Poor Adherence to the prophylactic Use of Vitamin D3 in Switzerland

Bartoli, Federica; Martinez, Juan M.; Ferrarini, Alessandra; Recaldini, Elena; Bianchetti, Mario G.

doi:10.1515/jpem.2006.19.3.281

Cited by 8 publications

(12 citation statements)

References 1 publication

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“…The literature describing such fractures in children is limited to two case reports, including a distal radius fracture 3 and an oblique non-displaced femur fracture. 4 Both reports describe a mechanism of injury consistent with the isolated injury, while the patient presented here sustained these fractures after minimal trauma, having fallen from standing height. Of note, 3 months following bilateral neck of femur fractures, the patient also sustained a fracture of the right distal tibia when transferring from a wheelchair, again a mechanism of low energy.…”

mentioning

confidence: 69%

Bilateral neck of femur fractures in a paediatric patient with graves' disease

Hoswell

Broadhead

Tewari

2017

J Paediatrics Child Health

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have assumed that the analyses were by per-protocol because in table 2 of our manuscript, the sample sizes for the analyses at 3-4 month were less than those for the analyses at 1 week. The former comprised subjects for whom outcome data were available, not subjects who adhered to the intent of treatment. Indeed, there was no 'cross-over' of subjects in our study, which means the results of analyses by intention-to-treat would have been the same as by results per-protocol anyway.An important point was made regarding vitamin D levels increasing in the daily group at 4 months despite a poor adherence rate of 33%. There are plausible explanations for this. Following production in skin from ultraviolet B light exposure, vitamin D undergoes hydroxylation, to form 25OHD (the form measured in routine vitamin D assays to assess vitamin D status) and then to the biologically active form of 1,25(OH) 2 D. Both 25OHD and 1,25(OH) 2 D are then inactivated by 24 hydroxylase to form 24,25(OH) 2 D and 1,24,25(OH) 3 D, respectively. We hypothesise that when this system is exposed to a high bolus dose of vitamin D, metabolism to its inactive form is upregulated, thereby resulting in a substantial decline and lower mean 25OHD at 4 months.In addition, the vitamin D supplement is unhydroxylated and, hence, is not measured in the assay used. It is unlikely that taking vitamin D supplements just prior to the 4-month blood test would explain why vitamin D levels in the daily group are increasing despite a 33% non-adherence rate. However, most poorly adherent infants (9/12) were on mixed feeding regimens and consequently received some vitamin D in their formula feeds. We also reiterate that while there was statistical significance between mean 25OHD levels between both groups at 4 months, this was not clinically significant as these values were greater than 50 nmol/L and therefore considered replete for clinical purposes.

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mentioning

confidence: 69%

Bilateral neck of femur fractures in a paediatric patient with graves' disease

Hoswell

Broadhead

Tewari

2017

J Paediatrics Child Health

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“…This has generated the impression that alcohol has a strong taste [3]. The poor palatability of alcoholic vitamin D 3 is not associated with some toxic potential.…”

Section: Discussionmentioning

confidence: 99%

“…In Switzerland, children receive 7.5 to 12.5 μg of vitamin D 3 in an alcoholic solution beginning during the first month of life [11]. Unfortunately, in Switzerland, approximately 50% of the families do not adhere to the recommendation, either because they consider unsatisfactory the palatability of the alcoholic vitamin D 3 preparation or because they oppose "alcoholic drugs" for socio-cultural reasons [3,7,13].…”

Section: Introductionmentioning

confidence: 99%

Acceptance of two liquid vitamin D3 formulations among mothers with newborn infants: a randomized, single-blind trial

Lava

Caccia²,

Osmetti-Gianini

et al. 2011

Eur J Pediatr

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In Switzerland, children are prescribed 7.5-12.5 μg per day of vitamin D(3) dissolved in alcohol, but many families do not adhere to the recommendation. The aim of the trial was to compare the acceptance of vitamin D(3) dissolved in alcohol or in medium-chain triglycerides among mothers of Swiss newborn infants. The acceptance was tested in 42 healthy newborn infants (20 girls and 22 boys) aged between 2 and 7 days. Their neonatal body weight ranged between 2.225 and 4.150 kg, and the gestational age between 36 1/7 and 41 3/7 weeks. The blinded mothers rated the facial reaction of their children by pointing on a facial hedonic scale. Thirty eight of the 41 mothers, who brought the comparison to completion, assigned a better score to the oily preparation with no difference in the remaining three cases (P < 0.0001). The acceptance for the oily preparation was significantly better both among mothers whose babies were initially presented the alcoholic preparation and among mothers whose babies were initially presented the oily preparation. Furthermore, the acceptance for the oily preparation was better irrespective of gender of the infant or parity of the mother. In conclusion, from the perspective of mothers, Swiss newborn infants prefer the taste of the oily vitamin D(3) preparation over the alcoholic preparation.

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“…This was based on the reported 50% poor adherence rate in daily dosing of vitamin D 4 and therefore the assumption of 50% difference in the two groups. We recruited 36 subjects (sample size = 72) to allow for drop-outs.…”

Section: Neonatal Vitamin D Supplementationmentioning

confidence: 99%

“…Additional treatment strategies have been useful in children but are rarely required: topical nitroglycerin or subcutaneous phentolamine infiltration at the puncture site. 4 Discharged auto-injectors should be replaced as soon as possible and a 'Users Medical Device Incident Report' made to the Therapeutic Goods Administration. …”

mentioning

confidence: 99%