Acute Caffeine Supplementation in Regular Caffeine Consumers Minimally Affects Strength in Knee Flexors

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Four Days of Caffeine Withdrawal in Caffeine Consumers Lowers Strength in Knee Flexors and Extensors

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Sudden hearing loss as an early detector of multiple sclerosis: a systematic review

To evaluate whether Sudden Sensorineural Hearing Loss (S-SNHL) may be an early symptom of Multiple Sclerosis (MS). A systematic review was conducted using the following keywords: "Multiple sclerosis, hearing loss, sudden hearing loss, vertigo, tinnitus, magnetic resonance imaging, otoacoustic emission, auditory brainstem responses, white matter lesions, sensorineural hearing loss, symptoms of MS and otolaryngology, nerve disease and MS". Only the articles that included results of at least one auditory test and MRI were considered. We evaluated the prevalence of SNHL in patients with MS, the presence of different forms of SNHL (S-SNHL and Progressive SNHL (P-SNHL)) and their correlation with the stage of MS, the results of electrophysiological tests, and the location (if any) of MS lesions as detected by white matter hyperintensities in the MRI. We reviewed a total of 47 articles, which included 29 case reports, 6 prospective studies, 6 cohort studies, 4 case-control studies, and 2 retrospective studies. 25% of patients suffered from SNHL. S-SNHL typically occurred in the early stage of the disease (92% of patients) and was the only presenting symptom in 43% of female subjects. Instead, P-SNHL occurred in the late stage of MS (88% of patients). Auditory Brainstem Responses (ABR) were abnormal in all MS patients with S-SNHL. When S-SNHL appeared during the early stage of the disease, MS lesions were found in the brain in 60% of patients and in the Internal Auditory Canal in 40% of patients. ABR remained abnormal after recovery. S-SNHL can be an early manifestation of MS and should always be considered in the differential diagnosis of this condition, especially in women. The pathophysiology can be explained by the involvement of microglia attacking the central and/or peripheral auditory pathways as indicated by WMHs

E-ABR in patients with cochlear implant: A comparison between patients with malformed cochlea and normal cochlea

OBJECTIVES: This study aims to compare the electrical auditory brainstem response (EABR) following cochlear implant (CI) surgery in pediatric subjects with cochlear malformation and a normal cochlea, in order to assess the sensitivity of EABR and to evaluate the surgery outcome. MATERIALS and METHODS: A total of 26 pediatric subjects who were deaf and scheduled for CI surgery were enrolled into this case control study. Group A (n=20) included subjects with a normo-conformed cochlea. Group B (n=6) included subjects with cochlear malformation. Subjects were evaluated with EABR immediately (T0) and 6 months (T1) post-CI surgery. The EABR Waves III and V average amplitude and latency were compared across time, separately for each group, and across groups, separately for each time. RESULTS: Auditory brainstem response (ABR) could only be recorded in Group A. We were able to record EABR from all subjects at T0 and T1, and waves III and V were present in all the recorded signals. There were no statistically significant differences between T0 and T1 in EABR Waves III and V in terms of average amplitude and latency in neither group. When comparing Groups A and B, the only statistically significant difference was the average amplitude of wave V, both at T0 and T1. CONCLUSION: EABR is a valid tool to measure the auditory nerve integrity after CI surgery in patients with a normal and malformed cochlea, as shown by its ability to measure waves III and V when ABR is absent. The EABR testing should be performed before and after CI surgery, and EABR should be used as a measure of outcome, especially in patients with a malformed cochlea

Healthy People 2020: Identifying Roles for Pharmacists in Public Health

Healthy People, sponsored by the United States Department of Health and Human Services, utilizes evidence-based medicine to create objectives addressing significant preventable health issues. The vision of Healthy People is to improve the quality and length of life free from preventable disease, disability, injury and death. Based on objectives outlined by Healthy People 2020 (HP 2020) pharmacists can play a role in public awareness, collaborate with other health care professionals and help achieve goals set forth by HP 2020. Based on the expertise and accessibility of the pharmacist, pharmacists can impact nine of the 13 new focus areas pf HP 2020, including adolescent health, blood disorders and safety, dementias, early/middle childhood, global health, health care-associated infections, older adults, emergency preparedness, and sleep health. HP 2020 is now an Internet-accessible, user-friendly, interactive database, that can further enhance communication between patients and pharmacists. Pharmacists and student pharmacists can use the various tools and resources available to them to implement these health improvement priorities and realize the goals and objectives set forth by HP 2020

Health Risks and Emerging Trends with the Use of Electronic Cigarettes

Cigarette smoking is associated with many health risks and complications. Despite smokers\u27 strong desire to quit, most battle with nicotine withdrawal and relapse. Because electronic cigarettes (e-cigarettes) do not contain tobacco, some believe them to be safer than traditional cigarettes and have used them as a replacement or adjunct nicotine source to prevent withdrawal symptoms. Electronic cigarettes are designed to mimic traditional cigarettes and expel a vapor composed of nicotine, water, glycerol, propylene glycol and other flavorings. Many e-cigarette companies use appealing platforms, which promise smoking cessation and harm reduction, to attract consumers; however, several studies have found e-cigarettes actually contain ingredients that are harmful to one\u27s health. Studies have demonstrated that the use of e-cigarettes can be toxic to patients\u27 health if patients do not research the products they intend to purchase. The flavoring of e-cigarettes may be a major contributor to e-cigarette cytotoxicity. If flavoring and other cytotoxic contents of e-cigarettes can be eliminated, e-cigarettes may be useful in smoking reduction and cessation. Many clinicians today support traditional forms of nicotine replacement therapy for smoking cessation rather than e-cigarettes. Due to the lack of regulation and studies by the U.S. Food and Drug Administration, e-cigarettes may not be as safe as users may perceive and should not be a preferred product for smoking cessation therapy until they are further studied and regulated

Using Biologic Markers in Blood to Assess Exposure to Multiple Environmental Chemicals for Inner-City Children 3–6 Years of Age

We assessed concurrent exposure to a mixture of > 50 environmental chemicals by measuring the chemicals or their metabolites in the blood of 43 ethnically diverse children (3–6 years of age) from a socioeconomically disadvantaged neighborhood in Minneapolis. Over a 2-year period, additional samples were collected every 6–12 months from as many children as possible. We analyzed blood samples for 11 volatile organic compounds (VOCs), 2 heavy metals (lead and mercury, 11 organochlorine (OC) pesticides or related compounds, and 30 polychlorinated biphenyl (PCB) congeners. The evidence suggests that numerous VOCs originated from common sources, as did many PCBs. Longitudinal measurements indicate that between-child variance was greater than within-child variance for two VOCs (benzene, toluene), for both heavy metals (Pb, Hg), for all detectable OC pesticides, and for 15 of the measured PCB congeners (74, 99, 101, 118, 138–158, 146, 153, 156, 170, 178, 180, 187, 189, 194, 195). Despite the relatively small sample size, highest measured blood levels of 1,4-dichlorobenzene, styrene, m-/p-xylene, Pb, Hg, heptachlor epoxide, oxychlordane, dichlorodiphenyldichloroethene (p,p′-DDE), trans-nonachlor, and PCB congeners 74, 99, 105, 118, 138, 146, 153, 156, 170, and 180 were comparable with or higher than 95th percentile measurements of older children and adults from national surveys. Results demonstrate that cumulative exposures to multiple environmental carcinogens and neurotoxins can be comparatively high for children from a poor inner-city neighborhood