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MS Care of CT News

New Siemens Avanto 1.5 Tesla MRI system

Jan 04, 2007

 New Siemens Avanto 1.5 Tesla MRI system fully operational. Brings advanced imaging capabilities to MS patients in Connecticut.


Derek Smith, MD

Jan 01, 2007

Derek Smith, MD becomes full member of Neurology Associates, LLC.


"Update on MS"

Dec 19, 2006

Derek Smith, MD presents "Update on MS" to medical staff at William Backus Hospital.


MS Care of Connecticut Clinical Center

Nov 15, 2006

Construction begins on new MS Care of Connecticut Clinical Center.


Clinical Assistant Professor of Neurology at Harvard University

Oct 16, 2006

Derek Smith, MD, Director MS Care of Connecticut appointed to new three year term as Clinical Assistant Professor of Neurology at Harvard University.


NIH Blue Ribbon Panel

Sep 11, 2006

Derek Smith, MD, Director Of MS Care of Connecticut participates on NIH Blue Ribbon Panel to advise NIAID on influenza strategic resource allocation.


Tysabri Infusions

Sep 05, 2006

First Tysabri infusions are adminstered at MS Care of Connecticut.


New MRI Scanner

Aug 28, 2006

State of Connecticut's Office of Health Care Access approves Certificate of need for new MRI Scanner for MS Care of Connecticut.

Read more at http://www.ct.gov/ohca/lib/ohca/condecisions/06-30674-con.pdf


MS Care of Connecticut

Jul 25, 2006

MS Care of Connecticut is certified as a Tysabri prescribing and Infusion site.


Replacement MRI

Jul 20, 2006

MS Care of Connecticut appears before Commissioner of OHCA to request a replacement MRI.


Clinical Assistant Professor of Neurology at Harvard University

Jun 29, 2006

Derek Smith, MD, Director MS Care of Connecticut appointed to new three year term as Clinical Assistant Professor of Neurology at Harvard University.


MS Support Group

Mar 30, 2006

First MS Support Group meets at MS Care of Connecticut. Meetings will be held the last Thursday of each month.


Nurse Coordinator

Mar 15, 2006

Kristin Watson, LPN begins as Nurse Coordinator for MS Care of Connecticut. She will help coordinate the care services as well as provide training and injection services to MS patients. Welcome!


Tysabri

Mar 08, 2006

FDA Advisory Panel votes unanimously to return Tysabri to market for treatment of relapsing forms of MS.


Neurology Grand Rounds at University Of Connecticut

Jan 26, 2006

Derek Smith, MD, Clinical Assistant Professor, Harvard Medical School, delivers Neurology Grand Rounds at University Of Connecticut, Hartford Hospital.


Western Institutional Review Board approves Dose Comparison Trial of IFN-B1a to determine effects upon Endocrine Function, with Derek Smith, MD as Principal Investigator

Jan 05, 2006

Protocol Title:

Effects of IFN-B1a treatment of MS upon steroid hormone production



Protocol short title/ identifier:

IFN-B1a effects on steroids



Rationale:

In vitro and animal studies have consistently demonstrated that a wide array of steroid hormones can dramatically influence immune responses. MS is twice as prevalent in women versus men and it is generally thought that this relates to differences in the hormonal mileu which is mainly determined by production of various steroids. Specifically, estradiol has been proposed as an enhancer of cell-mediated immunity, while a male hormone DHEA may inhibit cell mediated immune function (2,5). Moreover, reports suggest that estriol may confer protection from MS attacks during pregnancy (1,3). Because these hormones appear to be important in regulation of immune responses regardless of gender, they will be measured in both men and women. Glucocorticoids have been a mainstay in the treatment of human autoimmune diseases for decades, and other steroid hormones are now either under investigation or in early phase clinical trials. B-IFN's cause a pronounced reduction in inflammation in RRMS. While many IFN early effects are understood, their precise mechanism of action in MS remains poorly defined. The effects on steroid hormone production are unknown and it is possible that such an effect could be central to the mechanism of action in MS. Gd+ and CU lesions on MRI will be used as a surrogate marker of disease activity in this study and will be measured at each dose. Because there is a several month delay before a course of IFN-B1a achieves its peak effect on new lesion formation, MRI's will be performed at months 3 and 12.



Objectives:

Primary:

To screen for effects of IFN-B1a treatment on steroid production



Secondary:

To find correlations between these effects and MS MRI activity



Subjects and Centers:

This would be a single center pre versus post treatment study which would enroll 12 women and 12 men



Inclusion/Exclusion Criteria:

RRMS patients not previously treated with IFN's would be enrolled. Patients with a history of depression or an endocrine dysfunction or disease would be excluded. Women on oral contraceptives, planning to become pregnant, or post-menopausal would be excluded.



Other Therapy:

NA



Study Design:

Patients will have baseline MRI and steroid measures performed at predefined timepoints. These will be repeated at 1 month , and at 12 months. Study duration will be one year.



Efficacy Measures:

Serum FSH*, LH*, PRL, ACTH, TSH, estradiol*, DHEA, DHEAS, testosterone, pregenenediol*, androstenedione,Vit D3, 24 hour urine cortisol (*to be measured on day 4 and mid-luteal in women) Brain MRI with gad, CU lesions, EDSS with FSS's, VAS for fatigue, stress All of the above will be measured at baseline, 3, 7, and 12 months



Safety:

It is not anticipated that there will be any safety concerns beyond those of standard practice



Decision Points/Statistical methods/Interim analysis:

This is a pilot study designed to screen for potentially interesting results. Any post-treatment result which shows a difference from baseline with p<0.05 by Student's T test would then be pursued in a follow-on study. All available data will be evaluated.


Comprehensive MS Center

Dec 30, 2005

National MS Society recognizes MS Care of Connecticut as an affiliated Comprehensive MS Center.


New MS Care of Connecticut Clinical Center

Nov 15, 2005

Construction plans approved for new MS Care of Connecticut Clinical Center.


National Foundation of Neuroscience announces intent to fund study of Steroid Hormone levels in Beta-Interferon treated MS Patients at MS Care of Connecticut in cooperation with Prof. Andrew Herzog, Harvard Medical School.

Oct 17, 2005

Protocol Title:

Effects of IFN-B1a treatment of MS upon steroid hormone production



Protocol short title/ identifier:

IFN-B1a effects on steroids



Rationale:

In vitro and animal studies have consistently demonstrated that a wide array of steroid hormones can dramatically influence immune responses. MS is twice as prevalent in women versus men and it is generally thought that this relates to differences in the hormonal mileu which is mainly determined by production of various steroids. Specifically, estradiol has been proposed as an enhancer of cell-mediated immunity, while a male hormone DHEA may inhibit cell mediated immune function (2,5). Moreover, reports suggest that estriol may confer protection from MS attacks during pregnancy (1,3). Because these hormones appear to be important in regulation of immune responses regardless of gender, they will be measured in both men and women. Glucocorticoids have been a mainstay in the treatment of human autoimmune diseases for decades, and other steroid hormones are now either under investigation or in early phase clinical trials. B-IFN's cause a pronounced reduction in inflammation in RRMS. While many IFN early effects are understood, their precise mechanism of action in MS remains poorly defined. The effects on steroid hormone production are unknown and it is possible that such an effect could be central to the mechanism of action in MS. Gd+ and CU lesions on MRI will be used as a surrogate marker of disease activity in this study and will be measured at each dose. Because there is a several month delay before a course of IFN-B1a achieves its peak effect on new lesion formation, MRI's will be performed at months 3 and 12.



Objectives:

Primary:

To screen for effects of IFN-B1a treatment on steroid production



Secondary:

To find correlations between these effects and MS MRI activity



Subjects and Centers:

This would be a single center pre versus post treatment study which would enroll 12 women and 12 men



Inclusion/Exclusion Criteria:

RRMS patients not previously treated with IFN's would be enrolled. Patients with a history of depression or an endocrine dysfunction or disease would be excluded. Women on oral contraceptives, planning to become pregnant, or post-menopausal would be excluded.



Other Therapy:

NA



Study Design:

Patients will have baseline MRI and steroid measures performed at predefined timepoints. These will be repeated at 1 month , and at 12 months. Study duration will be one year.



Efficacy Measures:

Serum FSH*, LH*, PRL, ACTH, TSH, estradiol*, DHEA, DHEAS, testosterone, pregenenediol*, androstenedione,Vit D3, 24 hour urine cortisol (*to be measured on day 4 and mid-luteal in women) Brain MRI with gad, CU lesions, EDSS with FSS's, VAS for fatigue, stress All of the above will be measured at baseline, 3, 7, and 12 months



Safety:

It is not anticipated that there will be any safety concerns beyond those of standard practice



Decision Points/Statistical methods/Interim analysis:

This is a pilot study designed to screen for potentially interesting results. Any post-treatment result which shows a difference from baseline with p<0.05 by Student's T test would then be pursued in a follow-on study. All available data will be evaluated.


Counseling Services

Oct 14, 2005

Clinical Social Workers, Liz MacAdie and Beth Avery, begin counseling services as part of MS Care of Connecticut.


Infusion Service is Launched

Oct 13, 2005

Infusion Service is launched under direction of Derek Smith, MD and Lisa Basinet, RN at MS Care of Connecticut.


Psychological Counseling Services

Oct 01, 2005

Central Connecticut Chapter of NMSS gives preliminary approval to funding of Psychological Counseling Services at MS Care of Connecticut.


Smoking Cessation Study

Sep 27, 2005

MS Care of Connecticut to participate in study of smoking cessation in cooperation with School of Public Health at Brown University.


MS at Patient Program

Sep 24, 2005

Derek Smith, MD discusses MS at patient program at Mohegan Sun with Peter Wade, MD and TV Personality Sue Thomas. Over 250 attend.


Consortium of Multiple Sclerosis Centers

Aug 15, 2005

Consortium of Multiple Sclerosis Centers recognizes MS Care of Connecticut as a member center.


Full-time clinical services

Jul 18, 2005

Derek Smith, MD begins full-time clinical services at MS Care of Connecticut.


Derek Smith, MD, Assistant Professor at Harvard Medical School announces plans to build MS Care of Connecticut at Neurology Associates of Norwich in MS Connection newsletter

Jul 10, 2005

How did plans for developing a comprehensive MS center in Connecticut begin?



Because many MS patients were already getting their care at Neurology Associates in Norwich, Connecticut, many elements of an MS center are already in place. In addition, we have a rehabilitation facility that is located in the same building. We plan to include a social worker as part of the team as well. We will have a dedicated infusion area, where patients can interact with MS center providers as well as other MS patients - an important component as we move toward more intravenous treatments in MS. There is also an on-site MRI scanner and radiologist. MRI is an important component of diagnosis, but is also integral to the ongoing management of MS. At our MRI facility we will also be conducting cutting-edge MRI measures, such as quantitative atrophy assessments, which are most relevant to quantifying cognitive and physical disability in MS. There are very few other MS Centers in the country doing these measures as yet.



While the primary focus will always be on patient care, it is our hope to build MS Care of Connecticut into a first-rate facility, that in addition to serving the needs of our patients, can also conduct and support clinical research in the search for a cause, new treatments, and a cure for MS.



With approximately 6,000 state residents living with MS, it is important to spearhead the development of a comprehensive MS center in Connecticut. Most individuals with MS won’t need all of the services we will be organizing, but individuals with more complex cases do. For other patients and doctors our goal will be to fill the gaps in their care and act as a resource for certain services. Our goal is to ensure that Connecticut residents have easy access to comprehensive MS care.



What is a comprehensive MS center and what is its purpose?



Because multiple sclerosis (MS) can affect so many different parts of the central nervous system, it can potentially cause problems with almost any part of our mind or body. Frequently, individuals with MS are affected by more than one symptom of the disease. This can make coping with MS difficult for many people; and requires extra care from physicians to ensure that we are addressing all of the needs of our patients. The diversity of MS symptoms can require many different medical, psychological and social approaches in order to adequately address each issue. Unfortunately, that task is often too much for any one medical professional to provide. It was for this reason that the concept of a comprehensive MS center was developed.



A comprehensive MS center has a core group of providers who can enlist the support of additional specialists as needed. This core group includes a neurologist, who establishes patient diagnosis and guides the treatment plan. Some MS centers are managed by a physiatrist or rehabilitation doctor. Other key team members include a nurse or medical assistant, who can provide more day-to-day support and contact for the patient; and a social worker or case manager, who helps people with MS manage their home and work situations. Ideally, an MS center would also encompass the resources of rehabilitative personnel, including physical, occupational and speech therapists. Because cognitive problems and depression are also common in MS, a psychiatrist and neuropsychologist would be important professionals to include in an MS Center. Beyond this core group, many other specialists should be available such as urologists, ophthalmologists and pain specialists. Finally, many patients are interested in alternative and holistic approaches to their MS. For an MS center to be truly comprehensive, we need to have the ability to provide guidance regarding these therapeutic modalities as well.



An important feature of a well-functioning MS center is that members of the team meet on a regular basis to discuss patients. This way, care can be carefully coordinated for each patient we serve.



To learn more about MS Care of Connecticut, please call 860.886.1433 or email at info@mscarect.org.