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1.
BMC Nephrol ; 22(1): 91, 2021 03 15.
Artículo en Inglés | MEDLINE | ID: mdl-33722190

RESUMEN

BACKGROUND: COVID-19 infection in kidney transplant recipients often lead to allograft dysfunction. The allograft injury has various histopathological manifestations. Our case illustrates the unusual combination of allograft rejection, acute kidney injury secondary to oxalate nephropathy and SARS CoV-2 nephropathy as the cause of irreversible allograft failure. CASE PRESENTATION: A 56 year old renal allograft recipient presented with a history of fever and diarrhoea for the preceding 4 weeks, tested positive for Sars-CoV2 on nasal swab and was found to have severe allograft dysfunction, necessitating haemodialysis. He subsequently underwent an allograft biopsy, which demonstrated antibody mediated rejection along with the presence of extensive oxalate deposition in the tubules. Ultrastructural examination demonstrated spherical spiked particles in the glomerular capillary endothelium and the presence of tubulo-reticular inclusions suggestive of an active COVID-19 infection within the kidney. The intra-tubular oxalate deposition was considered to be the result of high dose, supplemental Vitamin C used as an immune booster in many patients with COVID - 19 infection in India. CONCLUSIONS: This case highlights the complex pathology that may be seen in following COVID-19 disease and the need for kidney biopsies in these patients to better understand the aetiology of disease.


Asunto(s)
Ácido Ascórbico/efectos adversos , Rechazo de Injerto/etiología , Hiperoxaluria/complicaciones , Trasplante de Riñón , Disfunción Primaria del Injerto/etiología , Lesión Renal Aguda/etiología , Ácido Ascórbico/administración & dosificación , Resultado Fatal , Humanos , Enfermedades Renales/complicaciones , Enfermedades Renales/patología , Masculino , Persona de Mediana Edad , Disfunción Primaria del Injerto/patología , Disfunción Primaria del Injerto/virología
2.
J Infect Dev Ctries ; 15(2): 209-213, 2021 03 07.
Artículo en Inglés | MEDLINE | ID: mdl-33690202

RESUMEN

INTRODUCTION: Coronavirus disease 2019 (COVID-19) is declared as pandemic by the World Health Orgnazation (WHO) on March 2020. One of the heavily utilized measures during this pandemic is vitamin C (aka ascorbic acid). Unfortunately, vitamin C has been associated with glucose measurement interference and thus this study highlights the elevated levels of blood glucose correlated with the presence of vitamin C interference. METHODOLOGY: Thirty samples were selected randomly and the blood glucose were measured prior and post the addition of spiked standard concentrations of vitamin C. The interference of vitamin C with glucose readings in COVID-19 pandemic were evaluated and observed employing the Auto Chemistry Analyzer machine. RESULTS: The addition of ascorbic acid (vitamin C) standards (spikes) into the isolated samples shows a correlated increment in the reading measures. Thereafter, the increments of Random Blood Sugar (RBS) readings after being spiked with the vitamin C standards shows a logarithmic correlation with good interesting R-squared (R2 = 0.9921). CONCLUSIONS: The authors find that the presence of vitamin C in blood actively and significantly alters the glucose level readings especially with the highly consumption of vitamin C during the COVID-19 pandemic.


Asunto(s)
Ácido Ascórbico/sangre , Glucemia/análisis , Ácido Ascórbico/administración & dosificación , Humanos
3.
PLoS One ; 16(2): e0247163, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33592050

RESUMEN

BACKGROUND: Ivermectin is one among several potential drugs explored for its therapeutic and preventive role in SARS-CoV-2 infection. The study was aimed to explore the association between ivermectin prophylaxis and the development of SARS-CoV-2 infection among healthcare workers. METHODS: A hospital-based matched case-control study was conducted among healthcare workers of AIIMS Bhubaneswar, India, from September to October 2020. Profession, gender, age and date of diagnosis were matched for 186 case-control pairs. Cases and controls were healthcare workers who tested positive and negative, respectively, for COVID-19 by RT-PCR. Exposure was defined as the intake of ivermectin and/or hydroxychloroquine and/or vitamin-C and/or other prophylaxis for COVID-19. Data collection and entry was done in Epicollect5, and analysis was performed using STATA version 13. Conditional logistic regression models were used to describe the associated factors for SARS-CoV-2 infection. RESULTS: Ivermectin prophylaxis was taken by 76 controls and 41 cases. Two-dose ivermectin prophylaxis (AOR 0.27, 95% CI, 0.15-0.51) was associated with a 73% reduction of SARS-CoV-2 infection among healthcare workers for the following month. Those involved in physical activity (AOR 3.06 95% CI, 1.18-7.93) for more than an hour/day were more likely to contract SARS-CoV-2 infection. Type of household, COVID duty, single-dose ivermectin prophylaxis, vitamin-C prophylaxis and hydroxychloroquine prophylaxis were not associated with SARS-CoV-2 infection. CONCLUSION: Two-dose ivermectin prophylaxis at a dose of 300 µg/kg with a gap of 72 hours was associated with a 73% reduction of SARS-CoV-2 infection among healthcare workers for the following month. Chemoprophylaxis has relevance in the containment of pandemic.


Asunto(s)
/prevención & control , Personal de Salud/estadística & datos numéricos , Ivermectina/uso terapéutico , Adulto , Ácido Ascórbico/administración & dosificación , Ácido Ascórbico/uso terapéutico , Estudios de Casos y Controles , Quimioprevención/métodos , Combinación de Medicamentos , Femenino , Humanos , India , Ivermectina/administración & dosificación , Masculino , Persona de Mediana Edad
4.
BMJ Case Rep ; 14(2)2021 Feb 04.
Artículo en Inglés | MEDLINE | ID: mdl-33541951

RESUMEN

Alkaptonuria is a rare genetic disorder resulting in abnormality of tyrosine metabolism. It is one of the Garrod's tetrad of 'inborn errors of metabolism' proposed to have Mendelian recessive inheritance. The disorder is characterised by deposition of homogentisic acid leading to ochronosis and ochronotic osteoarthropathy; however, blackish discoloration of urine is the only childhood manifestation. Other manifestations present only after third decade. A 13-year-old boy presented to paediatric nephrology clinic with blackish discolouration of urine since infancy. Examination revealed bluish black discolouration of bilateral sclera and ear cartilage; however, he had no symptoms of ochronotic osteoarthropathy. Genetic test pointed towards alkaptonuria. Currently, he is on regular follow-up and is being treated with vitamin C to delay the progression of the disease. Early diagnosis with appropriate intervention delays the onset of complications and preserves the quality of life of the patient.


Asunto(s)
Alcaptonuria/diagnóstico , Antioxidantes/administración & dosificación , Ácido Ascórbico/administración & dosificación , Diagnóstico Precoz , Ocronosis/complicaciones , Adolescente , Alcaptonuria/genética , Progresión de la Enfermedad , Humanos , Masculino , Esclerótica
5.
Aging (Albany NY) ; 13(5): 7020-7034, 2021 02 26.
Artículo en Inglés | MEDLINE | ID: mdl-33638944

RESUMEN

BACKGROUND: The inflammatory reaction is the main cause of acute respiratory distress syndrome and multiple organ failure in patients with Coronavirus disease 2019, especially those with severe and critical illness. Several studies suggested that high-dose vitamin C reduced inflammatory reaction associated with sepsis and acute respiratory distress syndrome. This study aimed to determine the efficacy and safety of high-dose vitamin C in Coronavirus disease 2019. METHODS: We included 76 patients with Coronavirus disease 2019, classified into the high-dose vitamin C group (loading dose of 6g intravenous infusion per 12 hr on the first day, and 6g once for the following 4 days, n=46) and the standard therapy group (standard therapy alone, n=30). RESULTS: The risk of 28-day mortality was reduced for the high-dose vitamin C versus the standard therapy group (HR=0.14, 95% CI, 0.03-0.72). Oxygen support status was improved more with high-dose vitamin C than standard therapy (63.9% vs 36.1%). No safety events were associated with high-dose vitamin C therapy. CONCLUSION: High-dose vitamin C may reduce the mortality and improve oxygen support status in patients with Coronavirus disease 2019 without adverse events.


Asunto(s)
Ácido Ascórbico/uso terapéutico , Vitaminas/uso terapéutico , Anciano , Ácido Ascórbico/administración & dosificación , Ácido Ascórbico/efectos adversos , Relación Dosis-Respuesta a Droga , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , /aislamiento & purificación , Resultado del Tratamiento , Vitaminas/administración & dosificación , Vitaminas/efectos adversos
6.
Eur J Med Res ; 26(1): 20, 2021 Feb 11.
Artículo en Inglés | MEDLINE | ID: mdl-33573699

RESUMEN

BACKGROUND: Vitamin C is an essential water-soluble nutrient that functions as a key antioxidant and has been proven to be effective for boosting immunity. In this study, we aimed to assess the efficacy of adding high-dose intravenous vitamin C (HDIVC) to the regimens for patients with severe COVID-19 disease. METHODS: An open-label, randomized, and controlled trial was conducted on patients with severe COVID-19 infection. The case and control treatment groups each consisted of 30 patients. The control group received lopinavir/ritonavir and hydroxychloroquine and the case group received HDIVC (6 g daily) added to the same regimen. RESULTS: There were no statistically significant differences between two groups with respect to age and gender, laboratory results, and underlying diseases. The mean body temperature was significantly lower in the case group on the 3rd day of hospitalization (p = 0.001). Peripheral capillary oxygen saturations (SpO2) measured at the 3rd day of hospitalization was also higher in the case group receiving HDIVC (p = 0.014). The median length of hospitalization in the case group was significantly longer than the control group (8.5 days vs. 6.5 days) (p = 0.028). There was no significant difference in SpO2 levels at discharge time, the length of intensive care unit (ICU) stay, and mortality between the two groups. CONCLUSIONS: We did not find significantly better outcomes in the group who were treated with HDIVC in addition to the main treatment regimen at discharge. Trial registration irct.ir (IRCT20200411047025N1), April 14, 2020.


Asunto(s)
Antivirales/uso terapéutico , Ácido Ascórbico/administración & dosificación , /tratamiento farmacológico , Antivirales/administración & dosificación , Ácido Ascórbico/uso terapéutico , Temperatura Corporal , Femenino , Humanos , Hidroxicloroquina/uso terapéutico , Unidades de Cuidados Intensivos , Tiempo de Internación , Lopinavir/uso terapéutico , Masculino , Persona de Mediana Edad , Oxígeno/sangre , /virología , Ritonavir/uso terapéutico , Resultado del Tratamiento
7.
Life Sci ; 269: 119097, 2021 Mar 15.
Artículo en Inglés | MEDLINE | ID: mdl-33482189

RESUMEN

AIMS: Exercise and food supplement of vitamin C (VC) are beneficial to human health, especially for those who suffer from hypertension. Here we tend to explore if gut microflora is involved in the anti-hypertensive effects of exercise and VC-supplement therapies. MATERIALS AND METHODS: With the spontaneously hypertensive rat (SHR) model, the small intestine pathology and the fecal microbiota was analyzed along with the pro- and anti-inflammatory cytokines (PICs and AICs) and reactive oxygen species (ROS) in the hypothalamus paraventricular nucleus (PVN) and intestine. KEY FINDINGS: We found that both exercise and VC intake, individually or combined, were able to alleviate the blood pressure in the SHRs comparing to the normotensive control Wistar-kyoto (WKY) rats. The expression level of PICs in the PVN and intestine of the SHRs was down-regulated while the AICs were up-regulated after treatments, together with down-regulation of ROS in the PVN. At meantime, the gut pathology was dramatically improved in the SHRs with exercise training or VC intake. Analysis of the gut microflora revealed significant changes in their composition. Several important micro-organisms that were deficient in the SHRs were found up-regulated by the treatments, including Turicibacter and Romboutsia which are involved in the short-chain fatty acid production. SIGNIFICANCE: Exercise training and VC intake individually can modify the gut microflora composition and improve the inflammatory state in both PVN and intestine, which contribute to their anti-hypertensive function. Combination of the two treatments enhanced their effects and worth to be considered as a non-medical aid for the hypertensive patients.


Asunto(s)
Antioxidantes/administración & dosificación , Ácido Ascórbico/administración & dosificación , Suplementos Dietéticos , Microbioma Gastrointestinal/efectos de los fármacos , Hipertensión/prevención & control , Condicionamiento Físico Animal , Animales , Presión Sanguínea , Terapia Combinada , Citocinas/metabolismo , Hipertensión/etiología , Hipertensión/patología , Estrés Oxidativo , Ratas , Ratas Endogámicas SHR , Ratas Endogámicas WKY , Especies Reactivas de Oxígeno/metabolismo
8.
Trop Anim Health Prod ; 53(1): 86, 2021 Jan 07.
Artículo en Inglés | MEDLINE | ID: mdl-33411090

RESUMEN

This study determined the effects of antioxidant supplementation and storage time at cool temperatures on the characteristics of epididymal camel spermatozoa. Camel testes were collected at the abattoir after animal slaughtering and kept at 4 °C during transportation and until processing (max 6 h). Spermatozoa were retrieved and diluted with SHOTOR extender, split in aliquots, supplemented with the following antioxidants: 200 µm/mL vitamin E, 1.0 g/L vitamin C, 1 µg/mL selenium nanoparticles, 50 µg/mL zinc nanoparticles, 2 µg/mL sodium selenite, and 100 µg/mL zinc sulfate, and stored at 4 °C for 2, 48, 96, and 144 h. The storage time significantly affected (P < 0.05) the sperms' motility and livability, the sperms' membrane integrity, and the percentages of cytoplasmic droplets as well as the percentage of morphologically normal spermatozoa. Epididymal sperm characteristics (progressive motility, livability, membrane integrity, and abnormalities) were significantly improved (P < 0.05) when the spermatozoa were diluted with antioxidants as compared with the control group, and the best additives were identified as nano-selenium, sodium selenite, nano-zinc, and zinc sulfate. In conclusion, adding nano-sized minerals or inorganic trace elements and vitamins maintained the progressive motility, livability, and membrane integrity, and decreased abnormalities and cytoplasmic droplet percentages of epididymal camel spermatozoa stored at 4 °C up to 144 h.


Asunto(s)
Antioxidantes/administración & dosificación , Camelus/fisiología , Preservación de Semen/veterinaria , Espermatozoides/efectos de los fármacos , Animales , Antioxidantes/farmacología , Ácido Ascórbico/administración & dosificación , Ácido Ascórbico/farmacología , Masculino , Nanopartículas del Metal , Distribución Aleatoria , Selenio/administración & dosificación , Selenio/farmacología , Vitamina E/administración & dosificación , Vitamina E/farmacología , Zinc/administración & dosificación , Zinc/farmacología
9.
Neurology ; 96(6): e895-e903, 2021 02 09.
Artículo en Inglés | MEDLINE | ID: mdl-33408141

RESUMEN

OBJECTIVE: To determine whether high baseline dietary antioxidants and total nonenzymatic antioxidant capacity (NEAC) is associated with a lower risk of Parkinson disease (PD) in men and women, we prospectively studied 43,865 men and women from a large Swedish cohort. METHODS: In the Swedish National March Cohort, 43,865 men and women aged 18-94 years were followed through record linkages to National Health Registries from 1997 until 2016. Baseline dietary vitamin E, vitamin C, and beta-carotene intake, as well as NEAC, were assessed by a validated food frequency questionnaire collected at baseline. All exposure variables were adjusted for energy intake and categorized into tertiles. Multivariable Cox proportional hazard regression models were fitted to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) for PD. RESULTS: After a mean follow-up time of 17.6 years, we detected 465 incidence cases of PD. In the multivariable adjusted model, dietary vitamin E (HR 0.68, 95% CI 0.52-0.90; p for trend 0.005) and vitamin C (HR 0.68, 95% CI 0.52-0.89; p for trend 0.004) were inversely associated with the risk of PD when comparing participants in the highest vs the lowest tertiles of exposure. No association was found with estimated intake of dietary beta-carotene or NEAC. CONCLUSION: Our findings suggest that dietary vitamin E and C intake might be inversely associated with the risk of PD. No association was found with dietary beta-carotene or NEAC. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that dietary vitamin E and C intake are inversely associated with the risk of PD.


Asunto(s)
Antioxidantes/administración & dosificación , Ácido Ascórbico/administración & dosificación , Alimentos/estadística & datos numéricos , Enfermedad de Parkinson/epidemiología , Sistema de Registros , Vitamina E/administración & dosificación , beta Caroteno/administración & dosificación , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Estudios de Seguimiento , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Suecia/epidemiología , Adulto Joven
10.
Pain Res Manag ; 2020: 8857287, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33335639

RESUMEN

Background: Herpes zoster (HZ) is an acute inflammatory neurocutaneous disease caused by the reactivation of varicella-zoster virus. It is estimated that the incidence of postherpetic neuralgia following HZ is 10-20%. The leading risk factors of the prognosis are aging and immunity dysfunction. Vitamin C plays a pivoted role in enhancing white blood cell function. Epidemiological evidence and clinical studies have indicated an association between pain and suboptimal vitamin C status. At present, vitamin C has been used as an additional option in the treatment of HZ-associated pain. Despite the current controversy, case reports and randomized controlled studies have indicated that both acute- and postherpetic neuralgia can be dramatically alleviated following intravenous vitamin C infusions. Case Presentation. Two patients (male aged 72 and female 78 years) with HZ did not respond well to antiviral therapy and analgesics. Skin lesions in the right groin and front thigh healed after early antiviral therapy, but the outbreak of pain persisted in the male patient. The female patient presented to our clinic with clusters of rashes in the right forehead with severe edema of her right upper eyelid. Because nerve blockade could not be conducted for both patients, intravenous infusion of vitamin C was applied and resulted in an immediate remission of the breakthrough pain in the male patient and cutaneous lesions in the female patient. Conclusions: The use of vitamin C appears to be an emerging treatment alternative for attenuating HZ and PHN pain. Hence, we recommend the addition of concomitant use of intravenously administered vitamin C into therapeutic strategies in the treatment of HZ-associated pain, especially for therapy-resistant cases. Furthermore, animal studies are required to determine analgesic mechanisms of vitamin C, and more randomized clinical trials are essential to further determine the optimal dose and timing of administration of vitamin C.


Asunto(s)
Ácido Ascórbico/administración & dosificación , Herpes Zóster/tratamiento farmacológico , Neuralgia Posherpética/tratamiento farmacológico , Administración Intravenosa , Anciano , Femenino , Herpesvirus Humano 3 , Humanos , Infusiones Intravenosas , Masculino
11.
BMJ Case Rep ; 13(12)2020 Dec 18.
Artículo en Inglés | MEDLINE | ID: mdl-33370932

RESUMEN

A 58-year-old woman presented with a 1-week history of lower limb bruising. She had a medical history of recurrent metastatic colon cancer with a sigmoid colectomy and complete pelvic exenteration leading to colostomy and urostomy formation. She had malignant sacral mass encroaching on the spinal cord. This caused a left-sided foot drop for which she used an ankle-foot orthosis. She was on cetuximab and had received radiotherapy to the sacral mass 1 month ago. On examination, there were macular ecchymoses with petechiae on the lower limbs. There was sparing of areas that had been compressed by the ankle-foot orthosis. Bloods showed mild thrombocytopaenia and anaemia with markedly raised inflammatory markers. Coagulation studies consistent with inflammation rather than disseminated intravascular coagulation. She was found to have Klebsiella bacteraemia secondary to urinary source. Skin biopsy showed dermal haemorrhage without vessel inflammation. Vitamin C levels were low confirming the diagnosis of scurvy.


Asunto(s)
Ácido Ascórbico , Colectomía/efectos adversos , Neoplasias Colorrectales , Equimosis , Desnutrición , Apoyo Nutricional/métodos , Escorbuto , Antineoplásicos Inmunológicos/uso terapéutico , Ácido Ascórbico/administración & dosificación , Ácido Ascórbico/sangre , Bacteriemia/diagnóstico , Bacteriemia/microbiología , Colectomía/métodos , Neoplasias Colorrectales/patología , Neoplasias Colorrectales/fisiopatología , Neoplasias Colorrectales/secundario , Neoplasias Colorrectales/terapia , Diagnóstico Diferencial , Equimosis/sangre , Equimosis/diagnóstico , Equimosis/etiología , Femenino , Humanos , Klebsiella/aislamiento & purificación , Extremidad Inferior , Desnutrición/etiología , Desnutrición/terapia , Persona de Mediana Edad , Metástasis de la Neoplasia , Estadificación de Neoplasias , Exenteración Pélvica/efectos adversos , Exenteración Pélvica/métodos , Escorbuto/sangre , Escorbuto/etiología , Escorbuto/fisiopatología , Escorbuto/terapia , Piel/patología , Resultado del Tratamiento , Vitaminas/administración & dosificación
12.
J Investig Med High Impact Case Rep ; 8: 2324709620963635, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33019829

RESUMEN

As COVID-19 (coronavirus disease 2019) spreads across the world multiple therapeutic interventions have been tried to reduce morbidity and mortality. We describe a case of collapsing focal sclerosing glomerulosclerosis (FSGS) and acute oxalate nephropathy in a patient treated with high-dose intravenous vitamin C for severe COVID-19 infection. Collapsing FSGS has been described in patients with COVID-19 infection associated with APOL-1; however, this case had collapsing FSGS developing in low-risk heterozygous APOL-1 variant, and we postulate that the intensity of the COVID-19 cytokine storm overwhelmed the protective state of APOL-1 heterozygosity. This case illustrates the importance of assessing the risk and benefit of planned therapeutic interventions on a case-by-case basis especially when there are still so many unknowns in the management of COVID-19 infection. Strong consideration should be given for performing a renal biopsy in patients who develop multifactorial acute kidney injury.


Asunto(s)
Ácido Ascórbico/efectos adversos , Betacoronavirus , Infecciones por Coronavirus/tratamiento farmacológico , Glomeruloesclerosis Focal y Segmentaria/inducido químicamente , Hiperoxaluria/inducido químicamente , Glomérulos Renales/patología , Oxalatos/metabolismo , Neumonía Viral/tratamiento farmacológico , Enfermedad Aguda , Lesión Renal Aguda/diagnóstico , Lesión Renal Aguda/etiología , Ácido Ascórbico/administración & dosificación , Biopsia , Infecciones por Coronavirus/epidemiología , Progresión de la Enfermedad , Glomeruloesclerosis Focal y Segmentaria/diagnóstico , Humanos , Hiperoxaluria/diagnóstico , Hiperoxaluria/metabolismo , Inyecciones Intravenosas , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/epidemiología , Vitaminas/administración & dosificación , Vitaminas/efectos adversos
13.
Trials ; 21(1): 892, 2020 Oct 27.
Artículo en Inglés | MEDLINE | ID: mdl-33109252

RESUMEN

OBJECTIVES: The primary objectives of this study are to determine efficacy of Siddha medicine, Kabasura kudineer in reduction of SARS-CoV-2 viral load and reducing the onset of symptoms in asymptomatic COVID-19 when compared to Vitamin C and Zinc (CZ) supplementation. In addition, the trial will examine the changes in the immunological markers of the Siddha medicine against control. The secondary objectives of the trial are to evaluate the safety of the Siddha medicine and to document clinical profile of asymptomatic COVID-19 as per principles of Siddha system of Medicine. TRIAL DESIGN: A single centre, open-label, parallel group (1:1 allocation ratio), exploratory randomized controlled trial. PARTICIPANTS: Cases admitted at non-hospital settings designated as COVID Care Centre and managed by the State Government Stanley Medical College, Chennai, Tamil Nadu, India will be recruited. Eligible participants will be those tested positive for COVID-19 by Reverse Transcriptase Polymerase Chain reaction (RT-PCR) aged 18 to 55 years without any symptoms and co-morbidities like diabetes mellitus, hypertension and bronchial asthma. Those pregnant or lactating, with severe respiratory disease, already participating in COVID trials and with severe illness like malignancy will be excluded. INTERVENTION AND COMPARATOR: Adopting traditional methods, decoction of Kabasura kudineer will be prepared by boiling 5g of KSK powder in 240 ml water and reduced to one-fourth (60ml) and filtered. The KSK group will receive a dose of 60ml decoction, orally in the morning and evening after food for 14 days. The control group will receive Vitamin C (60000 IU) and Zinc tablets (100mg) orally in the morning and evening respectively for 14 days. MAIN OUTCOMES: The primary outcomes are the reduction in the SARS-CoV-2 load [as measured by cyclic threshold (CT) value of RT-PCR] from the baseline to that of seventh day of the treatment, prevention of progression of asymptomatic to symptomatic state (clinical symptoms like fever, cough and breathlessness) and changes in the immunity markers [Interleukins (IL) 6, IL10, IL2, Interferon gamma (IFNγ) and Tumor Necrosis Factor (TNF) alpha]. Clinical assessment of COVID-19 as per standard Siddha system of medicine principles and the occurrence of adverse effects will be documented as secondary outcomes. RANDOMISATION: The assignment to the study or control group will be allocated in equal numbers through randomization using random number generation in Microsoft Excel by a statistician who is not involved in the trial. The allocation scheme will be made by an independent statistician using a sealed envelope. The participants will be allocated immediately after the eligibility assessment and informed consent procedures. BLINDING (MASKING): This study is unblinded. The investigators will be blinded to data analysis, which will be carried out by a statistician who is not involved in the trial. NUMBERS TO BE RANDOMISED (SAMPLE SIZE): Sample size could not be calculated, as there is no prior trial on KSK. This trial will be a pilot trial. Hence, we intend to recruit 60 participants in total using a 1:1 allocation ratio, with 30 participants randomised into each arm. TRIAL STATUS: Protocol version 2.0 dated 16th May 2020. Recruitment is completed. The trial started recruitment on the 25th May 2020. We anticipate study including data analysis will finish on November 2020. We also stated that protocol was submitted before the end of data collection TRIAL REGISTRATION: The study protocol was registered with clinical trial registry of India (CTRI) with CTRI/2020/05/025215 on 16 May 2020. FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol. The study protocol has been reported in accordance with the Standard Protocol Items: Recommendations for Clinical Interventional Trials (SPIRIT) guidelines (Additional file 2).


Asunto(s)
Ácido Ascórbico , Betacoronavirus , Infecciones por Coronavirus , Medicina Ayurvédica/métodos , Pandemias , Neumonía Viral , Zinc , Adulto , Ácido Ascórbico/administración & dosificación , Ácido Ascórbico/efectos adversos , Infecciones Asintomáticas/terapia , Betacoronavirus/efectos de los fármacos , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/tratamiento farmacológico , Suplementos Dietéticos , Monitoreo de Drogas/métodos , Femenino , Humanos , India , Masculino , Neumonía Viral/diagnóstico , Neumonía Viral/tratamiento farmacológico , Ensayos Clínicos Controlados Aleatorios como Asunto , Resultado del Tratamiento , Carga Viral/métodos , Zinc/administración & dosificación , Zinc/efectos adversos
14.
Medicine (Baltimore) ; 99(35): e20841, 2020 Aug 28.
Artículo en Inglés | MEDLINE | ID: mdl-32871858

RESUMEN

BACKGROUND: This study aimed to provide reliable estimates for dietary antioxidant vitamin (vitamins A, C, and E) intake and their effect on fracture risk at various sites. METHODS: The PubMed, EMBASE, and Cochrane Library databases were searched to identify prospective cohort studies published throughout October 2019. The pooled relative risk (RR) with its 95% confidence interval (CI) was calculated using a random-effects model. RESULTS: In total, 13 prospective cohort studies involving 384,464 individuals were selected for this meta-analysis. The summary RR indicated that increased antioxidant vitamin intake was associated with a reduced fracture risk (RR: 0.92; 95% CI: 0.86-0.98; P = .015). When stratified by the vitamin types, increased vitamin E intake was found to be associated with a reduced fracture risk (RR: 0.66; 95% CI: 0.46-0.95; P = .025), whereas increased vitamin A and C intake did not affect this risk. Increased antioxidant vitamin intake was associated with a reduced fracture risk, irrespective of fracture sites (HR: 0.90; 95% CI: 0.86-0.94; P < .001); however, it did not affect hip fracture risk. Furthermore, increased antioxidant vitamin intake was associated with a reduced fracture risk in men (RR: 0.81; 95% CI: 0.68-0.96; P = .017) and combined men and women (RR: 0.83; 95%CI: 0.73-0.93; P = .002); however, it did not affect fracture risk in women. CONCLUSION: Fracture risk at any site is significantly reduced with increased antioxidant vitamin intake, especially vitamin E intake and in men.


Asunto(s)
Suplementos Dietéticos/efectos adversos , Fracturas Óseas/epidemiología , Osteoporosis/tratamiento farmacológico , Vitaminas/administración & dosificación , Adulto , Anciano , Anciano de 80 o más Años , Antioxidantes/efectos adversos , Ácido Ascórbico/administración & dosificación , Ácido Ascórbico/uso terapéutico , Femenino , Fracturas Óseas/prevención & control , Fracturas de Cadera/epidemiología , Fracturas de Cadera/prevención & control , Humanos , Masculino , Persona de Mediana Edad , Osteoporosis/complicaciones , Osteoporosis/epidemiología , Osteoporosis/prevención & control , Prevalencia , Estudios Prospectivos , Factores de Riesgo , Vitamina A/administración & dosificación , Vitamina A/uso terapéutico , Vitamina E/administración & dosificación , Vitamina E/uso terapéutico , Vitaminas/uso terapéutico
15.
J Med Life ; 13(2): 138-143, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32742504

RESUMEN

Treatment with anticancer drugs such as cyclophosphamide can harm the male reproductive system. Vitamin C and zinc are micronutrients with antioxidant activity and are the essential components of semen. Therefore, this study aimed to evaluate whether cyclophosphamide-exposed mice can recover from fertility with vitamin C and zinc therapy. In this experimental study, fifty male mice were divided into five groups. Groups 1-4 received cyclophosphamide (100 mg/kg, once a week for eight weeks). Also, group 2 received zinc (200 mg/kg), group 3 received vitamin C (300 mg/kg), group 4 received zinc and vitamin C (200 mg/kg and 300 mg/kg, respectively), five times per week for eight weeks, and group 5 received normal saline once a week and water five days a week for eight weeks. The data collected were statistically analyzed using SPSS 22. Results showed a significant increase in mount latency and a significant decrease in the number of sperms in the cyclophosphamide group compared to the control group. However, mount latency has been significantly decreased in mice treated with cyclophosphamide plus zinc compared to the cyclophosphamide group. The study also showed that the sperm count in the group that received cyclophosphamide and zinc had been increased compared to the cyclophosphamide group; the other treatments have decreased mount latency and increased the sperm count compared to the group treated with cyclophosphamide but not significantly. The Tubule Differentiation Index showed an increase in the cyclophosphamide-Zinc-Vitamin C group in comparison with the cyclophosphamide group. The current study showed that zinc could improve cyclophosphamide-induced toxicity of the reproductive system in male mice.


Asunto(s)
Antineoplásicos/efectos adversos , Antioxidantes/farmacología , Ácido Ascórbico/farmacología , Sustancias Protectoras/farmacología , Reproducción/efectos de los fármacos , Zinc/farmacología , Animales , Ácido Ascórbico/administración & dosificación , Ciclofosfamida/efectos adversos , Hormonas/metabolismo , Humanos , Masculino , Ratones , Conducta Sexual Animal/efectos de los fármacos , Recuento de Espermatozoides , Motilidad Espermática/efectos de los fármacos , Espermatozoides/efectos de los fármacos
16.
Trials ; 21(1): 614, 2020 Jul 06.
Artículo en Inglés | MEDLINE | ID: mdl-32631405

RESUMEN

OBJECTIVES: This study will evaluate the main hypothesis that supplementation with vitamins A, B, C, D, and E significantly improves the severity and mortality rate in ICU patients with COVID-19. TRIAL DESIGN: This study is a randomized, single-blinded, two-arm (1:1 ratio) parallel group clinical trial. PARTICIPANTS: We are conducting this study in patients with COVID-19 admitted to intensive care units at the Imam Khomeini Hospital Complex in Tehran, Iran. The inclusion criteria are as follows: (1) aged between 20 and 60 years, (2) both male and female patients with COVID-19, (3) clinical or definitive diagnosis (using polymerase chain reaction (PCR) test), (4) patients have not participated in other clinical trials, and (5) no renal or hepatic abnormalities. The exclusion criteria are as follows: (1) patients with specific and rare viral diseases such as HIV and (2) patients who have been undergoing chemotherapy for the past month. INTERVENTION AND COMPARATOR: Duration of intervention: 7 days from randomization Intervention in the treatment group: Vitamin A 25,000 IU daily Vitamin D 600,000 IU once during study Vitamin E 300 IU twice daily Vitamin C is taken four times per day B vitamins are taken as a daily Soluvit [which included thiamine nitrate 3.1 mg, sodium riboflavin phosphate 4.9 mg (corresponding to vitamin B2 3.6 mg), nicotinamide 40 mg, pyridoxine hydrochloride 4.9 mg (corresponding to vitamin B6 4.0 mg), sodium pantothenate 16.5 mg (corresponding to pantothenic acid 15 mg), sodium ascorbate 113 mg (corresponding to vitamin C 100 mg), biotin 60 µg, folic acid 400 µg, and cyanocobalamin 5 µg] The control group will not receive any supplements or placebo. All supplements are made in Iran except for Soluvit (from Fresenius Kabi, New Zealand). MAIN OUTCOMES: 1. Weight, height, and BMI 2. Severity of pulmonary involvement according to CT scan 3. Respiratory support (invasive or non-invasive) 4. Percentage of oxygen saturation (SpO2 level) 5. Serum levels of WBC, CRP, ESR, IL6, IFN-G, and TNF-α 6. The patient's body temperature 7. The presence or absence of involvement of organs other than the lungs (e.g., heart, liver, kidneys) 8. Duration of hospitalization 9. Mortality rate RANDOMIZATION: At baseline, eligible patients were randomly assigned to a 1:1 ratio to one of two groups: intervention and control. Block randomization is used based on the gender of patients. BLINDING (MASKING): Patients are unaware of being placed in the intervention or control groups after signing consent. All treatment staff will be aware of which group each of the patients is in due to the specific conditions of the ICU and the absence of placebo for the control group. NUMBERS TO BE RANDOMIZED (SAMPLE SIZE): The researchers plan to include 60 patients in total, with 30 patients in each group. TRIAL STATUS: This is the first version of the protocol which started on April 2, 2020. Recruitment began April 2, 2020, and is expected to be complete by July 4, 2020. TRIAL REGISTRATION: The Iranian Registry of Clinical Trials IRCT20200319046819N1 . Registered on April 4, 2020 FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this letter serves as a summary of the key elements of the full protocol (Fig. 1, Table 1).


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/terapia , Suplementos Dietéticos , Neumonía Viral/terapia , Ensayos Clínicos Controlados Aleatorios como Asunto , Vitaminas/administración & dosificación , Adulto , Ácido Ascórbico/administración & dosificación , Infecciones por Coronavirus/mortalidad , Femenino , Humanos , Unidades de Cuidados Intensivos , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/mortalidad , Método Simple Ciego , Vitamina A/administración & dosificación , Complejo Vitamínico B/administración & dosificación , Vitamina D/administración & dosificación
17.
BMJ Open ; 10(7): e039519, 2020 07 08.
Artículo en Inglés | MEDLINE | ID: mdl-32641343

RESUMEN

INTRODUCTION: The rapid worldwide spread of COVID-19 has caused a global health crisis. To date, symptomatic supportive care has been the most common treatment. It has been reported that the mechanism of COVID-19 is related to cytokine storms and subsequent immunogenic damage, especially damage to the endothelium and alveolar membrane. Vitamin C (VC), also known as L-ascorbic acid, has been shown to have antimicrobial and immunomodulatory properties. A high dose of intravenous VC (HIVC) was proven to block several key components of cytokine storms, and HIVC showed safety and varying degrees of efficacy in clinical trials conducted on patients with bacterial-induced sepsis and acute respiratory distress syndrome (ARDS). Therefore, we hypothesise that HIVC could be added to the treatment of ARDS and multiorgan dysfunction related to COVID-19. METHODS AND ANALYSIS: The investigators designed a multicentre prospective randomised placebo-controlled trial that is planned to recruit 308 adults diagnosed with COVID-19 and transferred into the intensive care unit. Participants will randomly receive HIVC diluted in sterile water or placebo for 7 days once enrolled. Patients with a history of VC allergy, end-stage pulmonary disease, advanced malignancy or glucose-6-phosphate dehydrogenase deficiency will be excluded. The primary outcome is ventilation-free days within 28 observational days. This is one of the first clinical trials applying HIVC to treat COVID-19, and it will provide credible efficacy and safety data. We predict that HIVC could suppress cytokine storms caused by COVID-19, help improve pulmonary function and reduce the risk of ARDS of COVID-19. ETHICS AND DISSEMINATION: The study protocol was approved by the Ethics Committee of Zhongnan Hospital of Wuhan University (identifiers: Clinical Ethical Approval No. 2020001). Findings of the trial will be disseminated through peer-reviewed journals and scientific conferences. TRIAL REGISTRATION NUMBER: NCT04264533.


Asunto(s)
Ácido Ascórbico/administración & dosificación , Infecciones por Coronavirus/tratamiento farmacológico , Síndrome de Liberación de Citoquinas/tratamiento farmacológico , Neumonía Viral/tratamiento farmacológico , Vitaminas/administración & dosificación , Administración Intravenosa , Betacoronavirus , China , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/inmunología , Síndrome de Liberación de Citoquinas/etiología , Síndrome de Liberación de Citoquinas/inmunología , Mortalidad Hospitalaria , Humanos , Unidades de Cuidados Intensivos , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/inmunología , Respiración Artificial , Índice de Severidad de la Enfermedad , Resultado del Tratamiento
18.
Am J Case Rep ; 21: e925521, 2020 Jul 25.
Artículo en Inglés | MEDLINE | ID: mdl-32709838

RESUMEN

BACKGROUND Coronavirus disease 2019 (COVID-19) continues to spread, with confirmed cases now in more than 200 countries. Thus far there are no proven therapeutic options to treat COVID-19. We report a case of COVID-19 with acute respiratory distress syndrome who was treated with high-dose vitamin C infusion and was the first case to have early recovery from the disease at our institute. CASE REPORT A 74-year-old woman with no recent sick contacts or travel history presented with fever, cough, and shortness of breath. Her vital signs were normal except for oxygen saturation of 87% and bilateral rhonchi on lung auscultation. Chest radiography revealed air space opacity in the right upper lobe, suspicious for pneumonia. A nasopharyngeal swab for severe acute respiratory syndrome coronavirus-2 came back positive while the patient was in the airborne-isolation unit. Laboratory data showed lymphopenia and elevated lactate dehydrogenase, ferritin, and interleukin-6. The patient was initially started on oral hydroxychloroquine and azithromycin. On day 6, she developed ARDS and septic shock, for which mechanical ventilation and pressor support were started, along with infusion of high-dose intravenous vitamin C. The patient improved clinically and was able to be taken off mechanical ventilation within 5 days. CONCLUSIONS This report highlights the potential benefits of high-dose intravenous vitamin C in critically ill COVID-19 patients in terms of rapid recovery and shortened length of mechanical ventilation and ICU stay. Further studies will elaborate on the efficacy of intravenous vitamin C in critically ill COVID-19.


Asunto(s)
Ácido Ascórbico/administración & dosificación , Betacoronavirus , Infecciones por Coronavirus/terapia , Neumonía Viral/terapia , Recuperación de la Función , Respiración Artificial/métodos , Anciano , Femenino , Humanos , Infusiones Intravenosas , Pandemias , Vitaminas/administración & dosificación
20.
Buenos Aires; IECS; 28 jul. 2020.
No convencional en Español | LILACS, BRISA/RedTESA | ID: biblio-1119361

RESUMEN

CONTEXTO CLÍNICO: La enfermedad por el Coronavirus 2019 (COVID-19), por su sigla en inglés Coronavirus Disease 2019) es una enfermedad respiratoria de humanos por un nuevo Coronovirus identificado con la sigla SARS-CoV-2. TECNOLOGÍA: La vitamina C o ácido ascórbico es una vitamina soluble en agua con una función conocida sobre la síntesis de colágeno en tejidos conectivos y actúa como antioxidante. La vitamina D no solo es un nutriente sino también una hormona, que puede sintetizarse en nuestro cuerpo con la ayuda de la luz solar. El zinc es un oligoelemento dietético y es importante para el mantenimiento y el desarrollo de las células inmunes del sistema inmunitario innato y adaptativo. La deficiencia de Zinc resulta en la disfunción de la inmunidad humoral y mediada por células y aumenta la susceptibilidad a enfermedades infecciosas. OBJETIVO: El objetivo del presente informe es evaluar la evidencia disponible acerca de la eficacia, seguridad y aspectos relacionados a las políticas de cobertura del uso de suplementos vitamínicos (Vit. C, D) y Zinc en la infección por COVID-19. MÉTODOS: Se realizó una búsqueda en las principales bases de datos bibliográficas, en buscadores genéricos de internet, financiadores de salud. Se priorizó la inclusión de revisiones sistemáticas (RS), ensayos clínicos controlados aleatorizados (ECAs), evaluaciones de tecnologías sanitarias (ETS), evaluaciones económicas, guías de práctica clínica (GPC) y recomendaciones de diferentes organizaciones de salud. RESULTADOS: Se incluyeron una RS con MA, un protocolo de RS, un estudio observacional retrospectivo y ocho recomendaciones de sociedades científicas. No se hallaron estudios que evalúen la suplementación con vitaminas C y D para la prevención o tratamiento de la infección por COVID-19. Para Zinc, se halló un solo estudio que lo utiliza combinado con tratamientos discontinuados para esta patología por alertas en su seguridad. CONCLUSIONES: No hallaron estudios que evalúen la suplementación con las vitaminas C y D, solas o combinadas con otros tratamientos, en la prevención o tratamiento de la infección por COVID-19. Tampoco se encontraron estudios preventivos que evaluén el uso de Zinc. En el caso de su uso terapéutico, evidencia de muy baja calidad no permite determinar los efectos de la suplementación con Zinc en pacientes hospitalizados por COVID-19. Aunque se desconoce el efecto preventivo en relación al COVID-19, se halló evidencia de alta calidad de estudios realizados durante la era pre- COVID-19 que muestra que, en población general, la suplementación con vitamina D reduce el riesgo de infecciones respiratorias agudas. La incertidumbre actual podría reducirse a corto o mediano plazo debido a que se encuentran en curso aproximadamente 90 estudios que evaluarán el efecto de la administración C y D, y Zinc, solas o en combinación con otros tratamientos, para la prevención o tratamiento de la infección por COVID-19.


Asunto(s)
Humanos , Ácido Ascórbico/administración & dosificación , Vitamina D/administración & dosificación , Zinc/administración & dosificación , Infecciones por Coronavirus/prevención & control , Betacoronavirus/efectos de los fármacos , Evaluación de la Tecnología Biomédica , Evaluación en Salud , Análisis Costo-Beneficio
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