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Statin Benefits Secondary Progressive MS

Peiqing Qian

Peiqing Qian
Neurologist, Swedish Multiple Sclerosis Center

No treatments can currently abate the advanced stage of the disease, known as secondary progressive MS, which gradually causes patients to become more disabled. Statins are postulated to have immunomodulatory effects that appear to be independent of their effect on cholesterol. A benefit has been suggested in early multiple sclerosis (MS) based on reduction of magnetic resonance imaging brain lesions.  However, following trials have had inconsistent results.

In this multicenter, double-blind study, investigators randomized 140 participants with secondary progressive (SP) MS to 80 mg of simvastatin or placebo daily for 2 years. Participants were 18 to 65 years old, had active progression over the preceding 2 years, and had difficulties ambulating but were not wheelchair bound.  Whole brain atrophy was 43% slower annually in simvastatin recipients than in placebo recipients. The simvastatin group also had small clinical improvements over placebo on the disability scale and a patient-reported MS impact scale at 24 months.
 
These findings show that simvastatin reduced ...

Does your child have a food allergy or food sensitivity?

Uma Pisharody, MD, FAAP

Uma Pisharody, MD, FAAP
Pediatric Gastroenterologist

“Every time my child eats, his belly hurts. I think he must have a food allergy. Can you help us?”

Countless times have I heard this from parents of children worried about foods being the cause of their child’s gastrointestinal (GI) complaints. Some families wonder whether their child should start a “gluten-free” or other type of dietary change. More often than not, families have already tried a few diets before meeting with me.

Parents considering these types of elimination diets need to be aware of a few key points:
The difference between “food allergy” and “food sensitivity”:

Importance of planning pregnancies with Multiple Sclerosis (MS)

James D. Bowen, MD

A recent study addressed the outcomes of pregnancy in women with MS who were taking fingolimod (Gilenya). Of 66 pregnancies on the medication, 41 attempted to carry the pregnancy to term. 26 of the 41 had healthy newborns. There were, 9 miscarriages, 24 elective abortion, 4 ongoing pregnancies and 1 with an unknown outcome. Of the elective abortions, four were for fetal malformations. There were 5 cases with abnormal fetal development in the 66 pregnancies. Poor fetal outcomes were found in 14.6% of the pregnancies. This contrasts with a 3% rate of poor outcomes for most pregnancies.

This paper highlights the importance of care in planning pregnancies in MS. It is now known that women with MS have ...

Supporting patients with Parkinson's Disease

Peggy Shortt, MN, ARNP

Peggy Shortt, MN, ARNP
Manager, Swedish Deep Brain Stimulation Program

On Saturday, May 17, Swedish was well represented at the Washington Chapter of the American Parkinson’s Disease Annual Magic of Hope Dinner and Auction.  Several of our Swedish Neuroscience Institute providers, patients, caregivers, families, and distinguished community members attended the event, and contributed toward a successful fund raiser.  Swedish offered a generous donation to help sponsor the event, and Swedish patient and his wife David and Nancy Jones contributed a generous financial gift for programs and services for those living with Parkinson’s Disease in our communities.

Swedish is proud to partner with the APDA to support research, education, programs and services that stay in our community to benefit those living with Parkinson's Disease.

Join Swedish Cancer Institute at Seattle's Lung Force Walk on June 7

Joelle Thirsk-Fathi, DNP

The American Lung Association (ALA) has dedicated 100+ years to promoting lung health through prevention of tuberculosis, cleaner air, smoking prevention, and providing resources to those who wish to quit smoking.

In their fight for healthy lungs, the ALA has taken on a fight with lung cancer.  Lung cancer is the #1 leading cause of cancer deaths in America for men and women.  This initiative against lung cancer is called Lung Force.

Swedish Cancer Institute has a long history of fighting lung cancer through research, early detection via low dose CT screening, staging of lung cancer, surgical and medical therapies, and palliation of lung cancer.

In support of the ALA and their efforts to spread awareness of the risks of lung cancer, raising funds for lung cancer research and providing advocacy for those affected by lung cancer, Swedish will participate in the Lung Force Walk on June 7th, in Seattle.

We welcome you to join Team Swedish for a fun filled morning of music, the 5K walk, and festivities at the finish line.  You can register for the walk for free and/or make a donation in any amount that you wish.  Dogs are invited to walk too!

To join and learn more, click here and  ....

How to Manage a Sports Related Concussion

Janet Lee, MD

Janet Lee, MD
Pediatric Hospitalist

What is a concussion?
A concussion is a mild brain injury that causes a change in mental status that can occur with direct insult to the head. A concussion may also occur with movement of the body that cause acceleration/deceleration forces to the head.
 
What are the symptoms of a concussion?
  • Headache
  • Dizziness
  • Loss of consciousness
  • Amnesia
  • Difficulty concentrating
  • Confusion
  • Nausea and/or vomiting
  • Difficulty balancing
  • Sensitivity to light
  • Sensitivity to noise
  • Ringing in the ears
  • Drowsiness
  • Irritability
  • Sadness
When should I seek medical attention for a concussion?
  • A healthcare provider should evaluate every child or adolescent suspected of a concussion. 
  • If this occurs during a sporting event, the child should sit out the rest of the game
  • Your provider may conduct a standardized neuropsych assessment to help guide return to activities/sports
What is the best treatment for a concussion?
  • Rest, rest and more rest!
  • Absence from school may initially be necessary until one can concentrate on a task without exacerbating symptoms
  • Avoid excessive time texting, on the computer, watching television, playing video games or listening to loud music
  • Return to activity too soon can lead to worsening and prolonged symptoms.  A second injury to the brain while the brain is healing can lead to severe brain injury that is life-threatening
When can a child return to sports after a concussion?
A person with a concussion should not return to play until they no longer have symptoms at rest for at least 24 hours.  Return to play should then be a step-wise progression.  The child/adolescent should be symptom free for 24 hours before progressing to the next level of play:
  • Light aerobic exercise (e.g.: walking)
  • Sport-specific exercise
  • Non-contact training drills
  • Full contact practice
  • Return to play (Must first be cleared by a provider)
What resources are there for concussions?
Swedish’s Spine, Sports and Musculoskeletal Medicine team has developed a Sports Concussion Clinic with the following resources:
  • Baseline neurocognitive testing with a computerized exam called ImPACT can be done prior to playing a sport to assess changes and recovery if a concussion occurs.
  • Comprehensive concussion management, including clearance for return-to-play
Click here to learn more about the Sports Concussion clinic.  The team includes sports medicine physicians, psychiatrists, an athletic trainer, physical therapists and a neuropsychologist that can deliver individualized care for every athlete

Reducing visits to the operating room for breast cancer patients

Claire L. Buchanan, MD, FACS

Claire L. Buchanan, MD, FACS
Breast Cancer Surgeon

Swedish Cancer Institute has changed the way early stage breast cancer patients are cared for by adopting new surgical margin guidelines.  These guidelines will reduce the need for taking women back to the operating room if cancer cells are found at or near the specimen edge, also known as the margin. Following extensive review of the data, this new guideline was established by breast experts from the Society of Surgical Oncology and the American Society of Radiation Oncology and has been endorsed by the American Society of Breast Surgeons and the American Society of Clinical Oncology.
 
Many women with early stage invasive breast cancer opt for breast conserving surgery, known as lumpectomy or partial mastectomy. For 20-25% of these patients, a second surgery or re-excision was performed because the margin was not considered adequate based on previous practice guidelines. The latest peer reviewed evidence shows disease control is excellent when surgery is combined with whole breast radiation with or without hormonal therapy and/or chemotherapy, regardless of the margin width.
 
The Swedish Cancer Institute’s multidisciplinary breast cancer team reviewed and approved these guidelines for our program. We believe by reducing the need ...

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