ArchiveJuly 2017

#PoliticalSpeak & #ThinkSpeak: access inequality has not caught up with knowledge access

How can we democratise access to good quality healthcare? #PoliticalSpeak #ClinicSpeak I am often asked why I dedicate so much time to blogging. One of the reasons is to help disseminate knowledge and to help curate knowledge, i.e. to highlight what is important to pwMS. By doing this I am participating in a ‘healthcare revolution’ that is leading rapidly to an era when people with a...

Repeating Botox for bladder problems

Ni J, Wang X, Cao N, Si J, Gu B.Is repeat Botulinum Toxin A injection valuable for neurogenic detrusor overactivity-A systematic review and meta-analysis. Neurourol Urodyn. 2017 Jul 26. doi: 10.1002/nau.23354. [Epub ahead of print] AIM:To investigate the value of repeat botulinum toxin A (BTX-A) injections in patients with neurogenic detrusor overactivity (NDO).METHODS:We searched the...

Tadpoles for MS drugs

Mannioui A, Vauzanges Q, Fini JB, Henriet E, Sekizar S, Azoyan L, Thomas JL, Pasquier DD, Giovannangeli C, Demeneix B, Lubetzki C, Zalc B. The Xenopus tadpole: An in vivo model to screen drugs favoring remyelination.Mult Scler. 2017 Jul 1:1352458517721355. doi: 10.1177/1352458517721355. [Epub ahead of print] BACKGROUND: In multiple sclerosis, development of screening tools for...

#NewsSpeak & #ClinicSpeak: PML and fingolimod

How common is PML in fingolimoders? #NewsSpeak #ClinicSpeak I would like to congratulate Novartis for providing periodic updates on the PML risk associated with fingolimod. There have now been 13 cases of PML on fingolimod unrelated to prior natalizumab exposure, which provides a risk of getting PML on fingolimod of less than 1 in 10,000. Please note that the PML risk, and other...

Reconstitution with fingolimod is not always quick

Ghadiri M, Fitz-Gerald L, Rezk A, Li R, Nyirenda M, Haegert D, Giacomini PS, Bar-Or A, Antel J.Reconstitution of the peripheral immune repertoire following withdrawal of fingolimod Mult Scler. 2017;23(9):1225-1232. doi: 10.1177/1352458517713147. BACKGROUND:Following fingolimod cessation, immune reconstitution or lack thereof may have consequences for disease rebound or safety of commencing...

Legalising Cannabis. What’s your view?

Should we be legalising cannabis for use in multiple sclerosis?  There is an article in the Guardian about it. Currently there is a licensed version of Cannabis called Sativex, the problem is it costs too much and so it is not approved for use in Scotland, Northern Ireland and England yet it is available in NHS in Wales. Surely this is wrong!  Another example of the post code lottery...

EAE becomes a B cell Disease

‘t Hart BA, Dunham J, Faber BW, Laman JD, van Horssen J, Bauer J, Kap YS.A B Cell-Driven Autoimmune Pathway Leading to Pathological Hallmarks of Progressive Multiple Sclerosis in the Marmoset Experimental Autoimmune Encephalomyelitis Model.Front Immunol. 2017 Jul 11;8:804. doi: 10.3389/fimmu.2017.00804. The absence of pathological hallmarks of progressive multiple sclerosis (MS) in commonly...

What do you prefer

BACKGROUND:Treatment adherence in patients with multiple sclerosis (MS) is essential to reduce the rate of acute neurological attacks, severity of relapses, and hospitalizations and to slow its progression. Adherence rates in MS patients have been shown to be affected by multiple factors, including physical or cognitive difficulties, perceived lack of treatment efficacy, treatment-related adverse...

#GuestPost: More on the safety of MRI contrast agents

A recent post on the safety of Gadolinium based contrast agents used in MRI caused some concern, so I thought we should follow up with yet more expertise and analysis. I therefore asked Dr Tom Campion to summarise his thoughts on a recent guidance statement by the International Society for Magnetic Resonance in Medicine (ISMRM) on this important topic. Tom Campion is a senior radiology registrar...

Seizures in MS – what we don’t know

Brain Behav. 2017 May 24;7(7):e00726. doi: 10.1002/brb3.726. eCollection 2017 Jul. Unprovoked seizures in multiple sclerosis: Why are they rare? Kavčič A, Hofmann WE. Abstract INTRODUCTION: The frequency of seizures in patients with multiple sclerosis (MS) ranges from 1.5% to 7.8% and is considerably more common than chance events. The etiopathogenesis of seizures in MS is still poorly understood...

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