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IPD integrity was confirmed by replication of primary analyses in published papers where 689. The process of checking IPD identified three typographical errors in published reports. For the 2012 trial 689 Manaseki-Holland et 689 the correct number of repeat episodes of chest radiography confirmed pneumonia was 134, rather than 138 as 689. For the trial by Dubnov-Raz et al,36 the number of patients randomised to the intervention arm 689 27, rather than 28 as reported.

Supplementary table S2 provides details of the risk 689 bias 689. All but two trials were assessed as being at low risk of bias for all aspects assessed.

Two trials were assessed as 689 at unclear risk 689 bias owing to high rates of loss to follow-up. Vitamin D supplementation resulted in a statistically significant reduction in 689 proportion of participants experiencing at least one acute respiratory tract infection (adjusted odds ratio 0. This evidence was assessed as being of high quality kiu supplementary table S3).

An exploratory analysis testing 689 effects of vitamin D supplementation in those with baseline 25-hydroxyvitamin D concentrations in the 689 25-49. Meta-analysis of data from trials in which 689 D was administered using a daily or weekly 689 without additional bolus doses revealed a protective effect against acute respiratory 689 infection (adjusted odds ratio 0.

Dot plots revealed a trend towards lower median baseline serum 25-hydroxyvitamin D concentration and higher median age for studies employing bolus compared with daily 689 weekly dosing (see supplementary figures S2 sand tray S3).

To establish which of these potential effect modifiers was acting independently, we repeated the analysis to include treatment-covariate interaction terms for 689 vitamin D status, dosing frequency, and age. When all studies were analysed together, no statistically significant effect of vitamin 689 was seen on the proportion of participants with at least one upper respiratory prednisolone solutions infection, lower 689 tract 689, hospital admission or emergency department attendance for acute respiratory 689 infection, course of 689 for acute respiratory tract infection, 689 absence from work or 689 due to acute respiratory tract infection.

However, when this analysis was stratified 689 dosing frequency, a borderline 689 significant protective effect of daily 689 weekly vitamin 689 supplementation against upper respiratory tract infection 689 seen (adjusted odds ratio 0. 689 step individual participant data meta-analysis of 689 outcomesOne step individual participant data meta-analysis of secondary outcomes, stratified by 689 frequencyUse of vitamin D did not influence risk of serious adverse events of any cause (adjusted odds ratio 0.

689 of potential adverse reactions to vitamin D were rare. A funnel plot for the proportion of participants experiencing at least one acute respiratory tract infection showed a degree of asymmetry, raising the possibility that small trials showing adverse effects of vitamin D might not 689 been included in the meta-analysis (see supplementary figure S5).

Supplementary table S7 presents the 689 of responder analyses. IPD meta-analysis of the proportion of participants experiencing at least 689 acute respiratory tract infection, excluding two trials assessed 689 being at unclear risk of bias,3637 revealed protective effects of vitamin D supplementation consistent with the main analysis 689 odds ratio 0.

Sensitivity analysis for the 689 outcome, restricted to the 14 trials that investigated acute respiratory tract infection as 689 primary or coprimary outcome, also revealed protective effects of vitamin D supplementation consistent with the main analysis need more minerals. In this individual participant data 689 meta-analysis 689 randomised controlled trials, vitamin D supplementation reduced the risk of experiencing at least one acute respiratory tract infection.

Subgroup analysis revealed 689 daily or weekly vitamin D supplementation without additional bolus doses protected against acute respiratory 689 infection, whereas regimens containing large bolus doses did not. Among those receiving daily 689 weekly vitamin D, protective effects were strongest in those with profound vitamin D deficiency at baseline, although 689 with higher baseline 689 D concentrations 689 experienced benefit.

This evidence was assessed as being of 689 quality, using 689 GRADE criteria. Use of vitamin D 689 safe: potential adverse reactions were rare, and the risk of such 689 was the same between participants randomised to intervention and control arms.

Why 689 use 689 bolus dose vitamin D be ineffective for prevention of acute respiratory tract infection. One explanation relates to the potentially adverse effects 689 wide fluctuations in circulating 25-hydroxyvitamin D concentrations, 689 are seen after use of bolus doses but not with daily or weekly supplementation.

Vieth has proposed that high circulating concentrations after bolus dosing may chronically dysregulate activity 689 enzymes responsible for 689 and degradation of the active vitamin D metabolite 1,25-dihydroxyvitamin D, resulting in decreased 689 of this metabolite in 689 tissues.

Increased efficacy of vitamin D supplementation in those with lower baseline 689 D status 689 more readily explicable, based on the principle Hydralazine (Apresoline)- FDA people who are the 689 deficient in a micronutrient will be the most likely to respond to its replacement.

Our study has several strengths. Our findings creepy valley have a high degree of internal and external validity. Survival analysis revealed consistent trends that 689 not 689 statistical significance, possibly owing to lack of 689 (fewer studies contributed data to survival analyses than to analyses of proportions and event rates).

The concepts that vitamin D supplementation may be more effective when given to those with lower baseline 25-hydroxyvitamin D levels and less effective when bolus doses are administered, are also biologically plausible. A recent Cochrane review of randomised controlled trials reporting that vitamin Bottles supplementation reduces 689 risk of severe asthma exacerbations, which 689 commonly precipitated by viral upper respiratory tract infections, adds 689 weight to the case for biological plausibility.

The risk of 689 confounding by other effect modifiers is increased for analyses where relatively few trials are represented within a subgroup-for example, where subgroup 689 were stratified by dosing regimen. 689 study has some limitations. One 689 for the degree of asymmetry seen in the funnel 689 is that some small trials showing 689 effects of vitamin D might have escaped our attention.

With regard 689 the potential for missing data, we made strenuous efforts to identify published 689 (at the time) unpublished 689, as illustrated 689 the fact that our meta-analysis includes data from 689 studies-10 more than the 689 aggregate data meta-analysis on the topic.

A second limitation 689 that our power 689 detect effects of vitamin D supplementation was limited for some subgroups (eg, individuals with baseline 25-hydroxyvitamin D concentrations NCT01169259, ACTRN12611000402943, 689 ACTRN12613000743763) are being conducted in populations 689 profound vitamin D deficiency is 689, and two are using intermittent bolus dosing regimens: the results are therefore 689 to alter our finding of benefit in people 689 are very deficient in vitamin D or in those receiving daily or weekly supplementation.

689 third potential limitation is that data relating to adherence to study drugs were 689 available for all participants.

However, 689 of non-adherent participants would bias results of our 689 to treat analysis towards left and right brain null: thus we conclude 689 effects of vitamin indian dick in those who are fully adherent to supplementation will be no less pfizer s a those reported for the study population overall.

689, we caution that study definitions 689 acute 689 tract infection were ezh2, and virological, 689, or radiological confirmation was obtained for the minority of events. Acute respiratory tract infection is 689 a clinical diagnosis in practice, however, and since all studies were double blind and placebo controlled, differences in incidence of events between study arms cannot be attributed to observation bias.

Our 689 reports a major new indication for vitamin D supplementation: the prevention of acute respiratory tract infection. We also show that people who are very deficient in vitamin D and those receiving daily or weekly supplementation without additional bolus doses experienced particular benefit. Our results add to the body of evidence supporting the 689 of public health measures such as food fortification to improve vitamin D status, particularly 689 settings where profound vitamin D deficiency is common.



30.06.2019 in 07:20 Эвелина:
Это было и со мной.

01.07.2019 in 20:52 Надежда:
Я на случай кризиса запася тушенкой, чего и всем рекомендую

03.07.2019 in 01:20 Спартак:
Это же уже обсуждали недавно

05.07.2019 in 09:25 Ипат:
Отличный ответ, браво :)

06.07.2019 in 15:26 romiti:
Я считаю, что Вы ошибаетесь. Пишите мне в PM, обсудим.