Mayo Clinic Proceedings: November highlights

The November issue of Mayo Clinic Proceedings includes three articles with leading research, highlighted below.

Khat Chewing Increases Risk of Stroke and Death in Patients With Acute Coronary Syndrome

ROCHESTER, Minn. — Researchers found that people who chew khat and present with acute coronary syndrome had significantly higher rates of death, cardiogenic stroke, and stroke complications, despite having lower cardiovascular risk profiles.

“The leaves of khat, a leafy green shrub, are chewed habitually for euphoric and stimulating effects. The main ingredients, cathinone and cathine, are structurally related to amphetamine and ecstasy,” says lead author Waleed Ali, M.D., from Hamad General Hospital in Doha, Qatar. An estimated 5 million to 10 million people worldwide chew khat, predominantly those living in the horn of Africa and the Arabian Peninsula, according to an editorial written by Farrah Mateen, from Johns Hopkins University in Baltimore, and Gregory Cascino, M.D., from the Department of Neurology at Mayo Clinic. They further state that Khat is illegal in the United States, and is not currently an accepted form of medical treatment.

Dr. Ali says, “Patients of Eastern African and Yemeni origins should be evaluated and counseled about khat chewing, even when living in Western countries.”


Are Energy Beverages Safe to Drink When Exercising?

ROCHESTER, Minn. — The resurgence of exercise has been accompanied by multiple supplements, sports drinks, and energy beverages that promise to enhance performance, muscle growth, and recovery. But the question remains: Are energy beverages safe?

“One can of an energy beverage during one session of exercise is safe for most healthy individuals,” says John Higgins, M.D., lead author from The University of Texas Medical School in Houston. However, he states, “excess consumption and consumption with other caffeine-containing beverages or alcohol may lead to adverse effects and possibly death.”

The United States is the world’s largest consumer of energy beverages by volume, and consumption is primarily among people ages 11 to 35 years. The most common ingredient is caffeine, which ranges from 50 milligrams (mg) to 505 mg per 16-ounce serving.


Perspectives on Withdrawing Pacemakers and Implantable Cardioverter-Defibrillators at End of Life Vary Substantially

ROCHESTER, Minn. — Mayo Clinic researchers found that the majority of medical professionals and patients feel implantable cardiac device (ICD) therapy should be withdrawn based on the patient’s right to refuse continued life-sustaining therapy at the end of life.

“Almost one-third of medical professionals surveyed considered withdrawal of a pacemaker in a pacemaker-dependent patient as physician-assisted suicide or euthanasia, but only a very small percentage believed the same about an ICD,” says Samuel Asirvatham, M.D., lead author and cardiologist, Mayo Clinic. The article noted that legal professionals tend to view all devices as similar and saw little difference between withdrawal of an ICD and withdrawal of a pacemaker.

“Education and discussion of managing devices at the end of life are important when making end-of-life decisions to better understand patients’ perceptions and expectations,” says Dr. Asirvatham.

A peer-reviewed journal, Mayo Clinic Proceedings publishes original articles and reviews dealing with clinical and laboratory medicine, clinical research, basic science research and clinical epidemiology. Mayo Clinic Proceedings is published monthly by Mayo Foundation for Medical Education and Research as part of its commitment to the medical education of physicians. The journal has been published for more than 80 years and has a circulation of 130,000 nationally and internationally. Articles are available online at www.mayoclinicproceedings.com.

About Mayo Clinic

For more than 100 years, millions of people from all walks of life have found answers at Mayo Clinic. These patients tell us they leave Mayo Clinic with peace of mind knowing they received care from the world’s leading experts. Mayo Clinic is the first and largest integrated, not-for-profit group practice in the world. At Mayo Clinic, a team of specialists is assembled to take the time to listen, understand and care for patients’ health issues and concerns. These teams draw from more than 3,700 physicians and scientists and 50,100 allied staff that work at Mayo Clinic’s campuses in Minnesota, Florida, and Arizona; and community-based providers in more than 70 locations in southern Minnesota, western Wisconsin and northeast Iowa. These locations treat more than half a million people each year. To best serve patients, Mayo Clinic works with many insurance companies, does not require a physician referral in most cases and is an in-network provider for millions of people. To obtain the latest news releases from Mayo Clinic, go to www.mayoclinic.org/news. For information about research and education, visit www.mayo.edu. MayoClinic.com (www.mayoclinic.com) is available as a resource for your general health information.

Contact:

Rebecca Eisenman

507-284-5005 (days)

507-284-2511 (evenings)

e-mail: newsbureau@mayo.edu

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