Multiple Sclerosis

Multiple Sclerosis Group Presentation Clin 213-50 Humber College Clin 213-50 Humber College Downloaded from www.jama.com

Introduction ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College

Overview ,[object Object],Clin 213-50 Humber College

Multiple Sclerosis - Introduction ,[object Object],[object Object],[object Object],[object Object],[object Object]

History of Multiple Sclerosis ,[object Object],[object Object],Clin 213-50 Humber College

Multiple Sclerosis - Epidemiology ,[object Object],[object Object],[object Object],[object Object]

World Distribution of MS Clin 213-50 Humber College

Multiple Sclerosis - Types ,[object Object],[object Object],[object Object],[object Object],[object Object]

Multiple Sclerosis - Types ,[object Object],[object Object],[object Object],[object Object]

Multiple Sclerosis Signs and Symptoms ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College

Multiple Sclerosis Signs and Symptoms ,[object Object],[object Object]

Factors Contributing for MS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Multiple Sclerosis - Causes ,[object Object],[object Object],[object Object]

Multiple Sclerosis - Diagnosis ,[object Object],[object Object],[object Object]

Possible v/s Definite MS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College

MRI as Surrogate marker of disease process in MS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College

Multiple Sclerosis - Diagnosis ,[object Object],[object Object],[object Object],[object Object]

How Does it work? Clin 213-50 Humber College

Demyelination of Nerve Fibers in MS Clin 213-50 Humber College The destruction of the myelin sheath leads to impaired communication between nerve cells and neurological symptoms such as abnormal sensations, vision problems , and weakness

Mode of Action ,[object Object],Clin 213-50 Humber College

How Autoimmune response cause MS Clin 213-50 Humber College

Pathophysiology ,[object Object],[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College

Clinical Tools for MS Diagnosis Schumacher Clinical Criteria -1965 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College

Clinical Tools for MS Diagnosis Poser Criteria for the 1983 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College

Clinical Tools for MS Diagnosis McDonald Criteria Clin 213-50 Humber College

Clinical Tools for MS Diagnosis Expanded Disability Status Scale ,[object Object],[object Object]

Clinical Tools for MS Diagnosis EDSS - Issues ,[object Object],[object Object],[object Object],[object Object],[object Object]

Clinical Tools for MS Diagnosis EDSS - Issues ,[object Object],[object Object],[object Object]

Clinical Tools for MS Diagnosis Multiple Sclerosis Functional Composite ,[object Object],[object Object]

Treatment of Multiple Sclerosis ,[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College

Treatments available in Canada ,[object Object],[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College

Alternative Treatments ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College

Medications used for MS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College

Current Treatments Clin 213-50 Humber College ,[object Object],[object Object],[object Object],[object Object],[object Object]

Current Treatments Clin 213-50 Humber College ,[object Object],[object Object],[object Object]

C urrent treatments cont’d: Disease Modifying Drugs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College

Current Treatments cont’d: INTRAMUSCULAR INTERFERON BETA-1aTHERAPY ( LAWRENCE,D. JACOBS et al, SEPTEMBER28, 2000) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Current Treatments cont’d: Alemtuzumab ,[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College

Antidepressants Efficacy Trial Michael A. Posternak, M.D. et al, (Am J Psychiatry 2002; 159:191 – 200) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Safety and Efficacy Issues ,[object Object],[object Object],[object Object]

A Randomized, Placebo-Controlled Trial of Natalizumab for Relapsing Multiple Sclerosis ,[object Object],[object Object]

Nataluzimab: marketing withdrawal pending evaluation ,[object Object],[object Object],[object Object],[object Object]

Multiple Sclerosis and Epstein-Barr Virus Ref: Lynn I. Levin, PhD, MPH et al, JAMA . 2003;289(12):1533-1536 (doi:10.1001/jama.289.12.1533) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Research Themes for Multiple Sclerosis ,[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College

Focus on current trends ,[object Object],[object Object],[object Object]

Hookworms In MS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College

Stem Cells in Multiple Sclerosis ,[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College

Stem Cells in Multiple Sclerosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College

Stem Cells in Multiple Sclerosis ,[object Object],[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College

Stem Cells in Multiple Sclerosis ,[object Object],[object Object],[object Object],Clin 213-50 Humber College

Stem Cells in Multiple Sclerosis ,[object Object],[object Object],Clin 213-50 Humber College

Stem Cells in Multiple Sclerosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College

Stem Cells in Multiple Sclerosis ,[object Object],Clin 213-50 Humber College

Vitamin D – the basics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Sources of Vitamin D ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Vitamin D and Multiple sclerosis ,[object Object],[object Object]

1. High prevalence of vitamin D deficiency and reduced bone mass in multiple sclerosis J. Nieves, F. Cosman, J. Herbert, V. Shen and R. Lindsay ,[object Object],[object Object],[object Object]

Neives et. Al cont’d ,[object Object]

Neives et. Al cont’d (Results) ,[object Object]

Neives et al. cont’d ,[object Object]

Cytokine Profile in Patients with Multiple Sclerosis Following Vitamin D Supplementation. B.D. Mahon, S. A. Gordon, J. Cruz, F. Cosman, and M.T. Cantorna ,[object Object]

Cytokine Profile in Patients with Multiple Sclerosis Following Vitamin D Supplementation. B.D. Mahon, S. A. Gordon, J. Cruz, F. Cosman, and M.T. Cantorna ,[object Object],[object Object]

Cytokine Profile in Patients with Multiple Sclerosis Following Vitamin D Supplementation. B.D. Mahon, S. A. Gordon, J. Cruz, F. Cosman, and M.T. Cantorna ,[object Object],[object Object],[object Object]

Cytokine Profile in Patients with Multiple Sclerosis Following Vitamin D Supplementation. B.D. Mahon, S. A. Gordon, J. Cruz, F. Cosman, and M.T. Cantorna

Conclusion (vitamin D) ,[object Object],[object Object],[object Object]

Issues with Trial Design: ,[object Object],[object Object]

Issues with Trial Design Cont’d: ,[object Object],[object Object]

Issues with Trial Design Cont’d: ,[object Object],[object Object],[object Object],[object Object]

Ethical Considerations: ,[object Object],[object Object],[object Object],[object Object]

Guidelines 2001: ,[object Object],[object Object],[object Object]

Six terms for Placebo-Controlled Trials ,[object Object],[object Object],[object Object]

Six terms for Placebo-Controlled Trials Cont’d ,[object Object],[object Object],[object Object]

Informed Consent ,[object Object],[object Object]

Conclusion ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Reference ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College

Multiple Sclerosis

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Multiple Sclerosis