Unrelated Blogger Comments-August 2016

Sometimes you have a question unrelated to the Threads. This is the Place for You


I drew and painted this about thirty five years ago the original was by Patrick Woodroofe

This Peacock Butterfly was taken by one of our Readers. Thanks

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    • I've put it in ProfGs box to have a look at but we often do not comment on reviews…hes the vitamin D person

  • This ability of neutrophils to directly communicate with B lymphocytes and effect antibody production raises the question: do primed neutrophils drive the activation of T and B-cells? Or ,are neutrophils the first ones in to combat whatever is driving MS, a virus maybe? With the discovery of new CNS lymphatic drainage into deep cervical lymph nodes there is the possibility that lymphocyte activation originates inside the CNS via activated glia, neutrophil recruitment and subsequent lymphocyte involvement. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4563157/ provides a good summary of possible ramifications of this new lymphatic system in the CNS.

  • Interesting Steve.
    I always remember a publication that MD did last year in which he spoke of the possible role of neutrophils in the pathophysiology of MS, the order of events.
    And this study indicated that the ratio of the number of circulating neutrophils and lymphocytes might be a code, a quick high boomarcador authentic inflammatory activity, ie outbreak. I'll see if I located the publication. But now whenever I do a basic blood count I make this division …

  • I have a doubt:
    Why Budesonide isn't used in pulse therapy instead of metilprenidisolone?

    If it compared to prednisolone, it causes less loss of bone density and unlike other corticosteroids has little influence on the hypothalamic-pituitary-adrenal axis?
    And if the power of budesonide, measured as affinity for the glucocorticosteroid receptor is approximately 15 times higher than that of prednisolone?

  • TNF-alpha involved again with MS … The Wnt signaling molecule seems that acts by inducing the formation of new neurons, and it seems that the expression of Wnt increases with inflammation (and contradictory). But from what I understand to be exposed to TNF-alpha Wnt was blocked and stopped producing neurons … So how to translate this to the actual field of MS, the TNF-alpha blocking makes the disease worse for example?


  • Does anyone have anything to say about dealing with circulation issues in MS? I have this in only one foot – on my weakest side. I am still walking with aids and active. It results in reddness, sometimes swelling and pain. It is not there all the time, but only during bad fatigue episodes, and it is worse in cold weather.

  • I thought the information on PPMS in this video was very interesting, e.g. vitamin D and parity less important as a risk factors in PPMS – with relation to relapsing forms of MS.

  • Is it ok to have the MMR vaccine as an adult RR MSer on DMF? I ask this as reading about it the MMR vaccine contains weakened versions of live measles, mumps and rubella viruses. The vaccine works by triggering the immune system to produce antibodies against measles, mumps and rubella.

    Could this in anyway trigger activity or a relapse? thanks

  • I feel very depressed right now. The OH has had a terrible week in the heat and it gave me a taster of what to expect in the coming years. I feel very frustrated that little or no real progress has been made to help people with PPMS. It really is a life sentence for them and their families.
    Normal doesn't exist anymore.

    • I can say – having PPMS myself – that heat does have a profound effect, and it is not fully understood why. But you cannot take it as an indication of what is to come – not necessarily. Precisely because the effects of heat are not fully understood.

  • I have read here and there that sheep dip exposure, i.e. organophosphates, were responsible for development of MS in farmers (although this was hushed up by the UK government for a long time). What might this say about MS pathology, and whether the first insult is neurodegenerative or an autoimmune flare?

  • When a patient is examined in a neurology clinic and they are suspected of having MS or have an MS diagnosis is there much focus on the MSE (mental state examination)?.

    • Re: "…is there much focus on the MSE (mental state examination)?."

      In short no; we don't have time to do cognitive testing formally in clinic. This is why cognitive impairment are missed. In terms of anxiety and depression; I always, or nearly, always ask the question but the environment is not conducive to explore these issues in the detail that is necessary. For example, I often have medical students and other trainees present.

    • Thanks Prof G. I wondered if it could be useful for patients to complete a one page Patient Reported Outcome Measure (PROM) questionnaire before their neurological examination? They could complete it at home before the appointment or in the waiting room.

  • So.. my Alpine mountain biking holidays ended…
    And I'm wondering why we have not seen a single selfie from Prof G who started all this olympic challenge madness? I think this is utterly unfair and clearly his money is not where his mouth is heh .. so I pass the Challenge to Prof G for the upcoming winter ski season in hope his leg healed well from the last accident. 😉

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