In this pilot-project eight women with multiple sclerosis (MS), four Continence Nurse Advisers (CNAs) and one researcher formed a participatory action research (PAR) group. Ten group sessions were held in 1997. The CNAs found that 80 of their referrals for continence management were women with MS and they wanted to explore the way in which women manage their incontinence. Although the group was brought together to discuss incontinence, other emergent themes were raised by the women. These themes were: women's ad hoc experience with community services, their problems concerning access to toilets for the disabled, concern with health professionals' lack of knowledge about MS, their formidable experiences of hospitalisation and respite care admissions, their individual efforts in maintaining wellness in the context of chronic illness and the effect of MS on sexual relationships.Read more
During the tail-end of an active cluster several environmental investigations indicated that wildbirds were very probably the vectors of the unknown exogenous agent of MS. Canine distemper and genetic-autoimmune theories were very definitely eliminated because of the unusual pattern of the cluster. Studies of several avian pathogens unveiled Marek's (MDV) and/or IBD (Gumboro) as the most likely candidates for exogenous agent of MS.Read more
Family and population studies have shown the existence of genetic susceptibility to have multiple sclerosis (MS). The genes of the HLA system have been the only genetic markers for this tendency to have been confirmed in multiple studies in different countries. A relation has also been found between certain HLA genes and the clinical course or paraclinical parameters of MS.
In this article we first analyze the structure, function, typing and association of illnesses with the HLA system and their relation with MS. Subsequently we review the articles published or reported on the HLA-MS association in the Spanish population.
MS is generally associated with the DR15/DQ6 haplotype (subtypes of DR2/DQ1) in the Spanish population. There may be minor ethnic differences in some regions which explain other associations found. Although the Spanish studies on the association of HLA with clinical and paraclinical factors of MS require confirmation in samples with larger number of patients, the primarily progressive forms and those with a worse prognosis tend to be associated with DR4 and the benign forms with DR2. The DRw 13 (DR6) seems to be a protective allele. The presence of DR2 may be a marker for the development of MS after an optic neuritis.Read more