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Study Title and Description

Does an energy drink cause a transient ischemic attack?



Key Questions Addressed
1 For [population], is caffeine intake above [exposure dose], compared to intakes [exposure dose] or less, associated with adverse effects on acute toxicity*?
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Primary Publication Information
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TitleData
Title Does an energy drink cause a transient ischemic attack?
Author S Dikici,A Saritas,S Kilinc,S Guneysu,H Gunes,
Country
Year 2015
Numbers

Secondary Publication Information
There are currently no secondary publications defined for this study.


Extraction Form: Acute Toxicity - Study Design Details
Arms
No arms have been defined in this extraction form.

Design Details
Question... Follow Up Answer Follow-up Answer
Refid 25074693
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What outcome is being evaluated in this paper? Acute
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What is the objective of the study (as reported by the authors)? To report an incident of a patient who had a transient ischemic attack after ingestion of two Red Bull energy drinks
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Provide a general description of the methods as reported by the authors. Information should be extracted based on relevance to the SR (i.e., caffeine related methods)
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How many outcome-specific endpoints are evaluated? 1
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What is the (or one of the) endpoint(s) evaluated? (Each endpoint listed separately) Transient ischemic attack
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List additional health endpoints (separately).
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List additional health endpoints (separately)
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Notes The individual experienced a sudden-onset loss of vision in right eye which spontaneously disappeared after 4 hours.
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Clinical Clinical
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Physiological
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Other
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What is the study design? Case report
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Randomized or Non-Randomized?
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What were the diagnostics or methods used to measure the outcome? Subjective
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Optional: Name of Method or short description Diagnosis due to lack of etiological evidence
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Caffeine (general)
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Coffee
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Chocolate
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Energy drinks Energy drinks
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Gum
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Medicine/Supplement
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Soda
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Tea
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Measured
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Self-report Self-report
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Children
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Adolescents
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Adults Adults
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Pregnant Women
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What was the reference, comparison, or control group(s)? (e.g. high vs low consumption, number of cups, etc.) NA - case report
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What were the listed confounders or modifying factors as stated by the authors? (e.g. multi-variable components of models.  Copy from methods) NA
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Provide a general description of results (as reported by the authors). A previously healthy 26-year-old emergency department physician had a sudden-onset loss of vision in his right eye, which disappeared spontaneously after 4 hours. Because he was already in the emergency department when his symptoms started, his arterial blood pressure, pulse rate, and electrocardiography were taken immediately, and they were all normal. His chest x-ray was normal, too. Cardiovascular and respiratory systems were normal on physical examination. His thrombocyte count, blood urea nitrogen, glucose, thyroid hormones, vitamin B12, and homocysteine levels were normal. Computed tomography scan and magnetic resonance imaging of his brain were normal, too. Transthoracic and transesophageal echocardiography were performed, and no structural cardiac abnormality was found. Bilateral vertebral and carotid artery ultrasonography and abdominal ultrasonography were normal. Patient took the diagnosis of transient ischemic attack (TIA), and no etiologic factor that might cause that clinical condition could be found by detailed testing for possible factors. Patient had never smoked or used alcohol and any other illicit drugs. His medical history and family history were negative for stroke and any possible risk factors of stroke. When the patient was asked about any kind of unusual intake of any type of substances, it was learned that he had drunk 2 energy drinks (Redbull, Istanbul, Turkey, 250 mL) with an empty stomach to be more active while he was working in the emergency department. Finally, we suggested that energy drink was responsible from his symptoms after detailed evaluation of all possible etiologic factors.
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Did the authors perform a dose-response analysis (or trend/related analysis)? No
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What were the authors's observations re: trend analysis?
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What were the author's conclusions? The energy drink the patient consumed was responsible for the sudden-onset vision loss
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What were the sources of funding? NA
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What conflicts of interest were reported? NA
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Does the exposure (dose) need to be standardized to the SR? Yes
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Provide calculations/conversions for the exposure based on the decision tree in the guide (for all endpoints/exposure levels of interest). Red bull (2 cans)x(80mg/can) = 160 mg
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List all the endpoint(s) followed by the dose (mg) which will be used in comparison to Nawrot.  Characterize value as LOAEL/NOAEL, etc. if possible.  transient ischemic attack LOAEL = 160 mg
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Notes regarding selection/listing of endpoints and exposures/doses to be compared to Nawrot. There are several endpoints listed that were classified as 'normal' during treatment period
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What is the importance of the study with respect to the adverseness of the outcome? Critcal
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Baseline Characteristics
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Results & Comparisons

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Adverse Events
Arm or Total Title Description Comments

Quality Dimensions
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