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WELCOME to Stu's Views & MS News, a product of MS Views and News, a Not-for-Profit 501(c3) organization. Founded in 2008. Providing Educational, Information and Resources to those affected by Multiple Sclerosis via live seminars and via the internet.

Key-Note: Our live MS educational seminars average approx 65 people per educational program and SINCE our first program in February 2010, we have hosted more than 90 educational programs in Florida. In 2013 we expanded to Georgia and in 2014 we have expanded further, into Alabama and North Carolina.

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Friday, July 25, 2014

MS Family Planning 101: Should DMTs Be Discontinued Before and During Pregnancy?


The recent availability of a variety of disease-modifying therapies for RRMS raises many questions about when and which DMTs patients should start or stop before and during pregnancy

Like many autoimmune diseases, multiple sclerosis (MS) affects twice as many women as men. The average patient will be diagnosed at age 30, right around the time when many are starting or growing their families. Pregnancy is not a risk to women with MS, and the rate of relapse during pregnancy actually tends to decrease. But the relapse rate goes up in the first 3 months after birth (Confavreux et al., 1998). While many disease-modifying therapies (DMTs) are available for patients diagnosed with relapsing forms of MS, all can pose a risk to the fetus, and none are indicated for use during pregnancy.

Stopping DMTs to get pregnant

In an interview with MSDF, Bonnie W., a mom with relapsing-remitting MS (RRMS), expressed a fear common to many in her position: fear of disease progression while off therapy and the risk of permanent damage while trying to become pregnant. “[My husband and I] decided that we were ready for another baby, and then I had to stop [teriflunomide (Aubagio, Sanofi)],” she said. “I took a medicine to clear my system of the drug. And, so it's been about 4 months and we're still not pregnant. I'm not going to keep trying [to conceive] forever, because I want to get back on my meds.”

Indeed, the advice is for patients to stop taking all currently available DMTs for 1 or more months before becoming pregnant. Even though patients such as Bonnie know that none of the DMTs are 100% effective or curative, the drugs do reduce the risk of relapse and some other measures of disease progression. While patients and clinicians want to avoid causing damage to the fetus, this leaves patients trying to have a baby at risk for new relapses, at least until the poorly understood protective effects of pregnancy go into effect.

Elizabeth Crabtree-Hartman, M.D., sees about 1000 MS patients in her role as an associate clinical professor of neurology and the director of patient education and support at the UCSF Multiple Sclerosis Center. In an interview with MSDF she said, “Something that's really important to keep in mind—and this is a good tip for community physicians—if a person is on DMT and thinking about pregnancy, if that person is taking oral contraceptives, it's really important to discontinue the use of oral contraceptive pills and use a different means of birth control, while the person is on DMT, to establish a regular cycle while the person's MS is still covered by the DMT, prior to doing a washout for pregnancy. Because the idea is that we want the person to be uncovered for as little time as possible.”




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Thursday, July 24, 2014

EDSS Alternative in an iPad, that can accurately gauge walking, balance, manual dexterity, visual acuity, and a measure of cognition in people with MS

July 21, 2014

A study demonstrates that an iPad app can accurately gauge walking, balance, manual dexterity, visual acuity, and a measure of cognition in people with MS

Doctors, researchers, and patients could all benefit from an easier way to quantify MS disability. Now, scientists report that they were able to conduct performance tests on MS patients using an iPad and an app they designed (Rudick et al., 2014). The system, which the team described in the Journal of Visualized Experiments, might increase the number of doctors who can apply such measurements and could eventually allow patients to test themselves at home.

The iPad is positioned at the sacral level for walking and balance testing. From Rudick <em>et al</em>., 2014.
The iPad is positioned at the sacral level for walking and balance testing. From Rudick et al., 2014.
“I think this is a really exciting and elegant step forward,” said Jeffrey Gelfand, M.D., an assistant professor of neurology at the University of California, San Francisco, who wasn’t involved in the study. “This is the beginning of the next phase of bringing performance testing into the MS clinic.”

Although researchers have proposed several methods to quantify MS disability, for more than 30 years the standard has been the Expanded Disability Status Scale, or EDSS (Kurtzke, 1983). The scale runs from 0 to 10 and is based on an evaluation by a neurologist or other expert. For patients at the lower end of the scale, scores depend on whether certain functional systems, such as the bladder or the visual system, are impaired. For patients with more severe disabilities, ratings depend on factors such as how far they can walk without help and whether they are bedridden.

The EDSS has figured in thousands of studies and almost all clinical trials of MS treatments. “It’s been critical for getting 10 drugs to patients,” said Richard Rudick, M.D., former director of the Mellen Center for Multiple Sclerosis Treatment and Research at the Cleveland Clinic in Ohio and now a vice president for development sciences at Biogen Idec in Cambridge, Massachusetts.

But the EDSS has taken its lumps over the years. “It’s the measure we most love to hate,” said Rudick, who was lead author of the iPad study. One complaint is that the scale is not linear. So if a patient’s score increases from 1 to 2, that doesn’t represent the same amount of physical decline as an increase from 6 to 7—a problem that limits the statistical analyses researchers can perform on EDSS data (Goldman et al., 2010). Critics have also knocked the EDSS for leaning heavily on walking ability. “We all acknowledge that there are flaws and we should be able to do better to measure disability for MS,” Gelfand said.

To read more, click here



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Wednesday, July 23, 2014

Shopping at Amazon.com can now benefit MS educational programs


If you currently shop at Amazon.com or consider future purchases from AMAZON, please use the link found here: http://smile.amazon.com  - then when the page opens, you will see this:


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Marijuana Brownies Are Ok, But Not in Lollipops: Washington State

Marijuana Brownies Are Ok, But No Lollipops: Washington State Marijuana stores in Washington state can sell pot in cookies, brownies and other approved baked goods but cannot put the drug in candies, lollipops or food items that might appeal to children, according to newly released rules.

Washington became the second U.S. state to allow recreational sales of marijuana to adults on July 8 when its first retail stores opened under a heavily regulated and taxed system approved by voters in November 2012. 

The state's Liquor Control Board, which regulates the fledgling marijuana sector, published the guidelines on Wednesday for the packaging and labeling of marijuana edibles. It prohibited any products, labels or packaging designed to be especially appealing to children, including lollipops and suckers, gummy candy and jelly beans.

To gain approval to market a pot-laced food item, such as brownies or bottled drinks, a processor must submit a photo of the product along with its labels and packaging. 

The edible also has to pass a processing facility inspection and must be clearly labeled as containing marijuana. Edibles also must be tested for potency and to ensure that the marijuana derivatives are spread evenly throughout the products.

Washington's move to allow recreational sales comes amid a broader trend of liberalization taking hold in many parts of the United States. 

Continue reading




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Another new MS medication, PLEGRIDY™ (Peginterferon beta-1a) Approved in the European Union for the Treatment of Multiple Sclerosis

July 23, 2014

Today Biogen Idec announced that the European Commission (EC) has granted marketing authorization for PLEGRIDYTM(peginterferon beta-1a) as a treatment for adults with relapsing-remitting multiple sclerosis (RRMS), the most common form of multiple sclerosis (MS). PLEGRIDY is dosed once every two weeks and is administered subcutaneously with the PLEGRIDY PEN, a new ready-to-use autoinjector, or a prefilled syringe.

"PLEGRIDY offers people living with MS an interferon with compelling efficacy that requires considerably fewer injections than other platform therapies," said George A. Scangos, Ph.D., chief executive officer at Biogen Idec. "The approval of PLEGRIDY demonstrates our commitment to improving the lives of patients by providing innovative therapies that meet their individual needs, including flexibility in managing their disease.”


PLEGRIDY, the only pegylated interferon approved for use in RRMS, has been proven to significantly reduce important measures of disease activity, including number of relapses, MRI brain lesions, and disability progression.

The EC approval of PLEGRIDY is based on results from one of the largest pivotal studies of a beta interferon conducted, ADVANCE1, which involved more than 1,500 patients with relapsing forms of MS.


In the ADVANCE clinical trial, PLEGRIDY, dosed once every two weeks, significantly reduced annualized relapse rate (ARR) at one year by 36 percent compared to placebo

Read more, Including Safety and tolerability,  found here



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You don't have to be flexible to do yoga

Rosa Santana  

www.yogarosa.com

July 23, 2014
Most people think of a yogi (someone who practices yoga) As being very fit and flexible. This can happen over time, and with perseverance. My yoga career began at a gym by accident in 1995. Literally, I was there for my usual aerobics class, and the instructor didn't show because she was in a car accident. So the next class was a yoga class, and I reluctantly went. I was a very fit 30 year old, but this was a form of exercise like no other. The instructor was having us put our body in shapes my body had never experienced, and I became aware of my hamstrings. Especially because I realized how tight they were. With time, practice and perseverance, my hamstrings have become much more humbly stretchy, which led to the end of my back pain. This was so significant to my life, that I decided to open a yoga studio, and offer Iyengar Yoga, which is a form of Hatha Yoga which teaches us to become aware of our bodies in space. I realized I didn't have to be flexible to practice yoga, and I not only gained mobility in my muscles and joints, but it gained strength, and endurance.
i share my journey with others, and have helped numerous people realize why they have pain, and how to release it from their bodies. The purpose of yoga is not to be stretchy, it is to train the mind into silence. When one is in pain, the mind chatter can be deafening. Removing the noise of pain from the body, can free us to live a serene life.
350845a30c196987-RosaVirabhadrasana3462.jpg



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Monday, July 21, 2014

Research on immune activity in MS

Research on immune activity in MS

Understanding and stopping MS in its tracks requires a better understanding of the role that the immune system plays in this disease. This system is involved both in the inflammatory attacks on myelin and, very possibly, in the injury to axons (the wire-like nerve fibers) that contributes to longer-term disability. Research on the immune system includes studies on:
  • Understanding components of the immune system such as T cells, B cells, and antibodies
  • Identifying new targets for therapeutic intervention while leaving the rest of the immune system capable of fighting infections
  • Identifying substances and processes involved in the injury of axons
  • Identifying the body’s natural immune messenger molecules that can either turn on or turn off immune attacks
Significant progress is being made in understanding the immune system's involvement in MS, which will help drive breakthrough solutions to change the world for everyone with MS. 

We’re making progress

Studies of the immune system in MS laid the groundwork for every disease-modifying therapy now available, and these studies continue to hold promise for finding ways to stop MS. Here are reports of recent progress:

Decades of Basic Research Pay Off with Early Clinical Trial of Immune Therapy 
An international team has reported results of a small, early clinical trial involving 10 people with relapsing or secondary-progressive MS. The trial tested the feasibility and safety of using a patient’s own altered blood cells to reduce immune responses against specific components of myelin, the nerve covering that is a key target of immune attacks in MS. Treatment appeared safe and showed signs of reducing immune responses to myelin, This is one example of how the Society’s long-term investment in basic research that has relevance to MS pays off. Read details here.
 
Dietary Salt May Stimulate Activity of Key Immune Cells Involved in MS Attacks 
Three studies suggest that dietary salt can speed the development of an MS-like disease in mice, and provide new insights on immune system activity involved in MS.  While more research needs to be done to confirm a role for salt in triggering MS, or to determine whether reducing salt can inhibit MS immune attacks, these studies pinpoint new avenues for strategies that can decrease MS attacks. These studies were the product of a collaborative team effort funded in part by the Society. Read more.
 
Society’s Partner Apitope Reaches Key Milestone in Clinical Trial
Apitope International completed recruitment for a phase I study of the peptide therapy ATX-MS-1467 in 40 people with relapsing forms of MS. Apitope has developed an approach that might be able to train immune cells to ignore nervous system target tissues to suppress MS attacks. This study may yield findings that bring us closer to a potential novel targeted strategy that stops the MS immune attack in its tracks. Early investment by the Society through Fast Forward enabled Apitope to enter into a development and license agreement with Merck Serono for the ATX-MS-1467 program. By connecting people, ideas, and resources, promising treatments can now break through barriers, move through the pipeline, and enter clinical trials -- faster. Read more.
randd
Read More



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Researchers Funded By the National MS Society Shed New Light on Immune Attacks in MS and a Possible New Treatment Strategy

July 21, 2014
A team funded by the National MS Society has shed new light on immune cells known as macrophages, and how one type of these cells may play a significant role in launching damage in MS. The researchers have discovered a way to differentiate between good and bad types of these immune cells active during MS-like disease in mice, and if further research shows that these findings hold true for people with MS, this opens up possibilities for developing therapies that target the bad cells and spare the good cells. Richard Ransohoff, MD, Ryo Yamasaki, MD, PhD (Cleveland Clinic Foundation) and colleagues report their findings in The Journal of Experimental Medicine (published online July 7, 2014).
Background: MS is known to involve immune system attacks against the brain and spinal cord, damaging the myelin that surrounds and protects nerve fibers, as well as the nerve fibers themselves. The sequence of events and immune cells involved in this damage are not completely clear. In an MS-like disease model called EAE, immune cells known as macrophages (macro, meaning “big,” and  phages, meaning “ eaters”) play a dominant role in the immune attacks and their numbers increase with the severity of the disease in mice. The mechanisms by which macrophages promote EAE are not entirely clear, but might involve “eating” myelin from nerve cells.
Some macrophages are derived from cells within the brain (called microglia) and some are derived from cells known as monocytes which enter from the bloodstream, and they are thought to have different roles. To date, no research techniques have permitted researchers to differentiate between these two different types of macrophages and their roles in the disease process.
The Study: Dr. Ransohoff’s team developed a novel strategy to label these two types of macrophages and differentiate their activities, including the use of a novel microscopy method that generates high resolution 3D images from small samples.
The team found that macrophages derived from monocytes initiated damage to myelin immediately upon the onset of EAE in mice. These cells also attached themselves to the nodes of Ranvier – specialized structures along nerve fibers that are crucial to proper nerve impulse conduction. Abnormalities in these nodes have been noted in people with MS, and the authors suggest that these findings may help to explain these abnormalities. Macrophages derived from microglia did not cause damage or attach to nodes, but rather seemed to be involved in the helpful process of clearing debris from the damage site.
The team conducted a series of other studies to understand the different roles of macrophages, which supported these findings.
Conclusion: This study provides important and novel insight into the early stages of the immune attack in a mouse model of MS. If there are both good (debris-clearing) and bad (myelin-destroying) macrophages in people with MS, strategies for inhibiting the bad macrophages and promoting the good macrophages could be beneficial for people living with MS.
Read more about how the National MS Society is funding research to stop the immune attack in its tracks in people with MS.


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National MS Society-Supported Researchers Use Novel Technology To Identify FDA-Approved Compounds that May Stimulate Myelin Repair in MS

A team at the University of California at San Francisco led by Jonah Chan, PhD,  has identified a group of compounds approved by the U.S. Food and Drug Administration (FDA) for various disorders that might also stimulate myelin repair. They report the findings in Nature Medicine (Published online July 6, 2014). This study was mainly funded by friends of the MS Research Group at UCSF, with additional support from the National MS Society Harry Weaver Neuroscience Scholar Award to Dr. Chan and the UCSF Clinical & Translational Science Institute Catalyst Award for Innovation.
Background: In MS, the immune system attacks and destroys myelin, the fatty substance that surrounds and protects the nerve fibers, and the nerve fibers can also be damaged. Current therapies are largely aimed at dampening the immune system. However, a therapy that repairs damage to myelin and nerve fibers is also necessary.
Decades of research into nerve physiology, MS tissue damage and the biology of glial cells – the numerous brain cells that support nerve cells – have laid the groundwork for finding ways to repair damage and restore normal function in individuals with MS. Achieving this goal is a priority of research supported by the National MS Society.
One challenge in developing repair strategies has been identifying possible therapeutic targets. The fact that compounds need to be observed for their ability to form myelin around nerve fibers has limited the speed at which  the impact of compounds could be screened. This study reports on a novel technology developed by Dr. Jonah Chan that could revolutionize the development of myelin repair strategies. In September 2013, Dr. Chan was the first recipient of the Barancik Prize for Innovation in MS Research, a new international prize launched to recognize innovation and progress in MS research, for his pioneering work in applying this technology to the search for ways to stimulate brain repair in people who have MS. Read more
The Study: Dr. Chan’s team invented new nanofiber and micropillar technology to rapidly identify compounds that stimulate the regrowth of myelin. The “Binary Indicant for Myelination on Micropillar Arrays” (BIMA) uses arrays of tiny fabricated “micropillars” that simulate nerve fibers. Myelin-making cells called oligodendrocytes form myelin around each micropillar, looking somewhat like the rings of a tree, enabling an automated readout to permit the team to study functional myelination.
The team initiated a screen using this technology, testing 1000 molecules for their ability to promote oligodendrocyte development and wrapping of myelin around the micropillars. The screen identified a group of eight compounds that are approved by the U.S. Food and Drug Administration to treat various disorders, and are collectively known as anti-muscarinic compounds. Dr. Chan and colleagues followed up by inducing myelin damage in mice and then administering one of these compounds – clemastine, an oral antihistamine used to treat allergy symptoms. Analysis performed 14 days later revealed enhanced development of oligodendrocytes and accelerated myelin repair when compared with untreated control mice.
Based on these findings, a clinical trial of clemastine is now getting underway by the University of California, San Francisco team. Read more
Conclusion: Dr. Chan’s team reports on novel technology that allows for screening thousands of molecules for their potential to repair myelin, and may eventually help to fill this void in the growing arsenal of MS therapies A clinical trial stemming from this approach is now getting underway.
“We are at a pivotal time in MS research,” says Timothy Coetzee, PhD, Chief Advocacy, Services and Research Officer for the Society. “This study shows how reversing damage to regain function is almost within our grasp. By confirming and following through on these findings with clinical studies in people, we can change the world for everyone with MS.”
Read more about repairing damaged tissue and watch a webcast featuring Dr. Chan, on “Promising MS Research to Repair, Protect and Restore the Nervous System.”
Read more about this study on the MS Discovery Forum website.

About Multiple Sclerosis

Multiple sclerosis, an unpredictable, often disabling disease of the central nervous system, interrupts the flow of information within the brain, and between the brain and body. Symptoms range from numbness and tingling to blindness and paralysis. The progress, severity and specific symptoms of MS in any one person cannot yet be predicted, but advances in research and treatment are moving us closer to a world free of MS. Most people with MS are diagnosed between the ages of 20 and 50, with at least two to three times more women than men being diagnosed with the disease. MS affects more than 2.3 million people worldwide.





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Sunday, July 20, 2014

Low carb diets help diabetes and multiple sclerosis in new studies

Low carb diets have been shown to trump low fat plans for weight loss. Now new research is pointing to the benefits of low carb diets for several diseases. Most recently, a group of scientists and physicians have discovered that low carb diets represent the best initial intervention for diabetes, reported Science Direct on July 16.
The experts involved in the new report cite evidence that low carb diets lower high blood glucose and allow patients to reduce or, in some cases, eliminate their medication. And while low carb diets are effective for diabetes regardless of whether patients lose weight, the researchers also concluded that "nothing is better for weight reduction."
Side effects can pose problems with medication. However, the researchers also discovered that no such side effects result from low carbohydrate diets. They cited 12 points indicating that low carb diets are the most effective therapy for diabetes, beginning with hyperglycemia.
Noting that dietary carbohydrate restriction has the greatest effect on decreasing blood glucose levels, the researchers also pointed to the ongoing epidemics of obesity and type 2 diabetes. The calorie increases in the typical American diet occurring during these epidemics are primarily due to increased carbohydrates.


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