Use Of Oral Vitamin Research Articles

Recent Vitamin K Antagonist Use and Intracranial Hemorrhage After Endovascular Thrombectomy for Acute Ischemic Stroke

Use of oral vitamin K antagonists (VKAs) may place patients undergoing endovascular thrombectomy (EVT) for acute ischemic stroke caused by large vessel occlusion at increased risk of complications. To determine the association between recent use of a VKA and outcomes among patients selected to undergo EVT in clinical practice. Retrospective, observational cohort study based on the American Heart Association's Get With the Guidelines-Stroke Program between October 2015 and March 2020. From 594 participating hospitals in the US, 32 715 patients with acute ischemic stroke selected to undergo EVT within 6 hours of time last known to be well were included. VKA use within the 7 days prior to hospital arrival. The primary end point was symptomatic intracranial hemorrhage (sICH). Secondary end points included life-threatening systemic hemorrhage, another serious complication, any complications of reperfusion therapy, in-hospital mortality, and in-hospital mortality or discharge to hospice. Of 32 715 patients (median age, 72 years; 50.7% female), 3087 (9.4%) had used a VKA (median international normalized ratio [INR], 1.5 [IQR, 1.2-1.9]) and 29 628 had not used a VKA prior to hospital presentation. Overall, prior VKA use was not significantly associated with an increased risk of sICH (211/3087 patients [6.8%] taking a VKA compared with 1904/29 628 patients [6.4%] not taking a VKA; adjusted odds ratio [OR], 1.12 [95% CI, 0.94-1.35]; adjusted risk difference, 0.69% [95% CI, -0.39% to 1.77%]). Among 830 patients taking a VKA with an INR greater than 1.7, sICH risk was significantly higher than in those not taking a VKA (8.3% vs 6.4%; adjusted OR, 1.88 [95% CI, 1.33-2.65]; adjusted risk difference, 4.03% [95% CI, 1.53%-6.53%]), while those with an INR of 1.7 or lower (n = 1585) had no significant difference in the risk of sICH (6.7% vs 6.4%; adjusted OR, 1.24 [95% CI, 0.87-1.76]; adjusted risk difference, 1.13% [95% CI, -0.79% to 3.04%]). Of 5 prespecified secondary end points, none showed a significant difference across VKA-exposed vs VKA-unexposed groups. Among patients with acute ischemic stroke selected to receive EVT, VKA use within the preceding 7 days was not associated with a significantly increased risk of sICH overall. However, recent VKA use with a presenting INR greater than 1.7 was associated with a significantly increased risk of sICH compared with no use of anticoagulants.

Regular use of vitamin D supplement is associated with fewer melanoma cases compared to non-use: a cross-sectional study in 498 adult subjects at risk of skin cancers.

There are conflicting results on the role of vitamin D system in cutaneous carcinogenesis. Therefore, it was investigated whether the use of oral vitamin D supplements associates with photoaging, actinic keratoses, pigment cell nevi, and skin cancers. In this cross-sectional study, 498 adults (aged 21-79 years, 253 males, 245 females, 96 with immunosuppression) subjects at risk of any type of skin cancer were examined, and possible confounding factors were evaluated. The subjects were divided into three groups based on their self-reported use of oral vitamin D supplements: non-use, occasional use, or regular use. The serum level of 25-hydroxyvitamin-D3 was analyzed in 260 subjects. In 402 immunocompetent subjects, vitamin D use did not associate with photoaging, actinic keratoses, nevi, basal, and squamous cell carcinoma. In contrast, there were lower percentages of subjects with a history of past or present melanoma (32/177, 18.1% versus 32/99, 32.3%, P = 0.021) or any type of skin cancer (110/177, 62.1% versus 74/99, 74.7%, P = 0.027) among regular users compared to non-users. In the logistic regression analysis, the odds ratio for melanoma was 0.447 ( P = 0.016, 95% confidence interval, 0.231-0.862) among regular users. Furthermore, the investigator-estimated risk class of skin cancers was significantly lower among regular users. Serum 25-hydroxyvitamin-D3 did not show marked associations with skin-related parameters. The results on 96 immunosuppressed subjects were somewhat similar, although the number of subjects was low. In conclusion, regular use of vitamin D associates with fewer melanoma cases, when compared to non-use, but the causality between them is obscure.

The use of oral vitamin A in acne management: a review.

Changes to the iPLEDGE platform on December 13, 2021 made isotretinoin virtually inaccessible for many patients. Prior to the FDA approval of isotretinoin, a derivative of vitamin A, in 1982, vitamin A was used for severe acne. To review the efficacy, safety, affordability, and practicality of vitamin A as a substitute for isotretinoin when the latter is inaccessible. A literature review of PubMed was conducted using the key words: oral vitamin A, retinol, isotretinoin, Accutane, acne, iPLEDGE, hypervitaminosis A, and side effects. We identified 9 studies (8 clinical trials and one case report); acne improved in 8 studies. Dosages ranged from 36,000IU daily to 500,000IU with 100,000IU as the most common. Mean duration until clinical improvement was 7 weeks to four months after initiation of therapy. Mucocutaneous side effects were most common, along with headaches, which resolved with either continued treatment or cessation. Oral vitamin A is efficacious for the treatment of acne vulgaris, although the available studies have limited controls and outcomes. Side effects are qualitatively similar to those of isotretinoin and avoiding pregnancy for at least three months after stopping treatment is critical; like isotretinoin, vitamin A is a teratogen.

The role of vitamin D in the prevention of pathology associated with psoriasis and metabolic syndrome

The paper highlights modern views on the metabolism of vitamin D in the human body. The analysis of the literature data on the mechanisms of the effect of vitamin D deficiency on the pathological processes occurring in the skin with psoriasis is carried out. It is known that psoriasis is associated with a high prevalence of metabolic syndrome, diabetes mellitus, and cardiovascular diseases. There is a direct correlation between a decrease in vitamin D levels and an increased risk of developing metabolic syndrome and cardiovascular mortality, including in patients with psoriasis. Data on the possibility of using vitamin D in dermatology are presented. Based on international and Russian clinical recommendations, the place of oral colecalciferol preparations in the prevention and correction of vitamin D deficiency and deficiency has been determined. The use of oral vitamin D for the simultaneous treatment of psoriasis and metabolic syndrome reduces the risk of cardiovascular diseases and type 2 diabetes mellitus. We analysed the international and domestic recommendations for the treatment of vitamin D deficiency and insufficiency, the use of which makes the oral administration of vitamin D3 (cholecalciferol) optimal for the treatment and prevention of vitamin D deficiency, as the results of several studies showed a higher efficacy of vitamin D3 vs vitamin D2. Vitamin D3 is found in vitamin D-fortified foods and is available as dietary supplements and drugs. The bioavailability of vitamin D in dietary supplements may differ depending on the used vehicle substance.

Clinical Role of Oral Vitamin C and E Therapy in Skin and Hair Disorders

Clinical Role of Oral Vitamin C and E Therapy in Skin and Hair Disorders

Oral Vitamin D Therapy in Patients with Psoriasis

Vitamin D treatment is effective when applied topically to the skin for plaque-type psoriasis. Oral vitamin D supplementation might be effective as an adjuvant treatment option in psoriasis. This umbrella review aimed to highlight the current knowledge regarding the use of oral vitamin D for treatment of patients with psoriasis. We performed a literature search and identified 107 eligible full-text articles that were relevant to the research interest. Among these, 10 review articles were selected, and data were extracted. A data synthesis showed that only a few studies monitored oral vitamin D efficacy in patients with psoriasis. No studies investigated the optimal dose of systemic vitamin D in psoriasis. However, most studies did not observe side effects for doses within a relatively narrow range (0.25 to 2 μg/day). These results suggest that more large-scale studies are needed to determine the efficacy, optimal dose, and adverse effects of vitamin D administration in patients with psoriasis.

A qualitative study of knowledge, behaviour and attitudes regarding vitamin D acquisition among patients with photosensitivity disorders.

Cutaneous exposure to sunlight is a major source of vitamin D. Individuals with photosensitivity disorders have symptoms provoked by sunlight and may not achieve the brief sunlight exposures that convey vitamin D acquisition. To explore knowledge, behaviour and attitudes towards vitamin D and its acquisition in patients with photosensitivity. Patients (n=19) diagnosed with solar urticaria, erythropoietic protoporphyria or polymorphic light eruption at a specialist photoinvestigation centre participated in semi-structured focus groups to discuss vitamin D knowledge, acquisition behaviours and attitudes towards vitamin D acquisition through sunlight and diet. Discussions were analysed by thematic analysis using MAXQDA11. Knowledge of vitamin D was variable. There was good awareness that sunlight exposure is an important source but knowledge of dietary sources was poor. Patients had little concern for their own vitamin D status prior to attending the photoinvestigation centre. Most patients avoided sunlight exposure, were unable to achieve the guidance on sun exposure for healthy individuals and were aware this could affect their vitamin D status. Use of oral vitamin D supplements was common, and all were willing to consider supplements if required. Patients recommended improving education of clinicians to increase patient awareness of vitamin D, CONCLUSIONS: More targeted guidance is required on acquisition of vitamin D for patients with photosensitivity, supported by increased patient and clinician education.

Refusal of Intramuscular Vitamin K by Parents of Newborns: A Review.

In 2019, the American Academy of Pediatrics made public education about intramuscular vitamin K administration at birth a public health priority, partly in response to reports of refusal of intramuscular vitamin K by parents of newborns that led to vitamin K deficiency bleeding (VKDB). We reviewed the literature on the frequency of, reported reasons for, and factors associated with refusal of intramuscular vitamin K, incidence of VKDB in newborns who did not receive intramuscular vitamin K, and use of oral vitamin K to prevent VKDB. Without prophylaxis, estimates of the incidence per 100 000 births of VKDB range from 250 to 1700 for early VKDB and from 10.5 to 80 for late VKDB. The frequency of refusal of intramuscular vitamin K by parents ranged from 0% to 3.2% in US hospitals, up to 14.5% in home births, and up to 31.0% in birthing centers. Reported reasons for refusal were concern of harm from the injection, a desire to be natural, and a belief in alternative methods of prophylaxis. Parents who refused intramuscular vitamin K were more likely to refuse immunizations. Many different regimens were used for orally administered vitamin K; it is not clear which is best, but all are less effective than intramuscular vitamin K. VKDB is rare but can result in either neurologic sequelae or death. In addition to continued surveillance of the frequency of both refusal of intramuscular vitamin K and VKDB, a renewed focus on education of and collaboration with parents is needed to address this major public health threat.

Comparative study on the efficacy of high-dose oral ascorbic acid with/without zinc in reducing the severity of oral mucositis during cancer chemoradiation

Objectives Antioxidants may control the severity of oral mucositis during cancer treatment. A well-designed trial to investigate the use of oral vitamin C to reduce the severity of oral mucositis was warranted. This study aimed to investigate and compare the effect of oral ascorbic acid 4 mg, alone or in combination with zinc 50 mg, on oral mucositis during chemoradiotherapy according to the World Health Organization (WHO) grading and to evaluate pain and taste perception among the participants during treatment. Study Design A prospective, single-blinded, single-center randomized controlled trial was conducted among 180 participants, diagnosed with oral and oropharyngeal cancers and treated with chemoradiotherapy. Participants were categorized into 2 major groups: control group (group A) and test group (Group B). The test group with 120 patients was further divided into 3 subgroups: group B—60 patients, who received oral ascorbic acid 1 g 4 times daily; group C—30 patients, who received zinc acetate 50 mg twice daily; and group D—30 patients, who received the combination of zinc and Vitamin C. The control group (60 patients) received the hospital's standard protocol for oral mucositis treatment. The severity of oral mucositis was assessed according to the WHO grading at weekly intervals on days 7,14, 21, 27 and 35. Pain on a visual analogue scale (VAS) and taste perception were rated. Results A significant difference was observed between mucositis grades (P Conclusions Zinc with or without vitamin C demonstrated significant decrease in the severity of oral mucositis compared with vitamin C alone. Pain decreased with vitamin C supplementation compared with controls. Vitamin C use reduced pain perception, and zinc reduced the mucositis scores. A combination of zinc and vitamin C showed benefits, including pain reduction, mucositis reduction, and taste preservation.

The use of vitamin K supplementation to achieve INR stability: A systematic review and meta-analysis

Systematically review and quantitatively synthesize evidence on use of oral vitamin K supplementation in reducing international normalized ratio (INR) variability. PubMed, The Cochrane Library, PsycINFO, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Turning Research Into Practice (TRIP), Web of Science were searched for studies meeting predetermined inclusion/exclusion criteria. Five studies meeting criteria (three randomized trials, one quasi-experimental pre-post study, one retrospective case series) were appraised for quality and data synthesized by two reviewers. Pooled effect size of time in INR therapeutic range (TTR) was estimated using random effects meta-analysis. Pooled effect size representing data from four studies (678 subjects) was 0.31, 95% confidence interval 0.03-0.59 (Cochran Q = 7.1; p = .07; I(2) = 57.8) and favored vitamin K supplementation. Given wide variability among individual studies, there is not enough evidence to advise for or against the routine use of vitamin K supplementation to achieve INR stability. However, evidence does suggest that it may be of some benefit for some patients with INR instability. There is insufficient evidence to support routine supplementation with vitamin K in patients on chronic anticoagulation therapy but select patients, particularly those with persistent INR instability despite known adherence to regimen and no dietary or drug-drug interactions, may benefit from the intervention. Future research is warranted.

Use of Oral Vitamin K for Prevention of Late Vitamin K Deficiency Bleeding in Neonates When Injectable Vitamin K is Not Available

To evaluate the literature describing use of oral vitamin K(1) (phytonadione) to prevent late vitamin K deficiency bleeding (VKDB) in neonates when injectable vitamin K preparations are not available. Articles were retrieved through MEDLINE (1946-February 2012) using the terms vitamin K, vitamin K deficiency bleeding, newborn, neonate, and prophylaxis. Reference citations from publications identified were reviewed. All articles published in English on the use of prophylactic oral vitamin K in neonates were evaluated. The largest epidemiologic studies discussing the efficacy of continuous oral vitamin K prophylaxis were reviewed. Individual, smaller clinical trials were not reviewed. For prevention of early, classic, and late VKDB, use of intramuscular vitamin K 1 mg is preferred over oral administration because of superior efficacy. Single oral doses protect against early VKDB, but multiple oral doses are needed for late VKDB prophylaxis, especially in exclusively breast-fed neonates. Continuous oral dosing regimens used in the literature vary; European epidemiologic data suggest the lowest rates of late VKDB with oral vitamin K 1 mg at birth followed by 25 μg daily for 13 weeks, or 2 mg at birth followed by 1 mg weekly for 3 months. Limited data describe the use of oral prophylactic vitamin K in high-risk patients (eg, premature neonates, biliary abnormalities). While there are data supporting effective oral vitamin K dosing regimens for prevention of late VKBD in exclusively breast-fed neonates, lack of an appropriate oral dosage form prevents routine use of this technique in the US. In times of drug shortage, injectable vitamin K preparations should be reserved for use in neonates. If injectable vitamin K is not available, clinicians should choose the most practical method of administering oral vitamin K based on the oral products available.

Systemic Role for Vitamin D in the Treatment of Psoriasis and Metabolic Syndrome

The novel discovery of the systemic role of vitamin D in the modulation of the immune system especially the Type 1 helper T cell (Th1) pathway reveals its potential for treating Th1 inflammatory diseases. Psoriasis has been recently established to be a systemic disease centered on inflammation and involvement of cytokines of the Th1 pathway. There is an increased prevalence of metabolic syndrome in patients with psoriasis. Metabolic syndrome also involves a proinflammatory state. This paper proposes the idea of the potential use of oral vitamin D to treat psoriasis and metabolic syndrome concurrently. We propose there is merit in more clinical trials investigating the use of vitamin D to treat both psoriasis and metabolic syndrome through its anti-inflammatory effects. On application to psoriasis management and prognosis, the goal is to decrease the risk for cardiovascular disease and decrease disease morbidity and mortality.

Assessment of a Vitamin K Protocol for Managing Excessively Elevated INRs in an Outpatient Anticoagulation Clinic

PURPOSE: Data regarding the use of oral Vitamin K for management of excessively elevated INR (International Normalized Ratio) in patients with no signs and symptoms of bleeding is limited; there is no definitive conclusion as to when oral vitamin K is clinically appropriate. To assess the current written protocol in a pharmacist managed anticoagulation clinic, data on patients given oral vitamin K for excessively elevated INR was reviewed.

Update in Hematology and Oncology

This Update in Hematology and Oncology features 16 articles published in 2009 that the authors judged to be of high clinical relevance. Hematology topics include the use of dabigatran, anticoagulation in patients with deep venous thrombosis, estimation of warfarin dose, use of oral vitamin K to counter overanticoagulation, and adverse effects of erythropoiesis-stimulating agents. Oncology topics include screening for prostate and breast cancer, hormone replacement therapy and risk for breast cancer, cancer genomics and targeted therapies, short- and long-term cardiac effects of cancer treatment, and palliative care for patients with cancer.

Adherence to Vitamin D Recommendations Among US Infants

In November 2008, the American Academy of Pediatrics (AAP) doubled the recommended daily intake of vitamin D for infants and children, from 200 IU/day (2003 recommendation) to 400 IU/day. We aimed to assess the prevalence of infants meeting the AAP recommended intake of vitamin D during their first year of life. Using data from the Infant Feeding Practices Study II, conducted from 2005 to 2007, we estimated the percentage of infants who met vitamin D recommendations at ages 1, 2, 3, 4, 5, 6, 7.5, 9, and 10.5 months (n = 1952-1633). The use of oral vitamin D supplements was low, regardless of whether infants were consuming breast milk or formula, ranging from 1% to 13%, varying by age. Among infants who consumed breast milk but no formula, only 5% to 13% met either recommendation. Among mixed-fed infants, 28% to 35% met the 2003 recommendation, but only 9% to 14% would have met the 2008 recommendation. Among those who consumed formula but no breast milk, 81% to 98% met the 2003 recommendation, but only 20% to 37% would have met the 2008 recommendation. Our findings suggest that most US infants are not consuming adequate amounts of vitamin D according to the 2008 AAP recommendation. Pediatricians and health care providers should encourage parents of infants who are either breastfed or consuming <1 L/day of infant formula to give their infants an oral vitamin D supplement.

Use of Oral Vitamin C After Fractures of the Distal Radius

Use of Oral Vitamin C After Fractures of the Distal Radius

Use of Oral Vitamin C After Fractures of the Distal Radius

Use of Oral Vitamin C After Fractures of the Distal Radius

Use of Oral Vitamin C After Fractures of the Distal Radius

There has been considerable debate regarding the effect of vitamin C on the prevention of complex regional pain syndrome (CRPS) in the setting of distal radius fractures.1–3 Vitamin C, also known as ascorbic acid, is a water-soluble organic compound first identified in 1932. Although humans are unable to synthesize vitamin C, it is an essential micronutrient in many enzymatic and chemical pathways. Vitamin C acts as a cofactor for 8 different enzymes that are involved in collagen hydroxylation, carnitine and norepinephrine biosynthesis, amidation of peptide hormones, and tyrosine metabolism.

Patient Self-Management of Anticoagulation: An Idea Whose Time Has Come

Editorials4 January 2005Patient Self-Management of Anticoagulation: An Idea Whose Time Has ComeRebecca J. Beyth, MD, MScRebecca J. Beyth, MD, MScFrom Baylor College of Medicine and Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX 77030.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-142-1-200501040-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail As the indications for the use of oral vitamin K antagonists in the treatment and prophylaxis of thromboembolic disorders increase, thromboembolic disorders are increasingly being recognized as chronic conditions in which high-quality chronic care management is essential for maximizing the net benefit of therapy (1). As envisioned in the chronic care model, optimal chronic care occurs when a “prepared proactive practice team interacts with an informed activated patient” (2). Inherent in this model is the concept of the patient–professional partnership as a new paradigm in which patients with chronic conditions, such as thromboembolic disorders, are their own caregivers and health ...

Series of Monographs on Venous Thromboembolic Disease

HomeCirculationVol. 107, No. 23_suppl_1Series of Monographs on Venous Thromboembolic Disease Free AccessOtherPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessOtherPDF/EPUBSeries of Monographs on Venous Thromboembolic Disease Michael R. Jaff, DO and Jonathan L. Halperin, MD Michael R. JaffMichael R. Jaff Search for more papers by this author and Jonathan L. HalperinJonathan L. Halperin Search for more papers by this author Originally published17 Jun 2003https://doi.org/10.1161/01.CIR.0000078461.26801.B9Circulation. 2003;107:I-2On behalf of the Society for Vascular Medicine and Biology and the editors of Circulation, we are pleased to present this series of monographs on topics in venous thromboembolic disease. The objective of these supplements is to provide clinicians with a current review of the epidemiology, diagnosis, natural history, prevention, and treatment of deep venous thrombosis, and its principal complications, pulmonary embolism and chronic venous insufficiency. These disorders affect millions of people, especially those predisposed by serious illness, major surgery, intrinsic venous disease, or hypercoagulable states, and are responsible for considerable mortality and chronic disability.As with most vascular diseases, responsibility for recognition and prevention of venous thromboembolism in patients at risk falls mainly to the primary care physician. Hence, these supplements have been written with the needs of the practitioner in mind, aiming to provide a comprehensive compendium of practical information based, whenever possible, on data from well-designed clinical trials, so that recommendations parallel widely accepted clinical practice guidelines. Areas of controversy are identified as such, and when there is no consensus about optimum management, pragmatic approaches are offered. We have selected as guest editor for each monograph a widely recognized specialist in the topic at hand, and have asked each editor to guide the selection of authors for the detailed clinical reviews. A board jointly selected by the Society for Vascular Medicine and Biology and the editors of Circulation has reviewed each manuscript.The series begins with an issue devoted to the epidemiology, risk factors, and natural history of venous thromboembolic disease. Discussions of hypercoagulability and of criteria for identifying high-risk patient populations are aimed at clarifying these complex issues for the practicing clinician.The second monograph is centered on diagnostic approaches to patients with venous thromboembolism. Detailed descriptions of duplex ultrasonography, contrast venography, d-dimer assays, and emerging diagnostic modalities, including computerized tomographic angiography for diagnosis of pulmonary embolism, are provided, along with diagnostic algorithms.Additional issues review alternative strategies for prevention and management of venous thromboembolic disease. Although effective prophylaxis against venous thromboembolism is available in the form of a variety of antithrombotic agents, these drugs are associated with risks of bleeding, making their judicious use dependent on appropriate assessment of patient-specific thromboembolic risk. When preventive strategies have been overlooked or fail, the problem of venous thromboembolism itself similarly requires a risk-based therapeutic approach. Hence, a comprehensive review of therapeutic alternatives completes the series. Comparisons of low-molecular-weight heparins with unfractionated heparin, the use of oral vitamin K antagonists, and emerging opportunities, like direct thrombin inhibitors and synthetic pentasaccharides, round out the analysis of current algorithms.We hope this series of monographs provides a comprehensive resource, for primary care physicians and specialists alike, about current strategies in the diagnosis and management of this common and debilitating disease, and helps to foster improved patient care. Previous Back to top Next FiguresReferencesRelatedDetailsCited By Creager M, Hiatt W, Hirsch A, Olin J, Jaff M, Cooke J, Rooke T, Beckman J and Froehlich J (2015) The Society for Vascular Medicine: The first quarter century, Vascular Medicine, 10.1177/1358863X14566042, 20:1, (60-68), Online publication date: 1-Feb-2015. June 17, 2003Vol 107, Issue 23_suppl_1 Advertisement Article InformationMetrics https://doi.org/10.1161/01.CIR.0000078461.26801.B9 Originally publishedJune 17, 2003 KeywordsveinsembolismcoagulationthrombsisPDF download Advertisement