Can green tea do that? A literature review of the clinical evidence

OBJECTIVE: Habitual green tea consumption has long been associated with health benefits including chemoprevention and cardiovascular protection. This non-systematic literature review presents the clinical evidence to date. METHOD: A literature review of peer-reviewed articles on observational and interventional studies was conducted to include green tea, its extract or its purified polyphenol (-)-epigallocatechin-3-gallate (EGCG). Electronic databases searched included PubMed (1966-2009) and the Cochrane Library (Issue 4, 2008). RESULTS: Observational studies are inconclusive on the benefits of habitual consumption of green tea in the prevention of most cancers. However, there are trends towards prevention in breast and prostate cancers. Interventional studies have demonstrated reduction in relapses following surgical resection in colorectal adenomas and increased survival rates in epithelial ovarian cancer. Observational studies indicate that green tea may provide protection against hypertension and reduce the risk for stroke, and interventional studies are providing biochemical and physiological evidence. CONCLUSION: Although the overall clinical evidence is inconclusive, habitual green tea consumption may be providing some level of chemoprevention in prostate and breast cancer. Green tea may also attenuate the risk factors association with the development of atherosclerosis thus reducing the incidence of cardiovascular events and stoke.

The clinician's guide to the cardiovascular examination

A detailed examination of the cardiovascular system is indispensable to the full appreciation of the cardiac status. Yet, because this fundamental aspect of cardiology is so inadequately presented by many of the major texts, students often fail to grasp the essentials. The author not only brings a rich knowledge of the subject to his task, but also a wide experience of teaching and a firm conviction that the prime purpose of the undergraduate pre-clinical curriculum is to provide information on which the student may build. The student who masters this information will be well prepared for the clinical years and suitably equipped for more advanced studies

Daily variability in resting levels of cardiovascular variable in normal subjects and those with homozygous sickle cell disease

Measurements were made of cardiovascular variables and oral temperature in 16 male subjects with homozygous sickle cell disease (SS) and in 17 matched controls (AA) at 10.00 a.m, 1.00 p.m and 4.00 p.m. All subjects were in a rested state throughout. At 10.00 a.m. mean arterial pressure was lower, while heart rate, total forearm blood flow and cutaneous red cell flux in the forearm were higher in SS than AA. Vascular resistance in total forearm and forearm skin, calculated by dividing arterial pressure by blood flow or red cell flux, were lower in SS but hand cutaneous red cell flux and vascular resistance were not significantly different in SS and AA. In both SS and AA, there were parallel increase over the three sessions, in mean arterial pressure (by approximately 12 and 10 percent respectively) forearm vascular resistance (by approximately 17 and 27 percent) and hand cutaneous vascular resistance and hand cutaneous resistance (by approximately 2240 and 350 percent) whereas forearm blood flow and hand cutaneous red cell flux fell. By contrast, forearm cutaneous resistance showed no change during the day in SS, but increased progressively in AA (by approximately 75 percent). These results indicate that, during the day, there is progressive vasconstriction in forearm muscle and hand skin in SS and AA and also in forearm skin of AA that contributes to a progressive rise in the resting level of mean arterial pressure. We suggest this daily variability should be considered in studies of cardiovascular function: within a given study they should be performed at the same time of day.(AU)

Intravenous lignocaine prior to intubation effect on rhythm and changes in heart rate and rate pressure product - abstract

Tracheal intubation is frequently associated with occurrence of cardiac dysrhythmias and is almost always accompanied by increases in systolic and diastolic blood pressure. In some instances, these cardiovascular changes may lead to disastrous complications. A prospective study was undertaken to evaluate the efficacy of intravenous lignocaine prior to intubation in blunting the cardiovascular responses to intubation in a West Indian population. Seventy-five clinically fit patients (age range 20 -40 years, mean 27.5) were included. They were divided into 3 groups as follows: Group A: received 1 mg/kg lignocaine hydrochloride as I.V. bolus dose 1 min prior to induction of anaesthesia. Group B: - received 2mg/kg lignocaine, and Group C: - No ligocaine (control). Parameters recorded were heart rate (HR), cardiac rhythm (ECG), systolic and diastolic bloodpressure (BP), and (heart) Rate - (systolic) pressure product (RPP). These were measured at the following times: 1. Prior to induction of anaesthesia, 2. During laryngoscopy and intubation, 3: 1 min following intubation and 4: 5 mins following intubation. After the pre-induction parameters were recorded, lignocaine was given in 1 and 2 mg/kg doses in groups A & B patients. One minute following lignocaine, patients were anaesthetised using standard techique and the trachea was intubated. All parameters were again recorded, lignocaine was given in 1 and 2 mg/kg doses in groups A percent B patients. One minute following lignocaine, patients were anaesthetised using standard technique and the trachea was intubated. All parameters were again recorded at the stated times. Both the HRs and RPPs increased significantly in all the 3 groups following intubation. The increase in group B (2mg/kg) was significantly lower than in the control group. Group A patients (1mg/kg) did not show any consistent difference, statistically, compared to the control group. The incidence of dysrhythmias was 64 percent in the control group, 32 percent in group A patients (1mg/kg) and 12 percent in group B (2mg.kg). Seventy per cent of all dysrhythmias occurred at the time of laryngoscopy and intubation, consisting mainly of supra-ventricular and ventricular ectopics. Intravenous lignocaine prior to intubation decreases the incidence of dysrhythmias and also decreases the degree of rise in HRs and RPPs. Lignocaine at a dose of 2 mg/kg is better than a dose of 1 mg/kg (AU)

The pathology of sickle cell anaemia in Jamaican adults over 30

The pathological findings at autopsy in 7 patients over the age of 30 with sickle cell anaemia are described and discussed. The 3 youngest died of well recognized complications of sickle cell anaemia. The 4 older patients, all over 50, had been remarkably free of direct complications and died of disease which could have been unrelated to sickle cell anaemia. Cirrhosis and chronic nephritis were not seen. Pulmonary vascular disease was seen in 2 patients but its significance in relation to sickle cell anaemia has not yet been established in Jamaican patients.(AU)

Anaesthesia in patients with sickle-cell anaemia

The condition of sickle-cell anaemia is discussed from the viewpoint of the anaesthetist. Surgical conditions which arise in these patients have been described, and sixteen cases operated on at the University Hospital of the West Indies have been included. There were no complications attributable to anaesthesia. Suggestions have been made as to the pre-anaesthetic and anaesthetic care of these very frail individuals, with particular emphasis on the timing of elective surgery, preparation with alkali, caution in the use of blood transfusion, and the administration of oxygen (Summary)

Dilatation and unfolding of the aorta in a Jamaican population

In an analysis of 2085 70 mm. chest X-rays of subjects aged 35-64 from a rural population in Jamaica, 79 of the 1090 women (8.4 percent) showed some degree of aortic dilatation. The clinical examination of these people and age and sex balanced control groups drawn by random methods from the same population revealed three main findings. (1) Arterial pressure levels were consistently higher in the affected, than in the controls. (2) The conditions was associated with aortic regurgitation in 20 percent of men and 7 percent of women. (3) Both aortic dilatation and arterial pressure in these subjects were apparently unrelated to their present serological status. Positive serological reactions were found in about 25 percent of affected and controls. The possible role of syphillis and/or yaws in association with hypertension in producing aortic dilatation is discussed. A relationship between aortic dilatation, often gross, and hypertension has been demonstrated and this combination appears to have a high prevalence in West Indian negroes. Whatever the role of treponemal infection it is apparently not the most important single factor in the production of either the aortic dilatation, the associate hypertension, or the resulting aortic regurgitation. The significance of uncomplicated aortic dilatation, in terms of morbidity and mortality, remains to be determined by follow-up studies of these groups (Summary)

Veno-occlusive disease of the liver: essential pathology

The lesions of veno-occlusive disease of the liver appear to surround blockage of the hepatic veins. For this reason it is suggested that other names - serous hepatosis, collagenosis - used earlier to describe this condition be abandoned and that only the veno-occlusive disease be used. In progressive cases the end-result is non-portal cirrhosis (often with fatal haemorrhage from the oesophageal varices). The pancreas shows lesions which are commonly accepted as associated with protein undernutrition (Summary)