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Correction of Vitamin D Deficiency in Critically Ill Patients Study Protocol
1 VITdAL@ICU - Correction of vitamin D deficiency in critically ill patients VITdAL@ICU Correction of vitamin D deficiency in critically ill patients Study Protocol Version 1.0, 19.02.2010 Original Version Version 2.0, 10.11.2010 Addition of personal variant for 6 – month – follow-up (including assessment of falls and fractures) and data safety review Version 3.0, 17.8.2012 Addition of 24-month follow-up Downloaded From: https://jamanetwork.com/ on 10/01/2021 2 VITdAL@ICU - Correction of vitamin D deficiency in critically ill patients SYNOPSIS Sponsor- Univ.-Prof. Dr. Harald Dobnig Investigator Department of Internal Medicine Division of Endocrinology and Nuclear Medicine Medical University of Graz Tel.: +43/316/385-80252 Email: [email protected] Correction of vitamin D deficiency in critically ill patients: a Title randomized, double-blind, placebo-controlled trial (“VITDAL@ICU”) Background Low vitamin D status is associated with increased mortality, cardiovascular events, diabetes, hypertension and impaired function of the immune and musculoskeletal system in cross-sectional and prospective cohort studies. Given that most critically ill patients are vitamin D deficient, treatment with sufficiently high doses of vitamin D may represent a promising and inexpensive intervention option. To date, no clinical trial has prospectively evaluated clinical outcomes in patients treated with vitamin D in an intensive care setting. Objectives/ Primary endpoint Outcome - hospital stay measures Secondary endpoints - ICU stay - mortality in -
JOHN EVELYN and MEDICINE* by C
JOHN EVELYN AND MEDICINE* by C. D. O'MALLEY JOHN EvELYN has often been described as a virtuoso in the seventeenth-century meaning of that word, and if it be recalled that the Earl of Arundel, the greatest of the virtuosi was his patron, that Evelyn was a member of the Royal Society almost from its inception and a diligent attendant of its meetings, which at that time dealt with a wide variety of curiosa and technological as well as scientific problems, that he was a vocal and literary exponent and collector of the odd and the artistic, and a recognized authority on architecture and gardens, he must certainly be classed among the notable virtuosi of his day. But within his multifarious interests and their related activities Evelyn appears to have had a particular regard for medicine, one that transcended the usual concern of those members of his class who did not espouse that subject professionally. Except for somewhat intermittent studies at Oxford, undertaken more as an obligation than because of genuine desire, medicine was the only discipline in which he deliberately took any formal instruction, and throughout the many years covered by his Diary medicine and matters ancillary to it received uncommon attention." Anyone living in the seventeenth century was very much aware of accident, disease, and ever proximate death. It was quite in the order of things that Evelyn, born in 1620, recalled from his fifth year the severe plague in 1625, its high mortality and the fact, as he later wrote, that he himself 'was shortly after so dangerously sick of a Feavor, that (as I have heard), the Physitians despair'd of me' (ii.7).2 He was fourteen years old when his sister Elizabeth died (ii.12), fifteen at the death of his mother, whose four attending physicians were identified by name in the Diary (ii.14-15), and twenty at the time of his father's death (ii.26). -
Glee: Uma Transmedia Storytelling E a Construção De Identidades Plurais
UNIVERSIDADE FEDERAL DA BAHIA INSTITUTO DE HUMANIDADES, ARTES E CIÊNCIAS PROGRAMA MULTIDISCIPLINAR DE PÓS-GRADUAÇÃO EM CULTURA E SOCIEDADE ROBERTO CARLOS SANTANA LIMA GLEE: UMA TRANSMEDIA STORYTELLING E A CONSTRUÇÃO DE IDENTIDADES PLURAIS Salvador 2012 ROBERTO CARLOS SANTANA LIMA GLEE: UMA TRANSMEDIA STORYTELLING E A CONSTRUÇÃO DE IDENTIDADES PLURAIS Dissertação apresentada ao Programa Multidisciplinar de Pós-graduação, Universidade Federal da Bahia, como requisito parcial para obtenção do título de mestre em Cultura e Sociedade, área de concentração: Cultura e Identidade. Orientador: Prof. Dr. Djalma Thürler Salvador 2012 Sistema de Bibliotecas - UFBA Lima, Roberto Carlos Santana. Glee : uma Transmedia storytelling e a construção de identidades plurais / Roberto Carlos Santana Lima. - 2013. 107 f. Inclui anexos. Orientador: Prof. Dr. Djalma Thürler. Dissertação (mestrado) - Universidade Federal da Bahia, Faculdade de Comunicação, Salvador, 2012. 1. Glee (Programa de televisão). 2. Televisão - Seriados - Estados Unidos. 3. Pluralismo cultural. 4. Identidade social. 5. Identidade de gênero. I. Thürler, Djalma. II. Universidade Federal da Bahia. Faculdade de Comunicação. III. Título. CDD - 791.4572 CDU - 791.233 TERMO DE APROVAÇÃO ROBERTO CARLOS SANTANA LIMA GLEE: UMA TRANSMEDIA STORYTELLING E A CONSTRUÇÃO DE IDENTIDADES PLURAIS Dissertação aprovada como requisito parcial para obtenção do grau de Mestre em Cultura e Sociedade, Universidade Federal da Bahia, pela seguinte banca examinadora: Djalma Thürler – Orientador ------------------------------------------------------------- -
From Confusion to Coma: a Catastrophic Deterioration
52 Postgrad Med J 2001;77:52–55 Postgrad Med J: first published as 10.1136/pmj.77.903.53a on 1 January 2001. Downloaded from SELF ASSESSMENT QUESTIONS From confusion to coma: a catastrophic deterioration K Ashkan, F Johnston Answers on p 56. A previously well 45 year old woman presented ventilated before transfer. On arrival at the to the local casualty department with a one day neurosurgical intensive care unit, she was history of generalised headache, neck stiVness, found to have bilaterally fixed and dilated and blurred vision. On examination she had a pupils, with no corneal or gag reflexes. There temperature of 38°C, a pulse of 80 beats/min, was, however, abnormal flexion of the left and a blood pressure of 130/80 mm Hg. Neu- upper limb. She was given mannitol and urgent rologically, she had spontaneous eye opening repeat CT was carried out (fig 2). An operation and was able to obey commands, although she was then performed, but postoperatively she had confused speech (Glasgow coma scale failed to show any clinical improvement and (GCS), 14). Pupils were equal and reactive died the next day. with no cranial or peripheral neurological defi- cits. Blood tests showed a raised white cell Questions count of 20.9 × 109/l with a neutrophilia (1) What does figure 1 show and what is the (19.2 × 109/l). Computed tomography (CT) of diVerential diagnosis? the brain was performed (fig 1), on the basis of (2) How does figure 2 relate to the change in which the patient was referred to the regional the patient’s clinical condition? neurosurgical unit. -
Hypervitaminosis - an Emerging Pathological Condition
International Journal of Health Sciences and Research www.ijhsr.org ISSN: 2249-9571 Review Article Hypervitaminosis - An Emerging Pathological Condition J K Roop PG Department of Zoology, JC DAV College (Affiliated to Panjab University, Chandigarh), Dasuya-144205, District Hoshiarpur, Punjab, India ABSTRACT Vitamins are essential organic compounds that are required in small amounts to regulate various metabolic activities in the body. Prolonged and overconsumption of pharmaceutical forms of both water-soluble and fat-soluble vitamins may lead to toxicity and/or hypervitaminosis. Hypervitaminosis is an acute emerging pathological condition of the body due to excess accumulation of any of the vitamins. In case of acute poisoning with vitamin supplements/drugs, emergency assistance is required to detoxify the effects and restore the organization, structure and function of body’s tissues and organs. Sometimes death may occur due to intoxication to liver, kidney and heart. So, to manage any type of hypervitaminosis, proper diagnosis is essential to initiate eliminating the cause of its occurrence and accelerate the elimination of the supplement from the body. The present review discusses the symptoms of hypervitaminosis that seems to be a matter of concern today and management strategies to overcome toxicity or hypervitaminosis. Keywords: Hypervitaminosis, Toxicity, Vitamins, Vitamin pathology, Fat-soluble vitamin, Water- soluble vitamin. INTRODUCTION body, particularly in the liver. Vitamin B Vitamins are potent organic Complex and vitamin C are water- soluble. compounds present in small concentrations They are dissolved easily in food during in various fruits and vegetables. They cooking and a portion of these vitamins may regulate physiological functions and help in be destroyed by heating. -
History of Medicine in the City of London
[From Fabricios ab Aquapendente: Opere chirurgiche. Padova, 1684] ANNALS OF MEDICAL HISTORY Third Series, Volume III January, 1941 Number 1 HISTORY OF MEDICINE IN THE CITY OF LONDON By SIR HUMPHRY ROLLESTON, BT., G.C.V.O., K.C.B. HASLEMERE, ENGLAND HET “City” of London who analysed Bald’s “Leech Book” (ca. (Llyn-din = town on 890), the oldest medical work in Eng the lake) lies on the lish and the textbook of Anglo-Saxon north bank of the leeches; the most bulky of the Anglo- I h a m e s a n d Saxon leechdoms is the “Herbarium” stretches north to of that mysterious personality (pseudo-) Finsbury, and east Apuleius Platonicus, who must not be to west from the confused with Lucius Apuleius of Ma- l ower to Temple Bar. The “city” is daura (ca. a.d. 125), the author of “The now one of the smallest of the twenty- Golden Ass.” Payne deprecated the un nine municipal divisions of the admin due and, relative to the state of opin istrative County of London, and is a ion in other countries, exaggerated County corporate, whereas the other references to the imperfections (super twenty-eight divisions are metropolitan stitions, magic, exorcisms, charms) of boroughs. Measuring 678 acres, it is Anglo-Saxon medicine, as judged by therefore a much restricted part of the present-day standards, and pointed out present greater London, but its medical that the Anglo-Saxons were long in ad history is long and of special interest. vance of other Western nations in the Of Saxon medicine in England there attempt to construct a medical litera is not any evidence before the intro ture in their own language. -
Simulation of Physicochemical and Pharmacokinetic Properties of Vitamin D3 and Its Natural Derivatives
pharmaceuticals Article Simulation of Physicochemical and Pharmacokinetic Properties of Vitamin D3 and Its Natural Derivatives Subrata Deb * , Anthony Allen Reeves and Suki Lafortune Department of Pharmaceutical Sciences, College of Pharmacy, Larkin University, Miami, FL 33169, USA; [email protected] (A.A.R.); [email protected] (S.L.) * Correspondence: [email protected] or [email protected]; Tel.: +1-224-310-7870 or +1-305-760-7479 Received: 9 June 2020; Accepted: 20 July 2020; Published: 23 July 2020 Abstract: Vitamin D3 is an endogenous fat-soluble secosteroid, either biosynthesized in human skin or absorbed from diet and health supplements. Multiple hydroxylation reactions in several tissues including liver and small intestine produce different forms of vitamin D3. Low serum vitamin D levels is a global problem which may origin from differential absorption following supplementation. The objective of the present study was to estimate the physicochemical properties, metabolism, transport and pharmacokinetic behavior of vitamin D3 derivatives following oral ingestion. GastroPlus software, which is an in silico mechanistically-constructed simulation tool, was used to simulate the physicochemical and pharmacokinetic behavior for twelve vitamin D3 derivatives. The Absorption, Distribution, Metabolism, Excretion and Toxicity (ADMET) Predictor and PKPlus modules were employed to derive the relevant parameters from the structural features of the compounds. The majority of the vitamin D3 derivatives are lipophilic (log P values > 5) with poor water solubility which are reflected in the poor predicted bioavailability. The fraction absorbed values for the vitamin D3 derivatives were low except for calcitroic acid, 1,23S,25-trihydroxy-24-oxo-vitamin D3, and (23S,25R)-1,25-dihydroxyvitamin D3-26,23-lactone each being greater than 90% fraction absorbed. -
Question of the Day Archives: Monday, December 5, 2016 Question: Calcium Oxalate Is a Widespread Toxin Found in Many Species of Plants
Question Of the Day Archives: Monday, December 5, 2016 Question: Calcium oxalate is a widespread toxin found in many species of plants. What is the needle shaped crystal containing calcium oxalate called and what is the compilation of these structures known as? Answer: The needle shaped plant-based crystals containing calcium oxalate are known as raphides. A compilation of raphides forms the structure known as an idioblast. (Lim CS et al. Atlas of select poisonous plants and mushrooms. 2016 Disease-a-Month 62(3):37-66) Friday, December 2, 2016 Question: Which oral chelating agent has been reported to cause transient increases in plasma ALT activity in some patients as well as rare instances of mucocutaneous skin reactions? Answer: Orally administered dimercaptosuccinic acid (DMSA) has been reported to cause transient increases in ALT activity as well as rare instances of mucocutaneous skin reactions. (Bradberry S et al. Use of oral dimercaptosuccinic acid (succimer) in adult patients with inorganic lead poisoning. 2009 Q J Med 102:721-732) Thursday, December 1, 2016 Question: What is Clioquinol and why was it withdrawn from the market during the 1970s? Answer: According to the cited reference, “Between the 1950s and 1970s Clioquinol was used to treat and prevent intestinal parasitic disease [intestinal amebiasis].” “In the early 1970s Clioquinol was withdrawn from the market as an oral agent due to an association with sub-acute myelo-optic neuropathy (SMON) in Japanese patients. SMON is a syndrome that involves sensory and motor disturbances in the lower limbs as well as visual changes that are due to symmetrical demyelination of the lateral and posterior funiculi of the spinal cord, optic nerve, and peripheral nerves. -
D-L Alvarez B
! D-L Alvarez b. 1966 Lives and works in Berlin, Germany Solo Exhibitions 2015 The Children’s Hour, [2nd Floor Projects], San Francisco, CA 2014 D-L Alvarez and Eileen Maxson, Artadia Gallery, New York, NY 2013 The Unforgiving Minute, Derek Eller Gallery, New York, NY 2012 D-L Alvarez: MATRIX 243, Berkley Art Museum, Berkley, CA 2011 Galeria Casado Santapau, Madrid, Spain 2009 Dusty Hayes, 2nd Floor Projects, San Francisco, CA 2008 Dead Leafs, Galeria Casado Santapau, Madrid, Spain 2007 Parents' Day, Derek Eller Gallery, New York, NY DIG, with Wayne Smith, Derek Eller Gallery (project room), New York, NY 2006 Casper, (with Matthew Lutz-Kinoy), A +B Arratiabeer, Berlin, Germany, 2005 rise, Derek Eller Gallery, New York, NY Ice, Glue, Berlin, Germany 2004 Beausoleil, Derek Eller Gallery, New York, NY 2002 The Road to Hell Less Traveled, Derek Eller Gallery, New York, NY 2000 Sculpture Garden, Derek Eller Gallery, New York, NY ! ! 1999 Chorus, John Berggruen Gallery, San Francisco, CA 1998 Knights Gathering Flowers, Derek Eller Gallery, New York, NY Dust, Th.e (Theoretical Events), Naples, Italy 1995 Dandylion, Jack Hanley Gallery, San Francisco, CA A Shepherd and His Flock, London Projects, London, UK 1994 Night of the Hunter, Kiki, San Francisco, CA 1990 Political Stance, (installation documenting performance), ATA, San Francisco, CA 1989 Elvis Clocked, Les Indes Galantes, Paris, France Group Exhibitions 2017 Drawings from the Collection: 1980 to Today, San Francisco Museum of Modern Art, San Francisco, CA 2016 Subject To Capital, Henry -
Draft Vitamin D and Health Report
Draft Vitamin D and Health report Scientific consultation: 22 July to 23 September 2015 Contents Page 1. Introduction 3 2. Biology and metabolism 5 3. Photobiology of vitamin D 16 4. Measuring vitamin D exposure (from diet and sunlight) 24 5. Relationship between vitamin D exposure and serum (25(OH)D concentration 29 6. Vitamin D and health outcomes 35 Musculoskeletal outcomes 37 Rickets 39 Osteomalacia 41 Pregnancy and lactation 42 Infants (up to 12 months) 44 Children (1-3y) 45 Children (4-8y) 45 Adults < 50 years 47 Adults > 50 years 50 Conclusions – vitamin D & musculoskeletal health outcomes 59 Non-musculoskeletal health outcomes 61 Pregnancy & lactation – non-musculoskeletal health outcomes 61 Cancers 67 Cardiovascular disease & hypertension 70 All-cause mortality 74 Autoimmune disease 76 Infectious disease 81 Neuropsychological functioning 85 Oral health 88 Age-related macular degeneration 90 Conclusions – non-musculoskeletal health outcomes 92 Selection of health outcomes to inform the setting of DRVs for vitamin D 93 7. Potential adverse effects of high vitamin D intakes/high serum 25(OH)D 95 concentration 8. Dietary vitamin D intakes and serum/plasma 25(OH)D concentrations of the UK 102 population 9. Review of DRVs 109 10. Overall summary & conclusions 121 11. Recommendations 130 12. References 131 2 1. Introduction Background 1. Vitamin D is synthesised in the skin by the action of sunlight. Skin synthesis is the main source of vitamin D for most people; dietary sources are essential when exposure to sunlight containing the appropriate wavelength is limited. The Committee on Medical Aspects of Food and Nutrition Policy (COMA), which set Dietary Reference Values (DRVs) for vitamin D in 1991 (DH1, 1991), did not set a Reference Nutrient Intake (RNI2) for groups in the population considered to receive adequate sunlight exposure. -
The Dissenting Tradition in English Medicine of the Seventeenth and Eighteenth Centuries
Medical History, 1995, 39: 197-218 The Dissenting Tradition in English Medicine of the Seventeenth and Eighteenth Centuries WILLIAM BIRKEN* In England, medicine has always been something of a refuge for individuals whose lives have been dislocated by religious and political strife. This was particularly true in the seventeenth century when changes in Church and State were occurring at a blinding speed. In his book The experience of defeat, Christopher Hill has described the erratic careers of a number of radical clergy and intellectuals who studied and practised medicine in times of dislocation. A list pulled together from Hill's book would include: John Pordage, Samuel Pordage, Henry Stubbe, John Webster, John Rogers, Abiezer Coppe, William Walwyn and Marchamont Nedham.1 Medicine as a practical option for a lost career, or to supplement and subsidize uncertain careers, can also be found among Royalists and Anglicans when their lives were similarly disrupted during the Interregnum. Among these were the brilliant Vaughan twins, Thomas, the Hermetic philosopher, and Henry, the metaphysical poet and clergyman; the poet, Abraham Cowley; and the mercurial Nedham, who was dislocated both as a republican and as a royalist. The Anglicans Ralph Bathurst and Mathew Robinson were forced to abandon temporarily their clerical careers for medicine, only to return to the Church when times were more propitious. In the middle of the eighteenth century the political and religious disabilities of non-juring Anglicanism were still potent enough to impel Sir Richard Jebb to a successful medical career. But by and large the greatest impact on medicine came from the much larger group of the displaced, the English Dissenters, whose combination of religion and medicine were nothing short of remarkable. -
Kevin Mchale (Actor) Филм ÑпиÑък
Kevin McHale (actor) Филм ÑÐ ¿Ð¸ÑÑ ŠÐº (ФилмографиÑ) Rumours https://bg.listvote.com/lists/film/movies/rumours-2604427/actors Born This Way https://bg.listvote.com/lists/film/movies/born-this-way-2981342/actors https://bg.listvote.com/lists/film/movies/1065736/actors The Rocky Horror https://bg.listvote.com/lists/film/movies/the-rocky-horror-glee-show-2981329/actors Glee Show Showmance https://bg.listvote.com/lists/film/movies/showmance-2445773/actors Original Song https://bg.listvote.com/lists/film/movies/original-song-2600913/actors The Rhodes Not https://bg.listvote.com/lists/film/movies/the-rhodes-not-taken-2421156/actors Taken The Substitute https://bg.listvote.com/lists/film/movies/the-substitute-2982113/actors Acafellas https://bg.listvote.com/lists/film/movies/acafellas-517180/actors Special Education https://bg.listvote.com/lists/film/movies/special-education-2600265/actors Vitamin D https://bg.listvote.com/lists/film/movies/vitamin-d-2567406/actors Funeral https://bg.listvote.com/lists/film/movies/funeral-2604071/actors Duets https://bg.listvote.com/lists/film/movies/duets-2981365/actors Grilled Cheesus https://bg.listvote.com/lists/film/movies/grilled-cheesus-2981357/actors Furt https://bg.listvote.com/lists/film/movies/furt-2599821/actors The Break Up https://bg.listvote.com/lists/film/movies/the-break-up-1524605/actors The Role You Were https://bg.listvote.com/lists/film/movies/the-role-you-were-born-to-play-1704325/actors Born to Play Old Dog New Tricks https://bg.listvote.com/lists/film/movies/old-dog-new-tricks-16746534/actors