Consumo de psicoestimulantes por estudantes de medicina em um centro universitário privado / Consumption of psychostimulants by medical students in a private university center

O consumo de psicoestimulantes tem crescido exponencialmente, sobretudo entre estudantes de medicina, na busca por aumentar o rendimento acadêmico. Atualmente, a extensa carga horária de aulas e estudos, exigências de produtividade e altos níveis de estresse podem desencadear o uso. Objetivo: Analisar o uso de psicoestimulantes por estudantes do curso de Medicina de um Centro Universitário privado em Minas Gerais. Métodos: Foi realizado um estudo descritivo, quantitativo, com delineamento transversal entre os discentes do 1° ao 5° ano do curso de Medicina no 2° semestre de 2021. Os participantes responderam ao questionário semi-estruturado elaborado pelos autores. Os dados obtidos foram tabulados no software Statistical Product and Service Solutions. Resultados: Dos 244 entrevistados, cerca de 57.4% faziam uso de algum psicoestimulante. Houve maior uso entre os estudantes do 2° ano e as principais substâncias utilizadas foram: cafeína (85%), energético (65%) e metilfenidato (60%). A melhora na concentração (97%) foi o efeito mais percebido pelos usuários, seguido de redução do sono (83%) e melhora de raciocínio (80%). Muitos consideraram que os estimulantes cerebrais têm o potencial de melhorar o rendimento acadêmico, mas pode reduzir a qualidade do sono e consequentemente torná-los susceptíveis a outras enfermidades. Conclusão: É notável que existe uso abusivo de estimulantes cerebrais, sendo fundamental o trabalho em conjunto entre instituição de ensino e familiares, em prol da prevenção e do controle de danos causados por esse hábito

The consumption of psychostimulants has grown exponentially, especially among medical students, in the quest to increase academic performance. Currently, the extensive workload of classes and studies, productivity demands and high levels of stress can trigger use. Objective: To analyze the use of psychostimulants by medical students at a private University Center in Minas Gerais. Methods: A descriptive, quantitative, cross-sectional study was carried out among students from the 1st to the 5th year of the medicine course in the 2nd semester of 2021. The participants answered the semi-structured questionnaire prepared by the authors. The data obtained were tabulated in the Statistical Product and Service Solutions software. Results: Of the 244 respondents, about 57.4% used some psychostimulant. There was greater use among 2nd year students and the main substances used were: caffeine (85%), energy drink (65%) and methylphenidate (60%). Improved concentration (97%) was the effect most perceived by users, followed by reduced sleep (83%) and improved thinking (80%). Many considered that brain stimulants have the potential to improve academic performance, but can reduce sleep quality and consequently make them susceptible to other illnesses. Conclusion: It is notable that there is abusive use of brain stimulants, and it is essential to work together between educational institutions and family members in order to prevent and control the damage caused by this habit

Síntomas psicóticos y consumo de bebidas energizantes: reporte de caso / Psychotic symptoms and consumption of energy drinks: case report

RESUMEN: El consumo de bebidas energizantes y su rápida expansión ha creado preocupación desde el punto de vista científico y comunitario. Estas son bebidas que contienen cafeína como su principio activo más común. Se presenta el caso de un paciente sin antecedentes psiquiátricos con presentación clínica de síntomas psicóticos tras incremento del consumo de bebidas energizantes. Se realiza una revisión de literatura existente sobre otros casos de aparición de psicosis tras el consumo de estas bebidas en personas sin y con antecedentes psiquiátricos, así como casos en que predomina la presentación de otros síntomas psiquiátricos con la finalidad de discutir el impacto clínico. El consumo de bebidas energizantes podría representar un problema de salud pública mundial debido a los posibles efectos adversos graves y aún poco estudiados en la salud física y mental.

ABSTRACT The consumption of energy drinks and their rapid expansion has created concern from a scientific and community point of view. These are drinks that contain caffeine as their most common active ingredient. We present the case of a patient with no psychiatric history with clinical presentation of psychotic symptoms after increased consumption of energy drinks. A review of existing literature is carried out on other cases of the appearance of psychosis after the consumption of these beverages in people without and with a psychiatric history, as well as cases in which the presentation of other psychiatric symptoms predominates in order to discuss the clinical impact. The consumption of energy drinks could represent a global public health problem due to the possible serious and still little studied adverse effects on physical and mental health.

Selective Separation and Preconcentration of Caffeine from Natural and Pharmaceutical Products using New Polyurethane Foams

Abstract Two polyurethane foam-based sorbents (PUF) were synthesized by imprinting and grafting techniques and examined for selective separation and preconcentration of caffeine (CAF) in some pharmaceutical products and in black tea. Molecularly imprinted PUF was synthesized based on hydrogen-bonding interactions between CAF and alizarin yellow G (AYG) and subsequent polymerization into PUF. The static experiments indicated optimum sorption conditions at pH=6.5 and 5.5 for imprinted PUF (AY-IPUF) and grafted PUF (AY-GPUF), respectively. In the online experiments, the suitable preconcentration time was found to be 40 and 20s for (AY-IPUF) and (AY-GPUF), respectively, at a flow rate of 1.75 mL.min-1. Desorption of CAF has been affected by passing 500 µL of 0.05, 0.01 mol.L−1 HCl eluent onto (AY-IPUF) and (AY-GPUF), respectively. The online methods have provided satisfactory enrichment factors of 8.4 and 10.5 for (AY-IPUF) and (AY-GPUF), respectively. The time consumed for preconcentartion, elution and determination steps was 1.48 and 1.05 min, thus, the throughput was 42 and 57 h-1, for (AY-IPUF) and (AY-GPUF), respectively. The developed sorbents were studied for the determination of CAF in pharmaceutical samples which will be helpful to minimize caffeinism. Finally, in silico bioactivity, ADMET and drug-likeness predictive computational studies of caffeine were also carried out

Caffeine Adsorption onto Bentonite Clay in Suspension and Immobilized

Abstract This study describes the use of bentonite in suspension for the caffeine adsorption (pollutant of emerging concern) by taking different conditions of the pH, adsorbent mass, adsorbent calcination temperature and interferents into account. The results were compared with those obtained using bentonite immobilized in alginate beads. The acid medium has a greater efficiency for the caffeine adsorption and the adsorbent calcination temperature exerts, due to structural changes. Caffeine removal higher than 90% was obtained at optimized conditions. The Langmuir model indicated a better fit of the data and the adsorption capacity of caffeine onto bentonite. The bentonite immobilized led to a slower adsorption process in relation to the suspended.

Consumo excesivo de cafeína y eventuales poblaciones de riesgo / Excessive caffeine consumption and eventual risk populations

La cafeína (1,3,7-trimetilxantina), es uno de los componentes alimentarios más consumidos y estudiados. Aunque un consumo moderado no implica riesgos para la salud, un ingesta excesiva puede conducir a efectos adversos, tales como ansiedad, irritabilidad, palpitaciones e insomnio. Con el propósito de caracterizar el riesgo para la salud en mujeres adultas de 18 a 70 años en Argentina, se abordaron los siguientes objetivos: determinar el contenido de cafeína en cinco bebidas disponibles en el mercado argentino y con estos datos y otros de fuentes bibliográficas estimar la ingesta media diaria de esta sustancia en dicha población para establecer si existen grupos en riesgo, estudiar la relación de dicha ingesta con el lugar de residencia y determinar el aporte de cada bebida y alimento a la ingesta diaria total. La determinación de cafeína se realizó por cromatografía líquida de alta resolución (HPLC). A través de un cuestionario distribuido en la web, se obtuvieron datos de consumo de cafeína de 1947 mujeres que cumplieron el criterio de inclusión. Se encontraron contenidos más altos de cafeína en café expreso (1300 mg/L) y mate cebado (950 mg/L). En el total de la muestra el consumo promedio de cafeína fue de 340 mg/día (5,5 mg/kg/día), excediendo, el 31% de las participantes la ingesta recomendada de 400 mg/día. De las mujeres en edad fértil, el 37% excedió la ingesta de 300 mg/día y el 52% la de 200 mg/día, recomendadas durante la gestación y la lactancia. En el percentil 90 estas mujeres consumieron 851 mg/día y 775 mg/día de cafeína, respectivamente. El mate cebado y el café resultaron los mayores contribuyentes a la ingesta diaria de cafeína en este grupo de mujeres y en la muestra total. Se encontraron diferencias regiona­les en el consumo del mate cebado, resultando Misiones y Corrientes las provincias de mayores ingestas. Si bien el 68% de las personas entrevistadas consumieron dosis moderadas de cafeína, más de un cuarto de las mujeres en edad reproductiva excedió las ingestas recomendadas para el embarazo y la lactancia.

Caffeine (1,3,7-trimethylxanthine) is one of the most consumed and studied food ingredients. Although moderate consumption does not imply health risks, excess intake may lead to adverse effects, such as anxiety, irritability, palpitations and insomnia. In order to characterize the health risk in adult women aged 18 to 70 in Argentina, the following objectives were ad­dressed: to determine the caffeine content in five beverages available in the Argentine market and with these data and others from bibliographic sources estimate the daily intake of caffeine in this population to establish if there are groups at risk; to study the relation of this intake with the place of residence and to determine the contribution of each beverage and food to the total daily intake. The determination of caffeine was performed by high performance liquid chromatography (HPLC). Through a questionnaire distributed on the web, caffeine consumption data were obtained from 1947 women who met the inclusion criteria. Higher caf­feine contents were found in espresso coffee (1300 mg/L) and mate "cebado" (950 mg/L). In the sample, mean caffeine intake was 340 mg/day (5.5 mg/kg/day), with 31% of the participants exceeding the recommended intake of 400 mg/day. Of the women of childbearing age, 37% exceeded the intake of 300 mg/day and 52% the intake of 200 mg/day recommended during gestation and lactation. In the 90th percentile, these women consumed 851 mg/day and 775 mg/day of caffeine, respectively. Mate "cebado" and coffee were the major contributors to daily caffeine intake in this group of women and in the total sample. Regional differences were found in the consumption of mate "cebado", being Misiones and Corrientes the provinces with the highest intakes. Although 68% of the people interviewed consumed moderate doses of caffeine, more than a quarter of the women of reproductive age exceeded the recommended intakes for pregnancy and lactation.

The effects of different doses of caffeine on performance, rating of perceived exertion and pain perception in teenagers female karate athletes

ABSTRACT The present study set to examine the effects of different doses of caffeine on performance, rating of perceived exertion (RPE), and pain perception in female teenager athletes of karate. Ten female karate athletes (16.8±1.23 years; height 1.59±0.28 m; body-mass 57.73±8.33 kg; BMI 22.71±3.05 kg/m2) participated in the study. A double-blind, randomized, and crossover counterbalanced design was used. In three sessions (with an interval of seven days'), ten female karate athletes ingested low dose (2 mg/kg), moderate dose (5 mg/kg) caffeine, and placebo. Sixty minutes after consumption, they performed the tests as below: one repetition maximum and 60% of one repetition maximum in the leg press, explosive power test, and anaerobic RAST test. After the tests, the participants' RPE (6-20 scale) and pain perception (0-10 scale) were recorded using various categorical scales. The results showed that caffeine ingestion at moderate dose significantly reduced RPE and pain perception values compared with the placebo during muscular endurance test (P=0.0001 and P=0.039, respectively). The findings suggest that caffeine dose of 5 mg/kg body mass appears to improve RPE and pain perception in female teenager athletes of karate. The dose of 2 mg/kg body mass does not confer any additional improvement in performance.

Caffeine in Brazil: intake, socioeconomic and demographic determinants, and major dietary sources

Background: The objectives of the study were to describe caffeine intake by 10 years of age or older Brazilian individuals and to investigate possible associations with demographic and socioeconomic determinants as well as the major dietary sources. Methods: The data used are from the personal food consumption module (n= 34,003) of a country-representative household budget survey. Consumed foods and beverages were identified during the application of food diaries. Caffeine contents in food and beverage sources were obtained primarily in national publications. Multivariate regressions were calculated to assess the correlations between population factors and caffeine intake. Results: The daily intake per person was estimated as 115.7 mg, ranging from 84.7 mg, for 10­13 years of age children and adolescents, to 139.8 mg, for individuals with no education. The percentage of individuals whom diet reveals daily caffeine intake higher than 400 mg is up to 3.0 %, according to age groups. Males and individuals living in the Northeast or South regions or in the states of Minas Gerais, Rio de Janeiro, and Espírito Santo are likely to ingest higher contents of the substance. The major dietary sources are coffee (63.1 %) and coffee with milk (24.9 %), cola soft drinks (3.6 %) and yerba mate (1.9 %).Conclusions: Caffeine intake in Brazil is below the recommended limit reference value for adults, and the percentage of individuals whom diet reveals excessive content of caffeine is low. Thus, excessive caffeine intake may not be a health issue in Brazil and depends on the domicile and gender. The major source in the Brazilian diet is coffee.

Intake of stimulant foods is associated with development of parasomnias in children / Ingestão de alimentos estimulantes está associada ao desenvolvimento de parassonias em crianças

ABSTRACT Objective To verify if nighttime feeding habits can influence parasomnia in children. Method Seven private and four public Elementary Schools took part in the study. A total of 595 Sleep Disturbance Scale for Children were distributed to the parents of children aged from 7 to 8 years. Data of dietary recall, starting time to school, physical activity, and nutritional status were studied. Results Of the 226 questionnaires completed, 92 (41%) reported parasomnia. Girls had 2.3 times more the chance to parasomnia than boys. Children who consumed stimulant foods had 2.6 times more chance to have parasomnia than those of children who consumed non-stimulant foods. There were no difference between parasomnia and no-parasomnia groups in food type (p = 0.78) or timing of last meal before bedtime (p = 0.50). Conclusion Our findings suggest that intake of stimulant foods is associated with development of parasomnia in children.

RESUMO Objetivo Verificar se hábitos de alimentação noturna influenciam parassonias em crianças. Método Sete escolas privadas e quatro públicas, de Ensino Fundamental, fizeram parte do estudo. Um total de 595 Escalas de Distúrbio do Sono para Crianças foram distribuídas para os pais de crianças entre 7 e 8 anos. Dados de recordatório alimentar, período escolar, atividade física e estado nutricional foram estudados. Resultados Dos 226 questionários preenchidos, 92 (41%) relataram presença de parassonias. Meninas tiveram 2,3 vezes mais chance de parassonias e crianças que consumiram alimentos estimulantes tiveram 2,6 vezes mais chance de parassonias em relação àquelas que consumiram alimentos não estimulantes. Não houve diferença entre os grupos em relação ao tipo de alimento (p = 0,78) ou horário da última refeição antes de ir para a cama (p = 0,50). Conclusão Nossos achados sugerem que a ingestão de alimentos estimulantes está associada com o desenvolvimento de parassonias em crianças.

Efeitos da ingestão de cafeína durante a gestação e a lactação sobre a pele de ratas e de filhotes e sua relação com as concentrações séricas do cortisol materno / Effects of caffeine intake during pregnancy and lactation on the skin of rats and offspring and their relationship to maternal serum concentrations of cortisol

O objetivo deste trabalho foi verificar os efeitos da ingestão materna de diferentes doses de cafeína durante a gestação e a lactação, na pele de ratas-mães e filhotes, bem como sua relação com as concentrações séricas do cortisol materno. Vinte e quatro ratas Wistar adultas foram distribuídas em quatro grupos, representados pelo controle e tratados, com cafeína nas doses de 25, 50 e 100mg/kg. Os grupos tratados receberam cafeína por sonda orogástrica durante toda a gestação e a lactação. O controle recebeu água destilada como placebo. Foram avaliados e quantificados os diferentes tipos de folículos pilosos e a espessura da epiderme. A técnica de imuno-histoquímica, com o uso do anticorpo anti-CDC47, foi utilizada para avaliar a proliferação celular da epiderme e dos folículos pilosos das mães. Na mãe, também foram mensurados os níveis séricos de cortisol pela técnica da quimioluminescência. Os dados foram submetidos à análise de variância com comparação das médias pelos testes Kruskal-Wallis e SNK. Nos grupos tratados com cafeína nas doses de 25 e 50mg/kg, tanto as mães quanto seus filhotes apresentaram hipotricose e/ou alopecia focal. Apesar de a frequência de alterações macroscópicas das mães ter sido superior a dos filhotes, nestes as lesões, quando presentes, foram difusas. A análise histológica demonstrou calcinose de folículos pilosos nas mães e nos filhotes. Mas a morfometria somente revelou diferença significativa no número de folículos pilosos das mães, bem como redução significativa da proliferação celular dos folículos pilosos do grupo tratado com 50mg/kg de cafeína. Os níveis de cortisol materno somente foram significativamente elevados no grupo tratado com 100mg/kg de cafeína. Conclui-se que a cafeína ingerida pelas ratas gestantes e lactantes pode causar lesões cutâneas tanto nas mães quanto nos filhotes, caracterizadas por hipotricose e/ou alopecia, independentemente dos níveis séricos do cortisol materno.

The aim of this study was to investigate the effects of maternal caffeine intake during pregnancy and lactation on the skin of rats and their offspring, as well as their relationship to maternal serum levels of cortisol. 24 adult Wistar rats were equally divided into four groups represented by the control and treated with caffeine at doses of 25, 50 and 100mg/kg. The groups received caffeine by orogastric tube during the entire pregnancy and lactation. The control received distilled water as placebo. Different types of hair follicles and the thickness of the epidermis were assessed and quantified. Immunohystochemistry technique using antibody anti-CDC47 was used to evaluate cellular proliferation of the epidermis and hair follicles of the mothers. Also in the mothers, serum levels of cortisol were measured by the chemiluminescence technique. Data were submitted to analysis of variance comparing mediums by Kruskall Wallis Test and SNK. In groups treated with caffeine 25 and 50mg/kg, both mothers and their puppies had focal alopecia and/or hypotrichosis. Despite the higher frequency of macroscopic changes on the mothers, these lesions were diffuse when present on the puppies. Histological analysis showed calcinosis of hair follicles in the mothers and their puppies. But morphometry revealed significant difference in the number of hair follicles from mothers, as well as a significant reduction of cell proliferation of hair follicles in the group treated with 50mg/kg of caffeine. Maternal cortisol levels were significantly elevated in the group treated with 100mg/kg of caffeine. It is concluded that caffeine intake by pregnant and lactating rats can cause skin lesions in both the mothers and their offspring, characterized by alopecia and/or hypotrichosis, regardless of serum levels of maternal cortisol.

Caffeine increases Nr1i3 expression and potentiates the effects of its ligand, TCPOBOP, in mice liver / A cafeína aumenta a expressão Nr1i3 e potencializa os efeitos do seu ligando, TCPOBOP, em fígado de camundongos

Caffeine is one of the world's most consumed substances. It is present in coffee, green tea and guarana, among others. The xenobiotic-sensing nuclear receptor subfamily 1, group I, member 3 (Nr1i3), also known as the Constitutive Androstane Receptor (Car) is a key regulator of drug metabolism and excretion. No consistent description of caffeine effects on this receptor has been described. Thus, to unravel the effects of caffeine on this receptor, we performed experiments in mice. First, C57Bl/6 mice that were treated daily with caffeine (50 mg/kg) for 15 days presented a slight but significant increase in Nr1i3 and Cyp2b10 gene expression. A second experiment was then performed to verify the effects of caffeine on TCPOBOP (1,4-bis-[2-(3,5-dichloropyridyloxy)]benzene, 3,3′,5,5′-tetrachloro-1,4-bis(pyridyloxy)benzene), the most potent agonist known for mice Nr1i3. Interestingly, caffeine potentiated TCPOBOP pleiotropic effects in mice liver, such as hepatomegaly, hepatotoxicity, hepatocyte proliferation and loss of cell-to-cell communication through gap junctions. In addition, caffeine plus TCPOBOP treatment increased liver gene expression of Nr1i3 and Cyp2b10 comparing with only caffeine or TCPOBOP treatments. Together, these results indicate that caffeine increases the expression of Nr1i3 in mice liver, although at this point it is not possible to determine if Nr1i3 directly or indirectly mediates this effect...

A cafeína é uma das substâncias mais consumidas mundialmente, estando presente no café, chá-verde e guaraná, entre outros. O receptor sensor de xenobióticos Receptor Nuclear subfamília 1, grupo I, membro 3 (Nr1i3, mais conhecido como Androstano Consititutivo - Car) é um regulador chave da biotransformação e excreção de substâncias e nenhuma descrição consistente dos efeitos da cafeína sobre este receptor foi feita. Então, para avaliar os efeitos da cafeína sobre este receptor, realizamos experimentos em camundongos. Primeiramente, camundongos C57/Bl/6 foram tratados diariamente com cafeína (50 mg/kg) por 15 dias e apresentaram um leve, mas significativo, aumento na expressão do Car e do seu gene alvo Cyp2b10. Assim, um segundo experimento foi realizado para verificar os efeitos da cafeína sobre o TCPOBOP (1,4-bis-[2-(3,5-dicloropiridiloxi)]benzeno,3,3′,5,5′-tetracloro-1,4-bis(piridiloxi)benzeno), o mais potente agonista do Nr1i3 de camundongos conhecido. Interessantemente, a cafeína potencializou os efeitos pleiotrópicos do TCPOBOP no fígado dos camundongos, como hepatomegalia, hepatotoxicidade, proliferação celular e perda da comunicação intercelular por junções do tipo gap. Os camundongos tratados com cafeína e TCPOBOP apresentaram maior expressão gênica de Nr1i3 e Cyp2b10, quando comparados aos camundongos tratados apenas com cafeína ou TCPOBOP. Juntos, nossos resultados indicam que a cafeína aumenta a expressão do receptor CAR em fígados de camundongos C57/Bl/6, porém nesta etapa ainda não é possível afirmar se estes efeitos são direta ou indiretamente mediados pelo Nr1i3...

Validación de un método cromatográfico para la determinación de cafeína en muestras acuosas de la Industria Farmacéutica / Validation of a chromatographic method for determination of caffeine content in aqueous samples of the drug industry

Introducción: la cafeína es una sustancia que se encuentra en algunas plantas como el café, el té, el cacao, además es un ingrediente de algunos medicamentos como los analgésicos, es estimulante metabólico y del sistema nervioso central. Su consumo agudo o crónico puede dar lugar a una variedad de efectos adversos. Debido a su uso en la industria farmacéutica su determinación adquiere gran importancia. La validación de un método analítico demuestra científicamente que es adecuado para una aplicación específica, como la determinación de ingredientes farmacéuticos activos en disoluciones acuosas. Objetivo: validar un método analítico para la cuantificación por Cromatografía Líquida de Alta Resolución de la cafeína presente en disoluciones acuosas y la determinación de su contenido en muestras residuales acuosas de un laboratorio farmacéutico productor de medicamentos. Métodos: la validación del método cromatográfico se llevó a cabo empleando una columna RP-18 de 250 × 4,6 mm, 5 µm; Fase móvil: agua­CH3OH (70/30); flujo: 1,0 mL/min y un detector ultravioleta visible a 254 nm. La determinación de la cafeína se efectuó por el método validado según las regulaciones internacionales vigentes. Resultados: el método resultó selectivo frente a los productos de ozonización, lineal (r= 0,999 y r2= 0,999), preciso, exacto, robusto y sensible, en el intervalo de 1 × 10-4 mol/L a 2 × 10-3 mol ̸ L. Se evaluó la estabilidad del analito en las condiciones de análisis. El contenido de cafeína en aguas residuales de la industria farmacéutica productora del medicamento fue determinado en concentraciones inferiores a 3 × 10-4 mol/L. Conclusiones: el método validado fue selectivo, lineal, preciso, exacto y robusto en el intervalo de concentraciones analizado y permite la determinación de cafeína y del analito en disolución acuosa en muestras residuales acuosas del laboratorio farmacéutico productor del medicamento en Cuba(AU)

Introduction: caffeine is a substance located in some plants like coffee, tea, cocoa; it is also an ingredient of some drugs such as analgesics, a metabolic and central nervous system stimulant. The consumption of caffeine either acute or chronic may give rise to a variety of adverse effects. Due to its use in the drug industry, it is vitally important to determine it. The validation of an analytical method scientifically proves that it is adequate for a particular application as in the case of determination of active ingredients in aqueous solutions. Objective: to validate an analytical method for the quantitation by means of high performance liquid chromatography of the caffeine content in aqueous solutions and in wastewater samples from a drug manufacturing laboratory. Methods: the validation of the chromatographic method was performed by using a RP­18 de 250 x 4,6 mm, 5 µm column, a mobile phase: water/ CH3OH (70/30); Flow: 1,0 mL/min and an ultraviolet detector at 254 nm. The caffeine content was estimated by the high performance liquid chromatograpy following the international regulations in force. Results: the method was selective against the ozonization products, linear r = 0.999 y r2 = 0.999), precise, accurate, robust and sensitive in the 1x10-4mol/L to 2x10-3mol/L interval. The analyte stability was also evaluated under the analysis conditions. The caffeine content in wastewaters of the drug manufacturing industry was determined at concentrations lower than 3x10-4 mol/L. Conclusions: the validated method was selective, linear, precise, accurate and robust in the analyzed interval of concentrations and allows estimating the caffeine content in aqueous solutions and of the analyte in wastewater samples from a pharmaceutical laboratory that produces the drug in Cuba(AU)

Effects of the reduction of caffeine consumption on tinnitus perception / Efeitos da redução no consumo de cafeína sobre a percepção do zumbido

INTRODUCTION: For many years, excessive caffeine consumption has been touted as an aggravating factor for tinnitus. The pathophysiology behind this effect is probably related to the blockage of adenosine receptors by the action of caffeine on the central nervous system. OBJECTIVE: To evaluate the effects of reduction of coffee consumption on tinnitus sensation and to identify subgroups more prone to benefit from this therapeutic strategy. Study design: prospective. METHODS: Twenty-six tinnitus patients who consumed at least 150 mL of coffee per day were selected. All were asked to reduce their coffee consumption. The Tinnitus Handicap Inventory (THI) questionnaire was completed by the patients before and after the reduction of coffee consumption, as well as a visual-analogue scale (VAS) graduated from 1 to 10. RESULTS: THI and VAS scores were significantly reduced (p < 0.05). In the subgroups less than 60 years old, bilateral tinnitus and daily coffee consumption between 150 and 300 mL showed a significantly greater reduction of THI and VAS scores. CONCLUSION: Patients under 60 years of age with bilateral tinnitus and daily coffee consumption between 150 and 300 mL are more prone to benefit from consumption reduction. Thirty-day observation periods may be helpful for a better therapeutical decision. .

INTRODUÇÃO: O consumo abusivo de cafeína vem sendo descrito como fator de piora e causa do zumbido há muitos anos. A fisiopatologia deste efeito está provavelmente relacionada ao bloqueio dos receptores inibitórios adenosínicos pela cafeína no sistema nervoso central. OBJETIVO: Avaliar os efeitos da redução do consumo de cafeína na percepção do zumbido e identificar subgrupos de pacientes mais propensos a benefícios com esta proposta. Tipo de estudo: prospectivo. MÉTODO: Selecionados 26 pacientes com zumbido neurossensorial e consumo diário superior a 150 mL de café. Os efeitos da redução do consumo foram avaliados através do Tinnitus Handicap Inventory (THI) e da escala visual-análoga (EVA). RESULTADOS: Houve redução estatisticamente significativa (p < 0,05) nos escores do THI e EVA. Nos subgrupos com idade inferior a 60 anos, zumbido bilateral e consumo diário de café entre 150 e 300 mL apresentaram maior redução dos escores THI e EVA. CONCLUSÃO: Em pacientes com idade inferior a 60 anos, zumbido bilateral e consumo diário de café entre 150 e 300 mL apresentaram benefícios com a redução no consumo diário de cafeína. Períodos observacionais de 30 dias podem ser úteis para a decisão terapêutica. .

Dispepsia / Dyspepsia

Etmologicamente, a palavra dispepsia (do grego dis = difícil e pepse = digestão) significa digestão difícil. Sob o ponto de vista clínico, corresponde a uma série de sintomas de origem gastroduodenal, como dor, queimação ou desconforto epigástrico, plenitude pós-prandial ou saciedade precoce associadas ou não a náusea, vômitos e distensão em andar superior do abdome. Traduz, pois, um distúrbio funcional ou orgânico, de localização epigástrica e origem gastroduodenal...

Etymologically, the greek word dis means hard and pepse means digestion. Therefore, dyspepsia is a poor digestion. From the clinical point of view, dyspepsia corresponds to a range of symptoms originated from gastroduodenal, like pain, heartburn or epigastric discomfort, postprandial fullness or early fullness related or not to nausea, vomiting, upper abdominal distension. So, this explain that a functional or organic decline situated at the epigastric area and it is originated from gastroduodenal...

Café: uma bebida rica em substâncias com efeitos clínicos importantes, em especial a cafeína / Coffee: a beverage rich in substances with important clinical effects, especially caffeine

O café é uma das bebidas mais populares do mundo, chegando ao consumo aproximado de 6,7 milhões de toneladas por ano. Há certo tempo, alguns dos seus efeitos fisiológicos, relacionados a uma gama de substâncias encontradas na bebida, estão sendo amplamente estudados. Alguns estudos destacam a cafeína como uma substância fundamental para os efeitos estudados desta bebida. O trabalho objetivou discernir e ressaltar alguns efeitos clínicos relevantes da cafeína. Nesse sentido, foi realizada uma busca de trabalhos que valorizam as propriedades clínicas do café, que ressaltam algumas de suas substâncias, e estudos específicos sobre a cafeína, que a atribuem uma abordagem clínica. Foram definidos pelos autores alguns aspectos positivos e negativos dos efeitos clínicos provocados pela cafeína. Assim, reforça-se a discussão sob as perspectivas de uso da cafeína, seja na alimentação, como medicamento ou em estudos de parâmetros clínicos para diabetes tipo 2, arritmias, parada cardíaca, infarto agudo não fatal do miocárdio, Parkinson e Alzheimer. É preciso atribuir, nesse contexto, certa ponderação ao seu uso, relevando a vulnerabilidade do indivíduo e as manifestações clínicas atribuídas à cafeína...

Coffee is one of the most popular beverages in theworld, with an approximate consumption of 6.7 million tons per year. Some of the physiological effects of a variety of substances found in the beverage are being widely studied. Some research highlights caffeine as a substance crucial to coffee?s biological effects. The aim of this study was to discern and highlight some of the relevant clinical effects of caffeine. To this end, we made a search for studies related to the clinical properties of coffee, which highlighted some of its main substances, and studies specifically about caffeine, which followed a clinical approach. The authors defined some positive and negative features of the clinical effects provoked by caffeine. Thus, the prospects of using caffeine, in food, as a medicine or in clinical parameter studies of type 2 diabetes, arrhythmia, cardiac arrest, nonfatal acute myocardial infarction, Parkinson and Alzheimers disease, were well discussed. In this context, it is very important to give responsible consideration to theuse of caffeine, keeping in mind the vulnerability of the individual and the clinical manifestations of this substance...

Paradoxo do cálcio - o que temos a temer? / The calcium paradox - What should we have to fear?

O paradoxo do cálcio foi pela primeira vez citado em 1966 por Zimmerman et al. A partir daí, ganhou grande interesse por parte da comunidade científica internacional devido ao fato da ausência do íon cálcio produzir na célula muscular cardíaca dano semelhante à lesão de isquemia-reperfusão. Apesar de não serem conhecidos todos os mecanismos envolvidos no processo da lesão celular no paradoxo do cálcio, a conexão intercelular mantida somente pelo nexus parece ter papel chave na fragmentação celular. A adição de pequenas concentrações de cálcio, bloqueadores de canal de cálcio, hiponatremia ou hipotermia são importantes para evitar que haja lesão celular no momento da reperfusão com soluções com concentração fisiológica de cálcio.

The calcium paradox was first mentioned in 1966 by Zimmerman et al. Thereafter gained great interest from the scientific community due to the fact of the absence of calcium ions in heart muscle cells produce damage similar to ischemia-reperfusion. Although not all known mechanisms involved in cellular injury in the calcium paradox intercellular connection maintained only by nexus seems to have a key role in cellular fragmentation. The addition of small concentrations of calcium, calcium channel blockers, and hyponatraemia hypothermia are important to prevent any cellular damage during reperfusion solutions with physiological concentration of calcium.

Insônia e doença cardiovascular: marcadores inflamatórios e risco aumentado de cardiopatias / Insomnia and cardiovascular disease: inflammatory markers and risk of heart disease

Estima-se que aproximadamente um quarto dos adultos apresente queixas relacionadas ao sono: dificuldades para iniciar ou manter o sono, despertar precoce, sonolência diurna, pesadelos, terror noturno, entre outras. A maioria dos adultos jovens dorme de sete a oito horas por noite, mas a quantidade de sono oscila ao longo da vida, com tendência à diminuição das horas na medida em que se envelhece.

It is estimated that about a quarter of adults present sleep complaints such as: difficulty to sleep through the night, early-morning awakening, somnolency all day long, nightmares, night terrors, among others symptoms. Most young adults sleep 7 to 8 hours per night, but the sleep amount oscillates lifelong trending towards hours reduction as people grow older.

Avaliação dos efeitos da cafeína sobre a modulação autonômica e o ritmo cardíaco em pacientes com queixa de palpitações / Evaluation of the caffeine effects about the cardiac autonomic modulation and rhythm in patients with palpitations

A cafeína pertence ao grupo das metilxantinas e apresenta efeitos farmacológicos que podem contribuirpara o desencadeamento de arritmias cardíacas, com o aumento da estimulação simpática. Objetivo: Avaliara associação entre o consumo de cafeína e o desencadeamento ou o agravamento de arritmias cardíacas e suainfluência sobre o tônus autonômico. Método: Foram avaliados 51 pacientes submetidos ao Holter de 24 horasdevido a queixa de palpitação. O Holter avaliou a presença de diferentes arritmias e tônus autonômico por meiode índices de variabilidade da frequência cardíaca, principalmente do SDNN. Todos os pacientes preencheramum diário alimentar durante o período do registro. Estes foram avaliados por uma nutricionista por meio dosoftware NutWin 1.5 para quantificar a ingestão de cafeína e outros nutrientes. Os indivíduos foram divididos emdois grupos de acordo com a mediana do consumo de cafeína (35 mg). Resultados: O consumo médio diário decafeína foi de 14 ± 15 mg no grupo de menor consumo (n=27) vs. 100 ± 61 mg no grupo de maior consumo (n=24)(p<0,0001). Não foi observada associação entre o maior consumo de cafeína e qualquer extrassístole ventricular ousupraventricular isolada, pareada, > 10 ectopias/hora ou taquicardia ventricular ou supraventricular (p>0,05). Nogrupo de maior consumo, observou-se tendência de maior estimulação simpática, predominantemente durante operíodo do sono. Contudo, a análise restrita a esse período também não mostrou associação com o desencadeamentode qualquer arritmia. Conclusão: O consumo leve a moderado de cafeína (aproximadamente 100 mg/dia) não seassociou com o desencadeamento de qualquer arritmia, apesar de acarretar um discreto aumento da estimulaçãosimpática, principalmente durante o período do sono.

Abstract: Objective: Caffeine belongs to the methylxanthine group and has pharmacological effects that maycontribute to the onset of cardiac arrhythmias such as sympathetic overstimulation. The objectives were to evaluatethe association between caffeine intake and the onset or worsening of cardiac arrhythmias and their influenceon the cardiac autonomic tonus. Methods: Fifty-one patients underwent a 24-hour Holter due to complaintsof palpitations. The Holter evaluated the presence of different arrhythmias and autonomic tonus according toheart rate variability rates, mainly the SDNN. A food diary was filled out by all patients throughout their Holterrecording and were evaluated by a dietician using the NutWin 1.5 software to quantify the intake of caffeine andother nutrients. Subjects were divided into two groups according to the median caffeine intake (35 mg). Results:The mean daily consumption of caffeine was 14 ± 15 mg in the lowest consumption group (n=27) vs. 100 ± 61 mgin the highest consumption group (n=24) (p<0.0001). No association was observed between higher caffeine intakeand supraventricular or ventricular isolated premature beats, paired premature beats, > 10 premature beats perhour or ventricular or supraventricular tachycardia (p>0.05). A trend of sympathetic overstimulation was observed.

Caffeine intake by patients with autosomal dominant polycystic kidney disease

Because caffeine may induce cyst and kidney enlargement in autosomal dominant polycystic kidney disease (ADPKD), we evaluated caffeine intake and renal volume using renal ultrasound in ADPKD patients. Caffeine intake was estimated by the average of 24-h dietary recalls obtained on 3 nonconsecutive days in 102 ADPKD patients (68 females, 34 males; 39 ± 12 years) and compared to that of 102 healthy volunteers (74 females, 28 males; 38 ± 14 years). The awareness of the need for caffeine restriction was assessed. Clinical and laboratory data were obtained from the medical records of the patients. Mean caffeine intake was significantly lower in ADPKD patients versus controls (86 vs 134 mg/day), and 63% of the ADPKD patients had been previously aware of caffeine restriction. Caffeine intake did not correlate with renal volume in ADPKD patients. There were no significant differences between the renal volumes of patients in the highest and lowest tertiles of caffeine consumption. Finally, age-adjusted multiple linear regression revealed that renal volume was associated with hypertension, chronic kidney disease stage 3 and the time since diagnosis, but not with caffeine intake. The present small cross-sectional study indicated a low level of caffeine consumption by ADPKD patients when compared to healthy volunteers, which was most likely due to prior awareness of the need for caffeine restriction. Within the range of caffeine intake observed by ADPKD patients in this study (0-471 mg/day), the renal volume was not directly associated with caffeine intake.