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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...

My prevention hat

About three years ago I started wearing another hat; a preventive medicine hat. We started the Preventive Neurology Unit within our medical school focusing on MS, Parkison’s Disease and all-cause dementia. The unit is growing rapidly and gaining momentum. It was with great pride that I was able to attend and speak at first symposium. I have uploaded my slides for anyone who wants to download them...

The cost of MS. Filling your boots

Following on from NDG’s post on the cost of therapy.This is interesting. The outgoing corporates have sort of come clean about the costs of MS drugs. Perhaps they forgot to mention the saying Fill your own boots with cash even if you do a rubbish job. It’s like a petrol station. Get it fill up and get out of there quickly. What’s your view? November 25, 2019Qualitative study on...

Heart features of fingolimod

As we gear up for the mod wars as a number of S1P1 inhibitors arrive including siponimod and ozanimod, it will be interesting to see how fingolimod fairs. Fngolimod binds to S1P1, S1P3, S1P4 and S1P5 but the new variant bind to S1P1 and S1P5 and so avoid S1P3. This is in part the reason why fingolimod has heart issues and needs to be monitored. This risk is relatively low but needs to be checked...

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