Vitamin D and tuberculosis epidemiology
Vitamin D deficiency is a risk factor for tuberculosis, and vitamin D deficiency appears to impair the bodys ability to fight tuberculosis, but there is no clinical evidence to show that treating vitamin D deficiency prevents tuberculosis, although the available evidence is that it ought to. Reduced levels of vitamin D may explain the increased susceptibility of African-Americans to tuberculosis, and may also explain why phototherapy is effective for lupus vulgaris (tuberculosis of the skin) (a finding which won Niels Finsen the Nobel Prize in 1903), because skin exposed to sunlight naturally produces more vitamin D.
Concerns that tuberculosis treatment itself decreases vitamin D levels appear not to be an issue in clinical practice.Genetic differences in the vitamin D receptor in West African, Gujarati and Chinese populations have been noted to affect susceptibility to tuberculosis, but there is no data available in any population that shows vitamin D supplementation (that is, giving extra vitamin D to people with normal vitamin D levels) has any effect on susceptibility to TB. Vitamin D and tuberculosis treatment
Giving vitamin D to TB patients who are vitamin D deficient may be beneficial in a proportion of patients. When taken as a group, vitamin D supplementation appears to have no benefit when using sputum culture conversion as an endpoint, and giving vitamin D supplements to TB patients who have normal vitamin D levels does not provide any benefit from the point of view of TB.
Heart failure is often a concern because the inferior vena cava is disrupted due to the inappropriate morphology of the left ventricle to support the vena cava. Conductive nodes and tissues
Abnormal development of the heart results in impaired doubles of conductive nodes, as well as faulty electrical fibers throughout the ventricles. Individuals with right atrial isomerism develop two sinoatrial nodes, as they have 2 mirrored right atria, whereas those with left atrial isomerism fail to develop a sinus node at all. Thus, patients with left atrial isomerism are more likely to experience atrial fibrillation, or irregular rapid heart beat, and abnormal heart rhythm, known as atrial flutter. Development of the atrioventricular node and bundle of His largely depends on physiological looping of the ventricles. Abnormal looping of the ventricles contributes to arrhythmia and heart block in fetuses. Bronchial tree and lungs
Isomerism of the bronchial tree is not typically damaging and presents no significant clinical complications. Pulmonary valve stenosis results in issues of blood flow to the lungs. Abdominal organs
Abdominal organs, including the liver, stomach, intestinal tract, and spleen may be randomly arranged throughout the left-right axis of the body. Distribution of these organs largely dictates treatment, clinical outcomes, and further evaluation. The liver is typically symmetrical across the left-right axis in patients with situs ambiguus, which is abnormal. A majority of left atrial isomeric patients have defects throughout the biliary tree, which is responsible for bile production, even when the gall bladder is functional and morphologically normal.