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Identity

MS and identity. We know what MS does to us physically – but what about to our self? Receiving a diagnosis of multiple sclerosis is devastating. Full stop. The disease course is varied and unpredictable – and we humans we don’t like uncertainty. There is no cure; medical treatment is limited and the symptoms are wide and diverse. In addition, the onset of MS often occurs in young...

#ThinkSocial

At our second MS Services Variance meeting, ‘Raising the Bar’, in Birmingham last week my colleague Helen Ford and I co-chaired the workstream on the social determinants of health (SDoH).  What are the SDoH? The SDoH are life-enhancing resources, such as food supply, housing, economic and social relationships, transportation, education and health care, whose distribution across populations...

fifty shades of microglia

Fifty Shades of Microglia.Brioschi S, Peng V, Colonna M. Trends Neurosci. 2019 Apr 17. pii: S0166-2236(19)30044-X. In a recent study, Masuda and colleagues (Nature 2019;566:388-392) used single-cell RNA-sequencing (scRNA-seq) to profile microglia across different anatomical compartments, developmental stages, and types of brain pathology in mice. Moreover, the authors performed a novel...

Zombie

Are you an anticholinergic zombie?  A few months ago a 63-year-old MSer was admitted to hospital because of faecal impaction and overflow diarrhoea. She had had worsening constipation for years and was having intermittent diarrhoea due to liquification of stool from an overgrowth of bacteria in her colon, above a massive faecolith (a faecal rock). Her neurologist had her on a long-acting...

Education Anti-cholinergics

Cholinergic agents are compounds which mimic the action of acetylcholine and/or butyrylcholine. In general, the word choline refers to the various quaternary ammonium salts containing the N,N,N-trimethylethanolammonium cation. Found in most animal tissues, choline is a primary component of the neurotransmitteracetylcholine and functions...

Will we publish to the S club Beat

I always thought that S club 7 were abit rubbish, although my Nephew would beg to differ, But is the “S club 12” going to be any better?. They have come out with plan-S, I suspect it will be plan-B and not the second idea after the “open access fiasco” that they have created by lack of thought. Plan-S is another initiative that 12 organisizations in Europe have put forward...

Half a brain..watch the movie

Three-dimensional surface models of autopsied human brains constructed from multiple photographs by photogrammetry. Shintaku H, Yamaguchi M, Toru S, Kitagawa M, Hirokawa K, Yokota T, Uchihara T. PLoS One. 2019; 14 :e0219619.  Virtual three-dimensional (3D) surface models of autopsied human brain hemispheres were constructed by integrating multiple two-dimensional (2D) photographs. To avoid...

Bad Drug?…..Bad Idea? Remyelination Trial accepts the Null Hypothesis

The orginal title was changed read the comments Safety and efficacy of opicinumab in patients with relapsing multiple sclerosis (SYNERGY): a randomised, placebo-controlled, phase 2 trial.Cadavid D, Mellion M, Hupperts R, Edwards KR, Calabresi PA, Drulović J, Giovannoni G, Hartung HP, Arnold DL, Fisher E, Rudick R, Mi S, Chai Y, Li J, Zhang Y, Cheng W, Xu L, Zhu B, Green SM, Chang I...

Resilience

Down, but definitely not out! The WHO rejected our application to get glatiramer acetate, fingolimod and ocrelizumab/rituximab onto the Essential Medicined List. Why? The following is the relevant section from Executive Summary: “The Expert Committee recognized the public health need for effective and affordable treatments for multiple sclerosis (MS) but did not recommend the addition to...

Reporting of side effects in RRMS trials

Most research is about investigating the known unknowns. In other words, investigators have a certain hypothesis, but also a range of plausable possibilities as outcomes. However, in some instances the outcome is unexpected – the unknown unknown. Rare side effects are an example of this, and not always evident in the initial randomized-placebo (dummy treatment) controlled clinical trials...

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