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The majority of people with relapsing-remitting MS eventually transition to a secondary-progressive course

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    Deutsche Bank 33rd Annual Health Care Conference Business Wire (press release) - San Francisco,CA,USA Acorda s lead clinical product, Fampridine-SR, is in
    Message 1 of 1 , May 1, 2008
      Deutsche Bank 33rd Annual Health Care Conference
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      Acorda's lead clinical product, Fampridine-SR, is in Phase3 clinical trials to evaluate its safety and efficacy to improve walking ability in people with MS ...
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      Daily Living with MS



      Dr. Kalb

      Director of the Professional Resource Center at the National Multiple Sclerosis Society in New York City, NY

      View BIO




      Q :
      I have been diagnosed with secondary progressive MS and still find myself having a hard time accepting it. I have so much in my life I feel I could accomplish if only I was feeling healthier for example: I have someone very important in my life with Alzheimer's, I do my best to help. But I wish I could do so much more. How do you accept your limits with such ordeals?
      A :
      Accepting one's limits is never easy, particularly when the limits keep changing-and MS has a way of keeping people guessing. The first step toward adapting to this new, progressive phase of MS is to allow yourself some time to grieve. Even though
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      the majority of people with relapsing-remitting MS eventually transition to a secondary-progressive course,
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      the news is always unwelcome and difficult to accept. The grieving process allows you to feel sad about the changes you're experiencing and gives you time to gather the emotional energy you need to figure out how to move forward with your life. Grieving is a healthy, normal reaction to loss-one that you'll experience each time that MS causes a major shift or change in your life.

      The next steps include:
      . Learning everything you can about secondary-progressive MS-from the Canadian MS Society and other available resources. The MS Society of Canada has a booklet called Living with Progressive Multiple Sclerosis. In addition I particularly recommend a book entitled Living with Progressive Multiple Sclerosis: Overcoming the Challenges, 2nd ed., by Patricia Coyle, MD and June Halper, MSN, ANP, FAAN Demos Medical Publishing, 2007).
      . Partnering with your healthcare team to manage whatever symptoms you are experiencing. The goal of treatment during this phase of MS is to help you function at your very best-safely, comfortably, and effectively-in all of your chosen activities.
      . Making the best possible use of assistive technology-the vast array of tools available to help you do the things that are important to you. Being willing to do things differently is often the key to success, and Shelley Peterman Schwarz' book-Multiple Sclerosis: 300 Tips for Making Life Easier, 2nd ed. (Demos Medical Publishing, 2006) is filled with great suggestions to help you get started.
      . Paying attention to your overall health and wellness. Sometimes people get so bogged down dealing with their MS that they forget to take care of their other health needs.
      . Setting priorities. If your MS symptoms are preventing you from doing all that you want to do, check to make sure that you're saving your energies for the things that are most important to you.

      Keeping these ideas in mind, you'll be able to take better care of yourself and that important person in your life with Alzheimer's.

      5/1/2008 7:44:38 AM

      More answers from Dr. Rosalind Kalb

      More answers in the category: Daily Living with MS

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      Medical News: Men With MS Twice as Likely to Pass it On to Kids - in Neurology, Multiple Sclerosis from MedPage Today

      By Neil Osterweil, Senior Associate Editor, MedPage Today
      Published: July 24, 2006
      Reviewed by Zalman S. Agus, MD; Emeritus Professor at the University of Pennsylvania School of Medicine.


      ROCHESTER, Minn., July 24 -- Although women are more frequently affected with multiple sclerosis, men who have MS are twice as likely to pass it on to their offspring as are women with the disease, according to researchers.
      Action Points
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      a.. Explain to interested patients that although this study suggests that men with multiple sclerosis are twice as likely as women with the disease to pass it on to their children, the results need to be confirmed in larger studies and should not affect the decisions of MS patients about whether to have children.


      Women are two to three times more likely than men to get MS, suggesting that men have an intrinsic physiologic resistance to it. If this is true, men who buck the odds and develop MS anyway may have a strong genetic predisposition to getting it that they pass on to the next generation, wrote neurologist Orhun H. Kantarci, M.D., of the Mayo Clinic here, and colleagues.

      "Due to the apparent excess of intrinsic susceptibility of women to MS, men with MS may require a greater number of risk factors to overcome their resistance to MS relative to women," the authors wrote in the July 24 issue of Neurology.


      "If this difference were due to genetic rather than environmental factors, men would need a greater number of or more potent susceptibility genes than women and would be predicted to transmit the disease more often to their children," they added. "This phenomenon is known as the Carter effect and has been explained by a multifactorial threshold model with sex dimorphism for liability."


      The authors investigated whether the effect, first described in pyloric stenosis inheritance by British geneticist Cedric O. Carter, Ph.D., in the early 1960s, might also apply to MS, where there is a lopsided gender-based distribution of prevalence.


      "The hypothesis of the study is that men are more resistant to MS, so they need stronger or a larger number of genes in order to develop MS, and then pass these genes to their children," Dr. Kantarci said,


      The Mayo investigators, along with colleagues at the University of California at San Francisco and at Berkeley, and Kaiser Permanente in Oakland, California, started with a pool of 3,598 people in 206 multiplex pedigrees and narrowed in on 197 families of interest, in which there were 441 children (45 with definite MS) of a father or mother affected with MS.




      The researchers compared transmission of MS from affected men with transmission from affected women, and found that the fathers with MS transmitted the disease to their children more often. In all, MS was transmitted to 18 children of men with MS, with 99 children unaffected. In contrast, 27 children of women with the disease had definite MS, and 296 avoided transmission. The odds ratio for MS transmission from fathers vs. mothers was 1.99 (95% confidence interval, 1.05 - 3.77, P=0.032).


      "Adjusting for both the sex of the affected child and multiple transmissions from a single affected parent, the sex of the affected parent remained as an independent risk factor for transmission of MS to children, fathers transmitting more often than mothers (P=0.036; OR: 2.21, 95% CI, 1.05-4.63)," the authors wrote.


      The investigators noted that because women with MS have fewer children than women who don't have the disease, it is not possible to determine whether the Carter effect is related to over-transmission of genetic susceptibility due to some factor intrinsic among men, or under-transmission among women.


      "The magnitude of the Carter effect in our study was similar to that observed in the original description of this phenomenon in pyloric stenosis, which predominates in men and for which there is a 2.2-fold excess of maternal relative to paternal transmission. In our study, as in the results from analysis of pyloric stenosis, the Carter effect was independent of the sex of the child," the noted.


      The investigators cautioned that their results should not be factored into genetic counseling of men with MS who are considering fathering children, because the additional risk of transmission is not much greater than the already elevated (~20-fold) risk associated with MS transmission in general.


      The findings shouldn't change how men with MS are counseled about the risk to their offspring, wrote the researchers. The risk of having MS if a person has an affected parent is increased by about 20-fold compared to not having an affected parent; the additional risk by virtue of having an affected father is not sufficient to change patient counseling practices, they added.

      "The overtransmission by men is primarily of interest to scientists studying the mechanisms of genetic transmission of MS susceptibility, and may indicate that nontraditional, or so-called epigenetic factors, play some role in the transmission of MS," Dr. Kantarci said.




      Primary source: Neurology
      Source reference:
      Kantarci OH et al. "Men transmit MS more often to their children vs women: The Carter effect." Neurology 2006; 67:305-310.

      http://www.medpagetoday.com/Neurology/MultipleSclerosis/tb/3797

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      4 Steps To Reverse The Damage From A 'Super Size Me' Diet
      It was probably enough to make many Americans lose their appetite: A recent study from Europe showed that eating too much fast food a diet high in fat and sugar could cause serious damage to your liver.

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