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OVERCOMING MULTIPLE SCLEROSIS HANDBOOK

ROADMAP TO GOOD HEALTH

EDITED BY GEORGE JELINEK MD SANDRA NEATE FACEM AND MICHELLE ODONOGHUE MD MPH



 

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First published by Allen & Unwin, Australia, 2022 in the English Language.

This edition published by arrangement with Allen & Unwin and Synopsis Literary Agency



Copyright  George Jelinek, Sandra Neate and Michelle ODonoghue, 2023

    , .  -, 2023




   


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1.MS on the rise in Australia but still fyl ing under our radar, MS Research Australia, 1 May 2018, https://msra.org.au/news/ms-rise-australia-still-fyl ing-radar/, accessed 19 April 2021.

2.Culpepper, W. J., Marrie, R. A., Langer-Gould, A. et al., Validation of an algorithm for identifying MS cases in administrative health claims databases, Neurology, 2019, 92 (10).

3.Andravizou, A., Dardiotis, E., Artemiadis, A. et al., Brain atrophy in multiple sclerosis: Mechanisms, clinical relevance and treatment options, Autoimmune Highlights, 2019, 10 (7).

4.Kappos, L., Wolinsky, J. S., Giovannoni, G. et al., Contribution of relapse-independent progression vs relapse-associated worsening to overall confirmed disability accumulation in typical relapsing multiple sclerosis in a pooled analysis of 2 randomized clinical trials, JAMA Neurology, 2020, 77 (9): 19.

5.Siva, A., Asymptomatic MS, Clinical Neurology and Neurosurgery, 2013, 115, Suppl 1: S1S5.

6.University of California, San Francisco MS-EPIC Team: Cree, B. A.C., Gourraud, P. A., Oksenberg, J. R. et al., Long-term evolution of multiple sclerosis disability in the treatment era, Annals of Neurology, 2016, 80 (4): 499510.

7.Miller, D.H., Hornabrook, R.W. & Purdie, G., The natural history of multiple sclerosis: A regional study with some longitudinal data, Journal of Neurology, Neurosurgery and Psychiatry, 1992, 55: 341346.

8.Beiki, O., Frumento, P., Bottai, M., Manouchehrinia, A. & Hillert, J., Changes in the risk of reaching multiple sclerosis disability milestones in recent decades: A nationwide population-based cohort study in Sweden, JAMA Neurology, 2019; 76 (6): 665671.

9.Jongen, P. J., Ter Horst, A. T. & Brands, A. M., Cognitive impairment in multiple sclerosis, Minerva Medica, 2012, 103 (2): 7396.

10.Willis, S. N. & Stathopoulos, P., Investigating the antigen specificity of multiple sclerosis central nervous system-derived immunoglobulins, Frontiers in Immunology, 2015, 6: 600.

11.Frischer, J. M., Weigand, S. D., Guo, Y. et al., Clinical and pathological insights into the dynamic nature of the white matter multiple sclerosis plaque, Annals of Neurology, 2015, 78 (5): 710721.

12.Absinta, M., Lassmann, H. & Trapp, B. D., Mechanisms underlying progression in multiple sclerosis, Current Opinion in Neurology, 2020, 33 (3): 277285.

13.Alcina, A., Abad-Grau, M. & Fedetz, M., Multiple sclerosis risk variant HLA-DRB1*1501 associates with high expression of DRB1 gene in different human populations, PLoS One, 2012, 7 (1): e29819.

14.McDonnell, G. V., Mawhinney, H., Graham, C. A., Hawkins, S. A. & Middleton, D. A study of the HLA-DR region in clinical subgroups of multiple sclerosis and its influence on prognosis, Journal of the Neurological Sciences, 1999, 165 (1): 7783.

15.Williams, A., Eldridge, R., McFarland, H., Houf,f S., Krebs, H. & McFarlin, D., Multiple sclerosis in twins, Neurology, 1980, 30 (11): 11391147.

16.Sladek, T., The MS mystery in Syracuse: Why do we have highest rate of multiple sclerosis nationwide?, 5 November 2019, CNY Central, https://cnycentral.com/news/local/the-ms-mystery-in-syracuse-why-do-we-have-highest-rate-of-multiple-sclerosis-nationwide, accessed July 2020.

17.Correa-D?az, E. P. & Ortiz, M. A., Prevalence of multiple sclerosis in Cuenca, Ecuador, Multiple Sclerosis Journal  Experimental, transnational and clinical, 2019, 5 (4).

18.Zambrano, A. K. & Gaviria, A., The three-hybrid genetic composition of an Ecuadorian population using AIMs-InDels compared with autosomes, mitochondrial DNA and Y chromosome data, Scientific Reports, 2019, 9, 9247.

19.Langer-Gould, A., Brara, S. M., Beaber, B. E. & Zhang, J. L., Incidence of multiple sclerosis in multiple racial and ethnic groups, Neurology, 2013, 80 (19): 17341739.

20.Smatti, M. K., Al-Sadeq, D. W. & Ali, N. H. et al., Epstein-Barr Virus epidemiology, serology, and genetic variability of LMP-1 oncogene among healthy population: An update, Frontiers in Oncology




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   .

   ,     (https://www.litres.ru/book/dzhordzh-yelinek/pogovorim-o-rasseyannom-skleroze-sem-shagov-k-preodoleniu-70109893/chitat-onlayn/)  .

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notes








1


Jelinek, George. Overcoming Multiple Sclerosis: The Evidence-Based 7 Step Recovery Program. 1ed. ReadHowYouWant, 2010; 2ed. Allen & Unwin, 2016.       . . .




2


 . NEDA  no evidence of disease activity. . .




3


    : Swank, Roy Laver, Barbara Brewer Dugan. The Multiple Sclerosis Diet Book: A Low-Fat Diet for the Treatment of M. S. Revised and Expanded Edition, Doubleday, 1987. . .




4


   Twitter.com          24.02.2022. . .




5


  . . .




6


Jelinek, George, Karen Law. Recovering from Multiple Sclerosis: Real Life Stories of Hope and Inspiration. Allen & Unwin, 2013. . .




7


Jack McNulty, Ingrid Adelsberger, George Jelinek. Overcoming Multiple Sclerosis Cookbook: Delicious Recipes for Living Well With a Low Saturated Fat Diet. Allen & Unwin, 2017. . .




8


   . . .




9


,  ,       . . . .


