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I can get behind that!1eye wrote:I think the point they were trying to make was that 'primary ischemic' (i.e., CCSVI) was more likely than WD....discussion of Wallerian degeneration...
The doctors involved with the Beirut study did not "set the bar very high for what would be considered a stenosis." If you read the entire paper, you will see they exclude non-pathologic findings, and provide justification for doing so. How can a missing jugular have stenosis?Cece wrote:If I recall, the Beirut study set the bar very high for what would be considered a stenosis. So actual stenoses did not get counted. Valve issues were excluded, missing jugulars were excluded.... So for the 12 out of 13 late RR MSers to be found to have ccsvi stenoses (by whatever name), they had to really have it to clear that high bar.
This is not an insignificant point, since (1) not all vascular doctors agree that CCSVI is a pathologic condition, and (2) the "gold standard" of catheter venography is constantly emphasized, yet what is the criteria for diagnosing CCSVI with catheter venogram?ccsvi stenoses (by whatever name)
That is your expert opinion that the study was weighted toward false negatives. But I don't see how you can criticize so soundly the methodology used in a study, then quote parts of the same study as proof of anything.Some studies might have more false positives, some might have more false negatives. The Beirut study, by setting the bar too high and excluding stenoses that might have been included, would lean toward more false negatives. I was angry, as I recall, of how they set that up, since it was our first catheter venogram study. But I doubt it is the last. And in a study weighted toward false negatives, the positive findings of 12 out of 13 late RRMSers having CCVSI is valid.
I am surprised you can ask that question. The pathology is one of outflow obstructions. A missing jugular and a stenosed jugular both are outflow obstructions. No flow will go down either.patientx wrote:The doctors involved with the Beirut study did not "set the bar very high for what would be considered a stenosis." If you read the entire paper, you will see they exclude non-pathologic findings, and provide justification for doing so. How can a missing jugular have stenosis?
If a study sets the bar high, it sets the bar high. I am not sure how else to describe that. I was unhappy that, with our first catheter venogram study, the bar was set unreasonably high. But at the same time, with those very high standards, 12 out of 13 late RRMSers had CCSVI. If they'd included missing jugulars or the other exclusions, perhaps 13 out of 13 late RRMSers would've been seen to have CCSVI, and a greater percentage of the early CISers too. The fact that I was not happy with what was excluded in no way negates what can be learned from those stenoses that were included.That is your expert opinion that the study was weighted toward false negatives. But I don't see how you can criticize so soundly the methodology used in a study, then quote parts of the same study as proof of anything.
A missing jugular does not present an obstruction - it is missing. Zamboni's original published cases were stenoses in exisiting veins. i don't recall he ever mentioned missing veins. His original theory was that these stenoses caused blood reflux, which led to leakage of red blood cells into brain tissue, which led to iron deposits, which caused an immune reaction against myelin tissue, etc, etc. A missing jugular vein wouldn't have reflux. Of course, now it seems CCSVI is defined as whatever one wishes it to be.Cece wrote:I am surprised you can ask that question. The pathology is one of outflow obstructions. A missing jugular and a stenosed jugular both are outflow obstructions. No flow will go down either.patientx wrote:The doctors involved with the Beirut study did not "set the bar very high for what would be considered a stenosis." If you read the entire paper, you will see they exclude non-pathologic findings, and provide justification for doing so. How can a missing jugular have stenosis?
No, because your opinions on studies like this seem to be made without having read all of what the authors' wrote.Do you have any other opinions on my opinions??
And I don't see how the date on this affects its importance, especially since it was published in toto last week. Hypoperfusion was found in all pwMS who also had CCSVI. That's a pretty important correlation.The patency rate was also satisfactory for PTA treatment of azygous hypoplasia in five of six patients, yielding a cumulative patency rate of 96% at 18 months (Fig 7). In 12 patients, the AZY system presented stenoses at several points and even aspects of agenesis of the lumbar plexuses (18%). It is noteworthy that such presentation was significantly associated with the PP course, with MS plaques distributed in the spinal cord.4 This malformation, of course, was not treated, probably explaining the worse results obtained in these patients with respect to the RR course.
link to Italian pressFerrara, 11 March 2011 - In support of the Zamboni method involved a study of Italian-American, published in 'BMC Medicine' in March, and demonstrates how the narrowing of the jugular veins are the blood flow slowly in the brain impacting on the genesis and progression of multiple sclerosis (view put forward by Professor Paolo Zamboni).
The results of the study will be presented at the conference organized by the 'International Society for neurovascular disease' in Bologna on 14 and 15 March under the patronage of the Presidency of the Republic.
The study and 'the fruit of a collaboration between the University Centre vascular disease' Ferrara directed by Zamboni, the old 'good' Bellaria Hospital in Bologna, directed by Fabrizio Salvi and the department of neurology and neuroimaging at the University 'New York, home to Buffalo, directed by Professor Robert Zivadinov.
That's all I ask...MarkW wrote:I will ignore the discussion with the naysayer Lyon.
Lyon wrote: In all seriousness, it's clear to everyone except the most hardened CCSVI zealots that the theory of CCSVI has started circling the drain.......I think "all over but the crying" is the correct term.
Of course! That's why all those leading doctors are in Bologna right now! They must be just on vacation, hanging out, drinking espresso and eating pasta all day. It has nothing to do with so many of them dedicating their research to the topic of CCSVI.Lyon wrote: In all seriousness, it's clear to everyone except the most hardened CCSVI zealots that the theory of CCSVI has started circling the drain.......I think "all over but the crying" is the correct term.