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How effective are vitamin D and its analogues for preventing fractures in postmenopausal women and older men?
There is no evidence that vitamin D alone, in the formats and doses tested, prevents fractures. Supplements of vitamin D and calcium slightly reduced the likelihood of hip or any type of fracture. There was a small but significant increase in gastrointestinal symptoms and renal disease associated with vitamin D and calcium. There was no increased risk of death from taking vitamin D and calcium.
Other systematic reviews have found an increased association of myocardial infarction (MI) with supplemental calcium, and evidence of increased MI and stroke, but decreased cancer, with supplemental calcium plus vitamin D, without an overall effect on mortality.
Hip fractures and several other types of fractures are very common in postmenopausal women and older men, due to age-related osteoporosis.
Avenell A et al. Vitamin D and vitamin D analogues for preventing fractures in post-menopausal women and older men. Cochrane Reviews, 2014, Issue4. Art. No.: CD000227.DOI: 10.1002/14651858. CD000227.pub4. This review contains 53 studies involving 91,791 participants.
Cochrane Systematic Reviews for primary care practitioners
Developed by the Cochrane Primary Care Field, New Zealand Branch of the Australasian Cochrane Centre at the Department of General Practice and Primary Health Care, University of Auckland and funded by the Ministry of Health and New Zealand Doctor. PEARLS are meant for educational use and not to guide clinical care. New Zealanders can access the Cochrane Library free via www.cochrane.org.nz
Otolaryngologist, head and neck surgeon Francis T. Hall discusses the evaluation of thyroid nodules, which primarily aims to determine the likelihood of malignancy. He then reviews the treatment of thyroid nodules and thyroid cancer, including recent advances in management
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