ArchiveOctober 2014

ClinicSpeak: update on Tecfidera PML case

#Tecfidera update: very low lymphocyte counts are the preventable PML risk factor. #ClinicSpeak #MSBlog #MSResearch “Biogen-Idec have give us the green light to go public on the fact that the patient who developed PML, and died, whilst taking dimethyl fumarate (Tecfidera) had had a lymphocyte count of less than 500/mm3, or 0.5 X 10**9/L for over three and a half years.”...

Migration shows early encounter with risk factor

ProfG made a post about the output of school kids and found that they seem to have a reduced output compared to non-Msers. Yes this is depressing, but the other part of the MS jigsaw is  if you look at the at who have were born in a low-risk area and moved to a high risk area like the UK. The answer appears to be move before 15 and you take the risk of birth place. Understanding MS means...

ClinicSpeak: when does MS actually begin?

How long is the asymptomatic period of MS? #ClinicSpeak #MSBlog #MSResearch “The data below was presented at last year’s AAN meeting in San Diego and I have been presenting it in my talks ever since. It supports my MS dementia rebranding exercise. In Argentina all people do standardised examinations in the last 3 years of school. If someone develops a clinically isolated syndrome...

MouseDoctor-The Joker

Someone made a Complaint that I was a “Joker”. I wonder why you would think that?  🙂

P.S. You have freedoms to make comments but not to Insult. 
You may or may not like our styles or contents of the posts. If you no likey….no readie 🙂

So some don’t like “The Joker” They prefer Groucho Marx

IV IG making false positives for JC Virus

Kister I, Kuesters G, Chamot E, Omari M, Dontas K, Yarussi M, Subramanyam M, Herbert J. IV immunoglobulin confounds JC virus antibody serostatus determination. Neurol Neuroimmunol Neuroinflamm. 2014 Sep 18;1(3):e29. doi: 10.1212/NXI.0000000000000029. eCollection 2014 Oct. OBJECTIVE:To determine the impact of therapeutic infusion of IV immunoglobulin (IVIg) on John Cunningham virus antibody (JCV...

ClinicSpeak: macrophages infiltrates after alemtuzumab in a patient with NMO

What does the pathology of a case of NMO teach us about alemtuzumab? #MSResearch #MSBlog #ClinicSpeak “The case report below is of a patient with anti-aquaporin-4 NMO who was treated with alemtuzumab. Unfortunately the patient died and at post-mortem the pathology showed extensive innate immune activation, i.e. extensive macrophage infiltration, with very little lymphocytes. It is clear...

Natural History Studies

This is a retrospective study using the MS Registry in Kuwait. They took a cohort of patients and looked at certain variables to see if they were predictive of MS progression. The study is not revolutionary in its findings – it shows that a late age of onset, male gender and relapse frequency are all poor prognostic markers and increase the risk of progression to secondary-progressive MS...

Extended interval dosing of natalizumab

Bomprezzi R, Pawate S. Extended interval dosing of natalizumab: a two-center, 7-year experience. Ther Adv Neurol Disord. 2014;7(5):227-31 BACKGROUND:The enthusiasm for natalizumab, a highly efficacious agent in the treatment of multiple sclerosis (MS), has been tempered by the risks of progressive multifocal leukoencephalopathy associated with its use, and strategies to minimize those...

OffLabel: cyclophosphamide

Cyclophosphamide is my fifth off label DMT for treating MS in resource poor environments. #MSBlog #MSResearch #OffLabel “This post is the fifth in a series of posts to try and help neurologists who treat MS in healthcare environments where they cannot access high-cost innovator DMTs. If you want to know the history of this post please read my post on my visit to South Africa. The other...

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