Background: The strong association of multiple sclerosis (MS) and Epstein-Barr virus (EBV) infection raises the question whether there might be EBV seronegative patients with MS at all. Objective: To determine the rate of EBV seronegativity in a large and well-characterized cohort of patients with a clinically isolated syndrome (CIS) or early relapsing-remitting (RR)MS. Methods: Epstein-Barr nuclear antigen-1 (EBNA-1) antibodies were measured by a chemiluminescent assay (CLIA) in serum samples of 901 patients (median [interquartile range] age 33 [27-41] years, 69.9% females) with a CIS (n = 380) or early RRMS (n = 521) from the German National MS cohort. In EBNA-1 antibody seronegative patients, antibodies to the EBV viral capsid antigen (VCA) were measured by CLIA. EBNA-1 and VCA antibody double seronegative patients were analysed by an EBV immunoblot. Results: Antibodies to EBNA-1 were detected in 839 of 901 patients with CIS/RRMS. Of the 62 EBNA-1 antibody seronegative patients, 45 had antibodies to VCA. Of the 17 remaining patients, all had antibodies to EBV as detected by EBV immunoblot. Thus, all 901 (100%) patients with CIS/RRMS investigated in this study were EBV seropositive. Conclusions: The absence of EBV seronegativity in this large cohort of patients with early MS provides further evidence for a crucial role of EBV in MS and suggests that a negative EBV serology in a patient with suspected inflammatory central nervous system disease should alert clinicians to consider diagnoses other than MS. Disclosure SA reports no disclosures. BE reports no disclosures. BA received travel grants from Novartis, not related to this work. NH reports no disclosures. GA reports no disclosures. IRK reports no disclosures. M-MH received travel expenses from Bayer Health Care and honoraria for an advisory board from Merck Serono GmbH. LA reports no disclosures. FL serves as an advisory board member for Roche Pharma and has received travel grants from Teva Pharma. SG reports no disclosures. LK received compensation for serving on scientific advisory boards (Genzyme, Novartis Pharma); speaker honoraria and travel support (CSL Behring, Merck Serono, Roche, Novartis Pharma); research support (Biogen, Novartis Pharma). SGM received honoraria for lecturing, travel expenses for attending meetings, and/or financial research support from Almirall,
Aim The aim is to assess the bereavement needs in Newham and to provide support that is sensitive to the cultural, religious and language requirements of the borough’s population. The service operates via a compassionate community model, providing training to enable the local population to support people within their locality, as well as improving local knowledge around death and grief. Background Newham has a diverse community, with 68% of its 247,614 population coming from Black and minority ethnic communities (ONS, 2008). The estimated number of deaths in Newham in 2008 was 1,437 (ONS, 2008), yet the majority of those bereaved did not access professional support. Cultural attitudes to death and grieving could prevent people from accessing formal bereavement services and many people could be unaware of other areas of support they could access. Approach Volunteers, who are reflective of the local community, are being trained, on an on-going basis, as befrienders, allowing those who may not choose to access professionally led services to receive support and information following bereavement. Referrals are triaged to the service via Newham Psychological Services who partner us in providing this service. The service is mainly operated by volunteers, with only two members of staff dedicated to the service on a part-time basis. Findings and Recommendations We evaluate the impact of our service by measuring several factors including how the support has affected service user’s lives. Conclusion The services is in its first year, of three commissioned, but has had a strong start up with a high number of volunteers trained and ‘active’. The level of uptake will allow us to find out the gaps in service provision/uptake and the need for informal support. This model could be replicated in other boroughs if the need and response is supported.
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