a neurosonographer's critcal notes to Zamboni' s methodology

[blossom]

1eye, what you say makes sence to me. this is my life time is running out yrs. wise ms wise.

[frodo]

I think it is a problem, comparing number with and without Valsalva. What do you think?

Great catch!! it seems that the author has taken the numbers from that paper (it would be a surprising coincidence to find exactly the same ones in other source) and he has misunderstanded them (he says that is normal to find those numbers while the original paper says that they appear during valsava maneuvers).

For sure this is a weakness of this paper.

Besides I still think that the author speaks mostly about lack of flow instead of reflux. Maybe he didn't understand correctly the Zamboni papers.

This is the first serious critic I have read against CCSVI and it is flawed at least in two points. I suppose this makes CCSVI theory stronger.

[Cece]

I think it is a problem, comparing number with and without Valsalva. What do you think?

That is a good catch. huh! Smart folks here.

[Stacemeh]

I think Dr. Panczel has put together a well thought out critique and I am glad to see this rather than the usual "naw that ain't it, you just can't understand bla bla" sort of comments we usually hear.

[quote]The IJV can be heavily dilated in upright position, in Congestive heart failure (CHF) for example. Zamboni diagnosed a vein occlusion in patients with congestive heart failure.(which is false)
[\quote]


This is a valid point, I just happen to know that both human and veterinary Doctors look for this jugular reflux in conjestive heart failure patients.

However, how relevant this is? How much longer are these (CHF) patients are likely to live once this reflux begins to occur?

In my understanding, I'm not sure they would live long enough to accumulate enough of the slow luxuriant vicarious redistribution (as described by Dr. S ) necessary to show neuro damage on the level required for MS symptoms to develop.

But, I am not a doctor.

[drsclafani]

please visit my response to this question on DrSclafani answers some questions

[thisisalex]

Hello everyone!

Dr. Panczel is back

After 1,5 years he is still in a hurry to discredit Zamboni as a sonographer. He just had a presentation at a hungarian MS conference, and he is talking about the same thing: Zamboni's five criteria is worthless. I sent him dr. Sclafani's and dr. Zamboni's answer but he is unstoppable: Zamboni is an idiot and a very bad sonographer.

In his presentation he shows a case, a hungarian MS patient (a friend of mine) was treated in Tychy, Poland by dr. Jacek Kostecki (findings: http://m.blog.hu/cc/ccsvi/file/lelet4.pdf)

Dr. Panczel thinks the venogram is not valid because there is no stenosis but some kind of "washed out contrast agent"
you can hear his "solution" for this phenomenon in his presentation...

http://www.youtube.com/watch?v=Q4iRvfsqwZo

and here are the before videos he mentions in his presenatation more detailed:



I would like to post an answer for him, could you please help me?

thank you
Alex

[1eye]

Not worth the trouble.

[CureOrBust]

Lets go the "cup is half full", ie what he does appear to agree with..

Dr. Panczel clearly has problems with criteria 1,3 & 5. He mocked these explicitly. So, therefore, assuming test 2 is performed by a competent operator (which is what I expect for all my medical test/procedures, and an overly competent one on any "new" stuff), he must then agree with Zamboni, that if a patient exhibits criteria 2 & 4, there is something amiss?

The little he spoke on criteria 4 sounded as if he would not expect anyone to meet this criteria. Which Zamboni obviously found.

Also, from what I have read, apart from the Ultrasound, he's not fond of the venogram either. What does he think of IVUS?

[1eye]

Look. A working, non-refluxed circulatory system is easy to see with Doppler. If it looks like it is working OK using dye, you could still have problems that are hidden, that you can only see with IVUS. There are problems that are easily seen with 3D MRV and some of Dr. Haacke's other techniques. It might be good to do before and after of all the tests if you have time and/or money. I don't see the sense, though, of deciding on the existence of the problem, let alone what it causes, based on one possible test alone. Just because something is your specialty doesn't mean it can tell you everything there is to know. Could anybody else use a break?

[thisisalex]

Lets go the "cup is half full", ie what he does appear to agree with..

Dr. Panczel clearly has problems with criteria 1,3 & 5. He mocked these explicitly. So, therefore, assuming test 2 is performed by a competent operator (which is what I expect for all my medical test/procedures, and an overly competent one on any "new" stuff), he must then agree with Zamboni, that if a patient exhibits criteria 2 & 4, there is something amiss?

The little he spoke on criteria 4 sounded as if he would not expect anyone to meet this criteria. Which Zamboni obviously found.

Also, from what I have read, apart from the Ultrasound, he's not fond of the venogram either. What does he think of IVUS?

CureOrBust,

dr. Panczel does not think of IVUS nor a venogram. He is an old time neurosonographer

1eye
thank you for your answer. i think you are right: not worth the trouble.