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Dr. Roy Swank, who we lost recently at age 99, was a distinguished
neurologist whose research culminated in over 170 scientific papers. In the
above video I highlight a few.
As far back as 1950, we knew there were areas in the world that
had a lot of MS—North America, Europe—and other places—Africa and Asia—that
hardly had any. And migration studies show that those who move from a high risk
area to a low risk area significantly drop their risk, and vice versa. So it
seems less genetic and more lifestyle.
Dr. Swank had an idea. As he recounts in an interview with Dr.
John McDougall at the ripe young age of 84, “it seemed possible to me that this
could be a matter of food, because the further north you go the less vegetarian
a life is led and the more people are carnivores, you might say—they spend a
lot more time eating meat.”
After looking at the multiple sclerosis data from World War II in
occupied countries where meat and dairy were rationed, along with his famous
study in ’52 that found that the frequency of MS related directly to the amount
of saturated animal fat consumed daily in different areas of Norway, he
concluded that it might be the animal fat that was causing the increased risk.
He decided to put it to the test by restricting people’s intake of saturated
animal fat, most commonly coming from dairy and chicken in the U.S. (See Trans Fat,
Saturated Fat, and Cholesterol: Tolerable Upper Intake of Zero).
If you click on the above video, you can see data on his first 47
patients before cutting out about 90% of the saturated fat from their diet and
after, showing a decrease in both the frequency and severity of MS attacks.
Normally, you’re lucky if you can get people to stick to a diet for 6 months,
and so that’s why most dietary trials last a year at the most. The first study
he published reported results from the first 3 and a half years.
Multiple sclerosis (MS) usually develops in adults, but infrequently the neurodegenerative disease is diagnosed in children and teens. In fact, MS in young people may be more common than previously believed, although the diagnosis may be missed and the disease is somewhat different than in adults.
Of the estimated 400,000 people diagnosed with MS in the United States, approximately 10,000 are believed to be younger than 18 years old. Some experts believe this figure may be low, partly because it can be challenging to diagnose the disease in young people.
ADEM can persist in some children and then be accompanied by symptoms associated with MS normally seen in adults. However, young people also may continue to experience lethargy and seizures, which are not typical symptoms of adults with MS.
In addition, MS may progress more slowly in children and adolescents, although there is a chance young people will develop greater problems with disabilities at an earlier age when MS develops early. The psychological, social, and academic impacts also can be significant for children and teens who have MS.
A recent study looked at the development of MS before puberty and focused on identifying some typical ways young people present with the disease. The study included 47 pre-pubertal (younger than 11 years) and 41 post-pubertal (14-16 years) young people with relapsing-remitting MS who had had the disease for at least four years.
Pre-pubertal children were more likely to experience a severe first attack of the disease with numerous symptoms that included motor and brainstem involvement, cognitive problems, and sphincter dysfunction followed by milder neurological after effects of the attack that was maintained over two years
Post-pubertal patients were more likely to experience optic neuritis (inflammation of the optic nerve resulting in partial or complete blindness) and sensory symptoms
Diagnosing MS in young people A new study in the European Journal of Neurology reported on the incidence of MS among children and adolescents age 15 years or younger. The authors included information from all pediatric hospitals, MS centers, and private practices with an MS focus from 2009 to 2011.
The authors used an active prospective surveillance system and the McDonald criteria (highly sensitive and specific criteria for diagnosing MS) for their analysis and discovered that MS in children and teens is more common than previously believed. They determined that use of spinal magnetic resonance imaging (MRI) allowed them to make an early diagnosis in nearly 90 percent of cases.
Male vs female Among adults with MS, the disease generally first develops during the childbearing years and is more common among females; that is, a female:male ratio of about 2.5 to 1. However, among pre-pubertal young people, this gender difference does not seem to exist.
This observation, according to a recent report in Clinical Immunology, suggests that puberty plays a key role in the development of MS, especially in females. At least one study has noted that earlier age at menstruation increases the risk of MS development in females.
I Advise People re: Their Healthcare Team
As an Independent Health Care
Advocate, Gerontology and Multiple Sclerosis Nurse, I am often asked to help
patients with chronic illness or complex needs to be heard and tended to
appropriately on their Medical visits.
My advice to most is as
1. Prioritize! Make
a list of all of the things that you see as unaddressed issues and identify the
three that most impact your comfort and lifestyle. If there are more
than three issues you feel are urgent, make a second appointment or call ahead
to get a longer appointment to address these. Share this with
another person who knows you well before you go to the appointment to get their
2. Do not put
something on the high priority list if you are not willing to make lifestyle
changes to address these issues!
3. Bring a
list of all of the prescription medications you currently take including those
that are only used as needed. Be clear about how often and when you
use the as needed prescriptions.
4. Bring a
list of all supplements you take, how much and when. Some
prescription medications are not compatible with some natural products (such as
blood thinners and supplements with certain herbal components).
5. Be honest
about how much you smoke and drink in a day or week.
6. Move! Even
the most mobility impaired person can generally move something even if it’s
only their eyes. Spend a few minutes each day listening to music and
tapping toes or fingers if that is all you can do. Exercise is
important for all of us…no matter what our state of Health.
7. Hydrate! Drink
at least 6-8 glasses of water daily and remember that you have to drink an
extra glass for each caffeine or alcohol containing beverage consumed. If
you have bladder issues…drink a glass all at once rather than sipping
throughout the day.
something every day that gives you joy or enhances your knowledge. A
mind that is constantly expanding does not age as quickly and becomes less
susceptible to depression and cognitive decline.
9. Ask for
help if you need it. Do not assume people know your needs or
know what to do for you when they are with you.
10. If you don’t understand why
you are being asked to do something or take a particular medication, do not
leave the office until you do! Ask questions. Be an
important part of your Health Care team by learning why and following
directions and reporting problems related to the plan of care.
your Doctor or Nurse or PA or CNA is a Human being with problems and needs that
they leave behind when you are with them. Acknowledge that and know
they are not superhuman and may not have all the answers but they probably will
try to find the answers you need if you treat them with respect and care.
C. Binns RN BS MSCN
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The MS Atrium
is a source for innovative resources and tools on multiple sclerosis
information. Here you can access interactive content created with MS
experts on the condition, its treatment, and more.
Each room in the MS Atrium offers an
interactive experience with information that goes beyond traditional MS
education. Visit the MS Atrium on your computer, tablet, or phone to access
featured content including:
On Monday, I reported on an innovative, new acne bacteria-derived treatment for Secondary Progressive Multiple Sclerosis (SPMS) currently under development in Australia. Treatments such as these give new hope to patients with SPMS because very few of the approved, available therapies are reported to be beneficial, as the drugs (usually interferon- and disease-modifying drugs) are targeted towards patients with relapsing-remitting MS. A new, promising treatment, which is being specifically tested for secondary progressive MS, may be added to the mix in the near future.
The drug, natalizumab (Tysabri), from Biogen Idec is currently in Phase 3b Clinical Trials. Officially titled “A Multicenter, Randomized, Double-Blind, Placebo-Controlled Study of the Efficacy of Natalizumab on Reducing Disability Progression in Subjects With Secondary Progressive Multiple Sclerosis, With Optional Open-Label Extension,” the trial is split into two parts. Part 1 is investigating if natalizumab slows the accumulation of disability not related to relapses relative to a placebo, and Part 2 is a continuation of the safety evaluation of natalizumab, where all participants may receive natalizumab. The trial began in July 2011 and is estimated to be completed in December 2014, with longer-term endpoints being collected for a total of approximately four years.
Two groups of patients between the ages of 18 and 58 years are being evaluated in parallel: one group is receiving 300 mg of natalizumab intravenously every four weeks, and the other is receiving a placebo intravenously every four weeks. Neither the patients nor the evaluators are aware of who is in which group, making it a double-blind placebo-controlled trial. Primary endpoints will be determined through a series of tests, including a timed 25-foot walk and a questionnaire of work productivity and activity impairment.
Positive results from earlier-stage Secondary Progressive MS natalizumab trials are attributed to the anti-inflammatory properties of natalizumab. Continual inflammation surrounding neurons scarred by autoimmune attacks worsens disability in patients with SPMS, and the proposed benefit of natalizumab is a reduction in the number of attacks by immune cells on neurons. Natalizumab is similar to another drug, vedolizumab, which is under development by Takeda Pharmaceuticals for the treatment of ulcerative colitis,and was covered in the news last week on BioNews Texas. Both attenuate inflammation-promoting effects of the immune system.
A recently completed study at University College London Hospital suggests that administration of certain drugs can block the entry of sodium ions in nerve cells that in turn can prevent aggressive nerve cell damage. The research team proposed that delaying nerve cell destruction can limit the rate of disability in secondary progressive MS patients. The supporting study, which was completed after two years of testing, was aimed at employing nerve cell blockers like lamotrigine to monitor the rate of worsening disability in secondary progressive MS patients.
The Primary Outcome of this double-blind interventional study was to monitor changes in the volume of the whole brain with the help of the Loseff method using MRI technology (to monitor cerebral atrophy due to loss of axons). Secondary Outcomes for the study included monitoring the changes in the volume of whole brain with the help of Brain Boundary Shift Integral; the rate of atrophic changes in the spinal cord; appearance of new high intensity lesions on an MRI scan; ratio calculation of new T1 and T2 lesions; and the overall rate of changes in the MS Functional Composite and Impact Scale.
The cerebral and spinal volumes and cross-sectional area of the cervical spinal cord were tested at baseline, at 12 months into the study, and towards the end of the study period (24th month). Brain volume was measured more periodically at the 6th and 18 month marks, as well as at the 12 and 24 month marks. The clinical visits were planned for every 3 months.
Details of the Study:
The research team enrolled 120 patients with a positive history of MS and a progressive course of illness as seen in secondary progressive MS patients (patients with frequent episodes of clinical relapses resulting in disability were excluded). The study sample was divided into a test group and control groups, and the patients were randomly selected to receive either placebo or lamotrigine.
The research team explained that degenerative spinal or cerebral diseases can respond fairly well to neuroprotective treatments. The cause of disease progression in multiple sclerosis is degeneration of nerve axons. Previous research projects conducted by investigators at the University College London Hospitals have concluded that inflammatory mediators like nitric oxide can contribute to axonal degeneration. Various in-vitro studies confirm that blocking the activity of sodium channels can reduce the degeneration of axonal processes. Several pharmacological agents are currently available that are used to block sodium channels in the brain tissue (like phenytoin and flecainide in addition to lamotrigine).
Food poisoning could trigger Multiple Sclerosis, according to a just-released research study.Tests in mice from researchers at Weill Cornell Medical College in New York shows that a toxin that causes food poisoning may cause damage in the brain...
By John Gever, Deputy Managing Editor, MedPage Today
A relatively simple way to make progressive multifocal leukoencephalopathy (PML) more survivable appears to have worked in a multiple sclerosis patient taking natalizumab (Tysabri).
Before telling you what that remedy is, first let's go over what happens in PML. Those already familiar with it and a related condition called IRIS can skip over this part.
PML is a severe brain inflammation arising from reactivation of latent infection with the so-called JC virus, which is common in the general population. This reactivation usually results from some type of immunosuppression -- PML has been seen in conjunction with cancer chemotherapy, HIV infection, and with certain drugs targeting particular immune-system components.
Although natalizumab has attracted the most attention recently for PML risk, the condition has been linked to other drugs, including rituximab (Rituxan), fingolimod (Gilenya), and others.
JERUSALEM--(BUSINESS WIRE)--Teva Pharmaceutical Industries Ltd. (NYSE: TEVA) announced today that the U.S. Food and Drug Administration (FDA) has approved the Company’s supplemental new drug application (sNDA) for three-times-a-week COPAXONE® 40mg/mL, a new dose of COPAXONE®. This new formulation will allow for a less frequent dosing regimen administered subcutaneously for patients with relapsing forms of multiple sclerosis (MS). In addition to the newly approved dose, daily COPAXONE® 20 mg/mL will continue to be available. The daily subcutaneous injection was approved in 1996. Continue
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LUND, Sweden, Jan. 27, 2014 (GLOBE NEWSWIRE) -- Teva Pharmaceutical Industries Ltd. (TEVA) and Active Biotech (NASDAQ OMX NORDIC: ACTI) announced today that both companies remain committed to the NERVENTRA(R) (laquinimod) clinical development program for multiple sclerosis (MS) following the announcement of a negative opinion for the treatment of relapsing-remitting multiple sclerosis (RRMS) by the Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMA).
The CHMP has concluded that the risk-benefit profile of NERVENTRA is not favorable at this time. In accordance with European regulations, Teva and Active Biotech intend to request a re-examination of the CHMP opinion. Teva and Active Biotech are focusing on evaluating the CHMP's review and will continue to liaise closely with the EMA in working to make NERVENTRA available as a new treatment option for patients with RRMS in Europe.
NERVENTRA is a once-daily oral, investigational, CNS-active immunomodulator with a novel mechanism of action being developed for the treatment of relapsing-remitting MS (RRMS) and progressive MS (PMS). In extensive non-clinical and clinical studies NERVENTRA has demonstrated both anti-inflammatory and neuroprotective properties and effects that have been shown to provide clinically meaningful results. The global Phase III clinical development program evaluating NERVENTRA in MS includes two pivotal studies, ALLEGRO and BRAVO. A third Phase III NERVENTRA trial, CONCERTO, is evaluating two doses of the investigational product (0.6mg and 1.2mg) in approximately 1,800 patients for up to 24 months. The primary outcome measure will be time to confirmed disability progression as measured by the EDSS.
CLICK the LINK to REGISTER to attend this program on March 24th, 2014 in Jacksonville, Fl.
This is a Dinner program
Come to Learn, Come to Socialize with your MS Peers,
Free Raffle Tickets will be offered
Click the Flyer or visit: www.events.msvn.org - to register