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.

Wednesday, October 22, 2014

Clinical trial could change standard treatment for stroke

Whom is going to consolidate all this and create a damned f*cking stroke protocol?
 You are going to have to remember all this and immediately post-stroke question your doctors to see if they know what they are doing. You better hope you are not unconscious.

Someday our medical teams will figure out exactly what should be done for blood pressure lowering post-stroke. Maybe create a f*cking protocol and publish it for the world to see. Other research here:

1. Detrimental effect of blood pressure reduction in the first 24 hours of acute stroke onset
2. Early Intensive Blood-Pressure Lowering Improves Recovery in Patients With Acute Intracerebral Haemorrhage
 3.  Systolic Blood Pressure During Acute Stroke Is Associated With Functional Status and Long-term Mortality in the Elderly
 4. External Counterpulsation Augments Blood Pressure and Cerebral Flow Velocities in Ischemic Stroke Patients With Cerebral Intracranial Large Artery Occlusive Disease
5.  The One Benefit Of High Blood Pressure? It May Prevent Dementia
6.  Stopping Pre-Stroke Antihypertensive Medication Advised During Acute Stroke 
7.  Mild induced hypertension improves blood flow and oxygen metabolism in transient focal cerebral ischemia
8.  Low Diastolic Pressure Linked to Brain Atrophy 
9.  New Treatment for Stroke Set to Increase Chances of Recovery - haemorrhage blood pressure lowering
 
 
The latest here:
http://www.alphagalileo.org/ViewItem.aspx?ItemId=146425&CultureCode=en 
A large international clinical trial has shed new light on the effectiveness of current hospital protocols for managing blood pressure in stroke patients.
The two-part ENOS trial (Efficacy of Nitric Oxide in Stroke,) was carried out at The University of Nottingham in collaboration with 23 countries to try to solve two major conundrums faced by doctors when treating people who have suffered a stroke — should blood pressure be lowered using medicated skin patches, and should existing blood pressure medication be stopped or continued after a stroke?
The results of the trial, carried out by the University’s Stroke Trial Unit in the Division of Clinical Neurosciences, are being published in The Lancet.
The trial was funded by the Medical Research Council, Efficacy and Mechanism Evaluation (EME) Programme, and BUPA Foundation.
The trial involved 4,011 patients with acute stroke, both ischaemic (blood clot) and haemorrhagic (bleeding). Patients were randomly assigned to receive a glyceryl trinitrate 5mg skin patch (often used in angina patients) or no patch for 7 days. Patients who were already on medication for high blood pressure before their stroke were also randomly assigned to either continue or stop this for 7 days after the stroke.
Leading the trial, Stroke Association Professor of Stroke Medicine Philip Bath, said:  “We found that in patients with acute stroke and high blood pressure, treatment with glyceryl trinitrate patches had acceptable safety but did not improve functional outcome. But there seemed to be benefit in patients who were treated very early, within 6 hours of the onset of symptoms. We aim to carry out a further, larger trial testing very early treatment with the skin patch.
“Our results also show that there is no evidence to support the policy of continuing pre-stroke blood pressure-lowering medication in the acute phase of stroke. An adverse effect in the group continuing medication was pneumonia in patients who had difficulty swallowing, perhaps due to inhalation of the medication into the lungs. Furthermore, discharge home, disability and cognition were all less favourable in those who were allocated to continue BP treatment immediately.”
Professor Bath added: “Our results suggest that antihypertensive treatment should be continued once a patient who has suffered a stroke is stable and is able to swallow medications safely. But there appears to be no urgency to restart treatment in the first week.
“Some doctors in the emergency department seem to feel obliged to get a stroke patient back on their blood pressure medication as soon as possible, but our trial implies they should not rush it.”
The ENOS trial results were initially presented by Professor Bath at the European Stroke Association annual conference in May 2014.
 

No comments:

Post a Comment