Moom9335 wrote:Dr. Sclafani,
Is it worthwhile, in your mind, to possibly repeat the procedure ( in the future) on some of your patients who had no improvements the first time? Do you think your discussions with Dr. Zamboni have added information that might improve their response to the procedure?
And, in your collaborations in Italy, was there still agreement that the type of MS, when there is stenosis, definitely dictated the degree of improvement after the procedure?
bestadmom wrote:Do you/we have to wait until the IRB meets in July for them to respond to your clarifications?
Maybe a stupid question, but i will ask...
I got my clavicle broken when i was young. Could it be a cause of a stenosis in the azygos? Does the azygos is near the clavicle?
drsclafani wrote:2. we have a better way of seeing the azygous vein
3. we never really got good views of the lumbar veins
drsclafani wrote:... i did learn something about how to view the lumbar veins and paolo and roberto believe that lumbar veins answer some of the questions.
drsclafani wrote:magoo wrote:Dr. Sclafani,
Can you explain why people who have had treatment sometimes have a return of old symptoms when sick? The people I have talked with about this say it is to a lesser degree. I am included in this group because I have had more headaches and stiffness when I am sick, which resolves when I am well again. But this does seem to cause anxiety. Is there any way you can explain this to ease our minds?
rhonda, such a nice surprise for you to ask a question. And you ask a good one. i am not sure that "illness" brings on old symptoms when sick. perhaps it is the stress? I will look around.
if illness leads to stress???:
Psychosomatic Medicine 64:916-920 (2002)
© 2002 American Psychosomatic Society
Stressful Life Events Precede Exacerbations of Multiple Sclerosis
Kurt D. Ackerman, MD, PhD, Rock Heyman, MD, Bruce S. Rabin, MD, PhD, Barbara P. Anderson, PhD, Patricia R. Houck, MSH, Ellen Frank, PhD and Andrew Baum, PhD
From the Departments of Psychiatry (K.D.A., B.P.A., P.R.H., E.F., A.B.), Neurology (R.H.), Pathology (B.S.R.), and Psychology (A.B.), University of Pittsburgh, Pittsburgh, Pennsylvania.
Address reprint requests to: Kurt D. Ackerman, MD, PhD, Western Psychiatric Institute and Clinic, 3811 O’Hara St., Pittsburgh, PA 15213. Email: firstname.lastname@example.org
OBJECTIVE: We longitudinally monitored life events and health changes in patients with multiple sclerosis (MS) to determine whether stressful events may trigger exacerbation of MS.
METHODS: Twenty-three women with MS were followed for 1 year. Each subject completed the Psychiatric Epidemiologic Research Interview on a weekly basis. Further information on potentially stressful events was acquired using the Life Events and Difficulties Schedule. Neurologic symptoms were also monitored on a weekly basis throughout the year. Potential MS exacerbations were confirmed by a neurologist who was blind to the presence and timing of stressors.
RESULTS: Eighty-five percent of MS exacerbations were associated with stressful life events in the preceding 6 weeks. Stressful life events occurred an average of 14 days before MS exacerbations, compared with 33 days before a randomly selected control date (p < .0001). Survival analysis confirmed that an increase in frequency of life events was associated with greater likelihood of MS exacerbations (hazard ratio = 13.18, p < .05).
CONCLUSIONS: These results are consistent with the hypothesis that stress is a potential trigger of disease activity in patients with relapsing-remitting MS.
drsclafani wrote:L wrote:SofiaK wrote:Dr Sclafani:
Do all MS patients have vein narrowing? An MRV should show any narrowing, no?
I’m confused because I’m hearing different things.
Now these figures are rough, from the top of my head, but I believe that Zamboni found a 100% correlation, Simka 92%, Zivanidov 55% but a figure around 85% with progressive MS and Kuwait 100%. Then Bochum found 22% but, we guess, that they weren't quite trained to the degree necessary. How else to square the circle but to conclude that?
i will discuss this more later when i give my zamboni report, but not all ccsvi is picked up via azygous and jugular venography. I was caught by surprise on that one! but you will have to wait for an explanation of some of the negative venograms!
2) Can you please say somthing more specific about what is high and what are low stenosis. I mean the location.
a high lesion is anything in the upper half of the vein. most of the lesions are near the junction with the subclavian vein in the chest behind the clavicle.
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