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, March 20, 2024

Pragmatic solutions for the global burden of stroke

Absolutely nothing in here is trying for 100% recovery, so not even listening to survivor requirements!

EVERYTHING IN STROKE IS A COMPLETE FUCKING FAILURE INCLUDING THE WSO!

Oops, I'm not playing by the polite rules of Dale Carnegie, 'How to Win Friends and Influence People'.

Telling supposedly smart stroke medical persons they know nothing about stroke is a no-no even if it is true.

Politeness will never solve anything in stroke. Yes, I'm a bomb thrower and proud of it. Someday a stroke 'leader' will try to ream me out for making them look bad by being truthful, I look forward to that day.

The latest crapola here:

Pragmatic solutions for the global burden of stroke

Published:April, 2024DOI:https://doi.org/10.1016/S1474-4422(24)00039-5

The recent Commission by Valery L Feigin, Mayowa O Owolabi, and colleagues

effectively analyses the burden of stroke, but falls short in offering pragmatic solutions for tangible improvements in outcomes. Additionally, the recommendations lack the necessary assertiveness, particularly in areas where evidence and recommendations are well established. The Commission overlooks the crucial need for empowering local stroke providers in advocating for shifts in knowledge, attitude, and policy at regional and federal levels. Such advocacy is crucial to achieve systemic changes in stroke care. Intravenous thrombolytic therapy has revolutionised the treatment of stroke, transforming the field from a state of nihilism into active therapy. This paradigm shift has led to substantial advancements, such as the development of stroke units and endovascular therapy. However, in low-income countries, intravenous thrombolytic therapy remains inaccessible mainly due to prohibitive costs.

The Commission should have advocated more strongly for making intravenous thrombolytic therapy freely available to all eligible patients, considering its established cost-effectiveness for patients, communities, and countries.

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Such a recommendation would help to enhance the entire stroke care continuum.

Additionally, the Commission does not have a robust recommendation for developing and maintaining emergency services and the establishment and certification of stroke centres in low-income countries, such as the use of minimum service standards, for instance, in Nepal.

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The establishment and monitoring of advanced and essential stroke centres, accessible by ambulance or helicopter even from remote areas, need to be emphasised. There is a necessity for country-level task forces to create online, multilingual living guidelines based on the World Stroke Organization's core stroke guidelines. Furthermore, implementing an affordable, secure electronic medical record system in low-income countries, possibly using smartphone apps as personal health records and educational tools, could be crucial for quality care and data collection. The World Stroke Organization should lead the development of awareness campaigns for stroke symptoms across countries and in different languages. Finally, the Commission does not address the urgent need for stroke-related workforce development in low-income countries. It should have provided recommendations on enhancing neurological and stroke education across various levels of medical training and simplifying neurology residency programmes. Training emergency physicians, family physicians, and other relevant specialists as stroke providers could mitigate the severe shortage of neurologists in these regions.

In summary, while the Commission is a valuable analysis of the global stroke burden, more actionable and assertive recommendations are needed to impact stroke care and achieve health-related Sustainable Development Goals in low-income countries.

We declare no competing interests. During the preparation of this work, AK used ChatGPT to proofread for grammatical errors. After using this tool, the authors reviewed and edited the content as needed and take full responsibility for the content of the publication.