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Death and serious complications more likely in patients with vitamin D deficiency, study suggests
Patients with low blood levels of vitamin D are at increased risk of death and serious complications after noncardiac surgery, suggests a study in Anesthesia & Analgesia.
"Vitamin D concentrations were associated with a composite of in-hospital death, serious infections, and serious cardiovascular events," according to the new research by Dr Alparslan Turan and colleagues of the Cleveland Clinic. They believe their results warrant further study to see if giving vitamin D supplementation before surgery can reduce the risk of these adverse outcomes.
Lower Vitamin D Levels Linked to Higher Surgical Risk
The researchers analyzed the relationship between vitamin D level and surgical outcomes in approximately 3,500 patients who underwent operations other than heart surgery between 2005 and 2011. Only patients who had available data on vitamin D levels around the time of surgery-from three months before to one month afterward-were included in the study.
The concentration of vitamin D (specifically, 25-hydroxyvitamin D) in blood samples was analyzed as a risk factor for death, cardiovascular events, or serious infections while in the hospital. The analysis included adjustment for other factors such as demographic characteristics, medical conditions, and type and duration of surgery.
Most patients did not meet the recommended 25-hydroxyvitamin D concentration of greater than 30 nanograms per milliliter (ng/mL). The median vitamin D level was 23.5 ng/mL-more than 60 percent of patients were in the range of vitamin D insufficiency (10 to 30 ng/mL). Nearly 20 percent had vitamin D deficiency (less than 10 ng/mL).
"Higher vitamin D concentrations were associated with decreased odds of in-hospital mortality/morbidity," the researchers write. For each 5 ng/mL increase in 25-hydroxyvitamin D level, the combined risk of death, cardiovascular events, or serious infections decreased by seven percent.
Further Study Needed to Determine Cause and Effect
"Vitamin D deficiency is a global health problem," according to Dr Turan and coauthors. In addition to protective cardiovascular and neurological effects, vitamin D plays an important role in the immune system.
The high rates of vitamin D insufficiency and deficiency in the surgical patients studied are consistent with previous findings in the general population. In recent years, studies have suggested that vitamin D levels may affect a wide range of health outcomes.
Patients undergoing surgery are at risk of cardiovascular and infectious complications, both of which may be aggravated by vitamin D deficiency. Previous studies found no increased risk of adverse outcomes related to vitamin D levels in patients undergoing cardiac surgery. It may be that the tissue injury and inflammation associated with heart surgery overwhelms any potential protective effect of vitamin D.
However, Dr Turan and colleagues note that their study had some important limitations of their study-especially the fact that it included only patients who had recent measurements of vitamin D levels. They may represent a less-healthy group, introducing a potential source of selection bias.
The study can't determine whether there is any cause-and-effect relationship between vitamin D levels and the risk of adverse outcomes. Dr Turan and colleagues suggest a formal randomized trial to evaluate whether preoperative vitamin D supplementation can reduce the risk of serious complications and death after surgery.
A study conducted in more than 100 Mongolian schoolchildren found that daily treatment with a vitamin D supplement significantly reduced the symptoms of winter-related atopic dermatitis, a type of eczema. Led by a Massachusetts General Hospital (MGH) physician, the report in the October issue of the Journal of Allergy and Clinical Immunology supports the results of a preliminary study that showed similar results in a small group of children in Boston.
"While we don't know the exact proportion of patients with atopic dermatitis whose symptoms worsen in the winter, the problem is common," says Carlos Camargo, MD, DrPH, MGH Department of Emergency Medicine. "In this large group of patients, who probably had low levels of vitamin D, taking daily vitamin D supplements - which are inexpensive, safe and widely available - proved to be quite helpful." Camargo led both the earlier Boston pilot study and the current investigation, which was performed in collaboration with investigators from the Health Sciences University of Mongolia.
A chronic inflammatory disorder of the skin, atopic dermatitis is uncomfortable and makes patients more vulnerable to bacterial infection. Symptoms of the disorder - most commonly seen in children - often worsen during wintertime. While controlled administration of ultraviolet light, which can stimulate the production of vitamin D in the skin, is a common treatment for severe atopic dermatitis, the possibility that vitamin D deficiency contributes to the seasonal worsening of symptoms had received little consideration prior to the Boston study. That investigation involved only 11 children but provided preliminary support for the hypothesis.
The current study, conducted in collaboration with the National Dermatology Center in Mongolia, enrolled 107 children, ages 2 to 17, from nine outpatient clinics in the capital city of Ulaanbaatar. The participants - all of whom had a history of atopic dermatitis symptoms worsening either during cold weather or around the transition from autumn to winter - were randomly divided into two groups. One group received a daily vitamin D dose of 1000 IU while the other received a placebo - both delivered in odorless, colorless and tasteless drops. Neither the children's parents nor the study investigators knew to which group participants had been assigned.
Standard evaluations of atopic dermatitis symptoms were conducted at the outset of the trial and at the end of the month-long study period, and parents were also asked whether they saw any improvement in their child's condition. At the end of the month, children receiving the vitamin D supplement had an average 29 percent improvement on the primary assessment tool used, compared with 16 percent improvement in the placebo group. Additional assessments - including the report from parents - also showed significantly greater improvement among children receiving vitamin D.
While data gathered at the outset of the study could not determine whether or not participating children were deficient in vitamin D, the authors note that an even larger study of Ulaanbaatar children conducted at the same time found significant vitamin D deficiency in 98 percent of participants, supporting the probability that the children in this study were also deficient. While future studies are needed to assess the value of vitamin D treatment in adults and in children with year-round symptoms, Camargo - a professor of Medicine at Harvard Medical School - says that parents of children with symptoms that worsen in the winter should try a vitamin D supplement for a few weeks when symptoms flare to see if it helps. He encourages parents to discuss this study and their plan with their primary care provider.
A new study published in The Clinical Journal of Pain found that obese individuals who have knee osteoarthritis and healthy vitamin D levels demonstrated higher functional performance than obese participants with insufficient vitamin D levels.
Osteoarthritis is the most common form of arthritis, affecting more than 20 million people in the United States. It occurs when the protective cartilage at the end of your bones wears down as you age. Osteoarthritis most commonly affects joints in your hips, spine, hands, and knees.
Obesity is one of the most significant and modifiable risk factor for osteoarthritis. Due to the increasing rate of obese older adults, the prevalence of knee osteoarthritis is also rising.
Vitamin D levels, obesity, and aging are all associated with adverse health outcomes, including chronic pain. Researchers recently investigated the influence of vitamin D levels and obesity on knee arthritis pain and functional performance.
The researchers assessed the vitamin D levels, functional performance, and pain of 256 middle-aged and older adults with knee osteoarthritis. The participants provided a self-report of knee pain and completed functional performance tasks that included balancing, walking and rising from a sitting position to a standing position.
The researchers found healthy vitamin D levels were significantly associated with less knee osteoarthritis pain compared to participants with deficient or insufficient levels, regardless of obesity status. Those with healthy vitamin D levels could also walk, balance and rise from sitting to standing better than obese participants with insufficient levels.
Lead researcher, Toni Glover, stated, “Vitamin D is inexpensive, available over-the-counter and toxicity is fairly rare.”
“Older obese patients with chronic pain should discuss their vitamin D status with their primary care provider. If it’s low, take a supplement and get judicious sun exposure.”
Dr. Cameron Rink points to a picture of a brain that is currently undergoing a stroke, noting in particular the dark, feathery arteries that branch out across grayish brain tissue. Some of that tissue has faded to black around the vessels which are obstructed, and they very much resemble a city block that has lost power as the rest of the city remains well-lit.
"That part of the brain is not getting blood or oxygen and the cells are dying. There's not much we can do for a patient at this point and that's frustrating," Dr. Rink, a professor of surgery at the Ohio State University Wexner Medical Center, said.
It is easy to understand all of his frustration. After more than two and a half decades and the failure of some 1,000 experimental neuroprotective medications, only aspirin and tPA, the so-called "clot-busting" drug, are all that traditional medical science is offering to patients after they've suffered a stroke. And of the two, tPA is only used in about 4 percent of all stroke cases, said the university in a press release.
Prevention is the key
But Dr. Rink has long been convinced that such "after the fact" approaches don't really do much to prevent disability and death. So, for the past dozen years, Rink has focused his research on stroke prevention, and it is finally beginning to pay dividends.
What's more, one of the most promising of treatments is a natural alternative.
In published studies involving animals, Dr. Rink and fellow researchers write that they have discovered that brain damage during a strike can be prevented by triggering the surrounding blood vessels to dilate, thereby redirecting blood flow around a blockage.
The blood vessel "redirection" is the result of 10 weeks' worth of supplementation with a little known type of vitamin E called tocotrienol, which appears to stimulate arteriogenesis, or "the remodeling of existing blood vessels that can instantaneously expand in response to a demand for oxygen-rich blood," the press release states. And the creation of a collateral blood supply can make a huge difference in the outcome of strokes.
"We know that people who have good collaterals have better recovery from strokes. We think that tocotrienol helps improve the function of collaterals, which would offer someone better protection from an initial or secondary stroke," said Dr. Rink, who is currently participating in a study of stroke survivors to see if the supplement can help prevent or reduce damage from secondary strokes -- which can often be more disabling and costly than the first stroke.
More from the university's release:
To find out exactly how tocotrienol is impacting blood vessel remodeling, Rink pioneered a technique using laser capture microdissection (LCM) to take microscopic pieces of brain tissue and blood vessels from the exact area where collaterals are called into action during a stroke.
The LCM samples also give Rink a chance to study micro-RNA activity during a stroke. Micro-RNAs are tiny snippets of non-coding DNA that turn off the production of proteins created by genes, proteins that give cells a range of different instructions. By identifying the micro-RNAs, Rink will be able to find out what's happening at a genetic level during a stroke, and how tocotrienol may be influencing those genes.
More funding for more studies
The tocotrienol, which is formed naturally in palm oil, is a vitamin E variant and is currently available as an oral nutritional supplement. And because it does not interfere with other stroke therapies or have any side effects, Dr. Rink says he believes that the vitamin could someday become a common stroke-prevention strategy.
The university said that Dr. Rink's research was given pilot funding from Ohio State's Center for Clinical and Translational Science in 2012 to study tocotrienol's impact on stroke. The center has been studying the supplement for the past two years.
His initial findings also led to an additional funding grant from the American Heart Association, and Dr. Rink would like to apply for an RO1 grant in the next two years after the publication of several more studies on animal and human subjects.
"The animal studies are helping inform the optimal tocotrienol dose and therapeutic window for our human studies, so it's a great example of how the basic research is informing clinical studies, and helping us move the research forward faster," Dr. Rink said.
Learn more: http://www.naturalnews.com/045506_vitamin_E_stroke_prevention_brain_health.html#ixzz3eYE6CjWt
A study conducted in more than 100 Mongolian schoolchildren found that daily treatment with a vitamin D supplement significantly reduced the symptoms of winter-related atopic dermatitis, a type of eczema. Led by a Massachusetts General Hospital (MGH) physician, the report in the October issue of the Journal of Allergy and Clinical Immunology supports the results of a preliminary study that showed similar results in a small group of children in Boston.
"While we don't know the exact proportion of patients with atopic dermatitis whose symptoms worsen in the winter, the problem is common," says Carlos Camargo, MD, DrPH, MGH Department of Emergency Medicine. "In this large group of patients, who probably had low levels of vitamin D, taking daily vitamin D supplements - which are inexpensive, safe and widely available - proved to be quite helpful." Camargo led both the earlier Boston pilot study and the current investigation, which was performed in collaboration with investigators from the Health Sciences University of Mongolia.
A chronic inflammatory disorder of the skin, atopic dermatitis is uncomfortable and makes patients more vulnerable to bacterial infection. Symptoms of the disorder - most commonly seen in children - often worsen during wintertime. While controlled administration of ultraviolet light, which can stimulate the production of vitamin D in the skin, is a common treatment for severe atopic dermatitis, the possibility that vitamin D deficiency contributes to the seasonal worsening of symptoms had received little consideration prior to the Boston study. That investigation involved only 11 children but provided preliminary support for the hypothesis.
The current study, conducted in collaboration with the National Dermatology Center in Mongolia, enrolled 107 children, ages 2 to 17, from nine outpatient clinics in the capital city of Ulaanbaatar. The participants - all of whom had a history of atopic dermatitis symptoms worsening either during cold weather or around the transition from autumn to winter - were randomly divided into two groups. One group received a daily vitamin D dose of 1000 IU while the other received a placebo - both delivered in odorless, colorless and tasteless drops. Neither the children's parents nor the study investigators knew to which group participants had been assigned.
Standard evaluations of atopic dermatitis symptoms were conducted at the outset of the trial and at the end of the month-long study period, and parents were also asked whether they saw any improvement in their child's condition. At the end of the month, children receiving the vitamin D supplement had an average 29 percent improvement on the primary assessment tool used, compared with 16 percent improvement in the placebo group. Additional assessments - including the report from parents - also showed significantly greater improvement among children receiving vitamin D.
While data gathered at the outset of the study could not determine whether or not participating children were deficient in vitamin D, the authors note that an even larger study of Ulaanbaatar children conducted at the same time found significant vitamin D deficiency in 98 percent of participants, supporting the probability that the children in this study were also deficient. While future studies are needed to assess the value of vitamin D treatment in adults and in children with year-round symptoms, Camargo - a professor of Medicine at Harvard Medical School - says that parents of children with symptoms that worsen in the winter should try a vitamin D supplement for a few weeks when symptoms flare to see if it helps. He encourages parents to discuss this study and their plan with their primary care provider.
So you've decided to go cold turkey? You can white knuckle it and try to make it through on your own, or you can relieve much of the stress from withdrawals with the following supplements.
Vitamins and minerals to take to help quit smoking:
Vitamin C - 1,000 mg twice daily (remember to titrate down if you stop taking vitamin C)
B Complex vitamins - 1 or 2 a day (never take one B vitamin for any length of time - it will make you deficient in the others)
Calcium and magnesium - once a day
Vitamin C will help you flush toxins and nicotine from the body. This powerful antioxidant helps flush heavy metals from your body, including cadmium and lead.
Withdrawals are difficult and you will be irritable, to say the least. B vitamins are nature's valium. They will help you sleep and calm your nerves. It is important to take a high quality B complex. Many people choose B6 or B12 for stress relief. But B vitamins work together and they need one another to work their best. In addition, studies have shown that any long term use of one B vitamin can cause a deficiency in another. So always take B vitamins in a B complex.
Calcium and magnesium work together. Magnesium is very calming. Many of us are deficient in magnesium. Soaking in epsom salts will also help you to detox as it floods your cells with magnesium. Take a 40 minute soak using 1 cup of epsom salts per 100 lbs of body weight. The first 20 minutes releases toxins. During the second 20 minutes, you will absorb magnesium. At the end of that time you will be able to taste it. This is a sign that all of your tissues have soaked up magnesium.
Diet to help you stop smoking
There is a strong relationship between nicotine and blood sugar. When we withdraw nicotine, our blood sugar is low. This is what causes fatigue and sugar cravings when you quit smoking. If you resort to sugar for a fast boost, you will start a cycle of sugar highs and crashes that will only make your cravings worse.
Start with a healthy diet. A truly healthy diet is a whole foods diet with a wide variety of nutrient dense foods. Your diet should consist of 80% raw, organic, fresh produce - more fruits than vegetables.
When you are first withdrawing from nicotine, focus on healthy protein and produce. Avoid starches and simple carbs. For the first three days of withdrawals, however, you may need a little boost of sugar when those cravings hit. Drink a cup of fruit juice, but follow it twenty minutes later with protein.
Snack on veggies throughout the day along with whole fruits. And drink plenty of liquids. Cranberry lemonade is a great detox drink. See the link below for the recipe. A gallon a day, sipped throughout the day will help flush the toxins from your body and reduce cravings.
Conclusion
You can do this. Don't fall into the trap of thinking that you can't stop because you have tried before and failed. It doesn't matter if you have failed a hundred times. Just do it. You can win.
For more information, be sure to check out Natural Remedies for Anxiety, and How to Quit Smoking Naturally and http://www.naturalnews.com.