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:http://oc1dean.blogspot.com/2010/11/my-background-story_8.html

Wednesday, November 30, 2016

Walking faster after stroke

Fucking useless writeup. No link to what these new gait guidelines are. Sent an email to the writer on this, we'll see if she responds. A great stroke association would be responding to every article on stroke around the world.
The writers response:
Dean,
Good point. I will make sure the researcher sees your note. I’m not sure if the guidelines are publicly available yet. Thank you for writing.

Gloria
https://www.eurekalert.org/pub_releases/2016-11/ah-wfa112816.php
Courage Kenny Rehabilitation Institute researchers recently presented results from two studies at the American Congress of Rehabilitation Medicine. The annual conference is an expansive educational program covering brain injury, spinal cord injury, stroke, neurodegenerative diseases, pain, cancer, pediatric rehabilitation and neuroplasticity.
Nancy Flinn, PhD, OTR/L, senior scientific adviser, showed how new gait guidelines have improved the walking speed of stroke patients. Courage Kenny developed more aggressive guidelines based on best practices and began using them during physical therapy sessions in 2015. On average, patients doubled their improvement in speed during therapy after the implementation of the guidelines.
"Gait speed has a big impact of how people do in the community. The gains patients made in gait speed meant that, on average, patients were now walking at community walking speeds. If they went to the mall or the grocery store, they would be able to move at the speed of others, so they are safer, because they are less likely to get bumped by others who are passing them," said Flinn.

And if you can do a little more, then, of course, you can repeat those changes until you've done a lot more.

This quote from Seth Godin should be the first words out of your doctors mouth explaining how neuroplasticity will work for your recovery.

Plasticity by Seth Godin 

An occasional drink doesn't hurt coronary arteries

I bet your doctor reflexively tells you not to drink alcohol. Up to your discretion.

Alcohol for these 12 reasons.

A little daily alcohol may cut stroke risk

The latest here: 

An occasional drink doesn't hurt coronary arteries

CHICAGO - Having an alcoholic drink once or twice a day does not appear to affect the coronary arteries, researchers reported on Tuesday at the RSNA annual meeting.
The group used coronary CT angiography (CCTA) to observe the arteries of patients with suspected coronary artery disease. There was no association between light to moderate alcohol consumption and such disease, concluded Dr. Júlia Karády from Semmelweis University in Budapest and colleagues.

The researchers defined light to moderate drinking as 14 units per week of beer, wine, or spirits. One unit translates to approximately 6.8 fluid ounces of beer, 3.4 ounces of wine, or 1.35 ounces of hard liquor.  
Notice that standard beer sizes are 12 oz. in bottles/cans, 16 oz. in bars, wine is usually 5 oz. in bars. This research is not translatable to real life because of these incorrect research definitions.

More at link. 

Total red meat intake of ≥ 0.5 servings/d does not negatively influence cardiovascular disease risk factors: A systemically searched meta-analysis of randomized controlled trials

What does this news mean? What does your doctor say? ANYTHING AT ALL?
Positives:

Study: Protein from meat, fish may help men age well

Study links eating more protein to lowered stroke risk

Negatives:

 Results from this meta-analysis indicate that consumption of fresh red meat and processed red meat as well as total red meat is associated with increased risk of total stroke and ischemic stroke, but not hemorrhagic stroke.

Frequent red meat eaters at higher risk of stroke

10 Reasons To Stop Eating Red Meat

The latest news:

Total red meat intake of ≥ 0.5 servings/d does not negatively influence cardiovascular disease risk factors: A systemically searched meta-analysis of randomized controlled trials


American Journal of Clinical Nutrition, 11/30/2016
In this systematically searched meta–analysis, researchers evaluate the impacts of consuming ≥ 0.5 or <0.5 servings of total red meat/d on CVD risk factors [blood total cholesterol (TC), LDL cholesterol, HDL cholesterol, triglycerides, ratio of TC to HDL cholesterol (TC:HDL), and systolic and diastolic blood pressures (SBP and DBP, respectively)]. They speculated that the intake of ≥0.5 servings of total red meat/d would have a negative affect these CVD risk factors. The outcomes from this systematically sought meta–analysis of RCTs support the idea that the intake of ≥0.5 servings of total red meat/d does not impact blood lipids and lipoproteins or blood pressures.

Methods

  • From 24 qualified RCTs, 2 researchers independently screened 945 studies from PubMed, Cochrane Library, and Scopus databases and extracted data.
  • Inclusion criteria were 1) RCT, 2) subjects aged ≥19 y, 3) intake of ≥ 0.5 or <0.5 total red meat servings/d [35 g (1.25 ounces)], and 4) reporting ≥1 CVD risk factor.
  • They played out an adjusted 2–factor nested ANOVA mixed–effects model procedure on the postintervention values of TC, LDL cholesterol, HDL cholesterol, TC:HDL cholesterol, triglycerides, SBP, and DBP; ascertained general impact sizes of change values; and utilized a repeated–measures ANOVA to evaluate pre– to postintervention changes.

Results

  • Red meat consumption did not influence lipid–lipoprotein profiles or blood pressure values postintervention (P > 0.05) or changes over time [weighted mean difference (95% CI): –0.01 mmol/L (–0.08, 0.06 mmol/L), 0.02 mmol/L (–0.05, 0.08 mmol/L), 0.03 mmol/L (–0.01, 0.07 mmol/L), and 0.04 mmol/L (–0.02, 0.10 mmol/L) mmol/L; –0.08 mm Hg (–0.26, 0.11 mm Hg); and –1.0 mm Hg (–2.4, 0.78 mm Hg) and 0.1 mm Hg (–1.2, 1.5 mm Hg) for TC, LDL cholesterol, HDL cholesterol, triglycerides, TC:HDL cholesterol, SBP, and DBP, respectively].
  • Among all subjects, TC, LDL cholesterol, HDL cholesterol, TC:HDL cholesterol, triglycerides, and DBP, but not SBP, diminished over time (P < 0.05). 
  • Total gobbledegook I'm sure done on purpose so it looks important.
Go to PubMed Go to Abstract Print Article Summary Cat 2 CME Report

Tuesday, November 29, 2016

Milk Chocolate Benefits to Give Dark Chocolate a Run for Its Money?

How closely is your doctor and nutritionist following this? Or not at all? When the fuck will you get a stroke diet protocol? For rehab, for prevention, for blood pressure reduction? I'm betting never because we don't have a great stroke association leadiug the charge.
http://www.rdmag.com/article/2016/11/milk-chocolate-benefits-give-dark-chocolate-run-its-money?


There may be some more hidden health benefits the next time you reach for a chocolate cupcake, candy bar or cup of pudding.
While the debate between what tastes better between milk chocolate and dark chocolate rages on, antioxidant rich dark chocolate has more health benefits and researchers are attempting to improve the benefits of the milkier version.
Researchers led by Lisa Dean, associate professor of food science for the U.S. Department of Agriculture at North Carolina State University in Raleigh, explain in a recent study that adding peanut skin extract mixed with a sweet, edible powder called maltodextrin, to milk chocolate gives it some of the heart health benefits that dark chocolate has, while maintaining the sweeter chocolate taste.
“If applied to commercial products, peanut skin extracts would allow consumers to enjoy mild tasting products and have exposure to compounds that have proven health benefits,” Dean said in a statement.
Dark chocolate is rich in antioxidants, which prevent or delay some types of cell damage. While the benefits of dark chocolate outweigh the benefits of milk chocolate, many people prefer the lighter and sweeter version of chocolate when they are reaching for a candy bar.
According to an article in Science News for Students, all chocolate contains antioxidant-laden cocoa beans and those beans are broken down into cocoa solids and a fat called cocoa butter to produce chocolate. To produce chocolate commercially manufacturers add sugar to the product, with more sugar added to milk chocolate, as well as milk or cream, than what is added to dark chocolate.
With the additives, milk chocolate has less cocoa than dark chocolate, which also means it contains less antioxidants. In the past when scientists have attempted to add antioxidants to milk chocolate they have impacted the overall taste.
However, peanut skin extract has both improved the health benefits of milk chocolate without having the taste suffer. While healthier cookies, cakes and brownies are certainly needed, another benefit is the ability to use peanut skins, which is a byproduct of peanut butter production and is mostly buried as wastes in landfills.
Dean and her team of scientists decided to test out the new and improved milk chocolate by giving a sample piece of the new milk chocolate along with two pieces of regular milk chocolate to 100 volunteers.
The results were overwhelming.
Only 20 percent of the volunteers picked up on any extra bitterness, while 80 percent noticed no difference between the chocolate with peanut skin extract and the chocolate without it.
Dean said that peanut allergenicity was not investigated during the original study, but work is ongoing.
The study, which was published in the Journal of Food Science, can be viewed here.

Opportunities for the Next Administration to Advance Biomedical Innovation

Every single stroke hospital and stroke association should be sending members to this. But they won't because they don't want to tackle any of the stroke BHAGs(Big Hairy Audacious Goals) . They are lazy and useless.  I would tackle every single one and get them solved and I am brain-damaged.


Thursday, December 8, 2016 | 1:00 PM to 2:00 PM Eastern | Webinar

Biomedical innovation is vital to America’s health and economic well-being. President-elect Donald Trump has the opportunity to lead in this area and construct policies to maintain the system’s strength and productivity. FasterCures engaged our unique network of stakeholders across the R&D ecosystem to interview more than 150 thought leaders across eight sectors. We synthesized these insights into the “Rx for Innovation” report, which presents 26 recommendations for how the next administration can translate the ideas we heard into meaningful action.

Join FasterCures for a free Webinar to discuss “Opportunities for the Next Administration to Advance Biomedical Innovation,” on Thursday, Dec. 8, 2016, from 1 to 2 p.m. Eastern.

Biomedical Innovation
Speakers include:
  • Patrick White, President, Act for NIH
  • Mary Dwight, Senior Vice President for Policy and Patient Programs, Cystic Fibrosis Foundation
  • Margaret Anderson, Executive Director, FasterCures, a center of the Milken Institute (moderator)
Register Here

Unable to attend? Please click here

Why I use the term; fucking failures of stroke associations.

No database of stroke research, stroke rehab protocols, or exact stroke prevention tactics. No stroke strategy on how to solve all the problems in stroke, no leadership, no acknowledgement of any problems in stroke.
They don't take the simplest steps to do anything useful for survivors. NOTHING!!!
No outreach to survivors.
Doctors seem to be well supported but with no database of anything, joining these associations is worthless
No attempt to create a strategy that will solve everything in stroke.
A great stroke association would look like this:
Great stroke association 
Shaming doesn't seem to work unless they don't even know they are being blatantly criticized for everything they do and don't do. If they don't even know they are being criticized that shows even worse incompetence than I envisioned.   

The Michael J. Fox Foundation Hosted the Challenge toward Computational Analysis of the Robust Study Dataset

Our fucking failures of stroke associations can't even pull together $50,000 to create a challenge like this for stroke. They really are totally useless, you will need to research and create your own stroke recovery protocols. No one is going to help you.
https://www.michaeljfox.org/foundation/publication-detail.html?id=625&category=7
Answering Fundamental Questions on Parkinson's Progression and Subtypes Will Assist in Development and Testing of New Therapies
Each Winner Receives a $25,000 Award
NEW YORK and SAN FRANCISCO -- The Michael J. Fox Foundation for Parkinson's Research (MJFF) announces Duygu Tosun-Turgut, PhD, assistant professor of radiology and biomedical imaging at UC San Francisco and co-director of the Center for Imaging of Neurodegenerative Diseases at the San Francisco Veterans Affairs Health Care System; and Fei Wang, PhD, assistant professor of health care policy and research at Weill Cornell Medicine as winners of the MJFF-led 2016 Parkinson's Progression Markers Initiative (PPMI) Data Challenge. Each will receive a $25,000 award furnished by MJFF and supported in part by GE Healthcare.
The contest asked data analysts to provide a model of either Parkinson's disease subtypes or baseline predictors of progression using data from PPMI, a longitudinal biomarkers study sponsored by MJFF. Such tools could accelerate testing of new Parkinson's treatments by assisting in trial design and subject stratification.
"The Parkinson's Progression Markers Initiative offers a rich pool of open-access data from which to make connections that advance our understanding of Parkinson's disease and impact how we approach drug development," said Mark Frasier, PhD, MJFF senior vice president of research programs. "The award encouraged scientists from other disciplines to lend their expertise to our efforts to find a cure. Drs. Tosun-Turgut and Wang have provided a strong basis to build on."
The PPMI Data Challenge offered applicants the opportunity to partner with Parkinson's researchers to advise on their projects. Collaboration between computational and disease experts can direct analyses toward measures and features most relevant to the field.
PPMI has enrolled nearly 1,000 volunteers to date -- people with Parkinson's or with risk factors, as well as control participants -- at 33 clinical sites around the world. In the course of a minimum of five years' participation, volunteers contribute clinical and imaging data and biological samples.
GE Healthcare is one of 19 PPMI industry partners that provide financial or in-kind support and intellectual expertise to the study. MJFF and GE Healthcare will continue to collaborate on optimizing the PPMI dataset to develop digital solutions that aim to improve patients' clinical outcomes.
Characterization of Parkinson's Informs Research Directions and DesignDr. Tosun-Turgut reports that an MRI scan of brain structure and functionality (diffusion tensor imaging) and Unified Parkinson's Disease Rating Scale III (motor examination) total score at baseline are, together, the best factors for predicting slow versus fast progression.
"Parkinson's is a highly variable disease, which hinders clinicians' ability to give patients a clear prognosis and researchers' ability to efficiently measure the impact of treatments on the disease process," said Dr. Tosun-Turgut. "Identifying early clinical markers of rate of progression can benefit clinical care and testing of new therapies."
Dr. Wang outlines three Parkinson's subgroups: (i) progression of both motor and cognitive dysfunction; (ii) progression of cognitive dysfunction (especially long-term memory) but not motor progression; and (iii) progression of motor dysfunction (especially right-hand tremor) but not cognitive progression.
"Characterizing subgroups based on clinical symptoms may allow trial sponsors to test a new therapy, such as a cognition drug, in a subpopulation with greater need that is more likely to respond," said Dr. Wang. "Such classification also opens new avenues for investigations into the pathophysiology of these symptoms."
MJFF will host a webinar on Friday, February 24, 2017, where Drs. Tosun-Turgut and Wang will review their methods and findings. Register to join this live event and learn more about PPMI data analysis at www.michaeljfox.org/research/data-science.html.
Building Infrastructure and Leveraging Expertise to Advance Data Analysis and FindingsOpen data access and sharing are core values of The Michael J. Fox Foundation as part of our mission to speed discovery and replication of promising results. Since its launch in 2010, PPMI has made its data available to the broader research community in real time; study data has been downloaded more than 800,000 times. The Foundation hopes to host more challenges with PPMI data in the future and is launching a similar contest in early 2017 with data collected through wearable devices and a smartphone application for a levodopa response study in partnership with Intel. MJFF sponsored an analysis challenge in 2013 with data collected through smartphones.
About The Michael J. Fox Foundation for Parkinson's Research
As the world's largest nonprofit funder of Parkinson's research, The Michael J. Fox Foundation is dedicated to accelerating a cure for Parkinson's disease and improved therapies for those living with the condition today. The Foundation pursues its goals through an aggressively funded, highly targeted research program coupled with active global engagement of scientists, Parkinson's patients, business leaders, clinical trial participants, donors and volunteers. In addition to funding more than $650 million in research to date, the Foundation has fundamentally altered the trajectory of progress toward a cure. Operating at the hub of worldwide Parkinson's research, the Foundation forges groundbreaking collaborations with industry leaders, academic scientists and government research funders; increases the flow of participants into Parkinson's disease clinical trials with its online tool, Fox Trial Finder; promotes Parkinson's awareness through high-profile advocacy, events and outreach; and coordinates the grassroots involvement of thousands of Team Fox members around the world.
About UCSF and San Francisco VA Health Care System
UC San Francisco (UCSF) is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. It includes top-ranked graduate schools of dentistry, medicine, nursing and pharmacy; a graduate division with nationally renowned programs in basic, biomedical, translational and population sciences; and a preeminent biomedical research enterprise. It also includes UCSF Health, which comprises three top-ranked hospitals, UCSF Medical Center and UCSF Benioff Children's Hospitals in San Francisco and Oakland, and other partner and affiliated hospitals and healthcare providers throughout the Bay Area. Please visit www.ucsf.edu/news.
The San Francisco VA Health Care System has one of the largest medical research programs in the national VA system, with more than 200 research scientists, all of whom are faculty members at University of California, San Francisco.
About Weill Cornell Medicine
Weill Cornell Medicine is committed to excellence in patient care, scientific discovery and the education of future physicians in New York City and around the world. The doctors and scientists of Weill Cornell Medicine -- faculty from Weill Cornell Medical College, Weill Cornell Graduate School of Medical Sciences, and Weill Cornell Physician Organization -- are engaged in world-class clinical care and cutting-edge research that connect patients to the latest treatment innovations and prevention strategies. Located in the heart of the Upper East Side's scientific corridor, Weill Cornell Medicine's powerful network of collaborators extends to its parent university Cornell University; to Qatar, where an international campus offers a U.S. medical degree; and to programs in Tanzania, Haiti, Brazil, Austria and Turkey. Weill Cornell Medicine faculty provide comprehensive patient care at New York-Presbyterian Hospital/Weill Cornell Medical Center, New York-Presbyterian/Lower Manhattan Hospital and New York-Presbyterian/Queens. Weill Cornell Medicine is also affiliated with Houston Methodist. For more information, visit www.weill.cornell.edu.

Your Brain On God: Reward and Motivation - Stroke rehab

Your doctor should be exploiting this knowledge for your recovery if these areas were damaged. You should expect your doctor to have stroke protocols for each area of the brain either dead or damaged.
http://brainposts.blogspot.com/2016/11/your-brain-on-god-reward-and-motivation.html
"We demonstrated in a group of devout Mormons that religious experience, identified as "feeling the Spirit," was associated with consistent brain activation across individuals within bilateral nucleus accumbens, frontal attentional, and ventromedial prefrontal cortical loci."
More at link.

One man who believes in himself can defeat ten men who don't.


In this case I believe that almost all of the problems in stroke can be solved, contrary to the thousands of stroke medical professionals that seem to have given up. That doesn't necessarily mean I'm smarter, I just don't give up after setbacks. And this stroke was a huge fucking setback. Stroke should be able to have the same success rate as most normal hospital procedures. Because it doesn't is a huge failure and indictment of your stroke medical professionals.

Rant completed. I feel somewhat better now. Still no contact from any stroke medical professional telling me to eat shit and explaining why I'm wrong about everything. I think they are scared to talk to poor stroke-addled me. Throwing that damn gauntlet down. Think the 'Court Jester' scene with Danny Kaye, except it would be Danny Kaye(the Jester) throwing the gauntlet at the feet of Sir Griswold.

What is life like after a stroke? Rehabilitation and recovery following a stroke

I hate these 'happy talk' articles. Obviously with everything working perfectly in stroke there is no need for any further research to help stroke survivors.
https://lasvegassun.com/native/sunrise/2016/nov/28/what-is-life-like-after-a-stroke-rehabilitation-an/
According to the Centers for Disease Control and Prevention, every year more than 795,000 people in the United States suffer strokes, and nearly 130,000 of them die. Strokes also are a leading cause of serious, long-term disability with an array of short-term and long-term effects. These include speech problems, difficulty swallowing and mobility issues.
However, it’s important to remember that prevention efforts and rehabilitation can help lessen the impact of strokes.
“An important aspect to remember about strokes is that there often is improvement. In general, 50 percent of whatever deficits are present at the time of the initial stroke are resolved within one year,” said Phaniraj Iyengar, MD, Vascular Neurologist and Stroke Medical Director at Sunrise Hospital and Medical Center’s Nevada Neurosciences Institute.
While the aftereffects of a stroke can present many challenges for both patients and their families, recovery is possible for hundreds of thousands of stroke victims.
Common aftereffects of a stroke
“In general, the deficits from a stroke could be described similarly as a real estate transaction. Location and square footage determine the price of the property. For a stroke, it is the location in the brain and the size of the brain damage that determine the aftereffects,” Iyengar said. The American Stoke Association breaks down the possible aftereffects based on the location of the stroke.
For some people, the physical damage suffered after a stroke can be reversed over time. For others, the damage may be permanent.
“Strokes can be devastating. The patient may not be able to function independently and may need to live in an assisted-living residence for the rest of his or her life,” Iyengar said.
He also noted that the patient, regardless of the severity of his or her stroke, may experience an ongoing sense of emotional discomfort even after physical symptoms have ceased.
“There are two ways to look at the effects of a stroke: One is what is obvious to others, such as paralysis, and the other is felt only by the patient suffering from it. Sometimes, outwardly a person may seem completely normal, but they can have a sense that something is different or missing,” Iyengar said.
Because our brains control our behavior and emotion, the patient may feel unexpectedly different afterward. The emotional and behavioral effects of a stroke can include forgetfulness, carelessness, irritability, confusion, anger, anxiety and depression.
A stroke on the brain’s right side can cause...
• Paralysis on the left side of the body
• Vision problems
• Quick, inquisitive behavioral changes
• Memory loss
A stroke on the brain’s left side can cause...
• Paralysis on the right side of the body
• Speech/language problems
• Slow, cautious behavior changes
• Memory loss
The brain stem
Depending on the severity of the injury caused by a stroke located in the brain stem, it can affect both sides of the body and leave the patient in a “locked-in” state, which is when a patient is unable to speak or move anywhere below the neck.
Recovering from a stroke
Because the effects of a stroke vary greatly between individuals, there are multiple avenues of recovery.
“All patients need to be monitored in a specialized stroke center that can evaluate and treat complications. This is especially important because the patient may continue to deteriorate in the first three days before he or she stabilizes,” Iyengar said.
Once the patient stabilizes, an aftercare treatment plan can be made. “Aftercare treatment comes under the broad umbrella of rehabilitation services, including speech, physical and occupational therapies,” Iyengar said.
The goal of any rehabilitation service is to get the patient back to leading a normal and independent life, which can mean getting the patient comfortable with a new normal.
Rehab therapies can help reteach patients how to perform tasks and/or teach them different ways of doing things considering their new limitations. Ongoing medication, counseling and support groups also may be necessary to help the patient cope emotionally.
Prevention and recognition
Strokes can often be prevented by leading a healthy lifestyle. “A significant number of strokes are caused by modifiable risk factors, so addressing those risk factors can go a long way toward preventing a stroke,” Iyengar said.
Modifiable risk factors include management of treatable diseases such as hypertension, diabetes, high cholesterol, heart disease, smoking and substance abuse.
Furthermore, recognizing a stroke and acting quickly to receive medical treatment can help save the life of the patient and lessen the extent of the brain damage.
Because the majority of strokes that occur are first-time strokes, it’s especially important to be able to identify the symptoms for yourself or loved ones, even if you don’t think there’s a risk.
Learn to identify stroke symptoms
BE FAST is an acronym to help identify a stroke as it occurs.
B: Balance — Does the person have a sudden loss of balance or dizziness?
E: Eyes — Has the person suddenly lost vision in one or both eyes?
F: Face — Does one side of the face suddenly droop?
A: Arms — Does one arm suddenly drift downward when both arms are raised?
S: Speech — Is the person suddenly slurring his or her words, or seem confused? Can he or she repeat a sentence correctly?

My reply:
 This is all just 'happy talk'. No discussion on all the problems/failures in stroke.
1. 12% full tPA efficacy is a failure.
2.  10% full recovery is a failure.
3. No publicly available stroke protocols with efficacy is a failure.
4. Nothing to cure spasticity is a failure.
5. Nothing to cure fatigue is a failure.
6. Nothing to stop the neuronal cascade of death in the first week is a failure.
7. Not able to objectively and accurately identify stroke in the ER is a failure.
8. Nothing to prevent dementia is a failure.

Experts say playing trivia games can provide a dopamine rush much like gambling, without the negative effects

I bet your doctor and stroke hospital  will never provide this basically free intervention.  When I wasn't traveling for work I would play Team Trivia twice a week at bars. Great for your social connections and with drinking some alcohol great for your balance training. Triple your stroke rehab at one time/place. I bet your doctor never thinks of this.
http://www.healthline.com/health-news/obscure-facts-is-good-for-mental-health#2
It can be quite satisfying and doesn’t have many downsides.
That’s how psychologists describe the mental health benefits of trivia.
The way people play trivia games continues to evolve whether it’s folks enjoying Trivial Pursuit at home or attending a pub trivia night.
But the basic premise remains the same: People enjoy the thrill of providing correct answers to questions about lesser-known facts.
Trivia Question #1
Who was the first U.S. president born in a hospital?
“You get a rush or a neuroreward signal or a dopamine burst from winning,” John Kounios, Ph.D., professor of psychology and director of the doctoral program in applied cognitive and brain sciences at Drexel University in Pennsylvania, told Healthline. “I think whenever you’re challenged with a trivia question and you happen to know it, you get a rush. It’s sort of like gambling.”
He said the benefits can also be similar to those of playing a video game.
However, unlike gambling and even video games, Kounios says trivia is generally not a habit that’s a problem.
“I don’t think there are any pitfalls,” he said. “Like anything else that’s fun, it takes up time.”

UBC researchers develop new method to test for antioxidants in chocolate

Using this we should be able to quantify exactly what causes the benefits of eating chocolate for stroke, and we'll know what types and how much to eat. But that will never occur with the incompetency of the stroke medical world. You're screwed forever.
http://news.ubc.ca/2016/11/29/science-for-sweet-tooths/
Food scientists at the University of British Columbia have developed a faster and cheaper way to quantify antioxidant levels in chocolate. It’s a method they plan to use in new research to help uncover when antioxidant levels rise and fall during the manufacturing process, from raw cocoa beans to chocolate bars.
“Our method predicts the antioxidant levels in chocolate in under a minute, compared to the industry standard that can take several hours or even days,” said Xiaonan Lu, an assistant professor in food, nutrition and health in the faculty of land and food systems, who developed the method alongside PhD student Yaxi Hu. “It’s not a substitute for the traditional method used at the moment, but it does show a strong correlation for being just as reliable.”
The UBC method uses infrared spectroscopy, a technology that can be used to illuminate infrared light onto chocolate samples. The infrared spectra record the chemical composition of each sample, including the amount of polyphenols, micronutrients with high antioxidant properties. The traditional method relies on biochemical tests to read absorbance values and can be quite time consuming and expensive.
“Testing for antioxidant levels can give chocolatiers guidance on which cocoa beans to select, or how to improve their processing parameters,” said Hu.
Chocolate is made from cocoa beans and is manufactured through several processing stages, including drying, roasting and fermentation of the beans. The UBC food scientists have started to use their method to measure cocoa bean samples from around the world in each stage to determine when antioxidant levels are at their highest and lowest.
“If we identify drying as the step that significantly lowers the bean’s antioxidant properties, for example, we will want to develop a strategy to reduce the drying time, or drying temperature,” Lu said.
It could be considered incredibly valuable information for chocolate companies who want to make products high in antioxidants or appeal more to health-conscious consumers.
Antioxidants benefit human health and help contribute to the prevention of cancers, vision loss and heart diseases. Antioxidant compounds are commonly found in foods like pecans, blueberries and chocolate.
Lu and Hu’s research on cocoa beans is in its early stages as they test hundreds of samples. The method they developed to test for antioxidant levels was funded by a local chocolatier in Metro Vancouver, the Natural Sciences and Engineering Research Council (NSERC) and by the non-profit MITACS.
The UBC food scientists hope to attract additional funding, particularly from a major chocolate company, to further their studies.
Parts of their existing research were published earlier this year in a study, Determination of antioxidant capacity and phenolic content of chocolate by attenuated total reflectance-Fourier transformed-infrared spectroscopy, in the journal Food Chemistry.

BrainPlus IQ: Lying with Advertising

Be careful out there. This analysis by Science-Based Medicine is required reading before buying this.
https://www.sciencebasedmedicine.org/brainplus-iq-lying-with-advertising/

Cannabidiol reduces neuroinflammation and promotes neuroplasticity and functional recovery after brain ischemia

Where the fuck is the stroke protocol writeup so survivors can benefit from this knowledge. Getting the knowledge disseminated through doctors has been proven to be a complete failure. Let's do this through survivors. It will be much faster and complete. Write up the damn protocol.  If you can't do that until human research is done, get cracking on that human research. Survivors are adversely impacted by delays. Get going.
http://www.sciencedirect.com/science/article/pii/S0278584616302524
Choose an option to locate/access this article:
Check if you have access through your login credentials or your institution
Check access

Abstract

This study investigated the effects of cannabidiol (CBD), a non-psychotomimetic phytochemical present in Cannabis sativa, on the cognitive and emotional impairments induced by bilateral common carotid artery occlusion (BCCAO) in mice. Using a multi-tiered behavioral testing battery during 21 days, we found that BCCAO mice exhibited long-lasting functional deficits reflected by increase in anxiety-like behavior (day 9), memory impairments (days 12–18) and despair-like behavior (day 21). Short-term CBD 10 mg/kg treatment prevented the cognitive and emotional impairments, attenuated hippocampal neurodegeneration and white matter (WM) injury, and reduced glial response that were induced by BCCAO. In addition, ischemic mice treated with CBD exhibited an increase in the hippocampal brain derived neurotrophic factor (BDNF) protein levels. CBD also stimulated neurogenesis and promoted dendritic restructuring in the hippocampus of BCCAO animals. Collectively, the present results demonstrate that short-term CBD treatment results in global functional recovery in ischemic mice and impacts multiple and distinct targets involved in the pathophysiology of brain ischemic injury.

Fish consumption and risk of stroke: A second prospective case-control study from northern Sweden

Seems odd since we have this other research suggesting cold water fish lowers stroke risk. Maybe the full article links directly to the study showing a stroke risk, I prefer to analyze these studies myself. I have 8 posts on fish and 63 on fish oil so you can figure out for yourself what your diet protocol for fish and fish oil should be. No one else is going to do this for you because of all the incompetence in the stroke world.

Why eating fish might be better supplements for stroke risk

Fish consumption and risk of stroke: A second prospective case-control study from northern Sweden

Nutrition Journal, 11/29/2016
In this study, researchers aim to investigate if previous results on elevated stroke risk with high fish consumption in men in northern Sweden can be confirmed in a larger study with new cases in the same population. As per this study, the previous association between high total fish consumption and risk of stroke in men could not be repeated. In men, the increased risk found with a high intake of lean fish might be due to chance or confounding specific for this group.

Methods

  • The researchers performed a prospective nested case-control study within the population-based Northern Sweden Health and Disease Study cohort.
  • At baseline, information on fish consumption, other lifestyle and medical data were collected.
  • They identified incident stroke cases (1987–2007, n = 735) and 2698 controls matched for gender, age, year of baseline and geographical region.

Results

  • No associations was found between total fish or fatty fish consumption and stroke risk; in this manner the previous finding of increased risk of stroke with high fish consumption in men could not be repeated.
  • In men, high intake of lean fish (>twice/week compared to < once/month) was associated with increased stroke risk [OR 1.80 (95% CI 1.00, 3.21), but not in women [OR 0.50 (95% CI 0.24, 1.10)].
  • The study reveals that the association was driven by men living alone.
Go to PubMed Go to Abstract Print Article Summary Cat 2 CME Report

Early intervention in brain inflammatory pathways may improve stroke recovery

Followup needed in humans, bet it doesn't occur for decades.
http://m.medicalxpress.com/news/2016-11-early-intervention-brain-inflammatory-pathways.html

Intracerebral hemorrhage is a type of stroke characterized by the rupture of a blood vessel within the brain. When the brain is exposed to blood, local immune cells become activated, triggering inflammation that promotes ongoing injury in the days and weeks after the initial stroke event.

This month in the JCI, work from Laura Sansing's lab at Yale School of Medicine examined the pathways in the that drive injury-producing inflammation. They identified a signaling protein that plays a in activating immune system-mediated damage after intracerebral hemorrhage. In a mouse model, they observed that intracerebral hemorrhage-driven inflammation began to clear up at the same time as the TGF-β1 pathway was activated in local immune cells.

Treating mice with TGF-β1 immediately after the initial injury reduced pro-inflammatory signals and improved motor function compared to untreated mice. In a patient population, they also observed that higher bloodstream levels of TGF-β1 in the first 3 days following intracerebral hemorrhage predicted better outcomes 3 months into recovery.

Together, these results suggest that targeting the TGF-β1 pathway may have protective effects in individuals recovering from stroke and brain injury.

More information: Roslyn A. Taylor et al, TGF-β1 modulates microglial phenotype and promotes recovery after intracerebral hemorrhage, Journal of Clinical Investigation (2016). DOI: 10.1172/JCI88647

Provided by: JCI Journals

Effect of Exhaust- and Nonexhaust-Related Components of Particulate Matter on Long-Term Survival After Stroke

It is obvious that after your stroke you can no longer live in a polluted city unless your doctor gives you other interventions that neutralize that risk.
Like maybe a 307%  stroke risk reduction from these 11 possibilities?  
Effect of Exhaust- and Nonexhaust-Related Components of Particulate Matter on Long-Term Survival After Stroke
Anita Desikan, Siobhan Crichton, Uy Hoang, Benjamin Barratt, Sean D. Beevers, Frank J. Kelly and Charles D.A. Wolfe

Abstract

Background and Purpose—Outdoor air pollution represents a potentially modifiable risk factor for stroke. We examined the link between ambient pollution and mortality up to 5 years poststroke, especially for pollutants associated with vehicle exhaust.
Methods—Data from the South London Stroke Register, a population-based register covering an urban, multiethnic population, were used. Hazard ratios (HR) for a 1 interquartile range increase in particulate matter <2.5 µm diameter (PM2.5) and PM <10 µm (PM10) were estimated poststroke using Cox regression, overall and broken down into exhaust and nonexhaust components. Analysis was stratified for ischemic and hemorrhagic strokes and was further broken down by Oxford Community Stroke Project classification.
Results—The hazard of death associated with PM2.5 up to 5 years after stroke was significantly elevated (P=0.006) for all strokes (HR=1.28; 95% confidence interval [CI], 1.08–1.53) and ischemic strokes (HR, 1.32; 95% CI, 1.08–1.62). Within ischemic subtypes, PM2.5 pollution increased mortality risk for total anterior circulation infarcts by 2-fold (HR, 2.01; 95% CI, 1.17–3.48; P=0.012) and by 78% for lacunar infarcts (HR, 1.78; 95% CI, 1.18–2.66; P=0.006). PM10 pollution was associated with 45% increased mortality risk for lacunar infarct strokes (HR, 1.45; 95% CI, 1.06–2.00; P=0.022). Separating PM2.5 and PM10 into exhaust and nonexhaust components did not show increased mortality.
Conclusions—Exposure to certain outdoor PM pollution, particularly PM2.5, increased mortality risk poststroke up to 5 years after the initial stroke.

Monday, November 28, 2016

Results of the ICTuS 2 Trial (Intravascular Cooling in the Treatment of Stroke 2)

You, yourself are going to have to look at these 34 earlier posts on hypothermia and determine for yourself what should be the current protocol because no one seems to have written up anything earlier in summary form. What our great stroke association would be doing so you can focus on recovery rather than figuring out how to recover using the sparse information out there. In other words doing your doctors job because they are so fucking incompetent at it.
http://stroke.ahajournals.org/content/47/12/2888.abstract?etoc
Patrick Lyden, Thomas Hemmen, James Grotta, Karen Rapp, Karin Ernstrom, Teresa Rzesiewicz, Stephanie Parker, Mauricio Concha, Syed Hussain, Sachin Agarwal, Brett Meyer, Julie Jurf, Irfan Altafullah, Rema Raman, Collaborators, Mary Jane Hess, Anthony Mullin, Mary Jane Hess, Gabriela Muranevici, Bonnie Piantadosi, Gustavo Jimenez-Maggiora, Jia-Shing So, Sonia Jain, Michael Diringer, Colin Derdeyn, Barney Stern, Scott Hamilton, Dalton Dietrich, Kyra Becker, Midori Yenari, Ulrich Dirnagl, Christine Wijman, Ángel Chamorro, Scott Janis, Claudia Moy, Felice Lin, Shlee Song, Konrad Schlick, Pooja Khanolkar, Nancy J. Edwards, Ana Roldan, Jeanette Wilson, Amy Little, Pam Lewis, William Neil, Nhu Bruce, Amy Guzik, Ajeet Sohdi, Nabeel Herial, Bruce Ovbiagele, Dawn Meyer, Royya Modir, Ronelyn Chavez, Angela Velazquez, Stephan Mayer, Jan Claassen, Cristina Falo, Gilda Tafreshi, William Neil, Nhu Bruce, Amy Guzik, Royya Modir, Nancy Kelly, Ronelyn Chavez, Bruce Ovbiagele, Erin Shell, Guy Dugan, Elizabeth Kim, Amy Tanner, Patrik Michel, Ashraf Eskandari, Mauro Oddo, Tamarah Suys, Suzette Remillard, Maria Cordier, Robert Brown, Sara Jasak, Louise McCullough, Robert Brautigam, Andrei Alexandrov, April Sisson, Karen Albright, Gregor Broessner, Erich Schmutzhard, Elissanet Escioglou, William Jones, Sharon Poisson, Jennifer Simpson, Qaisar Shah, Karin Jonczak, Patricia Bussinger, Christopher Lewandowski, Shannen Berry, AnneMarie Lundell, Joseph B. Miller, Salvador Cruz-Flores, Eve Holzer, Susan Torretta, David Brown, Laura Heim, Carlos Smith, Chip Kelley, David Greer, Evadne G. Marcolini, Emily J. Gilmore, Neil Rutledge, Del McBee, Anna Khanna, Sonisha Warren, Christina Wilsom, Vishnumurthy Shushrutha Hedna, Christian Rosado, Rosie Kizza, Kristine O’Phelan, Andrea Escobar, Amedeo Merenda, Juan Perez Barcena and Amer Malik

Abstract

Background and Purpose—Therapeutic hypothermia is a potent neuroprotectant approved for cerebral protection after neonatal hypoxia-ischemia and cardiac arrest. Therapeutic hypothermia for acute ischemic stroke is safe and feasible in pilot trials. We designed a study protocol to provide safer, faster therapeutic hypothermia in stroke patients.
Methods—Safety procedures and 4°C saline infusions for faster cooling were added to the ICTuS trial (Intravascular Cooling in the Treatment of Stroke) protocol. A femoral venous intravascular cooling catheter after intravenous recombinant tissue-type plasminogen activator in eligible patients provided 24 hours cooling followed by a 12-hour rewarm. Serial safety assessments and imaging were performed. The primary end point was 3-month modified Rankin score 0,1.
Results—Of the intended 1600 subjects, 120 were enrolled before the study was stopped. Randomly, 63 were to receive hypothermia plus antishivering treatment and 57 normothermia. Compared with previous studies, cooling rates were improved with a cold saline bolus, without fluid overload. The intention-to-treat primary outcome of 90-day modified Rankin Score 0,1 occurred in 33% hypothermia and 38% normothermia subjects, odds ratio (95% confidence interval) of 0.81 (0.36–1.85). Serious adverse events occurred equally. Mortality was 15.9% hypothermia and 8.8% normothermia subjects, odds ratio (95% confidence interval) of 1.95 (0.56–7.79). Pneumonia occurred in 19% hypothermia versus 10.5% in normothermia subjects, odds ratio (95% confidence interval) of 1.99 (0.63–6.98). 19% pneumonia is considered safe, especially for the elderly?
Conclusions—Intravascular therapeutic hypothermia was confirmed to be safe and feasible (unknown as to efficacy) in recombinant tissue-type plasminogen activator–treated acute ischemic stroke patients. Protocol changes designed to reduce pneumonia risk appeared to fail, although the sample is small.
Clinical Trial Registration—URL: http://www.clinicaltrials.gov. Unique identifier: NCT01123161.

Stroke strategy, followup research, RFP, grants

This is a very simple concept to understand and complete. Which I'm sure thousands of people have figured out. That brings up the question why our fucking failures of stroke associations are not following it. Incompetence? Stupidity? Don't give a shit? Don't want to work themselves out of a job? I'm only going to live to 98 so that leaves me 38 years to solve this and work myself out of this stroke job.

Desmoteplase 3 to 9 Hours After Major Artery Occlusion Stroke

Whom is going to plan and execute followup research that will find and significantly improve functional outcome at 3 months?  A great stroke association would handily do this. I blame our boards of directors for allowing promising research to languish forever.
http://stroke.ahajournals.org/content/47/12/2880.abstract?etoc


Abstract

Background and Purpose—The DIAS-3 trial (Efficacy and Safety Study of Desmoteplase to Treat Acute Ischemic Stroke [phase 3]) did not demonstrate a significant clinical benefit of desmoteplase administered 3 to 9 hours after stroke in patients with major artery occlusion. We present the results of the prematurely terminated DIAS-4 trial together with a post hoc pooled analysis of the concomitant DIAS-3, DIAS-4, and DIAS-J (Japan) trials to better understand the potential risks and benefits of intravenous desmoteplase for the treatment of ischemic stroke in an extended time window.
Methods—Ischemic stroke patients with occlusion/high-grade stenosis in major cerebral arteries were randomly assigned to intravenous treatment with desmoteplase (90 μg/kg) or placebo. The primary outcome was modified Rankin Scale (mRS) score of 0 to 2 at day 90. Safety assessments included mortality, symptomatic intracranial hemorrhage, and other serious adverse events.
Results—In DIAS-4, 52 of 124 (41.9%) desmoteplase-treated and 46 of 128 (35.9%) placebo-treated patients achieved an mRS score of 0 to 2 (odds ratio, 1.45; 95% confidence interval, 0.79; 2.64; P=0.23) with equal mortality, frequency of symptomatic intracranial hemorrhage, and other serious adverse events in both the treatment arms. In the pooled analysis, mRS score of 0 to 2 was achieved by 184 of 376 (48.9%) desmoteplase-treated versus 171 of 381 (44.9%) placebo-treated patients (odds ratio, 1.33; 95% confidence interval, 0.95; 1.85; P=0.096). Treatment with desmoteplase was safe and increased the recanalization rate (107/217 [49.3%] versus 85/222 [38.3%]; odds ratio, 1.59; 95% confidence interval, 1.08–2.35; P=0.019). Recanalization was associated with favorable outcomes (mRS 0–2) at day 90 in both the treatment arms.
Conclusions—Late treatment with intravenous 90 µg/kg desmoteplase is safe, increases arterial recanalization, but does not significantly improve functional outcome at 3 months.
Clinical Trial Registration—URL: http://www.clinicaltrials.gov. Unique identifier: NCT00856661.

'Get out of jail free card' from your doctor

Your doctor and therapists use the term; 'All strokes are different, all stroke recoveries are different' as a 'Get out of jail free card' for not providing you with any way to get 100% recovered. Excuses, excuses for them. Call them on it.

Virtual Lobby Days: Advocating for stroke through the end of 2016--and beyond - National Stroke Association

Absolutely nothing here that the NSA is doing will directly solve any of the problems in stroke. It is all indirect action which means they can't be blamed to not accomplishing anything. The solution you stupid assholes is to define a stroke strategy that solves all these fucking problems in stroke, write RFPs for researchers, and get foundation grants to pay those researchers. Simple huh?
http://support.stroke.org/site/R?i=rmeEKfw7EJ0PLQMjnkyOHA
Dear dean,
While the elections are over, there's still work to be done in the coming weeks. Members of Congress, whether they've been re-elected or not, still have decisions to make between now and the end of the year. Many of our stroke-related issues are on the table, so we'll need to stay vigilant and active. That's why we're asking you to participate in our "Virtual Lobby Days" taking place Nov. 28 through Dec. 9.
We'll have to be flexible about the exact actions we'll ask you to take as we face uncertainties. Outlined below are a few of the issues we believe may be considered. Yet even if these issues don't move forward before the end of 2016, we still must act. We'll have a much higher likelihood of success if we go into next year showing how much we care.
Some potential policy changes include:
The Furthering Access to Stroke Telemedicine Act (FAST act), to improve access to life-saving treatments. Right now, Medicare covers telemedicine services for stroke survivors only if they are provided in a rural hospital. If passed, this bill would direct Medicare to cover stroke telemedicine services regardless of location, ultimately making diagnosis and treatment faster nationwide.
Telehealth Legislative Initiatives, including the CONNECT for Health Act, the Telehealth Innovation and Improvement Act, the Telehealth Enhancement Act, and the Medicare Telehealth Parity Act. Each of these would improve access to all telehealth services, making it easier for stroke survivors to receive the treatment they need.
The 21st Century Cures and Senate Innovation Initiatives, which seek to improve the discovery, development, and delivery of cures for a wide variety of diseases. Among many other things, this bill would establish a program at the National Institutes of Health to track neurological diseases.
Funding for federal research programs that conduct critical biomedical and health research on stroke. This research primarily takes place at the National Institute of Neurological Disorders and Stroke (NINDS) and the Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative. NINDS research has led to significant advancements in stroke diagnosis, treatment and recovery. The BRAIN Initiative aims to map the brain in an effort to better understand it and lead to cures and treatments for neurological diseases like stroke.
Capture2.PNG
Watch & share: https://youtu.be/RUw3MTm_gAo
As these bills move forward, we'll be asking you to contact your policymakers seeking their support. For specifics on each action, check your e-mail and the advocacy page on the national stroke association site at STROKE.org. Here you'll find background information, pre-written letters you can personalize, as well as sample social media posts you can use to engage others. In short, you'll have everything you need to make a difference.
As Congress considers essential stroke-related legislation, your voice is more important than ever. Our goal is to help you be as effective as possible in delivering your message, so you can be heard in Washington, D.C., and beyond.
Sincerely,
Mitchell Ronningen
Mitchell Ronningen, J.D.
Manager, Government Affairs