Acute Flaccid Paralysis Accompanying West Nile Meningitis Ahmed ...

More documents

Recommendations

Info

Vitamin D 2 Is As Effective As Vitamin D 3 In Maintaining Circulating Concentrations Of 25-Hydroxyvitamin D Biancuzzo RM, B.A, M.A., Holick, MF, Ph.D., M.D. University of New England College of Osteopathic Medicine, Biddeford, ME Introduction: Recent studies have suggested that vitamin D 2 was 30-50% less effective than vitamin D 3 in maintaining serum 25(OH)D levels. Results from two studies showed that when vitamin D 2 and vitamin D 3 was given as a single 50,000 IU dose or when 4000 IU vitamin D 2 and vitamin D 3 was given for 2 weeks, vitamin D 2 was less effective in maintaining serum 25(OH)D levels compared with vitamin D 3 Our objective was to determine whether vitamin D 2 was less effective than vitamin D 3 in maintaining serum 25-hydroxyvitamin D levels or increased the catabolism of 25-hydroxyvitamin D 3 .Give some grounding in this from the reports – what is the literature saying about this? Methods: This was an IRB approved, randomized, placebo-controlled, double-blinded study of 80 healthy adults subjects, with unknown vitamin d levels, age 18–84 years old. Subjects were randomized using a computer-generated program into 1 of 4 groups: (1) placebo, (2) 1000 IU vitamin D 3 , (3) 1000 IU vitamin D 2 , or (4) 500 IU vitamin D 2 plus 500 IU vitamin D 3 daily for 11 wk at the end of the winter. All subjects had blood samples collected at baseline and every week for a total of 11 wk. The results are presented as means ± SD. Data were analyzed using mixed-effects regression to perform a repeatedmeasures analysis of 25(OH)D levels across time and groups. Pairwise comparisons were performed between all treatment groups as well as each treatment group vs. placebo. Interactions between treatment group and time compared the linear change in 25(OH)D over time between the groups. A repeated-measures mixed-effect model also compared the 25(OH)D 2 and 25(OH)D 3 across visits for each of the treatment groups. Statistical analysis was performed using SAS (SAS Institute, Inc., Cary, NC). Results:, Sixty-eight (68) adults completed the study resulting in an 85% retention rate. Of the 68 study participants, sixty percent were vitamin D deficient at the start of the study. The circulating levels of 25-hydroxyvitamin D (mean ± SD) increased to the same extent in the groups that received 1000 IU daily as vitamin D 2 (baseline 16.9 ± 10.5 ng/ml; 11 wk 26.8 ± 9.6 ng/ml), vitamin D 3 (baseline 19.6 ± 11.1 ng/ml; 11 wk 28.9 ± 11.0 ng/ml), or a combination of 500 IU vitamin D 2 and 500 IU vitamin D 3 (baseline 20.2 ± 10.4 ng/ml; 11 wk 28.4 ± 7.7 ng/ml). The 25-hydroxyvitamin D 3 levels did not change in the group that received 1000 IU vitamin D 2 daily. The 1000 IU dose of vitamin D 2 or vitamin D 3 did not raise 25-hydroxyvitamin D levels in vitamin D-deficient subjects above 30 ng/ml. Conclusion: A 1000 IU dose of vitamin D 2 daily was as effective as 1000 IU vitamin D 3 in maintaining serum 25-hydroxyvitamin D levels and did not negatively influence serum 25-hydroxyvitamin D 3 levels. Therefore, in our study vitamin D 2 was found to be is equally as effective as vitamin D 3 in maintaining 25-hydroxyvitamin D status.
Delirium and the Family Caregiver: Best Practices for Optimal Care Carbone, MK, OMS-III, Gugliucci, MR, PhD, Aguilo-Sera, ME, DO, University of New England College of Osteopathic Medicine, Department of Geriatrics, Biddeford, ME Introduction: Delirium is known as an acute confusional state that is experienced by many hospitalized patients, especially older adults. Delirium presents as disturbances of cognitive function that can affect orientation, attention, memory and planning (Meagher 2001). Currently there is substantial research on the risk factors, etiology and management of delirium. However, there is a deficit of information educating the delirious patient’s family members and/or caregiver of this medical condition. In addition there is very little research exploring the impact of caring for a patient with delirium on family and caregivers. This research addressed two objectives relative to the medical literature on delirium for older adults: (1) to investigate published studies that address the impact on the family regarding caring for a loved one with delirium; and (2) determine if there are interventions that provide family caregivers with education and/or coping skills to manage delirium. Methods: A date specific literature review was conducted in several major databases, including: Medline-PubMed, Medline EBSCO, Medline Proquest, CINAHL, and Cochrane Collection Plus. Documented interventions related to delirium, family, and impact on informal caregivers were examined. A process of systematic elimination revealed key articles that met the objectives. Findings were summarized reporting the type of education available for family caregivers to aid in the care of the delirious loved one. Results: A total of 208 citations applied to the criteria for the initial data base searches, however after removing duplicate citations only 92 citations remained. After reading the abstracts of those 92 citations, only 30 journal articles were identified as addressing the objectives of this project. A complete read through of the 30 articles were conducted twice. Six articles were identified as focusing on education strategies for family/informal caregivers, specifically on how to care for a delirious loved one. These were analyzed and presented. Conclusion: Since delirium is an acute medical condition that can linger post hospital and ultimately can lead to death, it is imperative to explore the impact of delirium on family caregivers and educate them about this life threatening health condition and how best to augment care. Currently there is a dearth of research explaining and exploring the impact of delirium on the family/informal caregiver, and how best to educate them to aid in caring for a loved one with delirium.
Page 1 and 2:
Acute Flaccid Paralysis Accompanyin
Page 3 and 4:
Adult Typhilitis Associated With Ly
Page 5 and 6:
Acute Interstitial Nephritis Second
Page 7 and 8:
Atypical Presentation for Complex R
Page 9 and 10:
Ptosis As A Variant Presentation of
Page 11 and 12:
Isolated Gastric Varices as an Etio
Page 13 and 14:
A Case of Idiopathic Pulmonary Arte
Page 15 and 16:
Diagnosis and Management of Meningi
Page 17 and 18:
Surveillance for an Indeterminate H
Page 19 and 20:
contralateral trunk/extremities sho
Page 21 and 22:
An Unexpected Course of Rhabdomyoly
Page 23 and 24:
Severe Autoimmune Hemolytic Anemia
Page 25 and 26:
An Uncommon Cause of a Common Sympt
Page 27 and 28:
Implications of Epidemiology in Bre
Page 29 and 30: Methicillin-Resistant Staphylococcu
Page 31 and 32: An Unusual Electrocardiogram Presen
Page 33 and 34: Using NSQIP and Zynxhealth to Build
Page 35 and 36: Resident-Run OMM Skills Clinic: Doe
Page 37 and 38: Waves of Health Evaluation of Diabe
Page 39 and 40: A Comparison of Temporal Thermometr
Page 41 and 42: Lactation Assessment Standardized T
Page 43 and 44: Use of Opioids in Management of Chr
Page 45 and 46: Not All Anterior Wall ST Segment El
Page 47 and 48: A Case of Sudden Monocular Blindnes
Page 49 and 50: Can Name Recognition Allow for More
Page 51 and 52: Developing a Treatment Plan for a C
Page 53 and 54: Post-polypectomy Syndrome In A Pati
Page 55 and 56: A Classical Misnomer To Consider: G
Page 57 and 58: A Case of Mycoplasma Pneumoniae Rel
Page 59 and 60: Severe Hirsutism in a Patient with
Page 61 and 62: Case Report: Wernicke-Korsakoff Syn
Page 63 and 64: A New Diagnosis of Adult Onset Stil
Page 65 and 66: Acute Brodifacoum Poisoning: A Case
Page 67 and 68: Inguinal Hernia Containing Endometr
Page 69 and 70: Simultaneous Rupture of the Anterio
Page 71 and 72: Idiopathic Pulmonary Fibrosis: A Ca
Page 73 and 74: Uterine Perforation in a 36 Year Ol
Page 75 and 76: Co-infection with Lyme Disease and
Page 77 and 78: Axillary Pseudoaneurysm With Emboli
Page 79: Assessing Variability of the Americ
Page 83 and 84: in Haiti. Future research can focus
Page 85 and 86: Lessons to Be Learned: Changing Per
Page 87 and 88: Protective Characteristics of Criti
Page 89 and 90: The Patient Simulator for Training
Page 91 and 92: In Vivo Micron Scale Arthroscopic I
Page 93 and 94: Breast Cancer-Induced Bone Remodeli
show all

Acute Flaccid Paralysis Accompanying West Nile Meningitis Ahmed ...

Create successful ePaper yourself

Delete template?

Save as template?