Vitamin D as an Adjunctive Therapy in Asthma. Part 2: A Review of Human Studies

Vitamin D deficiency (VDD) is highly prevalent worldwide, with adverse effects on bone health but also potentially other unfavorable consequences. VDD and asthma-incidence/severity share many common risk factors, including winter season, industrialization, poor diet, obesity, dark skin pigmentation, and high latitude. Multiple anatomical areas relevant to asthma contain both the enzyme responsible for producing activated vitamin D and the vitamin D receptor suggesting that activated vitamin D (1,25- dihydroxyvitamin D) may have important local effects at these sites. Emerging evidence suggests that VDD is associated with increased airway hyperresponsiveness, decreased pulmonary function, worse asthma control, and possibly decreased response to standard antiasthma therapy. However the effect is inconsistent with preliminary evidence from different studies suggesting vitamin D is both beneficial and detrimental to asthma genesis and severity. Current evidence suggests that supplementation with moderate doses of vitamin D may be appropriate for maintenance of bone health in asthmatics, particularly steroid users. However emerging data from an increasing number of randomized, controlled, intervention studies of vitamin D supplementation in pediatric and adult asthma are becoming available and should help determine the importance, if any of vitamin D for asthma pathogenesis. The purpose of this second of a two-part review is to review the current human literature on vitamin D and asthma, discussing the possible consequences of VDD for asthma and the potential for vitamin D repletion as adjunct therapy

Dietary Nitrate Acutely and Markedly Increased Exhaled Nitric Oxide in a Cystic Fibrosis Case

Airway nitric oxide (NO) is a ubiquitous signaling molecule with bronchoprotective, antiinflammatory and anti-infective roles. Cystic fibrosis (CF) is a chronic lung condition associated with deceased exhaled NO. Strategies to increase exhaled NO in CF have yielded inconsistent results. A potential new method of increasing systemic NO involves ingestion of dietary, inorganic nitrate which is reduced to nitrite and NO. We present the case of a 12 year-old, athletic male with CF who demonstrated acute but marked increases in exhaled NO following dietary nitrate consumption compared to placebo

Prevalence of the persistent median artery in patients undergoing surgical open carpal tunnel release : a case series

Background: Carpal tunnel syndrome is a common condition in adults with an estimated prevalence of up to 5% in the general population. The presence of a persistent median artery is an important consideration for plastic and orthopedic surgeons who frequently perform carpal tunnel release. This artery may persist into adulthood and constitute a significant supply of blood to the hand, sometimes compressing the median nerve. Purpose: In this case series, we describe the prevalence of the persistent median artery identified intraoperatively in Polish subjects undergoing surgical open carpal tunnel release. Methods: The data regarding the prevalence of persistent median artery were retroactively collected postoperatively from the standard surgical protocols. Results: Persistent median artery was identified in 36 out of 1285 operated hands (2.8%). The observed PMAs were identified in 15 (2.0%) cases out of 750 right upper limbs and in 21 (3.9%) cases out of the 535 left upper limbs. Conclusions: Persistent median artery can be present in the operating field of any surgeon that performs carpal tunnel release and any other surgical procedures in the wrist region. Therefore awareness of its presence is crucial to minimize intraoperative complications such as bleeding or digital ischemia

Blunted serum 25(OH)D response to vitamin D3 supplementation in children with autism

Introduction: Data suggest a potential role for vitamin D in autism spectrum disorder (ASD) prevention and treatment. It is likely that the serum response to vitamin D supplementation contributes to its effectiveness. Multiple factors affect serum vitamin D 25(OH)D response to supplementation. Methods: We conducted post-hoc analysis of two double-blind, randomized, placebo-controlled trials (RCT) of vitamin D3 supplementation, one RCT involving children with ASD and another involving children with asthma. Both trials were conducted in the same geographic location (Dublin, Ireland, 53°N), conducted over Winter season and utilized the same vitamin D3 dose (2000 IU/day). Results: We included 18 children with ASD and 17 children with asthma. There was no significant difference in 25(OH)D or age at baseline, however, BMI was significantly lower in ASD (P = 0.03). Compliance with vitamin D supplementation was high in both trials. Despite a significantly longer intervention period (20w vs. 15w; P \u3c 0.0001), ASD children had a significantly lower absolute increase (+26 vs. +45 nmol/l) in 25(OH)D (P = 0.04). Conclusions: Despite similar demographics, children with ASD had a lower increase in 25(OH)D levels with supplementation. Potential mechanisms include altered absorption/metabolism as well as well genetic factors. Clinical and research work relating to vitamin D is ASD should measure 25(OHO)D response to supplementation to assess therapeutic doses

Vitamin D Receptor Variants and Uncontrolled Asthma

BACKGROUND: Asthma is a common childhood respiratory disease, affecting around 20% of Irish children. In other populations, vitamin D receptor (VDR) polymorphisms have been associated with asthma risk. We aimed to investigate the association between 2 VDR polymorphisms and uncontrolled paediatric asthma. METHODS: 44 asthmatic children and 57 healthy volunteers were studied. The VDR TaqI gene variant in exon 9 (T/C) (rs731236) and ApaI (rs7975232) in intron 8 (C/T) were determined, using TaqMan®Assays. The lung function, serum 25-hydroxyvitamin D (25OHD) levels and other biomarkers of allergy, immunity, airway and systemic inflammation were assessed. RESULTS: The distribution of T and C alleles and genotype frequencies differed significantly between asthmatics and controls for both polymorphisms (

The clinical impact of Lumacaftor-Ivacaftor on structural lung disease and lung function in children aged 6-11 with cystic fibrosis in a real-world setting

BACKGROUND: Data from clinical trials of lumacaftor-ivacaftor (LUM-IVA) demonstrate improvements in lung clearance index (LCI) but not in FEV1 in children with Cystic Fibrosis (CF) aged 6-11 years and homozygous for the Phe508del mutation. It is not known whether LUM/IVA use in children can impact the progression of structural lung disease. We sought to determine the real-world impact of LUM/IVA on lung structure and function in children aged 6-11 years. METHODS: This real-world observational cohort study was conducted across four paediatric sites in Ireland over 24-months using spirometry-controlled CT scores and LCI as primary outcome measures. Children commencing LUM-/IVA as part of routine care were included. CT scans were manually scored with the PRAGMA CF scoring system and analysed using the automated bronchus-artery (BA) method. Secondary outcome measures included rate of change of ppFEV1, nutritional indices and exacerbations requiring hospitalisation. RESULTS: Seventy-one participants were recruited to the study, 31 of whom had spirometry-controlled CT performed at baseline, and after one year and two years of LUM/IVA treatment. At two years there was a reduction from baseline in trapped air scores (0.13 to 0.07, p = 0.016), but an increase from baseline in the % bronchiectasis score (0.84 to 1.23, p = 0.007). There was no change in overall % disease score (2.78 to 2.25, p = 0.138). Airway lumen to pulmonary artery ratios (AlumenA ratio) were abnormal at baseline and worsened over the course of the study. In 28 participants, the mean annual change from baseline LCI2.5 (-0.055 (-0.61 to 0.50), p = 0.85) measurements over two years were not significant. Improvements from baseline in weight (0.10 (0.06 to 0.15, p < 0.0001), height (0.05 (0.02 to 0.09), p = 0.002) and BMI (0.09 (0.03 to 0.15) p = 0.005) z-scores were seen with LUM/IVA treatment. The mean annual change from baseline ppFEV1 (-2.45 (-4.44 to 2.54), p = 0.66) measurements over two years were not significant. CONCLUSION: In a real-world setting, the use of LUM/IVA over two years in children with CF aged 6-11 resulted in improvements in air trapping on CT but worsening in bronchiectasis scores. Our results suggest that LUM/IVA use in this age group improves air trapping but does not prevent progression of bronchiectasis over two years of treatment

Vitamin D as an Adjunctive Therapy in Asthma. Part 1: A Review of Potential Mechanisms

Vitamin D deficiency (VDD) is highly prevalent worldwide. The classical role for vitamin D is to regulate calcium absorption form the gastrointestinal tract and influence bone health. Recently vitamin D receptors and vitamin D metabolic enzymes have been discovered in numerous sites systemically supporting diverse extra-skeletal roles of vitamin D, for example in asthmatic disease. Further, VDD and asthma share several common risk factors including high latitude, winter season, industrialization, poor diet, obesity, and dark skin pigmentation. Vitamin D has been demonstrated to possess potent immunomodulatory effects, including effects on T cells and B cells as well as increasing production of antimicrobial peptides (e.g. cathelicidin). This immunomodulation may lead to asthma specific clinical benefits in terms of decreased bacterial/viral infections, altered airway smooth muscle-remodeling and efunction as well as modulation of response to standard anti-asthma therapy (e.g. glucocorticoids and immunotherapy). Thus, vitamin D and its deficiency have a number of biological effects that are potentially important in altering the course of disease pathogenesis and severity in asthma. The purpose of this first of a two-part review is to review potential mechanisms whereby altering vitamin D status may influence asthmatic disease

Gasification, Olive Pomace, Hazelnut Shell, Wood Sawdust, Syngas

Günümüzde en önemli enerji kaynağı olan fosil yakıtların sahip olduğu öneme rağmen, neden olduğu çevresel sorunlardan dolayı ve buna paralel yükselen enerji arzını karşılamak için en verimli, temiz ve ekonomik çözüm yollarını bulunması yolunda yapılan araştırmalar hızla sürdürülmektedir. Bu araştırmalar çerçevesinde, çevreyi daha az kirleten, yenilenebilir enerji kaynağı olan biyokütle, fosil kaynaklara alternatif olabilecek en önemli enerji kaynaklarından biridir. Biyokütlenin, termal, biyolojik ve fiziksel proseslerle bir takım teknolojilerle çeşitli enerji kaynaklarına dönüştürülmesi mümkündür. Bu teknolojiler içeresinde gazlaştırma teknolojisi çok önemli yer kapsamaktadır. Biyokütlenin gazlaştırılması sonucunda üretilen sentez gazından hidrojen, amonyak ve metanol gibi değerli kimyasal maddelerin de üretilmesi söz konusudur. Bu çalışmanın amacı, biyokütle atığı olan pirina, fındık kabuğu ve odun talaşının gazlaştırma işlemi ile hidrojence zengin sentez gazı üretilmesidir. Deneysel çalışmada, laboratuvar ölçekli dolaylı ısıtmalı 40 mm çapında 1 m yüksekliğindeki sabit yataklı gazlaştırma reaktör sistemi kullanılmıştır. Gazlaştırma için gerekli sıcaklık dolaylı olarak bir fırın yardımı ile sağlanmakta, gazlaştırma ajanı olarak kullanılan su buharı ise buhar jeneratörü vasıtasıyla sağlanmıştır. Çalışmada biyokütle atık olarak kullanılacak olan pirina (P), fındık kabuğu (FK) ve odun talaşı (OT) ilk önce öğütülerek kaba ve elementel analizleri yapılmıştır. Ortalama partikül boyutu1 mm olan pirina, fındık kabuğu ve odun talaşı, farklı sıcaklık (600oC, 650oC, 700oC, 750oC, 800oC ve 850oC), farklı su buharı akışı (5, 10 ve 15 g su/dk) ve farklı katalizörler (MgO, CaO ve K2CO3) kullanılarak gazlaştırma işlemine tabi tutulmuştur. Gazlaştırma sıcaklığının ve su buharı akış hızının ve katalizörlerin elde edilen sentez gazı bileşimi üzerine etkileri araştırılmıştır. Sentez gazı bileşenlerinin analizi gaz kromatografi cihazı kullanılarak yapılmış ve karışım içerisinde hacimce yüzdeleri belirlenmiştir. Deneysel çalışmalarda en yüksek hidrojen konsantrasyonu hacimce %66 ile 750 oC sıcaklığında ve 0,25 g su/s buhar akış hızı koşullarında pirina atığı beslemesinde elde edilmiştir. Elde edilen en yüksek hidrojen/karbon monoksit oranı 5,4 olup pirina atığı ile yapılan deneyde elde edilmiştir.Despite the importance of fossil fuels, which is an important energy source on the present time, the researches are continuing to find more efficient, clean and economic solutions to meet the increasing energy needs due to the environmental problems. Within the framework of these studies, biomass was found to be one of the most important energy sources that can act as an alternative to fossil fuels, because of its less polluting effects and renewability. Biomass can be transformed into a wide variety of energy sources with a wide variety of thermal, biological and physical technologies, and gasification technology are among the important technologies to use. With the biomass gasification process, it is also possible to produce valuable chemicals such as hydrogen, ammonia, and methanol as side products. The aim of this study to produce hydrogen-rich syngas production by the gasification process of olive pomace, hazelnut shell and sawdust as biomass residue. A fixed bed in indirectly heated gasification reactor with a diameter of 40 mm and a height of 1 m system was used during the experimental work. The temperature required for gasification was adjusted with a furnace and the water vapor used as gasification agent is also provided by steam generator. First grinding the olive pomace, hazelnut shell and wood sawdust which will be used as biomass waste, then quartz and elemental analyses were carried out. The olive pomace, hazelnut shell and wood sawdust pieces with an average of 1 mm diameter under various temperatures (600oC, 650oC, 700oC, 750oC, 800oC and 850oC), varying steam flow (5, 10 and 15 g water/min) and different catalysts (MgO, CaO, K2CO3) during gasification process. The effects of the gasification temperature, water vapor flow rate and catalysts on the syngas composition were investigated. The syngas composition was analyzed in gas chromatography equipment and the percentages in the mixture were determined. During the experimental studies, the highest hydrogen concentration of 66% was obtained while using the olive pomace as biomass residue the highest at 750 oC and under 15 g water/min steam flow rate conditions. The highest H2/CO ratio was recorded as 5.4 during the experiment with olive pomace wast