Kate Nicholson was working as a civil rights attorney for the Justice Department when a surgical error left her unable to sit or stand, largely bedridden, and in severe pain for almost 20 years. Using opioids as an appropriate pain management tool, she continued to function as a high-level federal prosecutor. In this talk, Kate pivots from her inspiring and excruciating story to examine the under-treatment of pain, showing how our approach to opioid abuse by 2.5 million Americans is hurting 50 million people in severe or persistent pain.
Gabriella Mammone, more commonly known as Gaby “with one b” is an award-winning business executive widely recognized as an advocacy leader in the charitable and not-for-profit sectors. She is an Ambassador with the MS Society of Canada where she advocates for people affected by multiple sclerosis and other episodic disabilities. Gaby has overcome personal challenges enforcing perseverance and resilience filled with appreciation, kindness, and a zest for life. She is an inspirational example of overcoming adversity.
Gaby promotes diversity, inclusion and acceptance. In this talk, Gaby talks about her journey in living with multiple sclerosis and how kindness has helped to heal her. Gaby is the founder of the kindness movement, #BeAwareBeKind. She encourages individuals to look for reasons to be kind. It is no surprise that Gaby’s company is appropriately titled Kind Projects where she provides marketing & communication strategies to increase awareness and fundraising goals.
Curtin researchers will develop a system that uses artificial intelligence to provide fast and personalised care for young people living with chronic musculoskeletal pain, as part of a new Curtin-led project that has been supported by the Federal Government.
Chief Investigator Professor Helen Slater, from the Curtin School of Allied Health, said the aim was to support young Australians aged 16-21 years with chronic musculoskeletal pain to take their health into their own hands and improve their health and wellbeing.
“Despite the significant burden of chronic musculoskeletal pain in young Australians, an enduring service gap remains,” Professor Slater said.
“While primary care services are available to young people with chronic conditions, age-appropriate, accessible, affordable and effective resources to support high-value musculoskeletal pain care across Australia are lacking.”
Professor Slater said an interdisciplinary team of researchers from Curtin, Flinders University and the Department of Health WA in collaboration with international researchers from New Zealand, Canada and USA would develop, implement and evaluate myPATH.
“MyPATH will function as a ‘virtual clinician and coach’ care model to provide personalised pain care directly to young people,” Professor Slater said.
“This dynamic, interactive system will rapidly learn from young people what pain care they need, when they need it and what works best for them, helping them to understand and better manage their individual care needs by supporting them and prompting healthy habits.”
Consequently, the drug’s label, which is marketed under the name Copaxone, has been updated. The researchers published their findings in Multiple Sclerosis Journal from 1 April 2022.
Reducing frequency of relapses
Multiple sclerosis affects women two to three times more often than men, and most patients are diagnosed in childbearing age. The majority of patients suffer from relapsing MS, in which episodes with more severe symptoms alternate with episodes without symptoms. But, as the disease progresses, the nervous system is damaged by these recurrent episodes. This often results in permanent disability. Disease modifying therapies can slow down the accumulation of permanent damage to the central nervous system by reducing the frequency of episodes and prolonging the periods of stability between them. Glatiramer acetate is one of these drugs.
No negative effects recorded
“In this study, we compared the development of 120 children in total, whose mothers suffer from MS; 50 per cent of the mothers in this cohort had been treated with glatiramer acetate during lactation,” explains Dr. Andrea Ciplea from Professor Kerstin Hellwig’s research group at the RUB clinic. During the first 18 months of life the researchers monitored infant body measurements, developmental delays as well as antibiotic treatments and inpatient hospital stays. “We didn’t observe negative effects attributable to the administration of the MS drug,” points out Ciplea. As a result, Copaxone’s label has been updated and treatment with glatiramer acetate during breastfeeding period is now approved
Andreas Tolf, PhD student at Department of Medical Sciences, Uppsala University, and Resident Physician at Uppsala University Hospital, Sweden. CREDIT Ann Westermark, Uppsala University
MS patients treated with Rituximab have better responses to the COVID-19 vaccine if they have higher B cell counts. This is the finding of a study from Uppsala University published in the journal JAMA Network Open. In patients with B cell counts of 40/µL (microlitres) or more, 9 of 10 patients developed protective levels of antibodies, while significantly fewer with lower counts had similar responses.
“In our study, the B cell level in patients given Rituximab was the only factor that influenced the ability to form antibodies after vaccination. Previously, it was assumed that it was enough to wait a certain period after administering Rituximab for the vaccine to have a good effect. But to increase the chance of the vaccine causing the body to form antibodies, you first need to measure the level of B cells and ensure there are enough,” says Andreas Tolf, a doctoral student in experimental neurology at Uppsala University and physician at Uppsala University Hospital.
In Sweden, Rituximab is the most common medicine for multiple sclerosis (MS), but it is also used for many other diseases. The medicine is given as a drip, normally once or twice a year, and has a documented good effect on slowing the progression of MS. The treatment knocks out the body’s B cells, which are an important part of our immune system though they also contribute to the MS disease process. As a result, the treatment increases the risk of patients suffering from serious infections, such as COVID-19. Having low levels of B cells also makes it more difficult for the body to form protective antibodies against viruses and bacteria, which is the primary purpose of vaccinations. In this case, this concerns the S protein in the SARS-CoV-19 virus.
Researchers at Uppsala University and Uppsala University Hospital have studied how MS patients treated with Rituximab react to vaccination against COVID-19. The purpose was to determine the optimal level of B cells for the patient to form sufficient numbers of antibodies after vaccination.
Blood from a total of 67 individuals with MS was analysed, of whom 60 were undergoing treatment with Rituximab and 7 were going to begin treatment after their COVID-19 vaccinations. Blood samples were taken before and after vaccination to study the levels of B cells and antibodies for SARS-CoV-2. The patients received two doses of Pfizer’s Covid-19 vaccine Comirnaty, with the active substance tozinameran.
The results show that the levels of B cells varied greatly among the subjects. The longer a patient had been treated with Rituximab, the longer it took their B cells to recover. For some patients, it took over a year before the B cells began to come back.
The patients who responded best to the vaccine and formed sufficiently high levels of antibodies had on average 51 B cells per microlitre (µL) before the vaccination. For the group that did not reach sufficient levels, the average was 22 B cells/µL.
“There was a threshold with a level of B cells at 40/µL or more where 90 per cent formed protective levels of antibodies. Of the patients who were undergoing MS treatment with Rituximab, 72 per cent formed sufficiently high levels of antibodies. The best effect with the highest percentage of antibodies was found in subjects who had never been treated with Rituximab,” says Anna Wiberg, a researcher in clinical immunology at the Department of Immunology, Genetics and Pathology at Uppsala University.
The researchers have also studied the ability of T cells to react to the virus. No differences were found between subjects who had been treated with Rituximab and those who had never been treated.
The ability of the T cells to react to the virus was just as strong in those who had received treatment. The levels of B cells before vaccination also did not impact the T-cell response, which suggests that all patients have a certain benefit from the vaccination, even if antibodies are not formed.
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