Alberta > Saskatchewan

At least insofar as the MS/CCSVI controversy goes:

Many people hope that CCSVI will prove to be the cause of MS but, at present, this idea is not supported by fact.

Alberta Health Services has compiled an excellent fact sheet about the issue, answering all the canards and faulty bits of reasoning brought up in the debate.

It Begins

Clerkship, that is. I'm excited to say the least. My rotations, beginning Aug. 30th and finishing mid-September 2011:

Introduction to Clerkship Pediatrics Obstetrics and Gynecology (Exams) Year 3 Elective (Christmas) Surgery and Emergency Medicine:           General Surgery Neurosurgery Emergency Medicine Plastics

And then... (Exams + OSCE) (Break) Family Medicine Psychiatry (Exams) Internal Medicine: Geriatrics Neurology Medical Teaching Unit (Exams + OSCE)

Exciting! I'd like to do radiology for my elective, but I may have to settle for something else. We don't really get paid for clerkship, but there's a modest stipend ($2800) and $50/week for up to 12 weeks spent outside HRM. Total time off = 3 weeks over 55 weeks. I'm generally really happy with my schedule and rotations; not only did I get almost all my top choices, but I'm looking forward to being able to figure out the Great Surgery Question relatively early on. It's not like I usually see much of the sun in January/February anyhow. On y va!

Hmm

A small addendum to my last post (picture from here):


You know, it's really quite strange that Dr Zamboni is examining what look to be plain film CT or MRI slices in an old-fashioned radiology viewing room. First, why is he using such antiquated technology? I've never even seen such plain films, and I've looked at many, many head CT/MRIs this summer. Is this some sort of promotional picture for the media's benefit? Second, Dr Zamboni is neither a radiologist nor a neurologist nor a neurosurgeon and his papers concerning both CCSVI and the "liberation treatment" do not actually provide any data about changes in MS lesion distribution before or following treatment. So, what's up with this? It's certainly a nice stock photo of him doing something "doctorly", but I'm unclear. Some of the most recent evidence is not, however:

The first study, out of Germany, involved 56 MS patients and 20 healthy patients. Scientists did ultrasound testing and other imaging exams and found blood flow was normal in all, except for one MS participant. A smaller study out of Sweden that involved 21 MS patients and 20 healthy patients used magnetic resonance imaging to compare blood flow and reached a similar conclusion.

“In this quite small study we find no support for venous vascular surgical treatment and we are not able to confirm the Italian theory,” lead researcher Peter Sundstrom of Umea University in Sweden said.

Dr. Zamboni’s study of the degenerative condition involved 65 patients, who underwent angioplasty to clear blockages. Many in the medical community have been skeptical of his work because it is preliminary, with a small sample size, and has been heavily promoted before going through the rigorous research process.

Yet hundreds of MS patients, including a few Canadians, have travelled to India, Poland, Bulgaria and a few other countries for the surgery. Most say they have increased energy and mobility, but others have described little change. The treatment has led to injury in some cases.

Hmm, indeed.