MS Views and News Be empowered with MS views and news. CLICK HERE - - to SUBSCRIBE for The MS BEACON e-Newsletter

MS Views and News uses state-of-the-art technology to provide resources to the MS Community. Visit our MS learning channel on YouTube, to gain knowledge from hundreds of MS educational videos presented by MS Experts from across the USA. Click: www.youtube.com/msviewsandnews

Within this blog you can find MS resources by viewing all showing below pertaining to thousands of MS articles, resources, event timing. Additionally, please visit our Social media platforms: Facebook, Twitter, and Instagram . Each providing important information for those affected by Multiple Sclerosis. * From the comfort of your home, you can join us for our VIRTUAL MS events. To learn more of these virtual events please subscribe here.

Disclaimer: 'MS Views and News' DOES NOT endorse any products or services found on this blog. It is up to you to seek advice from your healthcare provider. The intent of this blog is to provide information on various medical conditions, medications, treatments, for your personal knowledge and to keep you informed of current health-related issues. It is not a substitute for the advice of your physician. Should you or your family members have any specific medical problem, seek medical care promptly.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Wednesday, January 29, 2020

The effect of foot reflexology on constipation and quality of life in patients with multiple sclerosis. A randomized controlled trial


Abstract

BACKGROUND:

Constipation is a major problem in most patients with multiple sclerosis (MS). The aim of this study was to investigate the effect of foot reflexology on constipation and quality of life in patients with MS.

METHODS:

This study was a randomized controlled trial, in which 63 patients with MS referred to Arak MS Society, Iran were participated (from May to Dec. 2018). In this study participants were selected according to inclusion criteria and randomly divided into intervention (n = 33) and control (n = 30) groups. In the intervention group, foot reflexology was applied twice a week for 6 weeks (each session lasted about 30-40 min). Data were collected using demographic questionnaire, Constipation Assessment Scale (CAS) and Short Form (SF) 36 Quality of Life (QOL) questionnaire. 
Finally, the data were analyzed using SPSS Ver. 16 and descriptive and inferential statistical tests.
Click HERE to Register for the MS Beacon Newsletter

RESULTS:

The results of the study showed that severity of constipation and QOL score were not significant between the two groups before intervention (p > 0.05), but; after intervention, severity of constipation significantly decreased in the reflexology group (p < 0.05). Nevertheless, after intervention, the QOL was improved in the reflexology group compared to the control group but was not significant (p > 0.05).

CONCLUSION:

The results of this study showed that foot reflexology, as an effective intervention can be useful in management of constipation in patients with MS. Therefore, this intervention can be applied as a safe method for the decrease of constipation in MS patients.



.................................................................................................

CLICK Red BOX to SUBSCRIBE to the MS Learning Channel on YouTube

Click Red Box on banner to opt-in
........................................................................................................

This Article is Provided by:  #MSViewsandNews
::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::

Tuesday, January 28, 2020

Plant Based Diet study shows NO significant improvement on brain MRI, relapse rate or disability as assessed by EDSS scores in subjects with RRMS over one year

Low-fat, plant-based diet in multiple sclerosis: A randomized controlled trial.

Abstract

BACKGROUND:

The role that dietary interventions can play in multiple sclerosis (MS) management is of huge interest amongst patients and researchers but data evaluating this is limited. Possible effects of a very-low-fat, plant-based dietary intervention on MS related progression and disease activity as measured by brain imaging and MS related symptoms have not been evaluated in a randomized-controlled trial. Despite use of disease modifying therapies (DMT), poor quality of life (QOL) in MS patients can be a significant problem with fatigue being one of the common disabling symptoms. Effective treatment options for fatigue remain limited. Emerging evidence suggests diet and vascular risk factors including obesity and hyperlipidemia may influence MS disease progression and improve QOL.

OBJECTIVES:

To evaluate adherence, safety and effects of a very-low-fat, plant-based diet (Diet) on brain MRI, clinical [MS relapses and disability, body mass index (BMI)] and metabolic (blood lipids and insulin) outcomes, QOL [Short Form-36 (SF-36)], and fatigue [Fatigue Severity Scale (FSS) and Modified Fatigue Impact Scale (MFIS)], in relapsing-remitting MS (RRMS).

METHODS:

This was a randomized-controlled, assessor-blinded, one-year long study with 61 participants assigned to either Diet (N=32) or wait-listed (Control, N=29) group.

RESULTS:

The mean age (years) [Control-40.9±8.48; Diet-40.8±8.86] and the mean disease duration (years) [Control -5.3±3.86; Diet-5.33±3.63] were comparable between the two groups. There was a slight difference between the two study groups in the baseline mean expanded disability status scale (EDSS) score [Control-2.22±0.90; Diet-2.72±1.05]. Eight subjects withdrew (Diet, N=6; Control, N=2). Adherence to the study diet based on monthly Food Frequency Questionnaire (FFQ) was excellent with the diet group showing significant difference in the total fat caloric intake compared to the control group [total fat intake/total calories averaged ~15% (Diet) versus ~40% (Control)]. The two groups showed no differences in brain MRI outcomes, number of MS relapses or disability at 12 months. The diet group showed improvements at six months in low-density lipoprotein cholesterol (Δ=-11.99mg/dL; p=0.031), total cholesterol (Δ=-13.18mg/dL; p=0.027) and insulin (Δ=-2.82mg/dL; p=0.0067), mean monthly reductions in BMI (Rate=-1.125kg/m2 per month; p<0.001) and fatigue [FSS (Rate=-0.0639 points/month; p=0.0010); MFIS (Rate=-0.233 points/month; p=0.0011)] during the 12-month period.

Click HERE to Register for the MS Beacon Newsletter

CONCLUSIONS:

While a very-low fat, plant-based diet was well adhered to and tolerated, it resulted in no significant improvement on brain MRI, relapse rate or disability as assessed by EDSS scores in subjects with RRMS over one year. The diet group however showed significant improvements in measures of fatigue, BMI and metabolic biomarkers. The study was powered to detect only very large effects on MRI activity so smaller but clinically meaningful effects cannot be excluded. The diet intervention resulted in a beneficial effect on the self-reported outcome of fatigue but these results should be interpreted cautiously as a wait-list control group may not completely control for a placebo effect and there was a baseline imbalance on fatigue scores between the groups. If maintained, the improved lipid profile and BMI could yield long-term vascular health benefits. Longer studies with larger sample sizes are needed to better understand the long-term health benefits of this diet.
.................................................................................................

CLICK Red BOX to SUBSCRIBE to the MS Learning Channel on YouTube

Click Red Box on banner to opt-in
........................................................................................................

This Article is Provided by:  #MSViewsandNews
::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::

Ketogenic diet and fasting diet as Nutritional Approaches in Multiple Sclerosis (NAMS): protocol of a randomized controlled study

Abstract

BACKGROUND:

Multiple sclerosis (MS) is the most common inflammatory disease of the central nervous system in young adults that may lead to progressive disability. Since pharmacological treatments may have substantial side effects, there is a need for complementary treatment options such as specific dietary approaches. Ketone bodies that are produced during fasting diets (FDs) and ketogenic diets (KDs) are an alternative and presumably more efficient energy source for the brain. Studies on mice with experimental autoimmune encephalomyelitis showed beneficial effects of KDs and FDs on disease progression, disability, cognition and inflammatory markers. However, clinical evidence on these diets is scarce. In the clinical study protocol presented here, we investigate whether a KD and a FD are superior to a standard diet (SD) in terms of therapeutic effects and disease progression.

METHODS:

This study is a single-center, randomized, controlled, parallel-group study. One hundred and eleven patients with relapsing-remitting MS with current disease activity and stable immunomodulatory therapy or no disease-modifying therapy will be randomized to one of three 18-month dietary interventions: a KD with a restricted carbohydrate intake of 20-40 g/day; a FD with a 7-day fast every 6 months and 14-h daily intermittent fasting in between; and a fat-modified SD as recommended by the German Nutrition Society. The primary outcome measure is the number of new T2-weighted MRI lesions after 18 months. Secondary endpoints are safety, changes in relapse rate, disability progression, fatigue, depression, cognition, quality of life, changes of gut microbiome as well as markers of inflammation, oxidative stress and autophagy. Safety and feasibility will also be assessed.

Click HERE to Register for the MS Beacon Newsletter


DISCUSSION:

Preclinical data suggest that a KD and a FD may modulate immunity, reduce disease severity and promote remyelination in the mouse model of MS. However, clinical evidence is lacking. This study is the first clinical study investigating the effects of a KD and a FD on disease progression of MS.

See complete article information and the writers of this article / study by clicking here

.................................................................................................

CLICK Red BOX to SUBSCRIBE to the MS Learning Channel on YouTube

Click Red Box on banner to opt-in
........................................................................................................

This Article is Provided by:  #MSViewsandNews
::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::

Can a diagnosis of multiple sclerosis be made without ruling out neuromyelitis optica spectrum disorder ?


Abstract

BACKGROUND:

The symptoms of multiple sclerosis (MS) can overlap with neuromyelitis optica spectrum disorder (NMOSD). Although testing is available for aquaporin 4 (AQP4) and myelin oligodendrocyte glycoprotein (MOG) antibodies, screening for NMOSD is recommended but not mandatory to establish a diagnosis of MS.

METHODS AND RESULTS:

We queried 319,994 individuals who filed claims for MS and NMOSD in a Truven Health Analytics (THA) database and had at least one year of uninterrupted health insurance coverage. Of this cohort, 2001 (0.62%) were diagnosed as having NMOSD after an initial diagnosis of MS, based on ICD 9/10 codes. Since THA only offers claims-based data, we initiated an individual patient-based data search at our medical center to screen for potential misdiagnoses. We identified 4/54 (7.4%) NMOSD cases that were initially diagnosed as having MS.

CONCLUSIONS:

The results from our small study have significant implications--symptoms, clinical presentation or classic radiological findings perhaps cannot reliably separate MS from NMOSD. If our study findings can be replicated, guidelines to diagnose MS ought to recommend that NMOSD be excluded first despite typical clinical and radiological findings pointing to MS.
Click HERE to Register for the MS Beacon Newsletter


View the original article, here


.................................................................................................

CLICK Red BOX to SUBSCRIBE to the MS Learning Channel on YouTube

Click Red Box on banner to opt-in
........................................................................................................

This Article is Provided by:  #MSViewsandNews
::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::

Vitamin D: Giveth to Those Who Needeth.

Abstract

Severe vitamin D deficiency may cause rickets. While this point is not disputed, the use of vitamin D in the elderly to prevent fractures has been challenged recently by a meta-analysis of 81 RCTs, suggesting that the effects of vitamin D were trivial. As is true for any review of the literature, the interpretation of a meta-analysis can be confounded by the choice of publications to include or exclude. Indeed, the authors excluded RCTs with combined vitamin D and calcium supplementation, included futile studies of very short duration, or studies with high bolus doses known to transiently increase fracture risk. The best available data show that calcium and vitamin D supplementation of elderly subjects can decrease the risk of hip and other non-vertebral fractures, especially in institutionalized subjects or elderly subjects with poor calcium and vitamin D status. Vitamin D deficiency is associated with many chronic diseases. The VIDA and VITAL trials did not show a protective effect on cardiovascular diseases and cancer. 

Click HERE to Register for the MS Beacon Newsletter

The D2d study also did not influence the progress of prediabetes to diabetes. However, the baseline 25OHD concentrations of the majority of the participants of all these trials were essentially normal. Post-hoc analysis of these studies suggest some possibly beneficial health outcomes in vitamin D deficient subjects. A meta-analysis suggested that vitamin D could partly prevent upper respiratory infections. Mendelian randomization studies suggest a causal link between lifelong low vitamin D status and multiple sclerosis. A vitamin D supplement in pregnant women may decrease maternal morbidity and improve the health of their offspring. Better-designed studies are needed to answer all outstanding questions. However, based on all available data, it seems that correction of vitamin D and/or calcium deficiency of infants, pregnant women and elderly subjects can improve their health. © 2019 The Authors. JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research.
PMID:
 
31956848
 
PMCID:
 
PMC6957985
 
DOI:
 
10.1002/jbm4.10232

Article detail found here


.................................................................................................

CLICK Red BOX to SUBSCRIBE to the MS Learning Channel on YouTube

Click Red Box on banner to opt-in
........................................................................................................

This Article is Provided by:  #MSViewsandNews
::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::

What are the infectious risks with disease-modifying drugs for multiple sclerosis and how to reduce them?


Abstract

Patients with multiple sclerosis taking immunosuppressive therapy may be at risk of reactivating latent pathogens, community-acquired infections, worsening asymptomatic chronic infections, and contracting de novo infections. This risk was evaluated mainly in short-term clinical trials and few studies have investigated this risk in real-life settings. In clinical practice, this infectious risk should be evaluated when a multiple sclerosis diagnosis is made in order to propose specific follow-up or immunization as soon as possible and thus avoid contraindications or risk of lowered vaccination responses. Systematic screening should also be proposed for each patient before second-line therapy to ensure the risk is in line with the treatment plan. This systematic screening must include HIV and hepatitis B and C for all patients before treatment. The immunization schedule needs to be updated and influenza vaccine could be proposed each year for patients receiving disease-modifying drugs. Prevention is preferable to treatment, reducing both infectious morbidity and mortality, as well as interruptions in multiple sclerosis therapy. Therefore, preventive approaches should be tailored to individual patient and treatment risk factors. In this review, we describe the infectious risk with immunossuppressive therapies and propose minimal screening recommendations to evaluate the risk and adapt the prevention and strategy of immunization to each case at multiple sclerosis diagnosis and at specific follow-up visits to avoid difficulties using live-attenuated vaccines or risk reduced immune responses.


Click HERE to Register for the MS Beacon Newsletter


see the article detail by clicking here

.................................................................................................

CLICK Red BOX to SUBSCRIBE to the MS Learning Channel on YouTube

Click Red Box on banner to opt-in
........................................................................................................

This Article is Provided by:  #MSViewsandNews
::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::