Putting cardiovascular disease and vitamin D insufficiency into perspective.

The aetiology of CVD is still not completely understood. The present review article summarises data supporting the hypothesis that an insufficient vitamin D status may contribute to the worldwide high prevalence of CVD. Human vitamin D status primarily depends on skin exposure to the UVB spectrum of the sunlight.

A multidisciplinary network to save the lives of severe, persistent cardiogenic shock patients.

Background: Severe, persistent cardiogenic shock is associated with very high morbidity and lethality. We therefore tried to improve the outcome of these patients using a network between local hospitals and a specialized heart center that has facilities for transplantation and ventricular assist device (VAD) implantation.

Methods: Between 1998 and 2000, 50 patients, who were in cardiogenic shock (mean age 49 years, SD 14) despite high doses of at least three inotropic agents, were admitted to our specialized heart center.

[New Eastern Westfalian Postoperative Therapeutic Concept (NOPT). A telemedically guided study for ambulatory rehabilitation of patients after cardiac surgery].

Background And Purpose: In-hospital rehabilitation can improve recovery of patients after surgery, but also contributes to the high costs of the German health system. Therefore, the possibility of a telemedically monitored rehabilitation at home as an alternative to an in-hospital rehabilitation was evaluated in a pilot study.

Patients And Methods: In an open trial, 100 patients performed an ambulatory rehabilitation after heart surgery under coverage of telemedical monitoring for 3 months.

The Bad Oeynhausen concept of INR self-management.

Background: A significant number of patients depend on the intake of vitamin K antagonists for prevention and treatment of thromboembolic events. The development of portable anticoagulation monitors has enabled self-testing and self-adjustment of anticoagulation therapy.

Objective: To describe the principles of a training course to learn INR self-management and to illustrate reliability of our concept.

Low-dose international normalized ratio self-management: a promising tool to achieve low complication rates after mechanical heart valve replacement.

Background: International normalized ratio (INR) self-management can significantly reduce INR fluctuations, bleeding, and thromboembolic events compared with INR control managed by general practitioners. However, even patients with INR self-management may have an increased risk of bleeding if their INR value is above 3.5.

Immunosuppressive therapy with everolimus can be associated with potentially life-threatening lingual angioedema.

Everolimus has recently received approval for immunosuppressive therapy in heart transplant recipients in Austria and Germany. At our heart center we have treated 114 patients with everolimus since January 2004. Here we describe 6 cases of lingual angioedema (corresponding to 5.

Heart transplantation in a 68-year-old patient with senile systemic amyloidosis.

Senile systemic amyloidosis (SSA) results from deposition, predominantly in the heart, of amyloid fibrils derived from wild-type transthyretin (T TR) molecules. Cardiac autopsies indicate that SSA progressively increases in subjects 80 years of age and older. However, only a few cases of patients with SSA and cardiac failure have been recognized by cardiac biopsies during life.

Organs from donors with primary brain malignancy: the fate of cardiac allograft recipients.

Background: The phenomenon of malignancy transmission from donors with primary brain malignancy (PBM) which is relatively well documented in renal or liver transplant recipients, has not been analyzed in cardiac allograft recipients.

Methods: We reviewed the medical records of 32 cardiac allograft recipients who were transplanted with organs from donors suffering from primary brain malignancies from 1989 to 2003.

Results: No case of donor-transmitted malignancy has been reported with a mean follow-up of 80.

Clinical outcome of patients with deep sternal wound infection managed by vacuum-assisted closure compared to conventional therapy with open packing: a retrospective analysis.

Background: It is suggested that the vacuum technique is a promising new method for the therapy of mediastinitis, but reliable investigations are currently almost completely lacking. We therefore compared clinical outcome of patients whose sternal infection was managed with the vacuum-assisted closure system or with the conventional procedure of open packing.

Methods: We performed a retrospective analysis in 68 cases of sternal wound infection that were identified at our Heart Center between September 1998 and September 2003.

Beyond deficiency: potential benefits of increased intakes of vitamin K for bone and vascular health.

Vitamin K is well known for its role in the synthesis of a number of blood coagulation factors. During recent years vitamin K-dependent proteins were discovered to be of vital importance for bone and vascular health. Recommendations for dietary vitamin K intake have been made on the basis of the hepatic requirements for the synthesis of blood coagulation factors.

Low vitamin D status is associated with low cord blood levels of the immunosuppressive cytokine interleukin-10.

The cytokine interleukin-10 (IL-10) plays a pivotal regulatory role in tolerizing exogenous antigens. Experimental data indicate that low cellular availability of the vitamin D hormone 1,25-dihydroxyvitamin D [1,25(OH)2D] results in a down-regulation of IL-10 concentrations. The tissue production of an adequate amount of 1,25(OH)2D depends on a high circulating 25-hydroxyvitamin D (25-OHD) level.

Age-dependent effects of atorvastatin on biochemical bone turnover markers: a randomized controlled trial in postmenopausal women.

The use of HMG-CoA-reductase inhibitors (statins) has been associated with decreased risk of bone fractures in epidemiological studies. In vitro evidence suggests that statins may stimulate bone formation, but the data are still preliminary. We assessed the effects of the HMG-CoA-reductase inhibitor atorvastatin on biochemical parameters of bone metabolism in a multicenter, randomized, double-blind, placebo-controlled trial conducted between October 2001 and October 2002 in three hospital-based outpatient metabolism clinics.

Short-term effects of high soy supplementation on sex hormones, bone markers, and lipid parameters in young female adults.

Background: High intake of soy products has been suggested to prevent breast cancer, osteoporosis, and cardiovascular diseases.

Aim Of The Study: To investigate the effects of isoflavone-containing soy on circulating sex hormones, biomarkers of bone turnover, and lipoprotein profiles.

Methods: Fourteen young women received in a randomized crossover design 5 soy cookies (52 mg isoflavones) or 5 soy-free cookies (no isoflavones) per day for one menstrual cycle starting one week before menstruation.

[Phytoestrogens].

The soy-isoflavones genistein and daidzein and the flaxseed-lignans secoisolariciresinol and matairesinol belong to the group of phytoestrogens. Epidemiological data suggest that phytoestrogens have a preventive effect against various estrogen-related diseases/symptoms such as breast cancer, menopausal symptoms, cardiovascular diseases, and osteoporosis. To prove these assumptions, available controlled clinical trials have been critically reviewed.

Body mass index and disease duration are predictors of disturbed bone turnover in anorexia nervosa. A case-control study.

Objective: To characterize the influence of body mass index (BMI), body composition, hormonal factors and disease duration on bone metabolism markers in anorexia nervosa (AN) patients.

Design: Case-control study with 51 AN patients and 51 controls matched for age, sex and body height. Assessment of anthropometric and bioimpedance data, and of biochemical serum parameters and of oral contraceptives use.

Carbamazepine does not alter biochemical parameters of bone turnover in healthy male adults.

It is still not completely clear whether or not carbamazepine (CBZ) causes alterations in vitamin D status and in bone metabolism. The objective of this study was therefore to investigate prospectively in healthy adults the effects of CBZ on serum levels of 25-hydroxyvitamin D (25OHD) and on biomarkers of bone formation and resorption. Twenty-one free-living male adults were taking 800 mg/day CBZ for 10 weeks.

Low serum levels of intact osteocalcin in patients with congestive heart failure.

Impaired bone metabolism is a frequent complication following heart transplantation. Little is known, however, about possible alterations in bone turnover of pretransplant patients with congestive heart failure (CHF). We therefore studied biomarkers of bone turnover in 21 male patients with CHF (New York Heart Association [NYHA] classification > II) compared with 21 controls (NYHA classification < II).

Vitamin D in preventive medicine: are we ignoring the evidence?

Vitamin D is metabolised by a hepatic 25-hydroxylase into 25-hydroxyvitamin D (25(OH)D) and by a renal 1alpha-hydroxylase into the vitamin D hormone calcitriol. Calcitriol receptors are present in more than thirty different tissues. Apart from the kidney, several tissues also possess the enzyme 1alpha-hydroxylase, which is able to use circulating 25(OH)D as a substrate.

Low vitamin D status: a contributing factor in the pathogenesis of congestive heart failure?

Objectives: This study was designed to evaluate the association between vitamin D status and congestive heart failure (CHF).

Background: Impaired intracellular calcium metabolism is an important factor in the pathogenesis of CHF. The etiology of CHF, however, is not well understood.

Evidence for an acute rise of intestinal calcium absorption in response to aerobic exercise.

Background: The acute effects of physical activity on intestinal calcium (Ca) uptake and on bone metabolism are not known.

Aim Of The Study: To investigate the consequences of an acute aerobic exercise bout on fractional Ca absorption and on biomarkers of bone turnover.

Methods: With the use of a cross over design, eighteen male athletes, aged 25.

Oral contraceptives moderately effect bone resorption markers and serum-soluble interleukin-6 receptor concentrations.

This study investigated the effect of ethinylestradiol(EE2)-containing oral contraceptives on mineral and bone metabolism and on serum soluble-interleukin-6-receptor (sIL-6R) during the menstrual cycle. Twelve women, aged 24.3 +/- 2.