zxing barcode generator java example COSMETIC DERMATOLOGY: PRINCIPLES AND PRACTICE in Visual Studio .NET

Creation QR in Visual Studio .NET COSMETIC DERMATOLOGY: PRINCIPLES AND PRACTICE

COSMETIC DERMATOLOGY: PRINCIPLES AND PRACTICE
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Vitamin D
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Perhaps best known as the vitamin skin produces when exposed to ultraviolet light, vitamin D3, often shortened to vitamin D, is actually a hormone, and a potent antioxidant Besides sun exposure, vitamin D can be obtained through the diet, especially by consumption of fatty fish159 Through the metabolic process, vitamin D is converted into 25-hydroxyvitamin D (25(OH)D) by the liver and 1,25-dihydroxyvitamin D(1,25(OH)2D) by the kidneys159 It has been known for several years that UVB exposure induces epidermal keratinocytes to convert 7-dehydrocholesterol into vitamin D3 In addition, the metabolites of vitamin D3, particularly calcitriol, are known to confer significant benefits, such as antiproliferative and prodifferentiating activity as well as regulating cellular activity in keratinocytes and immunocompetent cells160 In addition to imparting benefits to most bodily organ systems, vitamin D plays a significant role in psoriasis treatments, including the drug Dovonex Like all antioxidants, vitamin D exhibits the capacity to decelerate aspects of cutaneous aging Cutaneous vitamin D3 synthesis declines with age Consequently, vitamin D deficiency is not uncommon in the elderly, the demographic group most in need of taking oral vitamin D supplements Low vitamin D status is a factor in the development of osteoporosis Vitamin D
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insufficiency is also associated with rickets, certain types of cancer, and various other diseases161 Vitamin D deficiency can lead to an elevation in serum parathyroid hormone, contributing to bone resorption, osteoporosis, and fractures Supplementation with vitamin D has been shown to inhibit serum parathyroid hormone, increase bone mineral density, and may reduce the incidence of fractures, particularly in the elderly159 In a 12-week randomized clinical study in a psychogeriatric nursing home comparing the effects of UV radiation and oral vitamin D3 on the vitamin D status and parathyroid hormone concentration in elderly nursing home patients, investigators found UVB to be as effective as oral vitamin D3 in raising serum 25(OH)D and serum calcium as well as inhibiting secondary hyperparathyroidism162 Research has also shown that vitamin D analogs may have a role to play in the medical therapy of melanoma, even though avoiding exposure to UV remains the best protection against melanoma and nonmelanoma skin cancers163 In addition, research has shown that obesity-related vitamin D insufficiency likely results from the diminished bioavailability of vitamin D3 from cutaneous and dietary sources due to deposition in body fat164 More than a decade ago, vitamin D became the subject of controversy when claims emerged that the use of sunscreen led to vitamin D deficiency165 Despite mounting evidence to the contrary, this remains a controversial topic Interestingly, Gilchrest cites evolutionary changes in countering the argument for controlled exposure to UV to obtain sufficient vitamin D levels Specifically, she suggests that when the human capacity to photosynthesize vitamin D emerged, the lifespan for human beings was considerably shorter than it is today, and the effects of long-term photodamage, or the modern option of purchasing oral vitamin D, could not be part of the equation166 Currently, the tolerable upper intake level (UL) for vitamin D3 stands at 50 g/d (2000 IU/d) in North Americans and Europeans, but several studies suggest that metabolic utilization of vitamin D3 would be optimized at a UL as high as twice this level, particularly to ameliorate vitamin D status in the elderly161,167,168 The challenge with vitamin D is balancing the mounting evidence that cutaneous vitamin D production helps prevent various diseases, including some cancers, with the
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understanding that prolonged sun exposure greatly increases the risk of skin cancer and other photodamage Oral vitamin D supplementation in place of UV exposure appears to be the safest approach, and may be particularly appropriate for certain populations For instance, individuals at high risk for skin cancer (eg, those who have red hair and freckles, or a family history of skin cancer) should be advised to avoid unprotected sun exposure and to obtain vitamin D in oral supplement form and diet Mushrooms have been found to be a good source of vitamin D Blood levels of vitamin D should be checked in all patients If levels are low, vitamin D supplementation and the addition of mushrooms to the diet should be recommended along with limited sun exposure It takes only a few minutes of solar exposure each day to stimulate vitamin D synthesis Patients should be reminded of this and advised that there is never a good reason to bake in the sun all day
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