This document summarizes research on vaccination in children with chronic diseases. It discusses issues with influenza and pneumococcal vaccinations in high-risk groups. It reviews studies examining the immunogenicity, safety and efficacy of influenza and pneumococcal vaccines in various chronic conditions like asthma, cancer, and immunosuppression. It also discusses gaps in knowledge around the impact of influenza in different at-risk groups and the need for more data on vaccine immunogenicity, safety and efficacy in each high-risk population. The document emphasizes the importance of recommending influenza vaccination for children with chronic diseases and implementing strategies to increase vaccination coverage.
The document summarizes findings from studies on various interventions for the primary prevention of allergic diseases. It finds that maternal avoidance of allergens during pregnancy does not prevent allergies in children but could harm nutrition. Exclusive breastfeeding for 4-6 months protects against wheeze and eczema in early childhood. Maternal avoidance of allergens during lactation may reduce cow's milk allergy and eczema in infants. The use of hydrolyzed milk formulas prevents cow's milk allergy and eczema in at-risk children. Strict avoidance of food and aeroallergens in high-risk infants can reduce allergic sensitization and diseases like asthma and eczema in early childhood
This document summarizes recent advancements in immunization. It discusses the goals of immunization as preventing disease in individuals and ultimately eradicating diseases worldwide. Data from the US shows significant decreases in morbidity from diseases like smallpox, polio, measles, and haemophilus influenza type B due to immunization programs. It also discusses common concerns parents have about immunization and ways to address those concerns. The document then describes the different types of immunization including active and passive immunization. It provides guidelines for many common vaccines and discusses considerations around vaccine handling, scheduling, and specific diseases.
Immunization schedule for infants and childrenapekshafunde
The document summarizes India's national immunization program and schedule. It details that the program aims to provide free vaccination against 12 diseases to all children and pregnant women. The schedule outlines the vaccines to be administered, including BCG, rotavirus, hepatitis B, DPT, polio, measles, and others. Vaccines are given according to an age-based routine, with the goal of fully immunizing all children within their first year.
Immunization is one of the best public health intervention to reduce mortality and morbidity caused by vaccine preventable diseases. in this part i am going to describe regarding cold chain ,frequently ask questions regarding vaccines and how to manage acute and life threatening adverse reactions at most peripheral level
Edward Jenner performed the first vaccination in 1796 in England, using cowpox matter to immunize a child against smallpox. His work laid the foundation for modern vaccination. Today, children receive a series of vaccinations for diseases like hepatitis B, diphtheria, and measles between birth and school age. However, some parents choose not to vaccinate due to disproven fears about side effects and links to autism, putting their own and other children's health at risk. While no vaccine is completely without risk, studies show the risks of contracting diseases without vaccination far outweigh any vaccine side effects.
The document discusses key terms related to immunization and vaccination. It defines terms like immunization, vaccine, vaccination, full immunization, partial immunization, non-immunization, ring immunization, and herd immunity. It also summarizes milestones in immunization in India and provides vaccination charts detailing the various vaccines recommended at different ages. Barriers to immunization like physical barriers and psychological barriers are highlighted. Reasons for low immunization coverage like failures to provide immunization, dropouts, and unreached populations are discussed.
This document summarizes research on vaccination in children with chronic diseases. It discusses issues with influenza and pneumococcal vaccinations in high-risk groups. It reviews studies examining the immunogenicity, safety and efficacy of influenza and pneumococcal vaccines in various chronic conditions like asthma, cancer, and immunosuppression. It also discusses gaps in knowledge around the impact of influenza in different at-risk groups and the need for more data on vaccine immunogenicity, safety and efficacy in each high-risk population. The document emphasizes the importance of recommending influenza vaccination for children with chronic diseases and implementing strategies to increase vaccination coverage.
The document summarizes findings from studies on various interventions for the primary prevention of allergic diseases. It finds that maternal avoidance of allergens during pregnancy does not prevent allergies in children but could harm nutrition. Exclusive breastfeeding for 4-6 months protects against wheeze and eczema in early childhood. Maternal avoidance of allergens during lactation may reduce cow's milk allergy and eczema in infants. The use of hydrolyzed milk formulas prevents cow's milk allergy and eczema in at-risk children. Strict avoidance of food and aeroallergens in high-risk infants can reduce allergic sensitization and diseases like asthma and eczema in early childhood
This document summarizes recent advancements in immunization. It discusses the goals of immunization as preventing disease in individuals and ultimately eradicating diseases worldwide. Data from the US shows significant decreases in morbidity from diseases like smallpox, polio, measles, and haemophilus influenza type B due to immunization programs. It also discusses common concerns parents have about immunization and ways to address those concerns. The document then describes the different types of immunization including active and passive immunization. It provides guidelines for many common vaccines and discusses considerations around vaccine handling, scheduling, and specific diseases.
Immunization schedule for infants and childrenapekshafunde
The document summarizes India's national immunization program and schedule. It details that the program aims to provide free vaccination against 12 diseases to all children and pregnant women. The schedule outlines the vaccines to be administered, including BCG, rotavirus, hepatitis B, DPT, polio, measles, and others. Vaccines are given according to an age-based routine, with the goal of fully immunizing all children within their first year.
Immunization is one of the best public health intervention to reduce mortality and morbidity caused by vaccine preventable diseases. in this part i am going to describe regarding cold chain ,frequently ask questions regarding vaccines and how to manage acute and life threatening adverse reactions at most peripheral level
Edward Jenner performed the first vaccination in 1796 in England, using cowpox matter to immunize a child against smallpox. His work laid the foundation for modern vaccination. Today, children receive a series of vaccinations for diseases like hepatitis B, diphtheria, and measles between birth and school age. However, some parents choose not to vaccinate due to disproven fears about side effects and links to autism, putting their own and other children's health at risk. While no vaccine is completely without risk, studies show the risks of contracting diseases without vaccination far outweigh any vaccine side effects.
The document discusses key terms related to immunization and vaccination. It defines terms like immunization, vaccine, vaccination, full immunization, partial immunization, non-immunization, ring immunization, and herd immunity. It also summarizes milestones in immunization in India and provides vaccination charts detailing the various vaccines recommended at different ages. Barriers to immunization like physical barriers and psychological barriers are highlighted. Reasons for low immunization coverage like failures to provide immunization, dropouts, and unreached populations are discussed.
Final childhood vaccination report pdf ajZahidManiyar
This document summarizes research on the impact of COVID-19 restrictions on childhood vaccination rates globally. It finds:
- Studies showed significant disruptions to vaccination services in countries in Africa, Asia, America, and Europe due to the pandemic. Vaccination rates declined the most in places where rates were already low.
- Many countries saw substantial drops in doses administered for vaccines like diphtheria-tetanus-pertussis, BCG, measles, and polio. Declines were generally larger for older children than younger children.
- Initiatives to increase vaccination post-restrictions included drive-through clinics, mobile centers, and emphasizing the importance of vaccination during pandemics. However
Influenza vaccine is nothing new . However there are lesser known facts about Influenza vaccine. This is just a humble attempt to highlight a few important points about Influenza vaccine, including some updates.
Burden of Influenza disease worldwide.
Importance of Influenza vaccine in Corona virus pandemic.
Influenza vaccine quadrivalent vs trivalent vaccine.
Split virion vs Subunit influenza vaccine
0.5 ml dose of influenza vaccine below 3 yrs age in children
Northern hemisphere or Southern hemisphere influenza vaccine for India, some suggestions
Vaccination and immunisation jane renton - principal pharmacist - nhs lothianNES
This document discusses vaccination and immunization. It provides a brief history of vaccination from Jenner's development of the smallpox vaccine in 1796 to modern vaccines. Key terms like vaccination, immunization, active immunity, and passive immunity are defined. The goals and benefits of vaccination programs are outlined, including herd immunity. Challenges to vaccination like misinformation, access issues, and cold chain management are also summarized.
ROTAVIRUS VACCINES IN INDIA .WHICH ONE WILL YOU CHOOSE AND WHY?DR SHAILESH MEHTA
Many brands of Rotavirus vaccine are available in India. However we need to have full evidence based decision making before we choose one rotavirus vaccine over another. This slideshow focuses on the need to have Indian studies which are not there with some of the international brands. Regionwise variability of rotavirus vaccines have prompted ICMR and various other scientific bodies in India to have our own data on efficacy of rotaviral vaccines in Indian scenario. Diarrhoea is a major cause of under 5 mortality in children. After the use of rotavirus vaccines there is a huge reduction of financial burden on our healthcare sytems.
Childhood diarrhoea incidence and severity have decreased ever since rotavirus vaccine was made a part of national immunization schedule.
This document summarizes guidelines and evidence for preventing allergic disease. It finds that maternal avoidance diets during pregnancy and lactation are not recommended. Exclusive breastfeeding for 4-6 months reduces atopic dermatitis, wheezing, and cow's milk allergy. While hydrolyzed formulas prevent cow's milk allergy compared to regular formula, no formula is conclusively better than breastfeeding. Complementary foods can be introduced between 4-6 months. House dust mite avoidance may reduce sensitization, but evidence is not compelling. Combining food and environmental allergen avoidance reduces wheezing and atopic dermatitis.
This presentation aims at helping the pediatric trainees and practitioners to brush up their knowledge in Immunization. The schedule is based on the Universal Immunisation Programme. I have tried to cover as much as possible in terms of individual vaccines and hope it is beneficial to the reader.
This document provides information on various vaccines used in India's national immunization schedule. It defines key terms related to immunization and vaccination. The national schedule recommends vaccines for diseases like tuberculosis, polio, diphtheria, pertussis, tetanus, hepatitis B, Hib, measles, and others to be administered to infants and children at specific ages. Details are provided on vaccine names, ingredients, dosage, administration route and effectiveness. The history and achievements of immunization programs in India and globally are also summarized.
This document discusses special situations and adverse events following immunization. It provides guidance on vaccinating preterm/low birth weight infants, those receiving corticosteroids or immunosuppressive therapy, children with malignancies, congenital immunodeficiencies, chronic diseases, allergies, bleeding disorders, or acute illness. It recommends that most vaccines can be administered according to chronological age for preterm/low birth weight infants. It also provides specific guidance on contraindications and precautions for different groups.
This document discusses approaches to preventing allergic diseases in children. It mentions that allergic diseases have increased rapidly in recent decades likely due to environmental and lifestyle changes. Early life exposure to allergens and microbes may influence the development of allergic immune responses. The document discusses genetic and environmental risk factors for atopic dermatitis and reviews evidence on the role of various allergens like food, aeroallergens and bacteria. It proposes that primary prevention aims to prevent sensitization to allergens, secondary prevention prevents disease progression after sensitization and tertiary prevention reduces symptoms after disease onset through allergen avoidance and treatment.
Pentavalent vaccine introduction in immunization programme in IndiaVikky3
This document provides operational guidelines for introducing the pentavalent vaccine, which protects against diphtheria, tetanus, pertussis, hepatitis B, and Haemophilus influenzae type b (Hib), into India's routine childhood immunization program. It discusses the diseases caused by Hib, the formulation and administration of the pentavalent vaccine, its safety, efficacy, and effectiveness. It also covers storage and handling guidelines, the vaccination schedule, and issues related to introducing the new vaccine. The pentavalent vaccine will replace standalone DPT and hepatitis B vaccines and is expected to reduce Hib-related mortality and morbidity in Indian children under five years of age.
Top 10 practical questions about Flu Vaccine in India!Gaurav Gupta
What does a practising paediatrician want to to know about the Flu vaccination? Talk for Abbott Vaccines (Influvac Tetra) in Oct 2020 about common queries that doctors have about the flu vaccine in India, including how it may help in COVID-19?
Vaccine Issues and the World Small Animal Veterinary Association (WSAVA) Guid...Yotam Copelovitz
Vaccination practices worldwide are changing. Various associations and organisations are updating their advice for vaccination best practices in dogs and cats upon an evidence-based research, and here is a recent update written by the honourable Dr. Jean Dodds.
This study investigated factors associated with latent tuberculosis infection (LTBI) and immune responses to BCG vaccination among children in Uganda. The prevalence of LTBI was 9% at age five years. Urban residence and history of TB contact were positively associated with LTBI. Multiple factors including BCG vaccine strain, LTBI status, HIV infection, helminth infection, and nutrition were associated with cytokine responses at age five. However, cytokine responses at age one year were not predictive of LTBI by age five. While exposure factors dominated the risk of LTBI, the child's immune responses were influenced by various host and environmental factors.
The universal immunization programme in India aims to protect infants and pregnant women against six vaccine preventable diseases. It is the largest immunization program in the world, targeting over 27 million infants and 30 million pregnant women annually. The national immunization schedule outlines vaccines to be administered according to age, including BCG, DPT, polio, hepatitis B, measles and more. Proper cold chain storage and handling of vaccines is essential to maintain their potency, as different vaccines have varying sensitivity to heat, cold, and light.
This document provides an overview of the Expanded Program on Immunization (EPI) including its objectives, strategies, elements, and principles of vaccinating children. The key points are:
1) EPI aims to reduce childhood diseases through vaccination coverage of at least 90% for diseases like tuberculosis, diphtheria, pertussis, neonatal tetanus, polio, hepatitis B, and measles.
2) General principles of EPI include administering multiple vaccines on the same day, continuing the vaccination schedule if doses are delayed, and strictly following vaccine storage and handling guidelines.
3) Contraindications to vaccination include severe allergic reactions to previous doses or known vaccine components,
The document discusses several vaccines including BCG, DTP, polio, Hib, MMR, rotavirus, varicella, hepatitis A, and pneumococcal. It provides information on the nature of the vaccines, indications for use, efficacy, administration schedule and route, storage requirements, adverse reactions and contraindications. Specific details are given for dosage, intervals between doses, age for administration and booster schedules for many of the vaccines.
The document discusses childhood immunization schedules and the benefits and risks of immunization versus the risks of diseases. It provides the recommended immunization schedule in the UK and explains that immunizations protect both an individual child's health as well as the health of others by helping to eliminate diseases. While immunizations carry small risks like fever or soreness, the diseases themselves pose much higher risks including death in some cases. The importance of immunization is evidenced by examples of disease outbreaks prior to widespread immunization. The document also discusses the discredited claim by Dr. Wakefield linking the MMR vaccine to autism and common reasons some people oppose immunization despite the lack of evidence that vaccines are dangerous.
IMMUNIZATION/VACCINATION(BOTH CHILD AND ADULT) WITH ALL UPDATESasifiqbal545
IMMUNIZATION/VACCINATION(BOTH CHILD AND ADULT) WITH ALL UPDATES AND DETAILS WITH FREQUENTLY ASKED QUESTIONS WITH DISCUSSION ON NEWEST VACCINES. ALSO DISCUSSION ON COLD CHAIN ETC.
This document appears to be a collection of pediatric immunology multiple choice questions and answers in Arabic. It includes questions about HiB vaccination schedules, conditions whose incidence has decreased due to HiB vaccination, live versus inactivated vaccines, vaccination routes and contraindications. The questions cover topics like BCG, diphtheria, pertussis, polio, measles, rubella, meningococcal and combination vaccines. It discusses vaccination schedules, precautions and contraindications for premature infants, immunocompromised children, those receiving certain medications and more.
Apresentação de projetos acadêmicos e profissionaisAlice Selles
O documento fornece dicas para apresentações acadêmicas e profissionais. Ele discute a importância de dominar o conteúdo, preparar antecipadamente, usar slides de forma clara e concisa, e praticar a apresentação para se sentir confortável na frente dos outros. Também dá conselhos sobre como lidar com nervosismo e como se portar profissionalmente durante uma apresentação.
Final childhood vaccination report pdf ajZahidManiyar
This document summarizes research on the impact of COVID-19 restrictions on childhood vaccination rates globally. It finds:
- Studies showed significant disruptions to vaccination services in countries in Africa, Asia, America, and Europe due to the pandemic. Vaccination rates declined the most in places where rates were already low.
- Many countries saw substantial drops in doses administered for vaccines like diphtheria-tetanus-pertussis, BCG, measles, and polio. Declines were generally larger for older children than younger children.
- Initiatives to increase vaccination post-restrictions included drive-through clinics, mobile centers, and emphasizing the importance of vaccination during pandemics. However
Influenza vaccine is nothing new . However there are lesser known facts about Influenza vaccine. This is just a humble attempt to highlight a few important points about Influenza vaccine, including some updates.
Burden of Influenza disease worldwide.
Importance of Influenza vaccine in Corona virus pandemic.
Influenza vaccine quadrivalent vs trivalent vaccine.
Split virion vs Subunit influenza vaccine
0.5 ml dose of influenza vaccine below 3 yrs age in children
Northern hemisphere or Southern hemisphere influenza vaccine for India, some suggestions
Vaccination and immunisation jane renton - principal pharmacist - nhs lothianNES
This document discusses vaccination and immunization. It provides a brief history of vaccination from Jenner's development of the smallpox vaccine in 1796 to modern vaccines. Key terms like vaccination, immunization, active immunity, and passive immunity are defined. The goals and benefits of vaccination programs are outlined, including herd immunity. Challenges to vaccination like misinformation, access issues, and cold chain management are also summarized.
ROTAVIRUS VACCINES IN INDIA .WHICH ONE WILL YOU CHOOSE AND WHY?DR SHAILESH MEHTA
Many brands of Rotavirus vaccine are available in India. However we need to have full evidence based decision making before we choose one rotavirus vaccine over another. This slideshow focuses on the need to have Indian studies which are not there with some of the international brands. Regionwise variability of rotavirus vaccines have prompted ICMR and various other scientific bodies in India to have our own data on efficacy of rotaviral vaccines in Indian scenario. Diarrhoea is a major cause of under 5 mortality in children. After the use of rotavirus vaccines there is a huge reduction of financial burden on our healthcare sytems.
Childhood diarrhoea incidence and severity have decreased ever since rotavirus vaccine was made a part of national immunization schedule.
This document summarizes guidelines and evidence for preventing allergic disease. It finds that maternal avoidance diets during pregnancy and lactation are not recommended. Exclusive breastfeeding for 4-6 months reduces atopic dermatitis, wheezing, and cow's milk allergy. While hydrolyzed formulas prevent cow's milk allergy compared to regular formula, no formula is conclusively better than breastfeeding. Complementary foods can be introduced between 4-6 months. House dust mite avoidance may reduce sensitization, but evidence is not compelling. Combining food and environmental allergen avoidance reduces wheezing and atopic dermatitis.
This presentation aims at helping the pediatric trainees and practitioners to brush up their knowledge in Immunization. The schedule is based on the Universal Immunisation Programme. I have tried to cover as much as possible in terms of individual vaccines and hope it is beneficial to the reader.
This document provides information on various vaccines used in India's national immunization schedule. It defines key terms related to immunization and vaccination. The national schedule recommends vaccines for diseases like tuberculosis, polio, diphtheria, pertussis, tetanus, hepatitis B, Hib, measles, and others to be administered to infants and children at specific ages. Details are provided on vaccine names, ingredients, dosage, administration route and effectiveness. The history and achievements of immunization programs in India and globally are also summarized.
This document discusses special situations and adverse events following immunization. It provides guidance on vaccinating preterm/low birth weight infants, those receiving corticosteroids or immunosuppressive therapy, children with malignancies, congenital immunodeficiencies, chronic diseases, allergies, bleeding disorders, or acute illness. It recommends that most vaccines can be administered according to chronological age for preterm/low birth weight infants. It also provides specific guidance on contraindications and precautions for different groups.
This document discusses approaches to preventing allergic diseases in children. It mentions that allergic diseases have increased rapidly in recent decades likely due to environmental and lifestyle changes. Early life exposure to allergens and microbes may influence the development of allergic immune responses. The document discusses genetic and environmental risk factors for atopic dermatitis and reviews evidence on the role of various allergens like food, aeroallergens and bacteria. It proposes that primary prevention aims to prevent sensitization to allergens, secondary prevention prevents disease progression after sensitization and tertiary prevention reduces symptoms after disease onset through allergen avoidance and treatment.
Pentavalent vaccine introduction in immunization programme in IndiaVikky3
This document provides operational guidelines for introducing the pentavalent vaccine, which protects against diphtheria, tetanus, pertussis, hepatitis B, and Haemophilus influenzae type b (Hib), into India's routine childhood immunization program. It discusses the diseases caused by Hib, the formulation and administration of the pentavalent vaccine, its safety, efficacy, and effectiveness. It also covers storage and handling guidelines, the vaccination schedule, and issues related to introducing the new vaccine. The pentavalent vaccine will replace standalone DPT and hepatitis B vaccines and is expected to reduce Hib-related mortality and morbidity in Indian children under five years of age.
Top 10 practical questions about Flu Vaccine in India!Gaurav Gupta
What does a practising paediatrician want to to know about the Flu vaccination? Talk for Abbott Vaccines (Influvac Tetra) in Oct 2020 about common queries that doctors have about the flu vaccine in India, including how it may help in COVID-19?
Vaccine Issues and the World Small Animal Veterinary Association (WSAVA) Guid...Yotam Copelovitz
Vaccination practices worldwide are changing. Various associations and organisations are updating their advice for vaccination best practices in dogs and cats upon an evidence-based research, and here is a recent update written by the honourable Dr. Jean Dodds.
This study investigated factors associated with latent tuberculosis infection (LTBI) and immune responses to BCG vaccination among children in Uganda. The prevalence of LTBI was 9% at age five years. Urban residence and history of TB contact were positively associated with LTBI. Multiple factors including BCG vaccine strain, LTBI status, HIV infection, helminth infection, and nutrition were associated with cytokine responses at age five. However, cytokine responses at age one year were not predictive of LTBI by age five. While exposure factors dominated the risk of LTBI, the child's immune responses were influenced by various host and environmental factors.
The universal immunization programme in India aims to protect infants and pregnant women against six vaccine preventable diseases. It is the largest immunization program in the world, targeting over 27 million infants and 30 million pregnant women annually. The national immunization schedule outlines vaccines to be administered according to age, including BCG, DPT, polio, hepatitis B, measles and more. Proper cold chain storage and handling of vaccines is essential to maintain their potency, as different vaccines have varying sensitivity to heat, cold, and light.
This document provides an overview of the Expanded Program on Immunization (EPI) including its objectives, strategies, elements, and principles of vaccinating children. The key points are:
1) EPI aims to reduce childhood diseases through vaccination coverage of at least 90% for diseases like tuberculosis, diphtheria, pertussis, neonatal tetanus, polio, hepatitis B, and measles.
2) General principles of EPI include administering multiple vaccines on the same day, continuing the vaccination schedule if doses are delayed, and strictly following vaccine storage and handling guidelines.
3) Contraindications to vaccination include severe allergic reactions to previous doses or known vaccine components,
The document discusses several vaccines including BCG, DTP, polio, Hib, MMR, rotavirus, varicella, hepatitis A, and pneumococcal. It provides information on the nature of the vaccines, indications for use, efficacy, administration schedule and route, storage requirements, adverse reactions and contraindications. Specific details are given for dosage, intervals between doses, age for administration and booster schedules for many of the vaccines.
The document discusses childhood immunization schedules and the benefits and risks of immunization versus the risks of diseases. It provides the recommended immunization schedule in the UK and explains that immunizations protect both an individual child's health as well as the health of others by helping to eliminate diseases. While immunizations carry small risks like fever or soreness, the diseases themselves pose much higher risks including death in some cases. The importance of immunization is evidenced by examples of disease outbreaks prior to widespread immunization. The document also discusses the discredited claim by Dr. Wakefield linking the MMR vaccine to autism and common reasons some people oppose immunization despite the lack of evidence that vaccines are dangerous.
IMMUNIZATION/VACCINATION(BOTH CHILD AND ADULT) WITH ALL UPDATESasifiqbal545
IMMUNIZATION/VACCINATION(BOTH CHILD AND ADULT) WITH ALL UPDATES AND DETAILS WITH FREQUENTLY ASKED QUESTIONS WITH DISCUSSION ON NEWEST VACCINES. ALSO DISCUSSION ON COLD CHAIN ETC.
This document appears to be a collection of pediatric immunology multiple choice questions and answers in Arabic. It includes questions about HiB vaccination schedules, conditions whose incidence has decreased due to HiB vaccination, live versus inactivated vaccines, vaccination routes and contraindications. The questions cover topics like BCG, diphtheria, pertussis, polio, measles, rubella, meningococcal and combination vaccines. It discusses vaccination schedules, precautions and contraindications for premature infants, immunocompromised children, those receiving certain medications and more.
Apresentação de projetos acadêmicos e profissionaisAlice Selles
O documento fornece dicas para apresentações acadêmicas e profissionais. Ele discute a importância de dominar o conteúdo, preparar antecipadamente, usar slides de forma clara e concisa, e praticar a apresentação para se sentir confortável na frente dos outros. Também dá conselhos sobre como lidar com nervosismo e como se portar profissionalmente durante uma apresentação.
Vitamina D ed Asma - Prof. Boner Attilio Università di VeronaRoberto Conte
1) Several studies show high rates of vitamin D deficiency and insufficiency among children with asthma. Low vitamin D levels are associated with worse asthma control, including increased exacerbations and hospitalizations.
2) Observational studies link higher maternal vitamin D intake during pregnancy to lower rates of wheezing and asthma in offspring. However, the evidence for a causal relationship is still insufficient.
3) Maintaining adequate vitamin D levels, especially during pregnancy and childhood, may help reduce asthma risk and severity by supporting lung development and function. Further research is still needed.
Vitamin D deficiency is common in obesity and is both a consequence of and risk factor for several metabolic conditions. Lower vitamin D levels are seen in obese individuals due to sequestration in fat tissue and lack of sun exposure. Vitamin D deficiency is associated with metabolic syndrome, hypertension, diabetes, high cholesterol, and increased cardiovascular risk. Supplementation may help treat vitamin D deficiency, but obesity also needs to be addressed to fully resolve the underlying causes.
Asthma, allergy and respiratory infections: the vitamin D hypothesisAriyanto Harsono
The document discusses the relationship between vitamin D and respiratory conditions like asthma. It suggests that vitamin D deficiency has been associated with increased risk of respiratory infections and asthma exacerbations. This may be because vitamin D plays important roles in immune function and lung development. The document reviews studies showing links between low vitamin D levels and higher risks of respiratory infections, asthma symptoms, and impaired lung function. However, the relationships are complex and not fully understood, as some studies have also linked high vitamin D supplementation to increased asthma risk. More research is still needed to clarify the roles and optimal levels of vitamin D.
Vitamina D in chiave Anti-aging- Amia- Spazio Nutrizione 2016Maurizio Salamone
Presentazione al congresso AMIA nell'ambito della kermesse "Spazio Nutrizione 2016" L'argomento Vit. D è stato affrontato in un ottica di salvaguardia della salute e modulazione del processo di invecchiamento. E' stato affrontato anche il rapporto tra la vitamina ormone e il sistema immunitario. Si è parlato di integrazione e trattamento delle carenze secondo le attuali linee guida italiane e internazionali.
Evento conclusivo del progetto Benessere: Cittadini più Sani Sicuri ed Informati. Presentazioni del Prof. Diego Peroni, Dott.ssa Maria Isabella Zuccalà, Dott.Marco Rossi,
Este documento proporciona una introducción al metabolismo, funciones y déficit de la vitamina D. Resume los principales puntos sobre las asociaciones entre la vitamina D y diversas enfermedades autoinmunes, cáncer, diabetes, infecciones, mortalidad y otras condiciones de salud. Explica los niveles normales de vitamina D y los factores que los afectan.
This document provides an overview of probiotics and prebiotics. It discusses the history of probiotics beginning with Elie Metchnikoff's conceptualization in the early 20th century. Examples of commonly used probiotic bacteria like Bifidobacterium and Lactobacillus are provided. The mechanisms of action of probiotics and examples of prebiotics like inulin and fructooligosaccharides are summarized. Finally, clinical applications of probiotics and prebiotics in managing conditions like antibiotic-associated diarrhea, lactose intolerance, and hypercholesterolemia are briefly described.
This document contains 4 scientific articles that discuss the role of vitamin D in infectious diseases:
1) The first article finds that vitamin D supplementation is associated with reductions in inflammatory cytokines in adults with cystic fibrosis hospitalized for a pulmonary exacerbation.
2) The second article finds a high rate of vitamin D deficiency in critically ill children and an association between lower vitamin D levels and increased illness severity.
3) The third article reviews evidence that vitamin D supplementation may have benefits for tuberculosis and viral respiratory infections based on randomized controlled trials.
4) The fourth article discusses a study finding that bolus-dose vitamin D can help prevent childhood pneumonia in areas where vitamin D deficiency and pneumonia are highly prevalent.
This document presents a thesis protocol investigating vitamin D levels between fertile and infertile women. It will be a prospective comparative study conducted at Bokaro General Hospital, Jharkhand, India. The study aims to assess and compare serum 25-hydroxyvitamin D levels in 60 infertile women and 60 fertile women between ages 21-40 years. Exclusion criteria include women with medical illnesses or using medications affecting vitamin D. Blood samples will be collected and 25-hydroxyvitamin D levels measured using ELISA to classify vitamin D status. Results will be statistically analyzed to compare vitamin D deficiency between the two groups and assess any associations with factors. The study aims to help evaluate prevalence of vitamin D deficiency in infertile women and potential benefits of
Vitamin D has wide-ranging effects throughout the body that help support immune function, respiratory health, digestive health, nervous system function, and brain development. It helps regulate inflammation, supports innate and adaptive immunity, and may downregulate the recruitment and activation of immune cells during infection. Vitamin D deficiency has been linked to increased risk of respiratory infections like pneumonia as well as autoimmune diseases and some cancers. The active form of vitamin D also induces the production of antimicrobial peptides that can help destroy pathogens like M. tuberculosis.
Effects of moderate doses of vitamin A as an adjunct to the treatment of pneu...ISAMI1
Effects of moderate doses of vitamin A as an adjunct to the treatment of pneumonia in underweight and normal-weight children: a randomized, double-blind, placebo-controlled trial
Vitamin D deficiency and Regulatory T cells in pregnant womenR Hemalatha
Vitamin D deficiency is highly prevalent in pregnant women (> 80%) and children (>75%). Beneficial effects of vitamin D on atopic allergic responses have been suggested to be mediated through Regulatory T cell population (Treg cells). Treg cell function are implicated in Non communicable diseases as well. Treg cells are known to play a significant role in the maintenance of maternal tolerance to the fetus and are detected in the human decidua and peripheral blood throughout pregnancy. Treg cell population, that comprises less than 1 % of peripheral CD4+ cells, has the ability to suppress both Th1 and Th2 immunity against paternal/ fetal alloantigen, a process, critical for immune regulation and continuation of pregnancy
1. The document summarizes various studies on prevention of allergy through modulation of the gut microbiota from early life.
2. Key areas of focus include the gut microbiota of pregnant women and its impact on the infant, early introduction of foods like peanuts and eggs to induce tolerance, use of probiotics and breastfeeding to influence the infant gut microbiota, and effects of a farm environment and dietary fibers on allergy risk.
3. Studies found that probiotics started prenatally and combined with breastfeeding were most effective in preventing eczema, and that early introduction of peanuts and eggs reduced the risk of developing an allergy to those foods.
This document discusses vitamin D in pregnancy. It covers the physiology of vitamin D, risks of deficiency like preeclampsia, low birthweight, and neonatal hypocalcemia. It recommends screening high-risk women like those with limited sun exposure or high BMI and supplementing deficient women with 1000-2000IU of vitamin D daily during pregnancy. Vitamin D supplementation is considered safe and may provide benefits, though more research is still needed on optimal dosing.
Vitamin D deficiency ( plasma 25(OH)D levels
<50 nmol/L)(20 ng/ml) was ubiquitous in patients with ARDS and
present in the vast majority of patients at risk of
developing ARDS following oesophagectomy.
Immunogenicity – i.e. immune response generated in the mother.
Transfer of antibodies to fetus Split –Vision Vaccine
Clinical efficacy in mother
Clinical efficacy in newborn
( up to 6 months of age )
Effectiveness of the Influenza vaccine . Dr. Sharda Jain , Lifecare Cent...Lifecare Centre
Effectiveness of vaccine can be judged in 4 ways
Immunogenicity – i.e. immune response generated in the mother.
Transfer of antibodies to fetus
Clinical efficacy in mother
Clinical efficacy in newborn
( up to 6 months of age )
ROLE OF VITAMIN D IN ALLERGIC RHINITIS.pptxPrithivVijay1
Vitamin D plays an important role in the immune system and may help treat allergic rhinitis. Studies show vitamin D can decrease proinflammatory cytokines, inhibit Th1 and Th2 responses, reduce IgE secretion, and maintain nasal mucosa integrity. A study on mice found that vitamin D administration lowered nasal symptoms and inflammation by regulating the Th1/Th2 and Treg/Th17 balances and correcting the inflammatory response at a microscopic level. However, human studies on the relationship between vitamin D levels and allergies have had conflicting results, due to differences in dosages and timing of supplementation.
Vita d defic mothers newborns merewood pediatrics 2010Alison Stevens
This study found high rates of vitamin D deficiency in newborns and their mothers in Boston, Massachusetts. The median vitamin D level was below the sufficient level in 58% of infants and 36% of mothers. Risk factors for infant deficiency included having a deficient mother, winter birth, black race, and a maternal BMI over 35. Prenatal vitamin use was protective against deficiency for both infants and mothers, however over 30% of mothers still had insufficient levels despite prenatal vitamin use. The results suggest prenatal vitamins may not provide enough vitamin D to ensure sufficiency.
Maternal Immunization with Tdap Vaccine Dr. Sharda Jain Lifecare Centre
Maternal
Immunization
with Tdap Vaccine
Agenda
Pertussis:Key facts & Epidemiology
Who is at risk?
Source of Pertussis infection
What is Tdap vaccine?
Recommendations for Maternal Immunization with Tdap vaccine
Safety data on Maternal Immunisation with Tdap vaccine
Summary
This document discusses a systematic review on the role of vitamin D in maternal and fetal outcomes in gestational diabetes mellitus (GDM). The review analyzed 36 studies on the effects of vitamin D supplementation in GDM pregnancies. The results showed that vitamin D supplementation improved insulin sensitivity, glucose tolerance, and pancreatic function in GDM patients with a BMI below 35. However, vitamin D supplementation had no effect on GDM outcomes in obese patients or those with genetic risk factors. The review concluded that vitamin D supplementation can help regulate blood glucose in normal-weight GDM patients but not in obese patients or those with strong genetic risk factors.
Relationship between low maternal serumvitamin d levels and gestational diabe...nen sonia
This study aimed to evaluate the relationship between low maternal serum vitamin D levels and gestational diabetes mellitus (GDM) in 140 pregnant women in India. 70 women diagnosed with GDM were the case group, and 70 normal pregnant women were the control group. The study found that the mean vitamin D level was significantly lower in the GDM group compared to the control group. Additionally, vitamin D levels correlated negatively with HbA1c and fasting blood glucose levels in the GDM group, indicating that lower vitamin D levels were associated with worse glycemic control. The study concluded that low maternal vitamin D levels were associated with GDM and that vitamin D levels correlated with glycemic control levels in women with GDM.
Vita D Defic Mothers Newborns Merewood Pediatrics 2010alisonegypt
This study found high rates of vitamin D deficiency in mothers and newborns in Boston, Massachusetts. 58% of infants and 36% of mothers had vitamin D levels below 20 ng/mL. Risk factors for infant deficiency included a deficient mother, winter birth, black race, and a maternal BMI over 35. Prenatal vitamin use was protective against deficiency for both mothers and infants, however 30% of mothers still had low vitamin D levels despite taking prenatal vitamins.
The document discusses vitamin C and its effects on the common cold based on two studies. The first study found that regular vitamin C supplementation reduced the duration and severity of colds but did not decrease incidence except in populations under physical stress. It concluded vitamin C intake may reduce annual cold symptoms by 1 day for adults and 4 days for children. The second study found that mega-doses of vitamin C administered before or after cold symptoms relieved and prevented symptoms compared to a control group, decreasing reports by 85%. Both studies support vitamin C supplementation reducing cold symptoms.
The document discusses vitamin D deficiency in children and its management approaches. It finds that vitamin D deficiency prevalence is around 30-90% across all age groups in India. This is a critical issue as vitamin D and calcium are important for musculoskeletal health in growing years. Infants and children are especially at risk of deficiency due to factors like minimal vitamin D in breast milk and diet, prolonged breastfeeding without supplementation, darker skin, and lack of sun exposure. Deficiency can lead to acute presentations like seizures from hypocalcemia in newborns or chronic rickets characterized by bone deformities and weakening. The document examines case studies and provides guidelines on testing, risk factors, presentations, and treatment approaches for vitamin D deficiency in children.
Vitamin D3 and DHA play important roles in pregnancy. Vitamin D3 deficiency has been associated with increased risk of preeclampsia, gestational diabetes, low birth weight, preterm delivery, and impaired neonatal immunity. It is recommended that pregnant women take a daily supplement of 10 micrograms of vitamin D3. DHA is important for brain and eye development of the fetus. Ensuring adequate DHA through diet or supplements can help reduce risks of preterm birth and improve infant cognitive development and immune response. Supplementation with DHA during pregnancy and lactation has shown benefits.
201911 - Tripodi - Immunoterapia specifica alla luce della e-mobile health?Asmallergie
1. The document discusses using digital solutions like mobile health to improve allergen immunotherapy (AIT) by combining clinical research data and mobile health for AIT prescription.
2. It proposes the "@IT-2020" process, a flexible 4-step modular approach for prescribing AIT for pollen allergy patients in Southern Europe/Mediterranean countries, to be validated in a pilot study (2016-2017) and multicenter study (2018-2019).
3. The 4 diagnostic steps of "@IT-2020" and validation testing are described, aiming to determine genuine vs false sensitization, primary sensitization, and the relationship between sensitization and symptoms to guide personalized AIT prescription.
201911 - Rossi - L'asma grave è sempre “grave”?Asmallergie
This document discusses a study of 437 patients with severe asthma (GINA step V) in Italy. The main findings were:
- The average annual exacerbation rate was 3.75.
- The mean blood eosinophil level was 536.7 cells/mcL and average serum total IgE was 470.3 kU/L.
- 64% were on regular oral corticosteroids, 57% with omalizumab and 11.2% with mepolizumab.
- The most common comorbidities were rhinitis, nasal polyposis, and bronchiectasis. Bronchiectasis was associated with more frequent severe exacerbations.
201911 - Conte - Asma eosinofilico: i farmaci biologici che contrastano l'azi...Asmallergie
This document summarizes a presentation about eosinophilic asthma and biological drugs that target interleukin-5 (IL-5). It discusses the role of eosinophils and IL-5 in asthma, clinical studies of anti-IL-5 drugs like mepolizumab and benralizumab, and real-world experience with these therapies. The presentation covers the pathophysiology of eosinophilic asthma, how anti-IL-5 drugs work, results from major clinical trials showing reduced exacerbations and oral corticosteroid use, and insights from real-world studies on treatment response and outcomes. It emphasizes the importance of patient phenotypes and endotypes in guiding therapy selection for severe asthma.
201911 - Villalta - Novità in ambito di diagnostica molecolare nella sensibil...Asmallergie
This document discusses advances in molecular diagnostics for mite sensitization. It begins with a brief history of allergy to house dust mites and an overview of the major allergenic molecules from mites, including Der p 1, Der p 2, and Der p 23. It describes the concept of "molecular spreading" where the IgE response spreads from initial sensitization to major allergens to include other milder allergens over time. The document then covers classical and molecular diagnostic techniques for mite allergy. It concludes by discussing the potential predictive role of antibody patterns to different mite allergens.
Travel Clinic Cardiff: Health Advice for International TravelersNX Healthcare
Travel Clinic Cardiff offers comprehensive travel health services, including vaccinations, travel advice, and preventive care for international travelers. Our expert team ensures you are well-prepared and protected for your journey, providing personalized consultations tailored to your destination. Conveniently located in Cardiff, we help you travel with confidence and peace of mind. Visit us: www.nxhealthcare.co.uk
Are you looking for a long-lasting solution to your missing tooth?
Dental implants are the most common type of method for replacing the missing tooth. Unlike dentures or bridges, implants are surgically placed in the jawbone. In layman’s terms, a dental implant is similar to the natural root of the tooth. It offers a stable foundation for the artificial tooth giving it the look, feel, and function similar to the natural tooth.
Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)MuskanShingari
Statistics- Statistics is the science of collecting, organizing, presenting, analyzing and interpreting numerical data to assist in making more effective decisions.
A statistics is a measure which is used to estimate the population parameter
Parameters-It is used to describe the properties of an entire population.
Examples-Measures of central tendency Dispersion, Variance, Standard Deviation (SD), Absolute Error, Mean Absolute Error (MAE), Eigen Value
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdfOsvaldo Bernardo Muchanga
GASTROINTESTINAL INFECTIONS AND GASTRITIS
Osvaldo Bernardo Muchanga
Gastrointestinal Infections
GASTROINTESTINAL INFECTIONS result from the ingestion of pathogens that cause infections at the level of this tract, generally being transmitted by food, water and hands contaminated by microorganisms such as E. coli, Salmonella, Shigella, Vibrio cholerae, Campylobacter, Staphylococcus, Rotavirus among others that are generally contained in feces, thus configuring a FECAL-ORAL type of transmission.
Among the factors that lead to the occurrence of gastrointestinal infections are the hygienic and sanitary deficiencies that characterize our markets and other places where raw or cooked food is sold, poor environmental sanitation in communities, deficiencies in water treatment (or in the process of its plumbing), risky hygienic-sanitary habits (not washing hands after major and/or minor needs), among others.
These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
To prevent this, it is necessary to promote health education, improve the hygienic-sanitary conditions of markets and communities in general as a way of promoting, preserving and prolonging PUBLIC HEALTH.
Gastritis and Gastric Health
Gastric Health is one of the most relevant concerns in human health, with gastrointestinal infections being among the main illnesses that affect humans.
Among gastric problems, we have GASTRITIS AND GASTRIC ULCERS as the main public health problems. Gastritis and gastric ulcers normally result from inflammation and corrosion of the walls of the stomach (gastric mucosa) and are generally associated (caused) by the bacterium Helicobacter pylor, which, according to the literature, this bacterium settles on these walls (of the stomach) and starts to release urease that ends up altering the normal pH of the stomach (acid), which leads to inflammation and corrosion of the mucous membranes and consequent gastritis or ulcers, respectively.
In addition to bacterial infections, gastritis and gastric ulcers are associated with several factors, with emphasis on prolonged fasting, chemical substances including drugs, alcohol, foods with strong seasonings including chilli, which ends up causing inflammation of the stomach walls and/or corrosion. of the same, resulting in the appearance of wounds and consequent gastritis or ulcers, respectively.
Among patients with gastritis and/or ulcers, one of the dilemmas is associated with the foods to consume in order to minimize the sensation of pain and discomfort.
Nutritional deficiency Disorder are problems in india.
It is very important to learn about Indian child's nutritional parameters as well the Disease related to alteration in their Nutrition.
“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...Université de Montréal
“Psychiatry and the Humanities”: An Innovative Course at the University of Montreal Expanding the medical model to embrace the humanities. Link: https://www.psychiatrictimes.com/view/-psychiatry-and-the-humanities-an-innovative-course-at-the-university-of-montreal
The Children are very vulnerable to get affected with respiratory disease.
In our country, the respiratory Disease conditions are consider as major cause for mortality and Morbidity in Child.
Breast cancer: Post menopausal endocrine therapyDr. Sumit KUMAR
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
Travel vaccination in Manchester offers comprehensive immunization services for individuals planning international trips. Expert healthcare providers administer vaccines tailored to your destination, ensuring you stay protected against various diseases. Conveniently located clinics and flexible appointment options make it easy to get the necessary shots before your journey. Stay healthy and travel with confidence by getting vaccinated in Manchester. Visit us: www.nxhealthcare.co.uk
Debunking Nutrition Myths: Separating Fact from Fiction"AlexandraDiaz101
In a world overflowing with diet trends and conflicting nutrition advice, it’s easy to get lost in misinformation. This article cuts through the noise to debunk common nutrition myths that may be sabotaging your health goals. From the truth about carbohydrates and fats to the real effects of sugar and artificial sweeteners, we break down what science actually says. Equip yourself with knowledge to make informed decisions about your diet, and learn how to navigate the complexities of modern nutrition with confidence. Say goodbye to food confusion and hello to a healthier you!
Summer is a time for fun in the sun, but the heat and humidity can also wreak havoc on your skin. From itchy rashes to unwanted pigmentation, several skin conditions become more prevalent during these warmer months.
1. Vitamina D e ….
Le azioni extrascheletriche
Diego Peroni
U.O. Pediatria
Università di Pisa
Le basi immunologiche
L’associazione
La supplementazione
I problemi aperti
Le conclusioni
diego.peroni@unipi.it
3. The vitamin D receptor (VDR), the nuclear hormone
receptor that mediates most if not all of the functions
of its preferred ligand 1,25 dihydroxyvitamin D
[1,25(OH)2D] or calcitriol, is found in most tissuesis found in most tissues
of the body.of the body.
Indeed, many of these tissues also contain the enzyme, CYP27B1,enzyme, CYP27B1,
which converts the major circulating metabolite of vitamin D,
25 hydroxyvitamin D25 hydroxyvitamin D (25OHD calcidiolcalcidiol) , toto 1,25(OH)2D (calcitriol)1,25(OH)2D (calcitriol).
Thus, it has been suspected for some time that vitamin D exertsvitamin D exerts
its actions not only on classic tissues regulating calciumits actions not only on classic tissues regulating calcium
homeostasishomeostasis such as bonebone, gutgut and kidneykidney but also on other tissuesother tissues.
Multiple Functions of Vitamin D
4. Overview of vitamin D and its interactions with cells of
the immune system. Muehleisen B, JACI 2013;131:324-9.
5. Vitamin D and
immune system.
1α,25(OH)2D appears to
influence susceptibility
to and severity of
infection via multiple
mechanisms via the
innate and adaptive
immune system.
Gröber U,Gröber U,
Dermatoendocrinol.Dermatoendocrinol.
2013;5:331-472013;5:331-47
6. Vitamina D e ….
Le azioni extrascheletriche
Diego Peroni
U.O. Pediatria
Università di Pisa
Le basi immunologiche
L’associazione
La supplementazione
I problemi aperti
Le conclusioni
diego.peroni@unipi.it
7. Vitamin D, the Gut Microbiome, and the Hygiene Hypothesis. How
Does Asthma Begin? S Weiss, AJCCM, 2015; 191:492
Interactions of vitamin D with the gut microbiome and the fetal
immune system. Vitamin D up-regulates TGF-beta1 and IL-10, which
will enhance Treg function and down-regulate CD4 T cells, reducing
both Th1 and Th2 CD41 cell inflammation.
8. Vitamin D, the Gut Microbiome, and the Hygiene Hypothesis. How
Does Asthma Begin? S Weiss, AJCCM, 2015; 191:492
Vitamin D also enhances antigenic traffic between dendritic cells
and Tregs. The gut microbiome is the primary source of antigen for
Treg cell processing and may also influence the development of
immunity in the fetus. Vitamin D controls the development of GALT
and dendritic cell trafficking from the gut dendritic cells in the gut
epithelium to the Tregs.
9. Studi che hanno valutato l’associazione tra
dermatite atopica e vitamina D
10. Correlation between serum 25-hydroxyvitamin D levels
and severity of atopic dermatitis in children.
Peroni DG, Br J Dermatol. 2011;164:1078-82.
Correlation between serum vitamin D
levels and individual SCORAD values.
37 children (8 months and
12 years) with AD,
SCORAD index,
Serum levels of
25-hydroxyvitamin D
sIgE to S. aureus
and to M. furfur
11. Serum Vitamin D levels and Vitamin D supplementation
do not correlate with the severity of chronic eczema in
children. Galli E, Eur Ann Allergy Clin Immunol. 2015;47(2):41-7.
89 children with chronic
eczema divided into two
groups according to the
state of sensitization
(YES/NO).
a daily oral Vitamin D3
supplementation
(2000 IUs)
for 3 months or
no supplementation.
1) Vitamin D concentrations in patients with
moderate and severe eczemamoderate and severe eczema were not
statistically different from Vitamin D
concentration detected in the serum of
patients with mild eczemamild eczema.
2)2) No correlationNo correlation was found between
Vitamin D levels, total IgEstotal IgEs and
SCORADSCORAD index, both in the Sensitized
and in the Not-Sensitized group.
3) Vitamin D3 supplementation did notsupplementation did not
influence the SCORAD severity or theinfluence the SCORAD severity or the
total IgEs concentration.total IgEs concentration.
12. Altri studi che hanno valutato l’associazione tra
dermatite atopica e vitamina D
13. Cord serum 25-hydroxyvitamin D and risk of early childhood
transient wheezing and atopic dermatitis.
Baiz N, JACI; 2014; 133:147
aim was to
investigate in
239 newborns the
associations
between cord
serum 25(OH)D
levels and
asthma,wheezing,
allergic rhinitis,
and atopic
dermatitis in the
offspring from
birth to 5 years.
Adjusted associations between cord serum 25(OH)D
levels and predicted probabilities of atopic dermatitis by
age of 5 years
14. 25–hydroxyvitamin D
levels
616 asthmatic children
Vitamin D levels
deficient (<20 ng/ml),
insufficient
(≥20 and <30 ng/ml),
and sufficient (≥30
ng/ml)
Vitamin D levels were significantlyVitamin D levels were significantly
and inversely associated with:and inversely associated with:
1) total IgE and eosinophil count
2) any hospitalization in the previous year
(p=0.03),
3) any use of anti-inflammatory medications
in the previous year (p=0.01),
4) increased airway responsiveness (p =
0.05).
Serum Vitamin D Levels and Markers of Severity
of Childhood Asthma in Costa Rica
Brehm Am J Respir Crit Care Med 2009;179:765
15. 75 asthmatic children
25-hydroxyvitamin D
Spirometry
asthma control, according
to GINA guidelines and with
Childhood Asthma Control
Test
Vitamin D Serum Levels and Markers of Asthma Control
in Italian Children Chinellato J Pediatr 2011;158:437
p=0.054
p=0.054
16. Vitamina D e ….
Le azioni extrascheletriche
Diego Peroni
U.O. Pediatria
Università di Pisa
Le basi immunologiche
L’associazione
La supplementazione
nella prevenzione
I problemi aperti
Le conclusioni
diego.peroni@unipi.it
17. Predictors of vitamin D status in subjects that consume a
vitamin D supplement. Levy M., Eur. J. Clin. Nutr. 2015; 69, 84
Retrospective,
cross-sectional
study involving 743
volunteers.
Serum 25-hydroxy-
vitamin D
(25(OH)D) level and
the variables diet,
supplement usage,
latitude of
residence, ethnicity,
age and body mass
index (BMI)
winter summer
18. Predictors of vitamin D status in subjects that consume a
vitamin D supplement. Levy M., Eur. J. Clin. Nutr. 2015; 69, 84
Supplemental vitamin D3 consumption was the most
significant positive predictor, whereas BMI was
the most significant negative predictor. Negative
predictors were: African American, Asian and
Hispanic race in the summer; latitude of residence
<36 °N, Asian and Hispanic ethnicity in the winter
19. Maternal nutrition during pregnancy and risk of asthma, wheeze,
and atopic diseases during childhood: a systematic review and
meta-analysis. Beckhaus A, Allergy 2015; 70: 1588
Pooled difference for maternal dietary vitamin D
intake during pregnancy and childhood wheeze.
Current evidence suggests a protective effect of maternal intake of each of three
vitamins or nutrients (vitamin D, vitamin E, and zinc) against childhood wheeze but is
inconclusive for an effect on asthma or other atopic conditions.
20. Vitamin D During Pregnancy and Infancy and Infant Serum 25-
Hydroxyvitamin D Concentration. C Grant, Pediatrics 2014;133:e143
Pregnant mothers,
from 27 weeks’
gestation to birth,
and then their
infants, from birth
to age 6 months,
were randomly
assigned to 1 of 3
mother/infant
groups:
placebo/placebo,
vitamin
D3 1000/400 IU, or
vitamin D3
2000/800 IU
21. Reduced primary care respiratory infection visits following
pregnancy and infancy vitamin D supplementation: a randomised
controlled trial. Grant, Acta Paediatrica, 2015; 104:396.
Pregnant mothers,
from 27 weeks’
gestation to birth,
and then their
infants, from birth
to age 6 months,
were randomly
assigned to 1 of 3
mother/infant
groups:
placebo/placebo,
vitamin
D3 1000/400 IU,
or vitamin D3
2000/800 IU
Time (in days) to first primary care visit for an acute
respiratory infection for children randomised to placebo,
lower-dose vitamin D3 or higher dose vitamin D3.
22. Vitamin D supplementation during pregnancy and infancy reduces
aeroallergen sensitization: a randomized controlled trial.
Grant, Allergy 2016
Woman/infant pairs were randomized to: placebo/placebo, 1000
IU/400 IU or 2000 IU/800 IU. When the children were 18 months
old, we measured sIgE and identified acute primary care visits
23. Vitamin D supplementation during pregnancy and infancy reduces
aeroallergen sensitization: a randomized controlled trial.
Grant, Allergy 2016
Woman/infant pairs were randomized to: placebo/placebo, 1000
IU/400 IU or 2000 IU/800 IU. When the children were 18 months
old, we measured sIgE and identified acute primary care visits
Vitamin D supplementation during pregnancy and infancy
reduces the proportion of children sensitized to mites at
age 18 months. Preliminary data indicate a possible
effect on primary care visits where asthma is diagnosed.
24. Effect of Vitamin D3 Supplementation During Pregnancy on Risk of
Persistent Wheeze in the Offspring. Chawes, JAMA. 2016;315(4):353.
COPSAC study cohort.
Vitamin D3 (2400 IU/d; n=315) or matching placebo tablets (n=308) from
pregnancy week 24 to 1 week postpartum.
All women received 400 IU/d of vitamin D3 as part of usual pregnancy care.
Age at onset of persistent wheeze in the first 3 years of life
25. Effect of Vitamin D3 Supplementation During Pregnancy on Risk of
Persistent Wheeze in the Offspring. Chawes, JAMA. 2016;315(4):353.
Effect of Vitamin D3 Supplementation
on Risk of Persistent Wheeze in
Children in the COPSACThe use of 2800 IU/d of
vitamin D3 during the third
trimester of pregnancy
compared with 400 IU/d did
not result in a statistically
significant reduced risk
of persistent wheeze in the
offspring through age 3 years.
However, interpretation of the
study is limited by a wide CI
that includes a clinically
important protective effect.
26. Effect of Prenatal Supplementation With Vitamin D on Asthma or
Recurrent Wheezing in Offspring by Age 3 Years.
Litonjua, JAMA. 2016;315(4):362
The Vitamin D Antenatal Asthma Reduction Trial 440 women were randomized to
receive daily 4000 IU vitamin D plus 400 IU, and 436 women were randomized to
receive a placebo plus a prenatal vitamin containing 400 IU vitamin D.
Coprimary outcomes of (1) parental report of physician-diagnosed asthma or
recurrent wheezing through 3 years of age and (2) third trimester maternal 25-
hydroxyvitamin D levels.
27. Effect of Prenatal Supplementation With Vitamin D on Asthma or
Recurrent Wheezing in Offspring by Age 3 Years.
Litonjua, JAMA. 2016;315(4):362
The Vitamin D Antenatal Asthma Reduction Trial 440 women were randomized to
receive daily 4000 IU vitamin D plus 400 IU, and 436 women were randomized to
receive a placebo plus a prenatal vitamin containing 400 IU vitamin D.
Coprimary outcomes of (1) parental report of physician-diagnosed asthma or
recurrent wheezing through 3 years of age and (2) third trimester maternal 25-
hydroxyvitamin D levels.
In pregnant women at risk of having a child with
asthma, supplementation with 4400 IU/d of vitamin D
compared with 400 IU/d significantly increased vitamin
D levels in the women. The incidence of asthma and
recurrent wheezing in their children at age 3 years was
lower by 6.1%, but this did not meet statistical
significance
28. Vitamina D e ….
Le azioni extrascheletriche
Diego Peroni
U.O. Pediatria
Università di Pisa
Le basi immunologiche
L’associazione
La supplementazione
nella terapia
I problemi aperti
Le conclusioni
diego.peroni@unipi.it
29. Effectiveness of vitamin D supplementation in the management
of atopic dermatitis: a review of current evidence.
Demirjian M. Curr Nutr Food Sci 2014; 10: 12
30. Vitamin D supplementation in the treatment of atopic dermatitis: a
clinical trial study.
Amestejani M, J Drugs Dermatol. 2012;11(3):327-30
60 AD patients
(mean age 23 yrs)
living in Tehran, Iran
Group D, 1600 IU1600 IU
cholecalciferolcholecalciferol
(vitamin D n= 30) and second
group placebo (n= 30)
for 2 monthsfor 2 months
severity of AD based on
SCORAD
(Scoring Atopic Dermatitis)
and TIS
(Three Item Severity score)
For both the SCORAD index and
TIS value, the vitamin Dthe vitamin D
supplemented group showedsupplemented group showed
improvement in patients with mild,improvement in patients with mild,
moderate, and severe AD.moderate, and severe AD.
All of these measures were statistically
significant except for the TIS value in the
moderate category of patients.
A statistically significant improvement was
not seen for patients taking the placebo pill
in any of the severity categories.
32. Randomized trial of vitamin D supplementation for
winter-related atopic dermatitis in children.
Camargo CA Jr, J Allergy Clin Immunol. 2014;134(4):831-835.
average % change from
the baseline EASI score
-00
-10 –
-20 –
-30 –
-16%
-29%
p=0.02
Vitamin D
Placebo
104 Mongolian
children with
winter-related AD
(age 2-17 yrs)
AD score 10 to 72 using
the Eczema Area andEczema Area and
Severity Index (EASI)Severity Index (EASI)
oral cholecalciferoloral cholecalciferol
(1000 IU/day)(1000 IU/day) versus
placebo for 1 monthfor 1 month.
33. Studi più recenti di supplementazione
Nei bambini con dermatite atopica severa e livelli
ridotti di 25(OH)D potrebbe essere indicato un
breve trial con vitamina D, per ripristinare uno
stato vitaminico D sufficiente e valutare
l’eventuale effetto di modulazione della severità
della dermatite atopica. Resta la necessità di
ulteriori studi…
34. Effect of Vitamin D and Inhaled Corticosteroid
Treatment on Lung Function in Children
Chen Wu A., AJRCCM 2012; 186: 508–513
Change in prebronchodilator FEVChange in prebronchodilator FEV11
Change in prebronchodilatorChange in prebronchodilator
FEVFEV11 % predicted% predicted
P = 0.0072
vitamin D sufficiencyvitamin D sufficiency (>30 ng/ml), insufficiencyinsufficiency (20–30 ng/ml),
deficiencydeficiency (<20 ng/ml)
35. Vitamin D supplementation in children may prevent
asthma exacerbation triggered by acute respiratory
infection. Majak P, J Allergy Clin Immunol 2011;127:1294
48 children (5-18 yrs)
with newly diagnosed
asthma and sensitive only
to house dust mites
budesonide 800 µg/d
administered as a dry
powder and vitamin D
placebo
(steroid group, n = 24), or
budesonide 800 µg/d and
vitamin D3-500 IU
(steroid + vit D
group n=24).
Follow-up: 6 months
36. Improved control of childhood asthma with low-dose, short-term
vitamin D supplementation: a randomized, double-blind, placebo-
controlled trial. Tachimoto, Allergy 2016.
placebo-controlled trial
comparing vitamin D3
supplements (800
IU/day) with placebo
for 2 months in
schoolchildren with
asthma. The primary
outcomes were
frequency and severity
by GINA.
Schoolchildren
received vitamin D
(n = 54) or placebo
(n = 35).
Low-dose, short-term vitamin D
supplementation in addition to
standard treatment may improve levels of
asthma control in schoolchildren.
37.
38. Vitamina D e ….
Le azioni extrascheletriche
Diego Peroni
U.O. Pediatria
Università di Pisa
Le basi immunologiche
L’associazione
La supplementazione
I problemi aperti
Le conclusioni
diego.peroni@unipi.it
39. The lower defined threshold value for bone healththreshold value for bone health
(25OHD ≥ 20 ng/mL(25OHD ≥ 20 ng/mL [50 nmol/L])[50 nmol/L]),
Holick MF, J Clin Endocrinol Metab 2011;96:1911–30
Rosen CJ, J Clin Endocrinol Metab 2012;97:1146–52.
Serum level of 25OHD 30–40 ng/mL30–40 ng/mL
(75–100 nmol/L)(75–100 nmol/L) has been suggested asas
a lower thresholda lower threshold of an optimal serum level
for the immune effectsfor the immune effects of vitamin D.
Vieth R, Am J Clin Nut 2007;85:649–50.
Bischoff-Ferrari HA, Am J Clin Nut 2006; 84:18–28.
MoreMore than one-third of the population worldwideone-third of the population worldwide may have levels of
vitamin D < 20 ng/mL< 20 ng/mL (50 nmol/L)(50 nmol/L). Hilger J. British J Nut 2014;111:23–45.
Vitamin D levels optimal for overall health.
40. Vitamin D–Binding Protein Modifies the Vitamin D–Bone Mineral
Density Relationship. Powe, JBMR; 2011: 26, 1609.
The free hormone hypothesis postulates that only hormones
liberated from binding proteins enter cells and produce biologic
action.
25(OH)D and 1,25-dihydroxyvitamin D3 [1,25(OH)2D3] circulate
bound to vitamin D–binding protein (85% to 90%) and albumin (10%to
15%), with less than 1% of circulating hormone in its free form.
In mice, vitamin D–binding protein (DBP) prolongs the serum half-life
of 25(OH)D and protects against vitamin D deficiency by serving as a
vitamin D reservoir. However, DBP also limits the biologic activity of
injected 1,25(OH)2D3 in mice and inhibits the action of vitamin D on
monocytes and keratinocytes in vitro.
The significance of circulating DBP levels with regard to vitamin D’s
biologic action in humans is unclear.
41. Vitamin D and DBP: The free hormone hypothesis
revisited. Chun, J Steroid Biochem Mol Biol. 2014; 144: 132
42. Vitamin D–Binding Protein and Vitamin D Status of Black Americans
and White Americans. Powe, NEJM 2013; 369: 1991.
(2085 participants)
measured levels of total
25-hydroxyvitamin D,
vitamin D–binding
protein, and parathyroid
hormone as well as bone
mineral density (BMD).
We genotyped study
participants for two
common polymorphisms
43. Vitamin D–Binding Protein and Vitamin D Status of Black Americans
and White Americans. Powe, NEJM 2013; 369: 1991.
(2085 participants)
measured levels of total
25-hydroxyvitamin D,
vitamin D–binding
protein, and parathyroid
hormone as well as bone
mineral density (BMD).
We genotyped study
participants for two
common polymorphisms
44. Vitamin D–Binding Protein and Vitamin D Status of Black Americans
and White Americans. Powe, NEJM 2013; 369: 1991.
(2085 participants)
measured levels of total
25-hydroxyvitamin D,
vitamin D–binding
protein, and parathyroid
hormone as well as bone
mineral density (BMD).
We genotyped study
participants for two
common polymorphisms
Community-dwelling black Americans, as compared with
whites, had low levels of total 25-hydroxyvitamin D and
vitamin D–binding protein, resulting in similar
concentrations
of estimated bioavailable 25-hydroxyvitamin D. Racial
differences in the prevalence of common
genetic polymorphisms provide a likely explanation for
this observation
45. Response of vitamin D binding protein and free vitamin D
concentrations to vitamin D supplementation in hospitalized
premature infants. Hanson, J Ped End Metab 2015; 28: 1107
32 infants < 32 wks’
gestation were
randomized to two
different levels of
vitamin D3
supplementation
(400 vs. 800
IU/day).
25(OH)D levels were
measured by LC-
MS/MS; DBP was
measured by
validated ELISA.
Free vitamin D was
calculated using
molar ratios of
25(OH)D and DBP
46. Response of vitamin D binding protein and free vitamin D
concentrations to vitamin D supplementation in hospitalized
premature infants. Hanson, J Ped End Metab 2015; 28: 1107
32 infants < 32 wks’
gestation were
randomized to two
different levels of
vitamin D3
supplementation
(400 vs. 800
IU/day).
25(OH)D levels were
measured by LC-
MS/MS; DBP was
measured by
validated ELISA.
Free vitamin D was
calculated using
molar ratios of
25(OH)D and DBP
Vitamin D binding protein acts as a reservoir for 25(OH)
D, controlling the bioavailability to target organs.
Supplementation with vitamin D3 increased the free
portion
of the vitamin D metabolite, calculated from measured
DBP levels, providing increased bioavailable substrate.
47. Vitamina D e ….
Le azioni extrascheletriche
Diego Peroni
U.O. Pediatria
Università di Pisa
Le basi immunologiche
L’associazione
La supplementazione
I problemi aperti
Le conclusioni
diego.peroni@unipi.it
48. Based on the results reported in the trials by Chawes et al and
Litonjua et al, what should clinicians do?
Given the lack of any major unwanted effects observed in either of these trials,
prescribing a higher than recommended vitamin D–containing supplement
during pregnancy to mothers who are at high risk of having children with
asthma (ie, with a history of asthma, eczema,or allergic rhinitis) seems to be a
reasonable strategy, especially if the pregnant woman has evidence of vitamin D
deficiency.
However, the data in these 2 RCTs do not support the use of very high-dose
vitamin D
These studies provide support for a larger adequately powered study of the role
of vitamin D supplementation during pregnancy for asthma prevention that
includes plans for rigorous outcome assessment and long-term follow-up.
Then it may be possible to know whether maternal vitamin D supplementation
can reduce the risk of childhood asthma.
Inconclusive Results of Randomized Trials of Prenatal Vitamin D
for Asthma Prevention in Offspring.
Curbing the Enthusiasm. E. von Mutius, F Martinez; JAMA 2016
49. Because different functions of vitamin D
(eg, bone mineral metabolism and
immunologic,) appear in different
serum levels and are dose dependent and there arethere are
suggestions that levelssuggestions that levels
greater than 40-50 ng/mL are optimal for vitamin Dgreater than 40-50 ng/mL are optimal for vitamin D
immune functions.immune functions.
•Brehm JM, Serum vitamin D levels and severe asthma exacerbations in the Childhood Asthma
Management Program study. J Allergy Clin Immunol. 2010;126:52e58.
•Hollis BW, Circulating vitamin D (3) and 25 hydroxyvitamin D in humans: an important tool to
define adequate nutritional vitamin D status. J Steroid Biochem Mol Biol. 2007;103:631e634.
•Taback SP, Simons FE. Anaphylaxis and vitamin D: A role for the sunshine hormone?
J Allergy Clin Immunol. 2007;120:128e130.
Conclusions
50. Because different functions of vitamin D
(eg, bone mineral metabolism and
immunologic,) appear in different
serum levels and are dose dependent and there arethere are
suggestions that levelssuggestions that levels
greater than 40-50 ng/mL are optimal for vitamin Dgreater than 40-50 ng/mL are optimal for vitamin D
immune functions.immune functions.
Conclusions
David Barker
born 29 June 1938;
died 27 August 2013
DOHDDOHD
The prenatal and early life period have been
identified as windows ofwindows of
opportunity’opportunity’ during which
immune responses can be permanently
programmed and therefore interventional studies
are needed.
51. Le azioni extrascheletriche della vitamina D
Nelle infezioni, nella dermatite atopicaNelle infezioni, nella dermatite atopica
Nella prevenzione delle allergieNella prevenzione delle allergie