A randomized, controlled trial of vitamin A in children with severe measles

Article Abstract:

Measles is a serious disease that kills and cripples many children; the survivors often suffer from blindness and lung disease. Over 50 years ago, it was suggested that giving vitamin A to children with measles might help to protect them from this disease, but this possibility was not tested. Then in 1987, a study was reported in which half as many children who were given high doses of vitamin A died of measles, as compared with children not given the vitamin; the effect was strongest in children under age two years. Based on this evidence, the World Health Organization recommended that all children with measles be given vitamin A supplements if they live in regions of the world where vitamin A deficiency is common. But this recommendation was based on very limited research. To further investigate, a study was performed in South Africa with children hospitalized for measles with complications, such as croup, diarrhea, and pneumonia. The average age of subjects was 10 months. Ninety-two children received vitamin A, while the 97 controls received an inert placebo, starting within five days of when the measles rash developed. Blood tests showed that before treatment, the children had markedly reduced blood vitamin A levels, as well as other indicators of nutritional status. The results of supplementation showed that in the vitamin A-treated group, risk of death or major complications while hospitalized was half that seen in the control group. A total of 12 children died, and 10 were taking placebos. Children taking vitamin A had less croup, recovered more quickly from diarrhea and pneumonia, and were discharged from the hospital sooner than the control subjects. It was noted that the study children had no outward signs of vitamin A deficiency, but their blood levels were very low; therefore all children with severe measles should take vitamin A supplements, even if they do not appear to have a nutritional deficiency. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Complications and side effects, Developing countries, Measles, Malnutrition in children, Child malnutrition, Vitamin A, Vitamin A deficiency, Vitamin A deficiency in children

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Vitamin D - solar rays, the milky way, or both?

Article Abstract:

The benefits of fortifying foods with vitamin D outweigh the risks. Vitamin D is needed for normal bone formation and growth. Vitamin D deficiency may cause soft bones and other health problems, but too much vitamin D is also harmful. Vitamin D is made in the skin from a cholesterol-containing substance after exposure to ultraviolet rays of the sun. Exposure to sunlight during summer months provides enough vitamin D to last throughout the year. But some individuals are not exposed to enough sunlight, and must obtain vitamin D from their diet. Elderly and chronically ill patients have a higher risk of vitamin D deficiency than others do. Few foods contain large amounts of vitamin D, so foods such as milk and infant formula are fortified with vitamin D. A research study found that individuals who developed hypervitaminosis D were drinking milk that was over-fortified with vitamin D. Another study found that milk and infant formula fortified with vitamin D contained inconsistent amounts of vitamin D. Fortification of foods with vitamin D should be closely monitored to prevent vitamin D intoxication.

Editorial, Vitamin D in human nutrition, Nutritional aspects, Vitamin D

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A controlled trial of a single dose of azithromycin for the treatment of chlamydial urethritis and cervicitis

Article Abstract:

A single dose of azithromycin may work as well as a seven-day regimen of doxycycline for treatment of a chlamydial infection in both men and women. Chlamydia trachomatis is the most common cause of sexually transmitted disease in the US. Among 266 male and female patients with an uncomplicated chlamydial infection of the genitals, 141 were treated with a single, one-gram dose of azithromycin and 125 were treated with 200 milligrams of doxycycline each day for seven days. Five patients (4%) treated with azithromycin did not respond to treatment, compared to three (2%) treated with doxycycline. Among the 214 patients who were re-tested for chlamydia infection 21 to 35 days after treatment, none of the patients treated with azithromycin were still infected, compared to one patient treated with doxycycline. The advantage of a single-dose treatment for a sexually transmitted disease is that patients are more likely to complete treatment and more likely to be cured before having sexual intercourse again.

Sexually transmitted diseases, Drug therapy, Chlamydia infections, Azithromycin, Doxycycline

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