Effects of energy drinks on the cardiovascular system

Throughout the last decade, the use of energy drinks has been increasingly looked upon with caution as potentially dangerous due to their perceived strong concentration of caffeine aside from other substances such as taurine, guarana, and L-carnitine that are largely unknown to the general public. In addition, a large number of energy drink intoxications have been reported all over the world including cases of seizures and arrhythmias. In this paper, we focus on the effect of energy drinks on the cardiovascular system and whether the current ongoing call for the products' sales and regulation of their contents should continue.

Effects of exercise training on diastolic and systolic dysfunction in patients with chronic heart failure

BACKGROUND Chronic heart failure(CHF)is a complex syndrome characterized by a progressive reduction of the left ventricular(LV)contractility,low exercise tolerance,and increased mortality and morbidity.Diastolic dysfunction(DD)of the LV,is a keystone in the pathophysiology of CHF and plays a major role in the progression of most cardiac diseases.Also,it is well estimated that exercise training induces several beneficial effects on patients with CHF.AIM To evaluate the impact of a cardiac rehabilitation program on the DD and LV ejection fraction(EF)in patients with CHF.METHODS Thirty-two stable patients with CHF(age:56±10 years,EF:32%±8%,88%men)participated in an exercise rehabilitation program.They were randomly assigned to aerobic exercise(AER)or combined aerobic and strength training(COM),based on age and peak oxygen uptake,as stratified randomization criteria.Before and after the program,they underwent a symptom-limited maximal cardiopulmonary exercise testing(CPET)and serial echocardiography evaluation to evaluate peak oxygen uptake(VO2peak),peak workload(Wpeak),DD grade,right ventricular systolic pressure(RVSP),and EF.RESULTS The whole cohort improved VO2peak,and Wpeak,as well as DD grade(P<0.05).Overall,9 patients(28.1%)improved DD grade,while 23(71.9%)remained at the same DD grade;this was a significant difference,considering DD grade at baseline(P<0.05).In addition,the whole cohort improved RVSP and EF(P<0.05).Not any between-group differences were observed in the variables assessed(P>0.05).CONCLUSION Exercise rehabilitation improves indices of diastolic and systolic dysfunction.Exercise protocol was not observed to affect outcomes.These results need to be further investigated in larger samples.

Electronic cigarettes — myocardial infarction, hemodynamic compromise during pregnancy, and systolic and diastolic dysfunction: Minireview

The aim of this study was to review the most recent literature on the safety of electronic cigarettes(ECs)in the context of cardiovascular disease and in the context as a tool for smoking cessation and recreational purposes.The format of this review begins with relevant research from the basic sciences and follows through with a pertinent review of clinical trials.Daily use of ECs has implications in myocardial infarction(MI)with an odds ratio of 1.70 compared to healthy,nonsmokers and even worse risk for MI with dual use of combustible cigarettes together with EC with an odds ratio of 4.62.Studies measuring cardiac function with echocardiography reported both systolic and diastolic dysfunction along with reduced ejection fractions.Platelet aggregation,endothelial function,and hemodynamics during pregnancy were all but some of the pernicious cardiovascular implications of EC exposure.Though more studies need to be done on the topic of EC use and cardiovascular disease,the majority of studies considered in this review concluded some level of harm albeit in some instances less than that of traditional combustible cigarettes.ECs are toxic to human beings and their harmful effects cannot be overlooked.There is some favorable evidence of efficacy in smoking cessation though mixed with concern of chronic EC use.It will take decades to collect data for chronic EC use on long term sequelae,such as lung cancer.Though more and more reports of acute lung injury and hospitalizations related to EC use have been reported.Due to undergoing investigations of possible harm and life threatening complications of EC use,we cannot recommend ECs as safer or a more efficacious method of smoking cessation to traditional nicotine replacement therapies.A notable consideration for much of the literature reviewed are that standardization of EC use is difficult as device generation and battery voltage,frequency of use,and contents of ECliquid are just some of the vast complicating factors that limit the ability to effectively compare data.

Nonalcoholic fatty liver disease as a multi-systemic disease

Nonalcoholic fatty liver disease(NAFLD) is the most common cause of chronic liver disease. NAFLD includes a wide spectrum of liver conditions ranging from simple steatosis to nonalcoholic steatohepatitis and advanced hepatic fibrosis. NAFLD has been recognized as a hepatic manifestation of metabolic syndrome linked with insulin resistance. NAFLD should be considered not only a liver specific disease but also an early mediator of systemic diseases. Therefore, NAFLD is usually associated with cardiovascular disease, chronic kidney disease, type 2 diabetes, obesity, and dyslipidemia. NAFLD is highly prevalent in the general population and is associated with increased cardiovascular morbidity and mortality. The underlying mechanisms and pathogenesis of NAFLD with regard to other medical disorders are not yet fully understood. This review focuses on pathogenesis of NAFLD and its relation with other systemic diseases.

Safety of epinephrine for anaphylaxis in the emergency setting

BACKGROUND:While epinephrine is the recommended first-line therapy for the reversal of anaphylaxis symptoms,inappropriate use persists because of misunderstandings about proper dosing and administration or misconceptions about its safety.The objective of this review was to evaluate the safety of epinephrine for patients with anaphylaxis,including other emergent conditions,treated in emergency care settings.METHODS:A MEDLINE search using PubMed was conducted to identify articles that discuss the dosing,administration,and safety of epinephrine in the emergency setting for anaphylaxis and other conditions.RESULTS:Epinephrine is safe for anaphylaxis when given at the correct dose by intramuscular injection.The majority of dosing errors and cardiovascular adverse reactions occur when epinephrine is given intravenously or incorrectly dosed.CONCLUSION:Epinephrine by intramuscular injection is a safe therapy for anaphylaxis but training may still be necessary in emergency care settings to minimize drug dosing and administration errors and to allay concerns about its safety.

Unbalance of the Physiological System May Cause Trouble —The Other Side of the Story from the Very Successful Drug, VIOXX

Selective cyclo-oxygenase-2 (CQX-2) inhibitor, VIOXX (rofecoxib), wasvoluntarily withdrawn worldwide from drugstores by its maker Merck & Co., Inc. on September 30,2004, for its potential lethal side effects of heart attack or stroke, The Merck' s decision wasbased on new, three-year data from a prospective, multi-center, randomized, placebo-controlled,double-blind clinical trial of VIOXX with an unrelated study, the APPROVe (Adenomatous PolypPrevention on VIOXX) trial. The trial has been enrolling 2 600 patients and comparing 156 weeks(three years) of treatment with VIOXX 25 mg to placebo since 2000.

Effect of endogenous nitric oxide synthase inhibitors on cardiovascular function:Insight obtained from tissue specific dimethylarginine dimethylaminohydrolase 1 deficient mice

Nitric oxide (NO) produced by nitric oxide synthases (NOS) exerts many important biological functions. Asymmetric dimethylarginine (ADMA) and

Effect of nursing-based on early rehabilitation on quality of life in elderly patients with cardiovascular disease:A randomized controlled trial

Background Patients with cardiovascular disease（CVD） have a reduced quality of life（QOL） partly due to their limited range of physical activity and independence. The objective of this study was to investigate whether the nurse based early cardiac rehabilitation will be improved QOL in elderly patients with CVD after8-week treatment from baseline and post intervention, compared with conventional care. Methods Sixty-six elderly patients with CVD were randomly assigned（using the coin tossing method） to either the ‘early cardiac rehabilitation＇ group（i.e. the experimental group）, and the control group（i.e. routine care group） for 8weeks between June 2013 and June 2014, with 33 participants in each group. The control group received routine CVD care, and the experiment group received early rehabilitation care in addition to routine CVD care.The outcome measures included the Short Form-36 Health Survey（SF-36）, and Self-rating Anxiety Scale（SAS）. Results There were non-significant differences between the groups at baseline in age, sex, duration of the disease, length of hospitalization, total number of comorbid conditions, and total number of medications（P 〉 0.05）. Following 8-week treatment, all groups improved their QOL scores and SAS anxiety scores（P 〈 0.05）. In addition, the nursing based on early cardiac rehabilitation group was significantly improved in QOL and SAS anxiety scores（P 〈 0.05）, when compared with the control group. Conclusions This study has demonstrated that the nurse based early cardiac rehabilitation is effective in increasing selected aspects of a general QOL and improved the anxiety situation in elderly patients with CVD. It is worthwhile to be widely used in clinical practice.

Effect of Tb(Ⅲ) on activity and stability of nattokinase

Nattokinase, is an effective fibrinolytic enzyme with the potential for fighting cardiovascular disease. The aim of study was to investigate the interaction of Tb（Ⅲ） with nattokinase and the impact of Tb（Ⅲ） on the enzyme activity and protein stability. The binding of Tb（Ⅲ） with nattokinase was studied by fluorescence spectrum in 100 mmol/L Tris-HCl（pH 8.0）. It could be seen that the protein bound one Tb（Ⅲ） with low affinity, and the binding constants K were 2.90×10~4 L/mol at 288 K. Although the activity of nattokinase determined by tetra-peptide substrate method at proper pH and temperature was not influenced for the binding of Tb（Ⅲ）, the transformation rate of substrate was increased to 113%. To better assess the stability of protease in the absence and presence of Tb（Ⅲ）, nattokinase was unfolded through continuous concentrations urea. Based on the model of structural element, the results showed that Tb（Ⅲ） could not change the average structural element free energy of nattokinase by the measurement of enzyme activity, but it could improve the stability of the global protein by the fluorescence spectral measurement.