Coffee linked to reduced risk of MS
Drinking more than 900 ml of coffee – around six cups—has been linked to a reduced risk of multiple sclerosis (MS), according to research published in the Journal of Neurology Neurosurgery & Psychiatry. Caffeine, a central nervous system stimulant, has neuroprotective properties and can suppress the production of chemicals involved in the inflammatory response, which may explain the association found, suggest the researchers. A linked editorial warns that it remains to be seen whether coffee drinking could ward off the development of MS. Two population studies – one Swedish and one from the US – were analysed by the researchers. The risk of MS was consistently higher among those drinking fewer cups of coffee every day in both studies. In the Swedish study, coffee consumption was associated with a reduced risk of MS both at the start of symptoms and 5 and 10 years beforehand, with a 28-30% lower risk among those drinking more than six cups (over 900 mL) every day. Similar results were found in the US study, with a 26-31% lower risk among those drinking more than 948 mL daily at least 5 years beforehand and at the start of symptoms compared with those who never drank coffee.

Cannabis users more likely to be hospitalised at onset of psychosis
People who use cannabis while experiencing their first episode of a psychotic illness are 50% more likely to be admitted to hospital than those that don’t, according to the UK authors of research published in BMJ Open. Cannabis use was also linked to higher numbers of prescriptions for different antipsychotic drugs, suggesting that it may contribute to treatment failure, say the researchers. The authors used anonymised electronic health records of 2026 people treated for a first episode of psychosis at one of the largest providers of mental health services in Europe between 2006 and 2013, to find out the prevalence of cannabis use recorded within a month of the first visit. Use of the drug was associated with a 50% increase in the frequency of hospital admissions, with an average of 1.8 admissions up to 5 years after the first service visit, compared with non-users who averaged 1.2 admissions over the same period. It was also associated with an increase in the risk of compulsory detention in hospital under the Mental Health Act — 45% of those who used cannabis compared to 34% of those who didn’t.

Zika virus infects brain stem cells
The Zika virus infects a type of neural stem cell that gives rise to the brain’s cerebral cortex, according to US research published in Cell Stem Cell. On laboratory dishes, these stem cells were found to be havens for viral reproduction, resulting in cell death and/or disruption of cell growth. While this study does not prove the direct link between Zika and microcephaly, it does pinpoint where the virus may be doing the most damage. One concerning discovery was that the stem cells that Zika was found to infect, called cortical neural precursors, become factories for viral replication. From a single infection, the virus particles spread through a plate of stem cells within a span of 3 days.

Major hip bone fractures found in teen rugby players
Broken and dislocated hipbones have been found in three teenage rugby union players by a group of Irish doctors, writing in BMJ Case Reports. Acetabular fractures affect the socket of the hip bone, and are generally sustained after violent trauma, such as road traffic accidents. But the Irish group wrote that “we have not previously encountered these injuries in a juvenile sporting population”. The injuries were sustained while playing rugby union, two during seasonal match play and one during a training drill. Previously, the doctors reported two acetabular fractures in two other young rugby players, aged 16 and 24 years. All four injuries occurred during the tackle phase of play, and occurred as a result of pressure exerted through a flexed hip with the knee on the ground. Three of these fractures occurred along with hip dislocations. This position can be encountered during a two-man tackle, as one tackler hits low and the other hits high. “In order to prevent the potentially devastating consequences of these injuries it may be necessary to implement rule changes or size restrictions in the juvenile game,” say the doctors.

Antimicrobial resistance in Africa
South African researchers, in collaboration with the World Health Organization’s Regional Office for Africa (WHO-AFRO), have found that just two African countries (4.3%) have national antimicrobial resistance (AMR) plans in place, while 14.9% (7) have overarching national infection prevention and control policies, 93.6% (44) have essential medicines lists and 91.5% (43) have national medicines policies and treatment guidelines. Published in the Journal of Public Health, the study also found that “[no African nations] currently have representative national surveillance systems nor do any incentivize research and development into new medicines and diagnostics”. “It is incumbent upon WHO-AFRO to assume the leadership role of monitoring, evaluating and reporting on the progress of member states towards implementation of the WHO Policy Package … to combat AMR,” the study concluded. “WHO-AFRO is well placed to establish multidisciplinary and multi-sectorial regional platforms for policy discourse and sharing good practice on the management of AMR within and across African countries while monitoring and evaluating incremental progress.”

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