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Vitamin D deficiency appears to be an underestimated risk factor for cardiovascular disease in patients with chronic kidney disease. Evidence from both basic science and clinical studies supports the possible protective role of vitamin D beyond its effect on mineral metabolism. Toxicity of pharmacologic doses of active vitamin D metabolites, in particular calcitriol, is mainly due to the possibility of positive calcium and phosphorus balance. Therefore, vitamin D analogs have been developed, which suppress PTH secretion and synthesis with reduced calcemic and phosphatemic effects. Observational studies suggest that in hemodialysis patients the use of a vitamin D receptor (VDR) activator, such as calcitriol, doxercalciferol, paricalcitol, or alfacalcidol, is associated with a reduced mortality when compared with nonusers of any VDR activator. In this article the existing literature on the topic is reviewed, although a more robust answer to the question of whether or not VDR activators have beneficial effects in hemodialysis patients will hopefully come from a randomized controlled trial. [ABSTRACT FROM AUTHOR]

Vitamin D deficiency appears to be an underestimated risk factor for cardiovascular disease in patients with chronic kidney disease. Evidence from both basic science and clinical studies supports the possible protective role of vitamin D beyond its effect on mineral metabolism. Toxicity of pharmacologic doses of active vitamin D metabolites, in particular calcitriol, is mainly due to the possibility of positive calcium and phosphorus balance. Therefore, vitamin D analogs have been developed, which suppress PTH secretion and synthesis with reduced calcemic and phosphatemic effects. Observational studies suggest that in hemodialysis patients the use of a vitamin D receptor (VDR) activator, such as calcitriol, doxercalciferol, paricalcitol, or alfacalcidol, is associated with a reduced mortality when compared with nonusers of any VDR activator. In this article the existing literature on the topic is reviewed, although a more robust answer to the question of whether or not VDR activators have beneficial effects in hemodialysis patients will hopefully come from a randomized controlled trial. [ABSTRACT FROM AUTHOR]

The stips of the sanctuary of Athana Ialisia at Rhodes, excavated between 1923 and 1926, yielded more than 6300 pieces and is thus the most important on the island. The offerings date from the middle of the eighth to the end of the fourth century BC. Among these materials is an especially interesting group of seals of the Lyre-Player Group, comprising all of 27 specimens. This is the second largest group found in the Mediterranean so far, after one from Pithekoussai, and raises the number of specimens found on Rhodes to about 50 (15 from Lindos, 3 from Kamiros). Along with a very rare four-faced specimen, there are several seals, some still with their original silver mount, showing iconographies already attested elsewhere, but including some very rare ones (trios of players, a player drinking from a wineskin, a fisherman) and some interesting variations which add to the existing repertoire (players alongside a tree or an ankh, astral symbols). The repertoire's resemblance, in themes and style, to that found on Phoenician Egyptianizing products; the seals' distribution, which parallels that of athyrmata and specific classes of materials produced or attested in large quantities on Rhodes; the presence in the stips of very rare examples of rock crystal lenses, optical instruments, the work of master stonecutters; all these elements suggest that the seals were manufactured by Phoenician craftsmen living and working on the island. Indeed, Rhodes played a crucial role in channeling exotic products towards the rest of the Aegean and the West. [ABSTRACT FROM AUTHOR]

Vitamin K (phylloquinone or vitamin K1 and menaquinones or vitamin K2) plays an important role as a cofactor in the synthesis of hepatic blood coagulation proteins, but recently has also aroused an increasing interest for its action in extra-hepatic tissues, in particular in the regulation of bone and vascular metabolism. The accurate measurement of vitamin K status in humans is still a critical issue. Along with indirect assays, such as the undercarboxylated fractions of vitamin K-dependent proteins [prothrombin, osteocalcin (OC), and matrix gla protein], the direct analysis of blood levels of phylloquinone and menaquinones forms might be considered a more informative and direct method for assessing vitamin K status. Different methods for direct quantification of vitamin K serum levels are available. High-performance liquid chromatography (HPLC) methods coupled with post-column reduction procedures and fluorimetric or electrochemical detection are commonly used for food and blood analysis of phylloquinone, but they show some limitations when applied to the analysis of serum menaquinones because of interferences from triglycerides. Recent advancements include liquid chromatography tandem mass spectrometry (LCMS/MS) detection, which assures higher specificity. The optimization and standardization of these methods requires specialized laboratories. The variability of results observed in the available studies suggests the need for further investigations to obtain more accurate analytical results. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the feasibility of the hysteroscopic resection of type II submucous fibroids regardless of the myometrial free margin separating them from the serosa and to report the dynamic changes the margin undergoes after the various phases of resection. Design: A prospective observational study. Setting: A tertiary-level university hospital. Patient(s): Thirteen women with single type II submucous fibroids of ≤5 cm in diameter regardless of the myometrial free margin. Intervention(s): Hysteroscopic myomectomy and ultrasound evaluation of myometrial free margin before and after each phase of the procedure. Main Outcome Measure(s): The possibility of a complete one-step resection, the incidence of intraoperative or postoperative complications, and the analysis of the dynamic changes occurring in myometrial free margin. Result(s): Complete resection was performed successfully in all patients. No complications were registered. The myometrial free margin decreased on the distension of the uterine cavity and then increased progressively and significantly after the various phases of resection. Conclusion(s): In selected cases and in experienced hands, hysteroscopic myomectomy of type II submucous fibroids may be performed successfully and safely regardless of the myometrial free margin. Myometrial free margin increases progressively with each step of the procedure probably leading to an increasing margin of safety. [ABSTRACT FROM AUTHOR]