Vitamin D supplementation and lipid profile: What does the best available evidence show?

Vitamin D supplements have increasingly been used for the treatment and prevention of osteoporosis. Historically, effects of the vitamin on the cardiovascular (CV) system have been proposed and demonstrated in the literature, including benefits on serum lipids. Although observational studies support an association between increased serum vitamin D levels and a favorable lipid profile, interventional studies have shown no effects.     

Erythropoietic protoporphyria in Sweden: demographic,clinical, biochemical and genetic characteristics

Abstract. Wahlin S, Floderus Y, Stål P, Harper P (Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden). Erythropoietic protoporphyria in Sweden: demographic, clinical, biochemical and genetic characteristics. J Intern Med 2010; 269 : 278–288. Objective. To investigate the demographic, clinical, biochemical and genotypic features of patients with erythropoietic protoporphyria (EPP) in a Swedish cohort. Design. Cross‐sectional questionnaire, biochemical and genetic study. Setting. Sweden. Subjects. Fifty‐one Swedish individuals known in 2008 to have EPP confirmed by molecular diagnosis. There were no exclusion criteria; all patients were included in the demographic and genetic study. A total of 92% participants completed the questionnaire study and 82% the biochemical study. Results. The prevalence of EPP was 1 : 180 000. Nine novel ferrochelatase gene mutations were found. The most commonly reported age at onset of symptoms was the first year of life and the mean age at diagnosis was 22 years. Painful photosensitivity was the main symptom. Exogenous factors other than sunlight were frequently reported to cause cutaneous symptoms. One in five patients reported a positive effect of beta‐carotene therapy. A marked impact of EPP on quality of life was reported. Women had a significantly lower mean erythrocyte protoporphyrin concentration than men. Of all participants, 84% had insufficient vitamin D concentrations, 44% had below normal serum ferritin or transferrin saturation levels and red cell abnormalities were common. Conclusions. The notably delayed diagnosis suggests the need for an increased awareness of EPP. Disturbed erythropoiesis, biochemical signs of iron deficiency and low vitamin D levels are frequent findings in this disease. New and better treatments are needed as current treatment options for symptom amelioration are limited. Vitamin D supplementation should be considered.     

高敏C-反应蛋白、同型半胱氨酸、D-二聚体在冠心病病情严重程度评估中的应用

目的探讨高敏c-反应蛋白（hs—cRP）、同型半胱氨酸（Hcy）、D一二聚体（D—D）与冠心痛（CHD）病情严重程度的相关性。方法选取冠心痛患者164例，其中急性心梗（AMI）7l例，不稳定性心绞痛（UA）58例，稳定性心绞痛（SA）35例，并对uA患者进行Braunwald分级，对AMI患者进行KiUip分级．另选健康体检者40例为对照；对以上所有受试者采用免疫散射比浊法检测hs—CRP的含量，采用循环酶法检测Hcy，采用增强免疫比浊法检测血浆D—D，并进行统计学分析。结果冠心病患者hs—CRP、Hey、D—D均显著高于正常对照组（P〈0．01），且AMI组〉uA组〉SA组；hs—CRP、Hey、D—D与疾病严重程度存在良好的相关性：随着Braunwald分级增高，uA患者hs—CRP、Hey、D—D逐渐升高，Hey、D—D三级问每两者之间的的差异均有统计学意义（P〈0．05）；随着KiUip分级增高。AMI患者血清hs—CRP、Hey、D—D也逐渐逐渐升高，Hey、D—D三级间每两者之间的的差异均有统计学意义（P〈0．05）；AMI组和uA组的hs—cI蹬、Hcy、D—D明显高于sA组（P〈0．05）。结论hs—cRP、Hcy、D—D与冠心病的严重程度存在良好的相关性，常规检测hs—CRP、Hcy、D—D时冠心病的辅助诊断及其病情严重程度的评估有一定的临床意义，并能早期预测急性冠脉综合症（hCS）危急事件的发生。     

3D micro-CT images of ossicles destroyed by middle ear cholesteatoma

Objective To reconstruct the 3D structures of normal ossicles and ossicles destroyed by different cholesteatomas, and to compare the volume fractions of the two types of ossicles.

Material and Methods Thirteen pathological ossicles from four kinds of middle ear cholesteatoma obtained during surgery were used. Normal ossicles harvested from cadaveric temporal bone specimens were used as controls. The structures of the ossicles were analyzed using micro-CT by filming 2D cross-sectional images perpendicular to the long axis, from which 3D images were reconstructed. The volume fraction was measured using a CT-Analyzer? and Ant?.

Results The volume fraction, indicating the relative strength of normal ossicles, was lower in the portion close to the articular surface. As the four types of cholesteatoma were found to express their patterns of destruction at various sites in the ossicles, they revealed a different volume fraction in each ossicle.

Conclusion Our preliminary data on ossicular structure obtained using micro-CT will be helpful for elucidating the normal and pathological structure of ossicles and for the further development of artificial prostheses.