ascorbic-acid and Pain

Fibromyalgia syndrome (FMS) is characterised by chronic widespread pain alongside fatigue, poor sleep quality and numerous comorbidities. It is estimated to have a worldwide prevalence of 1.78%, with a predominance in females. Treatment interventions for fibromyalgia have limited success, leading to many patients seeking alternative forms of treatment, including modifications to their diet and lifestyle. The effectiveness of dietary changes in fibromyalgia has not been widely researched or evaluated. This systematic review identified twenty-two studies, including 18 randomised control trials (RCTs) and four cohort studies which were eligible for inclusion. In total these studies investigated 17 different nutritional interventions. Significant improvements in reported pain were observed for those following a vegan diet, as well as with the low fermentable oligo di-mono-saccharides and polyols (FODMAP) diets. Supplementation with

Topics: Acetylcarnitine; Ascorbic Acid; Chlorella; Diet, Vegan; Dietary Supplements; Fermented Foods; Fibromyalgia; Humans; Nigella sativa; Pain; Phytotherapy; Quality of Life; Randomized Controlled Trials as Topic; Seeds; Treatment Outcome; Ubiquinone; Vitamin E

The vitamin C deficiency disease scurvy is characterised by musculoskeletal pain and recent epidemiological evidence has indicated an association between suboptimal vitamin C status and spinal pain. Furthermore, accumulating evidence indicates that vitamin C administration can exhibit analgesic properties in some clinical conditions. The prevalence of hypovitaminosis C and vitamin C deficiency is high in various patient groups, such as surgical/trauma, infectious diseases and cancer patients. A number of recent clinical studies have shown that vitamin C administration to patients with chronic regional pain syndrome decreases their symptoms. Acute herpetic and post-herpetic neuralgia is also diminished with high dose vitamin C administration. Furthermore, cancer-related pain is decreased with high dose vitamin C, contributing to enhanced patient quality of life. A number of mechanisms have been proposed for vitamin C's analgesic properties. Herein we propose a novel analgesic mechanism for vitamin C; as a cofactor for the biosynthesis of amidated opioid peptides. It is well established that vitamin C participates in the amidation of peptides, through acting as a cofactor for peptidyl-glycine α-amidating monooxygenase, the only enzyme known to amidate the carboxy terminal residue of neuropeptides and peptide hormones. Support for our proposed mechanism comes from studies which show a decreased requirement for opioid analgesics in surgical and cancer patients administered high dose vitamin C. Overall, vitamin C appears to be a safe and effective adjunctive therapy for acute and chronic pain relief in specific patient groups.

Topics: Analgesics; Analgesics, Opioid; Animals; Ascorbic Acid; Ascorbic Acid Deficiency; Humans; Pain

Lipoic acid (LA) is an antioxidant able to produce its effects in aqueous or lipophilic environments. Lipoate is the conjugate base of lipoic acid, and the most prevalent form of LA under physiological conditions. It presents a highly negative reduction potential, increases the expression of antioxidant enzymes and participates in the recycling of vitamins C and E. Due to these properties, LA is called the "universal antioxidant". LA is also involved with anti-inflammatory action, independently of its antioxidant activity. This review was carried out, aiming to identify, analyze, and rationalize the various clinical, physiopathological and/or physiological situations in which LA, through oral supplementation, was tested on human and animal (rats and mice) models. LA was mainly tested in cardiovascular diseases (CVD), obesity, pain, inflammatory diseases and aging. LA uses in CVD and obesity, in humans, are controversial. On the other hand, beneficial effects on inflammation and pain were observed. LA supplementation in animal models may prolong life, has neuroprotective effects and presents positive effects against cancer. Differences observed in human and animal models can be due, in part, to different treatments (LA combined with other antioxidants, different doses) and to the variety of biomarkers investigated in animal experiments. These results suggest the need for further clinical trials to guide health professionals regarding the safety of prescription of this supplement.

Topics: Aging; Animals; Anti-Inflammatory Agents; Antioxidants; Ascorbic Acid; Clinical Trials as Topic; Disease Models, Animal; Humans; Inflammation; Oxidative Stress; Pain; Reactive Oxygen Species; Thioctic Acid; Vitamin E

The effect of ascorbic acid on cancer has been a subject of great controversy. This is a follow-up review of the 1979 article by Cameron, Pauling, and Leibovitz published in Cancer Research. In this updated version, the authors address general aspects of ascorbic acid and cancer that have been presented before, while reviewing, analyzing, and updating new existing literature on the subject. In addition, they present and discuss their own mechanistic hypothesis on the effect of ascorbic acid on the cancer cell. The objective of this review is to provide an updated scientific basis for the use of ascorbic acid, especially intravenously as adjuvant treatment in pharmacological nutritional oncology.

Topics: Antioxidants; Ascorbic Acid; Clinical Trials as Topic; Combined Modality Therapy; Dose-Response Relationship, Drug; Drug Resistance, Neoplasm; Humans; Infusions, Intravenous; Neoplasms; Pain; Palliative Care

This review describes the methods of reducing the effects of delayed onset muscle soreness (DOMS) as a result of muscle contractions, including the cryotherapy, physical and pharmacological therapies. Concentric and eccentric exercise and some pharmacological agents are also described as the methods of DOMS prevention.

Topics: Ascorbic Acid; Electromagnetic Phenomena; Humans; Laser Therapy; Muscle, Skeletal; Neuromuscular Agents; Pain; Time Factors; Vitamin E

Several mechanisms have been forwarded to explain the etiology of exercise-induced muscle damage. Free-radical mediated processes appear to be an important component of the inflammatory mediated response. Free radicals have also been demonstrated to be a contributing factor in the loss of calcium homeostasis within the cell. Therefore, one of the proposed treatments for preventing or reducing the extent of this damage is the intervention of free-radical mediated processes. Antioxidants are agents that typically work to prevent free-radical mediated alterations within cells by quenching free radicals. The traditional dietary antioxidants most commonly investigated to inhibit free-radical damage are vitamin E, vitamin C, and beta carotene. Other nutritional agents have also been noted to contain antioxidant properties. Isofavonoids and some phytochemicals have been proposed to contain antioxidant properties. This paper briefly reviews some aspects of these agents and the! ! ir role, either proven or proposed, in the prevention of oxidative stress and muscle damage.

Topics: Animals; Antioxidants; Ascorbic Acid; beta Carotene; Calcium; Dietary Supplements; Exercise; Free Radical Scavengers; Free Radicals; Homeostasis; Humans; Isoflavones; Muscle, Skeletal; Oxidative Stress; Pain; Vitamin E

Patellar tendinopathy (PT) is a common problem in jumping athletes. Management can be challenging and treatment outcome is not always successful. In combination with tendon loading exercises, hydrolyzed collagen/vitamin C supplementation appears to have a promising effect on the recovery of tendinopathy. The aim of this study is to evaluate whether the use of oral supplementation of hydrolyzed collagen and vitamin C in combination with progressive tendon loading exercises (PTLE) is superior to PTLE and placebo on VISA-P score (which rates pain, function, sports participation) after 24 weeks for athletes with PT.. The JUMPFOOD study is a double-blinded, two-armed randomized controlled trial, in which the effectiveness of oral supplementation of hydrolyzed collagen/vitamin C combined with PTLE compared to PTLE with placebo on pain and recovery of function in athletes with PT will be investigated. Seventy-six athletes aged 16-40 years, with symptoms of PT for at least 12 weeks, who play sports at least once a week will be included. All participants will receive education, advice with regard to load management and a PTLE program according to the Dutch guidelines for anterior knee pain. In addition, the intervention group will receive daily 10 g hydrolyzed collagen and 40 mg vitamin C supplementation for 24 weeks whereas the control group receives 10 g maltodextrin placebo supplementation. Measurements will take place at baseline and at 12 and 24 weeks' follow-up. Primary outcome is the VISA-P score, which evaluates pain, function, and sports participation. For secondary outcome measures, data with regard to pain during functional tests, flexibility measurements, blood withdrawals, imaging characteristics of the tendon, and health questionnaires will be collected. During the follow-up period, participants will register sports participation, amount of training and tendon load, pain during sports, co-medication, and side-effects in a digital weekly diary.. The JUMPFOOD study is the first large RCT to study the effectiveness of hydrolyzed collagen/vitamin C supplementation in combination with the PTLE program in athletes with patellar tendinopathy. If supplementation of collagen/vitamin C appears to be effective, this treatment can be implemented in daily sports medicine practice to improve the treatment outcome of patients with PT.. ClinicalTrials.gov NCT05407194. Registered on 7 June 2022.

Topics: Adolescent; Adult; Ascorbic Acid; Athletes; Humans; Pain; Randomized Controlled Trials as Topic; Tendinopathy; Vitamins; Young Adult

The fundamental aim of this study is to establish the role of antioxidant supplementation in alleviating acute amitriptyline induced oxidative stress. The effect of supplementation was compared on treatment of acute amitriptyline intoxication cases for pain management, with alpha lipoic acid (ALA) alone or with vitamin C, with that of healthy individuals (group I), and those receiving only routine standard treatment (RST) as control (group II). A total of 132 human subjects divided into 5 groups were supplemented with either placebo, RST, RST with vitamin C, RST with ALA, or RST with vitamin C, and ALA. Results of this study revealed that the decrease in the level of oxidative stress and enzyme activity was observed among those supplemented with either alpha lipoic acid alone or along with vitamin C, with a slightly more decrease in the latter group. P value of < 0.001 was considered statistically significant. The percentage of benefit of treatment on supplementation with vitamin C and alpha lipoic acid showed a marked increase in group V cases after supplementation with both in combination. The results provided that the oxidative stress induced by acute amitriptyline poisoning is comparatively decreased by supplementation with antioxidants like alpha lipoic acid and vitamin C, than those only on routine standard treatment.

Topics: Acute Disease; Adult; Amitriptyline; Antioxidants; Ascorbic Acid; Dietary Supplements; Female; Humans; Male; Oxidative Stress; Pain; Substance-Related Disorders; Thioctic Acid

Complex regional pain syndrome (CRPS) type I, formerly known as reflex sympathetic dystrophy (RSD) or algodystrophy, is a condition with chronic pain condition following a trauma or surgery. The physiopathology of this syndrome remained incompletely known. Due to the lack of effective curative treatment, prevention of this complication is important. Therefore, we evaluated the efficacy of vitamin C in preventing this complication.. Between January 2018 and July 2019, we conducted a prospective randomized study on the efficiency of vitamin C (one group with and one without vitamin C) on prevention of CRPS risk in patients operated in our institution with TKA. Patients with a VAS pain score > 4 performed a three-phase bone scintigraphy. The diagnostic of CRPS was made by using the Budapest criteria associated to a bone scintigraphy. Statistical significance was set at p < 0.05 RESULTS: One hundred fifty-three patients were included in the vitamin C group, 139 in the control group without vitamin C. For the entire cohort, the prevalence of complex regional pain syndrome was 7.9% (23 of 292). The prevalence of complex regional pain syndrome was 3.9% (six of 153) in the vitamin C group and 12.2% (seventeen of 139) in the control group (p = 0.008). After multivariate regression, vitamin C was found to be an independent preventive factor of CRPS and there was a significant difference between the vitamin C group and the control group (relative risk, 0.27; 95% confidence interval, 0.1-0.8; p = 0.015).. Taking 1 g per day of vitamin C during 40 days after a TKA reduces the risk of CRPS.

Topics: Arthroplasty, Replacement, Knee; Ascorbic Acid; Complex Regional Pain Syndromes; Humans; Pain; Prospective Studies

The quality of colon cleansing and the tolerability of anterograde preparation are essential to the success of colorectal cancer screening.. To compare the tolerability and efficacy of low-volume preparations vs the standard regimen in individuals scheduled for an early morning colonoscopy.. Participants in a population-based colorectal cancer screening program using the fecal immunochemical test who were scheduled for a colonoscopy from 09:00 a.m. to 10:20 a.m. were prospectively included and assigned to: (1) control group (PEG-ELS 4L): PEG 4L and electrolytes; (2) group AscPEG-2L: a combination of PEG and ascorbic acid 2L; and (3) group PiMg: sodium picosulfate and magnesium citrate 500 mL plus 2L of clear fluids. Tolerability was evaluated with a questionnaire and the quality of bowel preparation with the Boston Bowel Preparation Scale.. A total of 292 participants were included: 98 in the PEG-ELS 4L control group, 96 in the AscPEG-2L study group and 98 in the PiMg study group. Low-volume treatments were better tolerated than the standard solution (AscPEG-2L 94.8% and PiMg 93.9% vs PEG-ELS 4L 75.5%; p < 0.0001). The effectiveness of AscPEG-2L was superior to that of PEG-ELS 4L and PiMg (p = 0.011 and p = 0.032, respectively). Patient acceptance was higher for single-dose than for split-dose administration but efficacy was higher with the split dose than with other doses.. In early morning colonoscopies, ascPEG-2L appears to be the best option, especially when administered in a split-dose.

Topics: Aged; Ascorbic Acid; Cathartics; Citrates; Citric Acid; Colonoscopy; Colorectal Neoplasms; Defecation; Dizziness; Drug Administration Schedule; Early Detection of Cancer; Female; Humans; Male; Middle Aged; Nausea; Organometallic Compounds; Pain; Patient Acceptance of Health Care; Picolines; Polyethylene Glycols; Prospective Studies; Surveys and Questionnaires; Vomiting

Minor recurrent aphthous stomatitis (MRAS) is a common, painful and inflammatory ailment of the oral cavity with juvenile onset and unknown aetiology. The purpose of this study was to evaluate the potential of ascorbate (vitamin C) to reduce the frequency of MRAS and severity of pain.. Sixteen MRAS patients (9 boys and 7 girls: mean age, 12.0 +/- 2.4 years old) were assigned to take an oral dosage of 2000 mg/m(2)/day ascorbate.. Their baseline frequency of outbreaks and the level of pains were compared during the treatment; in addition, a crossover clinical trial was performed. Polymorphonuclear leucocytes play a role in the pathogenesis, and then superoxide anion production was evaluated in prior to ascorbate treatment.. The data indicated a statistically significant 50% reduction in oral ulcer outbreaks and a decline of pain level. Neutrophils were primed for superoxide anion production in the patients with MRAS.. Ascorbate may modulate the generation of reactive oxygen species and augment neutrophil apoptosis, which could prevent neutrophil-mediated inflammation. Ascorbate seems to be effective, but the findings of our study were preliminary and it should be re-evaluated with a larger randomized controlled clinical trials.

Topics: Administration, Oral; Adolescent; Antioxidants; Ascorbic Acid; Child; Cross-Over Studies; Drug Administration Schedule; Female; Humans; Male; Neutrophils; Pain; Secondary Prevention; Severity of Illness Index; Stomatitis, Aphthous; Superoxides; Treatment Outcome

To evaluate changes on venous diameter and perimeter of lower limbs in chronic venous disorder (CVD) patients after different clinical treatments for four weeks.. Fifty-two female patients classified as C2,s or C2,3,s (CEAP classification) were allocated consecutively in three groups: Cirkan (40 mg of the root extract of Ruscus aculeatus + 100 mg of flavonoid hesperidine methylchalcone + 200 mg of vitamin C per pill); elastic compression stockings (ECS) and no treatment (NT). Diameters were determined by duplex ultrasound and perimeter with Leg-O-Meter.. After treatment, Cirkan significantly decreased popliteal vein and great saphenous vein (GSV) diameters bilaterally and ECS decreased popliteal vein diameter bilaterally and GSV and varices only on the left limb. Perimeters changed only with ECS. Clinical scores changed between Cirkan x NT and ECS x Cirkan. Disability score varied for ECS x NT and Cirkan x NT. chi2 test detected different distribution frequency for C3 and C2 classes according to treatment: ECS (both limbs) and Cirkan (only left limb). Varices and anatomical scores did not change.. ECS emerges as the most effective clinical treatment tested but improvements with Cirkan on vein diameter and CEAP class were also observed. Clinical scores improved due to pain relief and edema reduction (ECS). These findings point to a positive effect of Cirkan, suggesting that venotonic drugs should be taken into account in the treatment of CVD.

Topics: Adult; Anthropometry; Ascorbic Acid; Brazil; Cardiovascular Agents; Chi-Square Distribution; Chronic Disease; Chymotrypsin; Disability Evaluation; Drug Combinations; Female; Hesperidin; Humans; Lower Extremity; Middle Aged; Pain; Pain Measurement; Phytosterols; Popliteal Vein; Saphenous Vein; Stockings, Compression; Time Factors; Treatment Outcome; Trypsin; Ultrasonography, Doppler, Duplex; Vascular Diseases

Exercise involving lengthening muscle actions, such as downhill running, results in delayed onset muscle soreness (DOMS), which may be attributable to reactive oxygen species (ROS). Although exercise causes oxidative stress, any link between ROS and DOMS remains speculative. There is emerging evidence to suggest that ROS play an important physiological role, assisting in the recovery process and protecting the cell from future damage; however, this has not been fully established. Despite this uncertainty as to the precise role of ROS, attempts to prevent post-exercise ROS production through antioxidant intervention are still common. The study investigated the effects of ascorbic acid supplementation on ROS production and DOMS following downhill running. Subjects were assigned to two groups. The ascorbic acid group (group AA) received 1 g ascorbic acid 2 h pre-, and for 14 d post-downhill running, whilst the placebo group (Pl group) received a placebo. Blood samples were drawn pre-supplement, pre- and post-exercise, and then 1, 2, 3, 4, 7 and 14 d post-exercise for analysis of ascorbate, malonaldehyde and total glutathione. DOMS was assessed using a visual analogue scale and pressure algometry. Muscle function was assessed using isokinetic dynamometry. Plasma ascorbate was elevated throughout in group AA compared with the Pl group. Downhill running resulted in DOMS in both groups. Muscle function was impaired post-exercise in both groups, although a delayed recovery was noted in group AA. Malonaldehyde increased 4 d post-exercise in the Pl group only. Ascorbic acid supplementation attenuates ROS production following downhill running, without affecting DOMS. Furthermore, ascorbic acid supplementation may inhibit the recovery of muscle function.

Topics: Adult; Anthropometry; Ascorbic Acid; Double-Blind Method; Exercise; Humans; Male; Muscle Fatigue; Muscle, Skeletal; Pain; Reactive Oxygen Species; Recovery of Function; Running

This study investigated if vitamin C supplementation before and after eccentric exercise could reduce muscle soreness (MS), oxidative stress, and muscle function. Eighteen healthy men randomly assigned to either a placebo (P) or vitamin C (VC) (3 g/d) treatment group took pills for 2 wk prior and 4 d after performing 70 eccentric elbow extensions with their non-dominant arm. MS increased in both groups with significantly reduced MS for the first 24 h with VC. Range of motion was reduced equally in both groups after the exercise (P > or = 0.05). Muscle force declined equally and was unaffected by treatment. VC attenuated the creatine kinase (CK) increase at 48 h after exercise with similar CK after this time. Glutathione ratio (oxidized glutathione/total glutathione) was significantly increased at 4 and 24 h with P but VC prevented this change. These data suggest that vitamin C pretreatment can reduce MS, delay CK increase, and prevent blood glutathione oxidation with little influence on muscle function loss.

Topics: Adult; Antioxidants; Ascorbic Acid; Creatine Kinase; Dietary Supplements; Exercise; Glutathione; Humans; Male; Muscle Contraction; Muscle, Skeletal; Oxidation-Reduction; Oxidative Stress; Pain; Time Factors

The aim of this study was to compare the effects of 8 days of vitamin C (VC) supplementation on elbow flexor delayed onset muscle soreness (DOMS) to 8 days of placebo ingestion.. For 3 days prior to an exercise bout (2 x 20 eccentric elbow extensions), and for 5 days after, a treatment group ingested 3 x 1000 mg/day of VC versus 3 x 50 mg/day of glucose ingestion for the placebo group over the same time period. All subjects were prescreened via dietary recall to exclude any subjects with habitual VC consumption greater than 400 mg/day. Subject comprised 24 subjects (male and female) randomly divided into 2 groups of 12 subjects. Treatment group comprised 5 females and placebo group comprised 8 females.. Data from a repeated measures ANOVA indicate that DOMS was successfully induced in both groups via significant time effects for strength loss (P = 0.0001), point tenderness (P = 0.0001), elbow flexor decreased range of motion (P = 0.013), and subjective pain (P = 0.0001). However, there were no significant between group differences in response to any of the aforementioned variables: strength loss (P = 0.202), point tenderness (P = 0.824), elbow flexor range of motion (P = 0.208), subjective pain (P = 0.342).. The results of this study suggest that a VC supplementation protocol of 3 x 1000 mg/day for 8 days is ineffective in protecting against selected markers of DOMS.

Topics: Adult; Analysis of Variance; Antioxidants; Ascorbic Acid; Dietary Supplements; Elbow; Exercise Test; Female; Humans; Male; Muscle Contraction; Muscle Fatigue; Muscle Strength; Muscle, Skeletal; Pain; Pain Measurement; Pain Threshold; Range of Motion, Articular; Reference Values; Time Factors

We have previously shown that vitamin C supplementation affects recovery from an unaccustomed bout of demanding exercise, with the most pronounced effect being that on plasma interleukin-6 concentration. However, because of the proposed role of interleukin-6 in the regulation of metabolism, it was unclear whether this represented a reduced response to muscle damage or some form of interaction with the metabolic demands of the activity. Therefore, the aim of the present study was to investigate the effect of the same form of supplementation on a bout of exercise that initiated similar muscle damage but had a low metabolic cost. Fourteen male subjects were allocated to either a placebo (P) or a vitamin C (VC) group. The VC group consumed 200 mg of ascorbic acid twice a day for 14 days prior to a bout of exercise and for the 3 days after exercise. The P group consumed identical capsules that contained 200 mg lactose. Subjects performed 30 min of downhill running at a gradient of -18% and recovery was monitored for up to 3 days after exercise. Plasma VC concentrations in the VC group increased following supplementation. Nevertheless, downhill running provoked a similar increase in circulating markers of muscle damage (creatine kinase activity and myoglobin concentration) and muscle soreness in P and VC groups. Similarly, although downhill running increased plasma interleukin-6, there was no effect from VC supplementation. These results suggest that vitamin C supplementation does not affect interleukin-6 concentrations following eccentric exercise that has a low metabolic component.

Topics: Adult; Ascorbic Acid; Creatine Kinase; Dietary Supplements; Double-Blind Method; Exercise; Humans; Interleukin-6; Male; Muscle, Skeletal; Myoglobin; Myositis; Pain; Recovery of Function

To investigate in a double-blind placebo-controlled, parallel group study, the effects of a nutrient supplement, containing, among other ingredients, the omega-3 fatty acids eicosapentaenoic acid (1.4 g EPA), docosahexaenoic acid (0.211 g DHA), omega-6 fatty acid gamma-linolenic acid (0.5 g GLA) and micronutrients in patients with active rheumatoid arthritis (RA).. RA patients were randomized to receive either daily liquid nutrient supplementation or placebo for 4 months. The primary end point was the change in tender joint count at 2 and 4 months. Other clinical variables included swollen joint count, visual analogue scales for pain and disease activity, grip strength, functionality score and morning stiffness. Biochemical parameters included plasma concentrations of PUFA and vitamins C and E.. Outpatient university clinic.. In all, 66 patients enrolled, 55 completed the study. No significant change from baseline in tender joint count or any of the other clinical parameters was detected in either group. Patients receiving nutrient supplementation, but not those receiving placebo, had significant increases in plasma concentrations of vitamin E (P=0.015), and EPA, DHA and docosapentaenoic acid concomitant with decreases of arachidonic acid (P=0.01). Intergroup differences for PUFA and vitamin E were significantly different (P=0.01 and 0.03, respectively).. This double-blind, placebo-controlled study in RA patients did not show superior clinical benefit of daily nutrient supplementation with EPA, GLA and micronutrients at the doses tested as compared to placebo. The study adds information regarding doses of omega-3 fatty acids, below which anti-inflammatory effects in RA are not seen.

Topics: Antioxidants; Arthritis, Rheumatoid; Ascorbic Acid; Dietary Supplements; Docosahexaenoic Acids; Double-Blind Method; Eicosapentaenoic Acid; Fatty Acids, Omega-3; Fatty Acids, Omega-6; Fatty Acids, Unsaturated; Female; gamma-Linolenic Acid; Hand Strength; Humans; Male; Micronutrients; Middle Aged; Pain; Treatment Outcome; Vitamin E

The purpose of this study was to determine the effects of antioxidant therapy on indirect markers of muscle damage following eccentric exercise (EE). Eighteen women were randomized to an antioxidant supplement or a placebo before a bout of EE. Plasma creatine kinase (CK) activity, muscle soreness (MS), maximal isometric force (MIF), and range of motion (ROM) were assessed before and through 14 d postexercise. Eccentric exercise resulted in an increase in CK activity and MS, and a drop in MIF and ROM during the days following EE, which returned to baseline values 14 d after EE in both groups. Antioxidants attenuated the CK activity and MS response to the EE, while little difference was noted between groups in MIF or ROM. These findings suggest that antioxidant supplementation was helpful in reducing the elevations in plasma CK activity and MS, with little impact on MIF and ROM loss.

Topics: Adult; Antioxidants; Ascorbic Acid; Creatine Kinase; Dietary Supplements; Double-Blind Method; Exercise; Female; Humans; Muscle Contraction; Muscle, Skeletal; Oxidative Stress; Pain; Range of Motion, Articular; Time Factors; Vitamin E

The aim of this study was to investigate whether post-exercise vitamin C supplementation influences recovery from an unaccustomed bout of exercise. Sixteen male subjects were allocated to either a placebo (P; n=8) or vitamin C (VC) group ( n=8). Subjects performed a prolonged (90-min) intermittent shuttle-running test, and supplementation began after the cessation of exercise. Immediately after exercise the VC group consumed 200 mg of VC dissolved in a 500 ml drink, whereas the subjects in the P group consumed the drink alone. Later on the same day and then in the morning and evening of the following 2 days, subjects consumed additional identical drinks. Plasma VC concentrations in the VC group increased above those in the P group 1 h after exercise and remained above P values for the 3 days after exercise. Nevertheless, post-exercise VC supplementation was not associated with improved recovery. Post-exercise serum creatine kinase activities and myoglobin concentrations were unaffected by supplementation. Muscle soreness and the recovery of muscle function in the leg flexors and extensors were not different in VC and P groups. Furthermore, although plasma concentrations of interleukin-6 and malondialdehyde increased following exercise, there was no difference between VC and P groups. These results suggest that either free radicals are not involved in delaying the recovery process following a bout of unaccustomed exercise, or that the consumption of VC wholly after exercise is unable to deliver this antioxidant to the appropriate sites with sufficient expediency to improve recovery.

Topics: Adaptation, Physiological; Administration, Oral; Adult; Antioxidants; Ascorbic Acid; Dietary Supplements; Double-Blind Method; Humans; Interleukin-6; Leg; Male; Malondialdehyde; Muscle Contraction; Muscle Fatigue; Muscle, Skeletal; Pain; Physical Exertion; Recovery of Function; Running

Although vitamin C is essential for the formation of collagen and proteoglycan and has been shown to minimise surgically induced arthritis in guinea pigs, no controlled trial has examined its effect on human osteoarthritis.. The trial was a multicenter, double-blind, randomised, placebo-controlled, crossover-trial performed by ten general practitioners. The Declaration of Helsinki and the European guidelines for good clinical practice were strictly followed. One hundred and thirty-three patients with radiographically verified symptomatic osteoarthritis of the hip joints and/or the knee joints were treated with one gram of calcium ascorbate or identically looking placebo tablets. The calcium ascorbate tablets and the placebo tablets should be swallowed daily for 14 +/- 3 days respectively, separated by 7 +/- 3 days wash out. The main outcome measure was difference on the 100 mm visual analog scale (VAS) score for pain in a preselected joint. The secondary outcomes were Lequesne score for function and patient preference.. Calculated on an intention-to-treat principle, calcium ascorbate reduced pain significantly compared to placebo (p = 0.0078 by analysis of variance between groups (ANOVA) for difference in VAS, mean difference 4.6 mm (95% CI 1.2-8.0). Similar superiority was found for Lequesne index (p = 0.036, difference 0.56 (95% CI 0.04-1.08) and for patient preference (p = 0.012).. The demonstrated effect is less than half as pronounced as commonly reported for NSAID etc. If the finding can be reproduced with a smaller, acceptable intake of vitamin C this would be of importance considering the large prevalence of osteoarthrosis.

Topics: Adult; Antioxidants; Ascorbic Acid; Calcium; Cross-Over Studies; Drug Combinations; Female; Humans; Male; Osteoarthritis, Hip; Osteoarthritis, Knee; Pain; Tablets; Treatment Outcome

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

Anticipation of pain is a complex state that may influence the perception of subsequent noxious stimuli. We used functional magnetic resonance imaging (fMRI) to study changes of activity of cortical nociceptive networks in healthy volunteers while they expected the somatosensory stimulation of one foot, which might be painful (subcutaneous injection of ascorbic acid) or not. Subjects had no previous experience of the noxious stimulus. Mean fMRI signal intensity increased over baseline values during anticipation and during actual stimulation in the putative foot representation area of the contralateral primary somatosensory cortex (SI). Mean fMRI signals decreased during anticipation in other portions of the contralateral and ipsilateral SI, as well as in the anteroventral cingulate cortex. The activity of cortical clusters whose signal time courses showed positive or negative correlations with the individual psychophysical pain intensity curve was also significantly affected during the waiting period. Positively correlated clusters were found in the contralateral SI and bilaterally in the anterior cingulate, anterior insula, and medial prefrontal cortex. Negatively correlated clusters were found in the anteroventral cingulate bilaterally. In all of these areas, changes during anticipation were of the same sign as those observed during pain but less intense ( approximately 30-40% as large as peak changes during actual noxious stimulation). These results provide evidence for top-down mechanisms, triggered by anticipation, modulating cortical systems involved in sensory and affective components of pain even in the absence of actual noxious input and suggest that the activity of cortical nociceptive networks may be directly influenced by cognitive factors.

Topics: Adult; Arousal; Ascorbic Acid; Attention; Brain Mapping; Cerebral Cortex; Cognition; Cues; Female; Foot; Heart Rate; Humans; Injections, Subcutaneous; Intuition; Magnetic Resonance Imaging; Male; Nerve Net; Pain; Pain Measurement; Physical Stimulation; Skin; Skin Physiological Phenomena; Stimulation, Chemical

Exercise-induced free-radical production may be partly responsible for muscle soreness and damage following demanding exercise. A number of studies have investigated the effect of antioxidant supplementation although there is a paucity of information regarding vitamin C. Therefore the aim of the present study was to investigate the effect of vitamin C supplementation on exercise-induced muscle soreness and damage. Nine habitually active males consumed a 1 g dose of vitamin C 2 h before exercise, and on another occasion consumed an identical placebo. The exercise comprised a 90 min intermittent shuttle-running test, which was designed to simulate the multiple-sprint sports. Vitamin C supplementation increased plasma concentrations of vitamin C before exercise, and plasma concentrations continued to increase during the shuttle-run to reach a peak of approximately 200 micromol x l(-1) immediately after exercise. However, muscle soreness, and markers of both muscle damage (creatine kinase and aspartate aminotransferase) and lipid peroxidation (malondialdehyde) were elevated to an equal extent after exercise in placebo and supplemented trials. Therefore acute supplementation with vitamin C had no beneficial effects although it is possible that such short-term vitamin C supplementation was ineffective because it occurred at an inappropriate time.

Topics: Administration, Oral; Adult; Antioxidants; Ascorbic Acid; Dietary Supplements; Free Radicals; Humans; Male; Muscle Fatigue; Muscle, Skeletal; Pain; Running

There has been no investigation to determine if the widely used over-the-counter, water-soluble antioxidants vitamin C and N-acetyl-cysteine (NAC) could act as pro-oxidants in humans during inflammatory conditions. We induced an acute-phase inflammatory response by an eccentric arm muscle injury. The inflammation was characterized by edema, swelling, pain, and increases in plasma inflammatory indicators, myeloperoxidase and interleukin-6. Immediately following the injury, subjects consumed a placebo or vitamin C (12.5 mg/kg body weight) and NAC (10 mg/kg body weight) for 7 d. The resulting muscle injury caused increased levels of serum bleomycin-detectable iron and the amount of iron was higher in the vitamin C and NAC group. The concentrations of lactate dehydrogenase (LDH), creatine kinase (CK), and myoglobin were significantly elevated 2, 3, and 4 d postinjury and returned to baseline levels by day 7. In addition, LDH and CK activities were elevated to a greater extent in the vitamin C and NAC group. Levels of markers for oxidative stress (lipid hydroperoxides and 8-iso prostaglandin F2alpha; 8-Iso-PGF2alpha) and antioxidant enzyme activities were also elevated post-injury. The subjects receiving vitamin C and NAC had higher levels of lipid hydroperoxides and 8-Iso-PGF2alpha 2 d after the exercise. This acute human inflammatory model strongly suggests that vitamin C and NAC supplementation immediately post-injury, transiently increases tissue damage and oxidative stress.

Topics: Acetylcysteine; Adult; Antioxidants; Ascorbic Acid; Bleomycin; Creatine Kinase; Dinoprost; Double-Blind Method; Exercise; F2-Isoprostanes; Glutathione Peroxidase; Humans; Interleukin-6; Iron; L-Lactate Dehydrogenase; Lipid Peroxidation; Lipid Peroxides; Male; Muscle, Skeletal; Myoglobin; Myositis; Oxidative Stress; Pain; Peroxidase; Placebos; Superoxide Dismutase

The aim of the present study was to investigate whether 2 weeks of vitamin C supplementation affects recovery from an unaccustomed bout of exercise. Sixteen male subjects were allocated to either a placebo (P; n = 8) or vitamin C group (VC; n = 8). The VC group consumed 200 mg of ascorbic acid twice a day, whereas the P group consumed identical capsules containing 200 mg of lactose. Subjects performed a prolonged (90-min) intermittent shuttle-running test 14 days after supplementation began. Post-exercise serum creatine kinase activities and myoglobin concentrations were unaffected by supplementation. However, vitamin C supplementation had modest beneficial effects on muscle soreness, muscle function, and plasma concentrations of malondialdehyde. Furthermore, although plasma interleukin-6 increased immediately after exercise in both groups, values in the VC group were lower than in the P group 2 hours after exercise (p < .05). These results suggest that prolonged vitamin C supplementation has some modest beneficial effects on recovery from unaccustomed exercise.

Topics: Administration, Oral; Adult; Antioxidants; Ascorbic Acid; Creatine Kinase; Dietary Supplements; Double-Blind Method; Free Radicals; Humans; Hydrocortisone; Interleukin-6; Male; Malondialdehyde; Muscle Fatigue; Muscle, Skeletal; Myoglobin; Pain; Running

A 16-week randomized, double-blind, placebo-controlled crossover trial of a combination of glucosamine HCl (1,500 mg/day), chondroitin sulfate (1,200 mg/day), and manganese ascorbate (228 mg/day) in degenerative joint disease (DJD) of the knee or low back was conducted.. Thirty-four males from the U.S. Navy diving and special warfare community with chronic pain and radiographic DJD of the knee or low back were randomized. A summary disease score incorporated results of pain and functional questionnaires, physical examination scores, and running times. Changes were presented as a percentage of the patient's average score.. Knee osteoarthritis symptoms were relieved as demonstrated by the summary disease score (-16.3%; p = 0.05), patient assessment of treatment effect (p = 0.02), visual analog scale for pain recorded at clinic visits (-26.6%; p = 0.05) and in a diary (-28.6%; p = 0.02), and physical examination score (-43.3%; p = 0.01). Running times did not change. The study neither demonstrated, nor excluded, a benefit for spinal DJD. Side effect frequency was similar to that at baseline. There were no hematologic effects.. The combination therapy relieves symptoms of knee osteoarthritis. A larger data set is needed to determine the value of this therapy for spinal DJD. Short-term combination therapy appears safe in this setting.

Topics: Activities of Daily Living; Adult; Ascorbic Acid; Chondroitin Sulfates; Chronic Disease; Cross-Over Studies; Double-Blind Method; Drug Combinations; Glucosamine; Humans; Lumbar Vertebrae; Male; Manganese Compounds; Middle Aged; Military Personnel; Naval Medicine; Osteoarthritis; Osteoarthritis, Knee; Pain; Pilot Projects; Radiography; Running; Surveys and Questionnaires

Prevention of primary pain is a new topic, endowed with social and economic interest. We observed that L-5-HTP can induce a significant decrease of the cropping out of migraine, the commonest primary pain. This finding seems interesting, since it represents the first data in the field and was obtained in a prospective, long-term, placebo controlled study. The result obtained suggests that CNS abnormalities underlying the mechanism of migraine can be changed by L-5-HTP, if the amino acid is administered to subjects who are predisposed to headache.

Topics: 5-Hydroxytryptophan; Analgesics; Ascorbic Acid; Child; Child, Preschool; Female; Follow-Up Studies; Humans; Hyperalgesia; Male; Migraine Disorders; Pain; Pain Measurement; Placebos; Prospective Studies; Risk Factors; Time Factors

Delayed-onset muscle soreness following strenuous use of the posterior calf muscles was studied to determine if ascorbic acid might have an effect on the appearance of this familiar pain. A double-blind, randomized, crossover study compared the soreness in subjects taking ascorbic acid against those taking a lactose placebo. Visual analog scales were used in conjunction with a variety of pain-challenging methods, and the results indicated a significant difference between experimental and placebo groups at the height of soreness. Typical soreness abatement scores of 25-44% were observed. A sample size of 19, lack of an untreated control group as well as the singular nature of the exercise and its intensity were considered limitations of the study.

Topics: Adult; Ascorbic Acid; Double-Blind Method; Exercise; Female; Humans; Lactose; Male; Middle Aged; Muscles; Pain; Pain Measurement; Palliative Care; Placebos; Time Factors

Selenium-ACE, a formulation containing the trace element selenium with three vitamins, is widely promoted for the treatment of arthritis. A controlled double-blind trial of Selenium-ACE in osteoarthritis failed to demonstrate any significant efficacy for the compound over placebo at 3 or 6 months though there was a non-significant trend to improvement in some clinical parameters in both groups. Side-effects were more frequently seen in the placebo group.

Topics: Adult; Aged; Ascorbic Acid; Clinical Trials as Topic; Double-Blind Method; Drug Combinations; Female; Humans; Male; Middle Aged; Movement; Osteoarthritis; Pain; Random Allocation; Selenium; Time Factors; Vitamin A; Vitamin E

A double-blind trial of the effects of vitamin C on the frequency, severity and duration of post-suxamethonium pains was performed. Fifty-three patients undergone bronchoscopy received either a placebo or 10 g of vitamin C. No beneficial effect was demonstrated. In 18 patients no relationship was found between pre-anaesthetic buffy layer vitamin C levels and the subsequent pains. Measurement of buffy layer and plasma vitamin C levels before and after anaesthesia did not suggest that vitamin C deficiency occurs during or immediately after administration of suxamethonium. It is concluded that the administration of vitamin C cannot be recommended as a means for prevention of suxamethonium pains.

Topics: Adolescent; Adult; Aged; Anesthesia, General; Ascorbic Acid; Clinical Trials as Topic; Humans; Middle Aged; Pain; Succinylcholine

Topics: Antacids; Ascorbic Acid; Bismuth; Diet Therapy; Duodenal Ulcer; Estrogens; Glycyrrhiza; Histidine; Humans; Methods; Pain; Parasympatholytics; Placebos; Plants, Medicinal; Rest; Smoking

Topics: Adult; Ascorbic Acid; Female; Humans; Male; Middle Aged; Muscular Diseases; Pain; Succinylcholine

Pain is a major problem in 90% of patients with chronic pancreatitis (CP). Studies evaluating response to antioxidants (AO) are conflicting and no pediatric studies are available.. To evaluate markers of oxidative stress (OS), and efficacy and predictors of response to AO in improving pain in children with CP.. Antioxidants were given to CP children for 6 months. Subjects were assessed at baseline and post-therapy for pain and markers of OS [serum thiobarbituric acid reactive substances (TBARS), superoxide dismutase (S-SOD)] and antioxidant levels [vitamin C, selenium, total antioxidant capacity-ferric reducing ability of plasma (FRAP)]. Matched healthy controls were assessed for OS and antioxidant levels. Good response was defined as ≥ 50% reduction in number of painful days/month.. 48 CP children (25 boys, age 13 years) and 14 controls were enrolled. 38/48 cases completed 6 months of therapy. CP cases had higher OS [TBARS (7.8 vs 5.2 nmol/mL; p < 0.001)] and lower antioxidant levels [FRAP (231 vs. 381.3 µmol/L; p = 0.003), vitamin C (0.646 vs. 0.780 mg/dL; p < 0.001)] than controls. Significant reduction in TBARS and S-SOD and increase in FRAP, vitamin C, and selenium occurred after 6 months. 10.5% cases had minor side effects. 26(68%) cases had a good response, with 9(24%) becoming pain-free. Subjects with severe ductal changes had lower median BMI (- 0.73 vs 0.10; p = 0.04) and responded less often than those with mild changes (17/29 vs 9/9; p = 0.036).. CP children have higher OS than healthy controls. Antioxidant therapy is safe. Pain response is seen in 68% cases, less often in patients with severe ductal changes.

Topics: Adolescent; Antioxidants; Ascorbic Acid; Child; Humans; Male; Oxidative Stress; Pain; Pancreatitis, Chronic; Selenium; Superoxide Dismutase; Thiobarbituric Acid Reactive Substances; Vitamins

BACKGROUND Despite being considered a disease of the past, pediatric scurvy is increasingly reported in developed countries, especially among children with autism spectrum disorder, developmental delays, or a restrictive diet. Pediatric patients typically present with lower extremity pain or refusal to walk. This case study features an atypical presentation of scurvy in a non-ambulatory patient. CASE REPORT A 14-year-old boy with arthrogryposis multiplex congenita displayed a late-stage scurvy symptom: a necrotic gastrostomy tube site, indicative of poor wound healing due to vitamin C deficiency. The usual telltale symptoms of scurvy were camouflaged due to his non-ambulatory status, which may have contributed to a delayed presentation. Nevertheless, a comprehensive clinical evaluation, incorporating diet history, gingival symptoms, petechiae, and characteristic radiological signs, eventually led to the correct diagnosis. Although acute osteomyelitis was initially suspected, it was subsequently ruled out. Upon initiation of vitamin C therapy, the patient's symptoms subsided within a few days, and the necrotic tissue surrounding the gastrostomy tube healed completely within two weeks. CONCLUSIONS The highlighted case underscores the importance of including scurvy in the differential diagnosis for pediatric patients with lower extremity pain without fever. A detailed dietary history focusing on vitamin C intake is crucial during clinical evaluation. Early initiation of vitamin C therapy, when scurvy is suspected, may prevent unnecessary and extensive diagnostic workup for other potential causes, offering timely relief to the patient.

Topics: Adolescent; Ascorbic Acid; Autism Spectrum Disorder; Child; Gastrostomy; Humans; Male; Pain; Scurvy

Prolonged vitamin C deficiency can result in numerous metabolic abnormalities like impaired tissue repair and defective collagen synthesis. This case report describes a middle-age Japanese man presenting painful purpura on his lower limbs, severe anemia, and altered consciousness. The patient had been eating a selective diet lacking in vegetables and fruits since childhood. A serum analysis demonstrated a low level of vitamin C. The patient was treated with vitamin supplementation and psychological intervention. Scurvy is an under-considered illness with a favorable prognosis if diagnosed early while it is still sporadically encountered in some patients with malabsorption or malnutrition even in modern times.

Topics: Ascorbic Acid; Child; Humans; Leg; Male; Middle Aged; Pain; Purpura; Scurvy; Vitamins

In modern society, scurvy is well known in its historical perspective rather than clinical relevance. Scurvy is classically thought to manifest with signs of 'bleeding painful gums' in the undernourished. Little is known regarding its ability to mimic a wide range of rheumatological, orthopaedic, neurological and haematological illnesses. Due to the rarity of its occurrence, there is a poor understanding among present-day clinicians, and so scurvy can easily deceive the uninitiated. We report a school-aged boy with normal neurodevelopment who presented with lower limb pain and difficulty in walking. He was seen by multiple specialist doctors before the clinical diagnosis of scurvy was made by a general paediatrician. Investigations showed that this child had X-ray changes typical of scurvy with low serum ascorbic acid levels. On supplementation with vitamin C, he showed dramatic improvement in symptoms and gradually achieved complete recovery.

Topics: Ascorbic Acid; Child; Humans; Male; Pain; Scurvy; Vitamins; Walking

Vitamin C (ascorbic acid) is widely used in dermatology for skin depigmentation. However, there are very few clinical studies on the efficacy of vitamin C in gingival depigmentation. This preliminary case series aims to present the clinical effectiveness, histologic changes, and patient-reported outcomes of intra-epidermal vitamin C injections (oral mesotherapy) for managing patients with gingival melanin hyperpigmentation.. Five patients were administered locally injectable vitamin C (once per week for 4 to 5 visits) in maxillary or mandibular anterior pigmented gingiva. The depigmentation effect was evaluated using the Dummett Oral Pigmentation Index (DOPI) and Gingival Pigmentation Index (GPI). Digital photographs were used to assess gingival luminescence (L*) and pigmented surface area (PSA). Parameters were recorded at baseline and at 1 and 3 months. Melanocyte histopathologic count was determined at baseline and at 3 months. Pain, gingival color change, and patient satisfaction scores were also assessed.. Median GPI, DOPI, and PSA were significantly reduced (P ≤ .05) from baseline to 1 month. There was no statistically significant change from 1 month to 3 months. L* value significantly increased from baseline to 3 months. A median pain score of 3 (scale of 0 to 10) was observed on the day of the procedure. A score of 3 (scale of 0 to 4) was reported for the gingival color and scores 3 and 4 (scale of 0 to 4) for the overall patient satisfaction.. Oral mesotherapy using locally injectable vitamin C is a nonsurgical, minimally invasive, and efficient technique for gingival depigmentation. Indian patients were satisfied with the gingival color obtained and the overall treatment experience.. As all the branches of medicine, specifically dentistry, direct to minimally invasive approaches, mesotherapy shows great importance to reduce the surgical interventions, especially when esthetic outcomes are needed. Oral mesotherapy using locally injectable vitamin C can be a useful nonsurgical technique for achieving gingival depigmentation in the esthetic zone.

Topics: Ascorbic Acid; Gingival Diseases; Humans; Hyperpigmentation; Melanins; Mesotherapy; Pain

Ascorbyl palmitate is a fat-soluble ester of vitamin C and is used as an antioxidant food additive. While literature reports that ascorbyl palmitate can prevent exacerbation of pain and improve the quality of life of patients suffering from pain, this is not yet supported by clinical trial data. Our study aimed to investigate the effectiveness of ascorbyl palmitate in managing trigeminal neuralgia.. This study was carried out in a single-centre clinical trial in which subjects suffering from trigeminal neuralgia (N=11) were included. All patients were on carbamazepine when first included and, after washout period, received Ascorbyl palmitate. Eligible patients had the most severe trigeminal neuralgia pain in the oral cavity or pain on touching trigger zones, aged 20 years or older, were capable of proper assessment of the severity of pain and their condition, and had experienced multiple episodes of intraoral pain for at least 3 months with a pain intensity of more than 4 points on the numerical rating scale. The Brief Pain Questionnaire was used to evaluate patient's quality of life.. A total of 11 patients were included with a mean age 55.36±10.67 years (7 males, 4 females). Most patients had compression by the superior cerebellar artery and vascular loops upon magnetic resonance examination. The mean numerical rating scale score for carbamazepine after one month was 7.9±0.56 (95% CI 7.49, 8.30). Similarly, for ascorbyl palmitate was 5.5±1.50 (95% CI 4.42, 6.57) (p<0.001).. Ascorbyl palmitate can be used as an adjunct intervention in managing trigeminal neuralgia pain. According to the results, ascorbyl palmitate prevents frequent exacerbation of pain and improves patient quality of life.

Topics: Adult; Aged; Ascorbic Acid; Carbamazepine; Female; Humans; Male; Middle Aged; Pain; Quality of Life; Trigeminal Neuralgia

We present a case of an otherwise healthy 3-year-old child who presented with limping, bone pain, fatigue, and agitation. Differential diagnosis included an infection of the bone, malignancy, an inflammatory bone disease, and metabolic bone disease. Magnetic resonance imaging of the lower limbs and the spine was consistent with scurvy, and the diagnosis was confirmed by very low levels of vitamin C. Further history taking revealed a diet based entirely on dairy pudding, with no fruits or vegetables, and being a "picky eater" was the sole reason. Intravenous treatment with vitamin C led to full recovery. Previous reports of scurvy were in patients with other medical conditions, such as malabsorption, or behavioral conditions as in autism. This case demonstrates that scurvy, an almost forgotten condition from past centuries, can occur in otherwise healthy children and should raise awareness regarding the importance of a balanced diet and proper nutritional history taking. Following growth charts as the only screening tool for balanced and inclusive nutrition may not be sufficient.

Topics: Ascorbic Acid; Child, Preschool; Diagnosis, Differential; Diet; Feeding Behavior; Humans; Mobility Limitation; Pain; Scurvy; Treatment Outcome; Vitamins

Scurvy is seldom encountered in modern day clinical practice. Children can present with nonspecific features which can mimic several other common conditions. We describe here a four-year-old child who presented with severe pain and weakness of bilateral lower limbs and found to be severely malnourished. The diagnosis of scurvy was suspected in the context of underlying malnutrition after excluding other ominous pathologies. Pathognomic radiological changes clinched the diagnosis, and the best supportive evidence was the dramatic response to vitamin C supplementation.

Topics: Ascorbic Acid; Ascorbic Acid Deficiency; Child, Preschool; Dietary Supplements; Humans; Leg; Male; Malnutrition; Pain; Radiography; Scurvy; Treatment Outcome; Vitamins

Topics: Ascorbic Acid; Ascorbic Acid Deficiency; Child; Child, Preschool; Humans; Male; Pain; Treatment Outcome; Vitamins

Topics: Adolescent; Ascorbic Acid; Chest Pain; Cholecalciferol; Dietary Supplements; Echocardiography; Gingiva; Hemorrhage; Humans; Hypertension, Pulmonary; Iron; Leg; Male; Pain; Scurvy; Wounds and Injuries

Knee pain is one of the most common symptoms of knee osteoarthritis (OA) that affects the quality of life in the older adults, and identifying the contributing factors of knee pain is important. We hypothesized that higher fruit and vegetable consumption might be associated with the severity of knee pain lower prevalence of severe knee pain by affecting pain perception in the knee joint. Therefore, we investigated the relationship between self-reported knee pain and the consumption of fruits vegetables, carotenoids and vitamin C and self-reported knee pain.. Nationally representative cross sectional study.. 2010-2011 rounds of the Korean National Health and Nutrition Examination Survey.. A total of 6588 subjects aged ≥50 years were participated.. Severity of knee pain was estimated using a 10-point numeric rating scale (NRS). Daily intake of fruits, vegetables, and vitamins were estimated using data from 24-hour recalls and food frequency questionnaires.. The NRS scores of knee pain decreased significantly with increasing fruit and vegetable intake quartiles. A multivariate logistic regression analysis showed that the fourth quartile of vegetable and fruit consumption was associated with decreased prevalence of severe knee pain (OR 0.59, 95% CI 0.48-0.73) compared with first quartile of vegetable and fruit consumption; however, carotenoids and vitamin C consumption was not associated with the severity of knee pain.. In conclusion, severe knee pain was independently associated with fruit and vegetable consumption. Our findings suggest that intake of whole fruits and vegetables may help improve knee pain in older adults.

Topics: Aged; Ascorbic Acid; Carotenoids; Cross-Sectional Studies; Diet; Female; Fruit; Humans; Logistic Models; Male; Mental Recall; Middle Aged; Multivariate Analysis; Nutrition Assessment; Nutrition Surveys; Osteoarthritis, Knee; Pain; Prevalence; Republic of Korea; Self Report; Socioeconomic Factors; Surveys and Questionnaires; Vegetables

Scurvy, or vitamin C deficiency, is rarely presented to a rheumatology clinic. It can mimic several rheumatologic disorders. Although uncommon, it may present as pseudovasculitis or chronic arthritis. Scurvy still exists today within certain populations, particularly in patients with neurodevelopmental disabilities, psychiatric illness or unusual dietary habits.Scurvy presentation to the rheumatologist varies from aches and mild pains to excruciating bone pain or arthritis. Musculoskeletal and mucocutaneous features of scurvy are often what prompts referrals to pediatric rheumatology clinics. Unless health care providers inquire about nutritional habits and keep in mind the risk of nutritional deficiency, it will be easy to miss the diagnosis of scurvy. Rarity of occurrence as compared to other nutritional deficiencies, combined with a lack of understanding about modern-day risk factors for nutritional deficiency, frequently leads to delayed recognition of vitamin C deficiency. We report a case of scurvy in a mentally handicapped Saudi child, who presented with new onset inability to walk with diffuse swelling and pain in the left leg. Skin examination revealed extensive ecchymoses, hyperkeratosis and follicular purpura with corkscrew hairs, in addition to gingival swelling with bleeding. Clinical diagnosis of scurvy was rendered and confirmed by low serum vitamin C level. The patient did extremely well with proper nutritional support and vitamin C supplementation. It has been noticed lately that there is increased awareness about scurvy in rheumatology literature. A high index of suspicion, together with taking a thorough history and physical examination, is required for diagnosis of scurvy in patient who presents with musculoskeletal symptoms. Nutritional deficiency should also be considered by the rheumatologist formulating differential diagnosis for musculoskeletal or mucocutaneous complaints in children, particularly those at risk.

Topics: Arthritis; Ascorbic Acid; Ascorbic Acid Deficiency; Child; Chronic Disease; Dietary Supplements; Humans; Male; Pain; Refusal to Participate; Scurvy; Treatment Outcome; Walking

Some N-[(N-benzoyldehydrophenylalalnyl)glycinyl/cysteinyl]-N,N'-dicyclohexylurea analogs (3a-3o) were synthesized by conjugating different substituted N-benzoyldehydrophenylalanyl glycines/cysteines (differing substitutions on benzylidene ring) and dicyclohexyl carbodiimide (DCC) using base as a catalyst. The synthesized compounds were characterized and evaluated for biological activities. Compounds 3a and 3h with unsubstituted dehydrophenylalanyl glycinyl/cysteinyl moiety exhibited moderate anti-inflammatory and analgesic activities. Compound 3j bearing 4-hydroxy substitution on benzylidene ring of dehydrophenylalanyl cysteinyl moiety displayed potent antimicrobial and antioxidant activities. The results obtained from docking studies on compound 3j with penicillin binding protein and protease supported the results.

Topics: Acetic Acid; Analgesics; Animals; Anti-Bacterial Agents; Anti-Inflammatory Agents, Non-Steroidal; Antifungal Agents; Bacteria; Carrageenan; Dose-Response Relationship, Drug; Edema; Fungi; Mice; Microbial Sensitivity Tests; Models, Molecular; Molecular Structure; Pain; Rats; Structure-Activity Relationship; Urea

In the present study, an efficient synthesis of some Mannich base of 5-methyl-2-[(2-oxo-2H-chromen-3-yl)carbonyl]-2,4-dihydro-3H-pyrazol-3-one (4a-j) have been described by using conventional and non-conventional (microwave) techniques. Microwave assisted reactions showed that require shorter reaction time and good yield. The newly synthesized compounds were screened for their anti-inflammatory, analgesic activity, antioxidant, and antibacterial effects were compared with standard drug. Among the compounds studied, compound (4f) showing nearly equipotent anti-inflammatory and analgesic activity than the standard drug (indomethacin), along with minimum ulcerogenic index. Compounds (4b and 4i) showing 1.06 times more active than ciprofloxacin against tested Gram-negative bacteria.

Topics: Acetic Acid; Analgesics; Animals; Anti-Bacterial Agents; Anti-Inflammatory Agents, Non-Steroidal; Anti-Ulcer Agents; Bacteria; Carrageenan; Dose-Response Relationship, Drug; Edema; Mice; Microbial Sensitivity Tests; Microwaves; Molecular Structure; Pain; Pyrazolones; Rats; Structure-Activity Relationship

Topics: Aged, 80 and over; Ascorbic Acid; Fatigue; Humans; Male; Neoplasms; Pain; Palliative Care; Quality of Life; Terminally Ill

Scurvy, a disease caused by a deficiency of ascorbic acid (vitamin C), is not very common disease especially in pediatric age. In the late nineteenth century, instead, we assisted to increase incidence of this problem for the use of heated milk and convenience foods. We report two cases of scurvy: a child of 3 years old came to our observation for an important gums' stomatitis, fever, widespread petechiae and ecchymosis on the skin of the lower limbs; in the second moment he had pain in upper and lower limbs with difficulty in walking; a second child of 4 years came to our observation for pain lower limbs and maintained the posture of the legs down, inability to walking, with reduced muscle tone and trophism in all limbs; at the instrumental examination he had an alveolar hemorrhage. The two boys had a history of a diet completely lacking in fruits and vegetables; they were drinking almost only milk. They carried various laboratory and instrumental tests, in particular X-ray of lower limbs that showed "a thick sclerotic metaphyseal line with beak-like excrescences of tibiae and femur". The characteristic radiological appearance, the particular clinical aspects, the dietary history and the dosage of vitamin C, have led us to the diagnosis of scurvy. They started therapy with vitamin C and they had a progressive improvement in general condition.

Topics: Ascorbic Acid; Child; Child, Preschool; Humans; Male; Pain; Scurvy; Treatment Outcome; Vitamins; Walking

Topics: Ascorbic Acid; Canada; Edema; Female; Humans; Lower Extremity; Magnetic Resonance Imaging; Middle Aged; Pain; Purpura; Scurvy; Vitamins

The present study was designed to investigate the antioxidant, anti-inflammatory and analgesic potential of Citrus decumana peel extract. Antioxidant activity of Citrus decumana peel extract in four solvent systems was evaluated by 1,1-diphenyl-2-picrylhydrazyl (DPPH(.)) and hydrogen peroxide (H(2)O(2)) radical scavenging methods. Ethyl acetate peel extract of Citrus decumana (EtCD) was studied for its anti-inflammatory and analgesic activities at a dose level of 100, 200 and 300 mg/kg. Anti-inflammatory activity was performed using carrageenan-induced paw edema in rats. Analgesic activity was evaluated for its central and peripheral pharmacological actions in mice. EtCD showed significant antioxidant activity in a dose-dependent manner when compared with ascorbic acid. EtCD at the dose of 300 mg/kg produced significant decrease in paw volume and pain when compared with reference drug diclofenac and morphine, respectively. The Citrus decumana peel extract may be useful as a natural antioxidant in the treatment of inflammation and pain.

Topics: Analgesics; Animals; Anti-Inflammatory Agents; Antioxidants; Ascorbic Acid; Citrus; Diclofenac; Disease Models, Animal; Dose-Response Relationship, Drug; Female; Inflammation; Male; Mice; Morphine; Pain; Plant Extracts; Rats; Rats, Wistar; Solvents

Topics: Ascorbic Acid; Autistic Disorder; Bone and Bones; Bone Marrow; Child; Diagnosis, Differential; Exanthema; Gingival Hypertrophy; Humans; Male; Osteomyelitis; Pain; Radiography; Rheumatic Diseases; Scurvy; Skin

The purpose of the study was to determine the oxidative and antioxidative status of plasma in patients with fibromyalgia. Total antioxidant capacity (TAC) of plasma was significantly lower in patients with fibromyalgia (n = 20) than in healthy controls (n = 20) [1.5 (SD 0.3) and 1.9 (SD 0.3) mmol Trolox equiv./l, P = 0.001]. In contrast, the total peroxide level of plasma was significantly higher in patients than in healthy controls [37.4 (SD 6.7) and 33.0 (SD 2.7) micromol H2O2/l; P = 0.01]. The oxidative stress index (OSI) level was significantly higher in patients with fibromyalgia than in healthy controls [2.5 (SD 1.0) and 1.8 (SD 0.4); P = 0.007]. A significant negative correlation between visual analogue scale (VAS) and TAC level was determined (r = -0.79, P < 0.001). The present results indicate that patients with fibromyalgia are exposed to oxidative stress and this increased oxidative stress may play a role in the etiopathogenesis of the disease. Supplementation of antioxidant vitamins such as vitamins C and E to the therapy may be indicated.

Topics: Adult; Antioxidants; Ascorbic Acid; Case-Control Studies; Female; Fibromyalgia; Free Radicals; Humans; Hypoxia; Male; Oxidative Stress; Pain; Vitamin E

To investigate the aetiology of chronic idiopathic axonal polyneuropathy (CIAP), 50 consecutive patients were compared with 50 control subjects from the same region. There were 22 patients with painful neuropathy and 28 without pain, 26 with sensory neuropathy and 24 with sensory and motor neuropathy. The typical picture was a gradually progressive sensory or sensory and motor neuropathy. It caused mild or sometimes moderate disability, and reduced the quality of life. There was no evidence that alcohol, venous insufficiency, arterial disease or antibodies to peripheral nerve antigens played a significant part. There was a possible history of peripheral neuropathy in the first or second-degree relatives of six patients and no controls (P = 0.01), and claw toes were present in 12 patients and four controls (P = 0.03). Thirty-two per cent of the patients and 14% of the controls had impaired glucose tolerance or fasting hyperglycaemia but, after adjusting for age and sex, the difference was not significant (P = 0.45), even in the painful neuropathy subgroup. The mean (SD) fasting insulin concentrations were significantly (P = 0.01) higher in the patients [75.9 (44.4) mmol/l] than the controls [47.3 (37.9) mmol/l], and the mean was higher still in the painful neuropathy subgroup [92.2 (37.1) mmol/l] (P < 0.0001). However, insulin resistance as assessed using the homeostasis model assessment formula was not significantly greater in the patients, even in those with pain, than the controls. After adjustment for body mass index as well as age and sex, there was no significant difference in the serum cholesterol concentrations, but there were significantly higher triglyceride concentrations in the patients [mean 1.90 (1.41) mmol/l] than the controls [mean 1.25 (0.79] mmol/l) (P = 0.02). In the patients with painful peripheral neuropathy, the mean triglyceride concentration was 2.37 (1.72), which was even more significantly greater compared with the controls (P = 0.003). In conclusion, CIAP is a heterogeneous condition. A logistic regression analysis identified environmental toxin exposure and hypertriglyceridaemia, but not glucose intolerance or alcohol overuse as significant risk factors that deserve further investigation as possible causes of CIAP.

Topics: Aged; Anthropometry; Ascorbic Acid; Autoantibodies; Case-Control Studies; Disability Evaluation; Female; Glucose Intolerance; Hazardous Substances; Humans; Hypertriglyceridemia; Insulin Resistance; Male; Middle Aged; Pain; Polyneuropathies; Quality of Life; Risk Factors; Vitamin E

To analyse the conditioning effects of localised acute muscle pain on power output during ipsi- and contra-lateral ballistic arm extensions.. Eight male subjects performed right arm (ipsilateral) and left arm (contra-lateral) bench press movements. The power output (and force and velocity) of the concentric phase of movement was measured before and during muscle pain induced by a standardised intramuscular injection of levo-ascorbic acid in the right pectoralis major muscle (prime mover muscle) and in the lateral head of the right triceps brachii muscle (synergist).. The power output of ipsi- and contra-lateral arm bench press movements was significantly decreased during pain of the right pectoralis major muscle, but not during pain of the right lateral triceps muscle. The velocity and force were both affected and contributed to the decrease in power output.. Acute muscle pain of a prime mover muscle reduces ipsi- and contra-lateral motor performance of ballistic upper limb extension. This is not a generalised or non-specific inhibitory effect on the motor system, since pain failed to modify motor performance when applied to a synergist, non-prime mover, muscle. A basically bilateral executive cortical plan for ballistic upper limb extension could explain the conditioning effect of muscle pain on both ipsi- and contra-lateral arm.. The results presented here contributes to the understanding of the conditioning effects of muscle pain on movement performance.

Topics: Adult; Analysis of Variance; Ascorbic Acid; Humans; Male; Movement; Muscle Contraction; Muscle, Skeletal; Pain; Statistics, Nonparametric; Stimulation, Chemical; Upper Extremity

To test the hypothesis that 'metabolites released during fatiguing muscle contractions excite group III-IV muscle nociceptive afferents, inhibiting homonymous motoneurones via Renshaw cells,' by recording changes in recurrent inhibition of soleus motoneurones when high-threshold, small-diameter afferents (group III-IV fibres) from the same muscle were tonically activated.. Experiments were performed in 7 healthy subjects at rest and during weak isometric voluntary contraction of the soleus muscle. Muscle nociceptive afferents were activated by local standardized injection of levo-ascorbic acid. Renshaw cells were orthodromically activated by a conditioning H reflex and the resulting recurrent inhibition of the soleus motoneurones was assessed by a subsequent test H reflex. An additional H reflex of the same size as the test reflex was used to assess motoneurone excitability.. At rest, muscle nociceptive stimulation produced transient facilitation of both test H and reference H reflexes. Under weak voluntary contraction, muscle nociceptive stimulation produced long-lasting extra-inhibition and extra-facilitation of the test reflex and reference reflex respectively, the time course of which closely resembled that of the subjective muscle pain curve.. Discharge of putative group III-IV muscle afferents facilitated homonymous recurrent inhibition. The filtering property of recurrent inhibition may contribute to limit motoneurone activity during muscle pain and/or adapt motoneurone firing rate to the modified contractile properties of motor units as muscle fatigue developed.

Topics: Adult; Ascorbic Acid; H-Reflex; Humans; Muscle Contraction; Muscle Fatigue; Muscle, Skeletal; Neural Inhibition; Neurons, Afferent; Nociceptors; Pain; Rest; Spinal Cord; Stimulation, Chemical

It is known that tonic muscle pain induced by a Levo-Ascorbic (L-AS) solution injected in a foot muscle can transiently modify both regional proprioception and stimulus perception. These findings are paralleled by changes of middle-latency lower-limb somatosensory evoked potentials (SEPs). However, little is known on the behaviourally relevant aspect whether eventual SEP pain-induced changes could be partly due to a sort of 'motor strategy' of subjects in the frame of a self-protective reaction towards the noxious stimulus. Movement and imagery of movements are in fact known to reduce mainly pre-central SEP amplitude (i.e. gating effect).. Low-threshold afferents ulnar SEPs, psychophysical pain ratings and fingers' position sense were monitored in the time-course during L-AS injection in the right first dorsal interosseous muscle. Control experiments included SEPs (either following prevalent ulnar nerve low-threshold afferent stimulation or more conventional mixed nerve stimulation) during actual movements execution and imagery of movements of the right hand.. Tonic pain induced a significant reduction of the post-central N(20)-P(25)-N(33) complex and a significant increase of the N(18) wave. These changes, that were paralleled by distortion of the finger position sense, were delayed 2-5 min with respect to the maximal subjective pain sensation. Conversely, movement imagery tasks lead to a significant, selective, reduction of the pre-central N(30) complex. This wave was even more reduced during actual movements, in combination with a reduction of those post-central components peaking after the first activation of the primary sensory cortex.. Early sensory processing at cortical level is changed during tonic muscle pain, mainly for those components which may be theoretically involved in proprioceptive afferent elaboration. These changes are likely not due to subconscious or voluntary motor strategies of the subjects in the frame of a self-protective aversive reaction towards the noxious stimulus.

Topics: Adult; Ascorbic Acid; Brain; Electromyography; Evoked Potentials, Somatosensory; Female; Fingers; Humans; Imagery, Psychotherapy; Male; Motor Activity; Muscles; Pain; Pain Measurement; Perception; Peripheral Nerves; Proprioception; Reaction Time; Time Factors

To study the balance between the pro-oxidative and antioxidative defence system after repeated painful stimulation in rats and the efficacy of the administration of different antioxidants (vitamins C, E, A, and selenium), analgesics (acetylsalicylic acid, morphine), and their combinations.. Mechanical clamping of both hind limbs was applied for 10 min for 5 consecutive days in adult male Wistar rats. The tail-flick latency was measured before and after a 5-day nociceptive stimulation with or without the substance application. The reactive oxygen species (ROS) were determined in the sensorimotor cortex.. Painful stimulation increased lipoperoxidation which persisted for up to 15 days after it had been discontinued. A simultaneous injection of antioxidants decreased the levels of TBARS, SOD and GSHPx; however, antioxidants applied one week prior to the painful stimulation were ineffective. A simultaneous injection of analgesics reduced stress-induced analgesia caused by the nociceptive stimulation, but did not affect lipoperoxidation.. A combination of antioxidants with analgesics normalized both the oxidative stress and functional (the tail-flick latency) indicators. These results suggest that the administration of antioxidants in pain treatment may be employed to decrease the doses of analgesics and to prevent the negative impact of reactive oxygen species on nociception.

Topics: Analgesics; Analgesics, Opioid; Animals; Antioxidants; Ascorbic Acid; Aspirin; Drug Therapy, Combination; Free Radicals; Lipid Peroxidation; Male; Morphine; Pain; Pain Measurement; Rats; Rats, Wistar; Selenium; Vitamin A; Vitamin E

Topics: Ascorbic Acid; Enteral Nutrition; Enteritis; Gastrostomy; Humans; Infant; Leg; Male; Milk Hypersensitivity; Nutritional Requirements; Pain; Scurvy; Weight Loss

We describe a healthy 18-month-old child who developed a painful limp, without a history of trauma or fever. The initial laboratory investigations showed normal results but the radiological findings were suggestive of scurvy. Diagnosis was confirmed by blood tests and by a rapid recovery following replacement therapy.

Topics: Ascorbic Acid; Follow-Up Studies; Gait; Humans; Infant; Leg; Male; Pain; Radiography; Scurvy; Treatment Outcome

In a previous paper it was shown that muscle nociceptive discharge depressed the activity of interneurones mediating group I non-reciprocal inhibition (or Ib interneurones) in humans [A. Rossi, B. Decchi, Changes in Ib heteronymous inhibition to soleus motoneurons during cutaneous and muscle nociceptive stimulation in humans, Brain Res. 774 (1997) 55-61.]. However, since nociceptive discharge depressed the size of the soleus H-reflex (by which Ib inhibition was tested) the question arises as to whether modification of motoneurone membrane conductance per se could depress the size of Ib inhibitory post-synaptic potentials. The results of the present study suggest that the contribution of motoneurone hyperpolarization to Ib disinhibition is negligible and that muscle nociceptive discharge actually depresses the activity of these pathways.

Topics: Ankle; Antioxidants; Ascorbic Acid; Conditioning, Psychological; Femoral Nerve; H-Reflex; Humans; Interneurons; Knee; Membrane Potentials; Motor Neurons; Muscle, Skeletal; Neural Inhibition; Neurons, Afferent; Nociceptors; Pain

We noticed that an intraperitoneal injection of Freund's incomplete adjuvant (FIA) into mice could stimulate the induction of a writhing reaction. The FIA emulsion-induced writhing reaction was found to be remarkably inhibited by preadministration of oral indomethacin, a non-steroidal anti-inflammatory and analgesic drug. The induction of the writhing reaction was also inhibited by intravenous preadministration of sodium ascorbate (SAs) in saline. In the experiments where SAs was added to FIA, it was demonstrated that SAs had dual activity of suppression and enhancement. At lower concentrations SAs functioned as a suppressor of the writhing reaction, while at concentrations higher than about 1 mg/50 microl/mouse it acted as an enhancer of the reaction. Furthermore, this writhing reaction induced by FIA+SAs emulsion was also inhibited by preadministraion of SAs itself as well as indomethacin. These results suggested that the mechanism of the writhing reaction induced by FIA was concerned with the production of prostaglandins (PGs), and SAs might be involved in regulation of the writhing reaction. In this paper, we propose a mouse writhing model induced by FIA or FIA+SAs emulsion as a novel pain model useful for assessment of analgesic and anti-inflammatory agents.

Topics: Analgesics; Animals; Antioxidants; Ascorbic Acid; Behavior, Animal; Drug Interactions; Freund's Adjuvant; Inflammation Mediators; Lipids; Male; Mice; Pain; Prostaglandin Antagonists

Topics: Adolescent; Ascorbic Acid; Female; Gingival Hemorrhage; Humans; Pain; Radiography; Retrobulbar Hemorrhage; Scurvy; Visual Acuity

The effects of selective tonic cutaneous and muscle pain stimulation on heteronymous Ib pathways from the gastrocnemius medialis to the soleus motoneurones were studied in five healthy human subjects. Tonic pain stimulation, monitored by a psychophysical method, was obtained by local injection of 60 mg levo-ascorbic acid (L-AS) in a volume of 0.3 ml. Nociceptive cutaneous and muscle stimulation of the dorsal foot produced opposite, long-lasting changes in heteronymous Ib pathways to soleus motoneurones: Ib facilitation during cutaneous stimulation was reversed by disinhibition during muscle stimulation. The time-course of these Ib changes strictly paralleled that of subjective pain sensation. On the contrary, when the same nociceptive stimuli were applied to the leg (at pretibial level), the differences between cutaneous and muscle pain disappeared and similar short-lasting phases of facilitation and inhibition of Ib activity were observed. It is concluded that tonic discharge of cutaneous and muscle nociceptive afferents arising from the foot have specific and opposite effects on Ib inhibitory pathways to ankle extensor motoneurones. These interactions between muscle and cutaneous nociceptive and Ib pathways may be used to change muscle synergies, thus contributing to the establishment of appropriate adaptive locomotor strategies during pain.

Topics: Adult; Animals; Ascorbic Acid; Electric Stimulation; Hindlimb; Humans; Motor Neurons; Muscle, Skeletal; Muscles; Neural Inhibition; Neural Pathways; Neurons, Afferent; Nociceptors; Pain; Skin; Skin Physiological Phenomena; Stereoisomerism; Stimulation, Chemical

We report a case of scurvy, which is rarely encountered in Japan. A 75-year-old male was hospitalized with diffuse subcutaneous hemorrhaging of both feet, pain on walking, and shortness of breath. A remarkably low serum level of vitamin C was confirmed. Administration of ascorbic acid dramatically improved his clinical symptoms. Improvement paralleled the increase of serum vitamin C level. This case underscores the important role of vitamin C on the integrity function of the vessel wall.

Topics: Aged; Ascorbic Acid; Foot Diseases; Hemorrhage; Humans; Japan; Male; Pain; Scurvy; Skin

Tail pinch in the rat gives rise to a well characterised pattern of behaviour which includes gnawing, licking and eating. We have used both in vivo voltammetry and microdialysis to monitor neurochemical changes which accompany the behavioural response to a 5-min tail pinch. Tail pinch resulted in a increase of extracellular 5-hydroxytryptamine and a smaller and more delayed increase of 5-hydroxyindole acetic acid in the hippocampus. In the striatum there was a rise of both extracellular dopamine and ascorbate. With a recently developed constant potential voltammetric technique we can continuously monitor changes in extracellular ascorbate. Using this technique we found a very rapid rise in ascorbate current during a 5-min tail pinch; the current began to decline as soon as the clip was removed. The high time resolution of the technique also allowed us to record similar ascorbate changes during a 0.5-s tail pinch.

Topics: 3,4-Dihydroxyphenylacetic Acid; Animals; Ascorbic Acid; Brain Chemistry; Chromatography, High Pressure Liquid; Corpus Striatum; Dialysis; Dopamine; Hippocampus; Homovanillic Acid; Male; Pain; Rats; Rats, Inbred Strains; Serotonin; Tail

The effect of diazepam on spontaneous and tail-pinch-induced behaviour was monitored together with the measurement of extracellular ascorbate using constant potential voltammetry with carbon paste electrodes. Diazepam (3 mg/kg) was followed by eating during the 1st hour after administration in non-food-deprived rats and a reduction in the behaviour triggered by a mild tail-pinch 90 min after drug administration. There was no change in ascorbate concentration in parallel with the spontaneous eating; however, the brisk increase in ascorbate concentration in striatum, nucleus accumbens and hippocampus, which accompanies the tail-pinch, was decreased in size and duration after diazepam. This effect was blocked by the central benzodiazepine receptor antagonist Ro15 1788 (5 mg/kg).

Topics: Animals; Ascorbic Acid; Behavior, Animal; Brain Chemistry; Corpus Striatum; Diazepam; Electrodes, Implanted; Hippocampus; Male; Motor Activity; Nucleus Accumbens; Pain; Rats; Rats, Inbred Strains

This work attempts to determine the influence of vitamin C on locally induced inflammation and arthritis in rat paws, as measured by rat paw swelling, polymorphonuclear leukocyte infiltration, pain, and surface skin temperature. Daily subcutaneous administration of 150 mg/kg of vitamin C over 20 days reduced arthritic swelling, increased pain tolerance, and decreased polymorphonuclear leukocyte infiltration, with no significant change in surface temperature. Vitamin C may provide podiatrists with a supplemental or alternative treatment for patients with rheumatoid arthritis.

Topics: Animals; Arthritis, Rheumatoid; Ascorbic Acid; Body Temperature; Disease Models, Animal; Edema; Male; Pain; Rats; Rats, Inbred Strains

To investigate the involvement of dopamine (DA) in nociceptive sensitivity-behavioral reactivity regulation in animals during aversive states of different nature, the influence of pharmacologically-induced decrease and increase of DA neurotransmission on vocalization and movement reactivity were studied in rats in free behavior, during restraint stress, after acute trauma of an extremity and under intraperitoneal acetic acid administration. The influence of longterm increase (apomorphine in a high dose) and decrease (haloperidol, apomorphine in a low dose) on suprarenals weight and gastric ulceration in animals exposed by polymodal aversive stimulation was also studied. The data obtained are discussed in relation with; 1. DA involvement in regulation of nociceptive sensitivity and behavioral reactivity in aversive environment; 2. the role of DA and endogenous opioid peptides in endogenous analgesic mechanisms; 3. the functional significance of cerebral DA in organization and realization of various types of an organism's adaptive activity produced by different environmental and homeostatic variables; and 4. the interaction of DA and endogenous opioid peptides in mediation of this activity.

Topics: Acetates; Acetic Acid; Animals; Apomorphine; Ascorbic Acid; Avoidance Learning; Behavior, Animal; Dopamine; Electromyography; Female; Haloperidol; Nociceptors; Pain; Rats; Synaptic Transmission

The first peak in the voltammogram recorded with linear sweep and a carbon paste electrode implanted in the rat striatum is due to the oxidation of ascorbic acid. When the potential is held at a level slightly positive to this peak a current is recorded which is abolished by the microinjection of ascorbic acid oxidase in the vicinity of the electrode; this suggests that it is due to the oxidation of ascorbate. This current shows the same diurnal variation as the size of the ascorbate peak and its rise and fall coincides with the onset and offset of motor activity. A tail-pinch applied through a paper clip causes an immediate rise in the ascorbate current which begins to fall as soon as the paper clip is removed. Measurement of the ascorbate current at constant potential provides a technique for monitoring rapid changes in extracellular brain ascorbate in response to physiological stimuli.

Topics: Animals; Ascorbate Oxidase; Ascorbic Acid; Corpus Striatum; Electrochemistry; Male; Pain; Rats; Rats, Inbred Strains

A deafferentation syndrome, produced in rats by dorsal root ganglionectomies, is expressed as scratching of partially deafferented limb areas and/or biting of anesthetic limb areas. This self-mutilation may be objective evidence of dysesthesias, thus serving as an experimental model to study chronic dysesthesias and/or pain from deafferentation in man. This study included behavioral observations of the syndrome and the effects of intraventricular apomorphine, a dopamine agonist, on its expression. Thirty-eight female Sprague-Dawley rats underwent unilateral C5-T2 dorsal root ganglionectomies followed immediately by stereotactically guided cannulation of the right lateral ventricle in 20 of the rats. For 2 weeks continuously via an osmotic minipump, 10 rats received apomorphine (5 micrograms/h) and 10 others received L-ascorbate (the vehicle). Rats with ganglionectomies only, as well as those receiving L-ascorbate, demonstrated early onset, more severe and later onset, less severe biting groups (P less than 0.05 Mann-Whitney U). Animals receiving apomorphine exhibited low autotomy scores irrespective of time of bite onset. Among the control groups, but not the experimental animals, the earlier the onset of biting, the more severe was the autotomy. The rats receiving vehicle via the minipump had earlier bite onsets than the rats in the ganglionectomy only group. This may indicate that the presence of the minipump is a stress which can accelerate the onset of biting. Intraventricular apomorphine can affect the deafferentation syndrome in the rat; it seems to decrease the level of autotomy and disrupt the relationship of bite onset with degree of biting.

Topics: Afferent Pathways; Animals; Apomorphine; Ascorbic Acid; Behavior, Animal; Denervation; Female; Forelimb; Hindlimb; Nervous System Diseases; Pain; Rats; Rats, Inbred Strains; Syndrome

Topics: Analgesics; Animals; Anti-Inflammatory Agents; Ascorbic Acid; Dose-Response Relationship, Drug; Humans; Male; Pain; Pyridoxine; Rats; Thiamine; Vitamin B 12; Vitamin K 1; Vitamins

Topics: Adolescent; Adult; Ascorbic Acid; Back Pain; Bone Diseases; Child; Fractures, Bone; Humans; Muscular Diseases; Neoplasms; Osteogenesis Imperfecta; Pain

In a short trial, 24 patients with Paget's disease of the bone were treated for 2 weeks with either ascorbic acid and calcitonin in combination, or with calcitonin alone. Pain relief was then assessed subjectively by the patients and classified as nil, some, or a marked reduction in pain. There were 11 patients in the group on combined therapy and 73% of them experienced pain relief, compared with 85% of the 13 patients in the group on calcitonin alone. In the patients who experienced pain relief, however, 62% of those on the ascorbic acid and calcitonin combination claimed a marked relief of pain compared with only 36% of the patients who responded to calcitonin alone. These results indicate that when calcitonin and ascorbic acid are used in combination they may provide an increase in the extent of pain relief, but do not increase the total proportion of patients actually obtaining relief. Urinary hydroxyproline excretion was reduced in the calcitonin treated group, but there was little change in the patients on the combined therapy.

Topics: Ascorbic Acid; Calcitonin; Drug Therapy, Combination; Humans; Osteitis Deformans; Pain

Topics: Acetaldehyde; Acrolein; Adrenergic beta-Antagonists; Aldehydes; Anesthesia; Animals; Ascorbic Acid; Cysteine; Formaldehyde; Humans; Infant, Newborn; Male; Pain; Rats; Respiratory Distress Syndrome, Newborn; Smoking; Time Factors

Topics: Animals; Ascorbic Acid; Dogs; Exercise Therapy; Femur Head; Hip Dislocation, Congenital; Hip Dysplasia, Canine; Osteotomy; Pain; Pain Management

Sixteen patients with painful Paget's disease of the bone were treated with high doses of ascorbic acid. Of these patients, 8 experienced lessening of pain within a period of 5 to 7 days after commencing the vitamin therapy. In 3 of these patients pain was completely abolished. Subsequent treatment with calcitonin caused improvement in most cases. There was little change in plasma alkaline phosphatase levels but the excretion of hydroxyproline was elevated following administration of the vitamin. The highest excretions were found in those patients who experienced complete relief of pain. In patients treated with calcitonin alone, the excretion of hydroxyproline was reduced and urinary levels of ascorbic acid dropped in parallel. It seems clear that ascorbic acid and calcitonin have different effects upon bone metabolism.

Topics: Aged; Alkaline Phosphatase; Ascorbic Acid; Female; Humans; Hydroxyproline; Male; Osteitis Deformans; Pain

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: Adult; Aged; Arthritis, Rheumatoid; Ascorbic Acid; Drug Synergism; Female; Humans; Male; Middle Aged; Muscular Diseases; Neuralgia; Pain; Salicylamides; Spinal Diseases; Surveys and Questionnaires; Triamcinolone

Topics: Abdomen; Aged; Antiemetics; Ascorbic Acid; Bismuth; Carcinoma, Basal Cell; Diverticulum; Duodenal Diseases; Epididymitis; Gastrectomy; Humans; Liver Neoplasms; Male; Neoplasm Metastasis; Pain; Stomach Neoplasms; Tracheotomy

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

Topics: Anxiety; Ascorbic Acid; Blood Glucose; Conditioning, Classical; Metabolism; Nervous System Physiological Phenomena; Pain; Reflex

Topics: Acid-Base Equilibrium; Ascorbic Acid; Complementary Therapies; Humans; Pain; Vitamins

Topics: Acid-Base Equilibrium; Ascorbic Acid; Complementary Therapies; Humans; Pain; Vitamins