Beyond deficiency:Potential benefits of increased intakesof vitamin K for bone and vascular health

Vitamin K is wellknown for its role in the synthesisof a number of blood coagulationfactors.During recent years vitaminK-dependent proteins werediscovered to be of vital importancefor bone and vascular health.Recommendations for dietary vitaminK intake have been made onthe basis of the hepatic requirementsfor the synthesis of bloodcoagulation factors.Accumulatingevidence suggests that the requirementsfor other functions thanblood coagulation may be higher.This paper is the result of a closedworkshop (Paris,November 2002)in which a number of Europeanvitamin K experts reviewed theavailable data and formulated theirstandpoint with respect to recommendeddietary vitamin K intakeand the use of vitamin K-containingsupplements

Histomorphometric Analysis of the Rat Proximal Tibial Metaphysis by “Linear Scanning”

Twenty-four female Sprague-Dawley rats (10 weeks old, 200g BW) were either sham-operated (n = 6) or ovariectomized (ovx). Ovx rats were divided into 3 groups (n = 6 each) : ovx; ovx + 1,25(OH) 2D3; ovx + l,25(OH)2D3 + 1,24,25(OH)3D3. The vitamin D metabolites were fed orally starting the day after surgery. After 7 weeks all rats were sacrificed and the proximal tibiae were processed undecalcified for quantitative histomorphometry. Conventional histomorphometric analysis of the distal zone (\u3e 1 mm from the growth cartilage) of the tibial metaphysis revealed a dramatic loss of cancellous bone mass in ovx rats. Both l,25(OH)2D3 and the combination of l,25(OH)2D3 with l,24,25(OH)3D3 prevented the bone loss in the distal zone in ovx animals. Measurements in the proximal zone (\u3c 1 mm from the growth cartilage) of the tibial metaphysis were performed with a newly developed technique that utilizes the advantages of automatic image analysis, and that we propose to name linear scanning . This method revealed a significantly decreased hard tissue mass at about 100 μm and within 800 to 950 μm distance from the growth plate in ovx rats. However, ovx rats reached normal amounts of hard tissue within 250 to 450 μm from the growth plate. The results obtained by linear scanning suggest that the obvious loss of cancellous bone mass in the distal zone of the tibial metaphysis in growing ovx rats is not a consequence of structural changes in the proximal zone

In pursuit of vitamin D in plants

Vitamin D deficiency is a global concern. Much research has concentrated on the endogenous synthesis of vitamin D in human skin following exposure to ultraviolet-B radiation (UV-B, 280–315 nm). In many regions of the world there is insufficient UV-B radiation during winter months for adequate vitamin D production, and even when there is sufficient UV-B radiation, lifestyles and concerns about the risks of sun exposure may lead to insufficient exposure and to vitamin D deficiency. In these situations, dietary intake of vitamin D from foods or supplements is important for maintaining optimal vitamin D status. Some foods, such as fatty fish and fish liver oils, certain meats, eggs, mushrooms, dairy, and fortified foods, can provide significant amounts of vitamin D when considered cumulatively across the diet. However, little research has focussed on assessing edible plant foods for potential vitamin D content. The biosynthesis of vitamin D in animals, fungi and yeasts is well established; it is less well known that vitamin D is also biosynthesised in plants. Research dates back to the early 1900s, beginning with in vivo experiments showing the anti-rachitic activity of plants consumed by animals with induced rickets, and in vitro experiments using analytical methods with limited sensitivity. The most sensitive, specific and reliable method for measuring vitamin D and its metabolites is by liquid chromatography tandem mass spectrometry (LC-MS/MS). These assays have only recently been customised to allow measurement in foods, including plant materials. This commentary focuses on the current knowledge and research gaps around vitamin D in plants, and the potential of edible plants as an additional source of vitamin D for humans. © 2017 by the authors; licensee MDPI, Basel, Switzerland

Carbamazepine overdose after exposure to simethicone: a case report

<p>Abstract</p> <p>Introduction</p> <p>Carbamazepine is an anticonvulsant drug and is also used as a treatment for patients with manic-depressive illness, post-herpetic neuralgia or phantom limb pain. The drug itself has many drug interactions. Simethicone is an antifoaming agent and is reported to be an inert material with no known drug interaction with carbamazepine.</p> <p>Case presentation</p> <p>We present a case of a patient who was routinely using carbamazepine 400 mg three times per day and levetiracetam 500 mg twice daily, and experienced carbamazepine overdose after exposure to simethicone. After cessation of simethicone therapy normal drug levels of carbamazepine were obtained again with the standard dose of the drug. The mechanism of interaction is unknown but the risk of overdose should be considered when prescribing simethicone to a patient who is using carbamazepine.</p> <p>Conclusion</p> <p>Simethicone and carbamazepine, when taken together, may be a cause of carbamazepine toxicity. The risk of carbamazepine overdose should be considered when prescribing simethicone to a patient who is using carbamazepine.</p

Clinical efficacy and safety of lamotrigine monotherapy in newly diagnosed pediatric patients with epilepsy

Purpose : To verify the efficacy and safety of lamotrigine (LTG) monotherapy in newly diagnosed children with epilepsy. Methods : We prospectively enrolled 148 children who had undergone LTG monotherapy at our institution between September 2002 and June 2009. Twenty-nine patients were excluded: 19 due to incomplete data and 10 were lost to follow up. The data of the remaining 119 patients was analyzed. Results : We enrolled 119 pediatric epilepsy patients (aged 2.8-19.3 years&#59; 66 males and 53 females) in this study. Out of 119 patients, 29 (25.2&#37;) had generalized epilepsy and 90 (74.8&#37;) had partial epilepsy. The responses of seizure reduction were as follows: Seizure freedom (no seizure attack for at least 6 months) in 87&#47;111 (78.4&#37;, n&#61;111) patients&#59; partial response (reduced seizure frequency compared to baseline) in 13 (11.7&#37;) patients&#59; and persistent seizure in 11 (9.9&#37;) patients. The seizure freedom rate was in 81.6&#37; in patients with partial seizure (75.9&#37; for complex partial seizure and 90.9&#37; for benign rolandic epilepsy) and 44.8&#37; in patients with generalized epilepsy (30.0&#37; for absence seizure, 35.7&#37; for juvenile myoclonic epilepsy patients, and 100.0&#37; for idiopathic generalized epilepsy patients). Adverse reactions were reported in 17 (14.3&#37;) patients, and 8 patients (6.7&#37;) discontinued LTG because of rash and tic. No patient experienced severe adverse reaction such as Stevens-Johnson syndrome. Conclusion : LTG showed excellent therapeutic response and had few significant adverse effects. Our findings report may contribute in promoting the use of LTG monotherapy in epileptic children