Category: MS (Page 1 of 2)

A Trainee Phlebotomist Caused a Hematoma

September 26, 2023 / Anonymous Writer

A Trainee Phlebotomist Caused a Hematoma

Hematoma: Understanding the Bruising Beneath the Skin

From the smallest bump to the most severe trauma, our bodies are remarkably adept at healing themselves. One of the body’s remarkable defense mechanisms against injury is the formation of a hematoma. But what exactly is a hematoma, and how does it play a vital role in the healing process?

Defining Hematoma

A hematoma is a localized collection of blood that pools outside the blood vessels, usually within the soft tissues of the body, such as muscles or skin. Essentially, it is a bruise beneath the skin’s surface. Hematomas can range in size from small and inconspicuous to large and painful. They typically occur as a result of trauma, injury, or surgery but can also develop spontaneously in some medical conditions.

The Mechanism of Hematoma Formation

When a blood vessel, such as an artery, vein, or capillary, is damaged due to injury, the body activates a series of processes to stop bleeding and repair the vessel. This process is known as hemostasis.

Vasoconstriction: The initial response to vessel damage is vasoconstriction, where the blood vessel narrows to reduce blood flow to the injured area. This helps minimize blood loss.
Platelet Activation: Platelets, small cell fragments in the bloodstream, play a crucial role in forming blood clots. They quickly adhere to the damaged vessel wall, creating a temporary plug to stop bleeding.
Coagulation Cascade: A complex sequence of events known as the coagulation cascade is initiated. This process involves the activation of various clotting factors in the blood, eventually leading to the formation of a stable blood clot or thrombus.
Clot Retraction: After the initial clot forms, it begins to contract or retract, pulling the edges of the damaged blood vessel together. This helps seal the vessel and prevent further bleeding.
Fibrin Formation: Fibrin, a protein, forms a meshwork within the clot, further strengthening it.

Despite these intricate mechanisms, in some cases, blood can still leak out of the damaged vessel and accumulate in the surrounding tissues, leading to the formation of a hematoma.

Types of Hematomas

Hematomas can be classified into several types based on their location and the underlying cause:

Subcutaneous Hematoma: These occur beneath the skin and are often visible as a bruise or discoloration. They are commonly caused by blunt trauma.
Intramuscular Hematoma: These form within muscles and are typically associated with muscle injuries or strenuous physical activity.
Subdural Hematoma: These are located between the brain and the protective covering (the dura) and often result from head injuries.
Epidural Hematoma: These occur between the skull and the outermost layer of the brain’s protective covering (the dura) and are usually caused by severe head trauma.
Intracranial Hematoma: These hematomas form within the brain tissue and can result from various causes, including head injuries or blood vessel abnormalities.

Treatment and Management

The management of a hematoma depends on its location, size, and the underlying cause. In many cases, small hematomas resolve on their own as the body reabsorbs the trapped blood. However, larger or more severe hematomas may require medical intervention.

Treatment options may include:

Rest and Elevation: Elevating the affected area and resting can help reduce swelling and improve blood circulation.
Cold Compresses: Applying cold compresses or ice packs to the area can help reduce pain and inflammation.
Compression: In some cases, compression bandages may be recommended to prevent further bleeding and reduce swelling.
Surgical Drainage: For large or deep hematomas, surgical drainage may be necessary to remove the accumulated blood and relieve pressure on surrounding tissues.
Medications: In cases where blood clotting is impaired, or to prevent complications like infection, medication may be prescribed.

Medical Negligence: A Trainee Phlebotomist Caused A Hematoma

A hematoma is a common occurrence in the field of phlebotomy, and it can sometimes be an unintended outcome of the blood collection process. A trainee phlebotomist, while learning and perfecting their skills, may inadvertently cause a hematoma. Let’s explore how this can happen and what steps can be taken to minimize the risk of hematoma formation during blood collection.

Needle Insertion Technique: One of the key factors in preventing hematomas is the proper technique for needle insertion. A trainee phlebotomist may sometimes insert the needle too deeply, causing damage to not only the vein but also the surrounding tissues. This can lead to blood leaking out of the vein and into the surrounding tissue, resulting in a hematoma.
Vein Selection: Choosing the right vein is crucial. A trainee phlebotomist might select a vein that is too small, fragile, or prone to rolling. This can make it more challenging to successfully access the vein and increase the risk of hematoma formation.
Needle Positioning: The angle at which the needle is inserted matters. If the needle is not inserted at the correct angle, it can increase the likelihood of vein puncture and hematoma.
Failure to Release Tourniquet: Leaving the tourniquet on for an extended period can cause blood to pool in the vein, increasing the risk of hematoma when the tourniquet is finally released.
Improper Pressure Application: After withdrawing the needle, it’s essential to apply adequate pressure to the puncture site to help prevent blood from leaking into the surrounding tissue. A trainee phlebotomist may not apply sufficient pressure, leading to hematoma formation.
Inadequate Observation: Monitoring the patient for signs of hematoma during and after the procedure is crucial. A trainee phlebotomist may not be experienced enough to recognize the early signs of a hematoma developing.

Minimizing the Risk of Hematomas in Phlebotomy:

To reduce the risk of hematoma formation during blood collection, trainee phlebotomists should follow these best practices:

Proper Training: Thorough training and supervised practice are essential for phlebotomy students. This includes learning proper techniques for needle insertion, vein selection, and patient care.
Vein Assessment: Before attempting venipuncture, assess the patient’s veins carefully. Choose a suitable vein that is visible, palpable, and less likely to roll.
Correct Needle Angle: Ensure that the needle is inserted at the appropriate angle (usually around 15-30 degrees) to minimize the risk of vein damage.
Tourniquet Control: Use the tourniquet judiciously, and release it promptly once the vein is accessed and blood begins to flow.
Proper Pressure Application: After needle removal, apply gentle pressure to the puncture site with gauze or a cotton ball, holding it in place for a sufficient amount of time to allow the vein to seal.
Patient Education: Communicate with the patient throughout the process, explaining what is happening and what they can expect. Reducing anxiety can help minimize patient movement, which can contribute to hematoma formation.
Post-Procedure Observation: After blood collection, monitor the puncture site for any signs of hematoma formation and take appropriate action if necessary.

Understanding the Risks of Thrombotic Thrombocytopenic Purpura (TTP) and Hematoma

Thrombotic Thrombocytopenic Purpura (TTP) and hematoma are distinct medical conditions, each with its own set of risks and implications. However, they can be interconnected in certain scenarios, especially when TTP affects the blood’s ability to clot properly. Let’s explore these two conditions and their associated risks.

Thrombotic Thrombocytopenic Purpura (TTP):

TTP is a rare and potentially life-threatening blood disorder characterized by the formation of small blood clots throughout the body. It primarily affects the smallest blood vessels, leading to a cascade of health issues. TTP is caused by a deficiency of a specific enzyme called ADAMTS13, which is responsible for breaking down a large protein called von Willebrand factor (vWF). Without sufficient ADAMTS13, vWF accumulates, leading to abnormal blood clot formation.

Risks of TTP:

Clot Formation: The hallmark of TTP is the formation of microclots in small blood vessels throughout the body. This can lead to organ damage and dysfunction, as the clots impede blood flow to vital organs like the brain, kidneys, and heart.
Bleeding Tendency: Paradoxically, even though TTP is characterized by clot formation, it can also cause a decrease in platelet count (thrombocytopenia), leading to an increased risk of bleeding. This dual risk of clotting and bleeding makes TTP a challenging condition to manage.
Organ Damage: When clots disrupt blood flow to organs, it can result in damage and failure. For example, TTP-induced clots in the brain can cause strokes, while those in the kidneys can lead to kidney dysfunction.
Neurological Complications: TTP can lead to neurological symptoms, including confusion, weakness, and even coma, due to the impact of clots on the brain.

Risks of Hematoma:

Pain and Swelling: Hematomas can cause significant pain and swelling at the site of the injury. This can interfere with the function of the affected body part and disrupt daily activities.
Infection: There is a risk of infection if the hematoma breaks through the skin or if the injury that caused the hematoma is contaminated.
Compartment Syndrome: In severe cases, a hematoma can cause increased pressure within the affected area, known as compartment syndrome. This can lead to tissue damage and impaired blood flow, necessitating immediate medical attention.
Secondary Complications: Depending on the location and size of the hematoma, it can lead to secondary complications. For example, a hematoma near a joint may result in limited mobility.

The Connection Between TTP and Hematoma:

While TTP primarily involves abnormal clot formation within the bloodstream, it can impact the body’s overall ability to regulate clotting and bleeding. In some cases, individuals with TTP may be at an increased risk of both bleeding and clotting disorders. This dual risk might predispose them to the formation of hematomas, particularly if they experience trauma or injury.

Managing TTP typically involves therapies to suppress abnormal clot formation, such as plasma exchange and medication. In individuals with TTP, healthcare providers must carefully assess and address the risks of both bleeding and clotting to provide effective treatment.

Immune Thrombocytopenia (ITP)

ITP, or Immune Thrombocytopenia, is a medical condition characterized by a low platelet count in the blood. Platelets are a type of blood cell that plays a crucial role in blood clotting, and a low platelet count can lead to bleeding and easy bruising.

In ITP, the immune system mistakenly targets and destroys platelets as if they were foreign invaders. This is typically due to an autoimmune response, where the body’s immune system attacks its own healthy cells and tissues. In the case of ITP, it is believed that antibodies produced by the immune system bind to platelets, marking them for destruction by the spleen or other immune cells.

The exact cause of ITP is not always clear, but it is often considered an autoimmune disorder. It can occur in isolation, known as primary or idiopathic ITP, where there is no underlying cause, or it can be secondary to other autoimmune disorders or conditions such as lupus, rheumatoid arthritis, or certain infections.

The symptoms of ITP can vary from mild to severe and may include:

Easy bruising.
Prolonged bleeding from small cuts.
Petechiae (small red or purple spots on the skin).
Nosebleeds.
Blood in the urine or stools.
Heavy menstrual periods.
In severe cases, internal bleeding can be life-threatening.

Treatment for ITP may vary depending on the severity of the condition. Some individuals with mild ITP may not require treatment and can be managed through regular monitoring. In more severe cases or when bleeding symptoms are significant, treatment options may include:

Corticosteroids to suppress the immune response.
Intravenous immunoglobulin (IVIG) to temporarily raise platelet counts.
Platelet transfusions in cases of severe bleeding.
Medications that affect the immune system, such as rituximab or thrombopoietin receptor agonists.
In extreme cases, surgery to remove the spleen (splenectomy) may be considered.

Managing ITP with an underlying autoimmune disorder may involve treating the primary autoimmune condition as well. It’s essential for individuals with ITP to work closely with their healthcare team to determine the most appropriate treatment plan based on their specific circumstances and symptoms.

Both ITP (Immune Thrombocytopenia) and hematomas involve issues related to blood clotting and can carry certain risks:

Risks of ITP (Immune Thrombocytopenia):

Bleeding: The primary risk associated with ITP is bleeding due to a low platelet count. Platelets are essential for normal blood clotting, and when their numbers are low in ITP, there’s an increased risk of spontaneous bleeding, such as nosebleeds, gum bleeding, easy bruising, and, in severe cases, internal bleeding.
Severe Bleeding Episodes: In severe cases of ITP, there is a risk of life-threatening bleeding, such as gastrointestinal bleeding or intracranial hemorrhage. These are medical emergencies and require immediate attention.
Chronic Disease: ITP can become a chronic condition for some individuals, which means they may experience ongoing issues with low platelet counts and the associated risk of bleeding over an extended period.
Impact on Quality of Life: Living with ITP can be challenging due to the need for frequent medical monitoring, potential treatment side effects, and lifestyle adjustments to reduce the risk of bleeding.

The risks associated with ITP and hematomas can vary depending on the severity of the condition, the individual’s overall health, and the location and size of the hematoma. It’s essential to seek medical attention and follow medical advice for both conditions to manage and reduce these risks effectively. For ITP, this may involve treatments to increase platelet counts or manage bleeding, while for hematomas, treatment may include drainage, wound care, or surgical intervention if necessary.

Personal Experience

As a multiple sclerosis sufferer who has had Alemtuzumab Treatment with regular blood tests required by law, upon visiting the hospital on Wednesday 20th September 2023 I was greeted by a trainee phlebotomist whom may I add was supervised. I did not take either of their names. I explained I have problems with my veins being too thin, The trained phlebotomist looked at my arm and told the trainee phlebotomist to try the fatter vein, after a bit of poking and prodding the needle the trainee nurse took out the needle after several times going in a different direction and with a bit of perseverance she managed to draw blood. When she finally took the needle out this resulted in my arm bruising and swelling to the point it was extremely painful.

If the test tube is not removed when the needle comes out, it can cause a number of issues. For instance, the blood sample may clot inside the tube, making it difficult to extract the required amount of blood for testing. In some cases, if the needle is withdrawn too quickly, it can cause a hematoma. Hematomas can be painful and may require medical attention if they are large or do not resolve on their own.

I did have an independent nurse and pharmacist look at it afterward (not from the hospital) and both agreed it was really bad.

I realize the hospital (UHW) is a teaching hospital but the departments should get the patient’s permission first before letting trainee doctors/nurses and phlebotomists train on a patient. I was never informed until after the fact and by that time it was too late. Had I known from the start a trainee phlebotomist would be taking my blood I would have refused. This is not the first time I have had a hematoma.

My arm a week later is still bruised and swollen. This is a lesson learned. I would like to add I do not hold a grievance to the trainee phlebotomist but with my history of blood tests proving difficult, I would expect a professional fully trained nurse to take my blood.

Conclusion

Hematomas are a natural part of the body’s response to injury and play a crucial role in the healing process. While they can be painful and concerning, most hematomas resolve with time and appropriate care. However, it is essential to seek medical attention if you suspect a severe hematoma, especially if it is associated with head trauma, as prompt treatment may be necessary to prevent complications. Understanding how hematomas form and the importance of their role in the healing process can help individuals make informed decisions about their care when faced with these common injuries.

It’s important to remember that hematoma formation is a potential risk in phlebotomy, even for experienced practitioners. Trainee phlebotomists should focus on learning and consistently applying proper techniques to minimize this risk and ensure safe and adequate blood collection procedures. Supervision and feedback from experienced phlebotomists are valuable tools in the learning process.

TTP and hematoma are distinct medical conditions, each associated with its own set of risks and complications. However, in some cases, individuals with TTP may be more susceptible to hematoma formation due to disruptions in their blood clotting and bleeding mechanisms. It is essential for healthcare professionals to consider these risks when managing patients with TTP and tailor treatment accordingly.

What should a patient do if a trainee phlebotomist causes a hematoma in high-risk patients who are susceptible to ITP having blood tests because of Lemtrada alemtuzumab treatment?

If a trainee phlebotomist causes a hematoma in a high-risk patient who is susceptible to ITP (Immune Thrombocytopenia) due to Lemtrada (alemtuzumab) treatment, it is crucial for the patient to take the following steps:

Notify the Phlebotomist: Immediately inform the phlebotomist about the hematoma and any discomfort or pain you may be experiencing. They need to be aware of the issue to provide assistance and documentation.
Apply Pressure: If the hematoma is actively bleeding or swelling, gently apply pressure to the area with a clean cloth or sterile gauze to help control bleeding and minimize the size of the hematoma. Do not press too hard, as this could exacerbate the issue.
Elevate the Affected Area: If possible, keep the affected limb elevated. Elevating the area can help reduce swelling and minimize further blood accumulation in the hematoma.
Seek Medical Attention: Given the patient’s susceptibility to ITP and the potential complications associated with hematoma, it is advisable to seek immediate medical attention. This is especially important because ITP is a condition characterized by abnormal clot formation and bleeding tendencies, and it could be exacerbated by a hematoma.
Notify Healthcare Provider: Contact the healthcare provider responsible for managing your Lemtrada treatment. Inform them of the situation, including details about the hematoma and any symptoms you are experiencing. They may need to adjust your treatment plan or monitor your condition closely.
Follow Medical Advice: Follow the guidance provided by your healthcare provider regarding the management of the hematoma and any potential treatment adjustments necessary to mitigate the risk of ITP.
Document the Incident: Keep detailed records of the hematoma incident, including the date, time, and name of the phlebotomist involved. This documentation may be valuable for future reference, especially if it leads to complications related to your ITP susceptibility or Lemtrada treatment.
Consider Future Precautions: Discuss with your healthcare provider and the phlebotomy department whether any additional precautions or modifications to the blood collection process are necessary to minimize the risk of hematoma formation during future blood tests. This could include using experienced phlebotomists or employing alternative blood collection methods.

It is essential to prioritize your health and safety in this situation, especially if you are a high-risk patient with ITP susceptibility due to Lemtrada treatment. Prompt and effective communication with healthcare providers is critical to ensure that any potential complications are addressed promptly, and your treatment plan is adjusted as needed.

Photographic Evidence

The Link Between Multiple Sclerosis & Cerebellar Atrophy

September 24, 2023 / Andrew Jones / 0 Comments

The Link Between Multiple Sclerosis & Cerebellar Atrophy

Multiple Sclerosis (MS) is a complex and unpredictable neurological disease that affects millions of people worldwide. While it is primarily characterized by inflammation and demyelination of the central nervous system (CNS), the impact of MS extends far beyond the traditional understanding of the disease. Cerebellar atrophy, a condition involving the degeneration of the cerebellum, has gained attention in recent years as a significant neurological complication of MS. In this article, we will explore the link between multiple sclerosis and cerebellar atrophy, shedding light on the mechanisms, symptoms, and implications of this less-understood aspect of the disease.

Understanding Multiple Sclerosis

Multiple Sclerosis is an autoimmune disease in which the immune system mistakenly attacks the protective myelin sheath that covers nerve fibers within the CNS, leading to inflammation and damage. This damage can disrupt the normal flow of electrical impulses along nerve fibers, causing a wide range of neurological symptoms. The most common symptoms of MS include fatigue, difficulty walking, numbness or tingling, muscle weakness, and problems with coordination and balance. Over time, these symptoms can worsen and lead to significant disability.

The Cerebellum and Its Role

The cerebellum is a critical part of the brain located at the back of the head, just above the brainstem. It plays a crucial role in coordinating voluntary movements, maintaining balance, and fine-tuning motor skills. Additionally, the cerebellum contributes to cognitive functions like attention, language processing, and emotional regulation.

The Link between MS and Cerebellar Atrophy

Cerebellar atrophy is a condition characterized by the degeneration or shrinkage of the cerebellum. This phenomenon has been observed in a significant number of individuals with multiple sclerosis, and research has begun to shed light on the connection between the two conditions.

Inflammatory Processes: MS is primarily an inflammatory disease, and the inflammatory processes occurring within the CNS can extend to the cerebellum. This inflammation can disrupt the normal functioning of the cerebellum and contribute to its atrophy.
Demyelination: The demyelination of nerve fibers in the cerebellum, caused by MS, can lead to a loss of communication between neurons. This disruption in signaling can result in impaired coordination, balance, and motor skills, which are characteristic symptoms of cerebellar atrophy.
Neuronal Damage: In MS, not only the myelin but also the underlying neurons can be damaged. The loss of neurons within the cerebellum can further contribute to its atrophy and functional impairment.

Symptoms of Cerebellar Atrophy in MS Patients

The presence of cerebellar atrophy in individuals with MS can lead to a distinct set of symptoms, including:

Ataxia: Ataxia refers to a lack of coordination and balance, making everyday movements like walking and reaching for objects challenging.
Dysarthria: This condition affects speech and results in slurred or poorly articulated speech patterns.
Tremors: Tremors or shaky movements may occur, particularly when trying to perform fine motor tasks.
Cognitive Changes: Some individuals may experience changes in cognitive function, such as difficulties with concentration, attention, and problem-solving.
Fatigue: The increased effort required to perform even simple tasks due to ataxia and other symptoms can contribute to fatigue, a common symptom in both MS and cerebellar atrophy.

Implications and Treatment

The presence of cerebellar atrophy in MS patients can complicate the clinical course of the disease. It may lead to more severe disability and impact the overall quality of life for those affected. Therefore, it is crucial for healthcare providers to recognize and address cerebellar atrophy in MS patients.

Treatment approaches for cerebellar atrophy in MS are often focused on managing symptoms and improving overall function. This may include physical therapy to enhance coordination and balance, medications to address specific symptoms like tremors or spasticity, and speech therapy for individuals with dysarthria.

Conclusion

While the primary hallmark of multiple sclerosis is the inflammation and demyelination of the central nervous system, it is essential to recognize the broader impact of this disease on various parts of the brain. Cerebellar atrophy, a condition involving the degeneration of the cerebellum, is a significant complication that can worsen the clinical course of MS. Understanding the link between multiple sclerosis and cerebellar atrophy is crucial for healthcare providers to provide comprehensive care and improve the quality of life for individuals living with this challenging neurological condition. Further research into the mechanisms underlying this connection may pave the way for more targeted therapies in the future.

The Impact On Stonewalling Patients

July 25, 2023 / Zena Maziak / 0 Comments

The Impact of Stonewalling Patients: Communication Breakdown in Healthcare

Effective communication is the cornerstone of a successful patient-physician relationship, fostering trust, understanding, and better healthcare outcomes. However, when physicians stonewall patients, refusing to engage in open and empathetic conversations, the consequences can be detrimental to both the patient’s well-being and the overall healthcare system.

Erosion of Trust: Trust is a fundamental component of any patient-physician relationship. When physicians stonewall patients, the patient’s trust in their healthcare provider begins to erode. Stonewalling creates a perception of indifference or disinterest, leaving patients feeling dismissed, undervalued, or unheard. As trust diminishes, patients may become hesitant to share critical health information, seek follow-up care, or adhere to treatment plans, ultimately compromising their overall health outcomes.
Adverse Psychological Impact: Stonewalling can have significant psychological effects on patients. Feeling ignored or invalidated by their physician may lead to increased anxiety, frustration, and feelings of helplessness. Patients may be less likely to discuss their concerns openly, leading to a missed opportunity for timely diagnosis and appropriate intervention. In some cases, this emotional distress could exacerbate existing health conditions or even lead to the development of new ones.
Hindered Diagnostic Process: Effective communication is key to accurate diagnosis. When physicians stonewall patients, they might miss vital cues or symptoms that could provide essential information for diagnosis. Patients who feel unable to express their concerns openly may downplay symptoms or withhold important details, making it more challenging for physicians to arrive at an accurate diagnosis. This delay in diagnosis can lead to prolonged suffering for the patient and may even result in worsened medical conditions.
Reduced Patient Compliance: Stonewalling can negatively impact patient compliance with treatment plans and medical advice. When patients do not feel heard or respected, they are less likely to adhere to prescribed treatments, medications, or lifestyle changes. Consequently, this lack of compliance can lead to treatment inefficacy and a cycle of worsening health conditions, resulting in increased healthcare costs and potential hospitalizations.
Strained Patient-Physician Relationship: Stonewalling damages the patient-physician relationship, which is essential for fostering open dialogue and effective collaboration in healthcare decisions. A strained relationship can hinder the flow of information between patients and physicians, preventing a comprehensive understanding of the patient’s medical history, concerns, and preferences. A communication breakdown can create a hostile environment, making it challenging for physicians to provide patient-centered care tailored to individual needs.

Conclusion:

The impact of stonewalling patients extends far beyond simple miscommunication. It undermines the foundation of trust and compassion necessary for effective healthcare delivery. Physicians must recognize the significance of open and empathetic communication and actively work to create an environment where patients feel comfortable expressing their concerns without fear of judgment or dismissal.

By promoting transparency, active listening, and empathy, healthcare providers can strengthen the patient-physician relationship and, in turn, enhance patient outcomes and overall healthcare quality. Emphasizing effective communication in medical training and continuing education will play a crucial role in ensuring that stonewalling becomes a relic of the past, replaced by a more compassionate and patient-centered approach to healthcare.

My own experience of trying to update my symptoms with the MS & Neurology Team at the University Hospital Wales, Cardiff is abysmal. The Multiple Sclerosis department no longer has a telephone number, thus I emailed my consultant Professor N. Robertson, and have had no reply. I then tried to contact his secretary and the call went straight to voicemail stating she was out of the office. She seems to be always out of the office (do these people actually do any work). I then Last week after I had my blood tests done attempted to locate an MS nurse and was told there are no MS nurses at the hospital, even though they treat MS patients, which I find very odd. What is wrong, for there to be absolutely no one around to support MS patients?

If the neurologist comes back to me and says he was too busy or was out of office at least have the decency to have an autoresponder message or common courtesy and reply with a one-liner stating you will get back in touch shortly. Do not stonewall a person as it can affect their mental health. The Impact Of Stonewalling – CYMRU MARKETING JOURNAL

I have more than one bone to pick with this department since receiving a letter stating I was to have a phone consultation in which I rescheduled my day only to find out that the letter was sent out in error and there was no planned consultation. What I believe happened was that initially it was planned and at the last minute the consultant could not make the appointment.

I am fed up with having to chase the hospital for my blood forms and try and speak with someone about my health.

To think I have concerns about my health and have zero support is absolutely unacceptable and it lacks duty of care by an organization that is falling apart.

I invite anyone reading this that has had similar issues with the NHS, to voice their opinions by commenting below. This does not have to be MS related it could be about any illness. The more people that complain the quicker something that can be done to shake up the organization which is poorly managed. Government officials do read the article on this site so it will be interesting to read other people’s experiences. Bungling Welsh hospitals dodge complaints and issue payouts like £750 to a man they didn’t tell he had Covid – Wales Online

#ms #multiplesclerosis #msrelapse #neurology #msnurse #uhw #nhs #professorneilrobertson #dutyofcare #lackofdutyofcare #mssupport

What are Serum Biobanks?

June 20, 2023 / EDITOR

What are Serum Biobanks?

Unlocking the Power of Discovery: Exploring Serum Biobanks

Introduction

Medical research, advancements, and breakthroughs often rely on access to vast and diverse collections of biological samples. One valuable resource in this regard is serum biobanks. Serum biobanks are repositories of blood serum samples with immense potential for enhancing our understanding of diseases, identifying biomarkers, and developing personalized treatments. In this article, we will delve into the concept of serum biobanks, their significance, and their impact on medical research.

What are Serum Biobanks?

Serum biobanks are specialized facilities that store and preserve blood serum samples collected from various individuals over time. Blood serum is the liquid portion of blood that remains after the removal of cells and clotting factors. It contains a wide range of proteins, hormones, antibodies, and other molecules that can provide valuable insights into an individual’s health status, disease progression, and response to treatment.

These biobanks meticulously collect, process, and store serum samples, ensuring their long-term preservation and availability for scientific investigations. Samples are usually obtained through blood draws from volunteers, patients, or individuals participating in clinical trials, population studies, or disease-specific research initiatives.

Significance in Medical Research

Disease Biomarker Discovery: Serum biobanks enable researchers to analyze the molecular composition of blood serum samples from individuals with and without specific diseases. By comparing these profiles, scientists can identify potential biomarkers—measurable indicators of disease presence or progression. Biomarkers play a crucial role in early disease detection, monitoring treatment response, and developing personalized therapies.
Epidemiological Studies: Large-scale serum biobanks facilitate population-based research, providing invaluable data for epidemiological studies. By analyzing serum samples from diverse populations, researchers can investigate disease prevalence, risk factors, and genetic variations across different demographics, ultimately leading to a better understanding of global health patterns.
Pharmacogenomics and Drug Development: Serum biobanks support pharmacogenomic research, which explores how an individual’s genetic makeup influences their response to medications. By studying serum samples in conjunction with genetic information, researchers can identify genetic variants associated with drug efficacy and adverse reactions, leading to the development of tailored treatments and improved patient outcomes.
Longitudinal Studies: Serum biobanks offer the unique advantage of tracking health changes over time. By analyzing serial serum samples from the same individuals, researchers can observe disease progression, identify early warning signs, and monitor the impact of treatments. Longitudinal studies enhance our understanding of diseases’ natural history and help evaluate the effectiveness of therapeutic interventions.

How can Serum Bio Banks help people with multiple sclerosis

Leveraging Serum Bio Banks to Empower Individuals with Multiple Sclerosis

Multiple sclerosis (MS) is a chronic neurological condition that affects millions of people worldwide. The disease’s complexity and variability make it challenging to diagnose, monitor, and develop effective treatments. However, recent advancements in medical research, particularly in the field of serum biobanks, offer hope for better understanding and managing MS. Serum biobanks play a crucial role in storing and analyzing blood samples, providing invaluable resources to researchers, healthcare providers, and individuals with MS. In this article, we will explore how serum biobanks can aid in the battle against multiple sclerosis and enhance the lives of those affected by the condition.

Early Diagnosis and Identification of Biomarkers: One of the significant advantages of serum biobanks is their potential to contribute to early diagnosis and identification of biomarkers for MS. Biomarkers are measurable substances in the body that indicate the presence or progression of a disease. By analyzing blood samples from individuals with MS, researchers can search for specific biomarkers that may help early detection or even predict disease development. Serum bio banks facilitate the collection and long-term storage of blood samples from individuals at different stages of MS, including those who have not yet developed noticeable symptoms. By studying these samples, researchers can identify potential biomarkers and develop tests to aid early diagnosis. Early detection is crucial in MS, as it enables healthcare providers to effectively implement timely interventions and treatments to manage the disease.
Personalized Treatment Approaches: MS is a highly heterogeneous disease that manifests differently in each individual. Serum biobanks can assist in tailoring customized treatment approaches for people with MS. By analyzing blood samples and comparing them to clinical data, researchers can identify specific biomarkers that indicate how a person’s disease may progress or respond to different treatments. With this information, healthcare providers can create individualized treatment plans, optimizing each patient’s choice of medications and therapies. Serum bio banks enable researchers to identify patterns in large data sets, which can lead to the development of precision medicine approaches in MS. These personalized treatments have the potential to improve the efficacy of therapies while minimizing adverse side effects.
Monitoring Disease Progression and Treatment Efficacy: Monitoring disease progression and assessing the effectiveness of treatments are crucial aspects of managing MS. Serum biobanks play a pivotal role in this regard by providing a valuable resource for long-term follow-up studies. By regularly collecting blood samples from individuals with MS, researchers can track changes in biomarker levels over time, allowing them to gain insights into disease progression and the impact of treatments. These longitudinal studies can help identify biomarkers associated with disease activity, response to therapy, and potential relapses. Monitoring biomarkers can enable healthcare providers to make more informed decisions about treatment adjustments, ensuring optimal disease management. Additionally, studying blood samples from individuals with MS who have been on specific medications for an extended period can provide valuable data on these treatments’ long-term safety and effectiveness.
Accelerating Research and Drug Development: Serum biobanks offer a treasure trove of data and biological samples that accelerate research and drug development efforts in the field of MS. These biobanks provide researchers with access to a large number of well-characterized samples, enabling them to conduct comprehensive studies on various aspects of the disease. This wealth of information can enhance our understanding of MS’s underlying mechanisms, identify potential therapeutic targets, and facilitate the development of novel treatments. Moreover, serum bio banks promote research collaboration by sharing samples and data, which can expedite scientific discoveries. By pooling resources and knowledge, researchers can collectively work towards unraveling the complexities of MS and finding more effective treatment options.

Professor Neil Roberson’s Groundbreaking Parallel Biobank: Revolutionizing Precision Medicine Research

The availability of comprehensive and diverse biological samples is crucial for advancing our understanding of human health and developing personalized treatments. Professor Neil Roberson, a pioneering figure in the field of precision medicine, has spearheaded an innovative project known as the Parallel Biobank. This extraordinary initiative aims to collect and analyze DNA, serum, and cerebrospinal fluid (CSF) samples concurrently, opening up new avenues for groundbreaking research and medical breakthroughs.

The Significance of Biobanks: Biobanks play a pivotal role in scientific research by providing scientists with access to a vast array of biological materials. They serve as repositories for valuable samples that are crucial for investigating the genetic and molecular underpinnings of various diseases and conditions. Biobanks enable researchers to uncover biomarkers, identify potential therapeutic targets, and develop tailored treatments for individuals based on their unique genetic makeup.

Professor Neil Roberson, renowned for his expertise in genetics and molecular biology-based at the ‘University Hospital of Wales, has recognized the limitations of traditional biobanks. and has collaborated with Cambridge University and the IMSGC for studies into genetic susceptibility in MS Most biobanks focus on collecting either DNA, serum, or CSF samples, resulting in fragmented data sets that hinder comprehensive analyses. To overcome this challenge, Roberson conceived the idea of a parallel biobank that collects and preserves all three types of samples in tandem.

The Parallel Biobank: Roberson’s Parallel Biobank is a groundbreaking initiative that revolutionizes the landscape of precision medicine research. By simultaneously collecting and storing DNA, serum, and CSF samples, the biobank enables a holistic approach to understanding human health, genetics, and disease progression.

DNA Samples: DNA, the blueprint of life, provides invaluable insights into an individual’s genetic composition. By analyzing DNA samples from a diverse population, researchers can identify genetic variations that contribute to disease susceptibility, drug responses, and other critical factors influencing health outcomes.
Serum Samples: Serum, the liquid component of blood devoid of cells and clotting factors, contains a wealth of information about an individual’s metabolic profile and disease markers. By analyzing serum samples, scientists can detect biomarkers associated with specific conditions, monitor treatment efficacy, and identify potential disease progression indicators.
CSF Samples: Cerebrospinal fluid (CSF) is a clear, colorless fluid that surrounds the brain and spinal cord, playing a vital role in protecting and nourishing the central nervous system. CSF samples provide researchers with a direct window into the brain, allowing for the study of neurological disorders such as Alzheimer’s disease, Parkinson’s disease, and Multiple sclerosis. Analyzing CSF samples can unveil biomarkers associated with these conditions and aid in the development of targeted therapies.

Unleashing the Power of Integration: By collecting DNA, serum, and CSF samples in parallel, Professor Neil Roberson’s biobank eliminates the siloed nature of traditional repositories. Integrating these samples provides researchers with an unprecedented opportunity to uncover complex relationships between genetics, metabolic profiles, and neurological conditions. This integrated approach facilitates the identification of novel biomarkers, the development of targeted therapies, and the personalization of treatments based on an individual’s unique biological signature.

Professor Neil Roberson’s Parallel Biobank represents a paradigm shift in precision medicine research. This innovative initiative paves the way for transformative discoveries in genetics, metabolic research, and neuroscience by collecting and analyzing DNA, serum, and CSF samples in parallel. The integration of these comprehensive datasets holds immense potential for personalized medicine, where treatments are tailored to individual patients based on their unique biological characteristics. As the Parallel Biobank continues to grow, it is poised to reshape the medical research landscape and drive advancements in precision medicine, ultimately improving healthcare outcomes for individuals worldwide.

Ethical Considerations and Data Security.

Challenges and Ethical Considerations

As with any biobank initiative, ethical considerations are of utmost importance. Professor Roberson’s Parallel Biobank adheres to stringent ethical guidelines and obtains informed consent from participants, ensuring the protection of privacy and confidentiality. Additionally, robust data security measures are implemented to safeguard the integrity and anonymity of the samples and associated information.

While serum biobanks hold great promise, they face several challenges and ethical considerations. These include ensuring informed consent and privacy protection, maintaining sample quality during storage, standardizing protocols for sample collection and processing, and addressing issues related to sample accessibility and ownership.

Conclusion

Serum biobanks represent a crucial resource for medical research, facilitating the exploration of disease mechanisms, personalized medicine, and improved healthcare outcomes. By unlocking the secrets held within blood serum samples, scientists can uncover vital biomarkers, understand disease dynamics, and develop innovative treatments. However, it is essential to navigate the ethical challenges associated with serum biobanks to ensure that these invaluable repositories are utilized responsibly and for the benefit of all. With continued advancements in technology and increasing collaboration, serum biobanks have the potential to revolutionize medical research and contribute significantly to global health.

Serum biobanks have emerged as valuable assets in the fight against multiple sclerosis. Through the collection, storage, and analysis of blood samples, these biobanks enable researchers and healthcare providers to advance our understanding of the disease, identify biomarkers, personalize treatment approaches, monitor disease progression, and accelerate drug development. The insights gained from serum biobanks hold immense potential for improving the lives of individuals with MS, offering hope for more effective management strategies and ultimately, a cure for this debilitating condition.

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#genetherapy #genetherapyai #cellgenetherapyai #cgtai #gpai #ms #multiplesclerosis #biomarkers #serumbiobanks #repositories #dna #csf #parallelbiobank #professorneilrobertson #professorrobertson #professorofneurology #neurologist #neurology

Nitrous Oxide (NO) Balloons & Multiple Sclerosis

March 26, 2023 / Zena Maziak

Nitrous Oxide Balloons and Canisters. — ***Image Credit: Compass -uk.org***

Nitrous Oxide (NO) Balloons & Multiple Sclerosis – 30 seconds being high to a lifetime of MS.

Laughing Gas (Nitrous Oxide) or Balloons

Laughing gas is being banned in the UK (nitrous oxide otherwise known as balloons, hippy crack, or nos to young people).

The risks of being high for 30 seconds and living a life with MS.

Michael Gove has this morning announced plans for the government to ban Nitrous oxide.

In the United Kingdom, nitrous oxide is the second most prevalent drug among young adults aged 16 to 24 years, after cannabis, according to the European Union drugs monitoring agency EMCDDA.

About Michael Gove: Michael Gove – Wikipedia

Michael Gove Contact Details: Contact information for Michael Gove – MPs and Lords – UK Parliament

About Sophy Ridge: Sophy Ridge – Wikipedia

Sophy Ridge Contact Details: Sophy Ridge on Sunday & The Take (@RidgeOnSunday) / Twitter

Sophy Ridge asked: ‘Are you really going to give people a criminal record for a 30-second high from laughing gas?’

When asked if the plans were hypocritical given the fact that some MPs have been known to take drugs including himself, he said ‘No…because I’ve learned’.

Nitrous oxide set to be banned in crackdown on laughing gas (msn.com)

Editors Thoughts:

Nitrous Oxide is being used in many industries from catering to hospitals, and dentistry, whilst banning will only heighten the black market it would be better to enlighten people especially in schools and on social media the devasting effects of using nitrous oxide for recreational purposes. Hospitals are already restricting gas and air pain relief in maternity wards.

Why has this bill taken so long to come to light? The powers that be should educate young people with media amplification about the dangers of using recreational drugs and the consequences. Obviously, there will be people that will take risks and worry about the aftermath later.

“If more was done about teaching the masses the repercussions of taking drugs, more people will be inclined to think twice”.

If social media was flooded with dangers, more lives would be saved.

What is Nitrous Oxide

Nitrous oxide, also known as laughing gas, is a colorless and odorless gas with the chemical formula N2O. It is a non-flammable gas that is commonly used as a mild anesthetic in medicine and dentistry. Nitrous oxide is also used as a propellant in aerosol cans and whipped cream dispensers, as well as in the food industry for its preservative properties.

Nitrous oxide was first discovered in 1772 by the English chemist and natural philosopher Joseph Priestley. He observed that the gas had the ability to extinguish flames and wrote about its properties in his book, “Experiments and Observations on Different Kinds of Air.” It was not until the early 1800s that nitrous oxide began to be used for medical purposes.

Nitrous oxide works by suppressing the nervous system and reducing the sensation of pain. When inhaled, it enters the bloodstream and travels to the brain, where it acts on certain receptors to produce a sense of euphoria and relaxation. This is why it has been dubbed “laughing gas” – some people report feeling giddy or giggly after inhaling it.

In medicine, nitrous oxide is often used in combination with other anesthetics to produce a state of sedation for patients undergoing minor surgical procedures, such as dental work or endoscopy. It is also sometimes used during childbirth to help manage pain and reduce anxiety.

Outside of the medical setting, nitrous oxide is sometimes used recreationally as a “party drug.” In these situations, it is often inhaled from a balloon or canister and can produce feelings of euphoria, relaxation, and altered consciousness. However, it is important to note that nitrous oxide can be dangerous when used improperly, and can cause serious health problems or even death in high doses.

One of the potential dangers of nitrous oxide is oxygen deprivation. When inhaled in large quantities, nitrous oxide can displace oxygen in the bloodstream, which can lead to oxygen deprivation and cause damage to the brain and other organs. This is why it is important to only use nitrous oxide in a controlled medical or recreational setting, and to never inhale it directly from a canister or balloon.

In conclusion, nitrous oxide is a gas with a long history of use in medicine and industry. It has both therapeutic and recreational applications but can be dangerous when used improperly. If you are considering using nitrous oxide for any reason, it is important to do so under the guidance of a medical professional or in a controlled, safe setting.

What Is Nitrous Oxide Used For

Nitrous oxide is used for various purposes, both in medical and non-medical settings. Here are some of the most common uses of nitrous oxide:

Anesthesia: Nitrous oxide is widely used as a mild anesthetic agent in dentistry and surgery. It is often used in combination with other anesthetics to produce sedation and pain relief for minor surgical procedures.
Pain management during labor: Nitrous oxide can be used to manage pain and reduce anxiety during labor and delivery.
Whipped cream dispensers: Nitrous oxide is used as a propellant in whipped cream dispensers, where it helps to create a creamy, fluffy texture.
Aerosol cans: Nitrous oxide is used as a propellant in some aerosol cans, such as cooking sprays and hair sprays.
Food preservation: Nitrous oxide is used in the food industry as a preservative, as it can inhibit the growth of bacteria and other microorganisms.
Automotive industry: Nitrous oxide is used as a performance-enhancing substance in the automotive industry, where it is often used to boost the power output of high-performance engines.
Recreational use: Nitrous oxide can be used recreationally to produce a sense of euphoria and altered consciousness. However, this use is illegal in many countries and can be dangerous when used improperly.

Nitrous oxide has a wide range of applications, from medical and industrial.

Can the use of nitrous oxide can multiple sclerosis

Nitrous oxide, commonly known as laughing gas, is a colorless and odorless gas that has been used for its anesthetic properties in medical and dental procedures for over a century. While it is generally considered safe when used as directed, there is growing concern that the use of nitrous oxide may exacerbate or even trigger autoimmune disorders such as multiple sclerosis.

Multiple sclerosis (MS) is a chronic autoimmune disorder that affects the central nervous system, causing a range of symptoms such as numbness, tingling, weakness, and difficulty with balance and coordination. The exact cause of MS is not fully understood, but it is believed to involve a combination of genetic and environmental factors.

One potential environmental factor that has been implicated in the development and progression of MS is nitrous oxide. Nitrous oxide is known to inhibit the activity of an enzyme called methionine synthase, which is essential for the production of myelin, the protective coating that surrounds nerve fibers in the brain and spinal cord.

In individuals with MS, the immune system mistakenly attacks and damages the myelin, leading to the characteristic symptoms of the disease. By inhibiting methionine synthase, nitrous oxide may further disrupt myelin production and exacerbate the underlying autoimmune process.

Several studies have suggested a link between nitrous oxide use and the development or progression of MS. One study published in the journal Anesthesiology found that patients with MS who received nitrous oxide during surgery were more likely to experience a relapse of their symptoms within six months compared to those who did not receive nitrous oxide.

Another study published in the journal Neurology found that exposure to nitrous oxide was associated with an increased risk of developing MS among individuals with a genetic predisposition to the disease. The authors of the study concluded that nitrous oxide may act as a trigger for the autoimmune process in susceptible individuals.

Nitrous oxide, commonly known as laughing gas, is a colorless, odorless gas with several medical uses. It is used as an anesthetic agent during dental procedures, as an analgesic agent during labor, and as a recreational drug due to its euphoric effects. However, there is some concern about the use of nitrous oxide in individuals with multiple sclerosis (MS) and other autoimmune disorders.

Multiple sclerosis is a chronic autoimmune disorder that affects the central nervous system (CNS). It is characterized by inflammation and damage to the myelin sheath, which is a protective covering around nerve fibers. The symptoms of MS vary depending on the location and extent of the damage to the CNS. Common symptoms include muscle weakness, fatigue, difficulty with coordination and balance, and vision problems.

There is some evidence to suggest that the use of nitrous oxide may exacerbate the symptoms of MS. Nitrous oxide can increase the levels of homocysteine in the body, which is a non-protein amino acid that has been linked to increased inflammation and damage to the CNS. Studies have shown that individuals with MS have higher levels of homocysteine than individuals without MS and that elevated homocysteine levels may be a risk factor for disease progression.

In addition to MS, there is also concern about the use of nitrous oxide in individuals with other autoimmune disorders, such as rheumatoid arthritis and lupus. These disorders are characterized by inflammation throughout the body, and nitrous oxide may exacerbate this inflammation.

Despite these concerns, the use of nitrous oxide in individuals with MS and other autoimmune disorders is still considered safe in most cases under medical supervision such as anesthesia. However, it is important for individuals with these conditions to discuss the use of nitrous oxide with their healthcare provider before undergoing any procedures that require its use.

In some cases, alternative anesthesia options may be considered for individuals with MS and other autoimmune disorders. For example, regional anesthesia, such as an epidural or spinal block, may be used instead of general anesthesia. These types of anesthesia do not involve the use of nitrous oxide and may be a safer option for individuals with autoimmune disorders.

Conclusion:

While the use of nitrous oxide is generally considered safe for industries that use it, there is some concern about its use in individuals with MS and other autoimmune disorders. Therefore the risks of using nitrous oxide for recreational purposes should be avoided at all costs.

It is important for individuals with autoimmune conditions to discuss the use of nitrous oxide with their healthcare provider before undergoing any procedures that require its use. Alternative anesthesia options may be considered in some cases to minimize the potential risks associated with nitrous oxide.

With the dangers of nitrous oxide causing multiple sclerosis the powers that be should do more to promote the pitfalls through television and social media advertising.

Nitric oxide modulation for autoimmune disease | Dr. K. News (drknews.com)

The role of nitric oxide in multiple sclerosis – The Lancet Neurology

Nitrous Oxide Side Effects: Long Term, Short Term, Overdose, and More (healthline.com)

We can write similar articles and share them on social

#nitrousoxide #laughinggas #balloons #canisters #ms #multiplesclerosis #recreationaldrugs #anesthesia #autoimmunedisease #autoimmunedisrorders

What Is Cell & Gene Therapy AI

March 12, 2023 / EDITOR / 1 Comment

What Is Cell & Gene Therapy AI?

Cell and gene therapy are revolutionary approaches to treating diseases at the molecular level. They involve the manipulation of living cells and genetic material to correct or replace damaged or diseased cells in the body. The potential of these therapies to cure or significantly improve many types of diseases, including cancer, genetic disorders, and autoimmune diseases, has been recognized by the medical community as a significant breakthrough.

In cell therapy, healthy living cells are introduced into the body to replace damaged or diseased cells. This therapy has shown great promise in the treatment of certain types of cancer, where immune cells are modified to recognize and attack cancer cells. Gene therapy, on the other hand, involves introducing healthy genes into cells to replace or repair damaged or diseased genes. This therapy has been used to treat genetic disorders such as sickle cell anemia and hemophilia.

While cell and gene therapy holds great potential, the development of these therapies is a complex and challenging process that requires extensive research and testing. One area where artificial intelligence (AI) can help is in the identification of potential targets for cell and gene therapy.

AI can analyze vast amounts of genetic data and identify patterns that might not be visible to human researchers. This information can then be used to identify potential targets for cell and gene therapy. For example, AI can identify the specific genes that cause disease or the cells that are most vulnerable to attack by the immune system.

Another way AI can help is by predicting the efficacy of a cell or gene therapy treatment. AI can analyze data from clinical trials to predict the outcomes of future trials. This information can then be used to improve the design of future trials and identify the patients who are most likely to benefit from the treatment.

AI can also help with the development of personalized cell and gene therapy. Personalized therapy involves tailoring the treatment to the individual patient’s genetic makeup. AI can analyze a patient’s genetic data and identify the specific genes that need to be targeted. This information can then be used to design a treatment that is personalized to the patient’s specific needs.

Cell and gene therapy holds great promise for the treatment of many types of diseases. However, the development of these therapies is a complex and challenging process that requires extensive research and testing. AI can play a crucial role in this process by identifying potential targets for therapy, predicting the efficacy of a treatment, and developing personalized therapy. As AI continues to improve, it is likely that it will become an even more valuable tool in the fight against the disease.

Who would benefit from cell and gene therapy?

Cell and gene therapy are innovative approaches to treating a wide range of diseases and conditions, which have the potential to provide significant benefits to patients. These therapies involve using genetically modified cells or genes to restore or enhance the normal functioning of the body’s cells or tissues, thus offering new opportunities for treating both rare and common diseases.

Cell therapy involves the transplantation of cells, typically stem cells or immune cells, to replace or regenerate damaged tissues. Gene therapy, on the other hand, involves the transfer of genes into cells to correct genetic defects or provide therapeutic effects. Both therapies can be used alone or in combination with each other or other treatments.

There are several diseases and conditions that could benefit from cell and gene therapy, including:

Cancer: Cell therapy has shown significant promise in treating certain types of cancer, such as leukemia and lymphoma. The use of CAR-T cells, which are genetically modified immune cells that can target cancer cells, has led to remarkable responses in patients with advanced cancer.
Genetic disorders: Gene therapy can potentially cure or treat genetic disorders caused by mutations in a single gene. For example, gene therapy has been used to treat inherited retinal diseases, such as Leber congenital amaurosis, which can cause blindness.
Neurological disorders: Cell therapy has shown potential in treating neurological disorders, such as Parkinson’s disease, spinal cord injury, and multiple sclerosis. Stem cells can be used to regenerate damaged or lost cells in the brain or spinal cord, while gene therapy can target specific genes involved in these diseases.
Cardiovascular diseases: Cell therapy has been used to repair damaged heart tissue in patients with heart failure or heart attacks. Stem cells can be used to regenerate new heart tissue or blood vessels, while gene therapy can target genes involved in heart function.
Immunodeficiency disorders: Gene therapy has been used to treat severe combined immunodeficiency (SCID), also known as “bubble boy” disease, by correcting the genetic defect that causes the condition. Cell therapy can also be used to boost the immune system by transplanting immune cells.
Autoimmune diseases: Cell therapy has shown potential in treating autoimmune diseases, such as rheumatoid arthritis and lupus. Immune cells can be modified to reduce inflammation or target the cells causing the disease.

In summary, cell and gene therapy offers exciting new opportunities for treating a wide range of diseases and conditions. While these therapies are still in the early stages of development, they hold great promise for improving the lives of patients and potentially even curing some diseases. People who suffer from the diseases and conditions mentioned above and other chronic diseases could benefit from cell and gene therapy, and it is important to continue to support and invest in this promising area of medicine.

Multiple Sclerosis

February 12, 2023 / Zena Maziak / 0 Comments

Multiple Sclerosis

Multiple Sclerosis (MS) is a chronic autoimmune disease that affects the central nervous system (CNS). The CNS consists of the brain and spinal cord, which play a crucial role in transmitting signals throughout the body. MS damages the protective covering (myelin) of nerve fibers in the CNS, leading to a range of symptoms that can range from mild to severe.

MS is one of the most common neurological disorders, affecting an estimated 2.3 million people worldwide. It is more prevalent in women than men, and typically begins to develop in young adulthood, between the ages of 20 and 40.

The exact cause of MS is still not known, but researchers believe that a combination of genetic and environmental factors contribute to its development. Some of these factors include a person’s geographic location, viral infections, and low levels of vitamin D.

MS can present in several different forms, each with its own unique symptoms and progression. Some of the most common forms of MS include:

Relapsing-Remitting MS (RRMS): This is the most common form of MS and is characterized by periods of symptoms (relapses) followed by remissions.
Secondary Progressive MS (SPMS): This form of MS typically begins as RRMS and gradually becomes more progressive over time, with symptoms becoming more severe and frequent.
Primary Progressive MS (PPMS): This form of MS is characterized by a gradual progression of symptoms from the onset, with no remissions.

Common symptoms of MS include:

Muscle weakness or spasms
Loss of balance or coordination
Vision problems
Numbness or tingling in the limbs
Fatigue
Speech difficulties
Bladder problems

Diagnosis of MS can be challenging, as its symptoms are similar to those of other conditions. A neurologist will typically perform a physical exam, review the patient’s medical history, and order tests such as magnetic resonance imaging (MRI) and cerebrospinal fluid analysis to help determine if MS is the cause of the symptoms.

Currently, there is no cure for MS, but there are several treatments available to help manage its symptoms and slow its progression. Some of the most commonly used treatments include:

Disease-Modifying Therapies (DMTs): These medications can slow the progression of MS and reduce the frequency and severity of relapses.
Steroids: These medications can be used to treat acute relapses and reduce inflammation.
Physical and Occupational Therapy: These therapies can help improve muscle strength, coordination, and overall quality of life.
Supportive Therapies: This includes medications to help manage specific symptoms, such as fatigue, spasticity, and bladder problems.

Living with MS can be challenging, but it is important for people with MS to maintain a healthy lifestyle, including regular physical activity, a balanced diet, and adequate sleep. They should also keep a close relationship with their healthcare provider, who can help monitor their condition and recommend appropriate treatments.

In conclusion, MS is a chronic autoimmune disease that affects the central nervous system, leading to a range of symptoms. While there is no cure for MS, there are several treatments available to help manage its symptoms and slow its progression. With proper care and support, people with MS can continue to live fulfilling and active lives.

#ms #multiplesclerosis #msrelapses #muscleweakness #spasms #mshugs #visionimpairment #opticalnerve #numbness #fatigue #speechimpendiment #bladderproblems

Lesions

February 12, 2023 / Zena Maziak / 0 Comments

Lesions

Lesions are abnormal changes in the tissue or structure of an organ or body part. They can be caused by various factors including injury, disease, or infection. Lesions can range in size and severity, from small and benign to large and life-threatening. In this article, we will explore the different types of lesions, causes, and treatments.

Types of Lesions

There are several types of lesions, including:

Macules: Flat, discolored patches of skin that are different in color or texture from than surrounding skin. Macules can be red, brown, or lighter than the surrounding skin.
Papules: Raised, solid bumps on the skin that are usually less than 1 cm in diameter. Papules can be red, brown, or skin-colored.
Nodules: Larger, solid bumps on the skin that are more than 1 cm in diameter. Nodules can be painful and can be red, brown, or skin-colored.
Plaques: Raised, flat-topped patches on the skin that are larger than 2 cm in diameter. Plaques can be red, brown, or skin-colored.
Vesicles: Small, fluid-filled blisters that are less than 1 cm in diameter. Vesicles can be red, and painful, and are often surrounded by red, inflamed skin.
Bullae: Larger, fluid-filled blisters that are more than 1 cm in diameter. Bullae can be red, and painful, and are often surrounded by red, inflamed skin.

Causes of Lesions

Lesions can be caused by a variety of factors, including:

Infections: Lesions can be caused by bacterial, viral, or fungal infections. Some examples include impetigo, chickenpox, and athlete’s foot.
Physical injuries: Lesions can be caused by cuts, bruises, burns, or other physical injuries.
Skin disorders: Lesions can be caused by skin disorders such as acne, eczema, psoriasis, and rosacea.
Autoimmune diseases: Lesions can be caused by autoimmune diseases such as lupus and rheumatoid arthritis.
Cancer: Lesions can be caused by skin cancer, including basal cell carcinoma, squamous cell carcinoma, and melanoma.

Treatment of Lesions

The treatment of lesions depends on the type, size, and cause of the lesion. Some common treatments include:

Antibiotics: Lesions caused by bacterial infections can be treated with antibiotics.
Topical creams: Lesions caused by skin disorders can be treated with topical creams, ointments, or gels.
Surgical removal: Lesions that are large or that are caused by skin cancer can be removed surgically.
Radiation therapy: Lesions that are caused by cancer can be treated with radiation therapy.
Cryotherapy: Lesions can be treated with cryotherapy, which involves freezing the lesion with liquid nitrogen.

In conclusion, lesions are abnormal changes in the tissue or structure of an organ or body part. They can be caused by various factors including injury, disease, or infection, and can range in size and severity. Treatment of lesions depends on the type, size, and cause of the lesion and can include antibiotics, topical creams, surgical removal, radiation therapy, or cryotherapy. If you have a lesion that is causing concern, it is important to consult a healthcare provider for proper diagnosis and treatment.

#lesions #brainlesions #spinelesions #mslesions #multiplesclerosis #ms #multiplesclerosislesions

Anxiety: Understanding and Coping with a Common Emotional Disorder

February 12, 2023 / Zena Maziak / 0 Comments

Anxiety: Understanding and Coping with a Common Emotional Disorder

Anxiety is a common emotional disorder that affects millions of people around the world.

It is characterized by feelings of worry, nervousness, and fear, and it can have a significant impact on an individual’s quality of life. Despite its prevalence, many people still do not understand what anxiety is, how it develops, and how it can be treated.

What is Anxiety?

Anxiety is a normal response to stress and danger. It prepares us to face a challenge or respond to an emergency by increasing our heart rate, sweating, and tensing our muscles. However, anxiety becomes a problem when it interferes with our daily activities and causes significant distress.

There are several types of anxiety disorders, including generalized anxiety disorder, panic disorder, social anxiety disorder, and specific phobias. Each type of anxiety disorder has unique symptoms, but all share the common theme of excessive, persistent worry and fear.

What Causes Anxiety?

The exact cause of anxiety is not well understood, but it is thought to be a combination of genetic, environmental, and psychological factors. People with a family history of anxiety are more likely to develop the disorder, and traumatic life events, such as abuse, neglect, or loss, can trigger anxiety symptoms. Additionally, chronic stress, substance abuse, and certain medical conditions can also contribute to the development of anxiety.

How to Manage Anxiety

Fortunately, anxiety is a treatable condition, and there are several effective strategies for managing its symptoms. Some of the most commonly used strategies include:

Cognitive-behavioral therapy (CBT): CBT is a type of therapy that helps individuals understand and change negative thoughts and behaviors that contribute to anxiety.
Medication: Antidepressant and anti-anxiety medications, such as selective serotonin reuptake inhibitors (SSRIs) and benzodiazepines, can be effective in reducing anxiety symptoms.
Exercise: Regular exercise has been shown to have a positive impact on anxiety by reducing stress and improving mood.
Relaxation techniques: Techniques such as deep breathing, progressive muscle relaxation, and mindfulness can help reduce physical symptoms of anxiety and promote a sense of calm.
Lifestyle changes: Simple lifestyle changes, such as getting enough sleep, eating a healthy diet, and reducing caffeine and alcohol consumption, can also help reduce anxiety symptoms.

How Anxiety Affects Me

From a personal perspective anxiety comes and goes. It is the fear of the unknown that can spiral into stress, panic attacks, depression, and procrastination. For example, bearing in mind it is a Sunday so you would not expect any businesses to call you today, yet I noticed a missed call. Not knowing who it was that was calling me, I withheld my number and proceeded to call the number back and I was put through to the DWP.

Update Monday 13th February 2023. I had another missed call today and this time they left a message that they will phone me between 11 -12 despite me telling the PIP assessor I am in University Mon, Tue & Fri. I did accept the call when they rang and they said they are increasing my PIP payments as they needed some more information about my mobility. So it looks like they work Sundays as well.

Stress & Anxiety impact on a sufferer of multiple sclerosis.

Considering I have voice mail activated you would think the person that was trying to reach me would leave a message, but unfortunately, they didn’t which has now made me feel anxious and on edge. Stress and anxiety can cause a person suffering from multiple sclerosis to relapse. Relapsing remitting MS (RRMS) | Multiple Sclerosis Society UK (mssociety.org.uk)

Fortunately, I have my mum as my rock and she tried reassuring me that they will write to you if they cannot get in touch and that I needn’t worry as she will take care of things for me.

Conclusion

Anxiety is a common and treatable emotional disorder through medication, CBT therapy, and hypnosis. It can have a significant impact on an individual’s quality of life. By understanding its causes and learning how to manage its symptoms, people with anxiety can take back control of their lives and improve their overall well-being. If you are experiencing symptoms of anxiety, it is important to seek help from a mental health professional who can provide an accurate diagnosis and develop an effective treatment plan.

#ms #msrelapses #dep #pip #persoanlindependancepayments #stress #wory #anxiety #panicattacks #procrastination

Personal Independence Payment (PIP) Telephone Assessment

January 5, 2023 / EDITOR / 1 Comment

Personal Independence Payment (PIP) Telephone Assessment

Written by the Editor Renata M Barnes.

Today my daughter had her PIP assessment over the phone. My daughter told me she had four reminder text messages saying that her phone call appointment was scheduled for 09.15 hrs yet the assessor phoned at 08.45 am and when my daughter did not pick up phoned again at 09.10 am (where is that 09.15 may I ask, did the assessor have cognitive impairment to not phone at the scheduled time)?

The assessor was made aware I was listening in as the call was on loudspeaker.

The duration of the call lasted one hour and ten minutes and in that time my daughter was asked the same questions which were on the questionnaire she submitted.

Breach of GDPR

The caller never said the call was being recorded even though by law they have to say. Furthermore, the assessor did not offer a copy of the call recording which means that the assessor may have been working from home or the call was not recorded at all.

My daughter suffers from Multiple Sclerosis which is a progressive disorder that there is no cure.

There is (HSCT) hematopoietic stem cell transplantation currently not available on the NHS, which aims to wipe out and regrow the immune system similar to Lemtrada Alemtuzumab treatment which my daughter had last year.

Sensitive Questions

The assessor asked the same questions as what was on the form but went into some very alarming questions, some of which were so sensitive that could have caused a trigger in mental health patients, like have you ever had any suicidal thoughts or wanting to self-harm.

No one should be in a position to answer such a question because:

It can cause a trigger and the person may not have had those thoughts before, but may now have a seed planted in their head to do it sometime in the future. When asking such a question you should not put those words directly into a person’s thoughts. It should be handled in a way of “how low do you feel on any given day” and “how do you feel when you are feeling low“? You should not say “have you had suicidal thoughts”? This is a TRIGGER. This type of questioning should only be done by a qualified professional, face-to-face (not over the phone).
Secondly, the person being interviewed may not be truthful if there are many people present. Perhaps the person may not want to admit those thoughts in front of their carer, parent, or a total stranger. Someone who is feeling low and that question is asked, could theoretically not tell the truth to the person asking, yet the option would be there in their minds. One should never plant a seed in someone’s head. Only a professional psychologist or psychotherapist would assess a person’s mental health, not a complete stranger.
The assessor should go by the medical evidence from the doctor’s reports and not ask these questions directly (by asking this question it is deemed as reversed psychology). Only a mental health professional should ask these questions. Talking about suicide is a taboo topic that is very sensitive, one needs to build trust between the person asking and the patient. People with suicidal thoughts may sometimes never admit to having them, so it is best to ask “how low a person is feeling” or “has ever felt” and open up a dialogue, rather than ask that question directly.

Further Reading:

https://lifehacker.com/how-to-plant-ideas-in-someones-mind-5715912

Does asking about suicide and related behaviors induce suicidal ideation? What is the evidence? https://pubmed.ncbi.nlm.nih.gov/24998511/

PIP assessor told claimant to ignore her ‘irrelevant’ suicide attempt… then challenged her son to a fight – Disability News Service

Degrading & Humiliating Questions

Asking the person if they can wipe their posterior is degrading especially when admitting if one can or can’t to a stranger.
What has that got to do with my daughter’s condition she is not in a wheelchair which was made clear at the beginning and is on her medical records. I understand that these questions may be asked but should be directed to the clinician and not the patient.

Work & Studying

PIP is a non-means tested benefit and when deciding a person’s eligibility for support their disability or condition and how it affects their life is taken into account. So what with the twenty questions such as “what is content marketing” etc? (what I have written now is called content).

When my daughter was asked how she gets to university she said she takes a taxi. I noticed a pause from the assessor. So unless she was thinking that would cost an arm and leg, don’t tell me because I already know that is why I help my daughter pay for transportation. So despite telling the assessor my daughter does not walk far, why in the next line of questioning does the assessor ask how far can she walk in terms of a length of a bus? (I thought these questions were not relevant and were no longer being asked).
When asked what work she does my daughter said marketing and how many hours per week. My daughter is the assistant editor of this website so she may work two hours one week or 16 hours the next. It depends on the assignments I give her. My daughter is not self-employed unlike myself. The assessor continued so what is my daughter’s role which she replied writing blog posts. Blog posts can take an hour or can take a whole day to do and it all depends on how many words are written and for what purpose. I have more than one website www.irenata.com I use a link wheel of websites to drive traffic from multiple directions. www.mrketingcardiff.com and www.ukcontentwriters.com to name a few.
My daughter then was asked a question if there was a fire at the university how long would it take her to get out of the building? (How would she know that if she has never had a fire evacuation? The assessor continued to say this was a hypothetical question. This is ridiculous as how would my daughter know where she was at any given point in a worst-case scenario if the lifts did not work it would take her longer? How long is a piece of string? She could be on the top floor. (So does that mean if you escape a fire you have no problem with mobility).

Stress

My daughter was never asked about her stress levels although she did mention the frustration of her disability. Stress and frustration can coincide together but they can also have different meanings. The assessor did not go into too much detail other than how my daughter remembers to take her medication and who feeds the cat (yes that was asked). https://disabledentrepreneur.uk/stress-cognitive-function/

Stress is a complicated disorder in itself. Stress can be prolonged whilst frustration is short-term. The stress of rewriting a blog post or assignment due to a lack of concentration or increased fatigue can cause frustration.

Medication

My daughter was asked what medication she was on and the one medication the assessor said and I quote “Hold on I need to Google it“, this is no word of a lie and I can prove this was said, just don’t ask me how.

Irrelevant Questions

. Who lives with you (why is that relevant)?
How many bedrooms have you got? (and the point is what)?
Who pays the bills?
How long have you done online grocery shopping?
So you have a cat, who feeds the cat, and why?

Pointless Questions!

Final Thoughts From the Editor

PIP – medical assessor recommends zero points – Finance and benefits – MS Society UK | Forum

I am really looking forward to my assessment because it will open a can of worms regarding the GP support I have not had.

My daughter’s call lasted over an hour, this is not going to happen with me as time is money and I already wasted one hour today listening in to a call that was pointless.

“The assessor insinuated because my daughter has a part-time job and is studying it may look like there is nothing wrong with her even though it is her physical well-being that is affected and not her mental health.

I did not think this should be used as a fit for work assessment, but more so as a health and well-being assessment and the prognosis of the ability to function from day to day.

I have disabilities but I still can work by managing my health in such a way it does not hinder me. It is the outside world I have a problem with, because of my OCD and social disconnection issues. However, if I was put in a situation where it was an emergency and had to leave my home, I would worry about the consequences of my disorder afterward. I have literally thrown away things I have not been able to salvage or disinfect. I am the happiest in my own company with my own surroundings.

I run several businesses online for my clients but that does not make me fit to work in the physical world. One should not draw conclusions about a person’s ability because from one day to the next the ability to function can be impaired.

For my own assessment, I have given them enough information, that I envisage my call will be halved. I most certainly will not answer questions like what my daughter was asked today, because they have enough evidence on file. I am not going to answer questions such as am I capable of wiping my own ar#e?

My daughter should have stated she documents her health online but for some reason omitted this. We will have to wait on the decision in 8 weeks’ time.

Multiple Sclerosis is an auto-immune disease that attacks healthy white cells. The lesions that can affect the brain and spinal cord can cause a wide range of potential symptoms, including problems with vision, arm or leg movement, sensation, or balance. It is an incurable disease with lifelong symptoms that can sometimes cause serious disability, although it can occasionally be mild. The average life expectancy is slightly reduced for people with MS and symptoms can be alleviated with different courses of treatments. In most cases, people get diagnosed in their 20s or 30s but it has been known that patients have shown symptoms as young as 15 years of age. In fact, it can develop at any age. It’s about 2 to 3 times more common in women than men.

MS is one of the most common causes of disability in younger adults.

https://www.nhs.uk/conditions/multiple-sclerosis/symptoms/

The most common symptoms include:

fatigue (discussed)
vision problems (semi-discussed)
numbness and tingling (discussed)
muscle spasms, stiffness, and weakness (ms hugs -discussed)
mobility problems (discussed)
pain (discussed)
problems with thinking, learning, and planning (not discussed)
depression and anxiety (stress, anxiety, semi-discussed)
sexual problems (other than contraception which was Googled by the assessor – Libido? not discussed)
bladder problems (not discussed)
bowel problems (not discussed)
speech and swallowing difficulties (not discussed)
relapses due to temperature, either too hot or too cold (and cost of living price rises –not discussed)
cognitive impairment (concentration, balance, losing grip in hands – not discussed)

Other than fatigue, vision, numbness, and pain nothing else was discussed in the above list or the fact that stress and anxiety can cause MS relapses.

So why is the government somehow wanting people with disabilities to jump through hoops (quite literally) to prove they are disabled when their medical records should suffice?

I would have put a stop to the questioning and said so what do you know about multiple sclerosis or in my case OCD & cerebellar atrophy. Secondly, I would have said… so I gave you access to my medical records but clearly, you have not read them.

I reckon these assessors have to do something to sift through the scammers in this world, but the people that genuinely need help, are made to feel belittled, degraded, and inadequate just to get the extra bit of help.

Further Reading

PIP assessor walked out! – Benefits and Work Forum

Pip assessor has lied – Benefits and Work Forum

PIP Assessors Get £50 Bonuses For Meeting Targets Says Whistleblower | Same Difference (samedifference1.com)

PIP investigation: ‘Lie after lie after lie’ – Disability News Service

Fury As Nurses Offered Private Healthcare Perk To Become DWP Benefits Assessors | HuffPost UK News (huffingtonpost.co.uk)

‘Humiliating’ PIP Assessments Being Held At Luxury Spa Owned By Millionaire Duncan Bannatyne | HuffPost UK News (huffingtonpost.co.uk)

MS Relapses

With multiple sclerosis, the weather plays an important factor and people suffering from MS can relapse when the weather is too hot or too cold.

MS and Cold Weather: Are MS Symptoms Worse During Winter Months? (webmd.com)

Cold Weather and MS Symptoms: Effects and How to Cope (verywellhealth.com)

Therefore with the rise in the cost of living and keeping one’s home warm the extra bit of money helps. Yet this was not discussed, which tells me the assessor had no knowledge of Multiple Sclerosis.

The assessor said I quote so you are making an effort to work and let the disability stop you, sorry I am not being patronized even though it came across that way.

I did want to put my two penneth in, but I figured that it was best to keep my mouth shut and see what happens when the decision is made for my daughter.

The Assessor

The assessor should have:

Stuck to the given scheduled time and not rang half an hour earlier.
Said if the call was being recorded or not and asked the interviewee if they wanted a copy of the call recording.
The assessor should have also introduced herself properly (which she did not) and said what she was qualified in (which again she didn’t).
The assessor should have acknowledged the other person listening to the call but chose to ignore them (which was deemed unprofessional).
The assessor should not ask extremely sensitive questions to cause a trigger.
The assessor should have gone by the medical records to gain all the information she needed without humiliating the interviewee.
The assessor should not have asked irrelevant questions such as who feeds the cat and why?
The assessor should not have spoken about her own health issues as that is unprofessional.
Asked how long the household did online shopping (how is that relevant to the claimant when we were in lockdown which had nothing to do with the claimant’s illness).
Asked to explain what content was in my daughter’s job role.

As for me, let the circus begin, I can’t wait!

#personalindependencepayments #pip #pipassessment #pipassessor #multiplesclerosis #ms #humiliation #suicidalthoughts #triggers #telphoneassessments #callrecordings #gdpr

A Trainee Phlebotomist Caused a Hematoma

Hematoma: Understanding the Bruising Beneath the Skin

Defining Hematoma

The Mechanism of Hematoma Formation

Types of Hematomas

Treatment and Management

Treatment options may include:

Medical Negligence: A Trainee Phlebotomist Caused A Hematoma

Minimizing the Risk of Hematomas in Phlebotomy:

To reduce the risk of hematoma formation during blood collection, trainee phlebotomists should follow these best practices:

Understanding the Risks of Thrombotic Thrombocytopenic Purpura (TTP) and Hematoma

Thrombotic Thrombocytopenic Purpura (TTP):

Risks of TTP:

Risks of Hematoma:

The Connection Between TTP and Hematoma:

Immune Thrombocytopenia (ITP)

The symptoms of ITP can vary from mild to severe and may include:

Both ITP (Immune Thrombocytopenia) and hematomas involve issues related to blood clotting and can carry certain risks:

Risks of ITP (Immune Thrombocytopenia):

Personal Experience

Conclusion

What should a patient do if a trainee phlebotomist causes a hematoma in high-risk patients who are susceptible to ITP having blood tests because of Lemtrada alemtuzumab treatment?

Photographic Evidence

Further Reading

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The Link Between Multiple Sclerosis & Cerebellar Atrophy

Understanding Multiple Sclerosis

The Cerebellum and Its Role

The Link between MS and Cerebellar Atrophy

Symptoms of Cerebellar Atrophy in MS Patients

Implications and Treatment

Conclusion

Further Reading

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The Impact of Stonewalling Patients: Communication Breakdown in Healthcare

Conclusion:

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What are Serum Biobanks?

Unlocking the Power of Discovery: Exploring Serum Biobanks

Introduction

What are Serum Biobanks?

Significance in Medical Research

How can Serum Bio Banks help people with multiple sclerosis

Leveraging Serum Bio Banks to Empower Individuals with Multiple Sclerosis

Professor Neil Roberson’s Groundbreaking Parallel Biobank: Revolutionizing Precision Medicine Research

Ethical Considerations and Data Security.

Challenges and Ethical Considerations

Conclusion

Further Reading:

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Nitrous Oxide (NO) Balloons & Multiple Sclerosis – 30 seconds being high to a lifetime of MS.

Laughing Gas (Nitrous Oxide) or Balloons

Editors Thoughts:

“If more was done about teaching the masses the repercussions of taking drugs, more people will be inclined to think twice”.

What is Nitrous Oxide

What Is Nitrous Oxide Used For

Can the use of nitrous oxide can multiple sclerosis

Conclusion:

Further Reading:

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We can write similar articles and share them on social

What Is Cell & Gene Therapy AI?

Who would benefit from cell and gene therapy?

Further Reading

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Multiple Sclerosis

Lesions

Types of Lesions

There are several types of lesions, including:

Causes of Lesions

Treatment of Lesions

Anxiety: Understanding and Coping with a Common Emotional Disorder

What is Anxiety?

What Causes Anxiety?

How to Manage Anxiety

How Anxiety Affects Me

Stress & Anxiety impact on a sufferer of multiple sclerosis.

Conclusion

Personal Independence Payment (PIP) Telephone Assessment