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Thursday, June 13, 2013

UPCOMING MS Views & News - education programs in Florida



JUN
25
Jun 25 - 6:00 pm - 9:30 pm - Estero, Fl.
Treatment Strategies& Symptom Management in Multiple Sclerosis


JUL
16


JUL
22


JUL
23
Jul 23 - 5:30 pm - 8:30 pm - Ormond Beach/Daytona, Fl.
Treatment Options, Symptoms Management and Adaptive Exercise for MS - in Ormond Beach, Fl.

Other upcoming programs include:

August 6th - Adherence, MS Relapse, Treatment Strategies, MS101 and Symptom Management   - in Orlando, Fl.

August 24th - Su Vida Con Esclerosis MĂșltiple (Living with MS) - A Spanish Language Program in Lake Mary, Fl.

September 10th -  Su Vida Con Esclerosis MĂșltiple (Living with MS) - A Spanish Language Program in Orlando, Fl.

September 18th - Adherence, MS Relapse, Treatment Strategies, MS101 and Symptom Management   - in Brandon, Fl.





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New imaging technique holds promise for speeding MS research

Media Release | June 12, 2013
Researchers at the University of British Columbia have developed a new magnetic resonance imaging (MRI) technique that detects the telltale signs of multiple sclerosis in finer detail than ever before – providing a more powerful tool for evaluating new treatments.
A frequency-based MRI image of an MS patient shows changes in tissue structure.
A frequency-based MRI image of an MS patient shows changes in tissue structure.
Download Full Size Image
The technique analyzes the frequency of electro-magnetic waves collected by an MRI scanner, instead of the size of those waves. Although analyzing the number of waves per second had long been considered a more sensitive way of detecting changes in tissue structure, the math needed to create usable images had proved daunting.

Multiple sclerosis (MS) occurs when a person’s immune cells attack the protective insulation, known as myelin, that surrounds nerve fibres. The breakdown of myelin impedes the electrical signals transmitted between neurons, leading to a range of symptoms, including numbness or weakness, vision loss, tremors, dizziness and fatigue.

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Wednesday, June 12, 2013

Treat and Prevent a Multiple Sclerosis Flare-Up

Call it a flare-up, an exacerbation, an attack, or a relapse. Whatever you call it, it's not something you expect. When you have relapsing-remitting multiple sclerosis (MS), you can go days or years without major changes in your symptoms. Then, suddenly, things change.
You'll work closely with your doctor to feel better. You can also reset your schedule to take special care of yourself. Exercise, stretching, and relaxation can help you manage MS symptoms -- and they boost your mood, too.

Symptoms of a True Flare

Here's how to tell if you're having a relapse of MS, when the illness is active again:
  • You develop a new symptom of MS. For example, you’ve never had vision problems before, and suddenly you can’t see clearly out of your left eye.
  • A regular problem gets worse. Maybe you’ve had some numbness in your left leg before, but now you can’t feel anything below your knee.
  • Your symptoms last for 24 hours or longer. A relapse means a change in your brain, called a lesion. "If a symptom lasts less than 24 hours, it’s something transient that’s not related to a new lesion," says Edward Fox, MD, PhD, director of the MS Clinic of Central Texas.
  • Symptoms level off after a while and stop getting worse.
MS flares can last days, weeks, or even as long as a year.
"Then they usually do improve, but recovery can be quite slow," says Bruce Cohen, MD, of the Northwestern University Feinberg School of Medicine. You may recover completely, or you could have some permanent loss of function or sensation.

MS False Alarms and What Causes Them

Sometimes, you may fear you're having a relapse, but a different issue is to blame for your symptoms.  Once the trigger is gone, your symptoms should clear up, too. You can have muscle problems, numbness, or blurred vision after the following triggers:
  • Alcohol. One drink can worsen coordination for some people.
  • Cold or flu. Fever or an infection can feel like a flare-up. MS symptoms go away fairly quickly after the illness passes.
  • Heat or cold. Hot or humid weather, exercise, hot showers, and sunbathing can trigger symptoms such as blurred vision. Cold can bring on spastic muscles.
  • Poor sleep position. Morning numbness that goes away after you shake it out is not likely to be a flare-up, even if it happens every day. You just slept wrong.

Ordinary Fatigue or MS Relapse?

If you’re overworked, stressed, or not getting enough sleep, MS symptoms may trouble you more than usual. Rest and take extra time for yourself to get back on track.
If fatigue goes on even after you’ve rested -- especially if it’s extreme and keeps you from your regular activities -- check with your neurologist. Continued fatigue can be a sign of a flare-up.

How to Prevent a Flare

Nothing can completely prevent relapses of MS. However, starting medicine right after you're diagnosed with MS helps reduce how many flare-ups you have.
In addition to taking your medicine as directed, these steps may help.
  • Closely track your symptoms. "If you notice subtle breakthrough events, it may mean that your medication isn’t working for you, and we need to make a change," says Cohen.
  • Stop smoking. "Smoking is extremely bad for MS," says Fox. Smokers lose brain tissue much faster than those who don't smoke, he says.  Ask your doctor about nicotine patches, gums, or lozenges. They don't seem to cause the same damage as tobacco and can help you kick the habit.
  • Live healthy. Eat a balanced diet. Exercise most days of the week. Try to lower the stress in your life. You'll be healthier, which may make it easier to manage MS. Working out and relaxation may also help control your symptoms.

Treatments

Ask your neurologist how quickly you should call when you notice new symptoms. Some may require more than simply getting extra rest or using other coping strategies on your own.
These are the ways your doctor will usually treat a flare-up.
  • Steroids. If you've lost some vision or suddenly can't walk, your doctor may suggest this type of drug. "Steroids [help] make the patient better faster," says Mark Keegan, MD, of the Mayo Clinic. You'll need an IV for three to five days, or a lot of pills over a few days.
  • Physical therapy. These precise exercises help you recover the use of a hand or leg. Fox says PT works especially well while you're taking steroids.  The combination helps you get back to your normal strength and motion.
  • Plasma exchange. This may help treat a severe flare-up -- for example, you were walking fine and now you can’t walk at all -- when high-dose steroids aren’t working.
With plasma exchange, some of the blood is removed from your body. Your blood cells are separated from your plasma. The blood cells are then mixed with another fluid that replaces the plasma and transfused back into your body. Doctors think it helps some people because it removes antibodies in the plasma that may cause problems in MS.   
  • Watchful waiting. When symptoms are annoying but not severe, like a little numbness in your hand, you may choose to just watch them closely and see if they get better.
Talk with your doctor about what's right for you. You both may decide to avoid the hassle and side effects of steroids and just wait for the flare-up to go away.
"Steroids speed the healing of a relapse, but they don’t create healing that wouldn’t have occurred otherwise," Fox says. So you’ll recover just as much -- or as little -- without the steroids as you would with them.
Take care of yourself during a flare-up. "If it feels like you need more sleep, get more sleep," Fox says. But don't remain completely still. While the flare may limit your activities, you can -- and should -- still go about your daily business as much as possible. Maintain a healthy lifestyle, and pay attention to the signals your body is sending.

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Multiple Sclerosis and Stress Management

The prolonged stress of living with a chronic illness, like multiple sclerosis, can lead to frustration, anger, hopelessness, and depression. People with MS are especially at risk of becoming depressed, and for good reason: they face many stressors.
To better cope with the disease, it is important to learn how to manage stress. The first step is to recognize when you are stressed and then take steps to reduce your stress.

What Are the Warning Signs of Stress?

Your body sends out physical, emotional, and behavioral warning signs of stress:
  • Emotional warning signs include anger, an inability to concentrate, unproductive worry, sadness, and frequent mood swings.
  • Physical warning signs include stooped posture, sweaty palms, chronic fatigue, and weight gain or loss.
  • Behavioral warning signs include overreacting, acting on impulse, using alcohol or drugs, and withdrawing from relationships.

What Can I Do to Reduce Stress?

  • Keep a positive attitude.
  • Accept that there are events that you cannot control.
  • Be assertive instead of aggressive. Assert your feelings, opinions, or beliefs instead of becoming angry, combative, or passive.
  • Learn relaxation techniques (see below).
  • Exercise regularly. Your body can fight stress better when it is fit.  Talk to your doctor before starting an exercise program.
  • Eat well-balanced meals.
  • Rest and sleep. Your body needs time to recover from stressful events.
  • Don't rely on alcohol or drugs to reduce stress.

How Can I Learn to Relax?

There are a number of exercises that you can do to relax. These exercises include breathing, muscle and mind relaxation, and relaxation to music. Three that you can try are listed below.
First, be sure that you have:
  1. A quiet location that is free of distractions
  2. A comfortable body position; sit or recline on a chair or sofa.
  3. A good state of mind.; try to block out worries and distracting thoughts.
Two-minute relaxation: Switch your thoughts to yourself and your breathing. Take a few deep breaths, exhaling slowly. Mentally scan your body. Notice areas that feel tense or cramped. Loosen up these areas. Let go of as much tension as you can. Rotate your head in a smooth, circular motion once or twice. (Stop any movements that cause pain.) Roll your shoulders forward and backward several times. Let all of your muscles completely relax. Recall a pleasant thought for a few seconds. Take another deep breath and exhale slowly.
Mind relaxation: Close your eyes. Breathe normally through your nose. As you exhale, silently say to yourself the word "one," a short word such as "peaceful," or a short phrase such as "I feel quiet." Continue for 10 minutes. If your mind wanders, gently remind yourself to think about your breathing and your chosen word or phrase. Let your breathing become slow and steady.
Deep-breathing relaxation: Imagine a spot just below your navel. Breathe into that spot and fill your abdomen with air. Let the air fill you from the abdomen up, then let it out, like deflating a balloon. With every long, slow breath out, you should feel more relaxed.

Source - WebMD

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NPR News: A Delay In Relief From Copays For Costly Drugs


by MICHELLE ANDREWS
June 11, 2013


For people with a chronic or serious illness, drugs that can help slow or cure the disease often put a financial strain on even the best insurance coverage.

The Affordable Care Act sets annual limits on the amount that people will owe out of pocket for prescription drugs starting in 2014. But sick people in some plans won't get relief until the following year because the federal government is giving some health plans extra time to comply.

"People living with multiple sclerosis and other chronic illnesses have been counting on this annual out-of-pocket limit coming, and now that may not happen in 2014," says Bari Talente, executive vice president of advocacy at the National Multiple Sclerosis Society.

Drugs to treat multiple sclerosis are frequently on an insurer's specialty drug tier and require a person to pay 25 to 30 percent of the cost rather than a fixed copayment, she says. In such cases, someone might spend roughly $700 out of pocket every month — $8,400 a year — on a drug to slow progression of the disease.

Under the law, the maximum amount that a consumer with single coverage will pay out of pocket for all medical care, including drugs, will generally be $6,350 in 2014. A family could pay as much as $12,700.

Those totals include copayments, coinsurance and deductibles, but not premiums, and they apply only to plans that are not grandfathered under the law.

But for those consumers whose health plans use more than one administrator to manage plan benefits — one for major medical claims and coverage, and another for pharmacy, for example — there may be one out-of-pocket cap for major medical and another for drugs, or no drug spending limits at all if a plan doesn't currently have a cap, as is typical.

The administration said in February that it recognized that the new annual out-of-pocket limits would need to be coordinated and might require new communication between service providers. That communication step is the reason the government gave the health plans extra time to comply.

But what's good for health plans isn't necessarily good for patients. "For those who are going to be hit with a double out-of-pocket maximum, it could be problematic," Talente says.

Article Source: NPR News
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Personalised Therapy For Multiple Sclerosis Is Key Factor In Treatment Success

June 11, 2013

"Although the upcoming approval of new drugs against multiple sclerosis will offer a number of additional treatment options, it is important that we keep one thing in mind: The only way we can get this disease well under control is if we manage to provide personalised therapy tailored to the individual and to predict the effects and side-effects of a given drug. Unfortunately these efforts are still in the early stages of development," Prof Xavier Montalban (Multiple Sclerosis Centre of Catalonia, Spain) explained at the 23rd Meeting of the European Neurological Society (ENS) in Barcelona. More than 3,000 experts are currently gathered there to discuss latest developments in their field. 

Prof Montalban urged that more pharmacologic research be done on biomarkers and that physicians cooperate more closely with patients to optimise therapy. Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system characterised by a high degree of heterogeneity. The clinical course of the disease and its degree of severity can vary widely from one individual to the next. It is now known that one and the same treatment can yield very different therapeutic results. Prof Montalban: "Despite an awareness of this problem, personalised therapy was not an issue for a long time, not least because of the lack of options. This situation could well change in the near future." 

Highly effective drugs but a host of risks
We are seeing the end of a "one drug fits all" approach to multiple sclerosis therapy, said Prof Montalban. "Myriad new treatment options are becoming established right now. There is a well-founded hope that we will be able to help people suffering from MS more effectively and more quickly in future. We were familiar with this disease for 120 years without being able to treat it. For 15 years, drugs have been available without noteworthy side-effects but limited in their effectiveness. In the meantime a number of highly effective drugs have been put on the market. However, they involve risks ranging from hair loss and bradycardia to progressive multifocal leukoencephalopathy (PML). PML is a dangerous viral infection caused by the immune-suppressive effect of some drugs and can have fatal consequences. Prof Montalban: "In the meantime a test has been developed for determining the probability of patients to develop PML. This is a welcome step in the right direction. The genetic causes of the varying effectiveness of individual types of drugs are becoming increasingly clear." Interferon ?, the first disease-modifying drug that was approved, is effective on 20 to 55% of patients depending on the criteria applied. This fact has led science to make great efforts to find biomarkers that reliably indicate successful treatment and side-effects. Prof Montalban: "Right now we are at 100 possible biomarkers without a clear tendency. This shows how complex MS research is and how far we still have to go to achieve personalised medicine." 

Danger of changing or stopping therapy
Under certain circumstances, more pharmacogenetic findings could enable experts to predict the consequences of switching therapies. The medical field remains in the dark on many aspects of this issue too, to the detriment of those affected. A Catalonian study presented at the ENS Meeting shows how problematic it can be to switch therapies. After five years suffering from MS, the seven study participants were medicated with the highly effective disease-modifying drug natalizumab because the previous treatment had failed. Their state of health remained stable for the average period of about 2.5 years they took this substance. They then had to switch to other weaker drugs for reasons varying from PML risk to pregnancy and allergic reactions. Despite the alternative medication, the patients' neurological state deteriorated quickly. After about three months, four of the seven subjects exhibited new lesions and two of the seven were even found to have sustained 40 new injuries to the central nervous system. A mere eleven months later, all patients had 40 to 70 new lesions. Prof Montalban: "When patients stop taking drugs like natalizumab, they can suffer disastrous relapses with a more aggressive disease than before. It is therefore urgent that we devise strategies to ensure greater continuity. This task extends beyond pharmacogenetics and requires a holistic approach to treatment." 

New treatment guidelines take individual factors into account
Evidence-based treatment guidelines on MS therapy are now being thoroughly updated in a project under Prof Montalban's aegis and with the support of numerous national societies in this field. This revision takes account not only of the many pharmacological innovations such as oral therapies or drugs based on monoclonal antibodies. It also puts special emphasis on the many individual factors that personalise a therapy and make it more successful. These factors include thoroughly advising and informing the patients before treatment begins so they can decide on a therapy option and take part in carrying it out. To this end, the new guidelines also provide informational material for patients. Prof Montalban: "Initially, very fundamental questions have to be clarified: What do patients consider a successful therapy to be? What would they rather accept in this therapeutic tightrope walk: severe side-effects or early disablement? Are women planning to have children?" The decisive factor after that is to monitor and if need be, adapt the successful therapy. Prof Montalban: "To be successful, each therapy decision must be made in close consultation with the patients. Today, a patient-centred approach is more possible than ever before. That is because MS breaks out mostly in young adults aged 20 to 40. As a general rule, this group is digitally competent and can use the Internet to keep in constant contact with the physicians treating them. The extensive involvement of the patients is especially important with MS to increase compliance." Prof Montalban hopes the new guidelines will be implemented quickly and create greater awareness for personalised therapy options amongst general practitioners and neurologists. 

The source for the above article is Medical News Today


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Tuesday, June 11, 2013

Big Multiple Sclerosis Breakthrough Reduced 50-75% of bad immune system activity while leaving a normal immune system

 A phase 1 clinical trial for the first treatment to reset the immune system of multiple sclerosis 

JUNE 10, 2013

(MS) patients showed the therapy was safe and dramatically reduced patients’ immune systems’ reactivity to myelin by 50 to 75 percent, according to new Northwestern Medicine research.

In MS, the immune system attacks and destroys myelin, the insulating layer that forms around nerves in the spinal cord, brain and optic nerve. When the insulation is destroyed, electrical signals can’t be effectively conducted, resulting in symptoms that range from mild limb numbness to paralysis or blindness.

“The therapy stops autoimmune responses that are already activated and prevents the activation of new autoimmune cells,” said Stephen Miller, the Judy Gugenheim Research Professor of Microbiology-Immunology at Northwestern University Feinberg School of Medicine. “Our approach leaves the function of the normal immune system intact. That’s the holy grail.”

The human trial is the translation of more than 30 years of preclinical research in Miller's lab. 

In the trial, the MS patients’ own specially processed white blood cells were used to stealthily deliver billions of myelin antigens into their bodies so their immune systems would recognize them as harmless and develop tolerance to them. 

Current therapies for MS suppress the entire immune system, making patients more susceptible to everyday infections and higher rates of cancer.

While the trial’s nine patients -- who were treated in Hamburg, Germany -- were too few to statistically determine the treatment’s ability to prevent the progression of MS, the study did show patients who received the highest dose of white blood cells had the greatest reduction in myelin reactivity. 

The primary aim of the study was to demonstrate the treatment’s safety and tolerability. It showed the intravenous injection of up to 3 billion white blood cells with myelin antigens caused no adverse affects in MS patients. Most importantly, it did not reactivate the patients’ disease and did not affect their healthy immunity to real pathogens.

As part of the study, researchers tested patients’ immunity to tetanus because all had received tetanus shots in their lifetime. One month after the treatment, their immune responses to tetanus remained strong, showing the treatment’s immune effect was specific only to myelin. 

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Physician Overcomes Multiple Sclerosis; Inspires Others - a Patient's story

Dr. Francis Biagioli, who was diagnosed with MS in December 2000, recently became president of the Oregon Medical Association.
By: 
 Diane Lund-Muzikant

June 10, 2013 – Fear engulfed Dr. Frances Biagioli when she was diagnosed with multiple sclerosis after noticing some strange feelings in her left leg, as if her knee would give out. A young mother with two children under the age of 3, she knew the disease could leave her paralyzed. She feared the loss of independence, being a burden, losing her cognitive ability.
“I am now a patient, the tables are turned,” she wrote, shortly after being diagnosed. “My medical knowledge doesn't help. It hurts. The doctors assume I do not need the explanations. I can adequately answer my family's questions. I do not need hand-holding. I think of the patient who is stunned by his/her new diagnosis, hears nothing of what the doctor says, and has a million remaining questions. I understand.”
The treatment she endured was painful, as she injected medicine into her thigh with a long cold needle, her muscle twitching involuntarily. “A medication that is the only hope. A chance to improve long-term disability. This only hope instills fear. I think of the diabetic who self-punctures several times a day. I understand.”
It's been 13 years since Biagioli learned she had MS. Today she has only mild symptoms, occasional fatigue. For that she's thankful. An activist, she joined her colleague, Dr. Elizabeth Steiner Hayward (a state senator who also has MS) in the Mud Run sponsored by the National Multiple Sclerosis Society. “I think it’s hopeful — especially for people who are recently diagnosed — to know there are people who aren’t in wheelchairs who have MS,” she said.
What's more the experience has given her a much deeper understanding of how her patients feel when they’re told similar news. “Your mind shuts down when you hear the bad stuff,” said Biagioli, a family physician who practices at OHSU's Gabriel Park Family Health Center. “Now I'm able to connect with a wider variety of people, I can see things from their viewpoint, having been in their shoes, and from a personal perspective telling them how I made it through. Multiple sclerosis is very unpredictable. One minute you're fine, the next you might not be able to walk.” ”
Biagioli has also become a leader in Oregon's medical community. At 45, she's one of the youngest physicians to become president of the Oregon Medical Association, and is inspiring others to make a difference.
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Lemtrada Update - Multiple-sclerosis drug nears green light after pass-the-parcel marathon

BY BEN HIRSCHLER, JUNE 11 2013


ONE of the world’s longest-running drug-development sagas may draw to a close in June as French firm Sanofi hopes for a European green light for its new multiple-sclerosis (MS) medicine Lemtrada.
The drug’s 25-year journey from a laboratory in Cambridge, England, to a possible $1bn-a-year seller has involved a string of pass-the-parcel deals that serve as an object lesson in complex "drug dealing" between rival companies.
While Sanofi may end up with a new product to plug a hole in its medicine cabinet, the drug’s slow evolution is a mixed blessing in the eyes of some doctors worried about pricing.
But for the original scientists behind the antibody treatment, it has been a frustrating wait.
"It’s been painful," says Dr Herman Waldmann, emeritus professor of pathology at the University of Oxford, who co-invented the drug while at the University of Cambridge.
"We had to make the running to keep on convincing the pharmaceutical industry at every step that there was something interesting there."
After studying Lemtrada, also known as Alemtuzumab, in MS since the early 1990s, Dr Waldmann believes the drug’s infrequent infusions have a lot to offer patients.
Sanofi, too, is optimistic about a medicine that would mark its second victory in MS, following last year’s US approval (by the regulatory agency, the Food and Drug Administration) of Aubagio, a pill. It expects the European Medicines Agency’s (EMA’s) verdict by mid-year, implying a decision at the agency’s next expert meeting on June 24.
EMA decisions are usually endorsed by the European Commission within a couple of months.
Over the years, enthusiasm for Lemtrada, which works by knocking out immune system cells called lymphocytes, has ebbed and flowed, and there is still no guarantee it will be approved.
Welcome, now GlaxoSmithKline, took an early stab at developing the medicine in the 1990s — after acquiring rights via British Technology Group — but gave up.
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Living a ‘Normal’ life with MS from a Christian Perspective - a Patient's story

June 9, 2013

By Chris Tatevosian
Special to ASSIST News Service

For those of us who have the terrible illness of Multiple Sclerosis (MS), we have two choices: One is that we can either think about what we can do or, two, we can think about what we can no longer do.

Chris in a wheelchair
No matter what, this is our new reality. As difficult as our hardships maybe, it really is our choice how we choose to go on living.

I am deeply comforted as a committed Christian by these words: “Come to me you who are worried and burdened, and I will give you rest” (Matthew 11:28 NIV).
The first choice involves changes and adjustments to our new life, which will allow us to go on living and enjoying the life we have… smiling, even laughing. Yeah, it's not what any of us expected, but life throws us curves every day. Sometimes there are problems as simple as locking our keys in the car, having the power go out, or breaking a fingernail, so we just have to accept them, adjust, and continue our day.

I know the problems resulting from MS are not as trivial as breaking a fingernail or sitting on your eyeglasses, which I have done several times, actually. How about joking about the situation? The situation may not be funny at the time, but when you look back a lot of times the trials and situations we find ourselves in can be hysterical.

For example, I got stuck on the soapy shampoo covered floor of the shower. Trying to extricate and up right myself from that situation was like an episode of the Dick Van Dyke Show -- “Oooh, Rob”. I realize that I am aging myself, but if you're too young to remember or have seen the show, with today's technology, that's an issue easily rectified, or you can just visualize Bambi trying to stand up on a slippery ice covered pond.


The second choice is a life of despair, worry and loss. Either way, if you are a believer, and are truly walking the walk, and not just talking the talk, as they say, you have eternal life in Christ.

Remember, God has a plan for your life. MS does not present a stumbling, block for our Savior. Do you think that He is surprised by or taken back by the introduction of MS to our lives? Come on, our God, the great “I Am”, “the Messiah”, He who knows all that was, is and will be. 

Continue reading as this could be inspirational for some

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Monday, June 10, 2013

Santhera gets exclusive rights from NIH for novel approach to Primary Progressive multiple sclerosis treatment

June 6, 2013

Swiss Santhera Pharmaceuticals (SIX: SANN) says that it has obtained an exclusive license from the USA’s National Institutes of Health (NIH) to its rights on a patent granted in the USA for the use of idebenone for the treatment of primary progressive multiple sclerosis (ppMS), a currently untreatable disease affecting about 40,000 patients in the USA.
The NIH is investigating the efficacy of Catena (idebenone) in ppMS in a placebo-controlled Phase I clinical trial. Santhera currently has a Phase III DELOS study running of orally administered Catena in patients with Duchenne muscular dystrophy (DMD; The Pharma Letter April 16).
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Led by the Neuroimmunology Branch of the National Institute of Neurological Disorders and Stroke (NINDS), the NIH is investigating the efficacy of idebenone in patients with ppMS in a double-blind, placebo-controlled Phase II clinical trial (IPPoMS trial). Santhera is providing study medication under a clinical trial agreement which gives Santhera the rights to the results. Santhera has now obtained the exclusive rights to the use patent for idebenone in ppMS granted in the USA.
"Patients with ppMS do not respond to immunomodulatory therapies with proven efficacy in relapsing remitting MS," said Bibiana Bielekova, the principal investigator of the IPPoMS trial and chief of the Neuroimmunology Disease Unit at the NINDS, adding: "Accumulating data indicate that mitochondrial dysfunction and related oxidative stress may play a major role in the pathogenesis of progressive MS. Idebenone enhances mitochondrial function and acts as an anti-oxidant against membrane damage in laboratory models and is a rational treatment choice in ppMS based on these pharmacological properties. Recruitment is proceeding well in the IPPoMS trial and we are excited about the opportunity to study the potential of idebenone in this currently untreatable disease."
"We are very enthusiastic about this collaboration and about the progress currently being made. ppMS is a disease with high medical need. In contrast to other forms of MS, there is currently no treatment option available for the 10%-15 % of MS patients affected by this primary progressive subtype," commented Nick Coppard, Santhera's head of development.
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Diagnosing Multiple Sclerosis With MRI

Widespread use of MRI (magnetic resonance imaging) has revolutionized the ability to diagnose multiple sclerosis. Disease-related changes in the brain or spinal cord are detected by MRI in more than 90% of people suspected of having MS.

What Is MRI?

MRI is a test that produces very clear pictures of the human body without the use of X-rays. It uses a large magnet, radio waves and a computer to produce these images.
MRI can often detect damaged areas in the brain or spinal cord that would be missed by other imaging techniques such as a CAT scan.

Why Do I Need to Get an MRI?

  • To detect MS. MRI is considered the best test to help diagnose MS. However, 5% of people with MS do not have abnormalities detected on MRI; thus, a "negative" scan does not completely rule out MS. In addition, some common changes of aging may look like MS on a MRI.
  • To track the progress of disease. Although they aren't widely needed, people with MS may get repeat scans to determine the status of their disease and how well their medications are working.

Is the MRI Exam Safe?

Yes. The MRI exam poses no risk to the average person if appropriate safety guidelines are followed. Many people who have had heart surgery and people with the following medical devices can be safely examined with MRI:
  • Artificial joints
  • Staples
  • Many cardiac valve replacements (check with your doctor)
  • Disconnected medication pumps
  • Vena cava filters
  • Brain shunt tubes for hydrocephalus
Some conditions may make an MRI exam a bad idea. Tell your doctor if you have any of the following conditions:
  • Heart pacemaker
  • Cerebral aneurysm clip (metal clip on a blood vessel in the brain)
  • Pregnancy
  • Implanted insulin pump (for treatment of diabetes), narcotics pump (for painmedication), or implanted spinal cord  stimulators  for chronic pain
  • Metal in the eye or eye socket
  • Cochlear (ear) implant for hearing impairment
  • Implanted spine stabilization rods (newer titanium rods and plates are fine)
  • Severe lung disease (such as tracheomalacia or bronchopulmonary dysplasia)
  • Heartburn
  • Obesity (weighing more than 300 pounds may limit which machine can be used)
  • Not able to lie on your  back for 30 to 60 minutes
  • Claustrophobia (which can be handled with sedation)

How Long Does the MRI Exam Take?

Allow two hours for your MRI exam. In most cases, the procedure takes 40 to 80 minutes; during that time, several dozen images may be taken.

What Happens Before the MRI Exam?

Personal items such as your watch, wallet (including any credit cards with magnetic strips that can be erased by the magnet), and jewelry should be left at home if possible or removed prior to the MRI scan. Secured lockers are available to store personal possessions.

What Happens During the MRI Exam?

You may be asked to wear a hospital gown during the MRI scan.
As the MRI scan begins, you will hear the equipment making a variety of different sounds, including a muffled thumping sound or banging sound  that will last for several minutes at a time. Other than that sound, you should experience no unusual sensations during the scanning.
Certain MRI exams require an injection of a contrast material. This helps identify abnormalities in certain parts of the body on the scan images.
Feel free to ask questions and tell the technologist or doctor if you have any concerns.

What Happens After the MRI?

Your doctor will discuss the test results with you. Most imaging centers will give you a copy of your scan on a CD disk that you can take to your doctor at your next appointment. It is a good idea to let your doctor know that you have completed your scan, so that he or she can contact the imaging center to get your report. Generally, you can resume your usual activities immediately.
 Reviewed by Richard Senelick, MD on August 30, 2012
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