The following slides are a gra g phic representation of the material pr presen esented in in Re Rep. Sea Seaton on’s St State of of Reform 2014 booklet which can be found online at: http://akhouse.org/rep_seaton/
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The followingg slides are a grag pphic representation of the material
prpresenesentteedd inin ReRepp. SeaSeattonon’ss StStaattee ofof Reform 2014 booklet which can be
found online at: http://akhouse.org/rep_seaton/
State of Reform 2014Representative Paul Seaton
Evidence Based Medicine?
Worsening Severity of Vitamin D Deficiency is Associated with Increased Length of Stay, Surgical Intensive Care Unit Cost, and Mortality Rate in Surgical Intensive Care Unit Patients – American Journal of Surgery, Matthews, et. al. 2012
Survival
HospitalizedDaysHospitalizedDays
Treatment Costs
Grady Memorial Hospital Atlanta, Georgia
Treatment Costs Per Patient
60% LowerLower
14
Incidence of In‐Hospital Mortality and Cardiovascular and Infectious Morbidities for 3409 Noncardiac Surgical Patients by Quintiles of Serum Vitamin D Concentrations
Anesthesia Patient Safety Foundation ‐ The Association of Serum Vitamin D
12
f yConcentration with Serious Complications after Noncardiac surgery – Turanet. al. September 2014
Mortality
10
cide
nts
Mortality
Cardiovascular
Infectious
6
8
entage of Inc Infectious
4
Perce
2
01 2 3 4 5
Vitamin D Serum Levels
<13ng/ml 13.1‐20.4ng/ml 20.5‐27.3ng/ml 27.4‐36.2ng/ml >36.2ng/ml
Treatment with Oral Active Vitamin D is Associated with Decreased Risk of Peritonitis and Improved Survival in Patients on Peritoneal Dialysis Kerschbaum et al PLOS ONE July 2013
100%
Peritoneal Dialysis ‐ Kerschbaum et. al. PLOS ONE, July 2013
57% Reduced Incidence
54% Reduced Incidence
49% Reduced Incidence
66% Reduced Incidence
16% Reduced Incidence
80%
isk
60%
ve Ri
40%
Relati
No Vitamin D
20%R Treatment Regime
Received Oral
Vitamin D
1st Episode Peritonitis
All ‐ Cause Death
Gram‐Positive Peritonitis
Gram‐Negative Peritonitis
Sterile Peritonitis
Treatment with Oral Active Vitamin D is Associated with Decreased Risk of Peritonitis and Improved Survival in Patients on Peritoneal Dialysis ‐ Kerschbaum et. al. PLOS ONE, July 2013
Other Outcomes
Months to first episode of peritonitis with no oral active vitamin D: 5.5Months to first episode of peritonitis with oral active vitamin D: 16.3
Episodes of peritonitis per patient‐year with no oral active vitamin D: 0 45Episodes of peritonitis per patient‐year with no oral active vitamin D: 0.45Episodes of peritonitis per patient‐year with oral active vitamin D: 0.29
TYPE 2 DIABETES
4848ng/ml
22/ lng/ml
Type 2 Diabetes Incidence in GrassrootsHealth (N=4,933) and NHANES (N=4,078 Cohorts
79% Lower
2222ng/ml
41ng/ml
Median 25 (OH)D concentration in GRH cohort was 41 ng/ml and in NHANES was 22 ng/mlMedian 25 (OH)D concentration in GRH cohort was 41 ng/ml and in NHANES was 22 ng/ml
Data from GrassrootsHealth presentation at the June 2014 International Vitamin D Workshop
Recommended Daily Dose in Finland Cohort Study: 2000 IU in first year of life
80% LowerLower
Vitamin D and the risk of dementia and Alzheimer disease Neurology published online August 6, 2014
Clear Link Found Between Vitamin D Deficiency and Alzheimer’s Disease Yahoo Health-Yahoo! Health
S l D fi i
Alzheimer s Disease – Yahoo Health
Severely Deficient
Deficient Severely D fi i
Sufficient
Deficient
Deficient
Sufficient
Notes by the office of Rep. Seaton
Vitamin D level at first episode psychosis
Crews, M. et. al. Vitamin D deficiency in first episode psychosis: A case‐control study – Schizophrenia Research (2013)
p p yvs. control group
ml
30
el in
ng/m
Combined Relative Risk of being Vitamin D deficient is 2.99 times higher in first episode psychosis
n D Leve 20
g/ml
n Vitamin
10 4 ng
/ml
26.8 ng
ml
g/ml
/ml
6 ng
/ml
Mean
18.4
.7 ng/ml
14.3 ng/
0.1 ng
/ml
15.7 ng
14.7 ng/
21.6
White N= 39
9.
BlackN=20
1
AsianN=10
AllN=69
Association of Serum 25‐Hydroxyvitamin D with Symptoms of Depression after 6 months in Stroke Patients – Neurochemical Research, August 2014, Wei Yue et. al.
Odds Risk for Post Stroke Depression (PSD) increased by 21.12 times if vitamin D levels were below 11.2 ng/ml and still increased 10.32 times when fully adjusted for all confounders – notes by office of Representative Paul Seaton
5
sBreast Cancer Relation to Vitamin D
2014 Preliminary GrassrootsHealth Data at 1 1/2 Year Follow‐Up 0f 844 Women O 60
4
rson
‐Years Over 60
Median of 50 ng/ml
3
1,00
0 Pe
r
82% Risk Reduction
2
ncers Pe
r
1
New
Can
0
2007 ‐ 2011 Alaska Breast Cancer Rate
Study Rate <50ng/ml
Study Rate >50ng/ml
Hazard ratio of breast cancer for those with serum 25(OH)D <50ng/ml was 5.1 times more compared to those with > 50ng/ml, adjusting for age and BMI. Chart arranged by the office of Representative Seaton
GrassrootsHealth Prospective Study 2009‐2014
From GrassrootsHealth and U.C. San Diego
Anticancer Research, March 2014
2014 Mohr et. al.: 25‐Hydroxyvitamin D and Survival in Breast CancerCancer
50% Lower50% Lower Mortality Risk
Anticancer Research 2014 Mar;34(3):1163‐6.Meta‐analysis of vitamin D sufficiency for improving survival of patients with breast cancer.Mohr SB1, Gorham ED, Kim J, Hofflich H, Garland CF.
US ALow Serum 25 Hydroxyvitamin D level and Risk of Upper Respiratory tract infection in Children and Adolescents Science et. al. Journal of Clinical Infectious Diseases, August 2013 volume 57.Slide prepared by the office of Representative Paul Seaton
US Average
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