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  • 1
    ISSN: 0340-1855
    Keywords: Key words Vitamin D –¶muscle strength – elderly
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary To test the hypothesis that muscle weakness associated with aging is in part due to low serum levels of vitamin D, we investigated the relationship between muscle strength and serum levels of vitamin D metabolites in ambulatory elderly people who were not receiving vitamin D supplementation.¶ We enrolled 319 ambulatory elderly subjects (103 women: mean age 74.2, age range 65–86; 216 men: mean age 76.6, age range 66–95) between April and August 1995. The study design was cross-sectional. Muscle strength was measured as leg extension power in watts (LEP). Mean 25-hydroxyvitamin D serum concentrations were higher in male participants at 36.2ng/ml (range 3.0–85.0) versus 27.4ng/ml (range 5.0–88.0) in female subjects (p=0.008). We found 12 percent of female and 18 percent of male subjects with 25-hydroxyvitamin D values below the lower threshold (〈12ng/ml). Mean 1,25-dihydroxyvitamin D levels were similar in both sexes: 39.8pg/ml (range 15.0–73.0) in women and 37.9pg/ml (range 13.0–69.0) in men. LEP declined with age in women and men (f: r=–0.35, p=0.001; m: r=–0.48, p〈0.0001). Men were significantly stronger than women (p〈0.0001). In men both 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D showed pairwise correlation with LEP (r=0.24; p=0.0004/r=0.14; p=0.045). In women only 1,25-hydroxyvitamin D was significantly correlated with LEP (r=0.22; p=0.03). In ANCOVA, including all participants, explaining LEP by sex (p〈0.0001), age (p〈0.0001), BMI (p=0.013), 1,25-dihydroxyvitamin D (p=0.02), 25-hydroxyvitamin D (p=0.18) and iPTH (p=0.82), all factors showed significant effects except 25-hydoxyvitamin D and iPTH (r2 of the whole model: 0.41).¶ In conclusion our results support the view that, in concert with other factors, deficiency of both 25-hydroxyvitamin D and 1,25-hydroxyvitamin D contributes to the age-related decline in muscle strength. Modest, but significant relationships between 1,25-dihydroxyvitamin D and muscle strength in both sexes, and 25-hydroxyvitamin D in male participants could be documented. Whether the impact of vitamin D on calcium homeostasis and bone mineral density or directly on the muscle tissue level is more important for prevention of hip fractures remains unclear. Further prospective and comparative treatment studies should be performed, in order to evaluate whether and in which dose requirements, vitamin D supplementation can improve muscle strength in the elderly.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1459
    Keywords: Key words Multiple sclerosis ; Haemopoietic stem cell transplantation ; Consensus guidelines
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Recent reports suggest the possible beneficial effects of haemopoietic stem cell transplantation (HSCT) in autoimmune diseases such as multiple sclerosis (MS). The definition of the risk/benefit ratio for such a treatment is perceived as a major issue for the neurological community worldwide. The First Consensus Conference on Bone Marrow Transplantation in Patients with Multiple Sclerosis was held in Milan, Italy on 21 February 1998. Participants from 16 European, North American, and South American countries discussed the guidelines form performing HSCT in MS. This conference was organized in order to : (a) define criteria for patient selection; (b) define transplantation procedures to maximize efficacy of the treatment and minimize its toxicity; (c) standardize patient outcome evaluation; and (d) establish an international working group to evaluate the efficacy and safety of HSCT in MS and to study the immunological changes related to HSCT in MS patients. During the meeting in Milan agreement was reached on: (a) the preparation and distribution of a consensus report on HSCT in MS and (b) the design of an open trial for an initial assessment of the safety and efficacy of HSCT in MS. The consensus reached during the meeting and the design of the clinical trial are summarized in this contribution.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Clinical rheumatology 19 (2000), S. 222-225 
    ISSN: 1434-9949
    Keywords: Key words:Adult-onset Still’s disease – Acute hepatitis – Hyperferritinaemia – Macrophage hyperactivity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: The authors report a case of a young woman with adult-onset Still’s disease (AOSD) with massive hyperferritinaemia who developed acute florid hepatitis with intraparenchymatous histiocytic infiltration following oral iron substitution for presumed iron defiency, which settled on withdrawal of the iron. This suggests that the iron exacerbated the macrophage hyperactivity which is presumed to be present in AOSD. Oral iron substitution in the acute phase of this disease may be inadvisable.
    Type of Medium: Electronic Resource
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