Vascular comorbidity is associated with more rapid disabilit

A forum to discuss Chronic Cerebrospinal Venous Insufficiency and its relationship to Multiple Sclerosis.

Vascular comorbidity is associated with more rapid disabilit

Postby sbr487 » Sun Aug 01, 2010 9:35 am

Posted by Denise @ facebook:
http://www.neurology.org/cgi/content/ab ... 74/13/1041

Something interesting is that this article was initially submitted end of 2009.
So some neuros were pursuing vascular issues in MS. I am sure the study itself would have been going on for quite sometime.
A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die and a new generation grows up that is familiar with it
- Max Planck
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Postby Blaze » Sun Aug 01, 2010 1:34 pm

This is stunning! This seems to have been done totally separate from Zamboni. The neuros have certainly been quiet on this!
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Re: Vascular comorbidity is associated with more rapid disab

Postby frodo » Sun Aug 01, 2010 1:56 pm

sbr487 wrote:Posted by Denise @ facebook:
http://www.neurology.org/cgi/content/ab ... 74/13/1041

Something interesting is that this article was initially submitted end of 2009.
So some neuros were pursuing vascular issues in MS. I am sure the study itself would have been going on for quite sometime.



Wow. Thanks. This is another fact justifying a CCSVI test in MS patients.
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Postby AlmostClever » Sun Aug 01, 2010 3:52 pm

95% of 9,000 patients is not enough proof to show correlation?

Did I read that right?
If you can't explain it simply, you don't understand it well enough. - Al Einstein
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Postby beerduff » Sun Aug 01, 2010 7:41 pm

Comorbidity,
two or more coexisting medical conditions or disease processes that are additional to an initial diagnosis.

I had to look it up.
I wonder how they came to these conclusions.
Did they do a Doppler or mri to find these anomilies.
Very interesting article though.


Background: Vascular comorbidity adversely influences health outcomes in several chronic conditions. Vascular comorbidities are common in multiple sclerosis (MS), but their impact on disease severity is unknown. Vascular comorbidities may contribute to the poorly understood heterogeneity in MS disease severity. Treatment of vascular comorbidities may represent an avenue for treating MS.

Conclusions: Vascular comorbidity, whether present at symptom onset, diagnosis, or later in the disease course, is associated with a substantially increased risk of disability progression in multiple sclerosis. The impact of treating vascular comorbidities on disease progression deserves investigation.
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Re: Vascular comorbidity is associated with more rapid disab

Postby NHE » Sun Aug 01, 2010 8:10 pm

AlmostClever wrote:95% of 9,000 patients is not enough proof to show correlation?

Did I read that right?


What the abstract actually reported was the hazard ratio. This is a measure of the relative risk of some event in one group compared to another group.

Participants reporting one or more vascular comorbidities at diagnosis had an increased risk of ambulatory disability, and risk increased with the number of vascular conditions reported (hazard ratio [HR]/condition for early gait disability 1.51; 95% confidence interval [CI] 1.41–1.61).

Vascular comorbidity at any time during the disease course also increased the risk of ambulatory disability (adjusted HR for unilateral walking assistance 1.54; 95% CI 1.44–1.65).


What the first statement means is that MS patients with one or more vascular comorbidities at the time of diagnosis had a 1.51 times greater risk for ambulatory disability. The second statement indicates that having a vascular comorbidity at any time during the course of MS disease resulted in 1.54 times the risk of ambulatory disability.

The 95% CI numbers that are reported indicate the 95% confidence interval for the two hazard ratio numbers. The 95% CI functions essentially like error bars on the reported data. In effect, the first hazard ratio was found to vary from 1.41 to 1.61 with a mean of 1.51 and the second hazard ratio was found to vary from 1.44 to 1.65 with a mean of 1.54. The 95% CI indicates that 95% of the calculated hazard ratios lie under the center of the bell curve, the population of hazard ratios, with a value of 1.41 to 1.61 (for the first case), and that 2.5% of the data lie at either end of the extremes of the bell curve. The 95% CI is plus or minus 2 standard deviations from the mean on the bell curve.

Anyway, that's my best interpretation from my college biostatistics course which was about 16 years ago. Clear as mud (or at least slightly better I hope). :roll:

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Postby AlmostClever » Sun Aug 01, 2010 9:33 pm

thx NHE!

clear now!
If you can't explain it simply, you don't understand it well enough. - Al Einstein
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Postby ljh » Mon Aug 02, 2010 6:40 pm

Thanks SBR487 and Denise for posting this. Its a jewel! Could someone run it by an IR for comment?
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SO WHY IS THIS NOT USED???

Postby codefellow » Fri Aug 06, 2010 10:28 am

....every time some one asks to have his/her veins checked....it is a study of 9000 patients done by NEUROLOGISTS and concluding that vascular issues can contribute to the damage done by MS....

CLINICAL TRIAL --- FOR HEAVEN'S SAKE, IT'S RIGHT HERE WITH 9000 PATIENTS AND THE NEUROLOGISTS HAVE DONE IT!! WHAT THE F--K MORE DO WE NEED?

---so what am I missing?----
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Postby selkie » Fri Aug 06, 2010 11:14 am

Gosh , I must be stupid. I still don't understand the statistics explanation - I avoided that class like the plague when I minored in psychology. Why oh why didn't I take it? And also more anatomy, biology courses?

Oh well thanks for the link - I'll print this out and show it to my friend who understands these things. Maybe she can explain it to me. Thanks NHE for trying - I think I have about 3 brain cells working, so my bad in not getting it.

I do find this fascinating that vascular conditions were associated w/MS before Dr. Zamboni and by neurolgoists. Is this perhaps a study most of our neurologists aren't familiar with? My neuro sure doesn't seem to keep up on his reading and neither does my PCP.

Wonder what Dr. S thinks of this? And what kind of vascular disorders were found in these MS patients? Which veins?

thanks, s.
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