Browsing by Subject "VITAMIN-D"

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  • Bauer, Michael; Glenn, Tasha; Alda, Martin; Andreassen, Ole A.; Angelopoulos, Elias; Ardau, Raffaella; Ayhan, Yavuz; Baethge, Christopher; Bauer, Rita; Baune, Bernhard T.; Becerra-Palars, Claudia; Bellivier, Frank; Belmaker, Robert H.; Berk, Michael; Bersudsky, Yuly; Bicakci, Sule; Birabwa-Oketcho, Harriet; Bjella, Thomas D.; Cabrera, Jorge; Cheung, Eric Y. Wo; Del Zompo, Maria; Dodd, Seetal; Donix, Markus; Etain, Bruno; Fagiolini, Andrea; Fountoulakis, Kostas N.; Frye, Mark A.; Gonzalez-Pinto, Ana; Gottlieb, John F.; Grof, Paul; Harima, Hirohiko; Henry, Chantal; Isometsä, Erkki T.; Janno, Sven; Kapczinski, Flavio; Kardell, Mathias; Khaldi, Slim; Kliwicki, Sebastian; Konig, Barbara; Kot, Timur L.; Krogh, Rikke; Kunz, Mauricio; Lafer, Beny; Landen, Mikael; Larsen, Erik R.; Lewitzka, Ute; Licht, Rasmus W.; Lopez-Jaramillo, Carlos; MacQueen, Glenda; Manchia, Mirko; Marsh, Wendy; Martinez-Cengotitabengoa, Monica; Melle, Ingrid; Meza-Urzua, Fatima; Ming, Mok Yee; Monteith, Scott; Morken, Gunnar; Mosca, Enrica; Mozzhegorova, Anton A.; Munoz, Rodrigo; Mythri, Starlin V.; Nacef, Fethi; Nadella, Ravi K.; Nery, Fabiano G.; Nielsen, Rene E.; O'Donovan, Claire; Omrani, Adel; Osher, Yamima; Sorensen, Helle Ostermark; Ouali, Uta; Ruiz, Yolanda Pica; Pilhatsch, Maximilian; Pinna, Marco; da Ponte, Francisco D. R.; Quiroz, Danilo; Ramesar, Raj; Rasgon, Natalie; Reddy, M. S.; Reif, Andreas; Ritter, Philipp; Rybakowski, Janusz K.; Sagduyu, Kemal; Raghuraman, Bharathram Sathur; Scippa, Angela M.; Severus, Emanuel; Simhandl, Christian; Stackhouse, Paul W.; Stein, Dan J.; Strejilevich, Sergio; Subramaniam, Mythily; Sulaiman, Ahmad Hatim; Suominen, Kirsi; Tagata, Hiromi; Tatebayashi, Yoshitaka; Tondo, Leonardo; Torrent, Carla; Vaaler, Arne E.; Vares, Edgar; Veeh, Julia; Vieta, Eduard; Viswanath, Biju; Yoldi-Negrete, Maria; Zetina, Mark; Zgueb, Yosra; Whybrow, Peter C. (2019)
    In many international studies, rates of completed suicide and suicide attempts have a seasonal pattern that peaks in spring or summer. This exploratory study investigated the association between solar insolation and a history of suicide attempt in patients with bipolar I disorder. Solar insolation is the amount of electromagnetic energy from the Sun striking a surface area on Earth. Data were collected previously from 5536 patients with bipolar I disorder at 50 collection sites in 32 countries at a wide range of latitudes in both hemispheres. Suicide related data were available for 3365 patients from 310 onset locations in 51 countries. 1047 (31.1%) had a history of suicide attempt. There was a significant inverse association between a history of suicide attempt and the ratio of mean winter solar insolation/mean summer solar insolation. This ratio is smallest near the poles where the winter insolation is very small compared to the summer insolation. This ratio is largest near the equator where there is relatively little variation in the insolation over the year. Other variables in the model that were positively associated with suicide attempt were being female, a history of alcohol or substance abuse, and being in a younger birth cohort. Living in a country with a state-sponsored religion decreased the association. (All estimated coefficients p <0.01). In summary, living in locations with large changes in solar insolation between winter and summer may be associated with increased suicide attempts in patients with bipolar disorder. Further investigation of the impacts of solar insolation on the course of bipolar disorder is needed.
  • Kukkonen, Mari K.; Tiili, Emmi; Vehmas, Tapio; Oksa, Panu; Piirilä, Päivi; Hirvonen, Ari (2013)
  • Kiiski, Ville O; Salava, Alexander; Susitaival, Päivikki; Barnhill, Satu; Remitz, Anita; Heliövaara, Markku (2022)
    Background The prevalence of atopic dermatitis (AD) has increased, but studies in adult or elderly populations are sparse. Methods We investigated 12-month and lifetime prevalences of AD in the Finnish adult population ≥30 years of age and analyzed living environment factors, socioeconomic factors, lifestyle-related factors, and serum vitamin D levels for their associations with AD in a national health examination survey. Results The lifetime prevalence was 21.9% and 12-month prevalence 10.1%. The highest prevalence (lifetime 28.6%, 12-month 15.4%) was seen in subjects 30-39 years of age. Prevalence decreased with age. Subjects with highly educated parents were more likely to have active AD, though there was no effect of higher education in subjects themselves. Younger age and being an ex-smoker were associated with active AD. Female sex and daily smoking increased the risk in subjects 30-49 years of age. There was no dose– response relationship to serum vitamin D levels and no association with the living environment. Conclusions Our data show that the number of adult patients with atopic dermatitis has grown and prevalence numbers of AD in Finnish adults are among the highest reported. Together with the aging of the society, the burden of AD is not limited to childhood.
  • Valkama, Anita J.; Meinila, Jelena M.; Koivusalo, Saila B.; Lindstrom, Jaana; Rono, Kristiina; Tiitinen, Aila E.; Stach-Lempinen, Beata; Kautiainen, Hannu J.; Viljakainen, Heli; Andersson, Sture; Eriksson, Johan G. (2018)
    Obesity increases the risk of low 25-hydroxyvitamin D (25(OH) D) concentrations and gestational diabetes (GDM). We explored whether the association between GDM and change in 25(OH) D concentrations measured in the first (7-18 wk) and second (20-27 wk) trimesters of pregnancy is dependent on maternal BMI. The study was a prospective study of 219 women with BMI of >= 30 kg/m2, a history of GDM, or both. The participants were stratified by first-trimester BMI: BMI of = 35 kg/m(2). In the BMI group >= 35 kg/m(2), those who did not develop GDM during the follow-up showed higher increase in serum 25(OH) D concentrations compared with women who developed GDM (43.2 vs. 11.5%; P <0.001). No associations between 25(OH) D concentrations and GDM were observed in other BMI groups. These findings give an important aspect of the role of maternal body size in the association between vitamin D and GDM in high-risk women.
  • Uusi-Rasi, Kirsti; Karkkainen, Merja U. M.; Lamberg-Allardt, Christel J. E. (2013)
  • Pussila, Marjaana; Sarantaus, Laura; Dermadi Bebek, Denis; Valo, Satu; Reyhani, Nima; Ollila, Saara; Päivärinta, Essi Mari-Anna; Peltomäki, Päivi T; Mutanen, Marja; Nyström, Minna (2013)
  • Garn, Holger; Bahn, Sabine; Baune, Bernhard T.; Binder, Elisabeth B.; Bisgaard, Hans; Chatila, Talal A.; Chavakis, Triantafyllos; Culmsee, Carsten; Dannlowski, Udo; Gay, Steffen; Gern, James; Haahtela, Tari; Kircher, Tilo; Mueller-Ladner, Ulf; Neurath, Markus F.; Preissner, Klaus T.; Reinhardt, Christoph; Rook, Graham; Russell, Shannon; Schmeck, Bernd; Stappenbeck, Thaddeus; Steinhoff, Ulrich; van Os, Jim; Weiss, Scott; Zemlin, Michael; Renz, Harald (2016)
    Recent research indicates that chronic inflammatory diseases, including allergies and autoimmune and neuropsychiatric diseases, share common pathways of cellular and molecular dysregulation. It was the aim of the International von-Behring-Rontgen Symposium (October 16-18, 2014, in Marburg, Germany) to discuss recent developments in this field. These include a concept of biodiversity; the contribution of urbanization, lifestyle factors, and nutrition (eg, vitamin D); and new mechanisms of metabolic and immune dysregulation, such as extracellular and intracellular RNAs and cellular and mitochondrial stress. Epigenetic mechanisms contribute further to altered gene expression and therefore to the development of chronic inflammation. These novel findings provide the foundation for further development of preventive and therapeutic strategies.
  • Björkman, Mikko P.; Suominen, Merja H.; Kautiainen, Hannu; Jyväkorpi, Satu K.; Finne-Soveri, Harriet U.; Strandberg, Timo E.; Pitkälä, Kaisu H.; Tilvis, Reijo S. (2020)
    Objectives: To test the long-term effects of whey-enriched protein supplementation on muscle and physical performance. Design: A 12-month randomized controlled double blind trial with a 43-month of post-trial follow-up. Setting: Porvoo, Finland. Participants: A total of 218 older (>74 years of age) community-dwelling people with sarcopenia. Intervention: (1) Control with no supplementation; (2) isocaloric placebo; and (3) 20 g x 2 whey-enriched protein supplementation. All participants were given instructions on home-based exercise, dietary protein, and vitamin D supplementation of 20 mu g/d. Measurements: Physical performance was assessed by short physical performance battery and continuous summary physical performance scores. Hand grip strength and calf intracellular resistance based skeletal muscle index were measured by bioimpedance spectroscopy. The measurements were performed at 0, 6, and 12 months. The post-trial follow-up was performed by a postal questionnaire and national census record data. Results: The participants were older (75-96 years of age) and mostly women (68%). The test supplements had no significant effects on physical performance; the 12-month changes for short physical performance battery were -0.55, -.05, and 0.03 points in control, isocaloric, and protein groups (P = .17), respectively. The changes in continuous summary physical performance scores were similar between the intervention groups (P = .76). The hand grip strength decreased significantly in all intervention groups, and the 12-month changes in calf intracellular resistance-based skeletal muscle index were minor and there were no differences between the intervention groups. One-half of the patients (56%) in both supplement groups reported mild gastrointestinal adverse effects. Differences were found neither in the all-cause mortality nor physical functioning in the post-trial follow-up. Conclusions: The whey-enriched protein supplementation in combination with low intensity home-based physical exercise did not attenuate the deterioration of muscle and physical performance in community-dwelling older people with sarcopenia. (C) 2019 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
  • 2021 PARAT Working Grp; Bollerslev, Jens; Rejnmark, Lars; Zahn, Alexandra; Schalin-Jäntti, Camilla; Kamenicky, Peter (2022)
    This European expert consensus statement provides recommendations for the diagnosis and management of primary hyperparathyroidism (PHPT), chronic hypoparathyroidism in adults (HypoPT), and parathyroid disorders in relation to pregnancy and lactation. Specified areas of interest and unmet needs identified by experts at the second ESE Educational Program of Parathyroid Disorders in 2019 were discussed during two virtual workshops in 2021 and subsequently developed by working groups with interest in the specified areas. PHPT is a common endocrine disease. However, its differential diagnosis of familial hypocalciuric hypercalcemia (FHH), the definition and clinical course of normocalcemic PHPT, and the optimal management of its recurrence after surgery represents areas of uncertainty requiring clarifications. HypoPT is an orphan disease characterized by low calcium concentrations due to insufficient PTH secretion, most often secondary to neck surgery. Prevention and prediction of surgical injury to the parathyroid glands are essential to limit the disease-related burden. Long-term treatment modalities including the place for PTH replacement therapy and the optimal biochemical monitoring and imaging surveillance for complications to treatment in chronic HypoPT need to be refined. The physiological changes in calcium metabolism occurring during pregnancy and lactation modify the clinical presentation and management of parathyroid disorders in these periods of life. Modern interdisciplinary approaches to PHPT and HypoPT in pregnant and lactating women and their newborn children are proposed. The recommendations on clinical management presented here will serve as background for further educational material aimed at a broader clinical audience and were developed with the focus on endocrinologists in training.
  • Lofvenborg, J. E.; Andersson, T.; Carlsson, P-O; Dorkhan, M.; Groop, L.; Martinell, M.; Tuomi, T.; Wolk, A.; Carlsson, S. (2014)
  • Beck-Nielsen, Signe Sparre; Mughal, Zulf; Haffner, Dieter; Nilsson, Ola; Levtchenko, Elena; Ariceta, Gema; Collantes, Carmen de Lucas; Schnabel, Dirk; Jandhyala, Ravi; Mäkitie, Outi (2019)
    Background: X-linked hypophosphatemia (XLH) is an inherited disease of phosphate metabolism in which inactivating mutations of the Phosphate Regulating Endopeptidase Homolog, X-Linked (PHEX) gene lead to local and systemic effects including impaired growth, rickets, osteomalacia, bone abnormalities, bone pain, spontaneous dental abscesses, hearing difficulties, enthesopathy, osteoarthritis, and muscular dysfunction. Patients with XLH present with elevated levels of fibroblast growth factor 23 (FGF23), which is thought to mediate many of the aforementioned manifestations of the disease. Elevated FGF23 has also been observed in many other diseases of hypophosphatemia, and a range of animal models have been developed to study these diseases, yet the role of FGF23 in the pathophysiology of XLH is incompletely understood. Methods: The role of FGF23 in the pathophysiology of XLH is here reviewed by describing what is known about phenotypes associated with various PHEX mutations, animal models of XLH, and non-nutritional diseases of hypophosphatemia, and by presenting molecular pathways that have been proposed to contribute to manifestations of XLH. Results: The pathophysiology of XLH is complex, involving a range of molecular pathways that variously contribute to different manifestations of the disease. Hypophosphatemia due to elevated FGF23 is the most obvious contributor, however localised fluctuations in tissue non-specific alkaline phosphatase (TNAP), pyrophosphate, calcitriol and direct effects of FGF23 have been observed to be associated with certain manifestations. Conclusions: By describing what is known about these pathways, this review highlights key areas for future research that would contribute to the understanding and clinical treatment of non-nutritional diseases of hypophosphatemia, particularly XLH.
  • Elorinne, Anna-Liisa; Alfthan, Georg; Erlund, Iris; Kivimaki, Hanna; Paju, Annukka; Salminen, Irma; Turpeinen, Ursula; Voutilainen, Sari; Laakso, Juha (2016)
    Background Vegetarian and vegan diets have become more popular among adolescents and young adults. However, few studies have investigated the nutritional status of vegans, who may be at risk of nutritional deficiencies. Objective To compare dietary intake and nutritional status of Finnish long-term vegans and non-vegetarians. Methods Dietary intake and supplement use were estimated using three-day dietary records. Nutritional status was assessed by measuring biomarkers in plasma, serum, and urine samples. Vegans' (n = 22) data was compared with those of sex-and age-matched non-vegetarians (n = 19). Results All vegans adhered strictly to their diet; however, individual variability was marked in food consumption and supplementation habits. Dietary intakes of key nutrients, vitamins B12 and D, were lower (P <0.001) in vegans than in non-vegetarians. Nutritional biomarker measurements showed lower concentrations of serum 25-hydroxyvitamin D3 (25(OH) D3), iodine and selenium (corrected for multiple comparisons, P <0.001), Vegans showed more favorable fatty acid profiles (P <0.001) as well as much higher concentrations of polyphenols such as genistein and daidzein (P <0.001). Eicosapentaenoic acid proportions in vegans were higher than expected. The median concentration of iodine in urine was below the recommended levels in both groups. Conclusions Long-term consumption of a vegan diet was associated with some favorable laboratory measures but also with lowered concentrations of key nutrients compared to reference values. This study highlights the need for nutritional guidance to vegans.
  • Akesson, Agneta; Andersen, Lene F.; Kristjansdottir, Asa G.; Roos, Eva; Trolle, Ellen; Voutilainen, Eeva; Wirfalt, Elisabet (2013)
  • Tuokkola, Jetta; Lamminsalo, Anni; Metsälä, Johanna; Takkinen, Hanna-Mari; Tapanainen, Heli; Åkerlund, Mari; Niinistö, Sari; Toppari, Jorma; Ilonen, Jorma; Veijola, Riitta; Knip, Mikael; Kaila, Minna; Virtanen, Suvi M. (2021)
    Cows' milk allergy (CMA) is the most common food allergy in young children, and it is often the first manifestation of atopic diseases. Accordingly, very early environmental factors, such as maternal diet during pregnancy, may play a role in the development of CMA, but the evidence is limited. The aim of this study was to investigate the association between maternal intake of antioxidant nutrients during pregnancy and the subsequent development of CMA in the offspring in a prospective, population-based birth cohort within the Finnish Type 1 Diabetes Prediction and Prevention Study. Maternal dietary information during pregnancy was collected with a detailed, validated FFQ. The maternal dietary information and the information on putative confounding factors were available for 4403 children. Information on diagnosed CMA (n 448) was obtained from a medical registry and queried from the parents up to child's age of 3 years. The Finnish food composition database was used to calculate the average daily intake of nutrients. Logistic regression was applied for statistical analyses, and the nutrient intakes were adjusted for energy intake. OR are presented per 1 sd increment of the particular nutrient intake. Maternal total and dietary intake of beta-carotene was associated with an increased risk of CMA in the offspring when adjusted for the putative confounding factors (total OR 1 center dot 10, 95 % CI 1 center dot 02, 1 center dot 20; dietary OR 1 center dot 10; 95 % CI 1 center dot 01, 1 center dot 19). Using dietary supplements containing antioxidants in addition to a balanced diet may not confer any additional benefits.
  • Lingaiah, Shilpa; Morin-Papunen, Laure; Risteli, Juha; Tapanainen, Juha S. (2019)
    Objective: To study the effects of metformin treatment on bone turnover in women with polycystic ovary syndrome (PCOS), as measured by serum concentrations of bone turnover markers. Design: Post hoc study of a previously conducted prospective multicenter, placebo-controlled, randomized study. Setting: University clinic. Patient(s): The study cohort consisted of 74 non-obese women (body mass index <27 kg/m(2)) and 44 obese women (body mass index >= 27 kg/m(2)) diagnosed with PCOS, with a mean age of 27.6 +/- 4.0 (SD) years. Intervention(s): Randomization to receive metformin or placebo for 3 months. Main Outcome Measure(s): Serum levels of bone formation marker procollagen type I amino-terminal propeptide (PINP) and bone resorption marker carboxy-terminal cross-linking telopeptide of type I collagen (CTX) at baseline and after metformin/placebo treatment. Result(s): Serum levels of PINP and CTX were similar between the metformin and placebo groups at baseline in the whole study population. Obese women, when compared with non-obese, had lower baseline levels of PINP and CTX. Levels of PINP and CTX were significantly reduced in the whole study population, as well as in both non-obese and obese women after 3 months of metformin treatment, whereas no significant changes were observed in the placebo group. Conclusion(s): Metformin treatment, when compared with placebo, was associated with reduced bone turnover, as suggested by reductions in markers of bone formation and resorption, leading to slower bone remodeling in premenopausal women with PCOS. ((C) 2019 by American Society for Reproductive Medicine.)
  • Koljonen, Laura; Enlund-Cerullo, Maria; Hauta-Alus, Helena; Holmlund-Suila, Elisa; Valkama, Saara; Rosendahl, Jenni; Andersson, Sture; Pekkinen, Minna; Mäkitie, Outi (2021)
    Context: Phosphate homeostasis and its modifiers in early childhood are inadequately characterized. Objective: To determine physiological plasma phosphate concentration and modifying factors in healthy infants at 12 to 24 months of age. Design: This study included 525 healthy infants (53% girls), who participated in a randomized vitamin D intervention trial and received daily vitamin D3 supplementation of either 10 or 30 μg from age 2 weeks to 24 months. Biochemical parameters were measured at 12 and 24 months. Dietary phosphate intake was determined at 12 months. Main Outcome Measures: Plasma phosphate concentrations at 12 and 24 months of age. Results: Mean (SD) phosphate concentration decreased from 12 months (1.9±0.15 mmol/L) to 24 months (1.6±0.17 mmol/L) of age (P<0.001 for repeated measurements). When adjusted by covariates, such as body size, creatinine, serum 25-hydroxyvitamin D, intact and C-terminal fibroblast growth factor 23, mean plasma phosphate was higher in boys than girls during follow-up (P=0.019). Phosphate concentrations were similar in the vitamin D intervention groups (P>0.472 for all). Plasma iron was associated positively with plasma phosphate at both time points (B, 0.006 and 0.005; 95% CI, 0.004-0.009 and 0.002-0.008; P<0.001 at both time points, respectively). At 24 months of age, the main modifier of phosphate concentration was plasma creatinine (B, 0.007; 95% CI 0.003-0.011, P<0.001). Conclusion: Plasma phosphate concentration decreased from age 12 to 24 months. In infants and toddlers, the strongest plasma phosphate modifiers were sex, iron, and creatinine, whereas vitamin D supplementation did not modify phosphate concentrations.
  • Eskelinen, Saana; Suvisaari, Janne V. J.; Suvisaari, Jaana M. (2020)
    Background Guidelines on laboratory screening in schizophrenia recommend annual monitoring of fasting lipids and glucose. The utility and the cost effectiveness of more extensive laboratory screening have not been studied. Methods The Living Conditions and the Physical Health of Outpatients with Schizophrenia Study provided a comprehensive health examination, including a laboratory test panel for 275 participants. We calculated the prevalence of the results outside the reference range for each laboratory test, and estimated the cost effectiveness to find an aberrant test result using the number needed to screen to find one abnormal result (NNSAR) and the direct cost spent to find one abnormal result (DCSAR, NNSAR x direct cost per test) formulas. In addition, we studied whether patients who were obese or used clozapine had more often abnormal results. Results A half of the sample had 25-hydroxyvitamin D below, and almost one-fourth cholesterol, triglycerides or glucose above the reference range. One-fifth had sodium below and gamma glutamyltransferase above the reference range. NNSAR was highest for potassium (137) and lowest for 25-hydroxyvitamin D (2). DCSAR was below 5euro for glucose, all lipids and sodium, and below 10euro for creatinine and gamma glutamyltransferase. Potassium (130euro), pH-adjusted ionized calcium (33 euro) and thyroid stimulating hormone (33euro) had highest DCSARs. Several abnormal results were more common in obese and clozapine using patients. Conclusions An annual laboratory screening panel for an outpatient with schizophrenia should include fasting glucose, lipids, sodium, creatinine, a liver function test and complete blood count, and preferably 25-hydroxyvitamin D.
  • Högberg, Ulf; Winbo, Jenny; Fellman, Vineta (2019)
    Abstract Aim This population-based study assessed the incidence of rickets in infants up to age of one born in Sweden from 1997-2014. We also examined maternal and perinatal factors and co-morbidity. Methods We used Swedish National Board of Health and Welfare registers and data from Statistics Sweden. The outcome measure was an International Classification of Diseases, Tenth Revision, code for rickets. Results There were 273 cases of rickets, with an incidence of 14.7 per 100,000 and a 10-fold incidence increase between 1997-2014. The majority (78.4%) were born preterm, half were small-for-gestational age (SGA) (birthweight
  • Visuri, Sofia; Kivisaari, Reetta; Jahnukainen, Timo; Taskinen, Seppo (2018)
    Objective To evaluate whether grade 4-5 vesicoureteral reflux (VUR) can be predicted from renal ultrasound (RUS) findings and perform voiding cystourethrograms (VCUGs) only on high-risk patients. Methods The RUS and VCUG images of infants with prenatally detected hydronephrosis admitted to our institution between 2003 and 2013 were re-evaluated. The UTI episodes were collected retrospectively from patient journals. Patients with complex urinary tract anomalies were excluded. Results One hundred eighty, 44 female and 136 male, patients (352 renal units (RU)), 23 (30 RU) of them having grade 4-5 VUR, were included. The median age of the patients at the time of the RUS was 1.3 (0.1-3.0) months and the median follow-up time was 2.0 (0.1-11.2) years. In multivariate analysis, a visible ureter (OR 12.72; CI 5.33-32.04, p <0.001) and shorter renal length (OR 2.67; CR 1.504.86, p <0.001) in RUS predicted grade 4-5 VUR while a visible ureter predicted UTIs (OR 5.75; CI 2.59-12.66, p <0.001). A three-grade risk score for high-grade VUR was developed based on the RUS findings and the patients were categorized into low-, intermediate-, and high-risk groups. The incidence of grade 4-5 VUR was 2.9% in the low-risk, 12.2% in the intermediaterisk, and 52.2% in the high-risk group. The sensitivity and specificity for detecting grade 4-5 VUR were 79 and 82%, respectively. Conclusions In patients with antenatally detected hydronephrosis, a visible ureter and reduced renal length in RUS are significant risk factors for high-grade VUR. A RUS-based risk scoring would probably reduce the proportion of unnecessary VCUGs.
  • EuGMS Special Interest Grp; Alves, Mariana; Fernandes, Marilia Andreia; Bahat, Gülistan; Strandberg, Timo E. (2021)
    Purpose In the pathogenesis of severe COVID-19 complications, derangements of renin-angiotensin-aldosterone system (RAAS), vascular endothelial dysfunction leading to inflammation and coagulopathy, and arrhythmias play an important role. Therefore, it is worth considering the use of currently available drugs to protect COVID-19 patients with cardiovascular diseases. Methods We review the current experience of conventional cardiovascular drugs [angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers, anticoagulants, acetosalicylic acid, antiarrhythmic drugs, statins] as well as some other drug classes (antidiabetic drugs, vitamin D and NSAIDs) frequently used by older patients with cardiovascular diseases. Data were sought from clinical databases for COVID-19 and appropriate key words. Conclusions and recommendations are based on a consensus among all authors. Results Several cardiovascular drugs have a potential to protect patients with COVID-19, although evidence is largely based on retrospective, observational studies. Despite propensity score adjustments used in many analyses observational studies are not equivalent to randomised controlled trials (RCTs). Ongoing RCTs include treatment with antithrombotics, pulmonary vasodilators, RAAS-related drugs, and colchicine. RCTs in the acute phase of COVID-19 may not, however, recognise the benefits of long term anti-atherogenic therapies, such as statins. Conclusions Most current cardiovascular drugs can be safely continued during COVID-19. Some drug classes may even be protective. Age-specific data are scarce, though, and conditions which are common in older patients (frailty, comorbidities, polypharmacy) must be individually considered for each drug group. Key summary pointsAim To review current cardiovascular medications for benefits and potential harms during COVID-19. Findings Several cardiovascular drugs have a potential to protect patients with COVID-19, although evidence is largely based on observational studies and age-specific data are scarce. Message Most current cardiovascular drugs can be safely continued during COVID-19, but general conditions common in older patients must be considered.