Deans' stroke musings

Changing stroke rehab and research worldwide now.Time is Brain!Just think of all the trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 493 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It's quite disgusting that this information is not available from every stroke association and doctors group.
My back ground story is here:

Wednesday, August 23, 2017


Well worth the 2 days of vacation and the 8 hour drives up/down to St. Louis. The corona was so bright even during the eclipse the pictures didn't turn out very well. 2 minutes 35 seconds of totality for us, we missed getting an extra 5 seconds of totality by not getting to the exact center line.  We were at a rest area just outside Festus, MO.  Saving the eclipse glasses for the next one in 2024.
Wine for the eclipse

Researchers Make Surprising Discovery About How Neurons Talk to Each Other

Your doctor should be able to translate this into a stroke rehab protocol to make our damaged connections work better.
Researchers at the University of Pittsburgh have uncovered the mechanism by which neurons keep up with the demands of repeatedly sending signals to other neurons. The new findings, made in fruit flies and mice, challenge the existing dogma about how neurons that release the chemical signal dopamine communicate, and may have important implications for many dopamine-related diseases, including schizophrenia, Parkinson’s disease and addiction.

The research conducted at Pitt and Columbia University was published online today in the journal Neuron.

Neurons communicate with one another by releasing chemicals called neurotransmitters, such as dopamine and glutamate, into the small space between two neurons that is known as a synapse. Inside neurons, neurotransmitters awaiting release are housed in small sacs called synaptic vesicles.

“Our findings demonstrate, for the first time, that neurons can change how much dopamine they release as a function of their overall activity. When this mechanism doesn’t work properly, it could lead to profound effects on health,” explained the study’s senior author Zachary Freyberg, M.D., Ph.D., who recently joined Pitt as an assistant professor of psychiatry and cell biology. Freyberg initiated the research while at Columbia University.

When the researchers triggered the dopamine neurons to fire, the neurons’ vesicles began to release dopamine as expected. But then the team noticed something surprising: additional content was loaded into the vesicles before they had the opportunity to empty. Subsequent experiments showed that this activity-induced vesicle loading was due to an increase in acidity levels inside the vesicles.

“Our findings were completely unexpected,” said Freyberg. “They contradict the existing dogma that a finite amount of chemical signal is loaded into a vesicle at any given time, and that vesicle acidity is fixed.”

The team then demonstrated that the increase in acidity was driven by a transport channel in the cell’s surface, which allowed an influx of negatively charged glutamate ions to enter the neuron, thus increasing its acidity. Genetically removing the transporter in fruit flies and mice made the animals less responsive to amphetamine, a drug that exerts its effect by stimulating dopamine release from neurons.

“In this case, glutamate is not acting as a neurotransmitter. Instead it is functioning primarily as a source of negative charge, which is being used by these vesicles in a really clever way to manipulate vesicle acidity and therefore change their dopamine content,” Freyberg said. “This calls into question the whole textbook model of vesicles as having fixed amounts of single neurotransmitters. It appears that these vesicles contain both dopamine and glutamate, and dynamically modify their content to match the conditions of the cell as needed.”

In the future, the team plans to look more closely at how increases in vesicle acidification affect health. A number of brain diseases are characterized by abnormal dopamine neuron signaling and altered levels of the neurotransmitter.

“Since we have demonstrated that the balance between glutamate and dopamine is important for controlling the amount of dopamine that a neuron releases, it stands to reason that an imbalance between the two neurotransmitters could be contributing to symptoms in these diseases,” said Freyberg.

This article has been republished from materials provided by UPMC. Note: material may have been edited for length and content. For further information, please contact the cited source.

Gut microbes may talk to the brain through cortisol

With this from Feb. 2017 and the new research, what protocol is your doctor following to improve your stroke recovery?

Restoring gut bacteria to youthful age linked to improved stroke recovery in mice

Feb. 2017

Gut microbes may talk to the brain through cortisol

University of Illinois College of Agricultural, Consumer and Environmental Sciences

IMAGE: University of Illinois doctoral student Austin Mudd examines piglet brain images. view more 
Credit: Stephanie Henry
URBANA, Ill. - Gut microbes have been in the news a lot lately. Recent studies show they can influence human health, behavior, and certain neurological disorders, such as autism. But just how do they communicate with the brain? Results from a new University of Illinois study suggest a pathway of communication between certain gut bacteria and brain metabolites, by way of a compound in the blood known as cortisol. And unexpectedly, the finding provides a potential mechanism to explain the characteristics of autism.
"Changes in neurometabolites during infancy can have profound effects on brain development, and it is possible that the microbiome -- or collection of bacteria, fungi, and viruses inhabiting our gut -- plays a role in this process," says Austin Mudd, a doctoral student in the Neuroscience Program at U of I. "However, it is unclear which specific gut bacteria are most influential during brain development and what factors, if any, might influence the relationship between the gut and the brain."
The researchers studied 1-month-old piglets, which are remarkably similar to human infants in terms of their gut and brain development. They first identified the relative abundances of bacteria in the feces and ascending colon contents of the piglets, then quantified concentrations of certain compounds in the blood and in the brain.
"Using the piglet as a translatable animal model for human infants provides a unique opportunity for studying aspects of development which are sometimes more difficult or ethically challenging to collect data on in human infants," Mudd says. "For example, in this study we wanted to see if we could find bacteria in the feces of pigletsthat might predict concentrations of compounds in the blood and brain, both of which are more difficult to characterize in infants."
The researchers took a stepwise approach, first identifying predictive relationships between fecal bacteria and brain metabolites. They found that the bacterial genera Bacteroides and Clostridium predicted higher concentrations of myo-inositol, Butyricimonas positively predicted n-acetylaspartate (NAA), and Bacteroides also predicted higher levels of total creatine in the brain. However, when bacteria in the genus Ruminococcus were more abundant in the feces of the piglets, NAA concentrations in the brain were lower.
"These brain metabolites have been found in altered states in individuals diagnosed with autism spectrum disorder (ASD), yet no previous studies have identified specific links between bacterial genera and these particular metabolites," Mudd notes.
The next step was to determine if these four bacterial genera could predict compounds in the blood. "Blood biomarkers are something we can actually collect from an infant, so it's a clinically relevant sample. It would be nice to study an infant's brain directly, but imaging infants is logistically and ethically difficult. We can, however, obtain feces and blood from infants," says Ryan Dilger, associate professor in the Department of Animal Sciences, Division of Nutritional Sciences, and Neuroscience Program at U of I.
The researchers found predictive relationships between the fecal microbiota and serotonin and cortisol, two compounds in the blood known to be influenced by gut microbiota. Specifically, Bacteroides was associated with higher serotonin levels, while Ruminococcus predicted lower concentrations of both serotonin and cortisol. Clostridium and Butyricimonas were not associated strongly with either compound.
Again, Mudd says, the results supported previous findings related to ASD. "Alterations in serum serotonin and cortisol, as well as fecal Bacteroides and Ruminococcus levels, have been described in ASD individuals."
Based on their initial analyses, the researchers wanted to know if there was a three-way relationship between Ruminococcus, cortisol, and NAA. To investigate this further, they used a statistical approach known as "mediation analysis," and found that serum cortisol mediated the relationship between fecal Ruminococcus abundance and brain NAA concentration. In other words, it appears that Ruminococcus communicates with and makes changes to the brain indirectly through cortisol. "This mediation finding is interesting, in that it gives us insight into one way that the gut microbiota may be communicating with the brain. It can be used as a framework for developing future intervention studies which further support this proposed mechanism," Dilger adds.
"Initially, we set out to characterize relationships between the gut microbiota, blood biomarkers, and brain metabolites. But once we looked at the relationships identified in our study, they kept leading us to independently reported findings in the autism literature. We remain cautious and do not want to overstate our findings without support from clinical intervention trials, but we hypothesize that this could be a contributing factor to autism's heterogenous symptoms," Mudd says. Interestingly, in the time since the researchers wrote the paper, other publications have also reported relationships between Ruminococcus and measures of brain development, supporting that this might be a promising area for future research.
Dilger adds, "We admit this approach is limited by only using predictive models. Therefore, the next step is to generate empirical evidence in a clinical setting. So it's important to state that we've only generated a hypothesis here, but it's exciting to consider the progress that may be made in the future based on our evidence in the pre-clinical pig model."
The article, "Serum cortisol mediates the relationship between fecal Ruminococcus & brain N-acetylaspartate in the young pig," is published in Gut Microbes [DOI: 10.1080/19490976.2017.1353849]. Mudd and Dilger's co-authors include Kirsten Berding, Mei Wang, and Sharon Donovan from the Division of Nutritional Sciences and the Department of Food Science and Human Nutrition at U of I. The study was supported by Mead Johnson Nutrition.

Effect of postural insoles on gait pattern in individuals with hemiparesis: A randomized controlled clinical trial

You'll have to send your doctor after this since our fucking failures of stroke associations will do nothing to get this info distributed to all stroke doctors, therapists and hospitals, you will be continually screwed until the current stroke associations are destroyed.



Recovering the ability to walk is an important goal of physical therapy for patients who have survived cerebrovascular accident (stroke). Orthotics can provide a reduction in plantar flexion of the ankle, leading to greater stability in the stance phase of the gait cycle. Postural insoles can be used to reorganize the tone of muscle chains, which exerts an influence on postural control through correction reflexes. The aim of the present study was to perform kinematic and spatiotemporal analyses of gait in stroke survivors with hemiparesis during postural insole usage.

Material and Methods

Twenty stroke victims were randomly divided into two groups: 12 in the experimental group, who used insoles with corrective elements specifically designed for equinovarus foot, and eight in the control group, who used placebo insoles with no corrective elements. Both groups were also submitted to conventional physical therapy. The subjects were analyzed immediately following insole placement and after three months of insole usage. The SMART-D 140® system (BTS Engineering) with eight cameras sensitive to infrared light and the 32-channel SMART-D INTEGRATED WORKSTATION® were used for the three-dimensional gait evaluation.


Significant improvements were found in kinematic range of movement in the ankle and knee as well as gains in ankle dorsiflexion and knee flexion in the experimental group in comparison to the control group after three months of using the insoles.


Postural insoles offer significant benefits to stroke survivors regarding the kinematics of gait, as evidenced by gains in ankle dorsiflexion and knee flexion after three months of usage in combination with conventional physical therapy.

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Research highlights need for expert treatment to manage subarachnoid hemorrhages

But nowhere here do they actually refer to protocols being used that have those best treatment results. Experts is a useless term, subjective not objective.  My GOD, the stupidity displayed in stroke is appalling.
Research led by the head of the Barrow Neurological Institute and published in the July 20, 2017 issue of The New England Journal of Medicine reveals that subarachnoid hemorrhages, which are caused by ruptured brain aneurysms, account for 5-10 percent of all strokes and are best managed by experienced and dedicated experts at high-volume centers with neurosurgeons, endovascular surgeons and stroke neurologists. The article was co-authored by Barrow President and CEO Michael T. Lawton, M.D. and G. Edward Vates, M.D., Ph.D, of the University of Rochester Medical Center's Department of Neurosurgery. "Subarachnoid hemorrhage victims tend to be younger than typical stroke victims, and they risk a greater loss of productive life," Dr. Lawton said. "It is critical that they receive the best treatment for aneurysms - like the multidisciplinary team approach and state-of-the-art therapy like that offered at Barrow."
Neurosurgeons at Barrow have experience treating more than 12,000 aneurysms over the past 20 years. Dr. Lawton, has treated more than 4,000 aneurysms and recently succeeded Robert Spetzler, M.D., as the head of Barrow.
There are an estimated 14.5 hospitalizations for aneurysmal subarachnoid hemorrhage per 100,000 U.S. adults annually, according to the 2003 Nationwide Inpatient Sample. Aneurysmal subarachnoid hemorrhage is more common among women than among men, and the incidence increases with age to a peak among persons in their 50s. In The New England Journal of Medicine article, the doctors described the case of a 17-year-old boy who experienced a sudden, severe headache and loss of consciousness at soccer practice. The patient described in the vignette had clinical and radiographic findings that are consistent with subarachnoid hemorrhage. Catheter angiography was indicated to identify the source of his bleeding. An aneurysm is the most common cause and, if identified, is associated with a very high risk of re-rupture during the next 30 days; thus, the researchers recommend immediate treatment.
"Given this patient's age, his otherwise healthy status, and the location of the aneurysm in the anterior circulation, we would recommend open-surgical treatment by a specialized, experienced surgeon," Dr. Lawton wrote. Open-surgical treatment (surgical clipping) is preferred on the basis of certain features of the aneurysm (e.g., morphologic characteristics of the aneurysm and an associated large hematoma) or in younger patients, given the greater durability of the open-surgical treatment in the randomized trials. "If a surgeon with expertise in open-surgical technique is not available at the center, endovascular treatment could be provided instead to eliminate the immediate risk of re-rupture."
Subarachnoid hemorrhage without a preceding trauma is caused by the rupture of an intracranial aneurysm in 80 percent of cases; other causes include vascular malformations and vasculitis. Subarachnoid hemorrhage accounts for 5 to 10 percent of all strokes in the United States, and affected patients tend to be younger than those affected by other subtypes of stroke, which results in a greater loss of productive life. Among the patients with aneurysmal subarachnoid hemorrhage who survive, half suffer long-term neuropsychological effects and decreased quality of life.
The article describes "sentinel" headaches, which occur several weeks before aneurysmal subarachnoid hemorrhages in 10 to 40 percent of patients. Because such headaches are rare, accounting for only 1 percent of all headaches evaluated in the emergency department, a sentinel headache may be dismissed as a migraine headache or other headache without further evaluation; the likelihood of death or disability is four times as high among patients in whom a sentinel headache is misdiagnosed as it is among patients in whom a sentinel headache is correctly diagnosed.
"A high index of suspicion for aneurysmal subarachnoid hemorrhage from the patient's history is warranted and potentially lifesaving," Dr. Lawton said. "Expert care, analogous to that at a dedicated neuroscience institute like Barrow, is critical in these cases." Lazy bastards, talking about 'care', not results!

The Rehabilitation of Younger Stroke Patients

You are going to have to diagnose your stroke yourself and inform your doctors what to do. And likely have to figure out your own rehab.

Pediatric Stroke Often Misdiagnosed, Treatment Delayed


Doctors tell boy, 15, he had a migraine after rugby tackle - but he was actually suffering a paralyzing stroke which nearly killed him


Factors Associated With Misdiagnosis of Acute Stroke in Young Adults

The Rehabilitation of Younger Stroke Patients

Andreea Cotoi MSc, Hannah Mahon BSc, Cristina Batey MD, Norhayati Hussein MBBS, Jashan Brar BSc, Shannon Janzen MSc , Robert Teasell MD Last Updated: September 2016
Abstract The young stroke population represents a significant rehabilitation challenge. When compared to older stroke patients, young patients are more often employed, caring for dependants, and relying on work - related income. Although much less common than in older patients, stroke in young adults has an annual incidence rate from 6 to 20 per 100,000 individuals annually (Leys et al. 2002) . For every 5 individuals who experience a stroke, 1 is under the age of 65 while 5% of all stroke patients are younger than 45 years old . This represents a significant number of patients with some unique rehabilitation needs (Dixon et al. 2007; Stone 2007). This chapter reviews current research pertaining to incidence, risk, etiology, rehabilitation, recovery and prognosis of stroke in younger patients. Additional topics relevant to the young stroke population are also featured: Return to work, family stress, institutionalization, patient perceptions of care, and future needs.

S182 Introduction to neuroplasticity and its application in neurorehabilitation

I bet nothing in this article helps you make neuroplasticity repeatable by following exact protocols.
Cairo University, Department of Neurophysiology, Cairo, Egypt
Neuroplasticity is defined as the property of the brain to adapt to environmental pressures, experiences, and challenges including brain damage. It is a lifelong capacity of the brain to change and rewire itself in response to the stimulation of learning and experience. Based upon this input, several conclusions were recently appearing on the surface. First, there appears to be tremendous latent plasticity even in the adult brain. Second, the brain should be thought of, not as a hierarchy of organized autonomous modules, each of which delivers its output to the next level, but as a set of complex interacting networks that are in a state of dynamic equilibrium with the brain’s environment. Both principles can be potentially exploited in a clinical context to facilitate recovery of function. Promoting neuroplasticity in an enriched environment will eventually result in dendritic branching, synapses, glial processes, brain weight, and cortical thickness. Currently, it is believed that activity drives reorganization of cerebral networks, which is paralleled by functional improvements in cases of acquired brain injuries that are usually in need of intense rehabilitation programs. Numeral studies have demonstrated reorganization of brain activity pattern in response to intense training of motor and cognitive tasks and imagination of movements. For instance, promising results were shown using feedback techniques, like mirror visual feedback (MVF) improving chronic regional pain syndrome and hemiparesis following stroke. Evidence based therapeutic interventions using neuroplasticity as its base include aerobic exercise, bilateral arm training, constraint induced movement therapy,body weight supported treadmill training, mirror therapy, action observation, motor imagery/mental practice, functional electrical stimulation and music therapy.Promising therapies that may enhance training-induced cognitive and motor learning, such as brain stimulation and neuropharmacological interventions, were also identified, along with arousing questions involving more updated ways to use neuroplasticity in improving quality of life in cases of human disability.

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Artificial intelligence predicts dementia before onset of symptoms

What are your doctors dementia prevention strategies? You will need them. You need to DEMAND specifics not this general crap you are going to get.

1. A documented 33% dementia chance post-stroke from an Australian study?   May 2012.
2. Then this study came out and seems to have a range from 17-66%. December 2013.
3. A 20% chance in this research.   July 2013.
22 August 2017 McGill University
Imagine if doctors could determine, many years in advance, who is likely to develop dementia. Such prognostic capabilities would give patients and their families time to plan and manage treatment and care. Thanks to artificial intelligence research conducted at McGill University, this kind of predictive power could soon be available to clinicians everywhere.
Scientists from the Douglas Mental Health University Institute’s Translational Neuroimaging Laboratory at McGill used artificial intelligence techniques and big data to develop an algorithm capable of recognizing the signatures of dementia two years before its onset, using a single amyloid PET scan of the brain of patients at risk of developing Alzheimer’s disease. Their findings appear in a new study published in the journal Neurobiology of Aging.
Dr. Pedro Rosa-Neto, co-lead author of the study and Associate Professor in McGill’s departments of Neurology & Neurosurgery and Psychiatry, expects that this technology will change the way physicians manage patients and greatly accelerate treatment research into Alzheimer’s disease.
“By using this tool, clinical trials could focus only on individuals with a higher likelihood of progressing to dementia within the time frame of the study. This will greatly reduce the cost and the time necessary to conduct these studies,” adds Dr. Serge Gauthier, co-lead author and Professor of Neurology & Neurosurgery and Psychiatry at McGill.
Amyloid as a biomarker of dementia
Scientists have long known that a protein known as amyloid accumulates in the brain of patients with mild cognitive impairment (MCI), a condition that often leads to dementia. Though the accumulation of amyloid begins decades before the symptoms of dementia occur, this protein couldn’t be used reliably as a predictive biomarker because not all MCI patients develop Alzheimer’s disease.
To conduct their study, the McGill researchers drew on data available through the Alzheimer’s Disease Neuroimaging Initiative (ADNI), a global research effort in which participating patients agree to complete a variety of imaging and clinical assessments.
Sulantha Mathotaarachchi, a computer scientist from Rosa-Neto’s and Gauthier’s team, used hundreds of amyloid PET scans of MCI patients from the ADNI database to train the team’s algorithm to identify which patients would develop dementia, with an accuracy of 84%, before symptom onset. Research is ongoing to find other biomarkers for dementia that could be incorporated into the algorithm in order to improve the software’s prediction capabilities.
“This is an example how big data and open science brings tangible benefits to patient care,” says Dr. Rosa-Neto, who is also director of the McGill University Research Centre for Studies in Aging.
While new software has been made available online to scientists and students, physicians won’t be able to use this tool in clinical practice before certification by health authorities. To that end, the McGill team is currently conducting further testing to validate the algorithm in different patient cohorts, particularly those with concurrent conditions such as small strokes.

Walking and fungi

I needed to get my 70,000 weekly steps in by Friday, since Saturday was a 70th birthday party for a friend and Sunday was the drive to St. Louis for the eclipse. Got in 15,000 steps on Friday and saw this wonderful fungi on the trail. Notice the slugs crawling on it. Monday and Tuesday this week only managed 7,000 steps so will have to do extra daily once again.

Saturday, August 19, 2017

Lasers used to detect risk of heart attack and stroke

There was nothing in my profile or any risk calculator that even remotely suggested I was at risk for a stroke at age 50.   The only hint would have been that my Dad had 80% blockage in one of his carotid arteries.
18 August 2017 Warwick, University of
Patients at risk of heart attacks and strokes may be spotted earlier thanks to a diagnosis tool that uses near-infrared light to identify high-risk arterial plaques, according to research carried out at WMG, University of Warwick, the Baker Institute and Monash University.
The scientists observed that when they increased the wavelength of the light currently used to visualise the fatty build-up found in arteries (atherosclerotic plaques) they could selectively identify the rupture-prone deposits, which commonly lead to blood clots, heart attacks and strokes.
While some fatty deposits or plaques can remain stable for years, other high-risk cases develop complications, such as bleeding into the plaque, which leads to the formation of cracks and rupture of the fatty plaque. This can result in blockages in the blood vessels causing a heart attack or stroke. Current imaging techniques are able to identify some characteristics of high-risk plaques but none are generally accepted as reliable methods for selectively detecting the dangerous plaques.
“What we have done uses innovative, materials-based techniques to assist in the development of new diagnostic tools,” explains Dr Tara Schiller, WMG, University of Warwick.
“This could help us to detect the threat of an imminent heart attack and result in a decrease of the mortality rates,” Dr Schiller continues.
Dr Tara Schiller from the International Institute for Nanocomposites Manufacturing at WMG, along with colleagues from the Baker and Monash University, have discovered that increasing the wavelength of the infra-red (IR) radiation currently used to detect fatty deposit build-up in arteries to near-infrared (NIR) wavelengths allowed them to selectively identify plaques with internal bleeding, typically associated with high-risk deposits.
The products causing this fluorescence were identified using Raman spectroscopy. They are thought to be a mixture of heme products, formed during the degradation of red blood cells. These products were only observed in the unstable plaques with internal bleeding and not observed in the more stable fatty deposits. This can improve selectivity when looking for high-risk deposits in patients and could help doctors to identify the most at-risk patients.
“Despite the millions of dollars spent each year particularly on heart imaging, there still isn't a reliable way of identifying these unstable plaques,” explains Dr Karlheinz Peter.
“We realised when we shine a light in the near-infrared wavelength range, that this light is reflected at a certain wavelength. So in a way we can use laser light to shine up the plaques that are unstable, and it's very characteristic,” Dr Peter continues.
After further investigation with clinical trials this method of imaging technique could be used to assess unstable fatty arterial plaques and could be used to monitor the effectiveness of the drugs used to prevent heart attacks or strokes.
The research ‘Near-infrared autofluorescence induced by intraplaque hemorrhage and heme degradation as marker for high-risk atherosclerotic plaques’ is published in Nature Communications.

Attached files

  • Dr Tara Schiller

Friday, August 18, 2017

Cholesterol crystals are sure sign a heart attack may loom

You'll have to ask your doctor how this can be prevented. I'm using the following.

Watermelon juice reverses hardening of the arteries Nov. 2011 

New study shows aged garlic extract can reduce dangerous plaque buildup in arteries  Jan. 2016 

Pomegranate juice consumption for 3 years by patients with carotid artery stenosis reduces common carotid intima-media thickness, blood pressure and LDL oxidation  June 2004 

Regular coffee drinkers have 'cleaner' arteries March 2015 

I'm not medically trained so don't follow me.

Cholesterol crystals are sure sign a heart attack may loom 

A new Michigan State University study on 240 emergency room patients shows just how much of a role a person's cholesterol plays, when in a crystallized state, during a heart attack.
George Abela, lead author and chief cardiologist at MSU, analyzed the material that was obstructing the coronary arteries of patients who had suffered a and found that 89 percent of them had an excessive amount of these crystallized structures, referred to as .
The research is now published online in the American Journal of Cardiology.
These crystals are released from plaque that can build up in the heart and is often made up of fat, calcium and other substances as well. When this material hardens over time in the arteries, it's known as atherosclerosis.
"In previous studies, we showed that when cholesterol goes from a liquid to a solid, or crystal state, it expands in volume like ice and water," Abela said. "This expansion inside the wall of the artery can tear it and block causing a heart attack or stroke."
After entered the , Abela and his team suctioned out this plaque. They were able to see that clusters of large crystals had formed and were able to break through the plaque and walls of the arteries and then released into the heart. This caused damage by blocking blood flow.
"We now know to what great extent these crystals are contributing to a heart attack," Abela said.
This latest research also reconfirms what Abela discovered in an earlier study that cholesterol crystals activated the production of inflammation molecules, known as Interleukin-1 beta, which aggravate, or inflame, coronary arteries.
"Now that we've shown how extensive cholesterol crystals are irritating and blocking off these , treatments that dissolve these crystals may be used to reduce heart damage," Abela said.
Some of these treatments can include the use of statin drugs - often used to lower one's cholesterol - aspirin and solvents such as alcohol that can be injected in low doses into a vein during a heart attack. Using these options could allow doctors to improve patient outcomes and save more lives.
A recent clinical trial using an already FDA-approved antibody, known as canakinumab, has also shown to block the Interleukin-1 beta inflammation molecule and reduce the chances of a cardiac event.
"Saving heart muscle is the most important aspect of treating a heart attack," Abela said. "So, if we are able to provide patients with better, more targeted treatments, then this could help open up and calm down the aggravated artery and protect the muscle from injury."
Abela also added that by simply controlling one's cholesterol by eating a healthy diet, exercising and taking statin medications as needed, could be the best way to prevent these crystals from forming.
More information: Frequency of Cholesterol Crystals in Culprit Coronary Artery Aspirate during Acute Myocardial Infarction and Their Relation to Inflammation and Myocardial Injury , American Journal of Cardiology (2017). DOI:
Provided by Michigan State University

New study examines potential Alzheimer's disease prevention strategies

What are your doctors dementia prevention strategies? You will need them. You need to demand specifics not this general crap you are going to get.

1. A documented 33% dementia chance post-stroke from an Australian study?   May 2012.
2. Then this study came out and seems to have a range from 17-66%. December 2013.
3. A 20% chance in this research.   July 2013.

New study examines potential Alzheimer's disease prevention strategies

Alzheimer's disease (AD) is a type of dementia that causes problems with memory, thinking, and behavior. It affects more than 5 million Americans. The Alzheimer's Association estimates that some 16 million people will develop the disease by the year 2050 if an effective treatment is not discovered. Symptoms of AD usually develop slowly and worsen over time. They often become severe enough to interfere with daily tasks, and can eventually cause death.
In a new study, published in the Journal of the American Geriatrics Society, James E. Galvin, MD, MPH, Professor of Integrated Medical Science and Associate Dean for Clinical Research, Charles E. Schmidt College of Medicine, Florida Atlantic University, examined potential AD prevention strategies.
Dr. Galvin notes that just four medications have been approved to treat AD symptoms. A major effort is underway to develop new treatments for the disease by the year 2025, and researchers have launched several new studies.
Another area of research interest focuses on AD prevention strategies. In studies of people with AD, researchers have discovered conditions that increase risk factors associated with the disease. When these conditions are combined, they account for more than 50 percent of the risk for AD. They include:
  • Diabetes
  • High blood pressure
  • Kidney problems
  • Alcohol and tobacco use
  • High cholesterol
  • Coronary heart disease
  • Depression
  • Low activity life style
  • Diet
Researchers looked at 19 studies about various brain-stimulating activities that may lower risks for AD, . They discovered that doing crossword puzzles, playing card games, using a computer, making arts or crafts, taking classes, having group discussions, and listening to music all had protective effects against AD.
Researchers have learned that physical activity helps reduce AD risk by up to 65 percent, depending on the type of exercise and its intensity. That's because exercise reduces blood vessel disease risk, improves your breathing function, supports the survival of the cells that make up your body, and lessens inflammation.
Age remains the greatest risk factor for AD: by 82, the risk for developing the disease is 42 percent. The good news: 58 percent of older adults do not develop AD.
Presently, we don't understand why some people develop the disease and others don't. But addressing the risk factors we do know about could make a difference. For example, up to 30 percent of AD cases may be preventable by living a well-balanced, healthy life. That would include eating a healthy diet with plenty of fresh fruits and vegetables, whole grain foods, lean proteins, and few to no "fast" or processed foods. A healthy lifestyle also includes physical activity and social engagement.
The future of researching ways to prevent AD should probably focus on people at risk for developing the disease, said researchers, and should highlight how to improve management of chronic health conditions and education about living healthier.

Umbrella challenges

Luckily my umbrella has a powered opening. To close it I do have to push it against the floor. The real problem comes in trying to wrap the umbrella tight with the velcro strip. That usually ends up not being successful which results in not being able to put the umbrella back into the protective sleeve. Ask your occupational therapist for the protocol to accomplish this ADL. At least I no longer need a cane which made using an umbrella and cane at the same time impossible.

2017 IEEE-RAS-EMBS International Conference on Rehabilitation Robotics July 17-20, 2017, QEII Centre, London, UK

Your doctor has a lot of followup to do to to incorporate this information into your stroke protocols.  You better hope your doctor is the one in a million that gets this all right. Or maybe your doctor will DO NOTHING  because s/he is waiting for SOMEONE ELSE TO SOLVE THE PROBLEM? The solution to this overload of research is simple, that great stroke association takes all these and updates the stroke protocols publicly available in a database. 
The following were presented at the conference;
A Pilot Study on the Optimal Speeds for Passive Wrist Movements by a Rehabilitation Robot of Stroke Patients: A Functional NIRS Study

Clarification of Muscle Synergy Structure During Standing-Up Motion of Healthy Young, Elderly and Post-Stroke Patients

A Novel Pneumatic Stimulator for the Investigation of Noise-Enhanced Proprioception

Simulating the Impact of Sensorimotor Deficits on Reaching Performance

Position and Torque Control Via Rehabilitation Robot and Functional Electrical Stimulation

Codification Mechanisms of Wrist Position Sense

There Is Plenty of Room for Motor Learning at the Bottom of the Fugl-Meyer: Acquisition of a Novel Bimanual Wheelchair Skill after Chronic Stroke Using an Unmasking Technology

The Combined Action of a Passive Exoskeleton and an EMG-Controlled Neuroprosthesis for Upper Limb Stroke Rehabilitation: First Results of the RETRAINER Project

Maintaining Subject Engagement During Robotic Rehabilitation with a Minimal Assist-As-Needed (mAAN) Controller

Feedforward Model Based Arm Weight Compensation with the Rehabilitation Robot ARMin

Movement Therapy without Moving – First Results on Isometric Movement Training for Post-Stroke Rehabilitation of Arm Function

Application of Support Vector Machines in Detecting Hand Grasp Gestures Using a Commercially Off the Shelf Wireless Myoelectric Armband

Leap Motion Evaluation for Assessment of Upper Limbs Motor Skills in Parkinson's Disease

Improving Robotic Stroke Rehabilitation by Incorporating Neural Intent Detection: Preliminary Results from a Clinical Trial

Design of Continuous EMG Classification Approaches towards the Control of a Robotic Exoskeleton for Reaching Movements

Development of Elbow Spasticity Model for Objective Training of Spasiticy Assessment of Patients Post Stroke

A Multichannel-Near-Infrared-Spectroscopy-Triggered Robotic Hand Rehabilitation System for Stroke Patients

How Do Strength and Coordination Recovery Interact after Stroke? a Computational Model for Informing Robotic Training

Computational Rehabilitation of Neglect: Using State-Space Models to Understand the Recovery Mechanisms

The Effects of Silent Visuomotor Cueing on Word Retrieval in Broca’s Aphasics: A Pilot Study

MIT-Skywalker: On the Use of a Markerless System

Design of an Exoskeleton Ankle Robot for Robot-Assisted Gait Training of Stroke Patients

A Novel Robot-Assisted Training Approach for Improving Gait Symmetry after Stroke

A Generalized Framework to Achieve Coordinated Admittance Control for Multi-Joint Lower Limb Robotic Exoskeleton

The Effect of Haptic Interaction between Balance Assessment Robot and Pelvis on Muscle Activation of Leg Muscles

Research of the BWS System for Lower Extremity Rehabilitation Robot

Autonomous Hip Exoskeleton Saves Metabolic Cost of Walking Uphill

Biomechanical Effects of Robot Assisted Walking on Lower Limb Joint Kinematics and Muscle Activation Pattern

Development of an Automatic Rotational Orthosis for Walking with Arm Swing

Toward Goal-Oriented Robotic Gait Training: The Effect of Gait Speed and Stride Length on Lower Extremity Joint Torques

The Influence of the Re-Link Trainer on Gait Symmetry in Healthy Adults

Design and Experimental Evaluation of a Lightweight, High-Torque and Compliant Actuator for an Active Ankle Foot Orthosis

Comparing Neural Control and Mechanically Intrinsic Control of Powered Ankle Exoskeletons

Motor Adaptation to Lateral Pelvis Assistance Force During Treadmill Walking in Individuals Post-Stroke

Development of New Rehabilitation Robot Device That Can Be Attached to the Conventional Knee-Ankle-Foot-Orthosis for Controlling the Knee in Individuals after Stroke

Walking Speed Intention Model Using Soleus Electromyogram Signal of Nondisabled and Post-Stroke Hemiparetic Patients

Developing Safe Fall Strategies for Lower Limb Exoskeletons

Timing of Intermittent Torque Control with Wire-Driven Gait  Training Robot Lifting Toe Trajectory for Trip Avoidance

Using Wearable Physiological Sensors to Predict Energy Expenditure

Preliminary Assessment of a Lower-Limb Exoskeleton Controller for Guiding Leg Movement in Overground Walking

Effects of Partial Body-Weight Support and Functional Electrical Stimulation on Gait Characteristics During Treadmill Locomotion: Pros and Cons of Saddle-Seat-Type Body-Weight Support

An Optimized Design of a Parallel Robot for Gait Training

Active Impedance Control of a Knee-Joint Orthosis During Swing Phase

An Assistive Lower Limb Exoskeleton for People with Neurological Gait Disorders

Design and Evaluation of a Modular Lower Limb Exoskeleton for Rehabilitation

Comparison of Kinematic and EMG Parameters between Unassisted, Fixed and Adaptive-Stiffness Robotic-Assisted Ankle Movements in Post-Stroke Subjects

Gait Assessment System Based on Novel Gait Variability Measures