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Some Points About MS and Alzheimer Disease

1-In contrast with the earlier stages and, in particular, the predementia stage, of Alzheimer’s disease (AD), severe dementia is often neglected. However, the advanced stages of dementia are just as important as the earlier stages because of their frequency, their impact on the lives of patients and their caregivers, and their economic consequences. All patients with moderately severe to severe dementia must be evaluated for cognitive, functional, psychological and behavioural symptoms. Thorough and regular evaluation of patients in the advanced stages of the disease has the following objectives: improving patients’ quality of life by encouraging use of their remaining capacities; setting up or modifying a care plan; playing a role in the follow-up of measures instituted; and documenting the natural history of the disease. Therapeutic trials with cholinesterase inhibitors and memantine have been conducted in patients with severe stages of AD. As a consequence, memantine has been approved by numerous drug agencies and donepezil has been approved by the US FDA for use in severe stages of the disease. However, it is important to note that at this stage of AD, and perhaps more than in any other, management must be global and multidisciplinary because of the expression of the disease, its complications and intercurrent disorders. Indeed, thorough knowledge by health professionals of the expression of all disease disorders and intercurrent disorders, and of their significance during the severe stage of AD, is important in the management of these patients to limit complications and facilitate prompt establishment of appropriate care. More effort is needed in both clinical and research settings to ensure that patients with severe AD and their relatives can be offered optimal management.

2-SEATTLE, Wash — February 20, 2009 — Women who have multiple sclerosis (MS) may reduce their risk of relapses after pregnancy if they breastfeed their babies, according to a study released today that will be presented at the American Academy of Neurology’s 61st Annual Meeting in Seattle, Washington, in April.

For the study, researchers followed 32 pregnant women with MS and 29 pregnant women without MS during each trimester and up to 1 year after they gave birth. The women were interviewed about their breastfeeding and menstrual period history.

A total of 52% of the women with MS did not breastfeed or began supplemental formula feedings within 2 months of giving birth. Of those, 87% had a relapse after pregnancy compared with 36% of women with MS who breastfed exclusively for at least 2 months after pregnancy.

Sixty percent of the women reported their main reason for not breastfeeding exclusively was to start taking MS treatments again. Women who began taking MS treatments within the first 2 months after giving birth had significantly higher risk of suffering a relapse than women with MS who did not start taking medications early, regardless of whether they breastfed. Those who breastfed exclusively got their menstrual periods back later than the women who did not breastfeed or began early supplemental feedings.

“Our findings call into question the benefit of choosing not to breastfeed or stopping breastfeeding early in order to start taking MS therapies,” said study author Annette Langer-Gould, MD, Stanford University, Stanford, California. “Larger studies need to be done on whether women should delay taking MS medications in order to breastfeed.”

SOURCE: American Academy of Neurology


February 24, 2009 - Posted by | 1

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