CategoryClinicSpeak

Turkeys voting for Christmas

Barts-MS rose-tinted-odometer: ★★★ (dollar color Monday hex #6B8068) Did you know that the effectiveness of high-dose steroids to treat a relapse is small? In reality, there is no difference in outcome at 6 months between relapses treated with steroids and those managed without steroids. In reality, high-dose steroids simply speed up recovery of function by about 2 weeks. So if you are not...

Teleneurology fatigue

Barts-MS rose-tinted-odometer: ★★ (Fatigue Friday has to be a midnight blue day #191970)  Everyone is asking me what COVID-induced changes to your MS NHS service will you keep? What will be the new normal, etc.? What I don’t want to keep is not being able to examine my patients, in particular, new patients.To diagnose MS you need to show dissemination in space; i.e. does this person have...

C-sections: how common are they in women with MS?

Barts-MS rose-tinted-odometer: ★★ (Indian summer orange #FF7722) I have always said that women with early MS who start and extend families should have no reason to worry about additional problems with their pregnancy and childbirth because. It may be different for women with more advanced MS who are disabled. Maybe I should revise this general advice based on the study below.In this study, 15...

Is metformin a super-drug?

Barts-MS rose-tinted-odometer: ★★★★★ (skoda baby pink Wednesday #cca49a) Should we all be taking metformin? As you know metformin is being tested in a remyelination therapy trial in MS; it rejuvenates senescent oligodendrocyte precursors making them more likely to make myelin.  The biology of metformin is fascinating as it also activates NRF2 the master transcription factor for programmed cell...

Probiotics survey is inconclusive

As promised the following are the recent result from the probiotics survey. I think there are too few respondents to make any judgement on this data. Probiotics and microbiome are clearly hot topics and hence we will at some stage need to generate good evidence to make some sensible recommendations to pwMS. At the moment I don’t think there is enough evidence to recommend pwMS take...

Are you a potential faller?

Barts-MS rose-tinted-odometer: ★★ (A Green & Yellow Friday – Lime Green (#32CC32) & Lemon Glacier (#F4FF00)) The biggest risk of losing your independence is falling and long bone fractures of the lower limbs. PwMS are 6x more likely than the general population to fall and fracture a lower limb long bone. I currently have a patient of mine with PPMS in hospital with bilateral...

Are you feeling prematurely old?

Barts-MS rose-tinted-odometer: ★★ (Gray Thursday as in getting old Thursday #808080) As you are all aware ageing is a fact of life and is essential for evolution to do its job properly. Even bacteria and fungi age. Ageing is, therefore, a biological process and is driven by various biological pathways and networks controlled by our genes. It is well known that chronic inflammation results in...

To all MS earthlings: the DMT tool is ready for take-off!

Elon Musk has not been able to reach Mars yet but we have been able to officially launch the ‘DMT tool’ on the clinicspeak website! On April 29th, we invited all readers of The MS blog to share their opinions about our ‘DMT tool’. This online web tool was designed to help pwMS select a disease-modifying treatment that matches with their lifestyle and is fit for the literal and figurative long run...

Don’t walk and talk

Barts-MS rose-tinted-odometer: zero-★s (Blue Monday; Italian or Azzurri blue  #0A36AF) Have you noticed that you battle with multitasking? As MS progresses and damages the brain people with MS develop cognitive problems and have difficulty multitasking. This is because MS reduces your brain reserve and hence you have to concentrate on doing one task at a time. This is why pwMS have problems in...

Please, please, please #GetVaccinatedASAP

Barts-MS rose-tinted-odometer: ★ (Black & White Friday) As the delta variant of SARS-CoV-2 is surging it is putting residents of Whitechapel at serious risk of getting COVID-19. This is important because the vaccination rate in Whitechapel is so low; less than 30% of adults have both dose of the COVID-19 vaccine. Why is the uptake of vaccines so low in our local community? Vaccine hesitancy...

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