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Dr. Traboulsee: 70% of pwMS have narrowed neck veins

Posted: Tue Aug 13, 2013 8:35 pm
by Cece
http://www.ottawacitizen.com/health/Res ... story.html
“What we’ve been finding is that not everybody with MS will actually have this narrowing of veins,” said Traboulsee, medical director of the UBC Hospital MS Clinic. “Our finding is that maybe about 70 per cent have the narrowing.”

Re: Dr. Traboulsee: 70% of pwMS have narrowed neck veins

Posted: Tue Aug 13, 2013 11:07 pm
by eric593
Isn't he just speaking of those being examined for inclusion in the Vancouver arm of the cinical trial? A trial that, across Canada, will only have 100 particpants in total? So the Vancouver portion being examined for CCSVI would only be a small portion of those 100 people total, and assume more than that # were examined given that 30% of the people tested were not found to have CCSVI.

So, you really can't extrapolate and say 70% of MSer's have CCSVI with only a small sample size.

I wonder how CCSVI was diagnosed anyway, given that we've heard that ECD is not accurate. And I wonder why Traboulsee is indicating that such great pains are being taken to ensure unbiased results. Does he believe there is generally a bias in MS clinical trials? Or, is he trying to justify the expenditure of lots of money on new data collections systems? Or, is he trying to justify the lengthy delay in getting this trial underway? Why is he so worried about bias in THIS trial? He participates in many trials, why suddenly so much concern? Surely he should have had confidence in data collection methods before bidding for the trial? Isn't he one of the main players himself who has spoken OUT against CCSVI - is he protecting the trial results from himself?

Re: Dr. Traboulsee: 70% of pwMS have narrowed neck veins

Posted: Wed Aug 14, 2013 9:06 am
by Cece
I think he is vocal about his efforts to achieve unbiased results because of the controversy that is CCSVI. There is already dispute over his trial because of the inexperience of the IRs doing the procedure.

They've assessed about 50 patients so far and found narrowings in 70%. This is worth mentioning because of prior studies with conflicting evidence over whether or not CCSVI exists. We don't know if he would also have found narrowings in 70% of healthy controls because that is not being done. But if he'd found narrowings in 0% of pwMS, the trial could not have gone forward.

Re: Dr. Traboulsee: 70% of pwMS have narrowed neck veins

Posted: Wed Aug 14, 2013 2:01 pm
by 1eye
Cece wrote:I think he is vocal about his efforts to achieve unbiased results because of the controversy that is CCSVI. There is already dispute over his trial because of the inexperience of the IRs doing the procedure.

They've assessed about 50 patients so far and found narrowings in 70%. This is worth mentioning because of prior studies with conflicting evidence over whether or not CCSVI exists. We don't know if he would also have found narrowings in 70% of healthy controls because that is not being done. But if he'd found narrowings in 0% of pwMS, the trial could not have gone forward.
I think the intention is to conclude that, hey it might exist but something else causes "MS". We knew that already, didn't we?

Like a lot of Canadians in positions of power, he might end up with a little egg on his face. At least some people are getting the procedure.

Re: Dr. Traboulsee: 70% of pwMS have narrowed neck veins

Posted: Wed Aug 14, 2013 9:59 pm
by drsclafani
Cece wrote:http://www.ottawacitizen.com/health/Res ... story.html
“What we’ve been finding is that not everybody with MS will actually have this narrowing of veins,” said Traboulsee, medical director of the UBC Hospital MS Clinic. “Our finding is that maybe about 70 per cent have the narrowing.”
I have found that nearly 100% of patients with MS have narrowings, most of which are valvular stenoses. I have also found that venography misses about 30% of valvular stenoses.

So i am pleased that Dr Traboulsee is finding 70%, Compares to my results.

Now if they used IVUS......

Re: Dr. Traboulsee: 70% of pwMS have narrowed neck veins

Posted: Wed Aug 14, 2013 10:55 pm
by Robnl
Still struggling with diagnosis after 6/7 years, that's weird..isn't it?

(I agree with you, dr. S.)

Re: Dr. Traboulsee: 70% of pwMS have narrowed neck veins

Posted: Wed Aug 14, 2013 11:21 pm
by MrSuccess
This is very good news. I am pleasantly surprised to read of such a high - 70 % - number given right off the bat ....... I understand there is a learning curve in understanding and treating CCSVI. All of the CCSVI medical professionals report this.

Overall , the investigation conducted by Dr. Traboulsee seems well thought out .

I look forward to reading the future results. I have one great concern . And that is the involvement of DMD's. I have suggested that any Trial involving CCSVI treatment MUST have a small percentage of pwMS .... NOT taking ANY of the DMD's. :idea:

Any MS symptom improvements after CCSVI treatment ..... can then be credited to the treatment ..... and NOT the DMD's. The DMD's are the devil in the details. IMHO.

Again , I am very pleased with Dr.Traboulsee and his approach.



MrSuccess

Re: Dr. Traboulsee: 70% of pwMS have narrowed neck veins

Posted: Thu Aug 15, 2013 5:40 am
by 1eye
DrSclafani wrote:I have found that nearly 100% of patients with MS have narrowings, most of which are valvular stenoses. I have also found that venography misses about 30% of valvular stenoses.

So i am pleased that Dr Traboulsee is finding 70%, Compares to my results.

Now if they used IVUS......
That is nothing short of a crime, if they didn't even ask for help. The IVUS, though complex, is not rocket science, and this is not the third world.

Re: Dr. Traboulsee: 70% of pwMS have narrowed neck veins

Posted: Thu Aug 15, 2013 7:16 am
by erinc14
While the McMaster researchers' negative study on CCSVI - released today, 14 August 2013 - received wide media attention, a positive study published today in the Journal of Vascular Surgery wasn't on the media's radar. It's time to give balanced reporting.

http://www.wireservice.ca/index.php?mod ... &sid=10802

Re: Dr. Traboulsee: 70% of pwMS have narrowed neck veins

Posted: Thu Aug 15, 2013 9:18 am
by 1eye
Yeah, you can hear the Pharma generals hunkered down in the War Room telling each other:
Isn't there something we can do to counter the flack we're catching from the over 1000 procedures those &^%(&^$# Eye-talians did?

Here's some stuff we got out of Canada - yeah, I know, them again, but hey, it's better than that guy out in Canadian Lala-land with his plus 70%, I thought he was on our side! Anyway, here's something from McMaster: isn't that where that Professor Haacke works? He's American, too, right? This ought to hold them till we can think of something better...
One of those "bloggers" commenting on the CTV news report on the McMaster study put it very succinctly when he said:
Michael K
Aug. 15, 2013
7:15 AM

Dr. Ian Rodgers used to be the Executive Medical Director at Merck. I don't think this is an unbiased study.

Re: Dr. Traboulsee: 70% of pwMS have narrowed neck veins

Posted: Thu Aug 15, 2013 8:37 pm
by 1eye
Sorry. It's' hard for me not to argue ad-hominem against a guy who used to work in Inflammation for Merck when my mother died of heart failure while she was on Vioxx. I'm sure having no kidneys of her own didn't help. I think it's best you ignore my obviously biased opinions, and look at real arguments.

Re: Dr. Traboulsee: 70% of pwMS have narrowed neck veins

Posted: Thu Aug 15, 2013 9:17 pm
by Cece
1eye wrote:That is nothing short of a crime, if they didn't even ask for help. The IVUS, though complex, is not rocket science, and this is not the third world.
My understanding is that help was offered but was turned down.
The word grandiosity gets tossed around here sometimes, and maybe it's grandiosity to assume that help was needed, maybe it's grandiosity to turn down help from those with experience in the field.

Re: Dr. Traboulsee: 70% of pwMS have narrowed neck veins

Posted: Fri Aug 16, 2013 7:17 am
by 1eye
No, in the sense that Dr. Sclafani used it, not very grandiose at all. Not imaginative, and pretty egocentric. Oh well. Can't make a silk purse, and all.

I'm lucky. I have to ask for help a lot, and usually the human race is humane to me. But I do understand. Sometimes, you need to fail all by yourself, and bleed if that's the outcome. Just not on somebody else's shirt.

Re: Dr. Traboulsee: 70% of pwMS have narrowed neck veins

Posted: Fri Aug 16, 2013 10:43 am
by Cece
Lol - on wikipedia grandiosity is defined as an unrealistic sense of superiority.
So if the sense of superiority is realistic, then it is not grandiosity?

We heard from Dr. Trabalousee elsewhere today:
While the McMaster team is “very experienced” and their study was well-designed, Traboulsee said Wednesday from Vancouver, “my concern is with the ultrasound.”

Widely varying results from ultrasound studies by research groups worldwide — including a University of Buffalo study that found 56 per cent of MS patients and 23 per cent of healthy controls had CCSVI — are a reflection of the subjective nature of interpreting ultrasounds, he said.

“I don’t think ultrasound is reliable to make definitive conclusions about Zamboni’s original theory or (in) any other papers that have come out since.”

Using catheter venography, his team has found CCSVI in close to 60 per cent of patients, he said of a soon-to-be published study.

Traboulsee said the McMaster results won’t affect the federal study, which will compare how patients given balloon angioplasty fare compared to those given a sham treatment.

“The Hamilton study is out of keeping with our findings, and we really don’t think it’s going to impact on how we’re going to continue to go forward,” he said, adding that enrolment has begun but results aren’t expected before 2016
http://www.680news.com/2013/08/15/canad ... e-goes-on/

Re: Dr. Traboulsee: 70% of pwMS have narrowed neck veins

Posted: Fri Aug 16, 2013 1:07 pm
by 1eye
Even for avoiding unnecessary angioplasties it is not possible to do without training. In heart cases they carry a portable ultrasound machine to you, and do it at your bedside. The veins are trickier to assess. If you have enough experience you should be able to find what Dr. Sclafani has found to be 1%. After the results from the large Italian study, finding you will have more complications until you have done 400 procedures, I fear for the non-sham people.

One can only hope that great care will be taken, and that the patients will get good results.