Cardiovascular and Cerebrovascular Effects in Response to Red Bull Consumption Combined With Mental Stress Erik Konrad Grasser, PhD, MD, Abdul G. Dulloo, PhD, and Jean-Pierre Montani, MD The sale of energy drinks is often accompanied by a comprehensive and intense marketingwith claims of beneﬁts during periods of mental stress. As it has been shown that Red Bullnegatively impacts human hemodynamics at rest, we investigated the cardiovascular andcerebrovascular consequences when Red Bull is combined with mental stress. In a randomizedcross-over study, 20 young healthy humans ingested either 355 ml of a can Red Bull or waterand underwent 80 minutes after the respective drink a mental arithmetic test for 5 minutes.Continuous cardiovascular and cerebrovascular recordings were performed for 20 minutesbefore and up to 90 minutes after drink ingestion. Measurements included beat-to-beat bloodpressure (BP), heart rate, stroke volume, and cerebral blood ﬂow velocity. Red Bull increasedsystolic BP (D7 mm Hg), diastolic BP (D4 mm Hg), and heart rate (D7 beats/min), whereaswater drinking had no signiﬁcant effects. Cerebral blood ﬂow velocity decreased more inresponse to Red Bull than to water (L9 vs L3 cm/s, p <0.005). Additional mental stressfurther increased both systolic BP and diastolic BP (D3 mm Hg, p <0.05) and heart rate(D13 beats/min, p <0.005) in response to Red Bull; similar increases were also observed afterwater ingestion. In combination, Red Bull and mental stress increased systolic BP by about10 mm Hg, diastolic BP by 7 mm Hg, and heart rate by 20 beats/min and decreased cerebralblood ﬂow velocity by L7 cm/s. In conclusion, the combination of Red Bull and mental stressimpose a cumulative cardiovascular load and reduces cerebral blood ﬂow even under a mentalchallenge.
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Preventive Care Medications
Advantage Prescription Drug List (PDL)1,2,3
$0 Cost-share Medications & Products
U.S. Preventive Services Task Force A & B Recommendation
Medications and Supplements
These medications and supplements will be covered at $0 cost-share when:
Prescribed by a health care professional Age and/or gender appropriate Filled at a network pharmacy Most medications are available over-the-counter (OTC) except for prescription fluoride. All brands are covered by the pharmacy benefit. Aspirin - 81, 162 & 325 mg Prevent cardiovascular disease Folic acid 400 & 800 mcg Prevent birth defects Iron liquid supplement Children age 0-1 year Prevent anemia due to iron deficiency Vitamin D - 400 & 1,000 units Fall risk prevention Fluoride tablets, solution Prevent dental cavities if water Children age 0-6 years (not toothpaste, rinses) source is deficient in fluoride Over-the-Counter (OTC) Contraceptives for Women
These contraceptives are available over-the-counter (OTC) and will be covered at $0 cost-share when:
Prescribed by a health care professional Filled at a network pharmacyMale contraceptives are not covered under the Patient Protection and Affordable Care Act (PPACA).
Contraceptive films Contraceptive foams Contraceptive gels Emergency contraceptives (Next Choice, Next Choice One Dose, Plan B One-Step) Prescription Hormonal Contraceptives
Brand Hormonal Contraceptives
Generic Hormonal Contraceptives
Altavera, Chateal, Kurvelo, Levora-28, Marlissa, Portia (generic Nordette)
Alyacen, Cyclafem, Dasetta, Necon 1/35, Nortrel 1/35 (generic Ortho-Novum 1/35)
Apri, Emoquette, Reclipsen (generic Desogen, Ortho-Cept)
Aranelle, Leena (generic Tri-Norinyl)
Aviane, Falmina, Lessina, Lutera, Orsythia, Sronyx (generic Alesse)
Caziant, Velivet (generic Cyclessa)
Cryselle, Elinest, Low-Ogestrel (generic Lo/Ovral)
Enpresse, Levonest, Myzilra, Trivora-28 (generic Triphasil)
Gildess FE, Junel FE, Microgestin FE (generic Loestrin FE)
Kelnor 1/35, Zovia-1/35E (generic Demulen 1/35)
medroxyprogesterone acetate (generic Depo-Provera)
Necon 0.5/35, Nortrel 0.5/35, Wera (generic Brevicon, Modicon)
Necon 1/50 (generic Norinyl 1/50)
Necon 10/11 (generic Ortho Novum 10/11)
Zovia-1/50E (generic Demulen 1/50)
Prescription Emergency Contraceptives
Brand Emergency Contraceptives
Plan B One-Step
Generic Emergency Contraceptives
Levonorgestrel, Next Choice (generic Plan B)
1. Please note this list is subject to change.
2. Always refer to your benefit plan materials to determine your coverage for medications and cost share. Some medications listed on the PDL may not be covered under your specific benefit. Where differences are noted, the benefit plan documents will govern.
3. All branded medications are trademarks or registered trademarks of their respective owners.
Health Care Reform
Pharmacy Benefit Preventive Care Medications Coverage
Frequently Asked Questions Under the health reform law, health plans must cover Which Preventive Care Medications are
U.S. Preventive Services Task Force A & B Recommendation available at no cost?
medications and FDA-approved prescription and Over- A list of Preventive Care Medications can
The-Counter (OTC) contraceptives for women at 100 be found on page 1 and 2 of this document so
percent without charging a copayment, coinsurance you can discuss them with your doctor. You can also login or deductible when: to mynhp.com or call the number on your health ID
Prescribed by a health care professional card to confirm the most current list of Preventive Care Age- and gender-appropriate Medications for your plan. Filled at a network pharmacy Will this drug list change?
To comply with this new law which was clarified Drug lists can and do change, so it's always good to check. further by the U.S. Dept. of Labor on February 20, 2013, You can learn the cost of all products and no cost options by: we are is offering this updated list of no-cost Preventive Logging in to mynhp.com, and click on the
Care Medications. "Members" link and then select the "Pharmacy" tab on the left hand side of the page When did the new law take effect?
The list of prescription contraceptives became
Calling the number on the back of your available at $0 cost-share upon your plan's last renewal date after August 1, 2012. For most employer plans, Are all birth control products going to be
this was January 1, 2013. For some plans, the coverage available at no cost to me?
took effect later in 2013. If you have questions, ask your No, only the products on the list applicable to your plan will HR representative for the start date of your coverage, or be no cost under the pharmacy benefit. The health reform refer to your plan documents for your specific coverage. law al ows plans to use reasonable medical management to The list of U.S. Preventive Services Task Force A&B
decide which contraceptive products will be provided at no Recommendation medications and OTC contraceptives
on this Preventive Care Medications list will be available If you choose a no cost product from the list applicable to for $0 cost-share at network pharmacies beginning your plan, your cost at the pharmacy wil be $0. If you choose November 1, 2013 for most plans. a covered birth control product that is not on the list, a Please note, in order to obtain coverage, these copay or co-insurance may be required. And this cost will medications and supplements also require a apply to your deductible if you have one. prescription from a health care professional and must be age-and gender-appropriate. What if I have a high-deductible or
consumer-driven health (CDH) plan?
The same no cost options on the list applicable to your plan
will be available to you if you are in one of these plans. If you fill a prescription for covered birth control products not on your plan's no cost drug list, you will need to pay the full cost, until your pharmacy plan deductible is reached. Are the no cost Preventive Care Medications
What if my plan has a religious exemption for
available at both retail and mail pharmacies?
Prescription contraceptives will continue to be
Some plans may not have coverage for contraceptives if available at both network retail pharmacies and your employer qualifies for a religious exemption. However, the mail order pharmacy for plans with a mail order benefit. you will still have coverage without cost-share of the U.S. U.S. Preventive Services Task Force A & B Recommendation
Preventive Services Task Force A & B Recommendation medications and OTC contraceptives will be available at
medications listed on the Preventive Care Medications list network retail pharmacies beginning November 1, 2013 and (such as aspirin and Vitamin D).
at the mail order pharmacy beginning January 1, 2014. What if the health care reform law requirements
for Preventive Care Medication coverage change?
If the law requiring plans to provide Preventive Care
Medications at no cost changes, information on how your costs may be impacted will be available to you by:
Logging in to mynhp.com, and click on the "Members"
link and then select the "Pharmacy" tab on the left hand Calling the number on the back of your health Still have questions?
Login to mynhp.com and click on the "Members" link
and then select the "Pharmacy" tab on the left hand
side of the page or call the number on the back of your
health ID card.
Si usted esta interesado en conocer mas sobre su
beneficio de farmacia o si necesita asistencia leyendo
esta información, por favor llame al 1 877-842-6048.
M53613-A NHP 11/13 2013 United HealthCare Services, Inc.
Surveillance & Society 1(1): 86-101 Technical Review. Hair Testing: just how accurate Abstract Extensive forensic examination of the hair of 209 "ecstasy" (MDMA) users demonstrated virtually no correlation between self-reported tablet use, and traces of MDMA in the hair of users. Why should this be so? Three answers are possible, and all true. First, self-report is fallible; second, tablet strength varies enormously; and third, forensic analysis is of unknown accuracy. The first two are well known. Forensic analysis, however, typically presents itself as impeccably precise. The review demonstrates that not only is this claim spectacularly untrue, but also that validation of forensic analysis (and, thus, indirectly, self-report) lies in the very blind intra - and inter- laboratory comparisons that are never undertaken.