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Saturday, April 20, 2013

Researchers map use of alternative treatment among multiple sclerosis patients


Published April 19, 2013

A major Nordic research project involving researchers from the University of Copenhagen has, for the first time ever, mapped the use of alternative treatment among multiple sclerosis patients - knowledge which is important for patients with chronic disease and the way in which society meets them.

People with multiple sclerosis (MS) often use alternative treatments such as dietary supplements, acupuncture and herbal medicine to facilitate their lives with this chronic disease. This is the result of a new study of how MS patients use both conventional and alternative treatments which has been carried out by researchers from five Nordic countries. The results have been published in two scientific journals, the Scandinavian Journal of Public Health and Autoimmune Diseases.

"What we see is that patients do not usually use alternative treatments for treating symptoms, but as a preventative and strengthening element," says Lasse Skovgaard, industrial PhD candidate from the Faculty of Health and Medical Sciences and the Danish Multiple Sclerosis Society, who has been involved in conducting the questionnaire-based study among 3,800 people with MS in Denmark, Sweden, Norway, Finland and Iceland.
Multiple sclerosis is a chronic disease which attacks the central nervous system, and which can lead to a loss of mobility and sight. Denmark is one of the countries with the highest incidence of the disease worldwide, with approx. 12,500 MS patients. At the same time, the number of MS patients in the West is increasing, posing considerable challenges in respect of treatment, prevention and rehabilitation.


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Friday, April 19, 2013

Many myths surrounding multiple sclerosis today


Thursday, April 18, 2013 
Recently, there have been stories in the Herald and News and on KOBI 5 about multiple sclerosis. The story on KOBI 5 stated the young woman’s life “may still be cut short” due to a recent diagnosis of MS.
I am one of many people in our community who fight this disease every day of my life, and I was angered by this statement. It is untrue, and exactly the kind of statement that perpetuates the myths surrounding MS.
The fact is, MS is not a fatal disease, and although complications of the disease can and do occur, the average life expectancy for a person with MS is about the same as it is for someone without MS. The fact that such a thing was said shows that no research was done and no attempt was made to understand MS or its effects. I feel that was an injustice to all of us whose lives have been touched by MS. I wrote KOBI 5 to express my feelings and provide them with links to information about MS, only to receive no response.
Educating people about MS is so important, as there are many people in our community affected by it. These stories could’ve been a great starting point for education, especially given that a Walk MS event is taking place at 9 a.m., with the opening ceremony at 8:30 a.m. Saturday, April 20 at 210 W. Second St. in Merrill. If anyone wants to walk who isn’t yet registered, registration will open at 8 a.m. Anyone interested can go to walkms.org to learn more.
How about using this opportunity to spread some awareness of the disease? And just as importantly, how about we demand that we get good, accurate information in our news? People count on that and they deserve that much.

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Thursday, April 18, 2013

Accurate diagnosis key to identifying, managing multiple sclerosis


Source: National Multiple Sclerosis Society

http://www.whatdoctorsknow.com

Multiple sclerosis, which led to the recent death of actress Annette Funicello, affects more than 2.5 million people worldwide, according to the National Multiple Sclerosis Society. Because it is the most common neurologic disease among young adults, there's increasing urgency to find a cure.

While anyone can develop MS, there are environmental patterns that identify vulnerable populations. The National MS Society reports that women are diagnosed with MS at least two to three times more often than men, and most are diagnosed between the ages of 20 and 50. Geographically, people who live in more temperate regions, further from the equator, are more likely to develop MS.

Research studies suggest genetic factors and ethnicity may also play a role. The disease is more common in Caucasians, especially those of European descent, but also occurs in African-American, Hispanic/Latino ethnic groups and, more rarely, in Asians.

WHAT IS MS?

MS is an autoimmune demyelinating disease that affects the central nervous system. According to the USC Multiple Sclerosis Comprehensive Care Center and Research Group, "autoimmune diseases are those in which the body's own immune system, which normally targets and destroys substances foreign to the body, mistakenly attacks normal tissues."

In MS, the immune system attacks myelin, the fatty, insulating tissue that wraps around the fingerlike projections from nerve cells called nerve processes, much like the insulation on electrical cords. Nerve processes facilitate communication between the central nervous system and different parts of the body. Damage to myelin makes it difficult for the brain to send and receive messages from the body. This can lead to the many symptoms of MS.

Myelin damage is accompanied by inflammation in the central nervous system, much like the redness and swelling experienced when we cut a finger or scape a knee. Constant inflammation and damage lead to a buildup of scar tissue, or plaques, which can be detected through magnetic resonance imaging (MRI). Early in the disease, damage to myelin may be repaired, but as MS progresses, repaired processes are likely to break down.

MAKING A DIAGNOSIS

According to the Multiple Sclerosis Association of America (MSAA), neurologists most reliably diagnose MS through exams and lab tests. Laboratory tests are especially important because they can rule out other diseases that may have symptoms similar to MS.

Key evaluations include:

1. Medical history and neurologic exam. A physician obtains a medical history from a patient or suitable person who is familiar with the patient. Medical history includes information such as name, birthplace, family history, travel, allergies and other important details about a patient's life. Medical history reports help physicians formulate a diagnosis and provide appropriate medical care.

Physicians can also perform a variety of neurologic exams to evaluate functions such as vision, motor activity (e.g., ability to walk or maintain balance, coordination), sensory modalities (e.g., ability to feel and locate touch and pain), memory, ability to concentrate and mental and emotional health.

"In several cases, medical history, neurologic exams and an MRI may provide sufficient evidence for MS diagnosis. Neurologic exams provide evidence of damage that has occurred or is occurring in the central nervous system, and an MRI may prove this," says Lilyana Amezcua, M.D., assistant professor of clinical neurology, co-chief and medical director of the Multiple Sclerosis Comprehensive Care Center and Research Group at Keck School of Medicine of the University of Southern California (USC). If a diagnosis cannot be confirmed through these criteria, there are additional tests available.

2. Magnetic resonance imaging. MRIs are a diagnostic tool used for scanning internal structures of the body using magnetic fields. The National MS Society suggests MRIs are more useful for evaluating the extent of damage to the myelin, also known as plaques, and areas of inflammation.

Areas where the myelin is damaged may appear as bright white spots or darkened areas on MRI scans. However, it's important to note that these spots or indications of damage can also appear on scans of people who do not have MS -- mainly the elderly.

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Clinical features of multiple sclerosis in Puerto Rico


Epidemiology 1

Thursday, October 14, 2010, 15:30 - 17:00

Clinical features of multiple sclerosis in Puerto Rico

A. Chinea (Guaynabo, PR)

Background: Multiple Sclerosis (MS) is a chronic neurological disease of the central nervous system (CNS). There are currently about 350,000 people in the U.S. with MS.In Latin America, the estimated number of MS patients is 60,000 to 90,000. Latin America has a medium-low risk for MS and shows significant regional variations. Evidence indicates an increase of MS incidence in some regions. According to the Continuous Health Survey 2003/2005, Puerto Rico (PR) has a crude MS prevalence rate of 52/100,000 inhabitants. 
Objective: To evaluate and analyze data obtained from MS patients to determine the clinical features of MS patients in PR 

Methods: PR has a total population of 3.9 million. Ethnic groups include white 76.2%, black 6.9%, Amerindian 0.2%, mixed 4.4%, other 12.3%. A cross-sectional analysis was performed to examine disease-related information. A questionnaire was mailed to the Puerto Rico MS Foundation to gather information on MS patients. A total of 698 questionnaires were received and evaluated. Descriptive statistics were used to analyze demographic data (name, address, date and place of birth, sex, occupation and education), and MS related variables: age of onset, sex, current symptoms and symptoms after the first relapse, diagnosis, median disease duration, family history, relapse frequency and treatment. Three MS-trained neurologists assessed 10% of provisional cases and confirmed diagnosis. 

Results: Of 698 eligible participants, 79% were women (mean age 35 to 44 years) and 21% were men (mean age 45 to 54 years). The female/male ratio was 4:1. The mean age at onset was 33 years for women and 32 years for men. Mean age at diagnosis was 36 years for women and 34 years for men. The mean range between the clinical onset and the diagnosis of MS was 9 years. Median disease duration was 12 years. More than 60% of MS patients had completed at least a bachelor’s degree or higher. The most common current symptoms were numbness (74%), weakness in legs and arms (68%) and visual problems (63%). The main symptoms reported by patients after the first MS exacerbation were fatigue (68%), coordination and balance problems (64%) and weakness (60%). 

Conclusions: This is one of the first studies assessing MS patients in PR. Our findings suggest a possible high prevalence of MS. Differences in data reported in other Latin American countries could be attributed to environmental and/or genetic factors. Future studies should be performed to confirm prevalence data in PR.


Angel Chinea has nothing to disclose - 
Reported at ECTRIMS 2010
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This information was posted - because it was asked to me on April 17, 2013 to obtain this information.

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MS in Latin America


Summary
During the last few years, there has been an increasing desire to study and expand current knowledge about the different aspects of Multiple Sclerosis (MS) in Latin America (LATAM). This report analyzes epidemiological data and specific aspects of MS in this region and aims to describe the current situation, based on the very few scientific publications that contain reliable information.

Everything seems to indicate that MS in LATAM has some special characteristics that makes it different from what has been described in other areas of the world. Nevertheless, more thorough research has to be carried out in order to obtain conclusive data regarding the behaviour of the disease in LATAM.

Introduction:
Epidemiological aspects of MS have been the focus of extensive studies, mainly in high-risk areas
(Europe, the USA and Canada) where prevalence of the disease ranges from 60 to more than 250/100
000. Until recently, little was known about MS in LATAM, Asia and Africa, where MS prevalence was
estimated at 5/100 000.1,2 Recent studies show an increasing rate of prevalence in different European
cities as well as in countries previously considered as low-risk areas such as Mexico.3 LATAM is a vast geographical territory, extending from the southern limit of the USA to the Antarctic (South Pole). The total population of LATAM is nearly 450 000 000. From an historical point of view, it comprises all the countries of the American continent colonized by Spain, France and Portugal. The common language source of these countries is Latin; this gave rise to the term ‘Latin America’.


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The International MS Journal 2008;

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Wednesday, April 17, 2013

Myelin regrown in multiple sclerosis models


Artificial oligodendrocytes made from skin cells

By Bradley J. Fikes10 A.M.APRIL 14, 2013

Ordinary skin cells have been directly converted into the myelinating cells destroyed in multiple sclerosis, according to two new papers in Nature Biotechnology.
Using a process they call "cellular reprogramming," researchers at Stanford University School of Medicine and Case Western Reserve School of Medicine, in two very similar papers, described how they turned the fibroblasts into what appear to be oligodendrocyte precursor cells, in mice. Oligodendrocytes produce myelin, the fatty insulation necessary to allow nerve signal conduction. It is caused by an autoimmune reaction attacking the oligodendrocytes.
" We propose direct lineage reprogramming as a viable alternative approach for the generation of OPCs for use in disease modeling and regenerative medicine," the Stanford team stated in their paper.
In multiple sclerosis, the destruction of oligodendrocytes and myelin results in symptoms such as loss of balance, problems moving arms and legs, loss of coordination and weakness, according to the National Institues of Health. Other problems include loss of bladder control, impaired vision, depression, and memory loss.
To fix these problems, not only must the autoimmune reaction be brought under control, but the myelin must be repaired. That implies producing new oligodendrocytes. Hence, the OPCs, which researchers think could become effective sources of the olgodendrocytes when transplanted. (Transplantion of fully mature cells doesn't seem to work in such studies; the cells seem to need to complete the last step of maturation in their new enviroment to wire into the nervous system.)
photo
Myelin produced by mouse embryonic fibroblasts treated with chemicals that turned them into cells resembling oligodendrocyte-producing cells. — Case Western Reserve University
But until very recently, making OPCs has extremely difficult. In February, a team led by University of Rochester scientists created oligodendrocytes from induced pluripotent stem cells, which themselves were derived from fibroblasts. These cells were transplanted into animal models of multiple sclerosis, where they produced myelin.
The University of Rochester team's approach added IPS cells to other sources of oligodendrocytes, including stem cells committed to producing neural lineage-committed stem cells and embryonic stem cells. However, all of these sources require the cells to be taken through intermediate steps to get to the desired cell. By contrast, direct conversion offers a less complicated route, and avoids the troublesome pluripotent stage, in which cells are prone to form tumors.

Ian Wilmut discusses direct cell conversion

Ian Wilmut discusses stem cell and direct cellular transformation therapy at the 2011 Stem Cell Meeting on the Mesa in La Jolla.
If the Case Western or Stanford technology turns out to be useful for MS patients, it will help confirm the prediction of Ian Wilmut not long ago that direct conversion would become feasible and ultimately supplant the use of stem cells. The Case Western team spelled out this vision in their paper:
"With further optimization, this approach could provide a source of functional OPCs that will complement, and possibly obviate, the use of pluripotent stem cells and fetal cells in cell-based remyelinating therapies," the Case Western paper stated.
The induced oligodendrocyte precursor cells, or iOPCs, just produce oligodendrocytes, the paper said, while neural stem cells and induced neural stem cells are inefficient in producing them, and they produce other unwanted cells such as neurons and astrocytes.
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Sunday, April 14, 2013

Ordinary Skin Cells Morphed into Functional Brain Cells

Released: 4/14/2013 1:00 PM EDT 
Embargo expired: 4/14/2013 1:00 PM EDT
Source Newsroom: Case Western Reserve University


Newswise — Researchers at Case Western Reserve School of Medicine have discovered a technique that directly converts skin cells to the type of brain cells destroyed in patients with multiple sclerosis, cerebral palsy and other so-called myelin disorders.
This discovery appears today in the journal Nature Biotechnology.
This breakthrough now enables “on demand” production of myelinating cells, which provide a vital sheath of insulation that protects neurons and enables the delivery of brain impulses to the rest of the body. In patients with multiple sclerosis (MS), cerebral palsy (CP), and rare genetic disorders called leukodystrophies, myelinating cells are destroyed and cannot be replaced.
The new technique involves directly converting fibroblasts - an abundant structural cell present in the skin and most organs - into oligodendrocytes, the type of cell responsible for myelinating the neurons of the brain.
“Its ‘cellular alchemy,’” explained Paul Tesar, PhD, assistant professor of genetics and genome sciences at Case Western Reserve School of Medicine and senior author of the study. “We are taking a readily accessible and abundant cell and completely switching its identity to become a highly valuable cell for therapy.”
In a process termed “cellular reprogramming,” researchers manipulated the levels of three naturally occurring proteins to induce fibroblast cells to become precursors to oligodendrocytes (called oligodendrocyte progenitor cells, or OPCs).


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In Memory of National MS Society staff member - VP of Biomedical Research - Dr. Patricia O'Looney


Pain measurement study could help multiple sclerosis sufferers



Multiple sclerosis (MSpain is a pain most patients have a hard time describing. It can be described as a burning sensation, pins and needles or even like a toothache and it can be incredibly frustrating for both the sufferer and the doctor.
Mr. Yasime of Lima understands this all too well. “Years ago, about the time I was diagnosed, there was so little we could do about my MS Hug. The pain was intense and it scared me to death, I thought I was having a freaking heart attack,” he remembers.
Continuing, he says, “We tried Elavil and then gabapentin, which I stayed with since it seemed to work so much better for me and, although I have been doing pretty good with it all these years, I can always tell when I forget to take it after a couple days.”
A team of researchers at the University of Colorado at Boulder was able to look at a person’s brain and predict how much painthat person was feeling, resulting in what could create the first objective test for pain.
No more trying to explain on a one to ten scale about that stabbing, inexplicable, near debilitating pain that is felt for no apparent reason.
The lead author, and associate professor of psychology and neuroscience, Tor Wager stated, “Right now, there's no clinically acceptable way to measure pain and other emotions other than to ask a person how they feel,” and went on to explain how they used “painful heat” to measure responses.
114 subjects were exposed to different levels of heat, from a benign warm to the painfully hot. The researchers then used computer data-mining techniques to see the pattern of a “distinct neurologic signature for the pain.”
They had found that the “signature” was transferable across different people; meaning pain levels weren’t based on past images, and this incredible find permitted a 90 to 100% accuracy rate.
Their paper also tells of another surprising find: signatures were not specific to whatever kind of pain a person felt. The signature for physical pain was absent in those who had recently gone through a painful break-up, for instance.
Wager is excited about the findings and continuing on with it, “I think there are many ways to extend this study, and we're looking to test the patterns that we've developed for predicting pain across different conditions. Is the predictive signature different if you experience pressure pain or mechanical pain, or pain on different parts of the body?”
Although chronic pain wasn’t quantified during the study, the researchers do believe this study will be able to be of help to this in the future.

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