ArchiveDecember 2019

Post-partum relapses after alemtuzumab

One of the problems of immune reconstitution therapies (IRTs), such as HSCT, alemtuzumab and cladribine, is nagging worry that at some time in the future your MS will reactivate. Some people with MS (pwMS) try and avoid potential triggers of disease activity, for example, vaccinations and pregnancy, particularly the post-partum state. Unfortunately, there is some evidence the latter may trigger...

Do you take your pills

Risk Factors for Suboptimal Medication Adherence in Persons with Multiple Sclerosis: Development of an Electronic Health Record-Based Explanatory Model for Disease-Modifying Therapy Use.Gromisch ES, Turner AP, Leipertz SL, Beauvais J, Haselkorn JK. Arch Phys Med Rehabil. 2019 Dec 3. pii: S0003-9993(19)31430-3. OBJECTIVE:To determine which factors are associated with suboptimal disease-modifying...

MD ramblings.

I don’t get out very often, but this week I’ve been emulating profG. I haven’t had any time for reading so have been away from the blog, sorry My computer is on its last legs and has been driving me nuts as it crashes every few minutes. My replacement has been on order for 3 months. Early in the week I had to go to Liverpool for the the annual British Society of Immunology...

NOSE-TO-BRAIN DIRECT

A guest post from Dr Frederick Gay, School of Life Sciences at the University of Essex, Colchester. “There- is- an- underground passage,”,said the Badger impressively,”that leads from the riverbank, quite near here, right up into the middle of Toad Hall.” O nonsence! said Toad rather airily, “You’ve been listening to some of the yarns they spin in the public houses about here.” Kenneth Grahame...

Do no harm

Primum non-nocere is a Latin phrase that means “first, do no harm”.  On the tube this morning I recognised one of our medical students reading Henry Marsh’ book “Do no harm”.  He is a semi-retired neurosurgeon, turned author, who uses his past patients to discuss ethical dilemmas and to criticise the NHS. His book does showcase the life of a surgeon, warts and all.  It is clear that to be a...

Not diagnosing MS

Last night when I got home I was emotionally burnt-out. I had done an all-day clinic and saw many difficult and challenging patients with MS, both new and follow-up patients. My wife asked me if I had a good day. I replied that it had been exhausting and that I felt numb. She said there must have been something rewarding in my day’s activities? On reflection, there were a lot of small moments...

Bum Juice can Control Disease

What’s this all about? Yep it’s me using journalistic licence and I guess more towards the Gutter-press than high-brow stuff, I hear you say. The microbiome (gut bacteria + other stuff) is at the centre of lots of MS research and here it is reported that a micro RNA (a small piece of genetic material) comming out of the Pooh when animals are sick and people with MS, cause then to make...

Air pollution and MS

We know that smoking, passive smoking and solvent exposure increase your risk of getting MS. The hypothesis, supported by animal work, suggests these risk factors alter antigens or proteins in the lung that then trigger autoimmunity. In other words, the altered proteins are interpreted as being foreign by the immune system.  Particulate air pollution is another respiratory toxin that has...

Sustainable career in MS

Believe it or not, over a life-time an average person spends 3,750 days at work. Work provides income, independence, structure to the day, social interactions, and personal satisfaction from a task well done. Based on published figures the workforce population is aged between 15-64; with 50-64 and 25-34 year olds contributing to the bulk of this (see Figure below). And MS is in the thick of it...

Ich Klage An

When the Nazis used MS to support killing the disabled By Rachel Horne More than seventy years after the end of WWII, about forty Nazi propaganda films still remain banned by the Allies in Germany – due to their incendiary nature. One of the most notorious of these is Ich Klage An or I Accuse, which tells the story of a young woman who gets multiple sclerosis and convinces her husband to...

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