Current Controversies: Should we be giving enhanced vitamin D intakes to all?

It is widely established that vitamin D is critical for bone health. There is also an increasing body of evidence from observational studies that low levels of vitamin D are associated with a range of other disorders, including cancer and cardiovascular disease. People in temperate climates are often deficient in vitamin D, particularly in wintertime. The key question is whether there is sufficient evidence to justify supplementing vitamin D intakes for all. In this 'Controversy in Medicine', two international experts argue the case 'for' and 'against' universal vitamin D supplementation.

The history of osteoporosis: why do Egyptian mummies have porotic bones?

Paleopathologists have identified osteoporosis in ancient skeletons and modern physicians and scientists have identified risk factors for osteoporosis today, but they are not clearly linked, making it more difficult to clarify the causes of osteoporosis in the past. The evidence for osteoporosis in the remote past, its causes, and the management of this disease is reviewed in the light of evolving and improving diagnostic modalities, more precise definitions, and the recent rapid expansion of therapeutic options.

Bisphosphonate prescribing in chronic kidney disease

Osteoporosis and chronic kidney disease (CKD) are both increasingly prevalent with advancing age. Bisphosphonates are licensed for use in osteoporosis, but the appropriateness and safety of this class of drug in CKD is uncertain. This study assessed the use of bisphosphonates for persons with CKD in clinical practice. The prescribing pattern of bisphosphonates in all 595 persons attending renal services in one UK hospital was analysed.

Respiratory symposium report

This respiratory symposium focused on pleural disease, allergy and the new guidelines for oxygen delivery. The management of pleural disease is changing, partly due to safety concerns. For example, safer designs of the Seldinger drain are being developed and chest ultrasound is now recommended prior to siting an intercostal drain. Greater availability of medical and surgical thoracoscopy means there is less use of the Abrams pleural biopsy, although this has implications for the organisation and provision of services.

Should we be giving enhanced vitamin D intakes to all?

It is widely established that vitamin D is critical for bone health. There is also an increasing body of evidence from observational studies that low levels of vitamin D are associated with a range of other disorders, including cancer and cardiovascular disease. People in temperate climates are often deficient in vitamin D, particularly in wintertime. The key question is whether there is sufficient evidence to justify supplementing vitamin D intakes for all.