ascorbic-acid and Joint-Diseases

Alkaptonuria is a disease often forgotten because of its rarity. Its pathogenic mechanism is the deficiency of one of the enzymes of the tyrosine degradation pathway-homogentisate-1, 2-dioxygenase, which sequelae is accumulation and deposition of its metabolite homogentisic acid in connective tissues and urine. Alkaptonuria presents as a clinical triad-darkening urine upon prolonged exposure to air, pigmentation of connective tissues and debilitating arthropathy. We present a case report of a 67-year old patient with alkaptonuria who presented with the clinical triad, but was mistakenly diagnosed as having ankylosing spondylitis in the past. Currently there is no treatment for the disease hence the management strategy was focused on symptoms control with analgesics, physical therapy, dietary modification, vitamin C supplementation, and joint arthroplasty. Alkaptonuria's clinical features are extensively described in the literature and despite the fact that it is a rare disease, due to the similar radiographic changes with spondyloarthropathies, it should be included in the differential diagnosis in young patients presenting with severe joint involvement. Early recognition of the disease is necessary since its natural evolution is joint destruction leading to significant reduction in the quality of life. Alkaptonuria's articular features in the spine and peripheral tissues are well described using the classical imaging techniques. Musculoskeletal ultrasonography shows a characteristic set of findings in the soft tissues, including synovium, cartilage, tendons and entheses.

Topics: Aged; Alkaptonuria; Ascorbic Acid; Cartilage Diseases; Dioxygenases; Homogentisic Acid; Humans; Joint Diseases; Ochronosis; Osteoarthritis; Quality of Life; Spondylarthropathies; Tyrosine

Topics: Animals; Ascorbic Acid; Child; Female; Gingival Diseases; Hemorrhage; Humans; Infant; Joint Diseases; Nutritional Requirements; Scurvy

Topics: Alkaptonuria; Ascorbic Acid; Cartilage, Articular; Homogentisic Acid; Humans; Joint Diseases; Ochronosis; Oxygenases; Tyrosine

It is proposed that vitamin C administration can reduce disproportionate pain and stiffness after distal radius fracture; however, randomized trials that tested this hypothesis have had inconsistent results.. (1) Is administering vitamin C after distal radius fracture associated with better ROM, patient-reported upper extremity function, and pain scores? (2) What factors are associated with post-fracture finger stiffness and worse upper extremity function?. This is a double-blind, randomized, placebo-controlled, noncrossover study. Between August 2014 and July 2017, we approached 204 consecutive patients, of which 195 were eligible, and 134 chose to participate. Participants were randomized to receive once-daily 500 mg vitamin C (67 participants) or placebo (67 participants) within 2 weeks after distal radius fracture. All patients received usual care at the discretion of their surgeon. The mean age of participants was 49 ± 17 years, 99 patients (74%) were women, and 83 (62%) were treated nonoperatively. The primary outcome was the distance between the fingertip and distal palmar crease 6 weeks after fracture. This measure is easy to obtain and previously has been shown to correlate with aggregate ROM of all finger joints. The secondary outcomes were total active finger motion, total active thumb motion, upper extremity-specific limitations, and pain intensity.An a priori power analysis suggested 126 patients would provide 80% power to detect a difference of 2 cm (SD 4.0) fingertip distance to palmar crease with α set at 0.05 using a two-tailed Student's t-test. Accounting for 5% lost to followup, we included 134 patients.All analyses were intention-to-treat. Ten participants of the intervention group and five of the placebo group were lost to followup. Their missing data were addressed by multiple imputation, after which we performed linear regression analysis for our outcome variables.. Administration of vitamin C was not associated with ROM, function, or pain scores at 6 weeks (distance to palmar crease: β -0.23; 95% CI -1.7 to 1.2; p = 0.754; finger ROM: β 4.9; 95% CI, -40 to 50; p = 0.829; thumb ROM: β 0.98; 95% CI, -18 to 20; p = 0.918, Patient-Reported Outcomes Measurement Information System [PROMIS] score: β 0.32; 95% CI, -2.6 to 3.2; p = 0.828; pain score: β -0.62; 95% CI, -0.62 to 0.89; p = 0.729) nor at 6 months (PROMIS score: β -0.21; 95% CI, -3.7 to 3.3; p = 0.904; pain score: β 0.31; 95% CI, -0.74 to 1.4; p = 0.559). At 6 weeks, we found that more finger stiffness was mildly associated with greater age (β -1.5; 95% CI, -2.8 to -0.083; p = 0.038). Thumb stiffness was mildly associated with greater age (β -0.72; 95% CI, -1.3 to -0.18; p = 0.009) and strongly associated with operative treatment (β -32; 95% CI, -50 to -13; p = 0.001). Greater pain interference was modestly associated with greater functional limitations at 6 weeks (β -0.32; 95% CI, -0.52 to -0.12; p = 0.002) and 6 months (β -0.36; 95% CI, -0.60 to -0.11; p = 0.004).. Vitamin C does not seem to facilitate recovery after distal radius fracture, but amelioration of maladaptation to nociception (pain interference) merits greater attention.. Level I, therapeutic study.

Topics: Adult; Aged; Ascorbic Acid; Double-Blind Method; Female; Finger Joint; Humans; Joint Diseases; Male; Middle Aged; Prospective Studies; Radius Fractures; Range of Motion, Articular; Treatment Outcome; Vitamins

The effect of active absorbable algal calcium (AAA Ca) with collagen and other matrix components on aging-associated skin changes and backache and joint pain was tested in a case-controlled study of 40 test subjects and 40 age-matched control subjects (mean age, 65 years) complaining of backache and knee joint pain due to osteoarthritis, spondylosis deformans, and/or osteoporosis. Supplementation with 900 mg calcium (given as AAA Ca) and 3.5 g collagen and other matrix components, including glucosamine, daily for 4 months resulted in a marked alleviation of subjective pain, assessed by the face scale. A fall of skin impedance in response to exercise loads, such as standing up, walking, squatting, and climbing up and down stairs, reported as an objective manifestion of pain, was also alleviated. The basal skin impedance, which increases with age, was significantly reduced in response to the Ca-collagen-matrix supplementation, suggesting a change of skin properties similar to rejuvenation, along with subjective smoothening and moistening of the skin. Urinary excretion of N-terminal crosslinking telopeptide of type I collagen (NTx) was decreased in the Ca-collagen-matrix supplementation group, but not in the control group. In addition to calcium suppression of parathyroid hormone, preventing bone resorption, collagen, acting on the intestinal lymphatic system, may protect collagen from degradation through the inhibition of cytokine-induced release of metalloproteinases, including collagenase.

Topics: Absorption; Aged; Ascorbic Acid; Bone Density; Calcium; Case-Control Studies; Collagen; Collagen Type I; Electric Impedance; Extracellular Matrix; Female; Glucosamine; Glycosaminoglycans; Humans; Joint Diseases; Knee Joint; Male; Middle Aged; Osteoarthritis; Osteoporosis; Pain; Peptides; Skin Physiological Phenomena

Knee arthrofibrosis is a common complication of knee surgery, caused by excessive scar tissue, which results in functional disability. However, no curative treatment has been established. E8002 is an anti-adhesion material that contains L-ascorbic acid, an antioxidant. We aimed to evaluate the efficacy of E8002 for the prevention of knee arthrofibrosis in a rat model, comprising injury to the surface of the femur and quadriceps muscle 1 cm proximal to the patella. Sixteen male, 8-week-old Sprague Dawley rats were studied: in the Adhesion group, haemorrhagic injury was induced to the quadriceps and bone, and in the E8002 group, an adhesion-preventing film was implanted between the quadriceps and femur after injury. Six weeks following injury, the restriction of knee flexion owing to fibrotic scarring had not worsened in the E8002 group but had worsened in the Adhesion group. The area of fibrotic scarring was smaller in the E8002 group than in the Adhesion group (

Topics: Animals; Ascorbic Acid; Cicatrix; Fibrosis; Joint Diseases; Knee Injuries; Knee Joint; Male; Membranes, Artificial; Polyesters; Range of Motion, Articular; Rats; Rats, Sprague-Dawley; Tissue Adhesions

To evaluate the effect of a chondroprotective agent on hematologic, hemostatic, and biochemical variables in clinically normal dogs when administered over 30 days.. 13 clinically normal Beagles of either sex.. Hematologic and hemostatic variables were assessed prior to treatment and on days 3, 14, and 30 of treatment. Biochemical variables were assessed before treatment and on day 30 of treatment.. Significant (P < 0.05) decreases were noted in hematocrit, hemoglobin, WBC, and segmented neutrophil variables on days 3 and 14 of treatment. A significant decrease in red distribution width was noted on days 3 and 30, in RBC count on day 3, and in lymphocyte numbers on day 30. There were also significant reductions of aggregation in response to adenosine diphosphate and collagen on days 14 and 30. Significant decreases were noted in total ATP release in response to collagen on days 14 and 30, as well as significant decrease in platelet count on days 14 and 30. No changes were noted in prothrombin time, activated partial thromboplastin time, mucosal bleeding time, or biochemical variables during the study.. Administration of this chondroprotective agent causes minor but not clinically important changes in hematologic and hemostatic variables in young, clinically normal dogs.. Oral chondroprotective agents are widely prescribed in veterinary medicine for the treatment of degenerative joint disease; however, to date, little is known about safety of their use.

Topics: Administration, Oral; Animals; Ascorbic Acid; Blood Cell Count; Chondroitin Sulfates; Dog Diseases; Dogs; Electrolytes; Enzymes; Female; Glucosamine; Hematocrit; Hemoglobins; Joint Diseases; Male; Partial Thromboplastin Time; Platelet Aggregation; Prothrombin Time; Reference Values

Topics: Adult; Ascorbic Acid; Blood Cell Count; Hair Diseases; Humans; Joint Diseases; Male; Scurvy; Skin; Skin Diseases

Topics: Alkaptonuria; Ascorbic Acid; Diagnosis, Differential; Diet Therapy; Dietary Proteins; Humans; Joint Diseases; Male; Middle Aged; Ochronosis; Radiography

Topics: Adult; Antigens; Ascorbic Acid; Blood Glucose; Blood Protein Disorders; Body Weight; Carbon Isotopes; Cholesterol; Diet Therapy; Epinephrine; Epithelium; Fatigue; Gingival Diseases; Hemorrhage; Humans; Immunization; Insulin; Joint Diseases; Keratosis; Lipids; Male; Middle Aged; Muscular Diseases; Nutritional Requirements; Pain; Plasma; Scurvy; Time Factors; Typhoid Fever; Water

Topics: Adolescent; Adult; Ascorbic Acid; Dexamethasone; Female; Humans; Joint Diseases; Male; Middle Aged; Pain; Salicylates; Temporomandibular Joint; Thiamine

Topics: Anticoagulants; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Aspirin; Gout; Hip Joint; Humans; Joint Diseases; Rheumatology; Spondylitis; Spondylitis, Ankylosing

Topics: Ascorbic Acid; Calcium; Calcium, Dietary; Humans; Iodine; Joint Diseases; Osteomalacia; Osteoporosis; Spinal Diseases; Vitamins

Topics: Ascorbic Acid; Glycosaminoglycans; Humans; Joint Diseases; Synovial Fluid; Vitamins

Topics: Aminopyrine; Ascorbic Acid; Bone Diseases; Caffeine; Disease; Joint Diseases; Muscle Relaxants, Central; Muscle Relaxation; Muscles; Muscular Diseases; Vitamins

Topics: Aminopyrine; Ascorbic Acid; Connective Tissue Diseases; Hip; Humans; Joint Diseases; Muscle Relaxants, Central; Muscular Diseases; Osteoarthritis, Hip; Prednisolone; Spinal Diseases

Topics: Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Body Fluids; Humans; Joint Diseases; Thiamine; Vitamins

Topics: Ascorbic Acid; Injections, Intra-Articular; Joint Diseases; Prednisolone; Vitamins

Topics: Adrenal Cortex Hormones; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Desoxycorticosterone; Joint Diseases

Topics: Adrenal Cortex Hormones; Ascorbic Acid; Desoxycorticosterone; Joint Diseases; Joints; Vitamins

Topics: Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Desoxycorticosterone Acetate; Joint Diseases; Water-Electrolyte Balance

Topics: Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Humans; Joint Diseases; Niacin; Niacinamide

Topics: Adrenal Cortex; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Desoxycorticosterone; Joint Diseases; Tissue Extracts

Topics: Adrenal Cortex; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Desoxycorticosterone; Joint Diseases; Tissue Extracts