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Disclaimer: 'MS Views and News' DOES NOT endorse any products or services found on this blog. It is up to you to seek advice from your healthcare provider. The intent of this blog is to provide information on various medical conditions, medications, treatments, and procedures for your personal knowledge and to keep you informed of current health-related issues. It is not intended to be complete or exhaustive, nor is it a substitute for the advice of your physician. Should you or your family members have any specific medical problem, seek medical care promptly.

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Sunday, February 18, 2018

MS Hug: How to Ease the Pain

If you’ve been diagnosed with multiple sclerosis, an autoimmune disease that affects the brain and spinal cord, you might have felt a band of pain around your torso. It’s often called the “MS hug.”

What You’re Feeling

Like most symptoms of MS, the feeling is different for each person. You might have pain under your rib cage or anywhere between your neck and waistline. It can be dull and achy, sharp, or burning. It can last a few seconds to a few hours, and in rare cases, a few days.
Some people describe a slight tingling or tickling vibration, while others say it’s a crippling pressure below their ribs that can make it hurt to breathe. People often say it’s like wearing a girdle around the middle of your body. For that reason, you may also hear it called the “MS girdle” or “girdle-band” sensation.

What’s Really Going On?

In between each of your ribs are small muscles that hold your rib cage together and help it expand when you move, bend, or breathe. If these muscles have spasms, you feel painful, tightening pressure.

What Should You Do?

If you think you’re having an MS hug, talk to your neurologist or main doctor right away. The symptoms can seem like those of a heart attack, so it’s important to make sure that’s not the case and to rule out any other causes of the pressure.
Your doctor will most likely give you an MRI to look for other things, like gallbladder or lung disease. MS hug can also happen to people with other rib and spinal cord conditions.

Treatment and Therapy

You’re more likely to trigger an MS hug if you’re feeling stressed, overworked, or very tired. So try to take good care of yourself and avoid a flare.
A few things to try:     


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MS Drug Poses Hard Choices for Women Wanting Kids

By Dennis Thompson
HealthDay Reporter
THURSDAY, Feb. 8, 2018 (HealthDay News) -- A powerful multiple sclerosis drug presents women with a tough dilemma if they would like to have children, a pair of new studies suggests.
Those who take Tysabri (natalizumab) to manage their MS are more likely to suffer a relapse during pregnancy if they stop taking the drug before they conceive, the first study found.
But if a woman remains on Tysabri while trying to get pregnant, her unborn child could face serious health risks, the second study showed.
Fetal exposure to Tysabri up to 12 weeks of gestation was associated with an increased risk of miscarriage, the Italian researchers discovered. Babies exposed to the drug in the womb also tended to have shorter length and lower weight at birth.
The researchers said their findings provide a path forward for couples who'd like to start a family.
"Our findings suggest that if women who take natalizumab for MS want to become pregnant, it may be best to continue treatment up until a pregnancy test is positive and then at that point discontinue use," lead researcher Dr. Emilio Portaccio said in a statement.
"While there is still a risk of increased disease activity, this course of action may lower that risk," said Portaccio, a neurologist with the Don Carlo Gnocchi Foundation in Florence.
Other MS experts are less certain, arguing that these studies simply provide more data for couples to consider when planning a family.



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Inhibiting Enzyme Can Reverse Myelin Damage, Improve Limb Function, Mouse Study Shows

Inhibiting Enzyme Can Reverse Myelin Damage, Improve Limb Function, Mouse Study Shows

Inhibiting an enzyme responsible for turning genes on and off can reverse damage to the myelin sheath that protects nerve cells, improving limb function, a multiple sclerosis-related study in mice shows.
The research, which involved mice with sciatic nerve damage rather than MS, was published in the journal Nature Medicine. Its title is “A histone deacetylase 3–dependent pathway delimits peripheral myelin growth and functional regeneration.
Damage to the myelin sheath leads to such MS-related problems as muscle stiffness and weakness, fatigue and pain.
A team at the Cincinnati Children’s Hospital Medical Center and other researchers decided to look for compounds that could inhibit enzymes responsible for turning genes on and off.
Scientists dub the turning-on and -off process epigenetic regulation. The process does not interfere with a gene’s DNA sequence. It works by adding or removing an epigenetic mark from a DNA sequence — much like adding or removing a clothes pin .
CONTINUE reading


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Eye and balance exercises may ease multiple sclerosis symptoms



REUTER HEALTH: People with multiple sclerosis who do balance and eye movement exercises may feel steadier on their feet and experience less fatigue and dizziness, a small trial suggests.
Multiple sclerosis (MS) is a rare, disabling autoimmune disease that damages the central nervous system. It can lead to fatigue, pain, vision loss and impaired coordination and motor skills.
For the current study, researchers focused on 88 adults with MS who were able to walk 100m assisted with a cane if necessary. Half of them were randomly selected to participate in a supervised exercise programme, while the rest were put on a waiting list.

At the start of the study, researchers gave all of the participants computer-based balance tests. None of the participants approached scores of 90 out of 100 that are typical for healthy adults without balance issues.

After six weeks, however, average scores rose more for the exercise group. While both groups started with scores around 62-63, those in the exercise group rose to an average of 73, compared with an increase to 66 in the other group.

“It is possible that disability due to MS can be improved or the accumulation of disability lessened by participation in exercise such as (this) programme; however, additional research in this area is needed,” said lead study author Jeffrey Hebert of the University of Colorado School of Medicine in Denver.

Read more at https://www.channelnewsasia.com/news/health/eye-and-balance-exercises-may-ease-multiple-sclerosis-symptoms-9964882





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An update on Cladribine for relapsing-remitting multiple sclerosis

Pub Med

Despite recent progress, currently available therapies for relapsing remitting multiple sclerosis (MS) are only partly effective, and their use is limited by tolerability and safety issues, as well as high cost. Cladribine was originally rejected by the regulatory authorities in both the European Union and USA in 2011, but in June 2017 the European Medical Agency recommended marketing authorization for treatment of aggressive relapsing MS. Areas covered: We provide an update on chemistry, mechanism of action, efficacy and safety of cladribine for the treatment of MS. Expert opinion: Cladribine is well tolerated, it is dosed orally in cycles of one year, the need for regular blood testing during treatment is likely limited, and the two-year efficacy data for treatment of relapsing MS are at least in the same range as the most efficient licensed treatments. The increased risk of malignancies reported in the pivotal trial seems to be caused by unexpectedly low numbers of malignancies in the placebo group. Cladribine could therefore be an alternative for many patients with relapsing remitting MS. The main caveat is the lack of long term efficacy and safety data. Currently there are insufficient data to guide further treatment of patients who have completed two treatment cycles of cladribine.

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Systematic review of systematic reviews for medical cannabinoids: Pain, nausea and vomiting, spasticity, and harms.

PubMed

Allan GM, et al. Can Fam Physician. 2018.

Abstract


OBJECTIVE: To determine the effects of medical cannabinoids on pain, spasticity, and nausea and vomiting, and to identify adverse events.

DATA SOURCES: MEDLINE, the Cochrane Database, and the references of included studies were searched.

STUDY SELECTION: Systematic reviews with 2 or more randomized controlled trials (RCTs) that focused on medical cannabinoids for pain, spasticity, or nausea and vomiting were included. For adverse events, any meta-analysis for the conditions listed or of adverse events of cannabinoids was included.

SYNTHESIS: From 1085 articles, 31 relevant systematic reviews were identified including 23 for pain, 5 for spasticity, 6 for nausea and vomiting, and 12 for adverse events. Meta-analysis of 15 RCTs found more patients taking cannabinoids attained at least a 30% pain reduction: risk ratio (RR) of 1.37 (95% CI 1.14 to 1.64), number needed to treat (NNT) of 11. Sensitivity analysis found study size and duration affected findings (subgroup differences, P ≤ .03), with larger and longer RCTs finding no benefit. Meta-analysis of 4 RCTs found a positive global impression of change in spasticity (RR = 1.45, 95% CI 1.08 to 1.95, NNT = 7). Other results were not consistently statistically significant, but when positive, a 30% or more improvement in spasticity had an NNT of 10. Meta-analysis of 7 RCTs for control of nausea and vomiting after chemotherapy found an RR of 3.60 (95% CI 2.55 to 5.09) with an NNT of 3. Adverse effects caused more patients to stop treatment (number needed to harm [NNH] of 8 to 22). Individual adverse events were very common, including dizziness (NNH = 5), sedation (NNH = 5), confusion (NNH = 15), and dissociation (NNH = 20). "Feeling high" was reported in 35% to 70% of users. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) evaluation reduced evidence ratings of benefit to low or very low.

CONCLUSION: There is reasonable evidence that cannabinoids improve nausea and vomiting after chemotherapy. They might improve spasticity (primarily in multiple sclerosis). There is some uncertainty about whether cannabinoids improve pain, but if they do, it is neuropathic pain and the benefit is likely small. Adverse effects are very common, meaning benefits would need to be considerable to warrant trials of therapy.

Copyright© the College of Family Physicians of Canada.

PMID

 29449262 [PubMed - in process]

Full text


https://www.ncbi.nlm.nih.gov/m/pubmed/29449262/?i=12&from=multiple%20sclerosis


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Saturday, February 17, 2018

10 Tips to Combat Social Isolation in Multiple Sclerosis [2018]

By: Aaron Boster, MD - February 2018



10 Tips to Combat Social Isolation in Multiple Sclerosis [2018] Social Isolation is all too common amongst people with Multiple Sclerosis (MS). Dr. B offers 10 tips to combat social isolation: 10. participate in the online community. People who share your interests are out there on Twitter, Facebook, Instagram, YouTube and many many more. 9. Become a pen pal! 8. Set up a standing weekly phone date with a loved one or good friend 7. Complete some paperwork at a cafe instead of the home office 6. Take your workout outside of the home. Consider going to the park, taking group yoga or barre class, lifting at a rec center or joining a local gym. 5. Set up a standing monthly lunch date with a friend across town 4. Join a support group! Find a group right for you (ask your provider or check with the local NMSS chapter) 3. Sign up for a class at your community rec center! Underwater basket weaving at noon on Wednesdays! 2. Volunteer. It feels so good to give back. Usher at church, read to kids in a library, help with dinner at a soup kitchen. 1. The number one tip...GET A PET! Which tips sound right for you? What have you tried you could share with us? Please leave your own tips, your comments and questions below! #WeHaveMS



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Multiple Sclerosis and Dogs: 7 reasons people with MS should own a dog

Video by Aaron Boster, MD

Multiple Sclerosis and Dogs: 7 reasons people with MS should own a dog Reason #7 is health benefits. Owning a dog lowers blood pressure, lowers depression, lowers anxiety and lowers stress levels. That's very cool! Reason #6 Many dogs can be trained as therapy dogs. There are many really cool video's on YouTube about therapy dogs. Check them out! Watch this video to learn 5 more reasons people with MS should own a dog! Do you own a dog? Have you identified benefits I left out? Please share with use! Kindly leave your questions and comments below! #WeHaveMS #PetsOfMS, #MSViewsandNews,

OhioHealth MS Center: http://ow.ly/GSUX30i2mtG YouTube: https://www.youtube.com/c/AaronBosterMD

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Ipsen Announces Dysport® (abobotulinumtoxinA) Data Presentations Highlighting Duration of Response and Potential Benefit of Repeated Treatment in Spasticity

Oral Presentations at the 2018 Annual Meeting of the Association of Academic Physiatrists (AAP) Provide Additional Data on the Safety and Efficacy of Dysport® in Adults with Upper and Lower Limb Spasticity and Children with Lower Limb Spasticity 

BASKING RIDGE, N.J., February 15, 2018 – Ipsen Biopharmaceuticals, Inc., an affiliate of Ipsen (Euronext: IPN; ADR: IPSEY) (Ipsen), announced Dysport® (abobotulinumtoxinA) data will be presented today in two oral presentations at the annual meeting of the Association of Academic Physiatrists (AAP) being held in Atlanta, February 13-17, 2018. The oral presentations provide the outcomes of multiple Phase 3 studies that evaluated time to retreatment, as well as long-term treatment with Dysport® .

“The data being presented at this year’s AAP meeting indicate that Dysport® provides sustained spasticity relief for both adult and pediatric patients,” said David Cox, Vice President, US Medical Affairs, HEOR & Commercial Regulatory Affairs, Ipsen. “Improved outcomes from long-term therapy along with longer time between injections can be important factors in the management of these conditions, and we’re pleased to share these data to help inform physician and patient treatment decisions.”

In the first oral presentation, results from three randomized, placebo-controlled, double-blind Phase 3 studies of Dysport® evaluating time to retreatment in three patient groups showed that 37 percent of hemiparetic (post-stroke/traumatic brain injury) patients with adult upper limb spasticity (AULS), 20 percent of hemiparetic patients with adult lower limb spasticity (ALLS) and 74 percent of patients with pediatric (at least two years of age) lower limb spasticity (PLLS) due to cerebral palsy did not require reinjection until week 16 or later (Abstract #361196).

Learn more by clicking here



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Wednesday, February 14, 2018

Stem Cell Treatment Benefits Three-fourths of MS Patients in Phase 1 Trial

February 14, 2018

Stem Cell Treatment Benefits Three-fourths of MS Patients in Phase 1 Trial

A stem cell treatment improved the neurological symptoms of three-fourths of the multiple sclerosis patients in a Phase 1 clinical trial, New York researchers reported.
The results prompted the team at the Tisch MS Research Center of New York to start a Phase 2 trial to further assess the therapy’s safety and effectiveness.
Injecting mesenchymal stem cell-derived nerve cell progenitors directly into the spinal canal also improved the muscle strength and bladder function of many of the 20 progressive MS patients.
Eighty percent, or 16, of the patients in the open-label trial (NCT01933802) had secondary progressive MS.
Half were unable to walk at the beginning of the study, and had EDSS disability scores of 7 or higher. Eight required assistance to walk, and had EDSS scores of 6 to 6.5. Two were able to walk without assistance, with EDSS scores between 3.5 and 5.5. EDSS stands for Expanded Disability Status Scale.
The stem cell treatment led to improvements in 15 of the 20 patients’ neurological symptoms. The disease of two worsened, and the condition of three remained the same.
Fourteen of the patients had better muscle strength after the treatment, mainly in the lower limbs. Four of the 10 patients who were able to walk when the trial began improved their scores on a measure of exercise capacity — the timed 25-foot walk test — by 20 percent or more. And two patients who had been unable to walk when the study began were able to complete the walk test with assistive devices.
Patients who responded to the treatment improved their disability scores by 0.5 to 2.0 EDSS points
The stem cell treatment improved the bladder function of half the patients with a problem. Some were able to stop taking their bladder medications.
There were no serious adverse effects associated with the therapy. About 85 percent of the patients experienced headaches and fever in the first 24 hours after the treatment, which doctors managed with standard medications.
The treatment consisted of three injections of stem cells derived from the patients, administered three months apart. Patients received antibiotics to reduce the risk of infection.
Researchers used fresh cells rather than cells preserved by refrigeration. This may have contributed to the good results, they said.
“The protocol we created allowed for delivery of these stem cells within 30 minutes of harvesting” them, Dr. Violaine Harris, a senior research scientist at the Tisch center, said in a news release.
The Phase 1 results “justify the initiation of a planned FDA-approved Phase 2 trial in a larger group of patients,” said Dr. Saud A. Sadiq, the Tisch center’s director and senior author of the study.
“We anticipate that these novel studies may form the therapeutic basis of reversing disability in patients with MS, and if successful, these studies could have positive implications for treating other neurological diseases,” Sadiq added.
The Phase 2 trial (NCT03355365) is recruiting about 50 patients with primary progressive or secondary progressive MS. Patients must have an EDSS between 3 and 6.5. For additional information, visit the trial registry webpage.
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