Vitamin D insufficiency and hyperparathyroidism in a low income, multiracial, elderly population

This report examines the wintertime vitamin D and PTH status of 308 participants in the Boston Low Income Elderly Osteoporosis Study of noninstitutionalized low income elderly men and women (age, 64-100 yr) living in subsidized housing in Boston, MA. Twenty-one percent of the 136 black subjects and 11% of the 110 whites had very low plasma 25-hydroxyvitamin D (25OHD) concentrations (<25 nmol/L), and 73% of the blacks and 35% of the whites had 25OHD concentrations less than 50 nmol/L. The mean 25OHD levels of the smaller Hispanic and Asian subsets were generally similar to those of the white subjects. In addition to race, significant predictors of 25OHD included vitamin D intake (positive association) and smoking (inverse association), but not sex or age. Low 25OHD concentrations were associated with increased PTH and reduced serum calcium. The PTH level in the black subjects was substantially higher than that in the white subjects, and this difference was only partially explained by the racial difference in 25OHD. Elderly individuals who live in northern areas, particularly African-Americans, should be strongly encouraged to increase their vitamin D intake, especially in winter.

Life-threatening Haemophilus influenzae infections in Scandinavia: a five-country analysis of the incidence and the main clinical and bacteriologic characteristics

The five countries of Scandinavia (Denmark, Finland, Iceland, Norway, and Sweden) comprise 22.6 million inhabitants and rather homogeneous socioeconomic conditions. A survey of systemic Haemophilus influenzae diseases over the last decades revealed that the reported incidence of H. influenzae disease is increasing. In recent years, the overall incidence has been 3.5 cases per 100,000 people each year (800 cases annually); in children less than 5 years of age, the annual incidence has been 49 cases per 100,000. Meningitis represents only 52% of all systemic H. influenzae diseases, but lack of reliable data may obscure the importance of other entities. Few strains (less than 5%) are beta-lactamase-positive, and the case fatality rate is 3%. Analysis of seasonal variation shows peaks in June and September-October. If the efficacy of the H. influenzae conjugate vaccines were as high as that of a conjugate vaccine used in Finland during 1986-1987 (approximately 85% efficacy), then at least an 80% reduction in life-threatening H. influenzae infections would be achieved annually by routine immunization before or at the age of 6 months.