The Journal of clinical endocrinology and metabolism
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J. Clin. Endocrinol. Metab. · Nov 2014
Differences in overlapping meta-analyses of vitamin D supplements and falls.
Overlapping meta-analyses on the same topic are common and often report discordant results. An Endocrine Society (ES) meta-analysis reported that vitamin D with calcium reduced the risk of falls, whereas vitamin D monotherapy had no effect. Despite meta-analyzing an overlapping set of trials, we concluded that vitamin D with or without calcium had no effect on falls. ⋯ Methodological differences in utilizing data from the same trials directly led to substantially different conclusions between meta-analyses about the efficacy of vitamin D supplements on falls. More detailed reporting of meta-analyses is necessary to allow readers to understand the discordant results from overlapping meta-analyses.
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J. Clin. Endocrinol. Metab. · Nov 2014
Impact of duration of critical illness on the adrenal glands of human intensive care patients.
Adrenal insufficiency is considered to be prevalent during critical illness, although the pathophysiology, diagnostic criteria, and optimal therapeutic strategy remain controversial. During critical illness, reduced cortisol breakdown contributes substantially to elevated plasma cortisol and low plasma ACTH concentrations. ⋯ Lipid depletion and reduced ACTH-regulated gene expression in prolonged critical illness suggest that sustained lack of ACTH may contribute to the risk of adrenal insufficiency in long-stay ICU patients.