AuthorGavin

Professor of Neurology, Barts & The London. MS & Preventive Neurology thinker, blogger, runner, vegetable gardener, husband, father, cook and wine & food lover.

Calling all vegans

As a vegan what supplements do I need to take? I am in the process of researching the dietary landscape for people with MS and will not be ready to make any firm recommendations for some time, but I can make a recommendation of what diets to avoid. The first is a strict vegan diet without supplements. My index patient was an Asian woman, in her mid-20s, with RRMS who referred for a second opinion...

COMBAT-MS: have your say

What are the most important outstanding research questions for people with MS? Depending on how long you have been following this blog you may or may not be aware of the COMBAT-MS study. This is a study that is funded by the US government as part of  the Patient-Centered Outcomes Research Institute (PCORI). COMBAT-MS is a US-Swedish initiative for a hybrid study between a traditional...

Katerina Akassoglou

Did you enjoy ACTRIMS? On Thursday evening I had the privilege of being at the Barancik Prize award ceremony and lecture. Katerina Akassoglou received the award for her work on the blood-brain barrier and fibrin as a pro-inflammatory agent of the innate immune system. Her lecture was a tour de force on what a single individual with dedication and focus can achieve. Well done. I was particularly...

#AttackMS – a flipped pyramid

Why does Selma Blair’s speech sound slurred? Whenever a celebrity gets MS and comes out of the ‘closet’ MS trends on social media. When Selma Blair attended the Oscar ceremony on Sunday night walking with a cane it caused quite a stir. You can now watch an interview with her on ABC News. You will notice that she has a slurred speech, which we call dysarthria and she is unsteady...

Yin and Yang

What is your worldview of MS? Back in 1982 when I was in 1st-year medical school I had the good fortune of being taught by Professor David Hammond-Tooke, an eccentric social anthropologist, whose task was to make us view the world from different cultural perspectives. I was living in apartheid South Africa and Wits, a liberal English speaking University, wanted its medical graduates prepared for...

A call to arms – the need for a citizens jury on HSCT

A few weeks ago I did a post on using a Citizens Jury, as a potential way to deal with the emotive issue of a lack of access to HSCT as a potential 1st-line treatment for active MS in the UK. A Citizens Jury can help sort out the disconnect between the needs or implied needs, of the MS community, and the position of the NHS and/or the HCPs in relation to HSCT. A Citizens’ jury is when a group of...

Flipping the pyramid

Was the concept of flipping the pyramid as a treatment strategy explained to you when you were started on a DMT? For several years I have been arguing for adopting the concept of flipping the pyramid as a treatment strategy for MS. This is a treatment strategy developed by rheumatologists for treating rheumatoid arthritis with great success. In short, flipping the pyramid is using very high...

ADIOS

Yes, why can’t we use anti-CD20 therapies as an immune constitution therapy (IRT) or at least adapt the dose based on B-cell reconstitution kinetics? And if we can’t beat the Swedes why can’t we join them? ADIOS = ADaptIve Ocrelizumab dosing Study There is mounting evidence from NMO and rheumatology that anti-CD20 therapies can be used as either a maintenance therapy or an immune...

A sequence of losses

Prof G has the MS community go it wrong? In this week’s NEJM there is an insightful perspective by Louise Aronson on ageing and driving. Aronson. Don’t Ruin My Life — Aging and Driving in the 21st Century. N Engl J Med 2019; 380:705-707. Louise quotes the American poet Donald Hall, who explains in Essays After Eighty how life is irrevocably and excruciatingly changed when a person must let go of...

News for alemtuzumabers

Prof G what can be done to manage my hyperthyroidism if I want to fall pregnant? Carbimazole is associated with an increased risk of congenital malformations, especially when administered in the first trimester of pregnancy and at high doses. Women of childbearing potential should use effective contraception during treatment with carbimazole. Carbimazole: increased risk of congenital...

Translate

Categories

Recent Posts

Recent Comments

Archives