Evidence has shown a relationship between vitamin D deficiency and systemic lupus erythematosus (SLE). We evaluated the frequency of vitamin D deficiency and its association with disease activity in new cases of SLE. Women with newly diagnosed SLE, based on the American College of Rheumatology (ACR) criteria, were enrolled consecutively. Those receiving vitamin D supplements and postmenopausal women were not included. Disease activity was measured by the BILAG index (2004) and serum concentration of 25-hydroxyvitamin D (25[OH]D) was measured by radioimmunoassay method. Forty SLE patients with mean age of 25.3 ± 4.2 years were studied. Severe, moderate, and mild vitamin D deficiency, corresponding to serum 25[OH]D concentrations of <12.5, 12.5-24.9, and 25-39.9  nmol/l, were found in 12.5%, 62.5%, and 17.5% of the patients, respectively. Serum 25[OH]D concentration was inversely correlated with the British Isles Lupus Assessment Group (BILAG) index score (r = -0.486, p = 0.001). Those with a more severe vitamin D deficiency had also higher concentrations of liver enzymes (p < 0.05), lower serum albumin and hemoglobin concentrations (p < 0.05), and higher titers of antibodies to double-stranded DNA (ds-DNA) (p < 0.001). This study showed that most of the SLE patients in our society have vitamin D deficiency at the time of diagnosis that is associated with a higher disease activity. Routine screening for vitamin D deficiency and its prompt treatment in patients with newly diagnosed SLE is recommended.

Slow, deep breathing is being used as a self‐management intervention for various health conditions including pain and hypertension. Stimulation of the arterial baroreceptors and increased vagal modulation are among the proposed mechanisms for the therapeutic effects of slow, deep breathing. We investigated whether adding inspiratory threshold load can enhance the cardiovascular responses to controlled breathing at the frequency of 0.1 Hz, a common form of slow, deep breathing. Healthy volunteers (N = 29) performed controlled breathing at 0.1 Hz (6 breaths/minute) without load and with inspiratory threshold loads of 5 cmH2O and 10 cmH2O. Respiratory airflow, heart rate, and blood pressure were continuously recorded. The amplitude of the systolic blood pressure variation during respiratory cycles increased with increasing loads. Respiratory sinus arrhythmia was higher during controlled breathing at 0.1 Hz with the load of 10 cmH2O compared to without load. Baroreflex sensitivity was not affected by loads. The effect of loads on respiratory sinus arrhythmia was mediated by increasing the amplitude of systolic blood pressure variation during respiratory cycles. These results suggest that applying small inspiratory threshold loads during controlled breathing at 0.1 Hz increases cardiac vagal modulation by this breathing exercise. This effect seems to be mediated by stronger stimulation of the arterial baroreceptors because of larger systolic blood pressure swings along the respiratory cycle. The potential benefit of long‐term practice of controlled breathing at 0.1 Hz with inspiratory threshold loads on baroreflex function and cardiac vagal control needs to be investigated, particularly in pain and hypertension patients.

In overall, our studied multistrain probiotic compound has not beneficial effects in the treatment of H. pylori infection. It might be related to the low dosage of our probiotic regimen and/or high frequency of upper gastrointestinal adverse effects which in turn could decrease the eradication efficacy.

We found an association between vitamin D deficiency/insufficiency and disease activity in IBD patients. Prospective cohorts and clinical trials are required to clarify the role of vitamin D deficiency and its treatment in clinical course of IBD.

Poor sleep quality is common in women with SLE and significantly impairs their HRQoL. Age, disease activity and psychological factors were determinants of sleep quality in our study. Studies with objective sleep measures as well as interventional studies are warranted in this regard.