Albeit based on robust methods, the study by Dick de Zeeuw and colleagues (Nov 6, p 2010) raises several concerns. First, little attention is given to the fact that the primary endpoint— ie, the eff ect of the vitamin D receptor activator (VDRA) on urinary albuminto-creatinine ratio (UACR)—is actually negative. The positive results on secondary endpoints should thus be used only to generate new...

Objectives: To estimate the frequency of vitamin D insuffi ciency in individuals with cirrhosis liver based on histomorphology.Methods and materials: In current investigation, 148 patients were tracked to determine incidence adults histomorphology. All those participants, both males females, (of any severity) for at least 06 months aged 30 60 years included whereas, osteomalacia or insufficienc...

Myeloperoxidase (MPO) defi ciency is one of the most common inherited phagocyte defects, but it is rarely associated with clinical symptoms [1]. MPO, which is abundant in azurophilic granules of neutrophils and in the lysosomes of monocytes, plays a key role in amplifying the toxicity of hydrogen peroxide generated by the respiratory burst [1,2]. The diagnosis of MPO defi ciency was rare before...

Epistemic trustworthiness is defi ned as a complex character state that supervenes on a relation between fi rstand second-order beliefs, including beliefs about others as epistemic agents. In contexts shaped by unjust power relations, its second-order components create a mutually supporting link between a defi ciency in epistemic character and unjust epistemic exclusion on the basis of group me...

C ongenital diaphragmatic hernia (CDH), which occurs in one in 2,500 live births [1], is the most life-threatening cause of lung hypoplasia and is associated with high mortality, morbidity, cost, and suffering. The lungs are abnormally " stiff " in neonates with CDH [2], necessitating mechanical ventilation, often at high airway pressures, to prevent atelectasis and maximize the surface area av...

The discovery of vitamin D as an essential nutrient for skeletal development a century ago was a major public health victory. Supplementation, whether solar or dietary, prevented the devastating eff ects of rickets in chil dren. Five decades later, the molecular mechanisms of the vitamin’s active form (1,25-dihydroxyvitamin D) and its receptor (vitamin D receptor [VDR]), were elucidated, and su...

1 The Lancet. Solutions to the R&D crisis for neglected diseases. Lancet 2008; 372: 1784. 2 Bachmann C, Krähenbühl S, Colombo JP, Schubiger G, Jaggi KH, Tönz O. N-acetylglutamate synthetase defi ciency: a disorder of ammonia detoxication. N Engl J Med 1981; 304: 543. 3 Caldovic L, Morizono H, Panglao MG, et al. Cloning and expression of the human N-acetyglutamate synthase gene. Biochem Biophys ...

Bermejo-Martin and colleagues' article [1] and my comments [2], the authors concluded in their response that 'vitamin D should thus be considered in the context of a wider spectrum of factors infl uencing severe disease'. Although this is a reasonable proposal, it should be emphasized that vitamin D has been recognized as an important immuno-modulating factor [3], and studies show that both obe...

www.thelancet.com Published online May 28, 2015 http://dx.doi.org/10.1016/S0140-6736(15)60036-8 1 α1 antitrypsin is a serine antiprotease secreted by the liver. Its main function is inhibition of neutrophil elastase, a non-specifi c protease released by activated or dying neutrophils. In individuals with healthy concentrations of α1 antitrypsin, the fragile alveolar structures of the lung paren...