Self-medication with over-the-counter analgesics : a survey of patient characteristics and concerns about pain medication

Pain is a common reason for self-medication with over-the-counter (OTC) analgesics. However, this self-treating population has remained largely uncharacterized. This cross-sectional observational study investigated individuals who self-medicate their pain with OTC analgesics to elucidate their pain characteristics and medication use. In addition, presence of and risk factors for concerns about pain medication were examined. The clinical profile of the participants (n = 1,889) was worse than expected with long-standing pain complaints (median pain duration of 9 years), pain located at multiple body sites (median of 4, and 13% with ≥10 painful body areas), about one-third suffering from daily pain and about 40% experiencing substantial pain-related disability. Head (58.6% of sample), low back (43.6%), and neck (30.7%) were the most common pain locations. About 73% had a physician diagnosis, mainly migraine and osteoarthritis. Paracetamol (used by 68.6% of patients) and nonsteroidal anti-inflammatory drugs (46.8%) were the most frequently used pain medications. About 40% of our sample showed substantial concern about the perceived need for pain medication and the perceived potential for harmful effects (eg, fear for addiction). These findings highlight the importance for health professionals to systematically probe pain patients about their self-medication practices and explore attitudes about pain medication. Perspective: This study found that the clinical picture of people who self-medicate their pain with OTC analgesics looked worse than expected. We also identified substantial concerns about pain medication. Therefore, we recommend that health professionals systematically probe pain patients about their self-medication practices and explore concerns about pain medication. © 2018 the American Pain Societ

Evaluation of local tolerance of a plant extract by the slug mucosal irritation (SMI) assay

This article describes the performance of a laboratory exercise, the Slug Mucosal Irritation (SMI) assay, carried out by third year undergraduate students, to investigate the local tolerance of an ethanolic plant extract. The plant extract, Spilanthes acmella, contains various bio-active compounds, such as the N-alkylamide spilanthol. After administration of the plant extract to the slugs, they were observed for possible discomfort and tissue damage. When slugs are exposed to a substance with irritant properties, the mucus production of the slugs will increase. Furthermore, slugs will release proteins, including enzymes, when tissue damage occurs. This laboratory experiment is a practically feasible in vivo test using slugs which are invertebrates that are not protected by the legislation on animal testing. Students were supervised by lab instructors who encouraged students to actively contribute in their groups, to think about the experimental design of the laboratory test, and to facilitate scientific discussions, but the majority of the ideas had to come from the students themselves. Hence, this biomedical in vivo experiment offered a great opportunity for students to learn to work in group, to critically interpret and report their results, to gain knowledge about the subject, and to communicate and discuss with other students as well as with the lab instructors. Furthermore, this experiment teaches students current toxicological methodologies encompassing principles and their application of biochemistry, analytical chemistry, toxicology, animal experimentation and data handling. This way of interdisciplinary teaching is especially important for last year undergraduate students, as this is a good preparation for the Masters dissertation. At the end of the laboratory exercise, students received a questionnaire and most of the students indicated that they gained valuable knowledge and skills. This laboratory exercise can be incorporated into chemical, biological, pharmaceutical, toxicological and medical disciplines

Evaluation of local tolerance of a plant extract by the slug mucosal irritation (SMI) assay

This article describes the performance of a laboratory exercise, the Slug Mucosal Irritation (SMI) assay, carried out by third year undergraduate students, to investigate the local tolerance of an ethanolic plant extract. The plant extract, Spilanthes acmella, contains various bio-active compounds, such as the N-alkylamide spilanthol. After administration of the plant extract to the slugs, they were observed for possible discomfort and tissue damage. When slugs are exposed to a substance with irritant properties, the mucus production of the slugs will increase. Furthermore, slugs will release proteins, including enzymes, when tissue damage occurs. This laboratory experiment is a practically feasible in vivo test using slugs which are invertebrates that are not protected by the legislation on animal testing. Students were supervised by lab instructors who encouraged students to actively contribute in their groups, to think about the experimental design of the laboratory test, and to facilitate scientific discussions, but the majority of the ideas had to come from the students themselves. Hence, this biomedical in vivo experiment offered a great opportunity for students to learn to work in group, to critically interpret and report their results, to gain knowledge about the subject, and to communicate and discuss with other students as well as with the lab instructors. Furthermore, this experiment teaches students current toxicological methodologies encompassing principles and their application of biochemistry, analytical chemistry, toxicology, animal experimentation and data handling. This way of interdisciplinary teaching is especially important for last year undergraduate students, as this is a good preparation for the Masters dissertation. At the end of the laboratory exercise, students received a questionnaire and most of the students indicated that they gained valuable knowledge and skills. This laboratory exercise can be incorporated into chemical, biological, pharmaceutical, toxicological and medical disciplines

DNA barcodes and phylogenetic affinities of the terrestrial slugs Arion gilvus and A. ponsi (Gastropoda, Pulmonata, Arionidae)

The Iberian Peninsula is a region with a high endemicity of species of the terrestrial slug subgenus Mesarion. Many of these species have been described mainly on subtle differences in their proximal genitalia. It therefore remains to be investigated 1) whether these locally diverged taxa also represent different species under a phylogenetic species concept as has been shown for other Mesarion species outside the Iberian Peninsula, and 2) how these taxa are phylogenetically related. Here, we analysed DNA sequence data of two mitochondrial (COI and 16S) genes, and of the nuclear ITS1 region, to explore the phylogenetic affinities of two of these endemic taxa, viz. Arion gilvus Torres Mínguez, 1925 and A. ponsi Quintana Cardona, 2007. We also evaluated the use of these DNA sequence data as DNA barcodes for both species. Our results showed that ITS did not allow to differentiate among most of the Mesarion molecular operational taxonomic units (MOTUs) / morphospecies in Mesarion. Yet, the overall mean p-distance among the Mesarion MOTUs / morphospecies for both mtDNA fragments (16.7% for COI, 13% for 16S) was comparable to that between A. ponsi and its closest relative A. molinae (COI: 14.2%; 16S: 16.2%) and to that between A. gilvus and its closest relative A. urbiae (COI: 14.4%; 16S: 13.4%). Hence, with respect to mtDNA divergence, both A. ponsi and A. gilvus, behave as other Mesarion species or putative species-level MOTUs and thus are confirmed as distinct 'species'

Retrospective analysis of the Draize test for serious eye damage/eye irritation: importance of understanding the in vivo endpoints under UN GHS/EU CLP for the development and evaluation of in vitro test methods

For more than two decades, scientists have been trying to replace the regulatory in vivo Draize eye test by in vitro methods, but so far only partial replacement has been achieved. In order to better understand the reasons for this, historical in vivo rabbit data were analysed in detail and resampled with the purpose of (1) revealing which of the in vivo endpoints are most important in driving United Nations Globally Harmonized System/European Union Regulation on Classification, Labelling and Packaging (UN GHS/EU CLP) classification for serious eye damage/eye irritation and (2) evaluating the method’s within-test variability for proposing acceptable and justifiable target values of sensitivity and specificity for alternative methods and their combinations in testing strategies. Among the Cat 1 chemicals evaluated, 36–65 % (depending on the database) were classified based only on persistence of effects, with the remaining being classified mostly based on severe corneal effects. Iritis was found to rarely drive the classification (<4 % of both Cat 1 and Cat 2 chemicals). The two most important endpoints driving Cat 2 classification are conjunctiva redness (75–81 %) and corneal opacity (54–75 %). The resampling analyses demonstrated an overall probability of at least 11 % that chemicals classified as Cat 1 by the Draize eye test could be equally identified as Cat 2 and of about 12 % for Cat 2 chemicals to be equally identified as No Cat. On the other hand, the over-classification error for No Cat and Cat 2 was negligible (<1 %), which strongly suggests a high over-predictive power of the Draize eye test. Moreover, our analyses of the classification drivers suggest a critical revision of the UN GHS/EU CLP decision criteria for the classification of chemicals based on Draize eye test data, in particular Cat 1 based only on persistence of conjunctiva effects or corneal opacity scores of 4. In order to successfully replace the regulatory in vivo Draize eye test, it will be important to recognise these uncertainties and to have in vitro tools to address the most important in vivo endpoints identified in this paper.JRC.I.5-Systems Toxicolog

Experimental hybridization of two African Streptocephalus species (Crustacea, Branchiopoda: Anostraca)

Fairy shrimp are ancient crustaceans that live in islands of ephemeral waters all over the world. Although an ancient group, there is evidence that they evolve slowly and thus, genetic differences between species can be relatively small. Here, we hybridize two African species of Streptocephalus with overlapping geographical ranges, and find that hybrids have reduced viability. We postulate a model of allopatric speciation, and discuss what may happen if sympatry is secondarily regained. We argue that strong pre- and post-mating barriers should be favoured if speciation has proceeded in conditions where the risk of sympatry is non-negligible. In species that evolved in absolute allopatry (like in Africa and North America), no selection for such barriers exists, however. Man nowadays increasingly interferes with incipient speciation by artificially connecting ephemeral pools, in which case full introgression may occur