Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 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:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. 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 lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Tuesday, June 24, 2014

Newman's Notes: tPA -- Get With the Evidence

All this brainpower and not one understands that delivering tPA faster is not the solution to reduced disability. Damn it all tPA has only a 12% efficacy and does nothing on stopping the neuronal cascade of death. This is so f*cking simple to prove. You do daily MRI scans to see the progression of the dead area during the first week. And maybe then these idiots will solve the correct problem.
tPA delivery times are not the problem to solve. Reducing neuronal cell death is the problem to solve.
http://www.medpagetoday.com/Neurology/Strokes/46455?
The last paragraphs here;
The outcomes in stroke patients -- even those who don't get thrombolytics and, in fact, mostly in those who don't get thrombolytics -- have improved. Outcomes have improved immensely for almost every group over the last 10 to 12 years.
When you look at 2003 to 2010, we know that stroke mortality has been going down. We know it's been going down, partly because of epidemiologic trends that preceded the advent of the drug, and partly because of high quality stroke unit care. There is no reason to believe that these improvements have had anything to do with thrombolytics.
So, it's a little bit strange to see the JAMA trumpeting this as a success and talking about it in ways both in an editorial and in the discussion sections of this study, that suggest thrombolytic administration minutes earlier is the reason that stroke mortality went down.
The two almost certainly have nothing to do with each other.
This is probably, and sadly, another example of wishful thinking. We would like to believe that thrombolytics could save lives but randomized trials strongly contradict the idea. But we wish it was true, just like we wish that getting the drugs on board earlier could improve outcomes.
In the end, judging from the one marker that thrombolytics are supposed to affect -- disability -- the drugs seem to have failed yet again.

Read the rest and weep because our doctors still have absolutely no idea on how to treat stroke.



No comments:

Post a Comment