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Crohn's disease in black children is worse in 6 ways – Dec 2015

Racial disparities in readmission, complications, and procedures in children with Crohn's disease.

Inflamm Bowel Dis. 2015 Apr;21(4):801-8. doi: 10.1097/MIB.0000000000000325.
Dotson JL1, Kappelman MD, Chisolm DJ, Crandall WV.

Vitamin D Life

Overview Gut and vitamin D contains gut-friendly information

Gut-friendly, Sublingual, injection, topical, UV, sunshine

Getting Vitamin D into your body has the following chart
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Getting Vitamin D into your body also has the following

If poorly functioning gut

Bio-D-Mulsion Forte – especially made for those with poorly functioning guts, or perhaps lacking gallbladder
Sublingual – goes directly into bloodstream
Oil: 1 drop typically contains 400 IU, 1,000 IU, or 4,000 IU, typically not taste good
Topical – goes directly into bloodstream. Put oil on your skin, Use Aloe vera cream with Vitamin D, or make your own
Vaginal – goes directly into bloodstream. Prescription only?
Bio-Tech might be usefulit is also water soluble
Vitamin D sprayed inside cheeks 2X more response (poor gut) – RCT Oct 2015
    and, those people with malabsorption problems had a larger response to spray
Inject Vitamin D quarterly into muscle, into vein, or perhaps into body cavity if quickly needed
Nanoparticles could be used to increase vitamin D getting to the gut – Oct 2015
Poor guts need different forms of vitamin D has the following
Guesses of Vitamin D response if poor gut

Bio FormSpeedDuration
10Injection ($$$)
or Calcidiol or Calcitriol
D - Slow
C -Fast
Long
10 Sun/UVBSlowLong
10Topical
(skin patch/cream, vagina)
Slow
Fast nano
Normal
9Nanoemulsion -mucosal
perhaps activates VDR
FastNormal
9?Inhaled (future)FastNormal
8Bio-D-Mulsion ForteNormalNormal
6Water soluble (Bio-Tech)NormalNormal
4Sublingual/spray
(some goes into gut)
FastNormal
3Coconut oil basedSlowNormal
2Food (salmon etc.)SlowNormal
2Olive oil based (majority)SlowNormal

10= best bioavailable, 0 = worst, guesses have a range of +-2
Speed: Fast ~2-6 hours, Slow ~10-30 hours
Duration: Long ~3-6 months, Normal = ~2 months

Increased health problems in blacks is similar to that of low vitamin D whites (John Singleton Stroke)

Overview Dark Skin and Vitamin D contains the following summary

FACT - - People with dark skins have more health problems and higher mortality rate than those with light skins
FACT - - People with dark skins have low levels of vitamin D
FACT - - People with light skins who have low vitamin D have health problems
OBSERVATION - - The health problems of whites with low level of vitamin D are similar to those with dark skins
CONCLUSION - - People with dark skins have more health problems due to low levels of vitamin D


More to Consider in The Battle Against Crohn's Amazon $29, 2016
Book has section on Crohn's and Vitamin D


# of ways in results (below) were added by Vitamin D Life


 Download the PDF from Vitamin D Life

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BACKGROUND:
Racial disparities in care and outcomes contribute to mortality and morbidity in children; however, the role in pediatric Crohn's disease is unclear. In this study, we compared cohorts of black and white children with Crohn's disease to determine the extent race is associated with differences in readmissions, complications, and procedures among hospitalizations in the United States.

METHODS:
Data were extracted from the Pediatric Health Information System (January 1, 2004-June 30, 2012) for patients with 21 years or younger hospitalized with a diagnosis of Crohn's disease. White and black cohorts were randomly selected in a 2:1 ratio by hospital. The primary outcome was time from index hospital discharge to readmission. The most frequent complications and procedures were evaluated by race.

RESULTS:
There were 4377 patients. Black children had a

  1. shorter time to first readmission and
  2. higher probability of readmission (P = 0.009) and a
  3. 16% increase in risk of readmission
    compared with white children (P = 0.01). Black children had
  4. longer length of stay and
  5. higher frequency of overall and
  6. late (30-d to 12-mo postdischarge) readmissions (P < 0.001).
  7. During index hospitalization, more black children had perianal disease and anemia (P < 0.001).
    During any hospitalization, black children had
  8. higher incidence of perianal disease,
  9. anemia, and
  10. vitamin D deficiency, [2.3% vs .9%] and
  11. greater number of perianal procedures,
  12. endoscopies, and
  13. blood product transfusion (P < 0.001).

CONCLUSIONS:
There are differences in hospital readmissions, complications, and procedures among hospitalized children related to race. It is unclear whether these differences are due to genetic differences, worse intrinsic disease, adherence, access to treatment, or treatment disparities.

Comment in
African Americans May Access the Emergency Department for Inflammatory Bowel Disease Care More Often than Whites.
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Created by admin. Last Modification: Wednesday December 25, 2019 19:26:30 GMT-0000 by admin. (Version 7)

Attached files

ID Name Comment Uploaded Size Downloads
8916 CD letter to editor.jpg admin 10 Dec, 2017 15:36 155.00 Kb 393
8915 CD index hospitalization.jpg admin 10 Dec, 2017 14:52 43.73 Kb 421
8914 Crohn's disease - black children.pdf PDF 2015 admin 10 Dec, 2017 14:51 459.29 Kb 368
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