Diagnosis Of Vitamin Research Articles

8706 Hypoparathyroidism and Hypercalcemia in Premature Secondary to Excessive Vitamin D: Everything in Excess is Opposed

Abstract Disclosure: D.M. Bastos: None. A. Bastos: None. Introduction: Vitamin D intoxication in children is rare but its incidence is increasing as vitamin D is supplemented more often and in higher doses. Coma, ventricular fibrillation, and acute renal insufficiency are possible life-threatening presentations of vitamin D-induced hypercalcemia. Nephrocalcinosis, renal lithiasis, vascular calcifications, and arterial hypertension are known late complications of severe or longstanding hypercalcemia. The most common causes of vitamin D intoxication in children are manufacturing errors, parental dosing errors, and erroneous medical prescriptions. Case Presentation: A premature girl admitted to the neonatal ICU 3 months ago due to poor weight gain and was taking vitamin D and infant formulas and developed tachycardic heart rhythm with irregular rhythm and kidney changes. The investigation of the condition was re-evaluated, and the patient was seen with hypercalcemia, an increase of more than 100x in the dosage of 25(OH)vitamin D, an increase in the dosage of 1.25(OH)vitamin D, suppressed PTH, an increase in creatinine and urea. In addition, an ultrasound was performed showing the presence of small kidney stones, none of which were obstructive. After discontinuing vitamin D supplementation, the patient progressed satisfactorily with a reduction in cardiac and renal changes. Discussion: Currently, vitamin D supplementation has been carried out more frequently, as, in addition to increasing the absorption of calcium in the body, it reduces the risk of diseases, such as rickets and osteopenia of prematurity. The body is only able to produce vitamin D after exposure to sunlight. In the absence of regular exposure, dietary sources alone are not sufficient to maintain adequate levels. Cases of hypervitamin D generally occur in situations of excessive supplementation. In the present report, the dose used was 40 times higher than recommended. Initial tests revealed elevated calcium and undetectable PTH levels. The diagnosis of vitamin D intoxication is not common in cases of hypercalcemia, as it is infrequent, especially before the advent of vitamin D supplementation. Vitamin D toxicity is usually iatrogenic, or due to accidental overdose. These factors, along with a lack of public education about safe dosing, have likely contributed to the increase in reported cases of vitamin D toxicity. Conclusion: Vitamin D supplementation, especially when using compounded medications, must be adequately monitored due to the potential risk of poisoning. Vitamin D toxicity remains a pressing issue and its incidence will likely continue to grow, primarily because of the widespread availability of over-the-counter formulations and public interest. Presentation: 6/3/2024

Un paziente scorbu… tico con dolore, edema e petecchie agli arti inferiori…

The diagnosis of vitamin C deficiency was eventually made in an autistic child complaining about leg pain.

Vitamin D deficiency in Scheuermann's disease is associated with increased adverse outcomes.

Scheuermann's disease is a diagnosis of hyperkyphosis commonly encountered in pediatric patients. Studies in animal models suggest an association with vitamin D deficiency, however, extensive studies have not been performed in humans. This study analyzes the role of vitamin D deficiency on unfavorable results in patients with Scheuermann's disease. The TriNetX database was utilized to perform a retrospective analysis. Patients in the United States aged 0-18years with Scheuermann's disease were identified using International Classification of Diseases, Tenth Revision (ICD-10) codes and categorized into those with and without a diagnosis of vitamin D deficiency. Comparison of patient groups depending on age, sex, ethnic origin, prior diagnosis of fibromyalgia, anxiety disorder, myositis, and major depressive disorder. Statistical analysis was conducted to identify the association between vitamin D levels and unfavorable results including pain, depression, suicide attempt, emergency department (ED) consult, hospitalization, and procedures on the spine or spinal cord. In total, 11,277 patients were identified, 39% of whom had a concurrent diagnosis of scoliosis. A total of 1,024 (9.08%) were deficient in vitamin D. Patients with vitamin D deficiency had greater odds of pain (P<0.0001), depression (P<0.0001), suicide attempt (P=0.0021), ED visits (P=0.0246), and hospital admission (P<0.0015). Conversely, patients with vitamin D deficiency had decreased odds of surgery on the spine or spinal cord (P=0.0009). Vitamin D deficiency is associated with an elevated risk of pain, depression, suicide attempts, ED visits, and hospitalization. Our analysis highlights the need for more research to study the effect of vitamin D on Scheuermann's disease. Level III, Prognostic.

Out-of-pocket health expenditures in patients living with ınborn errors of metabolism

AimThe implementation of newborn screening programs for inborn errors of metabolism has advanced the diagnosis and management of affected infants and undoubtedly improved their outcomes. We aimed to determine out-of-pocket health expenditures of patients with inborn errors of metabolism during follow-up and treatment processes and to determine the economic burden on the families.Materials and methodsA total of 232 patients who voluntarily agreed to participate in the study and were regularly followed up in the Department of Pediatric Metabolism with the diagnosis of Inborn Errors of Metabolism between April 2022 and July 2022 were included. Questionnaires were asked about the demographic characteristics of patients, use of health services, follow-up, treatment procedures, frequency of controls and health expenditures.ResultsThe average out-of-pocket expenditure of the households in the last month was 1039.22 ± 1030.08 (minimum: 20, maximum: 5000) Turkish Liras. When we consider the catastrophic health expenditure rate as expenditure exceeding 40% of household income, we found that 9.9% (23 people) of parents included in the study made catastrophic health expenditures. The rate of catastrophic expenditure of patients with a diagnosis of Amino Acid Metabolism Disorders was found to be higher than that of patients with a diagnosis of Vitamin and Cofactor Metabolism Disorders. Similarly, patients with a diagnosis of lysosomal storage diseases had more expenditures than patients with a diagnosis of vitamin and cofactor metabolism disorders. When we compared the rate of catastrophic health expenditure of the patients with urea cycle disorders and the patients with a diagnosis of vitamin and cofactor metabolism disorders, the former had more expenditure than the latter (p < 0.05). There was no significant difference between other disease groups in terms of catastrophic expenditure. The rate of catastrophic expenditures of the households living as large family type were higher than the families living as nuclear family type (p < 0.01). A statistically significant difference was found between the rates of catastrophic expenditures of the families living in Ankara and those who were admitted from other provinces for follow-up and treatment (p < 0.001). However, there was no difference between the rates of catastrophic expenditure of the patients who received any treatment and those who were followed up without treatment (p > 0.05).ConclusionDue to the high rate of consanguineous marriages in our country, the development of newborn screening programs, the increase in awareness about metabolic diseases and the improvement in diagnostic methods, the frequency of metabolic diseases is increasing, and mortality and morbidity rates are significantly reduced with early diagnosis and treatment opportunities. It is necessary to carry out more comprehensive studies to determine and prevent the socioeconomic effects of out-of-pocket health expenditures of patients living with Inborn Errors of Metabolism.

A Diagnosis of Vitamin D Deficiency Is Associated With Increased Rates of Primary Patellar Instability and Need for Recurrent Surgical Stabilization.

Vitamin D has been proven experimentally to affect musculoskeletal health. The purpose of this study was to identify the relationship between vitamin D deficiency and patellar instability. Vitamin D deficiency is associated with an increased risk of experiencing primary patellar instability and recurrent patellar dislocation after primary surgical stabilization. Retrospective comparative study. Level 3. A 1:1 matched retrospective study of 328,011 patients diagnosed with vitamin D deficiency was performed using the PearlDiver database. Incidence of primary patellar instability was calculated according to sex and age. Rates of primary patellar instability and surgical stabilization for recurrent dislocation were calculated with sex- and age-specific stratifications. Multivariable logistic regression was used to compare the rates of primary injury and recurrent stabilization while controlling for demographics and medical comorbidities. A total of 656,022 patients were analyzed. The overall 1-year incidence rate of patellar instability in patients with vitamin D deficiency was 82.6 per 100,000 person-years (95% CI, 73.2-92.9), compared with 48.5 (95% CI, 41.4-56.5) in the matched control. Women were significantly more likely to experience primary patellar instability within 1 (adjusted odds ratio [aOR] = 1.45; 95% CI, 1.12-1.88) and 2 years (aOR, 1.31; 95% CI, 1.07-1.59) of hypovitaminosis D diagnosis. Patients aged 10 to 25 years with hypovitaminosis D were at greater risk of requiring recurrent patellar stabilization for both men (aOR, 2.48; 95% CI, 1.06-5.80) and women (aOR, 1.77; 95% CI, 1.04-3.02). Patients diagnosed with vitamin D deficiency experienced higher rates of primary patellar instability and have greater risk of requiring recurrent surgical stabilization for subsequent dislocations. These results suggest that monitoring and proactively treating vitamin D deficiency in the physically active patient may lower the risk of suffering primary patellar instability or recurrence after surgical stabilization.

A Diagnosis of Vitamin D Deficiency Is Associated With Increased Rates of Anterior Cruciate Ligament Tears and Reconstruction Failure

To characterize the association between a diagnosis of hypovitaminosis D and primary anterior cruciate ligament (ACL) tear, primary anterior cruciate ligament reconstruction (ACLR), and revision ACLR in different sex and age cohorts. In this retrospective cohort study of the PearlDiver claims database, records were queried between January 1, 2011, and October 31, 2018 for all patients aged 10 to 59 years who received a diagnosis of hypovitaminosis D. Rates of primary ACL tears, primary reconstruction, and revision reconstruction were calculated for sex- and age-specific cohorts and compared with a control of patients without a diagnosis of hypovitaminosis D. Incidence rates for primary ACL injuries were calculated, and multivariable logistic regression was used to compare rates of ACL injury, primary reconstruction, and revision reconstruction while controlling for age, sex, Charlson Comorbidity Index, and several other comorbidities. Among the 328,011 patients (mean age 41.9 ± 12.6 years, 65.8% female) included in both the hypovitaminosis D and control cohorts, the incidence of ACL tears was 115.2 per 100,000 person-years (95% confidence interval [CI] 107.2-123.7) compared with 61.0 (95% CI 55.2-67.2) in the demographic- and comorbidity-matched control cohort. The study cohort was significantly more likely to suffer an ACL tear over a 1- (aOR 1.67, 95% CI 1.41-1.99, P < .001) and 2-year (aOR 1.81, 95% CI 1.59-2.06, P < .001) period. This trend remained for both male patients at the 1- (aOR 1.66, 95% CI 1.29-2.14, P < .001) and 2-year (aOR 1.68, 95% CI 1.37-2.06, P < .001) mark and female patients at the 1- (aOR 1.69, 95% CI 1.33-2.14, P < .001) and 2-year (aOR 1.80, 95% CI 1.51-2.14, P < .001) mark. Finally, patients with vitamin D deficiency had a significantly increased likelihood of undergoing a revision ACLR within 2 years of a primary reconstruction (aOR 1.28, 95% CI 1.05-1.55, P= .012). This study reports an association between patients previously diagnosed with hypovitaminosis D and significantly increased rates of both index ACL tears (81% increase within 2 years of diagnosis) and revision ACLR (28% within 2 years). These results identify a population with increased odds of injury and provide valuable knowledge as we expand our understanding of the relationship between vitamin D and musculoskeletal health. Level III, retrospective database study.

Frattura e rachitismo in un’adolescente

The diagnosis of vitamin D deficiency (rickets) was finally made in a 13-year-old Pakistani girl who had fallen victim of bullying and social isolation during lockdown and who presented with multiple osteolytic femoral lesions.

Diagnosis of vitamin B deficiencies inducing inherited metabolic diseases (IMD) using GC-MS

Diagnosis of vitamin B deficiencies inducing inherited metabolic diseases (IMD) using GC-MS

Lower-Than-Expected Vitamin A Concentrations in a Commercial Diet Associated with Uroliths and Pyelonephritis in Rats.

Simple SummaryRats are often used to screen new foods or medications to ensure they are safe for human consumption. As the presence of lesions in a rat in such a study could indicate toxicity, it is essential that rats do not develop background lesions due to other diseases. In the present report, around 5% of rats in an oral safety study developed uroliths, with two of the affected rats also developing kidney infections. Histology was suggestive of vitamin A deficiency. Analysis of the food revealed much lower levels of vitamin A than stated on the label, but enough vitamin A to meet the published minimal nutritional requirements of rats. When the study was continued using rats fed food from a different source, no urinary tract lesions were observed. This suggests dietary factors may have caused the development of the uroliths in this case. It is hypothesized that the lower-than-expected concentration of vitamin A in the diet, potentially along with other dietary and environmental factors, resulted in squamous metaplasia of the uroepithelium and subsequent uroliths and pyelonephritis. The observations highlight the need to use high-quality diets for safety studies in rats.Five of 95 rats in an oral safety study developed uroliths, with two of these rats also developing pyelonephritis. Histology of the urinary tract revealed squamous metaplasia suggestive of vitamin A deficiency. Analysis of the diet showed around half the expected concentration of vitamin A, although the concentrations were close to the published nutritional requirements for rats. Due to the presence of squamous metaplasia of the transitional epithelium and the low vitamin A concentration in the diet, a presumptive diagnosis of vitamin A deficiency was made, although an interaction between the low vitamin A concentrations and other dietary components appears possible. Although the uroliths did not cause clinical signs of disease, the lesions observed during this study could have been misinterpreted as being due to the test substance. Observations from this study highlight the need for high-quality food to ensure background lesions do not develop when performing safety studies in rats.

A Case of Late-Onset Vitamin K Deficiency Bleeding in an Exclusively Breastfed Infant Emphasizing the Need for Revision of Vitamin K Prophylaxis Policy

A 4-month-old male child presented with a history of seizure and vomiting. There was no history of fever, fall, or any other trauma. On examination, there was anisocoria, and anterior fontanelle was bulging and nonpulsating. Computerized tomography revealed an acute on chronic bilateral subdural hematoma (left &gt; right) with a midline shift. He had no relevant past or family history suggestive of any bleeding disorder. Blood investigations revealed anemia with prolonged prothrombin time (PT)/international normalized ratio/and activated partial thromboplastin time (APTT). Mixing study was done and it showed a correction with pooled normal plasma. The possibility of coagulation factor deficiency was confirmed. Further, mixing studies and factor assays revealed normal levels of fibrinogen and Factor VIII, with a reduced level of Factor IX. Since both PT and APTT were prolonged and Factor IX level was low, a deficiency of Vitamin K-dependent coagulation factors was suspected. The child was immediately given intravenous Vitamin K injection. The diagnosis of Vitamin K deficiency bleeding (VKDB) was confirmed by protein induced by Vitamin K absence testing. Unfortunately, the child succumbed to the complications of the intracranial bleed.

Is 1,25 Dihydroxy vitamin D Measurement Useful for the Diagnosis of Vitamin D Deficiency in Early Pregnancy?

Is 1,25 Dihydroxy vitamin D Measurement Useful for the Diagnosis of Vitamin D Deficiency in Early Pregnancy?

Laboratory Parameters of Bone Metabolism in Premature Infants and Children Born Using In Vitro Fertilization

Aim. To study the indicators of bone metabolism in premature babies born naturally and children born with IVF. Material and methods. The premature babies’ study was conducted, they were divided into 4 groups: depending on the method of birth and weight: 1st-children born with IVF, with very low weight; the second group – similar to the first, but children with extremely low weight; the third – children with very low weight, born naturally, with ; the fourth – similar to the 3rd, but with extremely low weight. The level of calcium, parathyroid hormone, calcitonin and C-terminal telopeptides of type I collagen was determined. Results and discussion. Diagnosis of vitamin D deficiency is possible only by measuring certain biochemical parameters, primarily the levels of its metabolites in the blood. Clinical symptoms of vitamin D deficiency in the form of rickets, osteomalacia, osteoporosis and extra-skeletal manifestations as a result of this vitamin deficiency occur over a long period of time. The most informative indicator of the body’s vitamin D supply is the content of calcidiol [25 (OH)D] in both serum and blood plasma. Vitamin D deficiency was detected in more than half (67.7±4.8%) of premature newborns in the first year of life. It seemed that in premature babies born in different ways, vitamin D deficiency was noted in 8 %, insufficiency – in 67.7 %, and the normal content in 27.5 %. In children at an early age, there is a violation of bone metabolism (an increase in the level of calcium, parathyroid hormone, calcitonin, on the one hand, and a decrease in the C-terminal telopeptides of type I collagen, on the other). These changes were associated with the weight of children, while aggressive disorders were noted in children with extremely low weight. In premature infants (with a body weight of less than 1500 g), monitoring of the level of vitamin D in the blood and C-terminal telopeptides of type 1 collagen should be recommended. Conclusion. Bone modeling has a great advantage due to the analysis of the blood serum biomarkers levels in premature infants, it enables to establish the features of osteogenesis.

Disturbo della condotta alimentare, ecchimosi e carenza di vitamina C

The paper presents the case of a 16-year-old girl with a 6-month history of eating disorder, restrictive subtype and diffuse ecchymosis. Anamnestic history and laboratory investigations allowed excluding coagulation disorders and making the diagnosis of vitamin C deficiency. Vitamin C deficiency is a rare disease but still sporadically described in children with unusual eating habits.

Статус вітаміну D у населення Буковини і Прикарпаття залежно від місця проживання над рівнем моря

Попри певні відмінності у визначенні порогової величини вітаміну D для діагностування його дефіциту у різних країнах, очевидним є факт, що практично в усіх регіонах світу реєструють субоптимальні рівні 25(ОН)D у широких верств населення. При цьому в проведених дослідженнях детально не аналізувався статус вітаміну D залежно від розташування місця проживання над рівнем моря. Мета дослідження: визначити рівень вітаміну D у сироватці крові серед осіб, які проживають у різних регіонах Прикарпаття і Буковини, залежно від розташування населеного пункту над рівнем моря. Матеріал і методи. В одномоментному дослідженні обстежені 353 особи віком від 18 до 86 років, які постійно проживають у різних регіонах Прикарпаття (Коломийський, Косівський, Верховинський райони) і Буковини (Вижницький район). Результати. Лише у 28 випадках (7,9 %) вміст 25(ОН)D у сироватці крові перебував у межах норми, а в інших випадках (92,1 %) спостерігали дефіцит і недостатність вітаміну D. При цьому тяжка форма дефіциту вітаміну D спостерігалася у 7 (1,9 %) обстежених. При порівнянні показників 25(ОН)D у регіонах обстеження було встановлено, що рівень вітаміну D у сироватці був вірогідно вищим у мешканців Верховинського та Косівського районів (розташовані на висоті більше ніж 450 м над рівнем моря) порівняно з жителями Вижниці та Коломиї. Висновок. Середній рівень вітаміну D у сироватці крові дорослої популяції залежить від місця проживання та підвищується зі збільшенням висоти над рівнем моря.

Plasma Calcifedol Concentration as a Marker of Vitamin D Deficiency in Newborns with Congenital Malformations

Diagnosis of vitamin D deficiency and its management is the most difficult problem of modern neonatology.The objective: to study the concentration of 25(OH)D3 in newborns of St. Petersburg depending on the presence of congenital malformations (CM).Subjects and methods. 60 newborns were examined, their gestational age made 39.4 (38-41) weeks. Children were divided into 2 groups: Group 1 – healthy children, Group 2 – children with CM.Results. Regardless of the presence of CM, the calcifedol plasma concentration was below 15 ng/ml. It was found that children with CM whose plasma calcifedol concentration was below 8.0 ng/ml needed long-term invasive mechanical ventilation (80.0 vs 40.0 hours; p &lt; 0.005) and longer treatment in ICU (7.0 vs 4.0; p &lt; 0,002). Negative correlations were revealed between calcifedol concentration, duration of narcotic analgesics administration (R = -0.44; p = 0.01), duration of mechanical ventilation (R = -0.49; p = 0.003) and stay in ICU (R = -0.54; p = 0.001).Conclusion. The most pronounced deficiency of calcifedol was in children with severe CM requiring long-term treatment in ICU.

Personalising laboratory medicine in the 'real world': Assessing clinical utility, by clinical indication, of serum total B12 and Active-B12® (holotranscobalamin) in the diagnosis of vitamin B12 deficiency.

BackgroundAssessing the pre- and post-test probability of disease in the context of routine health care is challenging. We wished to study how test performance parameters relating to clinical utility vary by clinical indication in a ‘real-world’ setting.MethodsThe diagnostic accuracy of serum total B12 and Active-B12® (holotranscobalamin) was evaluated in a primary care population, using serum methylmalonic acid as the reference standard. We used electronic requesting to establish the clinical indication for each request. Routine requests from primary care for serum total B12 were included if creatinine was also measured and estimated glomerular filtration rate was at least 60 mL/min/1.73 m2.ResultsClinical indications included peripheral neuropathy (n = 168), anaemia (n = 168), cognitive decline (n = 125), suspected dietary deficiency (n = 76), other (n = 362). For peripheral neuropathy, the area under the receiver operator curve ± 95% confidence interval (AUC ± CI) was 0.63 (0.54–0.71) (P = 0.002) for total B12 and 0.68 (0.60–0.77) (P < 0.0001) for Active-B12®. For anaemia, AUC ± CI was 0.56 (0.47–0.66) (P = 0.10) for total B12 and 0.69 (0.59–0.78) (P < 0.0001) for Active-B12®. For cognitive decline, AUC ± CI was 0.54 (0.43–0.65) (P = 0.26) for total B12 and 0.69 (0.58–0.80) (P = 0.0002) for Active-B12®. The pre–post-test change in probability of disease varied by clinical indication.ConclusionCombining diagnostic accuracy studies and electronic testing in a ‘real-world’ setting allows clinical utility to be assessed by clinical indication. Wider application of this would permit more personalised laboratory medicine. In this study, diagnostic performance of total B12 and Active-B12® varied across all indications. Active-B12® provided better discrimination, but this may have reflected the cut-offs used.

Case 1: A Term Neonate with Conjunctival Hemorrhage, Ecchymoses, and Umbilical Hematoma

A term male neonate with a birthweight of 3,350 g is born via emergency cesarean delivery for the indication of abruptio placenta. The mother is a booked and immunized, gravida 4, para 3 woman with normal platelet counts and an uneventful antenatal course. The neonate was conceived spontaneously in a nonconsanguineous marriage and the family history is nonsignificant. The neonate has a normal transition after birth, is given a 1-mg intramuscular injection of vitamin K in the right thigh; he rooms in with the mother and is exclusively breastfed. Around 48 hours after birth, the neonate is noted to have bilateral conjunctival hemorrhages, ecchymoses on the face and trunk/back, boggy swelling over the scalp, and umbilical cord hematoma (Figs 1, 2 and 3). The neonate is noted to have pallor, but his vital sign parameters are normal (heart rate 140 beats/min, respiratory rate 40 breaths/min, temperature 98.6oF [37oC], capillary refill time <2 seconds, and oxygen saturation 96% in room air). There is no history of hematemesis, hematuria, or bleeding per rectum. Figure 1. Conjunctival hemorrhage. Figure 2. Ecchymoses on the face. Figure 3. Umbilical hematoma. ### Progression With a provisional clinical diagnosis of vitamin K deficiency bleeding (VKDB), the neonate is given a repeat 1-mg intramuscular injection of vitamin K and evaluated for the cause of the bleeding manifestations. Laboratory investigations reveal a hemoglobin of 6.4 …

Vitamin D: why does the body need it? The Importance of Controlling Vitamin D Levels All Year Round

Recently, there has been a growing amount of scientific information about the role of vitamin D in the body and the serious consequences of its deficiency. The article is structured in the form of questions and answers and focuses on the role of diagnosis of vitamin D deficiency and its subsidies

Vitamin D as a possible biomarker of mild cognitive impairment in parkinsonians

Introduction Mild Cognitive Impairment in Parkinson’s Disease (PD-MCI) is a transitional state between normal cognition and dementia. Cross-sectional studies revealed that low Vitamin D levels were associated with worse performance on cognitive tests in Parkinson’s Disease. The present longitudinal study aimed to examine the relationship between serum 25-hydroxyvitamin D [25(OH)D] levels at baseline and possible development of PD-MCI at 24 and 48 months. Materials and Methods Sixty untreated, de novo PD patients underwent clinical and cognitive evaluations and measurement of serum 25(OH)D at baseline assessment (T0). After 24 (T1) and 48 months (T2), cognitive status (presence or absence of PD-MCI) of PD patients were re-evaluated. Results Vitamin D insufficiency occurred in 93.3% at T0. At T1, significant differences among patients with PD-MCI at both baseline and follow-up, patients with PD-MCI at follow-up and patients who never developed PD-MCI were found on age, age at onset of PD, and education; no significant difference was found on vitamin D levels at T0. A binary logistic regression analysis showed that a lower level of 25(OH)D at T0 (B= −0.158, Wald= 5.280, p = 0.022, Exp (B)=0.854; CI 95%: 0.746-0.977) and lower education (B= −0.214, Wald= 3.859, p = 0.049, Exp (B)=0.807; CI 95%: 0652-1.000) were predictors of PD-MCI occurrence at T2. Discussion Our results demonstrated that a lower level of 25(OH)D is conceivable as a biomarker of development of PD-MCI throughout the disease. Early diagnosis of Vitamin D insufficiency and its management might be useful to prevent cognitive decline in PD patients.

The effect of sclerotherapy and pre-pregnancy training with inositol and vitamin D3 on the size and number of cysts in women with infertility on the background of endometriosis

Annotation. Among gynecological diseases, external genital endometriosis leads to disorders of reproductive function and promotes the development of infertility. Currently, the search for less traumatic and more effective treatments for endometriosis continues. The aim of our study was to analyze the diameter of endometrioid cysts in women with infertility on the background of endometriosis before and after sclerotherapy using pre-pregnancy preparation of a complex vitamin preparation with inositol and vitamin D3. The study included 105 women aged 22 to 40 years with endometriosis-associated infertility. The presence of cysts was confirmed by ultrasound and bimanual examination. The drug FT 500 plus was prescribed in a dosage of 1 sachet – once a day from the 2nd or 3rd day of the cycle for 2 menstrual cycles (the cycle in which sclerotherapy was performed and the next cycle). Vitamin D3 “EuTilia D3” was prescribed in prophylactic doses of 2000 IU to women, or therapeutic (depending on the diagnosed or refuted diagnosis of vitamin D hypovitaminosis). The sclerotherapy procedure was performed by transvaginal puncture of the cyst and aspiration of its contents under the control of transvaginal ultrasound, introduction into the capsule of the cyst (without violating its integrity) 76% ethanol solution. It was found that women with endometriosis-associated infertility, who underwent pre-pregnancy preparation with a complex vitamin preparation with inositol and vitamin D3 after sclerotherapy, probably decreased the diameter of cysts in the right (5.85 times) and left (5.57 times) ovaries relative to data before sclerotherapy. When comparing the diameter of cysts in women who underwent pre-pregnancy preparation with a complex vitamin preparation with inositol and vitamin D3, depending on the type of surgery (sclerotherapy or cystectomy) found a probable decrease in the diameter of cysts after sclerotherapy in the right (82.89%) and left (82.05%) ovaries for such data after cystectomy. Therefore, sclerotherapy with pregravidar preparation with a complex vitamin preparation with inositol and vitamin D3 in women with endometriosis-associated infertility probably reduces the diameter of cysts relative to the experimental group without pregravidar preparation, as well as to the group with a history of cystectomy.