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Friday, June 28, 2013
Thursday, June 27, 2013
Literacy is a fundamental human right and the foundation for lifelong learning. It is fully essential to social and human development in its ability to transform lives. For individuals, families, and societies alike, it is an instrument of empowerment to improve one’s health, one’s income, and one’s relationship with the world.
Literacy is the cornerstone of all learning and fundamental for participation in today’s global society, yet 793 million people across the globe lack the ability to read and write. If all children in low-income countries left school with basic reading skills 171 million people could be lifted out of poverty.
In addition to the basic skills of reading, writing, and arithmetic, it is equally important that students are given the tools required to take advantage of the information available to them. The ability to seek, find, and decipher information can be applied to countless life decisions, whether financial, medical, educational, or technical. Literacy includes every medicine bottle, employment ad and ballot form they encounter. The uses of literacy for the exchange of knowledge are constantly evolving, along with advances in technology. From the Internet to text messaging, the ever-wider availability of communication makes for greater social and political participation.
Of all the illiterate people in the world today, two-thirds are female and over 90 percent live in developing countries. A literate community is a dynamic community, one that exchanges ideas and engages in debate. Illiteracy, however, is an obstacle to a better quality of life, and can even breed exclusion and violence.
The above information was obtained the websites noted below. Read more about literacy awareness at:
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Wednesday, June 26, 2013
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A bone tumor is an abnormal growth of cells within a bone.
A bone tumor may be cancerous (malignant) or noncancerous (benign). Cancer can begin in any type of bone tissue. The cause of bone tumors is unknown. In most cases, no specific cause is found. Most patients with cancerous bone tumors that have not spread can achieve a cure.
Monday, June 24, 2013
National HIV Testing Day is on June 27th. This year's theme is "Take the Test, Take Control".
What is HIV?
H – Human – This particular virus can only infect human beings.
I – Immunodeficiency – HIV weakens your immune system by destroying important cells that fight disease and infection. A "deficient" immune system can't protect you.
V – Virus – A virus can only reproduce itself by taking over a cell in the body of its host.
What is AIDS?
A – Acquired – AIDS is not something you inherit from your parents. You acquire AIDS after birth.
I – Immuno – Your body's immune system includes all the organs and cells that work to fight off infection or disease.
D – Deficiency – You get AIDS when your immune system is "deficient," or isn't working the way it should.
S – Syndrome – A syndrome is a collection of symptoms and signs of disease. AIDS is a syndrome, rather than a single disease, because it is a complex illness with a wide range of complications and symptoms.
Read more about HIV/AIDS at http://aids.gov/hiv-aids-basics/
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Introduction to MS
Multiple Sclerosis (MS) is the most common disabling neurological disease of young adults. It most often appears when people are between 20 to 40 years old. However, it can also affect children and older people.
The course of MS is unpredictable. A small number of those with MS will have a mild course with little to no disability, while another smaller group will have a steadily worsening disease that leads to increased disability over time. Most people with MS, however, will have short periods of symptoms followed by long stretches of relative relief, with partial or full recovery.
There is no way to predict, at the beginning, how an individual person’s disease will progress.
Researchers have spent decades trying to understand why some people get MS and others don't, and why some individuals with MS have symptoms that progress rapidly while others do not. How does the disease begin? Why is the course of MS so different from person to person? Is there anything we can do to prevent it? Can it be cured?
There is no single test for MS. Doctors use a medical history, physical exam, neurological exam, MRI, and other tests to diagnose it. There is no cure for MS, but medicines may slow it down and help control symptoms. Physical and occupational therapy may also help.
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What is Multiple Sclerosis?
It damages the myelin sheath, the material that surrounds and protects your nerve cells. This damage slows down or blocks messages between your brain and your body, leading to the symptoms of MS. They can include
- Visual disturbances
- Muscle weakness
- Trouble with coordination and balance
- Sensations such as numbness, prickling, or "pins and needles"
- Thinking and memory problems
No one knows what causes MS. It may be an autoimmune disease, which happens when your immune system attacks healthy cells in your body by mistake.
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What are plaques made of and why do they develop in MS?
Plaques, or lesions, are the result of an inflammatory process in the brain that causes immune system cells to attack myelin. The myelin sheath helps to speed nerve impulses traveling within the nervous system. Axons are also damaged in MS, although not as extensively, or as early in the disease, as myelin.
Under normal circumstances, cells of the immune system travel in and out of the brain patrolling for infectious agents (viruses, for example) or unhealthy cells. This is called the "surveillance" function of the immune system.
Surveillance cells usually won't spring into action unless they recognize an infectious agent or unhealthy cells. When they do, they produce substances to stop the infectious agent. If they encounter unhealthy cells, they either kill them directly or clean out the dying area and produce substances that promote healing and repair among the cells that are left.
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What are the signs and symptoms of Multiple Sclerosis?
A diagnosis of MS is often delayed because MS shares symptoms with other neurological conditions and diseases.
The first symptoms of MS often include:
- vision problems such as blurred or double vision or optic neuritis, which causes pain in the eye and a rapid loss of vision.
- weak, stiff muscles, often with painful muscle spasms
- tingling or numbness in the arms, legs, trunk of the body, or face
- clumsiness, particularly difficulty staying balanced when walking
- bladder control problems, either inability to control the bladder or urgency
- dizziness that doesn't go away
MS may also cause later symptoms such as:
- mental or physical fatigue which accompanies the above symptoms during an attack
- mood changes such as depression or euphoria
- changes in the ability to concentrate or to multitask effectively
- difficulty making decisions, planning, or prioritizing at work or in private life.
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Neuro-myelitis optica is a disorder associated with transverse myelitis as well as optic nerve inflammation. Patients with this disorder usually have antibodies against a particular protein in their spinal cord, called the aquaporin channel. These patients respond differently to treatment than most people with MS.
Most individuals with MS have muscle weakness, often in their hands and legs. Muscle stiffness and spasms can also be a problem. These symptoms may be severe enough to affect walking or standing. In some cases, MS leads to partial or complete paralysis. Many people with MS find that weakness and fatigue are worse when they have a fever or when they are exposed to heat. MS exacerbations may occur following common infections.
Tingling and burning sensations are common, as well as the opposite, numbness and loss of sensation. Moving the neck from side to side or flexing it back and forth may cause "Lhermitte's sign," a characteristic sensation of MS that feels like a sharp spike of electricity coursing down the spine.
While it is rare for pain to be the first sign of MS, pain often occurs with optic neuritis and trigeminal neuralgia, a neurological disorder that affects one of the nerves that runs across the jaw, cheek, and face. Painful spasms of the limbs and sharp pain shooting down the legs or around the abdomen can also be symptoms of MS.
Most individuals with MS experience difficulties with coordination and balance at some time during the course of the disease. Some may have a continuous trembling of the head, limbs, and body, especially during movement, although such trembling is more common with other disorders such as Parkinson’s disease.
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Urinary symptoms, including loss of bladder control and sudden attacks of urgency, are common as MS progresses. People with MS sometimes also develop constipation or sexual problems.
Depression is a common feature of MS. A small number of individuals with MS may develop more severe psychiatric disorders such as bipolar disorder and paranoia, or experience inappropriate episodes of high spirits, known as euphoria.
People with MS, especially those who have had the disease for a long time, can experience difficulty with thinking, learning, memory, and judgment. The first signs of what doctors call cognitive dysfunction may be subtle. The person may have problems finding the right word to say, or trouble remembering how to do routine tasks on the job or at home. Day-to-day decisions that once came easily may now be made more slowly and show poor judgment. Changes may be so small or happen so slowly that it takes a family member or friend to point them out.
Most people experience their first symptoms of MS between the ages of 20 and 40; the initial symptom of MS is often blurred or double vision, red-green color distortion, or even blindness in one eye. Most MS patients experience muscle weakness in their extremities and difficulty with coordination and balance. These symptoms may be severe enough to impair walking or even standing. In the worst cases, MS can produce partial or complete paralysis. Most people with MS also exhibit paresthesias, transitory abnormal sensory feelings such as numbness, prickling, or "pins and needles" sensations. Some may also experience pain. Speech impediments, tremors, and dizziness are other frequent complaints. Occasionally, people with MS have hearing loss.
Approximately half of all people with MS experience cognitive impairments such as difficulties with concentration, attention, memory, and poor judgment, but such symptoms are usually mild and are frequently overlooked. Depression is another common feature of MS.
Approximately half of all people with MS experience cognitive impairments such as difficulties with concentration, attention, memory, and poor judgment, but such symptoms are usually mild and are frequently overlooked. Depression is another common feature of MS.
How many people have Multiple Sclerosis?
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As with most autoimmune disorders, twice as many women are affected by MS as men. MS is more common in colder climates. People of Northern European descent appear to be at the highest risk for the disease, regardless of where they live. Native Americans of North and South America, as well as Asian American populations, have relatively low rates of MS.
What causes Multiple Sclerosis (MS)?
The ultimate cause of MS is damage to myelin, nerve fibers, and neurons in the brain and spinal cord, which together make up the central nervous system (CNS). But how that happens, and why, are questions that challenge researchers. Evidence appears to show that MS is a disease caused by genetic vulnerabilities combined with environmental factors.
Although there is little doubt that the immune system contributes to the brain and spinal cord tissue destruction of MS, the exact target of the immune system attacks and which immune system cells cause the destruction isn't fully understood.
Researchers have several possible explanations for what might be going on. The immune system could be:
- fighting some kind of infectious agent (for example, a virus) that has components which mimic components of the brain (molecular mimickry)
- destroying brain cells because they are unhealthy
- mistakenly identifying normal brain cells as foreign.
The last possibility has been the favored explanation for many years. Research now suggests that the first two activities might also play a role in the development of MS. There is a special barrier, called the blood-brain barrier, which separates the brain and spinal cord from the immune system. If there is a break in the barrier, it exposes the brain to the immune system for the first time. When this happens, the immune system may misinterpret the brain as “foreign.”
Susceptibility to MS may be inherited. Studies of families indicate that relatives of an individual with MS have an increased risk for developing the disease. Experts estimate that about 15 percent of individuals with MS have one or more family members or relatives who also have MS. But even identical twins, whose DNA is exactly the same, have only a 1 in 3 chance of both having the disease. This suggests that MS is not entirely controlled by genes. Other factors must come into play.
Current research suggests that dozens of genes and possibly hundreds of variations in the genetic code (called gene variants) combine to create vulnerability to MS. Some of these genes have been identified. Most of the genes identified so far are associated with functions of the immune system. Additionally, many of the known genes are similar to those that have been identified in people with other autoimmune diseases as type 1 diabetes, rheumatoid arthritis or lupus. Researchers continue to look for additional genes and to study how they interact with each other to make an individual vulnerable to developing MS.
A number of studies have suggested that people who spend more time in the sun and those with relatively high levels of vitamin D are less likely to develop MS. Bright sunlight helps human skin produce vitamin D. Researchers believe that vitamin D may help regulate the immune system in ways that reduce the risk of MS. People from regions near the equator, where there is a great deal of bright sunlight, generally have a much lower risk of MS than people from temperate areas such as the United States and Canada. Other studies suggest that people with higher levels of vitamin D generally have less severe MS and fewer relapses.
A number of studies have found that people who smoke are more likely to develop MS. People who smoke also tend to have more brain lesions and brain shrinkage than non-smokers. The reasons for this are currently unclear.
Infectious factors and viruses found in MS patients
A number of viruses have been found in people with MS, but the virus most consistently linked to the development of MS is Epstein Barr virus (EBV), the virus that causes mononucleosis.
Only about 5 percent of the population has not been infected by EBV. These individuals are at a lower risk for developing MS than those who have been infected. People who were infected with EBV in adolescence or adulthood and who therefore develop an exaggerated immune response to EBV are at a significantly higher risk for developing MS than those who were infected in early childhood. This suggests that it may be the type of immune response to EBV that predisposes to MS, rather than EBV infection itself. However, there is still no proof that EBV causes MS.
Autoimmune and inflammatory processes for MS patients
Tissue inflammation and antibodies in the blood that fight normal components of the body and tissue in people with MS are similar to those found in other autoimmune diseases. Along with overlapping evidence from genetic studies, these findings suggest that MS results from some kind of disturbed regulation of the immune system.
How is MS diagnosed?
There is no single test used to diagnose MS. Doctors use a number of tests to rule out or confirm the diagnosis. There are many other disorders that can mimic MS. Some of these other disorders can be cured, while others require different treatments than those used for MS. Therefore it is very important to perform a thorough investigation before making a diagnosis.
In addition to a complete medical history, physical examination, and a detailed neurological examination, a doctor will order an MRI scan of the head and spine to look for the characteristic lesions of MS. MRI is used to generate images of the brain and/or spinal cord. Then a special dye or contrast agent is injected into a vein and the MRI is repeated. In regions with active inflammation in MS, there is disruption of the blood-brain barrier and the dye will leak into the active MS lesion.
Doctors may also order evoked potential tests, which use electrodes on the skin and painless electric signals to measure how quickly and accurately the nervous system responds to stimulation. In addition, they may request a lumbar puncture (sometimes called a "spinal tap") to obtain a sample of cerebrospinal fluid. This allows them to look for proteins and inflammatory cells associated with the disease and to rule out other diseases that may look similar to MS, including some infections and other illnesses. MS is confirmed when positive signs of the disease are found in different parts of the nervous system at more than one time interval and there is no alternative diagnosis.
What is the course of MS?
The course of MS is different for each individual, which makes it difficult to predict. For most people, it starts with a first attack, usually (but not always) followed by a full to almost-full recovery. Weeks, months, or even years may pass before another attack occurs, followed again by a period of relief from symptoms. This characteristic pattern is called relapsing-remitting MS.
Primary-progressive MS is characterized by a gradual physical decline with no noticeable remissions, although there may be temporary or minor relief from symptoms. This type of MS has a later onset, usually after age 40, and is just as common in men as in women.
Secondary-progressive MS begins with a relapsing-remitting course, followed by a later primary-progressive course. The majority of individuals with severe relapsing-remitting MS will develop secondary progressive MS if they are untreated.
Finally, there are some rare and unusual variants of MS. One of these is Marburg variant MS (also called malignant MS), which causes a swift and relentless decline resulting in significant disability or even death shortly after disease onset. Balo’s concentric sclerosis, which causes concentric rings of demyelination that can be seen on an MRI, is another variant type of MS that can progress rapidly.
Determining the particular type of MS is important because the current disease modifying drugs have been proven beneficial only for the relapsing-remitting types of MS.
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What is an exacerbation or attack of MS?
An exacerbation—which is also called a relapse, flare-up, or attack—is a sudden worsening of MS symptoms, or the appearance of new symptoms that lasts for at least 24 hours. MS relapses are thought to be associated with the development of new areas of damage in the brain. Exacerbations are characteristic of relapsing-remitting MS, in which attacks are followed by periods of complete or partial recovery with no apparent worsening of symptoms.
An attack may be mild or its symptoms may be severe enough to significantly interfere with life's daily activities. Most exacerbations last from several days to several weeks, although some have been known to last for months.
When the symptoms of the attack subside, an individual with MS is said to be in remission. However, MRI data have shown that this is somewhat misleading because MS lesions continue to appear during these remission periods. Patients do not experience symptoms during remission because the inflammation may not be severe or it may occur in areas of the brain that do not produce obvious symptoms. Research suggests that only about 1 out of every 10 MS lesions is perceived by a person with MS. Therefore, MRI examination plays a very important role in establishing an MS diagnosis, deciding when the disease should be treated, and determining whether treatments work effectively or not. It also has been a valuable tool to test whether an experimental new therapy is effective at reducing exacerbations.
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Is there any treatment for Multiple Sclerosis?
There is as yet no cure for MS.
Treatments for MS attacks
The usual treatment for an initial MS attack is to inject high doses of a steroid drug, such as methylprednisolone, intravenously (into a vein) over the course of 3 to 5 days. It may sometimes be followed by a tapered dose of oral steroids. Intravenous steroids quickly and potently suppress the immune system, and reduce inflammation. Clinical trials have shown that these drugs hasten recovery.
The American Academy of Neurology recommends using plasma exchange as a secondary treatment for severe flare-ups in relapsing forms of MS when the patient does not have a good response to methylprednisolone. Plasma exchange, also known as plasmapheresis, involves taking blood out of the body and removing components in the blood’s plasma that are thought to be harmful. The rest of the blood, plus replacement plasma, is then transfused back into the body. This treatment has not been shown to be effective for secondary progressive or chronic progressive forms of MS.
MS Treatments to help reduce disease activity and progression
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There is debate among doctors about whether to start disease modulating drugs at the first signs of MS or to wait until the course of the disease is better defined before beginning treatment. On one hand, U.S. Food and Drug Administration (FDA)-approved medications to treat MS work best early in the course of the disease and work poorly, if at all, later in the progressive phase of the illness. Clinical trials have shown convincingly that delaying treatment, even for the 1 to-2 years that it may take for patients with MS to develop a second clinical attack, may lead to an irreversible increase in disability. In addition, people who begin treatment after their first attack have fewer brain lesions and fewer relapses over time.
On the other hand, initiating treatment in patients with a single attack and no signs of previous MS lesions, before MS is diagnosed, poses risks because all FDA-approved medications to treat MS are associated with some side effects. Therefore, the best strategy is to have a thorough diagnostic work-up at the time of first attack of MS. The work-up should exclude all other diseases that can mimic MS so that the diagnosis can be determined with a high probability. The diagnostic tests may include an evaluation of the cerebrospinal fluid and repeated MRI examinations. If such a thorough work-up cannot confirm the diagnosis of MS with certainty, it may be prudent to wait before starting treatment. However, each patient should have a scheduled follow-up evaluation by his or her neurologist 6 to 12 months after the initial diagnostic evaluation, even in the absence of any new attacks of the disease. Ideally, this evaluation should include an MRI examination to see if any new MS lesions have developed without causing symptoms.
Until recently, it appeared that a minority of people with MS had very mild disease or “benign MS” and would never get worse or become disabled. This group makes up 10 to 20 percent of those with MS. Doctors were concerned about exposing such benign MS patients to the side effects of MS drugs. However, recent data from the long-term follow-up of these patients indicate that after 10 to 20 years, some of these patients become disabled. Therefore, current evidence supports discussing the start of therapy early with all people who have MS, as long as the MS diagnosis has been thoroughly investigated and confirmed. There is an additional small group of individuals (approximately 1 percent) whose course will progress so rapidly that they will require aggressive and perhaps even experimental treatment.
The current FDA-approved therapies for MS are designed to modulate or suppress the inflammatory reactions of the disease. They are most effective for relapsing-remitting MS at early stages of the disease. These treatments include injectable beta interferon drugs. Interferons are signaling molecules that regulate immune cells. Potential side effects of beta interferon drugs include flu-like symptoms, such as fever, chills, muscle aches, and fatigue, which usually fade with continued therapy. A few individuals will notice a decrease in the effectiveness of the drugs after 18 to 24 months of treatment due to the development of antibodies that neutralize the drugs' effectiveness. If the person has flare-ups or worsening symptoms, doctors may switch treatment to alternative drugs.
Many patients do well with no therapy at all, especially since many medications have serious side effects and some carry significant risks. However, three forms of beta interferon (Avonex, Betaseron, and Rebif) have now been approved by the Food and Drug Administration for treatment of relapsing-remitting MS. Beta interferon has been shown to reduce the number of exacerbations and may slow the progression of physical disability. When attacks do occur, they tend to be shorter and less severe. The FDA also has approved a synthetic form of myelin basic protein, called copolymer I (Copaxone), for the treatment of relapsing-remitting MS. Copolymer I has few side effects, and studies indicate that the agent can reduce the relapse rate by almost one third. Other FDA approved drugs to treat relapsing forms of MS in adults include teriflunomide and dimethyl fumarate. An immunosuppressant treatment,Novantrone (mitoxantrone), is approved by the FDA for the treatment of advanced or chronic MS. The FDA has also approved dalfampridine (Ampyra) to improve walking in individuals with MS.
One monoclonal antibody, natalizumab (Tysabri), was shown in clinical trials to significantly reduce the frequency of attacks in people with relapsing forms of MS and was approved for marketing by the U.S. Food and Drug Administration (FDA) in 2004. However, in 2005 the drug’s manufacturer voluntarily suspended marketing of the drug after several reports of significant adverse events. In 2006, the FDA again approved sale of the drug for MS but under strict treatment guidelines involving infusion centers where patients can be monitored by specially trained physicians.
While steroids do not affect the course of MS over time, they can reduce the duration and severity of attacks in some patients. Spasticity, which can occur either as a sustained stiffness caused by increased muscle tone or as spasms that come and go, is usually treated with muscle relaxants and tranquilizers such as baclofen, tizanidine, diazepam, clonazepam, and dantrolene. Physical therapy and exercise can help preserve remaining function, and patients may find that various aids -- such as foot braces, canes, and walkers -- can help them remain independent and mobile. Avoiding excessive activity and avoiding heat are probably the most important measures patients can take to counter physiological fatigue. If psychological symptoms of fatigue such as depression or apathy are evident, antidepressant medications may help. Other drugs that may reduce fatigue in some, but not all, patients include amantadine (Symmetrel), pemoline (Cylert), and the still-experimental drug aminopyridine. Although improvement of optic symptoms usually occurs even without treatment, a short course of treatment with intravenous methylprednisolone (Solu-Medrol) followed by treatment with oral steroids is sometimes used.
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How do doctors treat the symptoms of MS?
MS causes a variety of symptoms that can interfere with daily activities but which can usually be treated or managed to reduce their impact. Many of these issues are best treated by neurologists who have advanced training in the treatment of MS and who can prescribe specific medications to treat the problems.
Vision problems in MS patients
Eye and vision problems are common in people with MS but rarely result in permanent blindness. Inflammation of the optic nerve or damage to the myelin that covers the optic nerve and other nerve fibers can cause a number of symptoms, including blurring or graying of vision, blindness in one eye, loss of normal color vision, depth perception, or a dark spot in the center of the visual field (scotoma).
Uncontrolled horizontal or vertical eye movements (nystagmus) and "jumping vision" (opsoclonus) are common to MS, and can be either mild or severe enough to impair vision.
Double vision (diplopia) occurs when the two eyes are not perfectly aligned. This occurs commonly in MS when a pair of muscles that control a specific eye movement aren't coordinated due to weakness in one or both muscles. Double vision may increase with fatigue or as the result of spending too much time reading or on the computer. Periodically resting the eyes may be helpful.
MS Weak muscles, stiff muscles, painful muscle spasms, and weak reflexes
Muscle weakness is common in MS, along with muscle spasticity. Spasticity refers to muscles that are stiff or that go into spasms without any warning. Spasticity in MS can be as mild as a feeling of tightness in the muscles or so severe that it causes painful, uncontrolled spasms. It can also cause pain or tightness in and around the joints. It also frequently affects walking, reducing the normal flexibility or “bounce” involved in taking steps.
People with MS sometimes develop tremor, or uncontrollable shaking, often triggered by movement. Tremor can be very disabling. Assistive devices and weights attached to limbs are sometimes helpful for people with tremor. Deep brain stimulation& and drugs such as clonazepam also may be useful.
Multiple Sclerosis (MS) Problems with walking and balance
Many people with MS experience difficulty walking. In fact, studies indicate that half of those with relapsing-remitting MS will need some kind of help walking within 15 years of their diagnosis if they remain untreated. The most common walking problem in people with MS experience is ataxia—unsteady, uncoordinated movements—due to damage with the areas of the brain that coordinate movement of muscles. People with severe ataxia generally benefit from the use of a cane, walker, or other assistive device. Physical therapy can also reduce walking problems in many cases.
In 2010, the FDA approved the drug dalfampridine to improve walking in patients with MS. It is the first drug approved for this use. Clinical trials showed that patients treated with dalfampridine had faster walking speeds than those treated with a placebo pill.
Fatigue in MS Patients
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Fatigue may be reduced if the person receives occupational therapy to simplify tasks and/or physical therapy to learn how to walk in a way that saves physical energy or that takes advantage of an assistive device. Some people benefit from stress management programs, relaxation training, membership in an MS support group, or individual psychotherapy. Treating sleep problems and MS symptoms that interfere with sleep (such as spastic muscles) may also help.
Multiple Sclerosis Pain
People with MS may experience several types of pain during the course of the disease.
Trigeminal neuralgia is a sharp, stabbing, facial pain caused by MS affecting the trigeminal nerve as it exits the brainstem on its way to the jaw and cheek. It can be treated with anticonvulsant or antispasmodic drugs, alcohol injections, or surgery.
People with MS occasionally develop central pain, a syndrome caused by damage to the brain and/or spinal cord. Drugs such as gabapentin and nortryptiline sometimes help to reduce central pain.
Burning, tingling, and prickling (commonly called "pins and needles") are sensations that happen in the absence of any stimulation. The medical term for them is dysesthesias" They are often chronic and hard to treat.
Chronic back or other musculoskeletal pain may be caused by walking problems or by using assistive aids incorrectly. Treatments may include heat, massage, ultrasound treatments, and physical therapy to correct faulty posture and strengthen and stretch muscles.
Problems with bladder control and constipation with MS
The most common bladder control problems encountered by people with MS are urinary frequency, urgency, or the loss of bladder control. The same spasticity that causes spasms in legs can also affect the bladder. A small number of individuals will have the opposite problem—retaining large amounts of urine. Urologists can help with treatment of bladder-related problems. A number of medical treatments are available. Constipation is also common and can be treated with a high-fiber diet, laxatives, and other measures.
Sexual issues with MS
People with MS sometimes experience sexual problems. Sexual arousal begins in the central nervous system, as the brain sends messages to the sex organs along nerves running through the spinal cord. If MS damages these nerve pathways, sexual response—including arousal and orgasm—can be directly affected. Sexual problems may also stem from MS symptoms such as fatigue, cramped or spastic muscles, and psychological factors related to lowered self-esteem or depression. Some of these problems can be corrected with medications. Psychological counseling also may be helpful.
Studies indicate that clinical depression is more frequent among people with MS than it is in the general population or in persons with many other chronic, disabling conditions. MS may cause depression as part of the disease process, since it damages myelin and nerve fibers inside the brain. If the plaques are in parts of the brain that are involved in emotional expression and control, a variety of behavioral changes can result, including depression. Depression can intensify symptoms of fatigue, pain, and sexual dysfunction. It is most often treated with selective serotonin reuptake inhibitor (SSRI) antidepressant medications, which are less likely than other antidepressant medications to cause fatigue.
MS is sometimes associated with a condition called pseudobulbar affect that causes inappropriate and involuntary expressions of laughter, crying, or anger. These expressions are often unrelated to mood; for example, the person may cry when they are actually very happy, or laugh when they are not especially happy. In 2010 the FDA approved the first treatment specifically for pseudobulbar affect, a combination of the drugs dextromethorphan and quinidine. The condition can also be treated with other drugs such as amitriptyline or citalopram.
Cognitive changes in Multiple Sclerosis
Half -to three-quarters of people with MS experience cognitive impairment, which is a phrase doctors use to describe a decline in the ability to think quickly and clearly and to remember easily. These cognitive changes may appear at the same time as the physical symptoms or they may develop gradually over time. Some individuals with MS may feel as if they are thinking more slowly, are easily distracted, have trouble remembering, or are losing their way with words. The right word may often seem to be on the tip of their tongue.
Some experts believe that it is more likely to be cognitive decline, rather than physical impairment, that causes people with MS to eventually withdraw from the workforce. A number of neuropsychological tests have been developed to evaluate the cognitive status of individuals with MS. Based on the outcomes of these tests, a neuropsychologist can determine the extent of strengths and weaknesses in different cognitive areas. Drugs such as donepezil, which is usually used for Alzheimer’s disease, may be helpful in some cases.
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MS Complementary and Alternative Therapies
Many people with MS use some form of complementary or alternative medicine. These therapies come from many disciplines, cultures, and traditions and encompass techniques as different as acupuncture, aromatherapy, ayurvedic medicine, touch and energy therapies, physical movement disciplines such as yoga and tai chi, herbal supplements, and biofeedback.
Because of the risk of interactions between alternative and more conventional therapies, people with MS should discuss all the therapies they are using with their doctor, especially herbal supplements. Although herbal supplements are considered "natural," they have biologically-active ingredients that could have harmful effects on their own or interact harmfully with other medications.
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A physician may diagnose MS in some patients soon after the onset of the illness. In others, however, doctors may not be able to readily identify the cause of the symptoms, leading to years of uncertainty and multiple diagnoses punctuated by baffling symptoms that mysteriously wax and wane. The vast majority of patients are mildly affected, but in the worst cases, MS can render a person unable to write, speak, or walk. MS is a disease with a natural tendency to remit spontaneously, for which there is no universally effective treatment.
What research is being done for MS?
The National Institute of Neurological Disorders and Stroke (NINDS) and other institutes of the National Institutes of Health (NIH) conduct research in laboratories at the NIH and also support additional research through grants to major medical institutions across the country. Scientists continue their extensive efforts to create new and better therapies for MS. One of the most promising MS research areas involves naturally occurring antiviral proteins known as interferons. Beta interferon has been shown to reduce the number of exacerbations and may slow the progression of physical disability. When attacks do occur, they tend to be shorter and less severe. In addition, there are a number of treatments under investigation that may curtail attacks or improve function. Over a dozen clinical trials testing potential therapies are underway, and additional new treatments are being devised and tested in animal models.
In 2001, the National Academies/Institute of Medicine, a Federal technical and scientific advisory agency, prepared a strategic review of MS research. To read or download the National Academies/Institute of Medicine report, go to: "Multiple Sclerosis: Current Status and Strategies for the Future."
NIH Patient Recruitment for Multiple Sclerosis Clinical Trials
The above information was from the NIH: National Institute of Neurological Disorders and Strokehttp://www.ninds.nih.gov/disorders/multiple_sclerosis/multiple_sclerosis.htm
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