Synergistic effect of energy drinks and overweight/obesity on cardiac autonomic testing using the Valsalva maneuver in university students

BACKGROUND: Obesity and caffeine consumption may lead to autonomic disturbances that can result in a wide range of cardiovascular disorders. OBJECTIVES: To determine autonomic disturbances produced by the synergistic effects of overweight or obesity (OW/OB) and energy drinks. DESIGN: Cross-sectional, analytical. SETTING: Physiology department at a university in Saudi Arabia. SUBJECTS AND METHODS: University students, 18–22 years of age, of normal weight (NW) and OW/OB were recruited by convenience sampling. Autonomic testing by the Valsalva ratio (VR) along with systolic and diastolic blood pressure, pulse pressure, and mean arterial blood pressure were measured at baseline (0 minute) and 60 minutes after energy drink consumption. MAIN OUTCOME MEASURE(S): Autonomic disturbance, hemodynamic changes. RESULTS: In 50 (27 males and 23 females) subjects, 21 NW and 29 OW/OB, a significant decrease in VR was observed in OW/OB subjects and in NW and OW/OB females at 60 minutes after energy drink consumption. Values of systolic and diastolic blood pressure, pulse pressure and mean arterial blood pressure were also significantly higher in OW/OB and in females as compared to NW and males. BMI was negatively correlated with VR and diastolic blood pressure at 60 minutes. CONCLUSION: Obesity and energy drinks alter autonomic functions. In some individuals, OW/OB may augment these effects. LIMITATIONS: Due to time and resource restraints, only the acute effects of energy drinks were examined

HER2/neu expression status of post BCG recurrent non-muscle-invasive bladder urothelial carcinomas in relation to their primary ones

Background: Transurethral resection (TUR) followed by adjuvant therapy is still the treatment of choice of Non-Muscle-Invasive Bladder Urothelial Carcinoma (NMIBUC). However, recurrence is one of the most troublesome features of these lesions. Early second resection and adjuvant BCG therapy has been shown to improve the outcome. Objective: To evaluate the prognostic value of C-erbB-2 (HER2/neu) expression status in Non-Muscle-Invasive Bladder Urothelial Carcinoma cases, before and after intravesical Bacillus Calmette Guerin (BCG immunotherapy). Materials and methods: HER2/neu expression was studied in 120 (Ta-T1) Non-Muscle-Invasive Urothelial Carcinoma cases. The expression was evaluated and compared to the expression after Bacillus Calmette Guerin (BCG) immunotherapy. Results: HER2/neu expression in low and high grade of the Non- Muscle-Invasive Urothelial Carcinoma was (38%) and (83%) respectively. The difference of the expression rates by tumor grade was statistically significant. In recurring lesions post BCG therapy, C-erbB-2 expression was markedly decreased (31.6%) when compared to its expression before therapy (65%). Conclusions: The HER2/neu expression increased as the tumor grade rose. The reduction in expression following BCG treatment in Non-Invasive transitional cell carcinoma cases could reflect a reduction of the potential malignancy of the tumor

Efficient optimal sensor placement for structural model based diagnosis

International audienc

Hoarseness among school teachers: A cross-sectional study from Dammam

Background: Voice disorders are known to be a serious occupational hazard for teachers. Compared to the general population, teachers have a greater risk of developing hoarseness of voice. The prevalence of voice disorders in teachers is 20%–50%. To the best of our knowledge, there has been no study in Saudi Arabia (SA) on the prevalence of hoarseness in teachers. Materials and Methods: A cross-sectional survey was conducted in 13 randomly selected schools at different levels of education in Khobar, SA, between February 2016 and March 2016. Data collected included demographic data, comorbidity, smoking, school type, laryngopharyngeal reflux, hearing problems, common cold, family history, number of students, and stress. The study included teachers who were actively teaching. Teachers with laryngeal cancer and those who were not actively teaching as well as those who were on sick leave were all excluded from the study. Data were analyzed using SPSS version 20. Results: Out of 400 surveys distributed, 187 teachers responded; mean age of teachers was 42.5 years and 55.1% were females. The percentage of teachers who subjectively complained of hoarseness was 27%; teachers in public schools had a higher prevalence of hoarseness than teachers in private schools. The greater the number of students per class, the more likely it was for the teacher to develop hoarseness (P = 0.038). The factors statistically significantly associated with hoarseness included smoking, acid reflux, family history of hoarseness, and work-related stress. Conclusion: Prevalence of hoarseness in teachers is high owing to a combination of multiple associated factors, many of which can be controlle