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Breast Cancer Survival Guide: Physical & Clinical Updates

A diagnosis of breast cancer sets into motion a whirlwind of appointments, tests, surgeries and possibly chemotherapy and radiation treatment. A new study reviewed the timeline between surgery and initiating chemotherapy for different subtypes of breast cancer and found a survival advantage when chemotherapy was initiated within 30 days of surgery. Although treating within the 30-60 post-surgical window did not show a statistically significant survival advantage, there is a trend towards better outcomes. Exceeding 60 days post treatment had a negative impact on survival. The clinical impact of timing is most relevant for patients with stage II and III breast cancer, triple negative breast cancer and HER2-positive tumors.
 
Treatment for breast cancer can be exhausting and take a toll on the physical health of patients as treatment ends and they begin post-treatment life. Cancer survivors are at an increased risk of poor health, depression and physical disability. Approximately one third  ...

New Brain Stimulator Approved to Treat Epilepsy

On November 14th, 2013 the FDA gave its approval for an implanted brain stimulator to treat patients with medically refractory epilepsy. Epilepsy is one of the most common neurological disorders affecting nearly 1 in 100 Americans. This device has been under investigation for 10 years at the Swedish Neuroscience Institute (SNI) Epilepsy Center.

As principal investigator for the trial, I led  a team including Dr. Michael Doherty, Dr. Lisa Caylor and Dr. Alan Haltiner, along with the research department at Swedish to investigate the safety and effectiveness of the device through pivotal trials. The results showed that the responsive neurostimulator system (RNS) made by NeuroPace was indeed effective in treating patients with drug resistant seizures.

Why is this so significant? This device represents the first new non-medication treatment for seizures proven to be effective since 1997, and gives new hope to patients whose lives have been put on hold due to seizures. ...

Constraint induced movement therapy in MS may be equally effective as in stroke

Constraint induced movement therapy (CIMT), formerly called “forced use” is a treatment for impaired function of an upper extremity. It has been established as an effective evidence-based form of treatment for rehab of impaired upper extremity (UE) function for post stroke hemiparesis. The core features of CIMT are massed practice (high repetitions) and to overcome learned non-use thru behavior modification. The typical training protocol involves a 2 week period of physical restraint of the less-involved side (90% of the waking hours) and intensive training (3 hours/day) focused on movement patterns of the involved hand and arm. The physical restraint is usually a padded mitt, sling or glove thereby restricting stronger arm use.
At a recent ECTRIMS/RIMS meeting, this form of therapy was presented as being equally effective in

Research and progress for progressive Multiple Sclerosis (MS)

I am delighted to write the blog over the Progressive MS session that was given at ECTRIMS 2013.  Much emphasis has been given to the need for more research in the fields of progressive MS.  The majority of MS patients fit into this broad category: primary progressive MS, secondary progressive MS, and progressive relapsing forms of the disease.  During a session devoted to progressive MS, leaders in the field discussed several initiatives underway to address the challenges presented by these forms of the disease. 

Rehabilitation is a mainstay and key to improving the lives of patients with progressive MS. Many patients describe their progression in terms of mobility decline, which is a major target of improvement in rehabilitation programs.

The first session was devoted to confusion surrounding the definition of “progression in MS.”  We use ...

Testosterone is associated with worse disease severity in men with early relapsing onset multiple sclerosis

MS and many other autoimmune diseases are less common in men than in women. This is especially true during reproductive years. Sex hormones, including testosterone and estrogen, may be responsible for the difference. It is thought that men with multiple sclerosis may have lower testosterone levels than healthy controls.

Dr. Bove and his group assessed the prevalence and clinical associations of hypogonadism in men with recent onset relapsing multiple sclerosis.  Male subjects from the Comprehensive Longitudinal Investigations of MS at the Brigham and Women's Hospital (CLIMB) cohort were included. Hormonal measures included testosterone, the testosterone: estradiol ratio, leutinizing hormone (LH), and free testosterone. Clinical outcomes were collected every 6 months for Expanded Disease Severity Scale (EDSS), and annually for Symbol Digit Modalities test (SDMT).

The analysis included 96 men with a mean age of 40 years, disease duration of 4.6 years; 71% subjects were untreated at baseline. Of these men, 39% were ...

Gut Microbiome: Studying the links between people, bacteria, and MS

Our bodies are made of billions of cells. However, the cells in our bodies are far outnumbered by the bacteria that cover our skin and inhabit our gut. These bacteria are now increasingly recognized to have an important role in maintaining our health. For example, skin bacteria help protect us from more dangerous bacteria that could invade us. Gut bacteria help digest our food. There are suggestions that changes in these bacteria, particularly those in the gut, might play a role in several diseases.

2013 Heart & Stroke Walk

On October 26th the American Heart Association and American Stroke Association will be hosting the 2013 Puget Sound Heart & Stroke Walk in Seattle.

On average, someone in the U.S. experiences a stroke every 40 seconds.  Stroke can be a devastating disease, leaving many survivors with significant disabilities and leaving a permanent footprint on the lives of loved ones. 

The Puget Sound Heart & Stroke Walk gives us the opportunity to honor the survivors in our lives or the loved ones we have lost as we continue the fight to prevent stroke and improve stroke treatments. 

I will be walking in honor of ..

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