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MSWA Bulletin Magazine Summer 2019

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RESEARCH The findings

RESEARCH The findings suggested that physical activity in childhoodadolescence could be a contributor to cognitive reserve building, thus representing potential protective factors for MS-related CI susceptible to preventive strategies. The study also reviewed the influence of smoking, BMI, alcohol and caffeine. In MS, physical exercise may be protective against the development of cognitive dysfunction and exert a synergistic effect together with cognitive rehabilitation in patients with established CI. Is secondary progressive MS going to affect my life expectancy? Receiving a diagnosis of MS, a progressive neurological disorder, can be frightening. People often ask what does this mean for me? Will my life expectancy be affected? Life expectancy is a ’best guess’ of how long people will live, based on their date of birth, where they live, gender, and other considerations. It doesn’t refer to individuals, but the population. Currently data indicates the average life expectancy for MS patients is shortened by five to 10 years compared to people without MS. In the United States, the average life expectancy is 81 years for women and 76 years for men. However, most experts think that early diagnosis and new advances in treatments mean that this gap is narrowing. How does MS change life expectancy? This depends on several factors, including for example, susceptibility to chest and bladder infections which can be life-threatening if not treated properly. Currently it’s unclear why RRMS sometimes transitions to SPMS. But the gradual progression of symptoms means that patients need to keep a closer eye on their health. They will no longer have periods of remission as before, and many will experience a loss of mobility, which can increase the risk of injury and further lower life expectancy. FROM THE ANNALS OF INTERNAL MEDICINE Full articles are available at https://annals.org Red and processed meat consumption and risk for all-cause mortality and cardiometabolic outcomes; a systematic review and meta-analysis of cohort studies This study sought to evaluate the association between red and processed meat consumption and all-cause mortality, quality of life (QOL) and diet satisfaction in adults. The researchers reviewed cohort studies of a minimum of 1000 participants. They reviewed 55 cohorts with more than four million participants; none addressed QOL or diet satisfaction. Findings: The magnitude of association between red and processed meat consumption and all-cause mortality and adverse cardiometabolic outcomes is very small and has low-certainty evidence. Comments: Current dietary guidelines recommend limiting red and processed meat consumption. These results, however, demonstrate that the evidence implicating red and processed meat in adverse cardiometabolic outcomes is of low quality; thus, considerable uncertainty remains regarding a causal relationship. Moreover, even if a causal relationship exists, the magnitude of association between red and processed meat consumption and cardiometabolic outcomes is very small. FROM AN ECTRIMS 2019 Review on Researchreview.com.au Continuation of natalizumab versus interruption is associated with lower risk of relapses during pregnancy and postpartum in women with MS. Landi D et al. This small Italian study evaluated the continuation of natalizumab (Tysabri) treatment in pregnant women with MS, to minimise relapses during pregnancy and postpartum. Eighty-six pregnant women with MS in 19 Italian MS centres were divided into three groups according to time of last infusion of natalizumab; Group 0 = before last menstrual period; Group 1 = within the first trimester of pregnancy; Group 2 = beyond the first trimester. Mean gestational age and birthweight of newborns didn’t differ significantly between groups. Five Group 2 newborns had anaemia (three were premature), and one Group 0 newborn, four Group 1 newborns, and three Group 2 newborns had malformations. Comment: Washout of natalizumab in women with MS planning pregnancy brings with a risk of significant MS reactivation. This small Italian study involving 19 centres, collected data from 86 female patients (90 pregnancies) who either continued natalizumab until prior to their last menstrual period, until the first trimester of pregnancy, or who continued treatment beyond the first trimester of pregnancy. Although the study had small numbers and was underpowered to comment definitively, continuation of natalizumab beyond conception reduces the risk of relapse during pregnancy, compared to washout or treatment interruption. It was not associated with major foetal risks, with self-resolving neonatal anaemia being the commonest adverse event (seen in five neonates) in those mothers treated throughout pregnancy. 10

ACCOMMODATION & OUTREACH BUTLER NOW OFFICIALLY OPEN The team at MSWA was proud to officially open our new m Services Centre and Supported Accommodation facility for people in Butler and surrounding areas living with neurological conditions. Manager of Accommodation Claudia Taylor said it was a pleasure to celebrate this great new facility. “Even though we had been open a little while already, it was wonderful to be able to thank everyone involved in making it such a success and to celebrate us becoming part of the community,” said Claudia. “We already feel at home in Butler and that our hard work is making a positive impact on the lives of many with a neurological condition.” The opening in October was attended by Disability Services Minister, Hon Stephen Dawson MLA; MSWA President George Pampacos; and MSWA CEO, Marcus Stafford AM. “The number of people using our high-support accommodation facilities has significantly increased and it’s important that we can continue increasing our footprint to enable us to provide support and services for people experiencing the effects of disability,” said Mr Stafford. “With its state-of-the-art facilities and passionate staff, Butler will be a valued asset for the local people living with a neurological condition for years to come.” Butler provides a range of services including physiotherapy, occupational therapy, nursing, speech pathology, dietetics, counselling, social welfare services and peer group sessions. To cater for 10 of MSWA’s highsupport Customers, 24-hour 7-day a week care is also offered as an option for those who can no longer stay in their own home. Kate Gild, diagnosed with MS when she was 33 years old, loves her new home at Butler. “Before the move, I was living in Treendale for almost three years and my life was fine but it was just so far away from my friends and family,” Kate said. “It makes me appreciate the simple things like having friends over for a coffee or going to my parents’ house which has proved difficult whilst living regionally. The on-site care and support allows me to lead a fulfilling and independent life – I can take myself to physiotherapy sessions or go grocery shopping and I can’t begin to tell you what that means to me.” Currently, MSWA has 14 facilities across Western Australia, with ambitious plans to increase that to more than 20 within the next few years. Brian Dawson and Kate Gild at their home in Butler. Please visit mswa.org.au/butler to find out more. 11