lower BMI (p = 0·005) compared with younger women, independent of other confounders including smoking, alcohol, occupation and physical activity.

INTERPRETATION

Although postmenopausal women from Brazil had higher mean concentrations of 25(OH)D than younger women, more studies are necessary to understand how sun exposure and lifestyle variables interfere with these levels. These findings have important public health implications since they suggest that vitamin D deficiency in older age is not inevitable.

FUNDING

This study was funded by an award received by Universities Global Partnership Network - UGPN. KVSS and SLO receive scholarship from CAPES, Brazilian Ministry of Education. HR receives a productivity grant from CNPq.

Effects of Bifidobacterium animalis subspecies lactis supplementation on gastrointestinal symptoms: systematic review with meta-analysis

CONTEXT

The effects of probiotics on gastrointestinal (GI) symptoms have been increasingly investigated, particularly that of Bifidobacterium animalis. Clinical trials so far have shown differing evidence regarding these effects in healthy adults.

OBJECTIVE

To synthesize the published evidence on the effects of B. animalis subspecies lactis on GI symptoms (GIS) in healthy adults.

DATA SOURCE

A search of the Medline, Embase, Lilacs, Scopus, Web of Science, ProQuest, and Google Scholar databases was conducted for reports on randomized controlled trials published up to October 2021.

DATA EXTRACTION

Population characteristics and data on colonic transit time (CTT), stool consistency, defecation frequency, abdominal pain, bloating, flatulence, volunteer compliance, and adverse events were extracted. A random-effects model was used to estimate the effect of probiotic treatment on these variables.

DATA SYNTHESIS

In total, 1551 studies were identified, of which 14 were included in the qualitative synthesis and 13 in the meta-analysis. Overall, probiotic supplementation increased defecation frequency (standardized mean difference [SMD], 0.26; 95%CI, 0.13-0.39). Subgroup analysis revealed a decrease in CTT (SMD, -0.34; 95%CI, -0.62 to -0.07) in short-term treatment (≤14 d) and an improvement in stool consistency (SMD, 0.76; 95%CI, 0.44-1.08) in individuals without GIS. No improvement in abdominal pain and bloating was found.

CONCLUSIONS

B. animalis subspecies lactis supplementation may increase defecation frequency and, in short-term treatment, may reduce CTT in healthy adults and improve stool consistency in individuals without GIS. More high-quality randomized controlled trials are needed to develop a clinical protocol for the use of this strain to improve these symptoms.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. CRD42020154060.

Effect of multispecies probiotic on gut microbiota composition in individuals with intestinal constipation: A double-blind, placebo-controlled randomized trial

OBJECTIVE

The aim of this study was to evaluate the effect of a multispecies probiotic on gut microbiota composition and constipation symptoms.

METHODS

A randomized, double-blind, placebo-controlled clinical trial was conducted with 35 individuals with constipation for 30 days. The individuals were randomized into two groups: the control capsule (CC) and the probiotic capsule (PC) groups. Constipation symptoms were evaluated by the ROME IV criteria and by evacuation diaries. Fecal microbiota was analyzed by 16 S rRNA gene sequencing.

RESULTS

The majority of participants were women (85.7%). There was a significant reduction in the percent of participants who had incomplete defecation (P = 0.034), blockage sensation (P = 0.025), and rarely present liquid stools without the aid of laxatives (P = 0.046) only within the PC group (but no significant difference between groups). There was a significant increase in the relative abundance percentage of Blautia faecis and Ruminococcus torques in the CC group (P = 0.003 and P = 0.011, respectively), although there was no significant change in the PC group (P = 0.794 and P = 0.958, respectively), with a significant difference between groups (P = 0.029 and P 0.013, respectively), suggesting that probiotic treatment prevented the increase of percent relative abundance of these two species.

CONCLUSION

These results suggest that multispecies probiotics in capsule form may modulate gut microbiota by reducing the bacteria that are commonly increased in patients with constipation, contributing to the balance of microbiota and, consequently, to the well-being of the individual. Future studies with larger numbers of patients are required.

Does Vitamin D play a role in the management of Covid-19 in Brazil?

The study discusses the possible role of adequate vitamin D status in plasma or serum for preventing acute respiratory infections during the Covid-19 pandemic. Our arguments respond to an article, published in Italy, that describes the high prevalence of hypovitaminosis D in older Italian women and raises the possible preventive and therapeutic role of optimal vitamin D levels. Based on literature review, we highlight the findings regarding the protective role of vitamin D for infectious diseases of the respiratory system. However, randomized controlled trials are currently lacking. Adequate vitamin D status is obtained from sun exposure and foods rich in vitamin D. Studies in Brazil have shown that hypovitaminosis D is quite common in spite of high insolation. Authors recommend ecological, epidemiological and randomized controlled trials studies to verify this hypothesis.

Cheese-related listeriosis outbreak, Portugal, March 2009 to February 2012

In Portugal, listeriosis has been notifiable since April 2014, but there is no active surveillance programme for the disease. A retrospective study involving 25 national hospitals led to the detection of an outbreak that occurred between March 2009 and February 2012. The amount of time between the start of the outbreak and its detection was 16 months. Of the 30 cases of listeriosis reported, 27 were in the Lisbon and Vale do Tejo region. Two cases were maternal/neonatal infections and one resulted in fetal loss. The mean age of the non-maternal/neonatal cases was 59 years (standard deviation: 17); 13 cases were more than 65 years old. The case fatality rate was 36.7%. All cases were caused by molecular serogroup IVb isolates indistinguishable by pulsed-field gel electrophoresis and ribotype profiles. Collaborative investigations with the national health and food safety authorities identified cheese as the probable source of infection, traced to a processing plant. The magnitude of this outbreak, the first reported food-borne listeriosis outbreak in Portugal, highlights the importance of having an effective listeriosis surveillance system in place for early detection and resolution of outbreaks, as well as the need for a process for the prompt submission of Listeria monocytogenes isolates for routine laboratory typing.

Nasal mites of Tyrannidae (Aves) in Brazil

A total of 81 Tyraniidae birds were examined, 80 Pitangus sulphuratus (Linnaeus, 1766) (Great kiscadee), and one Machetornis rixosa (Vieilot, 1819) (Cattle tyrant), for collection of nasal mites, which were identified as Ptilonyssus spinosus (Brooks & Strandtmann, 1960) and Sternostoma longisetosae (Hyland, 1961) (Rhinonyssidae). This finding characterises the first report of P. spinosus and S. longisetosae in P. sulphuratus, and the first record of P. spinosus in M. rixosa, and expands the geographic distribution of these species. It is the first occurrence of S. longisetosae in the Neotropics, and the first citation of P. spinosus in the state of Rio Grande do Sul, Brazil.

Triacontyl p-coumarate: an inhibitor of snake venom metalloproteinases

Snake venom metalloproteinases (SVMPs) participate in a number of important biological, physiological and pathophysiological processes and are primarily responsible for the local tissue damage characteristic of viperid snake envenomations. The use of medicinal plant extracts as antidotes against animal venoms is an old practice, especially against snake envenomations. Such plants are sources of many pharmacologically active compounds and have been shown to antagonize the effects of some venoms and toxins. The present study explores the activity of triacontyl p-coumarate (PCT), an active compound isolated from root bark of Bombacopsis glabra vegetal extract (Bg), against harmful effects of Bothropoides pauloensis snake venom and isolated toxins (SVMPs or phospholipase A(2)). Before inhibition assays, Bg or PCT was incubated with venom or toxins at ratios of 1:1 and 1:5 (w/w; venom or isolated toxins/PCT) for 30 min at 37°C. Treatment conditions were also assayed to simulate snakebite with PCT inoculated at either the same venom or toxin site. PCT neutralized fibrinogenolytic activity and plasmatic fibrinogen depletion induced by B. pauloensis venom or isolated toxin. PCT also efficiently inhibited the hemorrhagic (3MDH - minimum hemorrhagic dose injected i.d into mice) and myotoxic activities induced by Jararhagin, a metalloproteinase from B. jararaca at 1:5 ratio (toxin: inhibitor, w/w) when it was previously incubated with PCT and injected into mice or when PCT was administered after toxin injection. Docking simulations using data on a metalloproteinase (Neuwiedase) structure suggest that the binding between the protein and the inhibitor occurs mainly in the active site region causing blockade of the enzymatic reaction by displacement of catalytic water. Steric hindrance may also play a role in the mechanism since the PCT hydrophobic tail was found to interact with the loop associated with substrate anchorage. Thus, PCT may provide a alternative to complement ophidian envenomation treatments.

Primary pleomorphic sarcoma of lung--11 year survival

Primary sarcomas of the lung are uncommon, potentially aggressive neoplasms that need to be distinguished from other malignant pulmonary tumors and whose biological behavior is as yet not fully understood. Primary undifferentiated pleomorphic sarcoma was diagnosed in the right lung of a 66 year-old man, who has survived over 11 years after treatment with endobronchial tumor debulking by laser therapy and radiotherapy.

[Nursing diagnoses by undergraduate students on hospitalized patients with neurological changes]

Diagnostic categories and patterns of human responses were identified in neurologic patients, assisted by nursing undergraduate students who attributed to them nursing diagnoses, according to NANDA's Taxinomy I. The majority of attributed diagnoses refer to the patterns Exchange, Move and Communicate and the minority to the patterns Choose, Receive and Feel. The non attribution of other diagnoses probably occurred due to the lack of emphasis given to them and to students' inexperience. Faculty determinations to develop in the students skills of analysis and synthesis confirm this positive experience.

[Evaluation of the surgical treatment of trapeziometacarpal arthroses]

The authors describe their experience, from July 1995 to December 1996, in the management of patients suffering from trapeziometacarpal degenerative arthrosis. Dell's classification is used for disease staging. The results of two different techniques are compared: 1) distal tenotomy of supranumerary insertions of abductor pollicis longus; and 2) trapeziectomy with tendon interposition arthroplasty and ligamentoplasty using the flexor carpi radialis.

[Experiences of a group of retired elderly: action research]

The present study aims at comprehending the retired people through a group experience as well as allowing them to reflect about their condition. The authors utilized the research-action methodology, with 25 retired subjects who worked in the University, aging from 51 to 79 years old. The narratives related to their experiences were obtained through verbal interaction, group discussions and interviews. From the analysis of the experiences emerged questions associated to the retired-elderly interests, their physical and mental health, relationship, learning process, social environment and leisure.

[Urinary incontinence in the elderly: a proposal for nursing behavior]

The authors make it evident the Urinary Incontinence in elderly people showing up the prevalence, their motives and types. It is subsidize the evaluation of the historical, the physical exam, registry of the incontinence and also the exercises for the training of the bladder, the musculature, hygiene habits and also the manipulation of the catheters and the aspects of the environment looking for the restoration of the continence and/or to treat and to live with in the urinary incontinence. They distinguish that the nursing conduct is done interrelated with the medical team with homely cares and elderly investing in the self care for to improve the urinary incontinence and favouring the continence.

[The theme of death: an educational proposal]

The necessity of educating the Health Professionals to the theme Death is concerned has become so evident during our educational activities that we have striven for the construction of a knowledge body about death and dying. Therefore, the knowledge we have generating refers to the pedagogical aspect of the theme. The aim of this study was to focus such dimension as far as it describes and analyses our experience in educating nursing undergraduates to deal with situations involving death and dying. In particular, we try to developing our students in order to be able to provide care to the dead body in a proposal to transcend the technical aspect of this care. Bearing this educational purpose, we strive for a space that makes possible a formation in the perspective of leading the students to another existencial dimension when facing and understanding death.