EFFECTS OF CAFFEINE CAPSULES ON DYNAMIC AND STATIC BALANCE

Caffeine (CAF) is known for its central nervous system (CNS) stimulating function by acting as an adenosine receptor antagonist, but it also has some ergogenic effects. That is, CAF has implications in enhancing physical performance and endurance10. CAF has been shown to alter skeletal muscle contractions by opening of calcium ion channels19. There is also some evidence that suggests that CAF affects rate of relaxation of the skeletal muscles2. To further understand how caffeine affects humans in our daily living activities, the effects of CAF on dynamic and static balance were investigated. With the consumption of CAF, it can be assumed that there will be improvement in balance and motor control due to increase in force and duration of skeletal muscle contraction in the muscles being used for balance

EXPRESS: Dual Versus Triple Antithrombotic Therapy in Atrial Fibrillation and Acute Coronary Syndrome: An Updated Meta-Analysis of Randomized Controlled Trials.

Antithrombotic treatment in patients with atrial fibrillation (AF) and acute coronary syndrome (ACS) poses a dilemma. We compared outcomes of dual thrombotic therapy (DAT) (direct oral anticoagulants [DOACs]/warfarin + antiplatelets) versus triple antithrombotic therapy (TAT) (DOACs/warfarin, aspirin, and P2Y12 inhibitor) in this population. Multiple databases were searched from inception to 12/17/2023 to identify randomized controlled trials (RCTs) comparing DAT versus TAT in patients with AF and ACS. Outcomes included major adverse cardiac events (MACE), bleeding events, stroke, stent thrombosis, and myocardial infarction (MI). Relative risk (RR) and 95% confidence intervals were estimated with a random-effects model using the inverse-variance technique. We assigned I2>50% as an indicator of statistical heterogeneity. P-value <0.05 was considered significant. Ten RCTs comprising 6186 patients on TAT (female 26%, mean age 71±9 yrs) and 6,800 patients on DAT (female 27%, mean age 71±9 yrs) were included. Patients receiving DAT experienced lower rates of bleeding events compared to those receiving TAT, with relative risks of 0.69 [0.55-0.87] (p<0.001), 0.65 [0.40-1.06] (p=0.09), and 0.62 [0.46-0.84] (p<0.001) for TAT durations of 3, 6, and 12 months, respectively. No difference was seen in the occurrence of MACE, MI, stroke, or stent thrombosis between DAT and TAT across all 3 durations of TAT therapy. This is the largest pooled analysis comparing TAT to DAT stratified by duration of antithrombotic therapy. Our results revealed that DAT was associated with reduced bleeding risk despite no difference in other outcomes

Influence of Social Vulnerability Index on Medicare Beneficiaries’ Expenditures upon Discharge

Medicare beneficiaries’ healthcare spending varies across geographical regions, influenced by availability of medical resources and institutional efficiency. We aimed to evaluate whether social vulnerability influences healthcare costs among Medicare beneficiaries. Multivariable regression analyses were conducted to determine whether the social vulnerability index (SVI), released by the CDC, was associated with average submitted covered charges, total payment amounts, or total covered days upon hospital discharge among Medicare beneficiaries. We used information from discharged Medicare beneficiaries from hospitals participating in the Inpatient Prospective Payment System. Covariate adjustment included demographic information consisting of age groups, race/ethnicity, and Hierarchical Condition Category risk score. The regressions were performed with weights proportioned to the number of discharges. Average submitted covered charges significantly correlated with SVI (β=0.50, p&lt;0.001) in the unadjusted model and remained significant in the covariates-adjusted model (β=0.25, p=0.039). The SVI was not significantly associated with the total payment amounts (β=-0.07, p=0.238) or the total covered days (β=0.00, p=0.953) in the adjusted model. Regional variations in Medicare beneficiaries’ healthcare spending exist and are influenced by levels of social vulnerability. Further research is warranted to fully comprehend the impact of social determinants on healthcare costs

Impact of social vulnerability on comorbid COVID-19 and acute myocardial infarction mortality in the United States

The trajectory of several cardiovascular diseases (CVD), including acute myocardial infarction (AMI), has been adversely impacted by COVID-19, resulting in a worse prognosis. The Social Vulnerability Index (SVI) has been found to affect certain CVD outcomes. In this cross-sectional analysis, we investigated the association between the SVI and comorbid COVID-19 and AMI mortality using the CDC databases. The SVI percentile rankings were divided into four quartiles, and age-adjusted mortality rates were compared between the lowest and highest SVI quartiles. Univariable Poisson regression was utilized to calculate risk ratios. A total of 5779 excess deaths and 1.17 excess deaths per 100,000 person-years (risk ratio 1.62) related to comorbid COVID-19 and AMI were attributable to higher social vulnerability. This pattern was consistent across the majority of US subpopulations. Our findings offer crucial epidemiological insights into the influence of the SVI and underscore the necessity for targeted therapeutic interventions

ALCOHOLIC CARDIOMYOPATHY MORTALITY AND SOCIAL VULNERABILITY INDEX: A NATIONWIDE CROSS-SECTIONAL ANALYSIS

Social vulnerability index (SVI) plays a pivotal role in the outcomes of cardiovascular diseases and prevalence of alcohol use. We evaluated the impact of the SVI on alcoholic cardiomyopathy (ACM) mortality

Alcoholic cardiomyopathy mortality and social vulnerability index: A nationwide cross-sectional analysis.

Social vulnerability index (SVI) plays a pivotal role in the outcomes of cardiovascular diseases and prevalence of alcohol use. We evaluated the impact of the SVI on alcoholic cardiomyopathy (ACM) mortality. Mortality data from 1999 to 2020 and the SVI were obtained from CDC databases. Demographics such as age, sex, race/ethnicity, and geographic residence were obtained from death certificates. The SVI was divided into quartiles, with the fourth quartile (Q4) representing the highest vulnerability. Age-adjusted mortality rates across SVI quartiles were compared, and excess deaths due to higher SVI were calculated. Risk ratios were calculated using univariable Poisson regression. A total of 2779 deaths were seen in Q4 compared to 1672 deaths in Q1. Higher SVI accounted for 1107 excess-deaths in the US and 0.05 excess deaths per 100,000 person-years (RR: 1.38). Similar trends were seen for both male (RR: 1.43) and female (RR: 1.67) populations. Higher SVI accounted for 0.06 excess deaths per 100,000 person-years in Hispanic populations (RR: 2.50) and 0.06 excess deaths per 100,000 person-years in non-Hispanic populations (RR: 1.46). Counties with elevated SVI experienced higher ACM mortality rates. Recognizing the impact of SVI on ACM mortality can guide targeted interventions and public health strategies, emphasizing health equity and minimizing disparities. [Abstract copyright: © 2023 The Authors. Published by Elsevier B.V.

Rural-Urban Stroke Mortality Gaps in the United States.

Disparities in stroke outcomes, influenced by the use of systemic thrombolysis, endovascular therapies, and rehabilitation services, have been identified. Our study assesses these disparities in mortality after stroke between rural and urban areas across the United States (US). We analyzed the CDC data on deaths attributed to cerebrovascular disease from 1999-2020. Data was categorized into rural and urban regions for comparative purposes. Age-adjusted mortality rates (AAMR) were computed using the direct method, allowing us to examine the ratios of rural to urban deaths for the cumulative population and among demographic subpopulations. Linear regression models were used to assess temporal changes in mortality ratios over the study period, yielding beta-coefficients (β). There was a total of 628,309 stroke deaths in rural regions and 2,556,293 stroke deaths within urban regions. There were 1.13 rural deaths for each one urban death per 100,000 population in 1999 and 1.07 in 2020 (β=-0.001, p =0.41). The rural-urban mortality ratio in Hispanic populations decreased from 1.32 rural deaths for each urban death per 100,000 population in 1999 to 0.85 in 2020 (β=-0.011, p <0.001). For non-Hispanic populations, mortality remained stagnant with 1.12 rural deaths for each urban death per 100,000 population in 1999 and 1.07 in 2020 (β=-0.001, p =0.543). Regionally, the Southern US exhibited the highest disparity with a urban-rural mortality ratio of 1.19, followed by the Northeast (1.13), Midwest (1.04), and West (1.01). Our findings depict marked disparities in stroke mortality between rural and urban regions, emphasizing the importance of targeted interventions to mitigate stroke-related disparities. [Abstract copyright: Copyright © 2024. Published by Elsevier Inc.