Predictive factors of the contracture test for diagnosing malignant hyperthermia in a Brazilian population sample: a retrospective observational study

Abstract Introduction Malignant Hyperthermia (MH) is a pharmacogenetic, hereditary and autosomal dominant syndrome triggered by halogenates/succinylcholine. The In Vitro Contracture Test (IVCT) is the gold standard diagnostic test for MH, and it evaluates abnormal skeletal muscle reactions of susceptible individuals (earlier/greater contracture) when exposed to caffeine/halothane. MH susceptibility episodes and IVCT seem to be related to individual features. Objective To assess variables that correlate with IVCT in Brazilian patients referred for MH investigation due to a history of personal/family MH. Methods We examined IVCTs of 80 patients investigated for MH between 2004‒2019. We recorded clinical data (age, sex, presence of muscle weakness or myopathy with muscle biopsy showing cores, genetic evaluation, IVCT result) and IVCT features (initial and final maximum contraction, caffeine/halothane concentration triggering contracture of 0.2g, contracture at caffeine concentration of 2 and 32 mmoL and at 2% halothane, and contraction after 100 Hz stimulation). Results Mean age of the sample was 35±13.3 years, and most of the subjects were female (n=43 or 54%) and MH susceptible (60%). Of the 20 subjects undergoing genetic investigation, 65% showed variants in RYR1/CACNA1S genes. We found no difference between the positive and negative IVCT groups regarding age, sex, number of probands, presence of muscle weakness or myopathy with muscle biopsy showing cores. Regression analysis revealed that the best predictors of positive IVCT were male sex (+12%), absence of muscle weakness (+20%), and personal MH background (+17%). Conclusions Positive IVCT results have been correlated to male probands, in accordance with early publications. Furthermore, normal muscle strength has been confirmed as a significant predictor of positive IVCT while investigating suspected MH cases.

Association between caffeine use disorder and socio-demographic characteristics (sex, employment and smoking status) of Quezon City residents: An analytical cross-sectional study / The Health Sciences Journal

Introduction@#Caffeine use disorder (CUD), a problematic caffeine use pattern, is yet to be recognized under DSM-5 and is under consideration for further research. This study aimed to determine if the sex, employment status, and smoking status of Quezon City residents aged 18 years old and above are associated with CUD, and to determine the mean daily caffeine consumption (MDCC) of caffeinated products and the proportion of individuals meeting the CUD criteria.@*Methods@#A total of 334 respondents accomplished the online survey that collected socio-demographic information and evaluated CUD using an 8-point Caffeine Consumption Questionnaire (CCQ). @*Results@#The study population was mostly composed of females, unemployed, and non-smokers. Results showed that 17% of respondents have CUD, that brewed coffee was most consumed daily, the MDCC of the study population was 158.31 mg; and females were at an increased risk for CUD, while nonsmokers and unemployed individuals were at reduced risk. @*Conclusion@#The proportion of Quezon city residents that have CUD is at 17%, consuming an average of 158.31 mg of coffee daily, with brewed coffee being consumed most. Female residents are at an increased risk of having CUD, while nonsmokers and unemployed individuals are at a decreased risk.

Development and validation of an analytical method by HPLC-DAD for determination of caffeine in products based on guarana extracts (Paullinia cupana)

Abstract Guarana (Paullinia cupana) is a native plant from the Amazon whose seeds contain a high concentration of caffeine. Aqueous extract of guarana is widely used in the world. In this study, the objective was to develop and validate a High-Performance Liquid Chromatography method for the determination of caffeine in extracts and commercial beverages based on guarana. A sensitive, simple, and viable high performance liquid chromatographic method without the need of an analyte extraction procedure was developed and validated according to Brazilian and international requirements. The method presented high performance, fulfilling Brazilian and international requirements, in addition to allowing product compliance tests. Results confirmed high selectivity and linearity (>0.999) between 5 to 135 ug/mL, with no significant matrix effect. Detection and quantification limits were 0.02 µg/mL and 2 µg/mL, respectively. Precision was less than 4 %, and accuracy varied from 99.9-120 %. Applicability of the method was demonstrated by conducting a limited evaluation in products containing caffeine. Commercial extracts showed quite different caffeine levels, while carbonated drinks follow Brazilian and American recommendations. Our results indicate that the developed method can be used to evaluate the quality of the guarana extract and of products containing caffeine

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.

Quality of cosmetics with active caffeine in cream and gel galenic bases prepared by compounding pharmacies / Qualidade de cosméticos com cafeína ativa em bases galênicas em creme e gel preparadas por farmácias de manipulação

As there is a great scarcity of studies on the importance of good compounding practices in the preparation of cosmetics, this study aimed to evaluate the quality control of cosmetics with active ingredient caffeine for the treatment of cellulite prepared by magistrals pharmacies. Microbiological analyzes, pH determination, color measurement, quantification of the percentage of the active ingredient caffeine and viscosity in creams and gels with 5% of the active ingredient caffeine were performed. In the microbiological analysis, the presence of molds and yeasts was verified above the permitted level according to the Brazilian pharmacopoeia. The pH decreased over time, contributing to the formulations becoming more acidic. In the color parameters, it was found that pharmacy F4 showed a brownish color, both for the gel and for the cream. The percentage of caffeine was within specifications in all formulations and the viscosity remained unchanged during the shelf life of the samples. It is important that the compounding pharmacies demand more effectively the commitment of the team, as well as the analysis of the raw material according to the microbiological control regulations to translate into the quality of the products prepared by the pharmacies and favor the consumer in the effective objective that the product you want to achieve.

Como há uma grande escassez de estudos sobre a importância de boas práticas de manipulação na elaboração de cosméticos, o presente estudo teve como objetivo avaliar o controle de qualidade de cosméticos com princípio ativo cafeína para o tratamento de celulite, elaborados por farmácias de manipulação de Campo Mourão. Foram realizadas análises microbiológicas, determinação do pH, mensuração da coloração, quantificação da porcentagem do princípio ativo cafeína e viscosidade em cremes e geís com 5% do princípio ativo cafeína. Nas análises microbiológicas foi verificada a presença de bolores e leveduras acima do pemitido segundo a farmacopéia brasileira. O pH diminuiu ao longo do tempo, contribuindo para que as formulações ficassem mais ácidas. Nos parâmetros de cor averiguou-se que a farmácia F4 apresentou uma coloração amarronzada, tanto para o gel quanto para o creme. A porcentagem de cafeína estava dentro das especificações em todas as formulações e a viscosidade se manteve inalterada durante o prazo de validade das amostras. Com o propósito de um melhor preparo magistral é importante que as farmácias de manipulação exijam de forma mais eficaz o comprometimento da equipe, bem como a análise da matéria-prima segundo as regulamentações de controle microbiológico. Além disso, a implementação de normas mais rígidas e o melhor controle da matéria-prima e das formulações finais fazem com que a qualidade dos produtos manipulados pelas farmácias magistrais seja aumentada significativamente, favorecendo o consumidor na efetiva finalidade a que o produto objetiva atingir.

Challenges of nanotechnology in cosmetic permeation with caffeine / Desafios da nanotecnologia na permeação cosmética com cafeína

The evolution of beauty market and personal care is constant in Brazil as well in the rest of the world. Technological advances have brought up nanotechnology to the cosmetological field, employing active principles at atoms enveloped by vesicles, in order to take the active principle precisely to the target tissue to optimize the results achieved because of the considerable ease to cross skin barriers. Manufacturing of nanotechnology cosmetics is confronted with low absorption capacity. One of the many active principle found in cosmetic industry is caffeine, a pseudoalkaloid from the xanthine group used as a stimulant with the mechanism of the lipolytic action. This active is widely used in a esthetics and cosmetics field in treatments involving dysfunctions such as localized fat and fibroedema geloid. To work out perfectly, the principle active need to interact and create a set of factors that includes lipolysis intensification. The caffeine encapsulation in gel-based nanocosmetics has the purpose of taking this active up to the adipocyte, the target cell, for mentioned dysfunctions treatment. Thus, we aim to present a review of how has been, the use of caffeine in the production of cosmetics.

A evolução do mercado de beleza e cuidados pessoais é constante no Brasil e no resto do mundo. Os avanços tecnológicos trouxeram a nanotecnologia para o campo cosmetológico, empregando princípios ativos em átomos envolvidos por vesículas, a fim de levar o princípio ativo precisamente ao tecido alvo para otimizar os resultados alcançados devido à considerável facilidade de atravessar barreiras cutâneas. A fabricação de cosméticos nanotecnológicos é confrontada com baixa capacidade de absorção. Um dos muitos princípios ativos encontrados na indústria cosmética é a cafeína, um pseudoalocalóide do grupo xantina usado como estimulante no mecanismo da ação lipolítica. Este ativo é amplamente utilizado no campo da estética e dos cosméticos em tratamentos que envolvem disfunções, como gordura localizada e fibroedema gelóide. Para funcionar perfeitamente, o princípio ativo precisa interagir e criar um conjunto de fatores que inclui a intensificação da lipólise. O encapsulamento de cafeína em nanocosméticos à base de gel tem o objetivo de levar esse ativo até o adipócito, a célula alvo, para o tratamento de disfunções mencionado. Assim, objetivamos apresentar uma revisão de como tem sido o uso de cafeína na produção de cosméticos.

Recent research on gene polymorphisms related to caffeine therapy in preterm infants with apnea of prematurity / 中国当代儿科杂志

Apnea of prematurity (AOP) is one of the common diseases in preterm infants. The main cause of AOP is immature development of the respiratory control center. If AOP is not treated timely and effectively, it will lead to respiratory failure, hypoxic brain injury, and even death in severe cases. Caffeine is the first choice for the treatment of AOP, but its effectiveness varies in preterm infants. With the deepening of AOP research, more and more genetic factors have been confirmed to play important roles in the pathogenesis and treatment of AOP; in particular, the influence of single nucleotide polymorphism on the efficacy of caffeine has become a research hotspot in recent years. This article reviews the gene polymorphisms that affect the efficacy of caffeine, in order to provide a reference for individualized caffeine therapy. Citation.

Clinical effect of different maintenance doses of caffeine citrate in the treatment of preterm infants requiring assisted ventilation: a pilot multicenter study / 中国当代儿科杂志

OBJECTIVES@#To explore the optimal maintenance dose of caffeine citrate for preterm infants requiring assisted ventilation and caffeine citrate treatment.@*METHODS@#A retrospective analysis was performed on the medical data of 566 preterm infants (gestational age ≤34 weeks) who were treated and required assisted ventilation and caffeine citrate treatment in the neonatal intensive care unit of 30 tertiary hospitals in Jiangsu Province of China between January 1 and December 31, 2019. The 405 preterm infants receiving high-dose (10 mg/kg per day) caffeine citrate after a loading dose of 20 mg/kg within 24 hours after birth were enrolled as the high-dose group. The 161 preterm infants receiving low-dose (5 mg/kg per day) caffeine citrate were enrolled as the low-dose group.@*RESULTS@#Compared with the low-dose group, the high-dose group had significant reductions in the need for high-concentration oxygen during assisted ventilation (P=0.044), the duration of oxygen inhalation after weaning from noninvasive ventilation (P<0.01), total oxygen inhalation time during hospitalization (P<0.01), the proportion of preterm infants requiring noninvasive ventilation again (P<0.01), the rate of use of pulmonary surfactant and budesonide (P<0.05), and the incidence rates of apnea and bronchopulmonary dysplasia (P<0.01), but the high-dose group had a significantly increased incidence rate of feeding intolerance (P=0.032). There were no significant differences between the two groups in the body weight change, the incidence rates of retinopathy of prematurity, intraventricular hemorrhage or necrotizing enterocolitis, the mortality rate, and the duration of caffeine use (P>0.05).@*CONCLUSIONS@#This pilot multicenter study shows that the high maintenance dose (10 mg/kg per day) is generally beneficial to preterm infants in China and does not increase the incidence rate of common adverse reactions. For the risk of feeding intolerance, further research is needed to eliminate the interference of confounding factors as far as possible.

Challenges of nanotechnology in cosmetic permeation with caffeine / Desafios da nanotecnologia na permeação cosmética com cafeína

The evolution of beauty market and personal care is constant in Brazil as well in the rest of the world. Technological advances have brought up nanotechnology to the cosmetological field, employing active principles at atoms enveloped by vesicles, in order to take the active principle precisely to the target tissue to optimize the results achieved because of the considerable ease to cross skin barriers. Manufacturing of nanotechnology cosmetics is confronted with low absorption capacity. One of the many active principle found in cosmetic industry is caffeine, a pseudoalkaloid from the xanthine group used as a stimulant with the mechanism of the lipolytic action. This active is widely used in a esthetics and cosmetics field in treatments involving dysfunctions such as localized fat and fibroedema geloid. To work out perfectly, the principle active need to interact and create a set of factors that includes lipolysis intensification. The caffeine encapsulation in gel-based nanocosmetics has the purpose of taking this active up to the adipocyte, the target cell, for mentioned dysfunctions treatment. Thus, we aim to present a review of how has been, the use of caffeine in the production of cosmetics.

A evolução do mercado de beleza e cuidados pessoais é constante no Brasil e no resto do mundo. Os avanços tecnológicos trouxeram a nanotecnologia para o campo cosmetológico, empregando princípios ativos em átomos envolvidos por vesículas, a fim de levar o princípio ativo precisamente ao tecido alvo para otimizar os resultados alcançados devido à considerável facilidade de atravessar barreiras cutâneas. A fabricação de cosméticos nanotecnológicos é confrontada com baixa capacidade de absorção. Um dos muitos princípios ativos encontrados na indústria cosmética é a cafeína, um pseudoalocalóide do grupo xantina usado como estimulante no mecanismo da ação lipolítica. Este ativo é amplamente utilizado no campo da estética e dos cosméticos em tratamentos que envolvem disfunções, como gordura localizada e fibroedema gelóide. Para funcionar perfeitamente, o princípio ativo precisa interagir e criar um conjunto de fatores que inclui a intensificação da lipólise. O encapsulamento de cafeína em nanocosméticos à base de gel tem o objetivo de levar esse ativo até o adipócito, a célula alvo, para o tratamento de disfunções mencionado. Assim, objetivamos apresentar uma revisão de como tem sido o uso de cafeína na produção de cosméticos.

Quality of cosmetics with active caffeine in cream and gel galenic bases prepared by compounding pharmacies / Qualidade de cosméticos com cafeína ativa em bases galênicas em creme e gel preparadas por farmácias de manipulação

As there is a great scarcity of studies on the importance of good compounding practices in the preparation of cosmetics, this study aimed to evaluate the quality control of cosmetics with active ingredient caffeine for the treatment of cellulite prepared by magistrals pharmacies. Microbiological analyzes, pH determination, color measurement, quantification of the percentage of the active ingredient caffeine and viscosity in creams and gels with 5% of the active ingredient caffeine were performed. In the microbiological analysis, the presence of molds and yeasts was verified above the permitted level according to the Brazilian pharmacopoeia. The pH decreased over time, contributing to the formulations becoming more acidic. In the color parameters, it was found that pharmacy F4 showed a brownish color, both for the gel and for the cream. The percentage of caffeine was within specifications in all formulations and the viscosity remained unchanged during the shelf life of the samples. It is important that the compounding pharmacies demand more effectively the commitment of the team, as well as the analysis of the raw material according to the microbiological control regulations to translate into the quality of the products prepared by the pharmacies and favor the consumer in the effective objective that the product you want to achieve.

Como há uma grande escassez de estudos sobre a importância de boas práticas de manipulação na elaboração de cosméticos, o presente estudo teve como objetivo avaliar o controle de qualidade de cosméticos com princípio ativo cafeína para o tratamento de celulite, elaborados por farmácias de manipulação de Campo Mourão. Foram realizadas análises microbiológicas, determinação do pH, mensuração da coloração, quantificação da porcentagem do princípio ativo cafeína e viscosidade em cremes e geís com 5% do princípio ativo cafeína. Nas análises microbiológicas foi verificada a presença de bolores e leveduras acima do pemitido segundo a farmacopéia brasileira. O pH diminuiu ao longo do tempo, contribuindo para que as formulações ficassem mais ácidas. Nos parâmetros de cor averiguou-se que a farmácia F4 apresentou uma coloração amarronzada, tanto para o gel quanto para o creme. A porcentagem de cafeína estava dentro das especificações em todas as formulações e a viscosidade se manteve inalterada durante o prazo de validade das amostras. Com o propósito de um melhor preparo magistral é importante que as farmácias de manipulação exijam de forma mais eficaz o comprometimento da equipe, bem como a análise da matéria-prima segundo as regulamentações de controle microbiológico. Além disso, a implementação de normas mais rígidas e o melhor controle da matéria-prima e das formulações finais fazem com que a qualidade dos produtos manipulados pelas farmácias magistrais seja aumentada significativamente, favorecendo o consumidor na efetiva finalidade a que o produto objetiva atingir.

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

El consumo de café: su asociación con el riesgo de padecer cáncer / Coffee consumption: its association with the risk of cancer

RESUMEN El café y su impacto en la salud es un tema en el que resulta válido profundizar. Históricamente, el consumo de café se ha asociado con efectos adversos, como problemas cardiovasculares y varios tipos de cáncer. Pero en gran cantidad de fuentes bibliográficas contemporáneas se enfatiza en los efectos beneficiosos de su consumo, sin mencionar los daños que puede ocasionar a la salud. Se hace esta revisión bibliográfica con el objetivo de profundizar en lo más actualizado sobre los beneficios y perjuicios del consumo del café y su relación con la aparición del cáncer. En la revisión se consultaron artículos de las bases de datos PubMed, SciELO, ClinicalKey y LILACS. Se constató que el consumo de café no se asocia con la aparición de diferentes tipos de cánceres, y que el consumo moderado aporta propiedades protectoras para la salud. Teniendo en cuenta el carácter multifactorial del cáncer, los autores consideran que suponer que el consumo de esta bebida puede impedir carcinogénesis, es una tesis que debe ser interpretada con cautela (AU).

ABSTRACT Coffee and its impact on health is a topic on which it is valid to deepen. Historically, coffee consumption has been associated with side effects, such as cardiovascular problems and several types of cancer. But many contemporary bibliographic sources emphasize the beneficial effects of its consumption, without mentioning the damage it can cause to health. This bibliographic review is done with the aim of deepening into the most updated knowledge about the benefits and harms of coffee consumption and its relationship with the appearance of cancer. Articles from PubMed, SciELO, ClinicalKey and LILACS databases were reviewed. It was found that coffee consumption is not associated with the appearance of different types of cancers, and that moderate consumption provides protective properties for health. In view of the multifactorial character of cancer, the authors consider that assuming that the consumption of this drink can prevent carcinogenesis is a thesis that should be taken with caution (AU).

Administración crónica de cafeína evita la alteración de la glucosa postprandial en ratas / Chronic caffeine administration prevents postprandial glucose disturbance in rats

La administración crónica de cafeína evita la alteración de la glucosa postprandial en ratas. El aumento en el consumo de la cafeína alrededor del mundo no es discutible, es así como su investigación se ha vuelto extensa en sus diferentes campos. Objetivo. Analizar los efectos de la administración crónica de cafeína en ratas alimentadas con dieta de cafetería, a través de evaluar índices de consumo, antropométricos y bioquímicos. Materiales y métodos. La dieta de cafetería es un modelo dietético equivalente a las características de la dieta occidental típica que origina síndrome metabólico en humanos. En esta investigación se realizó la administración crónica vía intraperitoneal de cafeína por ocho semanas a ratas adultas macho Wistar alimentadas con dieta de cafetería. Dada la poca evidencia acerca de los efectos biológicos y comportamentales de la administración crónica de dicha sustancia frente a un modelo de dieta de cafetería se evaluaron parámetros de consumo, antropométricos y bioquímicos. Resultados. La dieta de cafetería ocasionó anomalías asociadas al síndrome metabólico; no obstante, la administración de cafeína en las ratas alimentadas con esa dieta resultó ser un factor protector en la glucosa postprandial, más no en la alteración de la tolerancia a la glucosa o perfil lipídico. Conclusiones. La cafeína permitió proteger los niveles de glucosa postprandial al término del experimento y un descenso en el peso corporal y consumo de alimento solo en la primera semana. Sin embargo, no se observaron mejoras significativas en el perfil de lípidos, adiposidad, tolerancia a la glucosa y glucosa plasmática(AU)

Chronic caffeine administration prevents postprandial glucose disturbance in rats. The increase in caffeine consumption is not debatable, this is how his research has become extensive in his different fields. Objective. To analyze the effects of chronic administration of caffeine in rats fed a cafeteria diet, by evaluating consumption, anthropometric and biochemical indices. Previous studies refer to administering caffeine in diets high in carbohydrates and / or in fat that induce obesity or symptoms of metabolic syndrome. Material and methods. The cafeteria diet is a dietary model equivalent to the characteristics of the typical western diet that causes metabolic syndrome in humans. In this research, chronic intraperitoneal administration of caffeine was performed for 8 weeks to adult male Wistar rats fed a cafeteria diet. Given the little evidence about the biological and behavioral effects of the chronic administration of this substance against a cafeteria diet model, consumption, anthropometric and biochemical parameters were evaluated. Results. After eight weeks it was found that the cafeteria diet given to the controls caused abnormalities associated with the metabolic syndrome; regarding the administration of caffeine in the rats fed this diet, the treatment turned out to be a protective factor in postprandial glucose, but not in the alteration of glucose tolerance or lipid profile. Conclusions. Caffeine allowed to protect postprandial glucose levels at the end of the experiment and a decrease in body weight and food consumption only in the first week. However, no significant improvements were seen in lipid profile, adiposity, glucose tolerance, and plasma glucose(AU)

Rabdomiólisis inducida por consumo crónico de bebidas energizantes asociado a ejercicio físico de baja intensidad: reporte de caso / Rhabdomyolysis induced by long-term consumption of energy drinks associated with low intensity physical exercise: case report

RESUMEN Introducción: Un riesgo potencialmente mortal es el hábito de consumo de bebidas energizantes, porque puede producir un síndrome caracterizado por la necrosis muscular que promueve la liberación de enzimas y mioglobina proveniente del interior del miocito hacia la circulación, creando una peroxidación lipídica llegando a generar lesión renal aguda e hyperkalemia; conocido como rabdomiólisis. La rabdomiólisis la esperaríamos encontrar entre 24 y 48 h después de actividades extenuantes, aún más con un índice de Borg modificado mayor o igual a 5 puntos; sin embargo, las bebidas energizantes por su alto contenido de cafeína y otros componentes pueden generar este evento adverso poco conocido. Caso clínico: Paciente de 37 arios, obeso, que ingresó al servicio de urgencias por cuadro clínico de mialgia y orina oscura que apareció 24h después de 4 días de ejercicio muscular de baja intensidad, asociado a consumo diario de bebida energizante por 2 años. El diagnóstico de rabdomiólisis se confirmó por hiperCKemia e hipertrasaminemia; no fue posible medir los niveles de mioglobina. El paciente fue tratado con fluidoterapia agresiva. Nunca presentó complicaciones renales ni hidroelectrolíticas. Conclusión: Nuestro caso destaca la aparición de rabdomiólisis aguda en pacientes sometidos a ejercicios de baja intensidad no descartando como causa principal el consumo crónico de bebidas energizantes. Son pocos casos actualmente reportados en la literatura. Gracias al tratamiento oportuno se evitó la progresión a lesión renal aguda.

ABSTRACT Introduction: The habit of consuming energy drinks is a life-threatening risk, because it can produce a syndrome characterised by a muscle necrosis. This promotes the release of enzy mes and myoglobin from inside the myocyte into the circulation, creating lipid peroxidation and leading to acute kidney injury, and hyperCKemia, together producing rhabdomyolysis. Rhabdomyolysis can be expected to be found within 24 to 48 h after strenuous activities, even more so with a modified Borg index greater than or equal to 5 points. However, energy drinks, due to their high content of caffeine and other components, can generate this little known adverse event. Clinical case: A 37-year-old patient admitted to the emergency department due to clinical symptoms of myalgia, and dark urine that appeared 24 h after four days of low-intensity muscular exercises, and was associated with daily consumption of an energizing drink for 2 years. The diagnosis of rhabdomyolysis was confirmed by increased creatine kinase and transaminases. It was not possible to measure myoglobin levels. The patient was treated with aggressive fluid therapy. He never presented with any renal or electrolyte complica tions. Conclusion: This case highlights the appearance of acute rhabdomyolysis in patients taking low intensity exercises, and not ruling out long-term consumption of energy drinks as the main cause. There are few cases currently reported in the literature. Owing to the timely treatment, progression to acute kidney injury was avoided.

Coadministration of ibuprofen/caffeine on bleaching-induced tooth sensitivity: A randomized clinical trial

Abstract This clinical trial evaluated the effect of the coadministration of ibuprofen/caffeine on bleaching-induced tooth sensitivity (TS). A triple-blind, parallel-design, randomized clinical trial was conducted on 84 patients who received ibuprofen/caffeine or placebo capsules. The drugs were administered for 48 hours, starting 1 hour before the in-office bleaching. Two bleaching sessions were performed with 35% hydrogen peroxide gel with 1-week interval. TS was recorded up to 48 hours after dental bleaching with a 0-10 visual analogic scale (VAS) and a 5-point numeric rating scale (NRS). The color was evaluated with VITA Classical and VITA Bleachedguide scales (ΔSGU) and VITA Easyshade spectrophotometer (ΔE*ab and ΔE00). The absolute risk of TS in both groups was evaluated using Fischer's exact test. Comparisons of the TS intensity (NRS and VAS data) were performed by using the Mann-Whitney test and a two-way repeated measures ANOVA, respectively. The color alteration between the groups was compared with the Student's t test. The significance level was 5%. There was no statistically significant difference between the groups for the absolute risk of TS (p = 1.00) or for the intensity of TS (p > 0.05). A bleaching of approximately 7 shade guide units was observed on the Vita Classical and Vita Bleachedguide scales, with no statistical difference between the groups. It was concluded that coadministration of ibuprofen and caffeine did not reduce the absolute risk or intensity of TS and did not interfere with the efficacy of dental bleaching.

Resumo Este ensaio clínico avaliou o efeito da coadministração de ibuprofeno/cafeína na sensibilidade dental decorrente de clareamento (SD). Um estudo clínico randomizado, paralelo, triplo-cego, foi realizado em 84 pacientes que receberam cápsulas de ibuprofeno/cafeína ou placebo. Os fármacos foram administrados por 48 horas, começando 1 hora antes do clareamento em consultório. Duas sessões de clareamento foram realizadas com gel de peróxido de hidrogênio 35% com intervalo de 1 semana. A SD foi registrada até 48 horas após o clareamento dental com uma escala visual analógica (VAS) de 0-10 e uma escala de classificação numérica (NRS) de 5 pontos. A cor foi avaliada com as escalas Vita Classical e Vita Bleachedguide (ΔSGU) e com o espectrômetro Vita Easyshade (ΔE*ab e ΔE00). O risco absoluto de SD em ambos os grupos foi avaliado por meio do teste exato de Fischer. As comparações da intensidade da SD (NRS e VAS) foram realizadas utilizando-se o teste Mann-Whitney e uma ANOVA de dois fatores com medidas repetidas, respectivamente. A alteração de cor entre os grupos foi comparada com a o teste t de Student. O nível de significância foi de 5%. Não houve diferença estatisticamente significante entre os grupos para o risco absoluto de SD (p = 1,00) ou para a intensidade de SD (p > 0,05). Observou-se clareamento de aproximadamente 7 unidades nas escalas Vita Classical e Vita Bleachedguide, sem diferença estatística entre os grupos. Concluiu-se que a coadministração de ibuprofeno e cafeína não reduziu o risco absoluto ou intensidade da SD e não interferiu na eficácia do clareamento dental.

The timing of withdrawal from caffeine citrate in very preterm infants / 中国当代儿科杂志

OBJECTIVES@#To study the clinical features and outcome of very preterm infants withdrawn from caffeine citrate at different time points.@*METHODS@#A retrospective analysis was performed on the medical data of the preterm infants with a gestational age of <32 weeks, who were hospitalized in the Division of Neonatology, the Second Xiangya Hospital of Central South University, from January 1, 2016 to November 30, 2020. According to the time of withdrawal from caffeine citrate, the infants who met the study criteria were divided into the group with withdrawal before the last week of hospitalization and the group with withdrawal within the last week of hospitalization. The two groups were compared in terms of clinical features, features of citric caffeine use, length of hospital stay and hospital costs, change in the intensity of respiratory support, and preterm complications.@*RESULTS@#A total of 403 preterm infants were enrolled, with 285 infants in the group with withdrawal before the last week of hospitalization and 118 infants in the group with withdrawal within the last week of hospitalization. There were no significant differences in clinical features between the two groups (@*CONCLUSIONS@#A relatively long course of caffeine citrate treatment is more beneficial to the short-term clinical outcome of very preterm infants.

Effect of different maintenance doses of caffeine citrate on ventilator weaning in very preterm infants with respiratory distress syndrome: a prospective randomized controlled trial / 中国当代儿科杂志

OBJECTIVES@#To study the effect of different maintenance doses of caffeine citrate on the success rate of ventilator weaning in very preterm infants (gestational age of ≤32 weeks) with respiratory distress syndrome (RDS).@*METHODS@#A total of 162 preterm infants with RDS who were admitted to the hospital from January 2016 to December 2018 were enrolled in this prospective trial. These infants had a gestational age of ≤32 weeks and required invasive mechanical ventilation. They were randomly divided into a high-dose caffeine group and a low-dose caffeine group, with 81 infants in each group. Within 6 hours after birth, both groups were given caffeine at a dose of 20 mg/kg. After 24 hours, the high- and low-dose caffeine groups were given caffeine at a maintenance dose of 10 mg/kg and 5 mg/kg, respectively. The two groups were compared in terms of re-intubation rate within 48 hours after ventilator weaning, durations of ventilation and oxygen therapy, enteral feeding, weight gain, and the incidence rates of complications and adverse reactions during hospitalization.@*RESULTS@#The high-dose caffeine group had a significantly lower re-intubation rate within 48 hours after ventilator weaning than the low-dose caffeine group (@*CONCLUSIONS@#A high maintenance dose of caffeine can safely and effectively reduce the incidence rate of apnea after ventilator weaning and the failure rate of ventilator weaning in RDS preterm infants with a gestational age of ≤32 weeks, and therefore, it holds promise for clinical application.

Clinical effect of an additional maintenance dose of caffeine before ventilator weaning in preterm infants with respiratory distress syndrome: a prospective randomized controlled trial / 中国当代儿科杂志

OBJECTIVE@#To study the clinical effect of an additional maintenance dose (5 mg/kg) of caffeine citrate injection at 1 hour before ventilator weaning in improving the success rate of ventilator weaning in preterm infants (gestational age ≤32 weeks) with respiratory distress syndrome (RDS) on mechanical ventilation.@*METHODS@#A total of 338 preterm infants with RDS (gestational age of ≤32 weeks) who were admitted to the Neonatal Intensive Care Unit of Xiamen Maternal and Child Health Hospital from January 2017 to December 2019 and treated with mechanical ventilation were enrolled. They were randomly divided into an observation group and a routine group, with 169 infants in each group. Both groups received early routine treatment with caffeine. The infants in the observation group received an additional maintenance dose of caffeine citrate injection at 1 hour before ventilator weaning. The two groups were compared in terms of reintubation rate and number of apnea episodes within 48 hours after ventilator weaning, changes in blood gas parameters, blood glucose, heart rate, and mean blood pressure at 2 hours after ventilator weaning, and incidence rates of major complications during hospitalization.@*RESULTS@#Compared with the routine group, the observation group had significantly lower reintubation rate (@*CONCLUSIONS@#An additional maintenance dose of caffeine citrate injection at 1 hour before ventilator weaning is safe and effective in improving the success rate of ventilator weaning in preterm infants with RDS and thus holds promise for clinical application.

Determination of caffeine content in Ginkgo Folium by ultra high performance liquid chromatography-triple quadrupole mass spectrometry / 中国中药杂志

In this experiment, an ultra-high performance liquid chromatographytandem triple quadrupole mass spectrometry was established for the determination of caffeine in commercially available Ginkgo Folium. The samples were extracted by ultrasonic method with methanol, and separated on Waters CORTECS T3 column(2.1 mm×100 mm, 2.7 μm), with mobile phase of 0.1% formic acid solution-0.1% formic acid acetonitrile solution for gradient elution, at flow rate of 0.3 mL·min~(-1); column temperature of 30 ℃, and injection volume of 2 μL. Mass spectrometry was conducted at ESI~+ multiple reaction monitoring(MRM) mode; quantitative analysis was conducted with external standard method. The results showed that in the range of 0.099 6-9.96 ng·mL~(-1), there was a good linear relationship between the mass concentration of caffeine and the peak area, R~2=0.999; the average recovery was 84.51%, with RSD of 6.2%. The results of precision, repeatability and stability showed that the RSD was 5.1%, 5.9%, 7.2%, respectively. The content range of caffeine in 10 batches of Ginkgo Folium was 1.52-60.86 μg·kg~(-1). In conclusion, this method is accurate, reliable and reproducible, which provides a reference for the safety study of Ginkgo Folium.