St. Anna Hospital of Ferrara, Emilian town of about 135 thousand inhabitants and UNESCO, is located in the historic center, within
walking distance of the city walls. Inside the building, founded in

1445, are the new clinic. Through a long corridor that starts from the

main hospital in the course Giovecca, we arrive at the studio of Paolo

Zamboni, the one whose name, for almost a year, stands in the pages of

Italian newspapers, scientific journals and international press.

A desk, a computer, a diary, framed collage of photos on the walls and a
toy car license plate of the Zamboni Maple Leaf on the wall. A gift from

Canada will explain later. A few square meters that are now in a short

time the center of the universe, the epicenter of an earthquake whose

seismic wave came up in Canada.

The debate on his discovery continues unabated. Both in Italy where the doctor resigned
recently by the Scientific Committee for the epidemiological study of

the Italian Multiple Sclerosis Foundation, is in Canada where the

re-opening of the autumn session of the Bundestag, the patients were

gathered in sit-in protest at the ' Government inaction on skeptical

therapy. In an all-out Zamboni takes stock of the situation, insisting,

as he had announced in a recent interview with the Canadian Courier, his

total willingness to open the gates, with work experience and training,

experts and centers in Canada.

How should move the team of Canadian experts in Saskatchewan

The province of Saskatchewan was the first to announce funding for testing
cerebrospinal chronic venous inadequacy (CCSVI), a genetic malformation

of some in his veins discovered by Zamboni sclerosis. The narrowing of

these veins cause, according to the doctor, abnormal accumulations of

iron that are closely related to disease. The origin of the MS would

then be sought in this malformation.

Premier Brad Wall had expressed his determination to go all the way, despite the negative
opinion of Ottawa. The MS Society of Canada, immediately after the

announcement of the Zamboni at the end of 2009, announces the intention

to participate in the research and makes available in June, with the

National MS Society of the United States, $ 2.4 million for seven

research projects the link between CCSVI and sclerosis. One study,

however, that has already been conducted for years by Zamboni and which

therefore has already found some confirmations, those published by the

doctor last November.

One of these diagnostic studies in Canada is led by Katherine Knox, director of the MS Clinic of
Saskatchewan, according to Zamboni, "not the slightest idea of CCSVI."

"If the province wants to do a study on the treatment - he explains - the
principal investigator must be an endovascular interventional

radiologist or a surgeon. What is needed, Dr. Knox or his team? In

measuring changes in patients. These neurologists do not need to know if

the patient is subjected to treatment or not. Then analyze the data

before surgery and the patient held in check by a neurological point of

view to an end, for example, quarterly. They do not need to increase

their background. They just do their job. In this way the process should

be extremely quick. The radiologist and the interventional radiologist

have, however, a background that allows diagnostic and interventionist

with little to enable them to "run". Dr. Knox must not change anything

nor "struggling" ... but simply to analyze the results in an objective

and calm. Only then the trials in Saskatchewan could be done quickly."

Zamboni is in constant contact with the Reformed MS Society, whose founder,
Steven Simonyi-Gindele, had recently attacked the Federal Health

Minister Leona Aglukkaq. The doctor reiterated his call for a

collaboration with experts from Canada to save time and money. "Dr. Knox

and radiologists can come here in Italy - he says - we have a master

who could capture a major title at the international level and could be

part of the budget of the province, for example. And yet, we have made

available material, movies to download in e-learning, which is then

added a fortnight's work experience. Or join us potrebberp multicenter

study. It took us nine months to complete the project, so they save time

and we would be able to standardize the methods of data collection in

order to do a meta-analytic study. With a uniformity of methodologies

can greatly increase the high number of cases."

With a significant advantage for patients. "We would get a response, positive
or negative, but as soon as possible - he continues - Instead of having

so many fires blocks that need to be confirmed, this data can be merged

together and become funds to be allocated to arrive at answers that

people expect . If it is a matter of background that I am willing to

exchange and to speed up the process in order to make studies available

quickly is total."

The seven studies in Canada? - "Doomed to failure"

Zamboni also focuses on the debate starring patients and multiple sclerosis
society, driven by a single goal in their opinion. Economically.

"Unfortunately, the scientific strength not motivated by a desire for

knowledge but burdened by a conflict of interest in trying to design

studies that have methodological flaws that only one person can see the

field," explained the doctor, referring to German and Swedish studies

have recently dismantled his theory and would not follow his protocol.

"By measuring the height with a tape measure with an inch or not you

will never get the same results. I and others have written to the

publisher. They would have to wait for our remarks before publication,

at least in the name of the completeness of the information."

The doctor points out that the studies funded in Canada do not refer to the
methodology that he experienced in 4-5 years. "They are doomed to

failure. Two million 400 thousand U.S. dollars thrown out the window and

that could be used more appropriately. Seek only to make me go to a

visionary. I do not think, however, that through this funding will come

fully to destroy me like they want to do instead. We, in Italy, with

rates ten times lower than defend ourselves."

The doctor points out that "behind these experts are often shady types. As Freedman."

"A neurologist in Ottawa - he explained - after the funding said it was a
shame to see all this wasted money to do research on a deception. Years

ago, Freedman said that the sclerosis had a ten per cent mortality. In

an interview with CTV said that people should be ready to fight to the

death for this disease. Three years later he told reporters in Ottawa

that I am a fool who exposes people's lives in danger by doing this

angioplasty. I should point out that none of my patients has ever had

complications."

Trials in Italy: ten centers for 500 patients, the study year-long

The protocol for the trial, already postponed for months, should be
approved soon by the Emilia-Romagna and the scientific committee. The

first center could start as early in November. The other Italian cities,

around a dozen, should join in a few months. More than 500 patients

will be seen in Italian cities. The study, explained the doctor, will

last one year and the first result will be probably a year and a half

from now.

In Italy the debate goes on without much fanfare, as confirmed by the doctor, "even if this does not mean that
the fight is not hard as in Canada. With us is channeled in a way that

patients are not forced, perhaps because I do I load the battle more

directly, to get a tummy ache due to political and so on. There are

eight or nine months that has left the work on treatment, not years. If

we have one year after starting with the randomized trial is a big step

forward. " Waiting lists are now closed for months. 24 thousand requests

that are received by the Zamboni sclerosis patients in Italy and

abroad. Then, he admits, has stopped counting. For those who wish to

have information has been provided a point of listening (0532 236524)

available three to four hours every day, which meets a college student

of languages.

The stent controversy

The processing of the release of Zamboni, which is the placement of a
balloon to reopen the blocked veins, "lasts an average of an hour

depending on the complexity and operator experience." Zamboni not

recommend the use of the stent, a metal mesh that is introduced into the

vein is expanded to the level of obstruction, for two reasons: "At this

moment we must show that the treatment is useful for neurological

disease and to do this we should not have any type of complication. The

use of stents involves more procedures that can be successful so it is

also an increased risk of complications. Normally, the jugular vein is

very large and small when we sleep when we are awake. This means that

different volumes. If you put a piece of iron fixed in the neck this

regulatory game is lost. The second reason is that I do not have a

material dedicated to the problem of CCSVI so I have to use the

materials rather questionable. Once it has proved its usefulness, you

can create technology tools devoted to this problem, much more

comfortable and flexible."

Zamboni wants to clarify once and for all the case with the American surgeon Michael Dake and the
tragic death of a young woman after this type of intervention: "It was a

ride report from neurologists who have then spread to the media. After

the insertion of the stent should take an oral anticoagulant. On the

flight to Phoenix, the patient had a cerebral hemorrhage due to an

aneurysm, could happen to the 6 years as at 96. Happened to her after

the operation. An adverse event and then chronologically concomitant

intervention but not caused by the doctor."

Dake had been discussing for another episode, this time with a happy ending, but not
without having presented complications for the patient had undergone

open-heart surgery. "This was the only real serious complication of Dake

- he explains - During the operation, the stent has migrated to the

heart. Luckily I managed to save the patient, a researcher at Berkeley

which I had written long before there was a notion so popular CCSVI. I

had to wait but he had seen suggested that the risk was low enough and

wanted to do it now. Now you regret not having done only the dilation of

the veins. If you use these systems is obviously more drastic

possibility of complications. I'm more on the way slower. If I come

twice a patient and do not risk anything is a disgrace. I have people

that after four years do not even know anymore what multiple sclerosis

(Zamboni as the wife of the doctor himself has taken care of and now it

no longer has any symptoms of the disease, ed) and have two of these

interventions.

One thing though, he says, has not been understood. "I never proposed angioplasty as a treatment of disability. I
do not expect angioplasty to clear the neurological damage in a patient

stabilized after many years. It is a therapy that should prevent

further disability."

What is certain is that Zamboni has been able to rekindle hope in people with MS. A real hope. Even for
those who are devastated by years of illness. "The symptoms tend to fade

and fade. The hope comes from the fact that I offer something concrete,

measurable and visible that I do not know whether it is part of the

thirty or one hundred percent of the disease but it is certainly one of

the causative. Probably competes with other issues and perhaps to

varying degrees in people. Also because I think there is only one

multiple sclerosis. But CCSVI occurs in most patients and at least now

you have something you can control and treat. " "You no longer have an

unknown monster that lies with you to bed every night, but a monster

that you can keep quiet for the time being - continues the doctor - is

very different psychologically. Facing the unknown, dark, black, what

your mind can not understand or doctor can not explain is much heavier."

The internal struggle between radiologists and neurologists

Being a complex and multifactorial disease, amyotrophic is of
interdisciplinary interest, and the interventional radiologist should

offer a service to the neurologist who does not want to either work or

figure out if this service could be useful, it would pass just in the

wrong. And this is very wrong.

The answer to Florio

In what was a real scientific and political earthquake, which has drawn
critical acclaim and with it, Zamboni calls for dialogue and

constructive response to Francesco Florio, chairman of the Radiology

Section of Vascular and Interventional Radiology Society, which by pages

of the Corriere had harshly criticized his treatment. "Dr. Florio has

no evidence to speak - he says - His attitude is a bit 'stupid because

it goes against a position internationally. He never studied the veins

do not know the CCSVI.

The moment of discovery

Zamboni was fond of all patients who have to care. "How not to be?" He asks.
And remember the time of its discovery. "All persons to whom I explained

the treatment they are subjected to my delight with the project. In the

first three years I had told them not to tell anyone, not even his

girlfriend, otherwise the project would be skipped. They had to suppress

their joy. But at least I managed to get to the publication of the

study safely ...», jokes.

Translated from:

http://www.corriere.com/viewstory.php?storyid=102668

Alternate Link:

http://www.ccsvi-sm.org/?q=node%2F425

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