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Bogh M.K.B.,Copenhagen University | Schmedes A.V.,Lillebaelt Hospital | Philipsen P.A.,Copenhagen University | Thieden E.,Copenhagen University | Wulf H.C.,Copenhagen University
Journal of Investigative Dermatology | Year: 2010

UVB radiation increases serum vitamin D level expressed as 25-hydroxyvitamin-D 3 (25(OH)D), but the influence of skin pigmentation, baseline 25(OH)D level, and total cholesterol has not been well characterized. To determine the importance of skin pigmentation, baseline 25(OH)D level, and total cholesterol on 25(OH)D production after UVB exposure, 182 persons were screened for 25(OH)D level. A total of 50 participants with a wide range in baseline 25(OH)D levels were selected to define the importance of baseline 25(OH)D level. Of these, 28 non-sun worshippers with limited past sun exposure were used to investigate the influence of skin pigmentation and baseline total cholesterol. The participants had 24% of their skin exposed to UVB (3 standard erythema doses) four times every second or third day. Skin pigmentation and 25(OH)D levels were measured before and after the irradiations. Total cholesterol was measured at baseline. The increase in 25(OH)D level after UVB exposure was negatively correlated with baseline 25(OH)D level (P0.001) and positively correlated with baseline total cholesterol level (P0.005), but no significant correlations were found with constitutive or facultative skin pigmentation. In addition, we paired a dark-skinned group with a fair-skinned group according to baseline 25(OH)D levels and found no differences in 25(OH)D increase after identical UVB exposure. © 2010 The Society for Investigative Dermatology.

Bogh M.K.B.,Copenhagen University | Schmedes A.V.,Lillebaelt Hospital | Philipsen P.A.,Copenhagen University | Thieden E.,Copenhagen University | Wulf H.C.,Copenhagen University
British Journal of Dermatology | Year: 2012

Summary Background It is known that ultraviolet (UV) B radiation increases serum 25-hydroxyvitamin D 3 [25(OH)D] level. However, there is uncertainty about the relationship between the maintenance of vitamin D status and UVB. Objectives To define the frequency of UVB exposure necessary for maintaining summer 25(OH)D levels during the winter. Methods In total, 60 participants were included from October 2008 to February 2009 (16 weeks) and randomized for UVB exposure of 1 standard erythema dose (SED) to ∼88% body area once a week (n = 15 completed), every second week (n = 14 completed) or every fourth week (n = 12 completed). The controls (n = 14 completed) had no intervention. Vitamin D was measured at baseline, every fourth week before exposure, and 2 days after the last UVB exposure. Results The 25(OH)D levels (mean) after UVB exposure once a week increased significantly (from 71·9 to 84·5 nmol L -1) (P < 0·0001), whereas UVB exposure every second week maintained 25(OH)D levels (P = 0·16). A significant decrease in mean 25(OH)D levels (from 56·4 to 47·8 nmol L -1) (P < 0·0001) was found after UVB exposure once every fourth week and for the control group (from 64·8 to 40·1 nmol L -1) (P < 0·0001). The development in 25(OH)D levels during the 16-week study period were negatively correlated with baseline 25(OH)D (P < 0·0001). Further, the increase in 25(OH)D after the last UVB exposure was negatively correlated with the 25(OH)D level just before the last UVB exposure (P < 0·0001). Conclusions Exposure to a UVB dose of 1 SED every second week to ∼88% body area is sufficient for maintaining summer 25(OH)D levels during the winter. © 2011 British Association of Dermatologists.

Joergensen C.,Steno Diabetes Center | Hovind P.,Steno Diabetes Center | Schmedes A.,Lillebaelt Hospital | Parving H.-H.,Copenhagen University | Rossing P.,Steno Diabetes Center
Diabetes Care | Year: 2011

OBJECTIVE - To evaluate vitamin D as a predictor of all-cause mortality, progression from normoalbuminuria to micro- or macroalbuminuria, and the development of background or proliferative retinopathy in patients with type 1 diabetes. RESEARCH DESIGN AND METHODS - A prospective observational follow-up study in which an inception cohort of type 1 diabetic patients was followed from onset of diabetes diagnosed between 1979 and 1984. Plasma vitamin D [25(OH)D3] levels were determined by high performance liquid chromatography/tandem mass spectrometry in 227 patients before the patients developed microalbuminuria. Values equal to or below the 10% percentile (15.5 nmol/L) were considered severe vitamin D deficiency. RESULTS - Median (range) vitamin D was 44.6 (1.7-161.7) nmol/L. Vitamin D level was not associated with age, sex, urinary albumin excretion rate (UAER), or blood pressure. During follow-up, 44 (18%) patients died. In a Cox proportional hazards model, the hazard ratio for mortality in subjects with severe vitamin D deficiency was 2.7 (1.1-6.7), P = 0.03, after adjustment for UAER, HbA1c, and conventional cardiovascular risk factors (age, sex, blood pressure, cholesterol, smoking). Of the 220 patients, 81 (37%) developed microalbuminuria and 27 (12%) of these progressed to macroalbuminuria. Furthermore, 192 (87%) patients developed background retinopathy, whereas 34 (15%) progressed to proliferative retinopathy. Severe vitamin D deficiency at baseline did not predict the development of these microvascular complications. CONCLUSIONS - In patients with type 1 diabetes, severe vitamin D deficiency independently predicts all-cause mortality but not development of microvascular complications in the eye and kidney. Whether vitamin D substitution in type 1 diabetic patients can improve the prognosis remains to be investigated. © 2011 by the American Diabetes Association.

Hansen S.G.K.,Lillebaelt Hospital | Skov M.N.,University of Southern Denmark | Justesen U.S.,University of Southern Denmark
Journal of Clinical Microbiology | Year: 2013

We report two cases of bacteremia with the anaerobic bacterium Ruminococcus gnavus. In both cases, the bacteremia was associated with diverticular disease. Preliminary conventional identification suggested peptostreptococci, and matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) analysis did not produce scores high enough for species identification. Finally, the bacteria were identified by 16S rRNA gene sequencing. Copyright © 2013.

Nielsen L.H.,Lillebaelt Hospital | Ortner N.,Glostrup University Hospital | Norgaard B.L.,Aarhus University Hospital | Achenbach S.,Friedrich - Alexander - University, Erlangen - Nuremberg | And 2 more authors.
European Heart Journal Cardiovascular Imaging | Year: 2014

Aims To systematically reviewand perform a meta-analysis of the diagnostic accuracy and post-test outcomes of conventional exercise electrocardiography (XECG) and single-photon emission computed tomography (SPECT) compared with coronary computed tomography angiography (coronary CTA) in patients suspected of stable coronary artery disease (CAD). Methods and results We systematically searched for studies published from January 2002 to February 2013 examining the diagnostic accuracy (defined as at least ≥50% luminal obstruction on invasive coronary angiography) and outcomes of coronary CTA (≥16 slice) in comparison with XECG and SPECT. The search revealed 11 eligible studies (N = 1575) comparing the diagnostic accuracy and 7 studies (N = 216.603) the outcomes of coronary CTA vs. XECG or/and SPECT. The per-patient sensitivity [95% confidence interval (95% CI)] to identify significant CAD was 98% (93-99%) for coronary CTAvs. 67% (54- 78%) (P< 0.001) for XECG and 99% (96-100%) vs. 73% (59-83%) (P = 0.001) for SPECT. The specificity (95% CI) of coronary CTA was 82% (63-93%) vs. 46% (30-64%) (P< 0.001) for XECG and 71% (60-80%) vs. 48% (31-64%) (P = 0.14) for SPECT. The odds ratio (OR) of downstream test utilization (DTU) for coronary CTA vs. XECG/SPECT was 1.38 (1.33-1.43, P< 0.001), for revascularization 2.63 (2.50-2.77, P< 0.001), for non-fatal myocardial infarction 0.53 (0.39-0.72, P< 0.001), and for all-cause mortality 1.01 (0.87-1.18, P = 0.87). Conclusion The up-front diagnostic performance of coronary CTA is higher than of XECG and SPECT. When compared with XECG/ SPECT testing, coronary CTA testing is associated with increased DTU and coronary revascularization. © The Author 2014.

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