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EVIDENCE-BASED-HEALTH  April 1999

EVIDENCE-BASED-HEALTH April 1999

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Subject:

Re: ascorbic acid and influenza

From:

"N.P. van Duijn" <[log in to unmask]>

Reply-To:

N.P. van Duijn

Date:

Fri, 2 Apr 1999 12:03:09 +0100

Content-Type:

Multipart/Mixed

Parts/Attachments:

Parts/Attachments

text/plain (63 lines) , text/plain (115 lines)

Recently a well executed syst. literature review has been published 
in Huisarts & Wetenschap, the Dutch Journal of the dutch college of 
general practitioners. 
Unfortunately it is in Dutch (though often it includes a abstract in 
english). As we  haven't been succesful to get the journal 
accepted for indexing in Medline - we tried this four times over 
a period of more than 10 years - it isn't useful for us to publish 
original articles in english or with extensive english summaries. 
If you wish I could it look up for you. Possibly you find Dutch 
rather easy to read, and rather comparable to German. At least you 
could extract the references.

No luck with some Cochrane Library?

A quick search with ascorbic acid / common cold / 1985-1999 / review 
(search strategy included) resulted in two possibly useful articles: 
see attached file

I hope this is helpful.

Nico v Duijn 

Dr. N.P. van Duijn, gen. pract. - epidemiologist
Departm. General Practice
Division Public Health
Academic Medical Centre
University of Amsterdam
the Netherlands


Date:          Tue, 30 
Mar 1999 22:56:59 +0100
> Subject:       ascorbic acid and influenza
> From:          "Heimo Wallenko" <[log in to unmask]>
> To:            "Evidence-based Health" <[log in to unmask]>
> Reply-to:      "Heimo Wallenko" <[log in to unmask]>

> Dear members of list,
> 
> among general practitioners it is very common to use high doses of ascorbic
> acid (up to 5 gram daily) in patients with influenza vera or measles. I
> could not find any evidence for this treatment, neither for high doses nor
> low.
> Is there any, or - as I think - is this treatment common because patients
> wish to be treated this way?
> 
> Hope you don't mind about this
> 
> Heimo
> 
> Dr. Heimo Wallenko
> General Practitioner
> Seenstrasse 53, A-9081 Reifnitz
> Tel. 0043 4273 3565
> email: [log in to unmask]
> 
> 
> 
> 
> 




Date: 02-Apr-1999 Name: ascorbic Database: Medline (Alles) <1966 to March 1999> Set Search Results --------------------------------------------------------------------------- 001 exp *ascorbic acid/tu 1097 002 limit 1 to review articles 59 003 limit 2 to yr=1985-1999 42 004 exp *common cold/ 946 005 3 and 4 2 006 from 5 keep 1-2 2 007 6 2 <1> Unique Identifier   97129600 Authors   Hemila H. Institution   Department of Public Health, University of Helsinki, Finland. Title   Vitamin C supplementation and common cold symptoms: problems with   inaccurate reviews. [Review] [69 refs] Source   Nutrition. 12(11-12):804-9, 1996 Nov-Dec. Abbreviated Source   Nutrition. 12(11-12):804-9, 1996 Nov-Dec. MeSH Subject Headings   Adult   Ascorbic Acid/ad [Administration & Dosage]   *Ascorbic Acid/tu [Therapeutic Use]   Child   *Common Cold/dt [Drug Therapy]   Common Cold/pc [Prevention & Control]   Controlled Clinical Trials   Human   Nutrition Policy   Support, Non-U.S. Gov't Abstract   In 1971, Linus Pauling carried out a meta-analysis of four   placebo-controlled trials and concluded that it was highly unlikely that   the decrease in the "integrated morbidity of the common cold" in vitamin C   groups was caused by chance alone (P < 0.00003). Studies carried out since   then have consistently found that vitamin C (> or = 1 g/d) alleviates   common cold symptoms, indicating that the vitamin does indeed have   physiologic effects on colds. However, widespread conviction that the   vitamin has no proven effects on the common cold still remains. Three of   the most influential reviews drawing this conclusion are considered in the   present article. Two of them are cited in the current edition of the RDA   nutritional recommendations as evidence that vitamin C is ineffective   against colds. In this article, these three reviews are shown to contain   serious inaccuracies and shortcomings, making them unreliable sources on   the topic. The second purpose is to suggest possible conceptual reasons   for the persistent resistance to the notion that vitamin C might have   effects on colds. Although placebo-controlled trials have shown that   vitamin C does alleviate common cold symptoms, important questions still   remain. [References: 69] Publication Type   Journal Article. Review. Review, Tutorial. <2> Unique Identifier   92190136 Authors   Hemila H. Institution   Institute of Biotechnology, University of Helsinki, Finland. Title   Vitamin C and the common cold. [Review] [124 refs] Source   British Journal of Nutrition. 67(1):3-16, 1992 Jan. Abbreviated Source   Br J Nutr. 67(1):3-16, 1992 Jan. Local Messages   Aanwezig in Centrale Medische Bibliotheek, AMC MeSH Subject Headings   Antioxidants/pk [Pharmacokinetics]   Ascorbic Acid/pk [Pharmacokinetics]   *Ascorbic Acid/tu [Therapeutic Use]   Chemotaxis, Leukocyte/de [Drug Effects]   Clinical Trials   *Common Cold/pc [Prevention & Control]   Dose-Response Relationship, Drug   Histamine Antagonists/pd [Pharmacology]   Human   Neutrophils/ph [Physiology]   Phagocytosis/de [Drug Effects]   Time Factors Abstract   The effect of vitamin C on the common cold has been the subject of several   studies. These studies do not support a considerable decrease in the   incidence of the common cold with supplemental vitamin C. However, vitamin   C has consistently decreased the duration of cold episodes and the   severity of symptoms. The benefits that have been observed in different   studies show a large variation and, therefore, the clinical significance   may not be clearly inferred from them. The biochemical explanation for the   benefits may be based on the antioxidant property of vitamin C. In an   infection, phagocytic leucocytes become activated and they produce   oxidizing compounds which are released from the cell. By reacting with   these oxidants, vitamin C may decrease the inflammatory effects caused by   them. Scurvy, which is caused by a deficiency in vitamin C, is mostly   attributed to the decreased synthesis of collagen. However, vitamin C also   participates in several other reactions, such as the destruction of   oxidizing substances. The common cold studies indicate that the amounts of   vitamin C which safely protect from scurvy may still be too low to provide   an efficient rate for other reactions, possibly antioxidant in nature, in   infected people. [References: 124] Publication Type   Journal Article. Review. Review, Academic.

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