Name: Mendoza, Margarita Jacob

Course/major/year: BSED3-Biomajor
Date: January 30, 2014
Requirement: 2nd Professional Journal
Mechanisms of Disease: Sodium Channels and Neuroprotection in Multiple
Sclerosiscurrent status
Source: Nature Clinical Practice Neurology (2008) 4, 159-169
doi:10.1038/ncpneuro0735
Received 21 August 2007 | Accepted 23 November 2007 | Published online: 29 January 2008

By: Stephen G. Waxman

Synopsis:
The past decade has seen increasing interest in the possibility of neuroprotective
therapy with sodium channel blockers in multiple sclerosis (MS), as a result of
recognition that axon degeneration is a major contributor to disability in MS, and the
demonstration of a critical role for sodium channels in degeneration of CNS axons. This
area is one of rapid flux5 years ago sodium channel blockers had not been studied in
animal models of MS, and 2 years ago clinical studies had not begun to assess the
protective effects of sodium channel blockers in humans with MS. Now, however, data
are available from animal models on the effects of four sodium channel blockers, all of
which are in routine clinical use for other indications, and two clinical studies of sodium
channel blockers in patients with MS are ongoing. This article will review the
development of the concept of sodium channel blockers as neuroprotectants in MS, the
path of translation from laboratory to clinic, and the current status of this field. There are
some keypoints to consider:
Voltage-gated sodium channels can contribute to axonal injury in multiple
sclerosis (MS) by providing a pathway for sustained sodium influx that drives the
Na+/Ca2+ exchanger to import calcium into axons;

Sodium channel blockers protect axons from degeneration in several in

vitro models of axonal injury, and they prevent axon degeneration, maintain
impulse conduction, and improve clinical status in experimental autoimmune
encephalomyelitis, a mouse model of MS;

Sodium channels regulate the function of macrophages and microglia, so, in

addition to a direct protective effect on axons, sodium channel blockers might
have an immunomodulatory action;

Sudden withdrawal of the sodium channel blockers phenytoin and

carbamazepine from mice with experimental autoimmune encephalomyelitis
results in acute clinical exacerbation, accompanied by increased inflammatory
infiltrate within the CNS;

Until more is known about the effects of sodium channel blocker withdrawal in
humans with MS, clinical studies should monitor patients closely both in terms of
neurological function and axonal loss and with respect to immune and
inflammatory status;

If withdrawal of the sodium channel blocker is necessary in patients with MS

treated with carbamazepine or phenytoin for trigeminal neuralgia or other positive
disturbances, these medications should be discontinued via a gradual taper.

Reflection:
Sodium channels can provide a route for a persistent influx of sodium ions into
neurons. Over the past decade, it has emerged that sustained sodium influx can, in
turn, trigger calcium ion influx, which produces axonal injury in neuroinflammatory
disorders such as multiple sclerosis (MS). The development of sodium channel blockers
as potential neuroprotectants in MS has proceeded rapidly, and two clinical trials are
currently ongoing. The route from the laboratory to the clinic includes some complex
turns, however, and a third trial was recently put on hold because of new data that
suggested that sodium channel blockers might have multiple, complex actions. This
article reviews the development of the concept of sodium channel blockers as
neuroprotectants in MS, the path from laboratory to clinic, and the current status of
research in this area. As to clinical studies progress, it will be important, therefore, to
monitor patients closely not only in terms of neurological function and measures of
axonal loss, but also via imaging for new inflammatory events, and via serological and
cerebrospinal fluid analysis to assess inflammatory and immune status. I just hoped that
the ongoing trials will provide useful information within the next few years.

To the safety and efficacy of sodium channel blockers as neuroprotective agents

in patients with MS. As regards current neurological practice, given the long history of
clinical use of carbamazepine and related agents in patients with MS who have
trigeminal neuralgia and related disturbances, it seems appropriate to continue
symptomatic treatment of appropriately selected patients. Nevertheless, it seems
prudent to recommend careful selection of patients for treatment with sodium channel
blockers, and to caution against abrupt drug withdrawal. If withdrawal does prove
necessary, these medications should be withdrawn via a gradual taper.

Name: Mendoza, Margarita Jacob

Course/major/year: BSED3-Biomajor
Date: January 30, 2014
Requirement: 1st Professional Journal
The Inconvenient Bag
For the Eco Friendly Minds
Source: THE WALL STREET JOURNAL
online.wsj.com/news/articles/SB122238422541876879
By: ELLEN GAMERMAN
Updated Sept. 26, 2008 11:59 p.m. ET
Synopsis:
How green is your bag? The Deputy Prime Minister, John Anderson, made
headlines in August when he criticised them. "I don't know how they are made but you
don't know what goes into making them and how many plastic bags there really are in
the world," he said. "I'm not against it but I'm not sure." When asked recently if his views
had changed, Anderson told the Herald that he supports the use of reusable and
recyclable bags. His main concern now was whether they were "made from Australian
materials rather than imported".

The green bags, which are made from non-woven polypropylene, are designed
to have a relatively long life but they are not designed to break down in the compost
heap. Polypropylene is a byproduct of oil refining. Produced during the process is
propylene gas, which when put into a reactor, becomes propylene powder. After
stabilisers are mixed with the powder, it is placed in an extruder, which produces
propylene pellets, which can then be turned into a range of things including car bumper
bars and food containers. If the pellets are melted, they can be made into a fibre which
can then be made into bags.

Although environmentally aware shoppers have always carried tofu-stained

calico bags, the green bag movement gained momentum in 2002 when public concern
prompted a government study on a possible plastic bag levy. Australians were using

about 10.5 billion plastic bags each year, including about 6.9 billion retail carry bags.
Millions of these bags entered rivers and seas, where they could kill whales, birds, seals
and turtles. Plastic bags were also said to add $173 million to our annual grocery bill.
Reusable green bags got the nod over biodegradable plastic bags because it was found
many degradable bags did not break down as claimed. (A standard for biodegradable
plastic bags is not due until later this year).

In order to avoid levies or a ban, the Australian Retailers Association - which

represents most big supermarkets such as Coles and Woolworths - agreed to reduce
plastic bag use by 25 per cent by December last year and 50 per cent by this
December. In March, the retailers' association reported last year's target had been
achieved. Retailers would struggle to make this year's target, the association said. If the
targets are not achieved, the association expects a ban or tax of 25 cents per plastic
bag. The problem lies with smaller retailers such as pharmacies, newsagents and bottle
shops - about half of which had not even heard of the target, a March survey by Planet
Ark showed. Retailers cited cost, habit and convenience as reasons for sticking with
plastic bags.

Nevertheless, the Environment Minister has set an ambitious deadline for

phasing out plastic bags. On June 22, Campbell will ask retailers to sign a "formal
agreement with the Commonwealth of Australia" to phase out plastic bags completely
by 2008. Retailers will be given three months to sign. The document will then be made
public so shoppers know who has - and who hasn't - signed up.

Reflection:
Plastic bags end up as litter that fouls the landscape, and kill thousands of
marine mammals every year that mistake the floating bags for food. Plastic bags that
get buried in landfills may take up to 1,000 years to break down, and in the process they
separate into smaller and smaller toxic particles that contaminate soil and water.

If you decline plastic bags, then how do you get your groceries home? I strongly
recommend to everyone to use a high-quality reusable shopping bags made of
materials that dont harm the environment during production and dont need to be
discarded after each use.

A convenient bag is the typical paper or plastic bag given at the store, while the
inconvenient bag is the bag you bring to the store, mall, market, etc. (everywhere)

yourself. Inconvenience yourself by bringing your own bag for the sake of the
environment so that you dont have to use paper or plastic bags.