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Guaraná (Paullinia cupana) extracts are most commonly used in Western markets as putatively psychoactive food and drink additives. This double-blind, randomised, placebo-controlled, parallel groups study assessed the acute effects of either a vitamin/mineral/guaraná supplement or placebo drink in 129 healthy young adults (18-24 years). Participants completed a 10min version of the Cognitive Demand Battery (comprising: Serial 3s and Serial 7s subtraction tasks, a Rapid Visual Information Processing (RVIP) task, 'mental fatigue' scale). Thirty minutes following their drink participants made six consecutive completions of the battery (i.e. 60 min). The vitamin/mineral/guaraná combination resulted in improved task performance, in comparison to placebo, in terms of both increased speed and accuracy of performing the RVIP task throughout the post-dose assessment. The increase in mental fatigue associated with extended task performance was also attenuated by the supplement. This research supports previous findings demonstrating guaraná's cognition enhancing properties and provides evidence that its addition to a multi-vitamin-mineral supplement can improve cognitive performance and reduce the mental fatigue associated with sustained mental effort.

Rotator cuff problems are encountered frequently and must be rehabilitated precisely. The pace and intensity of the program are regulated by the degree of pathology and the patient's activity requirements. As our ability to understand the biomechanics of shoulder motion improves, we realize that many rotator cuff problems are secondary to instability. This instability can be subtle. The following article details a rehabilitative program for patients with rotator cuff pathology and includes both conservative and postoperative programs for pathology secondary to instability as well as primary impingement.

Forty-five patients who underwent a partial meniscectomy in an anterior cruciate deficient knee were followed from 2 to 9 years. The average age at the time of the meniscectomy was 28.6 years. The majority of the patients were injured in recreational athletics. The subjects were evaluated preoperatively by a questionnaire and clinical examination, both of which were repeated at followup. The efficacy of the postsurgical rehabilitation was monitored with measurement of quadriceps and hamstring strength on the Cybex Dynamometer. All of the patients had a KT-1000 knee ligament arthrometer test at followup that was compared with the clinical examination. Sixty-five percent of the subjects (13 of 20) with a Lachman and pivot shift of +1 returned to their previous activity level without limitation. Of the patients with a KT-1000 compliance index of 1 mm, 70% (11 of 17) returned to the same athletic level. However, only 20% (2 of 11) of the patients with a clinical instability greater than +1 or a compliance index of 2 mm were able to perform without limitation. The location of the meniscal tear did not correlate with the functional outcome. Six patients required ACL reconstruction.