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Athletes commonly use drugs and dietary supplements to improve athletic performance or to assist with weight loss. Some of these substances are obtainable by prescription or by illegal means; others are marketed as supplements, vitamins, or minerals. Nutritional supplements are protected from Food and Drug Administration regulation by the 1994 US Dietary Supplement Health and Education Act, and manufacturers are not required to demonstrate proof of efficacy or safety. Furthermore, the Food and Drug Administration lacks a regulatory body to evaluate such products for purity. Existing scientific data, which consist of case reports and clinical observations, describe serious cardiovascular adverse effects from use of performance-enhancing substances, including sudden death. Although mounting evidence led to the recent ban of ephedra (ma huang), other performance-enhancing substances continue to be used frequently at all levels, from elementary school children to professional athletes. Thus, although the potential for cardiovascular injury is great, few appropriately designed studies have been conducted to assess the benefits and risks of using performance-enhancing substances. We performed an exhaustive OVID MEDLINE search to Identify all existing scientific data, review articles, case reports, and clinical observations that address this subject. In this review, we examine the current evidence regarding cardiovascular risk for persons using anabolic-androgenic steroids including 2 synthetic substances, tetrahydrogestrinone and androstenedione (andro), stimulants such as ephedra, and nonsteroidal agents such as recombinant human erythropoietin, human growth hormone, creatine, and beta-hydroxy-beta-methylbutyrate. [ABSTRACT FROM AUTHOR]

Background: Young athletes may die suddenly when they are struck in the chest (commotio cordis). Proposed mechanisms of sudden death in commotio cordis include hypervagatonia and activation of the sympathetic nervous system. In an experimental model of commotio cordis, the importance of the sympathetic and parasympathetic nervous system in the initiation of ventricular fibrillation was evaluated., Material/methods: Juvenile swine weighing between 8 and 12 kg were anesthetized with ketamine and isoflurane and placed prone in a sling. Twenty animals were randomized to pretreatment with placebo or sympathetic and parasympathetic blockade. Chest blows were guided by echocardiography to the center of the left ventricle and animals received 1-3 strikes with a regulation baseball propelled at 30 mph and timed to impact 10-30 ms prior to the peak of the T-wave., Results: With 17 impacts in 10 autonomically blocked animals, 6 episodes of ventricular fibrillation were seen; with 15 impacts in 10 control animals, ventricular fibrillation occurred 6 times. There was also no significant difference between the groups in occurrence of nonsustained polymorphic ventricular tachycardia or ST elevation. Transient complete heart block was less commonly seen in animals treated with autonomic blockade, although this did not achieve statistical significance., Conclusions: In this experimental model of commotio cordis, autonomic blockade did not affect the frequency of sudden cardiac death, polymorphic ventricular tachycardia or ST segment elevation. Thus, vagotonic and sympathetic surges likely do not contribute to the syndrome of sudden death due to chest blows in young people and athletes.

Herbal medications and dietary supplements are unregulated in the United States. The use of these medications has dramatically increased over the past decade. Many of these drugs are biologically active, yet physicians are often unaware their patients are using a traditional remedy. Physicians are frequently unfamiliar with the medications being used and the intended effect, as well as the side-effect profiles that accompany them. Recently, some of the herbal mediations that are commonly used in the general population have been shown to be beneficial for the treatment of arrhythmias. Unfortunately, many more have been shown to be detrimental. In this article, the background behind herbal medication and the degree to which herbal medications are being used is reviewed. Herbal medications known to have beneficial effects in the treatment of arrhythmias, as well as those that have known detrimental effects with regard to cardiac arrhythmias, are highlighted. Finally, research that has been done in this field, focusing on those compounds that have been shown to be biologically active in the treatment of cardiac arrhythmias, are reviewed.

The present study investigates the relationship between upper respiratory infection (URI) and Type A behavior pattern. Type A and Type B college students completed a health survey which measured both incidence of and response to URI's. Overall, results revealed a pattern indicating that Type A's reported experiencing significantly more URI's than did their Type B counterparts, and that female Type A's reported significantly more frequent URI's than did female type B's. The results were discussed in terms of the Type A's stressful life style increasing his/her susceptibility to viral respiratory disease. The Type A's propensity to minimize or failure to attend to illness symptoms was also discussed.

Genital herpes, while having gained considerable attention as an important psychosexual disease, is not well understood. Precisely what factors trigger infectious reactivation is an important question that has yet to be answered. The present study investigated the relationship between recurrent genital herpes and personality. High and low recurrers were administered a demographic and disease history questionnaire and the Minnesota Multiphasic Personality Inventory (MMPI). Results revealed that, compared to low recurrers, the mean MMPI profile of high recurrers showed significantly greater elevations on nine of ten scales. The degree and pattern of elevation in the high profile is consistent with increased levels of autonomic arousal and stress. These findings are interpreted as suggestive of the possible role of personality in influencing the rate of infectious recurrence in genital herpes sufferers. The implications for psychologically based treatment strategies are discussed.