ObjectivesVitamin D (VitD) deficiency is a health problem prevalent not only in the elderly but also in young adults. The primary objective of our observational pilot study “MUVY” (Mood, UVR, Vitamin D in Young women) was to test both the short-term and long-term effects of a series of three suberythemal UV radiation (UVR) exposures on the VitD status and well-being of young healthy women during winter in a repeat measure design.Methods20 healthy young women (Fitzpatrick skin types I–III, aged 21–25 years) received three full body broad band UVR exposures with an escalating erythemally weighted dose schedule during one week in winter, and completed self-report questionnaires monitoring symptoms of depression (Beck Depression Inventory, BDI) and affective state/well-being (Profile of Mood States, POMS) at baseline and three days after the last UVR exposure. 25-hydroxyvitamin D (25(OH)D) and 1,25-dihydroxyvitamin D (1,25(OH)2D) were measured in serum at baseline, and at study days 8, 36 and 50.ResultsMean baseline 25(OH)D level was 54.3 nmol/L (standard deviation (s.d.) = 24.1), with seven women having VitD deficient status. Relevant symptoms of depression, as indicated by low BDI total scores (0–8), were absent. After the three UVR exposures the increment of 25(OH)D was an average of 13.9 nmol/L (95% confidence interval (CI) = 9.4–18.4) and 26.2 pmol/L (95%CI = 7.2–45.1) for 1,25(OH)2D. Δ25(OH)D, and corresponding baseline levels were significantly and inversely associated (rho = -0.493, p = 0.027). Only 25(OH)D remained significantly increased above baseline for at least six weeks after the last UVR exposure. A strong inverse correlation of the POMS subscale “Vigor/Activity” and the increment in 1,25(OH)2D was found (rho = -0.739, p<0.001) at day 8.ConclusionsThree suberythemal whole body UVR exposures during one week are a simple and suitable method for improving 25(OH)D levels during winter, for at least six weeks, and especially in young women with VitD deficient status.Trial RegistrationGerman Clinical Trials Register (Deutsches Register Kinischer Studien) DRKS00009274

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Background The prevalence of Vitamin D deficiency in northern countries such as Germany is as high as 60% [1]. Vitamin D deficiency is usually defined as 25(OH)D3 levels lower than 50 nmol/l. Insufficiency already starts at levels under 75 nmol/l, which consequentially leads to still more severe figures considering the population’s supply status [2]. Since Vitamin D is not only essential for calcium hemostasis, but has recently also been detected to play a role in the prevention of autoimmune diseases, carcinogenesis and psychiatric disorders, such as major depression and seasonal affective disorder, a solution for improving the Vitamin D supply is strongly needed. Objectives UV radiation is necessary for 90% of the body’s Vitamin D production and is not sufficiently available in Europe during the winter months [3]. Therefore, it was our aim to examine the effect of an artificial UV stimulation on Vitamin D status and mood of young women. Methods 20 healthy young women, aged 20-30 (Ø 22,95), were exposed to 3 sessions (on day 1, 3 and 5) of UV-B radiation during one week in winter. The irradiation dose was increased from 80 J/m2 on day 1 to 150 J/m2 on day 5 for Fitzpatrick skintype I, and from 100 J/m2 to 187,5 J/m2 for skintypes II and III. All doses applied were below the minimal erythema dose (MED), usually defined as 250 J/m2. Before (day 1) and after (day 7) the radiation week blood samples for 25(OH)D3 and 1,25(OH)2D3 determination were taken, and the subjects were asked to answer the mood questionnaire “Beck Depression Inventory” (BDI). The BDI was also assessed by additional 24 female, healthy controls before and after a week of negligible sun exposure. 4 and 6 weeks later, on day 36 and 50, further blood samples for Vitamin D detection were retained. Results Both Vitamin D metabolites increased considerably after the 3 UV-sessions: 25(OH)D3 rose from its 54,4 nmol/l (SD: 24,1 nmol/l) baseline level to 68,3 nmol/l (SD 18,2 nmol/l) on day 7 (p <0,001), as did 1,25(OH)2D3 from 130,9 pmol/l (SD 35,8 pmol/l) to 157,1 pmol/l (SD 49,8 pmol/l) (p= 0,009). Moreover, we detected still significantly higher 25(OH)D3 levels than at baseline 4 and 6 weeks after UV exposure (p <0,001 and. p= 0,044). Interestingly, the BDI also showed an improvement of more than 35%, from a score of 3,95 (SD 2,14) to 2,55 (SD 2,54) (p= 0,003) and correlated with both, 25(OH)D3 (-0,436; p= 0,005) and 1,25(OH)2D3 (-0,42; p= 0,007). There was no such improvement in the UV-unexposed controls, whose BDI scores did not differ on day 1 and 7. Conclusions 3 suberythemal UV-B stimulations increase Vitamin D levels and also considerably improve the mood of healthy young women. After further studies with an expanded spectrum of subjects, this method presents one possible solution to the difficult Vitamin D supply situation and can also have a preventive impact on the increasing number of mood disorders. Its application would be especially eligible for diseases such as rheumatoid arthritis, where patients suffer from seriously decreased Vitami...

Introduction PARP (Poly ADP Ribose Polymerase) inhibitors are an effective maintenance therapy for various entities, such as BRCA (breast cancer gene) mutated or HRD (homologous recombination deficiency) positive primary platin-sensitive advanced ovarian cancer after platin induction therapy and in relapse after responding to carboplatin reinduction. Other entities are metastatic BRCA mutated pancreas, prostate and Her2-negative breast cancer. Therefore, patients with allergic reactions to PARP inhibitors should undergo a desensitization procedure to be able to receive this efficient therapy. Case report We conducted a two-day desensitization on a 45-year-s old patient with advanced ovarian cancer who displayed symptoms of an allergic reaction to Olaparib. Management and outcome Using an Olaparib tablet suspension, we orally administered increasing Olaparib doses, starting with 12.5 mg and reaching a cumulative dose of 387.5 mg on the first day and starting with 100 mg and reaching a cumulative dose of 600 mg on the second day, without concomitant antiallergic medication. Except for mild erythema on day one receding within the hour, no further allergic reactions appeared during desensitization. The patient has since received 300 mg of Olaparib twice a day without further complications or interruptions. Conclusion Desensitization in a two-day suspension protocol is a safe method that ensures effective maintenance therapy for patients with allergic reactions to PARP inhibitors.

BackgroundThere is a high prevalence of depression in patients with rheumatic disorders. Especially, in rheumatoid arthritis, it is one of the most prevalent co-morbidities with 16% to 38%. Vitamin D (VD) deficiency is one of the known risk factors for depressive disorders. On the other hand, a VD deficiency has often been detected in rheumatic diseases. A possible correlation between these two co-morbidities has not been investigated so far in patients with early arthritis (EA).ObjectivesThe aim of this study was to examine the association between VD deficiency and depression and/or anxiety disorders in patients who have presented themselves for the first time in the EA clinic.MethodsPatients with a suspected EA (at least one swollen joint without previous trauma or joint infection with a symptom duration of 6 weeks to 12 months) received a screening date within five work days. The VD status (25-hydroxy-VD3) was obtained during the first EA clinic consultation. In addition, each patient completed questionnaires on the disease history, as well as evaluated self-assessment questionnaires including the health assessment questionnaire (HAQ) and the Hospital Anxiety and Depression Scale (HADS). The hereby-obtained results of disease activity, VD-status and HADS-scores were investigated. In the observation period from June 2012 to March 2015, 75 patients fulfilled the inclusion criteria of completed results and questionnaires as well as a disease duration of less than 12 months.ResultsThe mean age of this EA cohort was 51.7±16.9 years (♀ 65.3%, mean disease duration: 4.0±3.0 months). The prevalence of VD deficiency (<75 nmol/l) was 73.3%. 48.0% of EA patients showed a positive global distress score (≥13). The mean HADS global distress score in VD sufficient patients was 10.2±8.6 vs 13.3±6.9 in deficient patients. The observed difference was not statistically significant. There was neither an association between gender, age and VD status nor was there any difference in the laboratory parameters (e.g. C-reactive protein, rheumatic factor, anti citrullinated peptide, hemoglobine) or assessment of functional status (e.g. HAQ, disease activity score by 28 joints).ConclusionsThe prevalence of VD deficiency is higher in EA patients with 73% than in the general German population (vs. 60%). The prevalence of positive distress with 50% is also higher. Interestingly, no association of deficient VD levels and positive distress in the HADS was detected in our examined EA cohort. This might be explained by the early stage of disease, but further studies are necessary to evaluate this new insight.References Dougados, M., et al., Prevalence of comorbidities in rheumatoid arthritis and evaluation of their monitoring: results of an international, cross-sectional study (COMORA). Ann Rheum Dis, 2014. 73(1): p. 62–8.Linseisen J, Bechthold A, Bischoff-Ferrari HA et al. Vitamin D und Prävention ausgewählter chronischer Krankheiten – Stellungnahme. In: V. DGfEe, ed. Bonn 2011.Merlino LA, Curtis J, Mikuls TR, Cerhan JR, Criswell LA, Saag KG, e...