Paracetamol ‘no good for back pain’


 

Back pain

Paracetamol is ineffective at treating back pain and osteoarthritis despite being a recommended treatment, a group of Australian researchers has warned.

Their review of 13 clinical trials, published in the British Medical Journal, said the drug did not reduce disability or improve quality of life.

Instead, the group warned, it increased the odds of liver problems.

The NHS is to review its guidelines. Experts say patients should consult a doctor before changing medicines.

Back pain is a leading cause of disability and in the UK alone it is estimated to affect 26 million people each year.

The National Institute for Health and Care Excellence (NICE), which establishes best NHS practice, currently recommends paracetamol for both lower back painand for osteoarthritis.

However, questions have been raised about the quality of the evidence which led to the decisions.

A team at the University of Sydney assessed data from 13 drug trials involving more than 5,000 patients.

They concluded that paracetamol was “ineffective” at reducing back pain.

In osteoarthritis in the hip or knee, they found a small improvement with paracetamol. Yet the impact was so small it was “not clinically important”.

Man with backpain

Gustavo Machado, one of the researchers, argued: “Paracetamol is the most widely used over-the counter medicine for musculoskeletal conditions so it is critical that we review treatment recommendations in light of this new evidence.

“In our research, paracetamol for low back pain and osteoarthritis was also shown to be associated with higher risk of liver toxicity in patients.

“Patients were nearly four times more likely to have abnormal results on liver function tests compared to those taking placebo pills.”

Exercise

Dr Christian Mallen, from Keele University in the UK, said options other than drugs should be the “cornerstone” of managing the conditions.

However, he added: “While the effectiveness of exercise for both osteoarthritis and spinal pain is established, we know that uptake of and adherence to exercise is poor.”

In the UK, the safety of over-the-counter drugs is being reviewed by the medicines safety regulator.

NICE said it was waiting for the results of that review before conducting its own assessment.

A spokesperson said: “Looking at all of the relevant painkillers together, instead of just one, will then provide a comprehensive overview of this aspect of managing osteoarthritis.”

Jane Tadman from Arthritis Research UK said: “We’ve known for some time that paracetamol may not work for everyone with severe pain from their arthritis, but some people find it helps them and allows them to sleep and to exercise without discomfort.

“Physical activity is probably a better and more effective way of keeping the pain of arthritis and joint pain at bay than taking currently available painkillers.”

Prof Roger Knaggs, from the Royal Pharmaceutical Society, said: “There are other medicines, such as nonsteroidal anti-inflammatory drugs and opioids, which may provide better pain relief but these are associated with a range of other side-effects.

“Anybody with concerns about whether taking paracetamol could cause harm should discuss their concerns with their GP or pharmacist.”

Ants in space grapple with zero-g


 

ants on the ISS
On board the ISS the ants were kept inside special plastic containers, with vents to allow them to breathe

Ants carried to the International Space Station were still able to use teamwork to search new areas, despite falling off the walls of their containers for up to eight seconds at a time.

Their “collective search” was hampered but still took place, biologists said.

The insects also showed an impressive knack for regaining their footing after taking a zero-g tumble.

Researchers want to learn from the ants’ cooperative methods and develop search algorithms for groups of robots

The ants were sent aloft in a supply rocket in January 2014, and results from the experiments are published in the journal Frontiers in Ecology and Evolution.

The team is now beginning a citizen science project where schoolchildren can help collect data from other ant species – in their classrooms, rather than up in space.

Speaking to the BBC’s Science in Action, senior author Deborah Gordon said that ants have demonstrated their remarkable collective abilities in myriad environments on Earth, but the results from the microgravity conditions of the ISS were something new.

“We had no idea what the ants would do. We didn’t know if they would be able to search at all,” said Prof Gordon, a biologist at Stanford University.

As it turned out, although they had a little difficulty maintaining contact as they crawled, once adrift the ants showed a “remarkable ability” to get their six feet back on solid ground.

“Sometimes they would grab onto another ant and climb back down… And sometimes, they somehow managed to just flatten themselves back onto the surface. I think the biomechanics of that are interesting,” Prof Gordon said.

Testing times

The team sent up eight colonies of 80 common pavement ants, housed in small, transparent plastic boxes. Each container had a “nest” area where the animals lived.

To start the experiment, a barrier was removed that allowed them to explore a new area. After a few minutes, a second barrier was lifted, expanding the available territory even further.

“The idea is to ask the ants to search a small space – and then provide more space and see what will happen when the same number of ants have to use a larger space,” Prof Gordon explained.

Equivalent experiments were also run back on Earth, for comparison.

Down on ground level, adding extra space and dropping the “density” of ants caused them to adjust their paths, covering more ground and spreading out much more. In this way, nearly every corner of the container was visited by more than one ant within five minutes.

The ants in space still did their best to search, moving out into the expanded area as expected – but they were nowhere near as effective as their counterparts on the ground, which had the luxury of normal gravity.

experiment apparatus on the ISS
astronaut observing the experiment
The experiments were overseen by Nasa astronauts on the ISS and recorded by cameras

Battling to keep their feet on the plastic surfaces, the space-ants tended not to spread out as effectively. And some parts of the new area never even encountered the patter of six tiny feet.

“The ants didn’t do as well as they might have in microgravity,” Prof Gordon said. “I think that’s partly because the effort to hold on led to them moving more slowly, and so they didn’t have a chance to cover the ground as thoroughly.”

Adding to the problem was the fact that ants kept dropping off the surfaces altogether, tumbling in the air for periods lasting three to eight seconds. So the ants were constantly interrupted in gauging how far apart they were.

“I don’t think it’d be that easy to use interactions to keep track of density, because about 10% of the ants at any time were just floating around – and so they were not really available to interact.”

Call for help

When the history-making ants took their first steps in zero-g they were adding one more new environment to an already extensive list. It just happens to be a very new environment.

“There’s not been a lot of evolution to shape their collective search in microgravity,” Prof Gordon said.

By contrast, nearly every clime on Earth is inhabited by at least one of the 14,000 species of ant.

Different strategies have evolved in different places – for example, the European pavement ants that were taken into space tend to head straight for the edges of their new territory, while a species of Argentine ants, which the team studied previously, tends to work over fresh ground slowly and thoroughly, inch by inch.

ant experiment set-up
The researchers have provided instructions for school classes to test more ant species, here on Earth

“All ants have to perform collective search and we don’t know how they do it. There may be very interesting algorithms for collective search that we haven’t discovered,” Prof Gordon said.

Algorithms like these could help program robots to search in groups, without the need for a central control centre. And Prof Gordon is asking for help to find out more about them.

She and her team have set up a website with instructions for school classes to run the same experiment, using equipment they can make themselves, on whatever species of ant are local to their area.

“We hope that kids around the world will try this same experiment with all of the many thousands of species of ants that have never been studied,” Prof Gordon said.

She has set up a website for sharing the results and hopes to build up a database of “how different species solve this problem differently” around the world.

There is no suggestion, yet, that any other species will get the chance to strut its stuff in space.

Interventions for reducing wrong-site surgery and invasive clinical procedures .


Background

Specific clinical interventions are needed to reduce wrong-site surgery, which is a rare but potentially disastrous clinical error. Risk factors contributing to wrong-site surgery are variable and complex. The introduction of organisational and professional clinical strategies have a role in minimising wrong-site surgery.

Objectives

To evaluate the effectiveness of organisational and professional interventions for reducing wrong-site surgery (including wrong-side, wrong-procedure and wrong-patient surgery), including non-surgical invasive clinical procedures such as regional blocks, dermatological, obstetric and dental procedures and emergency surgical procedures not undertaken within the operating theatre.

Search methods

For this update, we searched the following electronic databases: the Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register (January 2014), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2014), MEDLINE (June 2011 to January 2014), EMBASE (June 2011 to January 2014), CINAHL (June 2011 to January 2014), Dissertations and Theses (June 2011 to January 2014), African Index Medicus, Latin American and Caribbean Health Sciences database, Virtual Health Library, Pan American Health Organization Database and the World Health Organization Library Information System. Database searches were conducted in January 2014.

Selection criteria

We searched for randomised controlled trials (RCTs), non-randomised controlled trials, controlled before-after studies (CBAs) with at least two intervention and control sites, and interrupted-time-series (ITS) studies where the intervention time was clearly defined and there were at least three data points before and three after the intervention. We included two ITS studies that evaluated the effectiveness of organisational and professional interventions for reducing wrong-site surgery, including wrong-side and wrong-procedure surgery. Participants included all healthcare professionals providing care to surgical patients; studies where patients were involved to avoid the incorrect procedures or studies with interventions addressed to healthcare managers, administrators, stakeholders or health insurers.

Data collection and analysis

Two review authors independently assesses the quality and abstracted data of all eligible studies using a standardised data extraction form, modified from the Cochrane EPOC checklists. We contacted study authors for additional information.

Main results

In the initial review, we included one ITS study that evaluated a targeted educational intervention aimed at reducing the incidence of wrong-site tooth extractions. The intervention included examination of previous cases of wrong-site tooth extractions, educational intervention including a presentation of cases of erroneous extractions, explanation of relevant clinical guidelines and feedback by an instructor. Data were reported from all patients on the surveillance system of a University Medical centre in Taiwan with a total of 24,406 tooth extractions before the intervention and 28,084 tooth extractions after the intervention. We re-analysed the data using the Prais-Winsten time series and the change in level for annual number of mishaps was statistically significant at -4.52 (95% confidence interval (CI) -6.83 to -2.217) (standard error (SE) 0.5380). The change in slope was statistically significant at -1.16 (95% CI -2.22 to -0.10) (SE 0.2472; P < 0.05).

This update includes an additional study reporting on the incidence of neurological WSS at a university hospital both before and after the Universal Protocol’s implementation. A total of 22,743 patients undergoing neurosurgical procedures at the University of Illionois College of Medicine at Peoria, Illinois, United States of America were reported. Of these, 7286 patients were reported before the intervention and 15,456 patients were reported after the intervention. The authors found a significant difference (P < 0.001) in the incidence of WSS between the before period, 1999 to 2004, and the after period, 2005 to 2011.  Similarly, data were re-analysed using Prais-Winsten regression to correct for autocorrelation. As the incidences were reported by year only and the intervention occurred in July 2004, the intervention year 2004 was excluded from the analysis. The change in level at the point the intervention was introduced was not statistically significant at -0.078 percentage points (pp) (95% CI -0.176 pp to 0.02 pp; SE 0.042; P = 0.103). The change in slope was statistically significant at 0.031 (95% CI 0.004 to 0.058; SE 0.012; P < 0.05).

 

Plain language summary

Interventions for reducing wrong-site surgery

Wrong-site surgery is a rare, but serious event that can have substantial consequences for patients and healthcare providers. It occurs when a surgical or invasive procedure is undertaken on the wrong body part, wrong patient, or the wrong procedure is performed. A number of interventions to reduce surgical error or prevent WSS, mainly involving pre-operative verification, such as the development of Universal Protocol, site marking and ‘time-out’ procedures have been proposed over recent years. This updated review contains two interrupted-time-series (ITS) studies (studies in which data are collected at multiple time points before and after an intervention), one from the original review, which evaluated a targeted educational intervention aimed at reducing the incidence of wrong-site surgery, and which was found to reduce its incidence. An additional study evaluated the incidence of wrong-site surgery before and after the introduction of the Universal Protocol, however the relevance of these findings regarding the impact of the intervention is unclear given that prior to its introduction, the incidence was decreasing due to other unclear factors. Overall, this review now contains two studies, of relatively low quality evidence, on very specific populations and their generalisability to a larger audience is low.

A virus that makes you stupid has infected up to 1/2 of humanity


Although a few stops short of a zombie apocalypse, and a bit more exciting than toxoplasmosis (which may affect 1/3 of humans), a newly found algae virus appears to be negatively impacting the cognitive abilities of at least those living in cities on the ocean.algalvirus

This is actually pretty revolutionary, primarily because it is the first known example of a virus completely jumping kingdoms and moving between plants and animals. The virus, called ATCV-1, which first showed up assays of human brain tissue several years ago, was initially assumed to have entered the tissue after the death of the patients. This post-mortem hypothesis was quickly defeated when the virus started showing up in the throats of people with psychiatric diseases.

Infectious disease expert Robert Yolken fr,om Johns Hopkins University School of Medicine in Baltimore, Maryland, and his colleagues were investigating what pathogens play a role in these psychiatric conditions. At first, they didn’t know what ATCV-1 was, but a database search exposed its identity as a virus that typically infects a species of freshwater green algae.

A follow-up study of 92 healthy people found that 43% of them had the virus, and that was associated with a reduction in cognitive functioning by approximately 10%.  To see if this was really more likely simply a correlation, and not a causation, the cognitive experiments were repeated with mice (further reducing the number of complex variables and genetic differences when dealing with humans). Surprisingly, the 10% reduction in cognitive ability  was exactly replicated in the mice (10% longer to escape a maze, and 20% less time investigating a new object), as well as revealing that infection with ACTV-1 changed the expression levels of 1300 genes found in brain tissue!

Before you stop eating sea food, no one has figured out how this virus infects people or how many people actually have it (the preliminary studies were carried out in Baltimore). Although it seems likely at this point, there is not even any guarantee that it is actually slowing down those who are infected. More follow-up studies are going to be needed before we can really characterize exactly how this virus infects and affects humans, and through what channels so many could become infected: by the ocean breeze, sushi, or something else entirely?

 

Clues found into cognitive dysfunction in chronic fatigue syndrome .


Model of the human head and brain.

       

Immune Markers in Cerebrospinal Fluid Provide Insights Into the Basis for Symptoms Like “Brain Fog”

Scientists at Columbia University’s Mailman School of Public Health have identified a unique pattern of immune molecules in the cerebrospinal fluid of people with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) that provides insights into the basis for cognitive dysfunction—frequently described by patients as “brain fog”—as well as new hope for improvements in diagnosis and treatment.

In the study published in Molecular Psychiatry, Mady Hornig, MD, and colleagues used immunoassay testing methods to measure levels of 51 immune biomarkers called cytokines in the cerebrospinal fluid of 32 people with ME/CFS for an average of seven years, 40 with multiple sclerosis, and 19 non-diseased controls. The researchers found that levels of most cytokines, including the inflammatory immune molecule interleukin 1, were depressed in individuals with ME/CFS compared with the other two groups, matching what was seen in a blood study in patients who had the disease for more than three years. One cytokine—eotaxin—was elevated in the ME/CFS and MS groups, but not in the control group.

“We now know that the same changes to the immune system that we recently reported in the blood of people with ME/CFS with long-standing disease are also present in the central nervous system,” says Dr. Hornig, professor of Epidemiology and director of translational research at the Center for Infection and Immunity at the Mailman School. “These immune differences may contribute to symptoms in both the peripheral parts of the body and the brain, from muscle weakness to brain fog.”

Implications for Diagnosis and Treatment

“Diagnosis of ME/CFS is now based on clinical criteria. Our findings offer the hope of objective diagnostic tests for disease as well as the potential for therapies that correct the imbalance in cytokine levels seen in people with ME/CFS at different stages of their disease,” adds W. Ian Lipkin, MD, John Snow Professor of Epidemiology and director of the Center for Infection and Immunity.

There is precedent for use of human monoclonal antibodies that regulate the immune response in a wide range of disorders from rheumatoid arthritis to multiple sclerosis. However, the researchers note, additional work will be needed to assess the safety and efficacy of this approach.

 

Researchers Create “Wikipedia” for Neurons .


The decades worth of data that has been collected about the billions of neurons in the brain is astounding. To help scientists make sense of this “brain big data,” researchers at Carnegie Mellon University have used data mining to create www.neuroelectro.org, a publicly available website that acts like Wikipedia, indexing physiological information about neurons.

The site will help to accelerate the advance of neuroscience research by providing a centralized resource for collecting and comparing data on neuronal function. A description of the data available and some of the analyses that can be performed using the site are published online by the Journal of Neurophysiology.

The neurons in the brain can be divided into approximately 300 different types based on their physical and functional properties. Researchers have been studying the function and properties of many different types of neurons for decades. The resulting data is scattered across tens of thousands of papers in the scientific literature. Researchers at Carnegie Mellon turned to data mining to collect and organize these data in a way that will make possible, for the first time, new methods of analysis.

“If we want to think about building a brain or re-engineering the brain, we need to know what parts we’re working with,” said Nathan Urban, interim provost and director of Carnegie Mellon’s BrainHubSM neuroscience initiative. “We know a lot about neurons in some areas of the brain, but very little about neurons in others. To accelerate our understanding of neurons and their functions, we need to be able to easily determine whether what we already know about some neurons can be applied to others we know less about.”

Shreejoy J. Tripathy, who worked in Urban’s lab when he was a graduate student in the joint Carnegie Mellon/University of Pittsburgh Center for the Neural Basis of Cognition (CNBC) Program in Neural Computation, selected more than 10,000 published papers that contained physiological data describing how neurons responded to various inputs. He used text mining algorithms to “read” each of the papers. The text mining software found the portions of each paper that identified the type of neuron studied and then isolated the electrophysiological data related to the properties of that neuronal type. It also retrieved information about how each of the experiments in the literature was completed, and corrected the data to account for any differences that might be caused by the format of the experiment. Overall, Tripathy, who is now a postdoc at the University of British Columbia, was able to collect and standardize data for approximately 100 different types of neurons, which he published on the website www.neuroelectro.org.

Since the data on the website was collected using text mining, the researchers realized that it was likely to contain errors related to extraction and standardization. Urban and his group validated much of the data, but they also created a mechanism that allows site users to flag data for further evaluation. Users also can contribute new data with minimal intervention from site administrators, similar to Wikipedia.

“It’s a dynamic environment in which people can collect, refine and add data,” said Urban, who is the Dr. Frederick A. Schwertz Distinguished Professor of Life Sciences and a member of the CNBC. “It will be a useful resource to people doing neuroscience research all over the world.”

Ultimately, the website will help researchers find groups of neurons that share the same physiological properties, which could provide a better understanding of how a neuron functions. For example, if a researcher finds that a type of neuron in the brain’s neocortex fires spontaneously, they can look up other neurons that fire spontaneously and access research papers that address this type of neuron. Using that information, they can quickly form hypotheses about whether or not the same mechanisms are at play in both the newly discovered and previously studied neurons.

To demonstrate how neuroelectro.org could be used, the researchers compared the electrophysiological data from more than 30 neuron types that had been most heavily studied in the literature. These included pyramidal neurons in the hippocampus, which are responsible for memory, and dopamine neurons in the midbrain, thought to be responsible for reward-seeking behaviors and addiction, among others. The site was able to find many expected similarities between the different types of neurons, and some similarities that were a surprise to researchers. Those surprises represent promising areas for future research.

In ongoing work, the Carnegie Mellon researchers are comparing the data on neuroelectro.org with other kinds of data, including data on neurons’ patterns of gene expression. For example, Urban’s group is using another publicly available resource, the Allen Brain Atlas, to find whether groups of neurons with similar electrical function have similar gene expression.

“It would take a lot of time, effort and money to determine both the physiological properties of a neuron and its gene expression,” Urban said. “Our website will help guide this research, making it much more efficient.”

 

Eating spinach every day could make your brain 11 years younger


We all know that vegetables are good for us – but did you know that eating just one portion of leafy greens a day could stave off dementia?

Delicious: spinach cooked with ginger

Researchers at Rush University in Chicago evaluated the diet and mental ability of around 950 older people every year for two to 10 years.

Participants, who had an average age of 81 years, participated in 19 tests to assess their mental function and identified, from a list of 144 items, what food and drinks featured in their diet.

Those adults who ate leafy green vegetables such as spinach and kale once or twice a day experienced significantly less cognitive decline than those who did not, even when other factors such as education, exercise and family history of dementia were taken into account.

Om average, participants who ate greens halted their mental decline by an average of 11 years, the researchers revealed this week at the Experimental Biology Conference in Boston.

Lead researcher Martha Clare Morris said: “Losing one’s memory or cognitive abilities is one of the biggest fears for people as they get older. Since declining cognitive ability is central to Alzheimer’s disease and dementias, increasing consumption of green leafy vegetables could offer a very simple, affordable and non-invasive way of potentially protecting your brain from Alzheimer’s disease and dementia.”

Morris said that the benefits of leafy greens were probably linked to their high levels of vitamins and nutrients, such as vitamin K, lutein, folate and beta-carotene.

Kava: A Natural Alternative To Anxiety Medication?


Kava (Piper Methysticum), also known as awa, ava and yaqona, is a crop native to the South Pacific and is a member of the pepper family. The plant sports relatively large, heart-shaped leaves, which accompany slender flower blossoms that reside at the intersections where the branch and stems meet. However, the kava plant has earned its status due to what resides within its hairy, woody roots.

Photo by Simpler Days.

Kava has been used in traditional, tribal settings on the islands of Fiji, Micronesia and Polynesia for hundreds of years. These cultures use the psychoactive beverage as a social and ceremonial offering in a way that’s often compared to how wine is used and consumed in European countries. Traditionally, after being harvested, the root is then pulverized, ground (often by mouth) and shredded. The herbal preparation is then repetitively strained into a bowl using a cold water extraction method, before being served in, and drunk out of, a half coconut shell. This preparation is enjoyed reverently due to its calming and sedating qualities. Because of these effects, growing evidence is starting to support claims that kava is useful for those suffering from insomnia, high stress, depression and anxiety. Interestingly, kava is proving to be as effective as dissolving anxiety as pharmaceutical drugs that are often prescribed for this condition.

The array of active ingredients responsible for the psychoactive effects of kava are known to science as kavaclones. These chemicals include compounds such as dihydrokavain, methysticum and kawaii, all of which have been thoroughly studied in laboratory settings. As a result, there’s empirical evidence that these compounds promote sleep, decrease convulsions and relax muscles in animals. The chemicals described have also shown to be effective painkillers, which is associated with the temporary numbness of the tongue that kava beverages induce when drunk. A double-blind, randomized, placebo controlled study conducted by The University of Melbourne in Australia found kava to be significantly more effective than a placebo at reducing anxiety in a group of 75 participants, all of whom were diagnosed with GAD (General Anxiety Disorder).

Lead researcher, Dr. Jerome Sarris, believes GAD to be a complex and potentially debilitating disorder that can significantly effect the daily lives of those affected, with existing medications only showing modest clinical results. Sarris was quoted by News Room in reference to the study, stating: “We have recognized that plant based medicines may be a viable treatment for patients with chronic anxiety. In this study we’ve been able to show that kava offers a potential natural alternative for the treatment of chronic clinical anxiety. Unlike some other options it has less risk of dependency and less potential side effects.”

Another study carried out at The School of Veterinary Medicine in Berlin, Germany found kava to have very similar anti-anxiety effects to the drug diazepam (Valium) when it was administered to animals. The authors of the study claim that the data supports the use of kava in treating anxiety disorders. Additionally, researchers at the University of Hertfordshire in the United Kingdom and the University of Zurich in Switzerland set out to explore how kava can affect mood and emotions, measuring the three areas of seriousness, cheeriness and bad mood. After a single dose of kava, an increase in cheerfulness was observed in the volunteers and they even performed better when given certain cognitive tasks. This led the researchers to draw a comparison between kava and conventional prescription drugs used to treat anxiety. Conventional drugs often cause unwanted mental side effects and cognitive impairment, whereas kava has been found to actually promote brain function while providing strong anti-anxiety effects and positive feelings such as exhilaration.

There’s much anecdotal evidence related to kava on the internet, many of which can be found in Erowid’s user experience vaults. One user has detailed kava’s ability to cease their anxiety and depression. Another contributor to Erowid gave details of theirexperience claiming: “The quieting of my conscious mind and the total clarity of thought I was experiencing was nothing short of wonderful.”

Kava has seen a recent surge in popularity in the Western world in the areas of medicine and recreational activity. It can be obtained in many different forms from the dried roots, condensed capsules and more potent tinctures. However, users looking for more of a social and recreational setting may want to pay a visit to the growing number of kava bars erupting across the U.S. — from California, to Florida, to Hawaii and elsewhere. In such establishments, both experienced and novice kava drinkers can enjoy the anxiety-easing yet clarity promoting substance legally in the company of friends, sipping from a half coconut shell surrounded by tiki statues, palm leaves, gentle laughter and easy smiles.

Much like practically every medicinal and recreational substance, kava does not come without its fair share of controversy. There are some safety concerns that link kava usage to possible liver damage, which has led to some governments, such as Poland‘s, to ban and control it. However, Dr. Sarris, a professional who has studied kava in-depth points out: “When extracted in the appropriate way, kava may pose less or no potential liver problems. I hope the results will encourage governments to reconsider the ban.”

Also, many Erowid users speak of using kava extensively for many years without any detrimental side effects, such as this user who has been a frequent drinker for three consecutive years. The author takes a liver test every three months and has reported perfectly safe medical results.

Ultimately, kava is another example of an effective plant medicine that could potentially offer individuals a natural and safer alternative to often dangerous and addictive conventional treatments.

Kochi arachnologists discover rare spiders


Researchers at the Division of Arachnology in Sacred Heart College here have recorded the sighting of a huntsman and jumping spider in the Western Ghats.

Martensopoda sanctor and Stenaelurillus albus were sighted by arachnologists near Ponmudi and Malayattoor respectively. Photo: Special Arrangement

The spiders belong to the Sparassidae and Salticidae families. The research team included Dr. Mathew M.J., Fr. Jobi Malamel and Pradeep Kumar M.S. and were led by Dr. P.A. Sebastian, director of the Division of Arachnology.

The huntsman spider was sighted at Ponmudi, while the researchers found the jumping spider at the Malayattoor and Bhoothathankettu reserve forest near here.

“Huntsman spiders are known for their speed and mode of hunting. Sometimes they hide in the ambush and surprise the prey. Some of these spiders have been found making a substrate-borne sound deliberately when they detect a chemical left by a nearby female of their species,” said the researchers.

They said that the males anchor themselves firmly to the surface to which they have crawled and use their legs to transmit vibrations from their bodies to the surface. The characteristic frequency of vibration and the pattern of bursts of sound alert the females, who will approach if they are interested in mating, they said.

Dr. Sebastian said that jumping spiders prey like a grasshopper, as it jumps from one place to another.

It has been given the name Stenaelurillus albus owing to the presence of a unique whitish area on the copulatory organ of the male spider. The discovery is unique as it has the presence of mating plugs that have been reported in only 17 species of the approximate 5,800 jumping spiders recorded till now, he said.

Impact of COPD on the Mortality and Treatment of Patients Hospitalized With Acute Decompensated Heart Failure.


BACKGROUND:  COPD is a common comorbidity in patients with heart failure, yet little is known about the impact of this condition in patients with acute decompensated heart failure (ADHF), especially from a more generalizable, community-based perspective. The primary objective of this study was to describe the in-hospital and postdischarge mortality and treatment of patients hospitalized with ADHF according to COPD status.

METHODS:  The study population consisted of patients hospitalized with ADHF at all 11 medical centers in central Massachusetts during four study years: 1995, 2000, 2002, and 2004. Patients were followed through 2010 for determination of their vital status.

RESULTS:  Of the 9,748 patients hospitalized with ADHF during the years under study, 35.9% had a history of COPD. The average age of this population was 76.1 years, 43.9% were men, and 93.3% were white. At the time of hospital discharge, patients with COPD were less likely to have received evidence-based heart failure medications, including β-blockers and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, than patients without COPD. Multivariable, adjusted in-hospital death rates were similar for patients with and without COPD. However, among patients who survived to hospital discharge, patients with COPD had a significantly higher risk of dying at 1 year (adjusted relative risk [RR], 1.10; 95% CI, 1.06-1.14) and 5 years (adjusted RR, 1.40; 95% CI, 1.28-1.52) after hospital discharge than patients who were not previously diagnosed with COPD.

CONCLUSIONS:  COPD is a common comorbidity in patients hospitalized with ADHF and is associated with a worse long-term prognosis. Further research is required to understand the complex interactions of these diseases and ensure that patients with ADHF and COPD receive optimal treatment modalities.