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Timothy L. Vollmer, MD
Department of Neurology
University of Colorado Health Sciences Center Professor

Co-Director of the RMMSC at Anschutz Medical Center

Medical Director-Rocky Mountain MS Center
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Brian R. Apatoff, MD, PhD
Multiple Sclerosis Institute
Center for Neurological Disorders

Associate Professor Neurology and Neuroscience,

Weill Medical College of Cornell University

Clinical Attending in Neurology,
New York-Presbyterian Hospital
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Tuberculosis shot may also prevent Multiple Sclerosis


A new Italian study finds a vaccine, typically used to prevent tuberculosis(TB), may also help prevent multiple sclerosis(MS).

"The rationale is that you give a vaccination which typically protects you against an infection like tuberculosis to MS patients and what that does is we think that it fiddles with the immune system.
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Sanofi MS Drug Added With Genzyme Fails to Win FDA Approval

Sanofi (SAN) failed to win U.S. regulatory approval for its multiple sclerosis drug Lemtrada, denting the company’s ambitions of capturing a larger share of the $20 billion market for the disease.
The U.S. Food and Drug Administration said Sanofi’s Genzyme unit didn’t submit evidence from “adequate and well-controlled studies” showing that the benefits of Lemtrada outweigh its side effects, the Paris-based company said in a statement today. Sanofi disagrees with the conclusion and said it will appeal.

Lemtrada, which was approved in the European Union in September, was a key part of Sanofi’s $20.1 billion acquisition of Genzyme in 2011. The FDA indicated one or more additional trials comparing Lemtrada with another drug are needed for approval, Sanofi said. That would delay the product’s entry to a market dominated by Teva Pharmaceutical Industries Ltd. (TEVA:US)’s Copaxone, Biogen Idec Inc. (BIIB:US)’s Tecfidera, Avonex and Tysabri, Novartis AG’s (NOVN) Gilenya and Merck KGaA’s Rebif.
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HSE spent €7.5m providing injectable treatment for MS patients in 2013

THE HSE SPENT just less than €7.5 million providing injectable beta-interferon to patients suffering from multiple sclerosis (MS) in the first ten months of this year.

The information was revealed by Minister of State Alex White, in response to a question from independent TD Terence Flanagan who also asked about the prescribing guidelines for disease modifying treatments and the extent to which White believed they were being adhered to.
Figures show the number of patients receiving the injection treatments has fallen from 1,103 in 2011 to 866 in 2012. In the first ten months of 2013, 814 patients received the injectable beta-interferon treatment.

Costs from January to October reached €7,480,363 this year, falling from €10.2 million in 2013 and €11.3 in 2011.

The junior minister said the Medicines Management Programme, which was established by the HSE aims to ensure patients have access to the essential medicines that they need. He said it also” facilitates more cost-effective prescribing with initiatives in relation to high-costs medicines” and ensures value for money in relation to medicines.

There have been calls for a cannabis-based drug called Sativec to be approved for the Irish market as it has been identified as suitable for the relief of certain symptoms of MS. The Department of Health has said that it is engaging with experts on how best to make it legally available in Ireland while maintaining existing controls on cannabis.
It is expected that new regulations to allow for this will be introduced early in 2014.
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The Future Of Translational Medicine

There are currently ten FDA approved MS medications for use in relapsing forms of MS. None of these drugs is a cure, and no drug is approved to treat the type of MS that shows steady progression at onset. MS disease management decisions are complex and requires a patients neurologist to figure out what drugs to use.

Mira Medicine And Multiple Sclerosis

The team came to class with the thought of commercializing the UCSF Multiple Sclerosis BioScreen Project a Precision Medicine application that integrates a patients medical records with the latest population-based data from hundreds of other Multiple Sclerosis patients, (including their 3D MRI scans,) and using predictive algorithms makes it possible to chart a unique course of treatment for each patient.
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Are Teva's Stumbles Reason to Sell the Stock?

Are Teva's Stumbles Reason to Sell the Stock?

Teva Pharmaceutical had a rough 2013. Between losing a court battle on the patent extension for Copaxone, its key branded product, and the loss of its CEO due to a feud with the board over restructuring, the company struggled significantly.
These struggles largely kept Teva's shares from participating in 2013's incredible bull market. In addition, as they affected the company's operations, they're also reducing my fair-value estimate to below where it was when Teva was selected for the real-money Inflation Protected Income Growth portfolio.

What does the future bring?
But no matter a company's past, what matters to investors is what it will do in the future. With Copaxone losing patent protection in 2014, a large portion of Teva's revenue and profit will be lost to generics -- a somewhat ironic fate for a company that is the world's largest generic-drug maker. Teva's immediate future looks a bit weak as that profit source evaporates, but the company's core generics operations will continue. That's the advantage of generics -- once a medication goes generic, it stays that way.

Between Copaxone's early loss and the discord from the management shake-up, my fair-value estimate for the company has been lowered to $31.6 billion. That's down from the $37.2 billion I estimated the company was worth when originally picking Teva for the portfolio. Still, the company's recent market capitalization of $33.7 billion is close enough to that estimate that I'm willing to hold based on valuation.

Teva's dividend remains covered by earnings, but with a payout ratio of 85%, it looks like there isn't much room to continue increasing the payout. That number may be a bit misleading, though, as Teva's second-quarter loss was driven by high legal costs. Litigation is a big risk in the pharmaceuticals business, but if those costs were truly one-time, then Teva's core looks stronger than that number would indicate.

Still, owning companies with rising dividends is a key part of the iPIG portfolio's strategy. Teva's dividend has been steady at 1.15 Israeli shekel, or $0.33, throughout 2013, and if the company follows past trends it may consider an increase around February 2014. Time will tell whether Teva continues its trend of increasing its dividend. In the meantime, the payout looks solid enough to continue to hold the company at least through that February announcement.

One key reason Teva still looks like it's worth keeping despite its current blemishes is that its balance sheet remains strong, with a debt-to-equity ratio of about 0.6. A strong balance sheet is what helps companies survive through tough times.
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Utah Federal Judge Allows Plaintiff to Replead Negligence Claim in Tysabri Case

A Utah federal judge has allowed a plaintiff to amend his negligence claim to hone his allegations that the makers of the immunomodulator Tysabri negligently failed to warn physicians that the drug can cause progressive multifocal leukoencephalopathy.

In the Dec. 26 order, Judge David Nuffer of the U.S. District Court for the District of Utah dismissed the negligence claim against Biogen Idec Inc. and Elan Pharmaceuticals Inc. without prejudice, but dismissed the strict liability and warranty claims with prejudice pursuant to the parties’ stipulation.
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Study Findings Warrant Clinical Trials of Aerobic Exercise to Treat MS Memory Deficits, Researchers State

Recent research offers evidence that aerobic exercise may benefit memory in patients with multiple sclerosis (MS). Kessler Foundation’s Victoria Leavitt,
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PLUS: 829 new Studies we posted from 11/1 to Monday 12/30 Start at the Bottom!

At least 13% of patients who fulfill the TMCWG criteria for definite and possible IATM will convert to MS. Functional recovery in IATM is poorer in patients with urinary sphincter dysfunction at admission or LETM on MRI.

Depression and sleep disturbance in patients with MS is significantly correlated with associated fatigue.

We found a higher prevalence and incidence of Multiple Sclerosis among populations living in the eastern flank of Mount Etna. According to our data a possible role of TE cannot be ruled out as possible co-factor in the MS pathogenesis. However larger epidemiological study are needed to confirm this hypothesis.

ExtaviJect 30G was convenient to use and was associated with high levels of compliance.

Interleukin-10 expression during the acute phase is a putative prerequisite for delayed viral elimination in a murine model for multiple sclerosis.
Results substantiate the hypothesis that an imbalanced cytokine milieu during the early infection phase contributes to ineffective antiviral immunity in animals with a susceptible genetic background.

Ethical challenges in paediatric clinical trials in multiple sclerosis.
Future treatment trials in children and adolescents with MS will require a multicentre design, definition and selection of key outcome measures, and identification of the most promising therapies. Risks versus benefits of each specific treatment should be weighed and comprehensively discussed.

Quantification of retinal neural loss in patients with neuromyelitis optica and multiple sclerosis with or without optic neuritis using Fourier-domain optical coherence tomography.
Although FD-OCT RNFL and macular thickness measurements can reveal subclinical or optic neuritis-related abnormalities in NMO-spectrum and MS patients, abnormalities are predominant in the macula of MS patients and in RFNL measurements in NMO patients. The correlation between OCT and VF abnormalities was stronger in NMO than in MS, suggesting the two conditions differ regarding structural and functional damage.

[HTLV-1-associated myelopathy/tropical spastic paraparesis: a differential diagnosis in multiple sclerosis].
The therapy is limited to symptomatic treatment. Transmission of HTLV-1 can occur vertically by breast feeding, through sexual contact or via infected blood products. Based on a clinical case report, we present here a current review on the pathophysiology, epidemiology, clinical manifestations, diagnosis and treatment of HAM/TSP.

Vitamin D levels in Hispanics with multiple sclerosis.
We found that the relationship between vitamin D and MS differs by Hispanic ethnicity. Hypovitaminosis D was significantly more common among Hispanics than among whites with MS, and the majority of Hispanics were vitamin D insufficient. Interestingly, there was no association between vitamin D levels and season or increasing disability in the Hispanics. Our findings imply that factors influencing vitamin D levels and possibly vitamin D requirements may vary by ethnicity in patients with MS. These results should be confirmed in larger, prospective multi-ethnic cohort studies.

Bruxism and temporal bone hypermobility in patients with multiple sclerosis.
The increase in magnitude of bi-temporal bone intracranial expansion was approximately six times greater in subjects with MS compared to controls. Therefore, jaw clenching/bruxism is associated with more marked displacement of the temporal bones and expansion of the cranial cavity in patients with MS than in control subjects.

Smoked cannabis for spasticity in multiple sclerosis: a randomized, placebo-controlled trial.
Smoked cannabis was superior to placebo in symptom and pain reduction in participants with treatment-resistant spasticity. Future studies should examine whether different doses can result in similar beneficial effects with less cognitive impact.

Importance of human leukocyte antigen (HLA) class I and II alleles on the risk of multiple sclerosis.
In conclusion, these results confirms a complex role of HLA class I and II genes that goes beyond DRB1*15 and A*02, in particular by including all three classical HLA class I genes as well as functional interactions between DRB1*15 and several alleles of DRB1 and class I genes.

Shape analysis of the corpus callosum and cerebellum in female MS patients with different clinical phenotypes.
this study revealed CC and cerebellar shape change in RRMS and SPMS, and showed that deformations both in CC and cerebellum advances with the disease progression.

Disease-modifying drugs for multiple sclerosis and JC virus expression.
The small number of patients on other therapies precluded meaningful comment about their effects. No obvious effect of the platform DMDs on JCV prevalence was observed even for the interferon-βs.

Exploration of the relationships between regional grey matter atrophy and cognition in multiple sclerosis.
These findings clarify the pathophysiology of cognitive impairment in MS, and propose measures which could be considered for longitudinal monitoring of patients.

829 STUDIES FROM 11/1 to Monday 12/30 are below: 
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Antioxidant drug may reverse multiple sclerosis 
For people suffering from multiple sclerosis — that affects more than 2.3 million people worldwide — a cure may lie in an antioxidant drug. Designed by scientists more than a dozen years ago to fight damage within human cells, this drug significantly reversed symptoms in mice that had a multiple sclerosis-like disease. Researchers led by an Indian-American scientist P Hemachandra Reddy at the Oregon Health and Science University have discovered that MitoQ — an antioxidant — shows some promise in fighting neuro-degenerative diseases. But this is the first time it has been shown to significantly reverse a multiple sclerosis-like disease in an animal, says the study published in the journal Biochimica et Biophysica Acta Molecular Basis of Disease.
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Natural Treatment Review Exposes Fastest Way to Stop MS Symptoms

In its Multiple Sclerosis Natural Treatment review, the website reveals that patients dealing with this condition have so many disturbing symptoms that finding a quick and effective way to overcome the disease is a must.

To find out more about this new natural treatment read the full review at:
Symptoms of MS are going to vary depending on the location of the affected nerves.
They can include dizziness, fatigue, weakness, numbness, tremor, but also vision problems, lack of coordination and slurred speech.

One of the most important reasons why the Multiple Sclerosis Natural Treatment program is so appreciated is the fact that it targets the cause of MS to overcome it.

When the cause is gone, symptoms will gradually disappear. Well, the creator of this new healing method claims that the real cause of MS is a damaged immune system.

When the immune system is damaged, it attacks and destroys the sheaths that cover nerves, causing all the aforementioned symptoms.

Dr. Gary M. Levin, the author of the Multiple Sclerosis Natural Treatment, says that with the best and most effective natural remedies, the immune system can be repaired and overall health can be enhanced.
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Smoking stops your Multiple Sclerosis drugs from working SO: Try a Patch or E-Cigarette!!!


BARCELONA, Spain — Electronic cigarettes are as effective as the patch when it comes to helping smokers overcome the cravings of nicotine addiction, suggests the first randomized study of its kind.

The work, presented here at the European Respiratory Society (ERS) 2013 Annual Congress, and simultaneously published online in the Lancet, demonstrates that smokers using e-cigarettes and those using the patch are able to abstain from smoking in equal proportions after 6 months.
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Capable coaching: Poulin powers through MS

Two years after being diagnosed with multiple sclerosis, doctors advised Jim Poulin to give up teaching and stop coaching.

The longtime Winslow coach looked at his doctor and nodded in agreement.
Then, he continued teaching, and kept on coaching.

“He suggested I teach no more than half a day,” Poulin said. “I’d say, ‘OK, no problem.’ I never changed it. He said that coaching was getting too much for me. I listened to him, said, ‘Fine. Good.’ Then I continued to coach.”

That was in 1997, two years after his initial diagnosis. He kept going, but continued to live with the fear that he’d one day have to step away from coaching.

“I still have it to this day,” Poulin said, comparing stepping away from coaching football to addiction withdrawal. “The big thing was having access to talk to the kids and talk to them more than just about football.”

“I walked into the hospital and came out in a wheelchair,” Poulin said. “I haven’t walked since. The operation wasn’t successful, but we tried. We tried to improve the quality of life and it didn’t work.”
Poulin said that’s a lesson he wants kids to know. Sometimes, what you attempt to do doesn’t work, but you change things up and keep trying.

“There’s no promise to anybody that life is going to give you exactly what you want every single day,” Poulin said. “These kinds of lessons are hard to get in the classroom. Those classes are necessary and part of our education, but they don’t teach kids how to deal with adversity. That is one of the biggest things that I love about sports.”

And it’s one of the reasons Poulin never wanted to stop being involved. As a coach and a teacher, he still has plenty of lessons to share.

“Life is still good,” Poulin said. “God has been very good to me. God has blessed me. I’ve been very fortunate with everything that’s happened in my life, including this MS. If it’s going to be used for good, then so be it.

“If a kid says, ‘If coach isn’t going to give up on coaching us, then I’m not going to give up when I’m playing or as an adult, I’m not going to give up no matter the difficulties in my life.’
“So whatever good may come of it, I have been very, very blessed.”
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Antioxidant Has Promise in MS 

An antioxidant to protect mitochondrial function stopped an MS-like syndrome in mice, researchers found. Also this week: getting closer to an insulin pill and a new approach to flu treatment.

Antioxidant Protects Nerves in MS

A commercially available antioxidant that targets mitochondria, MitoQ, may provide neuroprotection against the central nervous system ravages of multiple sclerosis, a mouse study suggested.
Mitochondrial dysfunction and the accumulation of reactive oxygen species have been implicated in the axonal damage of MS, so a group of researchers from Oregon Health and Science University in Portland led by P. Hemachandra Reddy, PhD, administered MitoQ (mitochondrial CoQ10) to mice with experimentally induced autoimmune encephalomyelitis, a common model for MS. Clinical and behavioral symptoms were both delayed and attenuated in the treated animals, whereas neurologic disabilities including limb paralysis developed within 2 weeks in untreated controls.

Further analyses revealed that MitoQ treatment reduced inflammation in the central nervous system and spine and helped preserve neurons against demyelination and the cytotoxic events that can ensue. These findings support MitoQ as a "promising neuroprotective treatment for patients with MS," the researchers wrote in Biochimica et Biophysica Acta.
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The discovery could lead to an entirely new way to treat multiple sclerosis

An antioxidant drug knocks down multiple sclerosis-like disease in mice, says a new study. Now researchers at Oregon Health & Science University have discovered that an antioxidant designed by scientists more than a dozen years ago to fight damage within human cells significantly helps symptoms in mice that have a multiple sclerosis-like disease.

The antioxidant — called MitoQ — has shown some promise in fighting neurodegenerative diseases. But this is the first time it has been shown to significantly reverse an MS-like disease in an animal.
Can this human-made antioxidant also work in humans with similar ailments? Unrelated to this new study, there's also a book, Multiple Sclerosis published that discusses the role of antioxidants and multiple sclerosis symptoms. You also can check out the site, "Do antioxidants decrease the severity of multiple sclerosis (MS)?

The discovery could lead to an entirely new way to treat multiple sclerosis, which affects more than 2.3 million people worldwide. 

“It appears that MitoQ enters neuronal mitochondria quickly, scavenges free radicals, reduces oxidative insults produced by elevated inflammation, and maintains or even boosts neuronal energy in affected cells,” said Reddy, according to the December 26, 2013 news release, "Antioxidant drug knocks down multiple sclerosis-like disease in mice." The hope has been that MitoQ might help treat neurodegenerative diseases like Alzheimer's and Parkinson's. Studies evaluating its helpfulness in treating those diseases are ongoing.

Read more »

 Fine-tuned MRI may help MS diagnosis

 The research, published in the Proceedings of the National Academy of Sciences (PNAS), has found a way to improve a magnetic resonance imaging (MRI) approach called quantitative susceptibility mapping (QSM).

The scanning method could prove "an important tool for diagnosing and tracking the progression of multiple sclerosis (MS) and other neurological diseases," say the researchers from the Schulich School of Medicine & Dentistry at the University of Western Ontario, Canada.
The work was led by Ravi Menon, PhD, an expert in functional MRI (fMRI) with a Canada Research Chair in the subject.

They found this lack of sensitivity by changing the orientation of the MRI scanner signal, using a set up that rotated a rat's brain so that it could be scanned from 18 different angles.  The brains were then sent to the histology department for comparison. The scientists correlated scan data with these laboratory findings of "the microstructure of the brain" such as myelin concentration and integrity, and iron deposition.
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PLUS: 814 new Studies we posted from 11/1 to Sunday 12/29 Start at the Bottom!

Abnormal blood-brain barrier permeability in normal appearing white matter in multiple sclerosis investigated by MRI.
Our results emphasize the importance of BBB pathology in MS, which we find to be most prominent in the periventricular NAWM, an area prone to development of MS lesions. Both the facts that recent relapse appears to cause widespread BBB disruption and that immunomodulatory treatment seems to attenuate this effect indicate that BBB permeability is intricately linked to the presence of MS relapse activity. This may reveal further insights into the pathophysiology of MS.

Multiple sclerosis impairs regional functional connectivity in the cerebellum.
In patients, two clusters in the left posterior cerebellum expressed a reduction in regional homogeneity with increasing global disability as reflected by the Expanded Disability Status Scale (EDSS) score or higher ataxia scores. The two clusters were mainly located in Crus I and extended into Crus II and the dentate nucleus but with little spatial overlap. These findings suggest a link between impaired regional integration in the cerebellum and general disability and ataxia.

Upper limb motor rehabilitation impacts white matter microstructure in multiple sclerosis.
these findings indicate the importance of administering, when possible, a rehabilitation treatment consisting of voluntary movements. We also demonstrated that the beneficial effects of a rehabilitation treatment are task-dependent and selective in their target; this becomes crucial towards the implementation of tailored rehabilitative approaches.

Mitochondrial dysfunction contributes to neurodegeneration in multiple sclerosis.
This review provides a comprehensive overview on the current knowledge regarding mitochondrial dysfunction in MS. Importantly, more insight into the cause and consequences of impaired mitochondrial function provide a basis for mitochondrial-targeted medicine to combat progressive MS.

[Multiple sclerosis and familial Mediterranean fever: a case report].
Neurological complications of FMF are rare. It is important to rule out a neuro-Behçet disease in a FMF patient with neurological disorders. Previous studies and case reports on the association between FMF and MS have failed to draw a clear conclusion as to whether this is a true association or a simple coincidence. In our patient's clinical situation, we found no argument for changing the treatment of MS and FMF.

[Approaches to segment multiple-sclerosis lesions on conventional brain MRI].
Different sets of criteria are currently used for the diagnosis of multiple sclerosis (MS). Some are based on clinical features, while others are related to imaging findings. Among the image processing systems, specific criteria include spatial dissemination of lesions in one image or their temporal dissemination in images acquired at different time points. In addition, the evolution of the lesion load can be used to evaluate treatment efficiency in MS clinical research. Consequently, obtaining a precise segmentation of the MS lesion appears to be crucial. In the literature, a number of semi-automated or completely automated approaches have been proposed enabling a reduction of the inter- and intra-expert variability for manual delineations. A comprehensive state-of-the-art classification of the most representative systems is presented here.

[High prevalence of restless legs syndrome in multiple sclerosis].
Prevalence of RLS seems to be doubled in MS patients compared to the general population. This finding warrants further study. Identification of this syndrome in MS patients might lead to specific treatments

Concomitant radiochemotherapy in a patient with multiple sclerosis and glioblastoma.
This report demonstrates that concomitant radiochemotherapy according to the STUPP protocol, was safe in our patient with respect to the radiological as well as the clinical course of multiple sclerosis.

[Choice of early and escalation treatment options for multiple sclerosis].
Here we summarize available data from studies on early treatment with immunomodulatory drugs for a first demyelinating event, also referred to as clinically isolated syndrome. Furthermore, options for the escalation of immunomodulatory therapy will be discussed, e.g. with the recently licensed monoclonal antibody natalizumab.

Cognitive impairment in multiple sclerosis.
It is only through further studies that it will be possible to identify patients with, or at risk of, cognitive impairment and to provide appropriate therapy to limit the effects of this potentially devastating symptom.

Differential diagnosis of suspected multiple sclerosis: a consensus approach.
Differential diagnosis leading to MS or alternatives is complex and a strong evidence base is lacking. Consensus-determined guidelines provide a practical path for diagnosis and will be useful for the non-MS specialist neurologist. Recommendations are made for future research to validate and support these guidelines. Guidance on the differential diagnosis process when MS is under consideration will enhance diagnostic accuracy and precision.

Interferon-beta bioactivity measurement in multiple sclerosis: feasibility for routine clinical practice.
Our data suggest that for IFN beta bioactivity screening a single post-injection measurement seems reasonable. However, MxA induction measurement based on both pre- and post-IFN beta injection samples at second measurement is somewhat more precise in determining ultimate IFN beta bioactivity status.

Development of autoimmune hepatitis type 1 after pulsed methylprednisolone therapy for multiple sclerosis: a case report.
A 43-year-old woman with multiple sclerosis (MS) was treated with pulsed methylprednisolone and interferon beta at a hospital. Four weeks after initiating treatment, liver dysfunction occurred and she was referred and admitted to our hospital. Clinical and laboratory findings were consistent with and fulfilled the criteria for drug-induced hepatitis, but not for autoimmune hepatitis (AIH). She was successfully treated with corticosteroids. As ataxia developed after 1 year, she was treated with pulsed methylprednisolone for 3 d, then readmitted to our hospital when liver dysfunction occurred. Clinical and laboratory findings led to the diagnosis of AIH. To the best of our knowledge, this is the second case of AIH developed after pulsed methylprednisolone for MS.

[The social and familial dimension: experiences of caregivers and people with multiple sclerosis. The GEDMA study].
The social stigma, the lack of work and coming to terms with MS were the greatest issues for the patient, while support from the family network, the relationship that should be established with the patient, the impact of MS on children and the role played by remunerated work were the main dimensions of the disease for the caregiver.

[Acute disseminated encephalomyelitis: study of factors involved in a possible development towards multiple sclerosis].
Some clinical and paraclinical patterns are considered to confer risk of developing MS when present in ADEM patients. Our study has aimed to: a) describe a series of 29 patients (22 children and 9 adults) admitted in our hospital and diagnosed of ADEM between 1990 and 2005; b) study those patients considered to have risk patterns of developing MS, and c) compare the child and adult populations of our series. After a median 55 month follow-up, 6 children (27%) and no adults developed MS. In our series, risk patterns for developing MS predicted conversion to MS more accurately in children than in adults. Eight patients (6 children and 2 adults) had sequelae, cognitive in 6 of them. Our work supports that also observed in recent publications: that both conversion to MS or presence of sequelae after an episode of ADEM are more frequent than traditionally considered.

814 STUDIES FROM 11/1 to Sunday 12/29 are below: 
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Dr. Jeff Hersh, Ph.D., M.D.
Can MS strike at a young age?

Multiple sclerosis (MS) is a disease of the central nervous system (CNS, made up of the brain, spinal cord and the nerves to the eyes, the optic nerves). The CNS controls many body functions by sending electrical impulses through long nerve fibers (axons), which are insulated with myelin. MS is thought to be an autoimmune disease where the body’s immune system attacks this myelin coating causing inflammation (demyelization). Think of this like the light switches in your house which send electrical signals through insulated wires to turn the lights on; if the insulation comes off the wires the signals will not be transmitted correctly and the lights will not work properly.

There are many other diseases that can affect the myelin sheath. MS is differentiated from these in that it occurs “over space and time.”

 This means:
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Bone marrow mesenchymal stem cells isolated from multiple sclerosis patients have decreased suppressive function 

"This study highlights one of the potential problems with autologous stem cell transplants" said Dr. Paul R. Sanberg, distinguished professor at the Center of Excellence for Aging and Brain Repair, Morsani College of Medicine, University of South Florida, Tampa, FL. "Autologous cells are frequently affected by the disease etiology thus reducing their ability to be effective, meaning that allogenic transplants maybe preferable to maximize their potential benefit if other concerns such as rejection can be overcome." 

a research team in Brazil has compared MSCs isolated from MS patients and from healthy donors to determine if the MSCs from MS patients are normal or defective. The study will be published in a future issue of Cell Transplantation.

"The ability of MSCs to modulate the immune response suggests a possible role of these cells in tolerance induction in patients with autoimmune diseases, and also supports the rationale for MSC application in the treatment of MS," said study corresponding author Dr. Gislane Lelis Vilela de Oliveira of the Center for Cell-Based Research at the University of Sao Paulo. "We found that MS patient-derived MSCs present higher senescence, or biological aging, and decreased expression of important immune system markers as well as a different transcriptional profile when compared to their healthy counterparts."

The researchers suggested that further clinical studies should be conducted using transplanted allogenic (other-donated) MSCs derived from healthy donors to determine if the MSCs have a therapeutic effect over transplanted autologous (self-donated) MSCs from patients.
"Several reports have shown that bone marrow-derived MSCs are able to modulate innate and adaptive immunity cell responses and induce tolerance, thus supporting the rationale for their application in treating autoimmune diseases, " said the researchers.

They also noted that studies have shown that transplanted MSCs migrate to demyelinated areas as well as induce generation and expansion of regulatory T cells, important in immunity.
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How To Reduce The Multiple Sclerosis Symptoms Quickly And Naturally: HealthReviewCenter  

Matt Traverso, a public speaker, best-selling author, and natural health expert who has over 10 year of experience in teaching other people how to improve their health dramatically without using any dangerous and expensive prescription drug. Since Matt Traverso released the “How To Reverse MS Now” program, many people used it to learn how to relieve their multiple sclerosis symptoms rapidly such as fatigue, dizziness, slurred speech, electric-shock sensations, and tingling. Accordingly, Drummond Szasz performed a full How To Reverse MS Now review that points out whether this program is worth buying.

The review on the site indicates that the How To Reverse MS Now program provides people with tips to reduce their cravings for toxic foods naturally, and tips to choose foods to treat their multiple sclerosis fast. The program also covers a list of fruits and vegetables for cleaning up excess acidic waste. In addition, Matt Traverso will provide people with instruction books when they order this program. Firstly, people will receive the “21st Century - 10 Deadly Health Myths” book that reveals to them secrets about the medical industry. This book also helps people change their view of modern healthcare forever. Secondly, Matt Traverso will give people the “How To Reverse MS Now” book that provides them with a list of safe ingredients to cleanse their body from acids and toxins quickly. Finally, people will get the “Mind Control in the USA” book, and the “Miracle Doctors – and Lessons From Them” book.
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Genzyme's Lemtrada Gets Approval in Canada

Genzyme, a Sanofi company, announced that Health Canada has approved Lemtrada (alemtuzumab) for the management of adult patients with relapsing remitting multiple sclerosis (RRMS), with active disease defined by clinical and imaging features, who have had an inadequate response to interferon beta or other disease-modifying therapies.

"Lemtrada is an important new treatment option for Canadians with MS. It has impressive effectiveness following two treatment courses for those patients with active relapsing MS," said Dr. Anthony Traboulsee, Associate Professor of Neurology and Medical Director of the UBC Hospital MS Clinic of Vancouver Coastal Health. "Our own local experience in treating 35 patients through clinical trials with Lemtrada has been extremely positive."

In a release, the company noted that Lemtrada is supported by a clinical development program that involved nearly 1,500 patients and 5,400 patient-years of follow-up. Approval in Canada follows the recent approval of Lemtrada in the European Union. Marketing applications for Lemtrada are also under review in numerous other countries, including the US and Mexico.

More than 2.3 million people worldwide have been diagnosed with MS, including approximately 100,000 people in Canada.

Lemtrada 12 mg has a novel dosing and administration schedule of two annual treatment courses. The first treatment course of Lemtrada is administered via intravenous infusion on five consecutive days, and the second course is administered on three consecutive days, 12 months later.

"The approvals of Lemtrada in Canada and the EU are further recognition of its potential as a transformative treatment option for patients living with active MS," said Genzyme President and CEO, David Meeker. "Lemtrada is now approved in 30 countries, and we are very pleased that Canadian patients and physicians will have access to this important new treatment option."
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BioTrends Research Group Rolls Out The TreatmentTrends: Multiple Sclerosis 2013 Report

BioTrends Research Group, a research and advisory firms for specialized biopharmaceutical issues, finds that physician-reported patient shares for Novartis's Gilenya and Biogen Idec's Tysabri are 8 percent and 10 percent among relapsing-remitting multiple sclerosis (RR-MS) patients treated with a disease-modifying therapy (DMT) across the EU5 (France, Germany, Italy, Spain and the United Kingdom); significantly higher than those reported by EU5 neurologists surveyed in 2012.
According to a release, surveyed neurologists also report that recent changes in treatment management include a shift toward earlier and more-aggressive treatment and increased use of the anti- JCV antibody assay, changes that are consistent with the increased patient shares reported for Gilenya and Tysabri. Survey data indicate that these agents occupy distinct niches, with Gilenya a preferred second-line therapy in JCV-positive patients and Tysabri a preferred second-line therapy in JCV-negative patients.

The TreatmentTrends: Multiple Sclerosis (EU) 2013 report finds that, despite fewer than 30 percent of surveyed neurologists reporting access to Genzyme's* Aubagio and Genzyme/Bayer HealthCare's Lemtrada--and given the limited time these agents had been available at the time the survey was fielded--these DMTs have nevertheless captured a 1 percent physician-reported weighted MS patient share. The data also reveal that surveyed neurologists anticipate substantial changes in DMT use in the coming months as access to Aubagio and Lemtrada expands and as new products, notably Biogen Idec's Tecfidera, become available. Neurologists indicate that Aubagio will most likely compete with first-line products (i.e., Biogen Idec's Avonex, Bayer HealthCare's Betaferon and Teva's Copaxone), while Tecfidera may replace these products as well as Merck Serono's Rebif and Gilenya. Lemtrada, conversely, will most likely compete with Tysabri or would not replace an existing DMT, suggesting anticipated use as a last-line therapy.

"The European MS market is entering a dynamic period with two recent DMT launches and as many as six new DMTs launching in the next five years," said Decision Resources Group Senior Business Insights Analyst Georgiana L. Kuhlmann, S.M. "Our data find that gains for new brands will likely come at the expense of the interferon-beta therapies and Copaxone."

BioTrends Research Group provides syndicated and custom primary market research to pharmaceutical manufacturers competing in clinically evolving, specialty pharmaceutical markets.
Decision Resources Group is a cohesive portfolio of companies that offers information and insights on sectors of the healthcare industry.
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Researchers help reveal how specific wavelengths of light can heal 

Multiple sclerosis (MS) causes progressive paralysis by destroying nerve cells and the spinal cord. It interrupts vision, balance and even thinking.

On a suggestion from a colleague, Jeri-Anne Lyons decided to test how the disease responded to a radical therapy – exposure to a certain wavelength of light called near-infrared (NIR).
“Never in a million years did I think it would help,” says Lyons, an associate professor of biomedical sciences at the University of Wisconsin-Milwaukee (UWM), who studies the role of the immune response in MS.

But it did. In rodent models, early MS-like symptoms were treated with exposure to NIR light for a week, alternating with a week of no light. The clinical condition of the mice improved.
Professor Janis Eells, who shared the idea with Lyons, had the same initial reaction after she used NIR therapy on rats to treat blindness caused by poisoning, a condition thought to be permanent. Repeating experiments again and again, she found that certain doses of NIR light allowed lab animals to regain their sight.

Scientists have known for years that certain wavelengths of light in certain doses can heal, but they are only now uncovering exactly how it works, thanks in large part to three UWM faculty researchers, including Chukuka S. Enwemeka, dean of UWM’s College of Health Sciences who is internationally known for his work in phototherapy.

Enwemeka researches the effects of both NIR and blue light in the visible range on healing wounds. Among his discoveries is that some wavelengths of blue light can clear stubborn infections – even MRSA, the antibiotic-resistant “superbug” form of Staphylococcus aureus.

Together, the UWM cluster has found that NIR and blue light repair tissue in dramatically different ways, but both act on the same enzyme in the cell’s energy supply center: the mitochondria.
The studies have revealed key information about managing the effects of aging and disease.
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Exercise program in senior centers helps reduce pain and improve mobility of participants

- 48% fewer participants had pain on a daily basis after completing the program

- 69% more participants could climb several flights of stairs after the program

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PLUS: 799 new Studies we posted from 11/1 to Saturday 12/28 Start at the Bottom!

[A possible effect of the immunomodulating therapy with beta-interferons and glatimer acetate on the development of thyroid disease in patients with multiple sclerosis].
The dynamics of thyroid gland structure during the treatment with DMD was followed during one year. Beta-interferons provoked the development of hypothyreosis. The study of thyroid gland in MS patients, in particular, those treated with DMD is needed.

[Phagocyte activity and the interferon system in patients with different types of multiple sclerosis].
The most marked changes in the phagocyte section of immunity and in the interferon system were seen in patients with primary progressive and secondary progressive MS. The data obtained may be used in diagnosis and choice of treatment in MS patients.

[Antibodies to native and denatured DNA in multiple sclerosis].
The higher levels of antibodies were found in patients with remitting MS compared to primarily- and secondary progressive MS. The results obtained support the hypothesis that anti-DNA antibodies to DNA are the key component of the pathogenesis and their level depends on the immunoreactivity of the patient and MS course.

Perinatal outcomes in women with multiple sclerosis exposed to disease-modifying drugs.
The incidence of DMD exposure was relatively low and no cases were intentional. Further studies are needed to ascertain the safety of DMD exposure during pregnancy in MS.

The effects of heat stress on cognition in persons with multiple sclerosis.
A significant increase in core body temperature during heat stress is associated with a mild and reversible worsening of the PASAT 3" performance, while visual vigilance performance seems to remain almost unaffected.

Assessment of lesion pathology in a new animal model of MS by multiparametric MRI and DTI.
In conclusion, the combined information from different DTI parameters allows for a more precise identification of solely demyelinated lesions versus demyelinated and acutely inflamed lesions. These findings are of relevance for offering individualized, stage-adapted therapies for MS patients.

B cell-derived IL-15 enhances CD8 T cell cytotoxicity and is increased in multiple sclerosis patients.
Exposure of CD8 T cells to this cytokine enhanced their ability to kill glial cells as well as to migrate across an in vitro inflamed human blood-brain barrier. The elevated levels of IL-15 in patients relative to controls, the greater susceptibility of CD8 T cells from patients to IL-15, in addition to the enhanced cytotoxic responses by IL-15-exposed CD8 T cells, stresses the potential of therapeutic strategies to reduce peripheral sources of IL-15 in MS.

IL2RA gene polymorphism rs2104286 A>G seen in multiple sclerosis is associated with intermediate uveitis: possible parallel pathways?
These findings suggest an association of the rs2104286 polymorphism with intermediate uveitis, but not with HLA-B27-associated acute anterior uveitis. Because this polymorphism was associated with multiple sclerosis in previous studies, the authors suggest possible parallel pathways between multiple sclerosis and intermediate uveitis but not HLA-B27-associated uveitis.

Endocrine and phototransduction effects in the prevention of multiple sclerosis.
It presents published studies as evidence and suggests a number of straightforward tests of these theories which could allow clinicians to advise their MS patients to take appropriate actions to help slow down or prevent disease progression.

Mannose binding lectin mediated complement pathway in multiple sclerosis.
These findings suggest a potential activation of MBL complement pathway in MS that may possibly alter the risk or progression of MS disease.

Correlates of stages of change for physical activity in adults with multiple sclerosis.
The overall accuracy of predicting stages of change was 58.75%. Behavioral (r(2)  = .35) and cognitive processes (r(2)  = .17) accounted for the most variance, followed by mobility (r(2)  = .11) and self-efficacy (r(2)  = .05). Results provide support for evaluating whether TTM-based interventions can promote PA in adults with MS.

Data mining for response shift patterns in multiple sclerosis patients using recursive partitioning tree analysis.
PCS and MCS change scores are obfuscated by response shifts. The contingent true scores for PCS change scores are not comparable across patient groups.

Impaired neurosteroid synthesis in multiple sclerosis.
The findings also indicate that allopregnanolone and perhaps other neurosteroid-like compounds might represent potential biomarkers or therapies for multiple sclerosis.

VCAM-1-targeted magnetic resonance imaging reveals subclinical disease in a mouse model of multiple sclerosis.
These findings describe a highly sensitive molecular imaging tool that may enable detection of currently invisible pathology in MS, thus accelerating diagnosis, guiding treatment, and enabling quantitative disease assessment.

Statin therapy and multiple sclerosis disability in a population-based cohort.
In this cohort, disability progression did not differ between those receiving statin therapy and controls. These findings support the hypothesis that statins, in doses currently prescribed for hyperlipidemia, do not affect the long-term course of MS.

799 STUDIES FROM 11/1 to Saturday 12/28 are below: 
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Innovation Pays For Biogen Idec Inc. 

The financial risks associated with getting a drug out of the lab and into the market are astronomical. It's easy to understand the tendency for the Drug Majors to play it safe and funnel their limited resources toward programs likely to win approval. Sadly, with the string of big expiring patents over the past few years, this has been happening far too often.

Consider sodium glucose co-transporter 2 (SGLT2) inhibitors for treatment of type 2 diabetes. There are at least half-a-dozen late stage programs all trying to fit in this space. During the latest annual meeting of the American Diabetes Association, Boehringer Ingelheim clinical development director, Dr. Maximilian von Eynatten, said "I think probably from a clinical perspective, there is no big difference between the SGLT2 compounds so far, at least from everything we have seen." His employer is partnered with Eli Lilly to develop these compounds, and even he admits the program isn't accomplishing anything significant.

Government and private payers are getting fed up with the lack of innovation coming out of Big Pharma. During Q3 2013, Express Scripts Holding Company implemented a far more aggressive design of its National Preferred Formulary. Government payers in the Eurozone have long been austere, but are increasingly flexing their muscles. Demanding heavy discounts for non-breakthrough therapies in return for reimbursement approvals is on the rise.
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Skydive for charity

A multiple sclerosis sufferer with ties to Cape Breton is defying all the odds to take part in a Christmas skydive for charity.

Rob Tanner has always wanted to complete a skydive.  He has decided now, despite being wheelchair-bound, is the time to do it.  The 66-year-old will jumping with his son Matthew on Friday, and is raising money for the North Devon Hospice which has supported him since he was diagnosed with MS.

Westmount resident Christiane Tanner said brother-in-law lived in Cape Breton for several years, but circumstances brought him back to the United Kingdom.  She describes Rob as "a very brave and amazingly resilient man, always cheerful and positive in spite of a very, very crippling illness that has seen a slow deterioration of his physical abilities for many years."

In an interview with the North Devon Journal, Rob Tanner says Friday's skydive will be a dream come true.

“It’s been a lifelong ambition of mine to take part in a skydive, but I just never got around to it,” said Rob Tanner. “This is the perfect opportunity for me, because I have the strongest motivation possible, which is to raise money for North Devon Hospice.  “I just love it at the hospice, and it has become so important to me that I wanted to do whatever I could to raise money.  “It may seem unusual for someone in a wheelchair with Multiple Sclerosis to be jumping out of a plane, but I’m hoping that will encourage people to sponsor me because it really is a fantastic cause.”



Communication Is Key

If you live with a chronic condition like multiple sclerosis (MS), diabetes, fibromyalgia, or Crohn’s disease, you know how hard everyday life can be. But that doesn’t mean your family automatically knows that, too. The best way to prevent uncomfortable holiday moments is through communication.
“I'm clear with everyone when I'm not feeling well,” says Jenni Prokopy, communications strategist and founder of “I've learned to keep the drama low but the honesty high.”
Prokopy lives with fibromyalgia, along with a list of other chronic illnesses, and she has recently gone gluten-free. “I ask for what I need—which is usually a little quiet time to myself in a cool dark room—and the family obliges.”

The more you know about one another’s conditions, the more helpful and understanding you can be. Instead of feeling insulted when your uncle refuses your homemade pumpkin pie, knowing about his diabetes ahead of time will give you a chance to demonstrate your compassion and offer a suitable substitute.

Prokopy and her boyfriend are planning to visit his family in Cleveland this holiday season, so she’s packing her own snacks to take along on the trip. “I've offered to cook some of the meals to make things easier on my boyfriend's mom,” she adds.
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Antioxidant Drug Tackles Symptoms of MS in Mice 

The antioxidant, known as MitoQ, has shown to be promising in the fight against the neurodegenerative disease, and for the first time, may be able to reverse symptoms of this disorder.
Researchers induced mice to contract a disease known as experimental autoimmune encephalomyelitis, or EAE, that is very similar to MS in humans. They then separated the mice into four groups: : a group with EAE only; a group that was given the EAE, then treated with the MitoQ; a third group that was given the MitoQ first, then given the EAE; and a fourth "control" group of mice without EAE and without any other treatment.

Following 14 days after the study began, the EAE mice who were treated with the MitoQ exhibited a reduction via inflammatory markers and increased neuronal activity in the spinal cord that showed an improvement in their EAE symptoms. They also experienced a reduced loss of nerve fibers was also-a commen marker of MS.

"The MitoQ also significantly reduced inflammation of the neurons and reduced demyelination," said lead study author P. Hemachandra Reddy, Ph.D., an associate scientist in the Division of Neuroscience at OHSU's Oregon National Primate Research Center, via a press release. "These results are really exciting. This could be a new front in the fight against MS."
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Injectable Generic and Biosimilar Drugs - Potential Opportunities for Developers 2013 

The market for injectable generics has been through a period of consolidation over the last few years as the leading companies have increased their presence through acquisition. The major players include Hospira, Sandoz (Novartis), Hikma Pharmaceuticals, Fresenius Kabi and Teva Pharmaceutical Industries. But interest in generic injectables has not been limited to established generic companies, as pharmaceutical majors like Pfizer have also become attracted to the market.
This is hardly surprising with a global injectables market in the region of US$144 billion. While the lion's share remains with the innovative industry for the time being, the generic injectables market is worth around US$12.2 billion and numerous high value injectable products will face patent expiry in major markets over the next decade. But, many of the big sellers are biological products and biosimilar approvals will only be possible for a few companies. Gaining regulatory approval in developed markets will be far more complex for biosimilars than for chemical generics and will involve costly clinical trials. To date, only a handful of companies have gained regulatory approval for biosimilars in Europe, and the US is likely to remain elusive to all but a select few. Among these, as the only US-based company with approval for biosimilars in the EU, Hospira is well positioned to take advantage of the potential US market.
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Breakthrough for Western team 

London scientists have made a breakthrough fighting the scourge of multiple sclerosis, fine-tuning MRIs to detect the disease before it ravages its victims.

“This could be a real game-changer,” said Dr. Bruce Bebo, who this year will decide how to invest $50 million in research raised by the National MS Society in the United States.

Bebo marvelled Thursday from afar at the work of a London research team headed by Dr. Ravi Menon that’s aimed at what has been an elusive target — finding and treating MS before it causes physical and cognitive ­impairment.

The challenge is especially pressing in Canada, where MS rates are the highest in the world — nine times higher than the world average.

Neurologists have long used MRIs to diagnose MS by showing damage to the protective sheath that insulates the body’s central nervous system.

Now, London researchers have fine-tuned a high-powered MRI to actually measure the amount of damage to that protective sheath —called myelin — as well as the deposits of iron typically found with the disease.

The team from Western ­University perfected the scans first on rats in a study published this month in the journal Proceedings of the National Academy of Sciences.
“It’s a huge step (forward),” Menon told The Free Press.

They then tested it on ­people, and though that study won’t be published until January, ­preliminary data showed that damage might be pinpointed long before patients are ­traditionally diagnosed, potentially before they had suffered any ill effects.

“It’s really the holy grail, being able to track myelin,” Bebo said.
Though it’s not practical or affordable to screen everyone for MS using an MRI, research is underway to identify those most at risk from the disease. Some day, that work might lead to simpler tests such as a blood test to find those more at-risk who could then be scanned before the onset of symptoms, Bebo said.

In the meantime, more precise MRIs may help people already being treated for the disease with conventional drugs that suppress their immune system — it’s the immune system that attacks the myelin.

That treatment is by trial and error: If patients continue to deteriorate, doctors switch medications. Menon’s MRIs might help doctors switch away from failing medications before the damage occurs, Bebo said.

New research is aimed at reversing the damage to myelin, a task that may deliver even greater benefit if MS is discovered early, he said.

News of the breakthrough brought optimism this week to a Londoner who has grown skeptical over 30 years about “breakthroughs” as he helped his wife and the local MS society.

“It’s been a slow grind to hell,” Bob Sadler said of the challenges faced by his wife Margo and others with the disease. “An early detection system would be great.”
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How To Reverse MS Now Review – How To Reduce The Multiple Sclerosis Symptoms Quickly And Naturally

MS (multiple sclerosis) is a nervous system disease, which affects the brain and spinal cord. This disease damages the myelin sheath, which surrounds and protects the nerve cells. How To Reverse MS Now is a new solution for those people who want to prevent or treat multiple sclerosis related conditions such as muscle weakness, visual disturbances, trouble with coordination and balance, thinking and memory problems, and sensations such as numbness and prickling. This program is designed by Matt Traverso, a public speaker, best-selling author, and natural health expert who has over 10 year of experience in teaching other people how to improve their health dramatically without using any dangerous and expensive prescription drug. Since Matt Traverso released the “How To Reverse MS Now” program, many people used it to learn how to relieve their multiple sclerosis symptoms rapidly such as fatigue, dizziness, slurred speech, electric-shock sensations, and tingling. Accordingly, Drummond Szasz performed a full How To Reverse MS Now review that points out whether this program is worth buying.

The review on the site indicates that the How To Reverse MS Now program provides people with tips to reduce their cravings for toxic foods naturally, and tips to choose foods to treat their multiple sclerosis fast. The program also covers a list of fruits and vegetables for cleaning up excess acidic waste. In addition, Matt Traverso will provide people with instruction books when they order this program. Firstly, people will receive the “21st Century - 10 Deadly Health Myths” book that reveals to them secrets about the medical industry. This book also helps people change their view of modern healthcare forever. Secondly, Matt Traverso will give people the “How To Reverse MS Now” book that provides them with a list of safe ingredients to cleanse their body from acids and toxins quickly. Finally, people will get the “Mind Control in the USA” book, and the “Miracle Doctors – and Lessons From Them” book.
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PLUS: 784 new Studies we posted from 11/1 to Friday 12/27 Start at the Bottom!

JCV epidemiology in MS (JEMS)-Epidemiology of anti-JCV antibody prevalence in multiple sclerosis patients-Portuguese data.
The results of Portuguese MS patients participating in the JEMS study present some differences when compared with the global population and literature results. An overall prevalence higher than expected raises awareness for data confirmation with greater sample size studies.

Morphostructural MRI abnormalities related to neuropsychiatric disorders associated to multiple sclerosis.
It is conceivable that grey matter pathology (i.e., global and regional atrophy, cortical lesions), which occurs early in the course of disease, may involve several areas including the dorsolateral prefrontal cortex, the orbitofrontal cortex, and the anterior cingulate cortex whose disruption is currently thought to explain late-life depression. Further MRI studies are necessary to better elucidate OCD pathogenesis in MS.

Methodology of an International Study of People with Multiple Sclerosis Recruited through Web 2.0 Platforms: Demographics, Lifestyle, and Disease Characteristics.
This paper describes the study methodology in detail and provides an overview of baseline participant demographics, clinical characteristics, summary outcome variables, and health and lifestyle behaviours. The sample described is unique due to the nature of recruitment through online media and due to the engagement of the group, which appears to be well informed and proactive in lifestyle modification. Conclusion. This sample provides a sound platform to undertake novel exploratory analyses of the association between a variety of lifestyle factors and MS outcomes.

Prognostic risk estimates of patients with multiple sclerosis and their physicians: comparison to an online analytical risk counseling tool.
While the OLAP tool was rated understandable and acceptable, it was only of modest interest and did not change patients' prognostic estimates. The results suggest, however, that patients had some idea regarding their prognosis and which factors were most important in this regard. Future work with OLAP should assess long-term prognostic estimates and clarify its usefulness for patients and physicians facing treatment decisions.

Patients with neuromyelitis optica have a more severe disease than patients with relapsingremitting multiple sclerosis, including higher risk of dying of a demyelinating disease.
The odds ratio for reaching EDSS 6.0 and being deceased due to NMO in comparison to RRMS were, respectively, 3.14 and 12.15. Conclusion: Patients with NMO have a more severe disease than patients with RRMS, including higher risk of dying of a demyelinating disease.

Disease-specific molecular events in cortical multiple sclerosis lesions.
we confirmed by immunohistochemistry that oxidative damage in cortical multiple sclerosis lesions is associated with oligodendrocyte and neuronal injury, the latter also affecting axons and dendrites. Our study provides new insights into the complex mechanisms of neurodegeneration and regeneration in the cortex of patients with multiple sclerosis.

Extracellular matrix metalloproteinase inducer shows active perivascular cuffs in multiple sclerosis.
In summary, we describe the prominence of extracellular matrix metalloproteinase inducer in central nervous system inflammatory perivascular cuffs, emphasize its dual role in matrix metalloproteinase induction and leucocyte adhesion, and highlight the elevation of extracellular matrix metalloproteinase inducer as an orchestrator of the infiltration of leucocytes into the central nervous system parenchyma.

Three times weekly glatiramer acetate in relapsing-remitting multiple sclerosis.
GA 40mg sc tiw is a safe and effective regimen for the treatment of RRMS, providing the convenience of fewer sc injections per week.

Changing associations between cognitive impairment and imaging in multiple sclerosis as the disease progresses.
In a previous study of the same cohort, gray-matter atrophy measured shortly after CIS failed to predict development of cognitive impairment years later. Our findings suggest that gray-matter pathology, reflected by atrophy measurements, becomes increasingly important in determining cognition as MS progresses.

Evaluation of cytokines in multiple sclerosis patients treated with mesenchymal stem cells.
Intrathecal injection of MSCs does not affect cytokine variation in peripheral blood. Because the condition of most of our patients either improved or stabilized after stem cell therapy (SCT), we speculate that the immunomodulatory or neuroregenerative effects of MSC are exerted locally in the central nervous system.

Costs and quality of life in multiple sclerosis patients with spasticity.
The results of this study show that MS spasticity is associated with a substantial burden on society in terms of costs and HRQoL.

Driving performance in persons with mild to moderate symptoms of multiple sclerosis.
Subjects with mild to moderate MS are able to prioritize the driving task above the DA task. The relationship between depression and driving performance in MS merits further investigation.

Pharmacokinetic evaluation of teriflunomide for the treatment of multiple sclerosis.
While teriflunomide is no more effective than a number of other agents that are used in the treatment of MS, it has a favorable side-effect profile and the convenience of once a day oral administration. As such, it is likely to be a popular agent in the treatment of MS over the next 5 years.

Early white matter changes in childhood multiple sclerosis: a diffusion tensor imaging study.
The microstructure of white matter is altered early in the disease course in childhood multiple sclerosis.

Association of Expanded Disability Status Scale and Cytokines after Intervention with Co-supplemented Hemp Seed, Evening Primrose Oils and Hot-natured Diet in Multiple Sclerosis Patients.
Our study shows that co-supplemented hemp seed and evening primrose oils with hot-natured diet can have beneficial effects in improving clinical symptoms in relapsing remitting MS patients and significant correlation was found between EDSS and immunological findings.

784 STUDIES FROM 11/1 to Friday 12/27 are below: 
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Migraine Attacks Shortened by Diamine Oxidase Supplements

VIENNA, Austria — Preventive treatment with diamine oxidase (DAO), an enzyme that degrades histamine, significantly shortened the duration of migraine attacks and trended toward reducing the number of episodes.

Histamine is present in many foods, is released in allergic reactions, and is one of the chemical mediators that contributes to migraine. About 25% of the population may have an alteration in DAO that decreases its activity in breaking down histamine. The enzyme is expressed most in the intestine, kidney, and placenta.

"We diagnosed 137 patients who have a migraine, of whom 119 showed deficits of the activity of the enzyme, around 87% of the total patients that we have studied," said Joan Izquierdo, MD, from
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Resveratrol, found in red wine, worsens MS-like symptoms and neuropathology in mice

Resveratrol, a naturally occurring polyphenol compound produced by the skin of red grapes and peanuts, and found in red wine, has been touted as a beneficial supplement due to its anti-inflammatory and antioxidant properties. This has been supported by some experimental studies, whereas others suggest a lack of benefit.

A new study using two multiple sclerosis (MS) models published in The American Journal of Pathology has found that resveratrol actually worsened MS-like neuropathology and inflammation and had no neuroprotective effects.

"Resveratrol should be discouraged for supplemental use by MS patients pending further research," says lead investigator Ikuo Tsunoda, MD, PhD,
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Improved anti-inflammatory therapy for acute MS relapses 

Last week, the First-in-Human study with 2B3- 201, to-BBB's second product, was initiated at the Centre for Human Drug Research (CHDR) in Leiden, the Netherlands. This Phase I trial is designed to determine the safety profile, and will also give a first glance at the pharmacological profile. In this double-blind crossover study, 18 healthy volunteers are assigned to three cohorts in which they will receive an ascending single dose of 2B3-201, as well as placebo and standard of care methylprednisolone.

2B3-201 is being developed for treatment of diseases with neuroinflammation, such as acute relapses of multiple sclerosis (MS). The current standard of care methylprednisolone is effective, yet it requires high dose infusions for several days. This often results in side effects and inconvenience for the patient. Therefore, there is a high medical need for an effective treatment that could be given at lower doses with a more convenient dosing regimen.

"to-BBB's G-Technology® provides a safe method to enhance the slow and sustained delivery of drugs to the brain," says Werner Gladdines, Head of Development at to-BBB. "By combining this technology with methylprednisolone, 2B3-201 was developed and tested in nonclinical models with neuroinflammation, in which it showed a similar efficacy at single administration with a 10 times lower dose compared to multiple high doses of methylprednisolone."

"Next to the standard safety parameters and pharmacokinetics, assessments of effects on cognition, behavior, and glucose tolerance will be evaluated," adds Dr. Geert Jan Groeneveld, Research Director Neurology & Pain at CHDR. "By including specific neurological tests in CHDR's NeuroCart and therapeutic dose levels of methylprednisolone in the control arm, this study allows for an extensive read-out of pharmacological and neurological effects."

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Brain Reserve Found To Protect Against Cognitive Decline In Multiple Sclerosis 

U.S. and Italian researchers have determined that brain reserve, as well as cognitive reserve, independently protects against cognitive decline in multiple sclerosis (MS). Their article, "Brain reserve and cognitive reserve in multiple sclerosis: What you've got and how you use it", was published in Neurology (Neurology 2013;80:2186-2193). Authors James Sumowski, PhD, Victoria Leavitt, PhD, and John DeLuca, PhD, are with Kessler Foundation in West Orange, NJ. Maria Rocca, MD, Gianna Riccitelli, PhD, Giancarlo Comi, MD, and Massimo Filippi, MD, are with San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.

"Our research interests focus on why many people with MS suffer cognitive impairment, while others with MS withstand considerable disease progression without cognitive decline," said Dr. DeLuca, VP for Research & Training at Kessler Foundation. "With our colleagues in Milan, we explore factors associated with lack of cognitive decline despite marked changes on imaging studies." In this study, 62 patients with MS (41 relapsing-remitting MS, 21 secondary progressive MS) had MRIs to estimate brain reserve and disease burden. Early-life cognitive leisure was measured as a source of cognitive reserve. Cognitive status was measured with tasks of cognitive efficiency and memory.

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Harding thrives in face of adversity 

Overcoming MS to play at all helped earn Harding the 2013 Masterton Trophy for perseverance. He followed that up with the creation of a charity, Harding’s Hope, to help those with the disease.
And he didn’t stop there; his play to start the current season has people thinking he could win a different award: the Vezina Trophy.

With Backstrom again dealing with injuries to start the 2013-14 campaign, Harding seized his opportunity to play and has dazzled throughout the year, going 18-5-3 with a league-leading 1.55 goals-against average and a .939 save percentage.

The Wild are challenging for a playoff spot in the incredibly difficult Western Conference and have Harding to thank for a lot of their success.

Dealing with MS has its pitfalls, however, because it never goes away. He was put on injured reserve on Dec. 19 to undergo a change in treatment of the disease. Wild GM Chuck Fletcher says it’s not a major situation, but it’s a reason to be concerned nonetheless.
Dealing with an incurable disease like MS is difficult regardless of a person’s situation. Watching Harding excel through it all has been incredible to witness.

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High-Dose Flu Vax Better for Frail Elderly

Among the frail elderly in long-term care, a high-dose influenza vaccine improved antibody responses compared with standard vaccines, a researcher said.

In a randomized, single-blind trial over two flu seasons, the higher dose gave superior responses to four out of five strains contained in the vaccines, according to Richard Zimmerman, MD, of the University of Pittsburgh.
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Antioxidant drug knocks down multiple sclerosis-like disease in mice 

Researchers at Oregon Health & Science University have discovered that an antioxidant designed more than a dozen years ago to fight damage within human cells significantly helps symptoms in mice that have a multiple sclerosis-like disease.

The antioxidant—called MitoQ—has shown some promise in fighting neurodegenerative diseases. But this is the first time it has been shown to significantly reverse an MS-like disease in an animal.
The discovery could lead to an entirely new way to treat multiple sclerosis, which affects more than 2.3 million people worldwide.

Multiple sclerosis occurs when the body's immune system attacks the myelin, or the protective sheath, surrounding nerve fibers of the central nervous system. Some underlying nerve fibers are destroyed. Resulting symptoms can include blurred vision and blindness, loss of balance, slurred speech, tremors, numbness and problems with memory and concentration.

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A Closer Look at Multiple Sclerosis Treatments in 2014: BIIB, NVS, TEVA, SNY, RCPT 

Several companies made notable advancements this year in treating multiple sclerosis (MS), a debilitating disease in which the body's immune system attacks the central nervous system.
MS affects an estimated 2.5 million people worldwide and 400,000 people in the United States. Of those patients, 85% are initially diagnosed with relapsing-remitting MS, which is characterized by alternating periods of relapses and remissions of the disease.

There is no cure for MS, and treatments have often caused terrible side effects, such as birth defects, cancer, and the risk of rare brain infections.
To better understand how much the market for MS treatments has evolved over the past year, let's take a closer look at Biogen Idec , Novartis , Teva Pharmaceutical , Sanofi , and newcomer Receptos .

Three promising plays: Biogen, Sanofi, and NovartisBiogen, Sanofi, and Novartis are the most promising plays in the MS treatment market. Let's take a look at their most notable treatments.

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PLUS: 771 new Studies we posted from 11/1 to Thursday 12/26 Start at the Bottom!

Demyelinating disease in SLE: Is it multiple sclerosis or lupus?
This review discusses clinical, pathophysiological, radiological and therapeutic concepts of demyelinating disease of the CNS in SLE, focussing on its differentiation from MS and its relation with other CNS demyelinating processes, such as transverse myelitis, optic neuritis and neuromyelitis optica.

New insights into an autoimmune mechanism, pharmacological treatment and relationship between multiple sclerosis and inflammatory bowel disease.
In this article, we provide a detailed review of the linkage and potential interchangeable medication between IBD and MS in addition to Natalizumab, Trichuris suis egg therapy and vitamin D. Different treatment strategies may have potential in treating both diseases in the future.

Control of spasticity in a multiple sclerosis model using central nervous system-excluded CB1 cannabinoid receptor agonists.
A cannabinoid drug pump is polymorphic and functionally lacking in many laboratory (C57BL/6, 129, CD-1) mice used for transgenesis, pharmacology, and toxicology studies. This phenotype was mapped and controlled by 1-3 genetic loci. ABCC1 within a cluster showing linkage is a cannabinoid CNS-drug pump. Global and conditional CB1 receptor-knockout mice were used as controls.

Prevalence of extracranial venous narrowing on catheter venography in people with multiple sclerosis, their siblings, and unrelated healthy controls: a blinded, case-control study.
This study shows that chronic cerebrospinal venous insufficiency occurs rarely in both patients with multiple sclerosis and in healthy people. Extracranial venous narrowing of greater than 50% is a frequent finding in patients with multiple sclerosis, unaffected siblings, and unrelated controls. The ultrasound criteria are neither sensitive nor specific for narrowing on catheter venography. The significance of venous narrowing to multiple sclerosis symptomatology remains unknown.

Disease Modifying Therapies Modulate Cardiovascular Risk Factors in Multiple Sclerosis Patients.
There is an association between higher CV risk factors and the use of DMTs. Furthermore, the use of CV and related drugs is associated with MS disease severity. This article is protected by copyright. All rights reserved.

Biopsy findings of symptomatic cerebral X-linked adrenoleukodystrophy and histological differentiation from multiple sclerosis.
Ultrastructural examination to determine the typical laminar inclusions in X-ALD is not always possible. Here, we report on two patients who underwent brain biopsy before the diagnosis of CALD was made. We describe the pathological findings of the biopsied brain lesions and point out histological characteristics which help to differentiate CALD and MS in routine diagnostics.

Can we switch microglia's phenotype to foster neuroprotection? Focus on multiple sclerosis.
While activated microglia have been observed in many neurological diseases of diverse etiology, "activation" indeed does not reveal the functional state of the cells which are often engaged in highly different roles. Indeed, microglia can play both detrimental and beneficial roles depending on inputs and feedback signals arising from the neural environment; such paradoxical roles are associated with phenotypes that range from so-called "classically activated", with highly pro-inflammatory features, to "alternatively activated" associated with a repair-oriented profile.

Predictors of successful acceptance of home telemanagement in veterans with Multiple Sclerosis.
The feasibility of the MS HAT system was assessed by (1) analyzing attitudinal surveys of veterans with MS who used the MS HAT system at home for over a month; (2) identifying factors affecting acceptance of the MS HAT system; (3) reviewing adherence of MS HAT users to self-testing regimen; (4) analyzing veteran feedback on MS HAT functionality using semi-structured qualitative interviews.

Time and time-frequency analysis of near-infrared signals for the assessment of ozone autohemotherapy long-term effects in multiple sclerosis.
The MS subjects showed a marked increase of the CYT-c activity and concentration about 40 minutes after the end of the autohemotherapy, possibly revealing a reduction of the chronic oxidative stress level typical of MS sufferers. From a technical point of view, this preliminary study showed that NIRS could be useful to show the effects of ozone autohemotherapy at cerebral level, in a long term monitoring. The clinical result of this study is the quantitative measurement of the CYT-c level changes in MS induced by ozone autohemotherapy.

Decoding movement intent of patient with multiple sclerosis for the powered lower extremity exoskeleton.
The designed intent recognition algorithm can accurately classify the subject's intended movements with 98.73% accuracy in static states and correctly predict the activity transitions about 100 to 130 ms before the actual transitions were made. These promising results indicate the potential of designed intent recognition interface for volitional control of powered lower extremity exoskeletons.

Monitoring technology for wheelchair users with advanced multiple sclerosis.
The sensors collect information related to the main issues of MS patients: fatigue, heat sensitivity and low mobility. Preliminary results show the signals as the wheelchair is moving, stopped and tilting. The system is able to capture sufficient relevant information to provide suggestions and alarms in a future stage. The system will be tested at The Boston Home, a specialized residence for adults with advanced MS.

Comprehensive Analysis of Human Endogenous Retrovirus Group HERV-W Locus Transcription in Multiple Sclerosis Brain Lesions by High-Throughput Amplicon Sequencing.
However, we obtained evidence for interindividual differences in HERV-W transcript levels. Reporter gene assays indicated promoter activity of many HERV-W long terminal repeats (LTRs), including structurally incomplete LTRs. Our comprehensive analysis of HERV-W transcription in the human brain thus provides important information on the biology of HERV-W in MS lesions and normal human brain, implications for study design, and mechanisms by which HERV-W may (or may not) be involved in MS.

A regenerative approach to the treatment of multiple sclerosis.
Evidence from a cuprizone-induced model of demyelination, in vitro and in vivo T-cell assays and EAE adoptive transfer experiments indicated that the observed efficacy of this drug results directly from an enhancement of remyelination rather than immune suppression. Pharmacological studies indicate that benztropine functions by a mechanism that involves direct antagonism of M1 and/or M3 muscarinic receptors. These studies should facilitate the development of effective new therapies for the treatment of multiple sclerosis that complement established immunosuppressive approaches.

Predictors and dynamics of postpartum relapses in women with multiple sclerosis.
Results confirm a favourable effect on relapses as pregnancy proceeds, and an early postpartum peak. Pre-conception DMT exposure and low ARR were independently protective against postpartum relapse. This novel finding could provide clinicians with a strategy to minimise postpartum relapse risk in women with MS planning pregnancy.

Immunological and clinical consequences of splenectomy in a multiple sclerosis patient treated with natalizumab.
Splenectomy may increase the risk for the development of natalizumab-associated PML via effects on the B cell compartment. It may be regarded as a risk factor in MS patients independent from the duration of disease.

771 STUDIES FROM 11/1 to Thursday 12/26 are below: 
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