ascorbic-acid and Femoral-Fractures

In a prospective, randomized, controlled study an intravenous vitamin B complex and vitamin C preparation was administered pre- and post-operatively to 28 elderly patients with a fractured proximal femur and compared with 32 nonsupplemented postoperative controls. Vitamin supplementation significantly, though only transiently, improved postoperative thiamine status (P less than 0.001), but had no influence on mental state or outcome during the postsurgical period. Therefore, the use of parenteral vitamins for postoperative confusion cannot be justified on a routine basis.

Topics: Aged; Aged, 80 and over; Ascorbic Acid; Cognition Disorders; Confusion; Female; Femoral Fractures; Humans; Male; Middle Aged; Postoperative Complications; Premedication; Prospective Studies; Random Allocation; Thiamine; Vitamin B Complex

Dysfunctional inflammation following traumatic hemorrhage can lead to multiple-organ failure and death. In our polytrauma swine model, lyophilized plasma (LP) reconstituted with sterile water and ascorbic acid suppressed systemic inflammation and attenuated DNA damage. However, it remains unknown whether the inflammatory response is affected by the type of fluid used to reconstitute LP. We hypothesized that common resuscitation fluids such as normal saline (LP-NS), lactated Ringer's solution (LP-LR), Hextend (LP-HX), or sterile water (LP-SW) would yield similar inflammation profiles and DNA damage following LP reconstitution and transfusion.. This was a randomized, prospective, blinded animal study. LP was reconstituted to 50% of original volume with NS, LR, HX, or SW buffered with 15-mM ascorbic acid. Forty swine were subjected to a validated model of polytrauma, hemorrhagic shock, and Grade V liver injury and resuscitated with LP. Serum interleukin 6 (IL-6), IL-10, plasma C-reactive protein, and 8-hydroxy-2-deoxyguanosine concentrations were assessed for systemic inflammation and DNA damage at baseline, 2 hours, and 4 hours following liver injury. Lung inflammation was evaluated by Real Time Polymerize Chain Reaction (RT-PCR).. Reconstituted LP pH was similar between groups before resuscitation. IL-6 and IL-10 increased at 2 hours and 4 hours compared with baseline in all groups (p < 0.017). DNA damage increased at 2 hours and 4 hours compared with baseline and from 2 hours to 4 hours in the LP-NS, LP-LR, and LP-SW groups (all p < 0.017). Animals resuscitated with LP-HX not only demonstrated increased DNA damage at 4 hours versus baseline but also had the lowest C-reactive protein level at 2 hours and 4-hours (p < 0.017). Overall, differences between groups were similar for DNA damage and lung inflammation.. Reconstitution fluid type does not affect inflammatory cytokine profiles or DNA damage following LP transfusion in this swine polytrauma model. Based on universal availability, these data suggest that sterile water is the most logical choice for LP reconstitution in humans.. Prognostic, level II.

Topics: Animals; Antioxidants; Ascorbic Acid; C-Reactive Protein; Disease Models, Animal; DNA Damage; Female; Femoral Fractures; Fluid Therapy; Freeze Drying; Hemorrhage; Hydrogen-Ion Concentration; Inflammation; Liver; Lung; Oxidative Stress; Plasma; Prospective Studies; Random Allocation; Real-Time Polymerase Chain Reaction; Swine; Water

We studied the effect of vitamin C on fracture healing in the elderly. A total of 80 elderly Osteogenic Disorder Shionogi rats were divided into four groups with different rates of vitamin C intake. A closed bilateral fracture was made in the middle third of the femur of each rat. Five weeks after fracture the femora were analysed by mechanical and histological testing. The groups with the lower vitamin C intake demonstrated a lower mechanical resistance of the healing callus and a lower histological grade. The vitamin C levels in blood during healing correlated with the torque resistance of the callus formed (r = 0.525). Therefore, the supplementary vitamin C improved the mechanical resistance of the fracture callus in elderly rats. If these results are similar in humans, vitamin C supplementation should be recommended during fracture healing in the elderly.

Topics: Animals; Ascorbic Acid; Ascorbic Acid Deficiency; Biomechanical Phenomena; Dietary Supplements; Disease Models, Animal; Female; Femoral Fractures; Femur; Fracture Healing; Rats; Rats, Mutant Strains; Stress, Mechanical; Vitamins

Topics: Ascorbic Acid; Femoral Fractures; Humans; Infant; Male; Radiography; Scurvy

Topics: Adolescent; Adult; Aged; Ascorbic Acid; Calcium Gluconate; Combined Modality Therapy; Femoral Fractures; Fibula; Fractures, Bone; Fractures, Closed; Gluconates; Humans; Injections; Middle Aged; Thiamine; Tibial Fractures; Traction

Topics: Animals; Ascorbic Acid; Bone Transplantation; Bony Callus; Femoral Fractures; Follow-Up Studies; Humans; Nandrolone; Pseudarthrosis; Rats; Rats, Inbred Strains; Tibial Fractures

Topics: Ascorbic Acid; Bone Nails; Child; Collagen; Dose-Response Relationship, Drug; Female; Femoral Fractures; Fracture Fixation, Internal; Fractures, Spontaneous; Humans; Osteogenesis Imperfecta

Topics: Adolescent; Adult; Aged; Ascorbic Acid; Bony Callus; Drug Therapy, Combination; Female; Femoral Fractures; Fibula; Humans; Male; Middle Aged; Orotic Acid; Osteogenesis; Postoperative Care; Thiamine; Tibial Fractures

Topics: Ascorbic Acid; Bony Callus; Child, Preschool; Female; Femoral Fractures; Humans; Male; Meningomyelocele; Spinal Dysraphism; Tibial Fractures