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.

Showing posts with label xPrize. Show all posts
Showing posts with label xPrize. Show all posts

Friday, April 14, 2017

With $10 million at stake, scientists compete to build a ‘Star Trek’-style medical tricorder

Back in 2013 stroke was included in the core set. We are once again screwed so you'll have to hope  that these 17 ways for objective diagnosis are followed up on for your children and grandchildren.
The Core Set includes(from 2013):
1. Anemia
2. Urinary tract infection, lower
3. Diabetes, type 2
4. Atrial fibrillation
5. Stroke
6. Sleep apnea, obstructive
7. Tuberculosis
8. Chronic obstructive pulmonary disease (COPD)
9. Pneumonia
10. Otitis ("ear infection")
11. Leukocytosis
12. Hepatitis A
13. Absence of conditions
Core set now is here:
Required Core Health Conditions (10): Anemia, Atrial Fibrillation (AFib), Chronic Obstructive Pulmonary Disease (COPD), Diabetes, Leukocytosis, Pneumonia, Otitis Media, Sleep Apnea, Urinary Tract Infection, Absence of condition.

With $10 million at stake, scientists compete to build a ‘Star Trek’-style medical tricorder




Fifty years ago, the “Star Trek” series envisioned a handheld medical device that could diagnose every condition with just a swipe over the patient’s body. The tricorder was just one of the show’s futuristic gadgets — but it’s one that real-world scientists seized upon.
And some have spent years working to bring it to existence, under the banner of the Qualcomm Tricorder X Prize, a competition launched in 2012. From a starting roster of over 300 teams, just two are now in the running.
The competition has just a few rules: Each prototype must have the capacity to monitor five vital signs and diagnose medical conditions, send data to the internet, and weigh under five pounds.
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That’s not quite the gadget Dr. McCoy made famous. For one thing, the real-life versions being developed now aren’t no-touch wands but rather what look like iPads with associated sensors — electrodes, cuffs, probes, and clips — linked with or without wires.
But it’s also intended for a different user: Not a doctor, but rather the patient him or herself. The tricorder, then, is more akin to the “quantified self” trend — gathering all manner of data, on an ongoing basis, to “allow individuals to incorporate health knowledge and decision-making into their daily lives,” the prize website says.
For now, that seems some way off. The working designs by Basil Leaf Technologies, a Pennsylvania-based medical device startup, and the Dynamical Biomarkers Group (DBG), a research group out of the National Central University in Taiwan, are still somewhat bulky and accompanied by lots of little doodads. But as sensor technology improves, it’s not hard to imagine wireless electrodes stuck to our bodies or wired into our implants, keeping running tabs on our health.

Searching for indicators

Sequestered away in a computer-filled basement of Beth Israel Deaconess Medical Center in Boston, the DBG has a team of 40 people working on their tricorder project. Using decades-old patient data from the hospital, and current clinical trials in Taiwan, the team had been steadily tweaking and evaluating its design.
On a desk in the lab sits their most recent prototype, a nondescript, eggshell-colored box about the size of a toaster oven. A smart phone sits in a hub on top. Drawers on three sides open to reveal compartments holding various fobs and attachments. With them, the device measures heart rate, blood pressure, and other vital signs, wirelessly sending the readings to the smart phone.
In its most recent round of testing, which took place in 2015, X Prize evaluators tested the gadget’s ability to diagnose 10 required conditions: Anemia, atrial fibrillation, chronic obstructive pulmonary disease, diabetes, elevated white blood cell count, pneumonia, middle ear infection, sleep apnea, and urinary tract infection. Competitors also had the option of diagnosing the absence of those core conditions and for the presence of additional conditions, such as melanoma, mononucleosis, or shingles.
Now the finalists’ devices are in the consumer-testing stage, which began in December. For this stage, a coordinator trains consumers to use the device. Afterward, consumers get a 90-minute session in which they independently use the device to diagnose themselves.
One goal of the competition is to raise the possibility of more precise diagnoses. Dr. Andrew Ahn, DBG’s lead medical advisor, suggested that the use of dynamic biomarkers — ongoing readings of vital functions — could improve medical treatment.
“Right now, medicine is based on one-time readings,” he said. “But the science of medicine needs to be able to work with continuous data.”
He added that the way that a vital sign changes over a period of minutes or hours can be more meaningful than individual readings taken weeks or months apart. This is the “hidden data” of medical diagnosis, said DBG team leader Chung-Kang Peng.
“There could be all kinds of hidden indicators we’ve been missing,” agreed David Sept, a University of Michigan professor of biomedical engineering, who is not involved with DBG or X Prize. “You could collect a large, complex dataset of vital signs that might be an indication of something.”
Sept cautions, however, that more data does not mean better information.
“It might be that only one or two specific factors are correlative to a specific disease state,” he said, adding that having the capacity to take many and varied measurements does not mean it’s always useful to do so.
Sept added that the technology might not take medicine far enough beyond what it does already. “Correlations [between indicators and diagnoses] can be extremely useful without a showing a direct causative effect,” he said. “But we’re still not predicting causation.”
Sept likes the idea of competitions like the X Prize, however.
“They do seem to get people to innovate in great ways,” he said, “so I see it as a worthwhile endeavor.”
After refining the requirements and extending the deadline last year, X Prize plans to pay out its grand prize of $10 million in April.
Win or lose, Team DBG hopes to continue developing its prototype. But whether the device would ever be commercialized is still up in the air. The Food and Drug Administration has been offering advice to help teams prepare for potential FDA review post-competition. But X Prize did not require or conduct clinical trials of the devices, so the designers may also have to clear that hurdle with an FDA-approved trial.
For now, Ahn said, “Our primary goal is to enhance health and empower patients… It’s an exciting time to be working on this.”




















Thursday, December 22, 2016

Stroke outcomes can be worse when they occur in hospital, Canadian study finds

The takeaway from this is that when you do have a stroke you need ALL the classic symptoms, dropped mouth, slurred speech, total paralysis and loss ofsensation on one side.  This will not get better until people are removed from the diagnosis. We need fast, objective and cheap stroke diagnosis, maybe these 17 diagnosis possibilities to find out which one is the best? Or maybe the Qualcomm Xprize for the tricorder?

Stroke outcomes can be worse when they occur in hospital, Canadian study finds


Date:
October 6, 2014
Source:
Heart and Stroke Foundation of Canada
Summary:
At the first sign of a stroke, time is of the essence. For every minute of delay in treatment, people typically lose almost two million brain cells. Yet a new study reveals that those delays -- in getting the right tests and the right drugs -- can be longer when people experience a stroke in a hospital. "Intuitively, you would imagine that having a stroke in the hospital is the best place possible, and that is just not the case," says one expert. 
 
Investigators from the University of Toronto Faculty of Medicine, the Institute for Clinical Evaluative Sciences (ICES) and the University Health Network looked at data from acute care facilities in Ontario over nine years. They examined stroke care delivery and outcomes for two groups: those who had a stroke in the community (about 32,000 people), and those who had a stroke while already hospitalized for another reason (just over 1,000 cases), such as, for example, a hip replacement. The results were surprising.
"Intuitively, you would imagine that having a stroke in the hospital is the best place possible, and that is just not the case," says Dr. Alexandra Saltman, a third year internal medicine resident at the University of Toronto, and one of the authors of the Code Stroke on the Ward study.
Compared to the patients brought into a hospital from the community, people with in-hospital strokes:
  • waited significantly longer from the time stroke symptoms were recognized to neuroimaging (i.e., a CT scan);
  • waited longer from the time a stroke was confirmed to getting clot-busting drugs; and
  • were less likely to receive clot-busting drugs than those who were admitted following strokes outside of hospitals, even when they were eligible.
The study's authors made the comparisons using the Heart and Stroke Foundation's Canadian Stroke Best Practice Recommendations and the American Heart Association best practice guidelines for stroke care. After adjusting for age and other factors, the in-hospital stroke patients also had longer hospital stays and were more likely to be disabled.
"There is evidence that people do worse when they have a stroke in the hospital, and not just because they are already sicker," says Dr. Saltman.
She suggests two possibilities for what seems to be a lag in response, despite the fact that the patient is surrounded by health-care professionals.
First, the signs of a stroke are too often overlooked. When patients are admitted for other medical reasons (for example, heart surgery or pneumonia), hospital staff on that ward are understandably focused on that ailment or condition, and are not specifically looking for stroke symptoms.
"We're all human, and things get missed," says Dr. Saltman. "In a medically or surgically complicated patient, it may be harder to detect the stroke symptoms than in someone with no other acute issues."
This is an important reminder for hospitals to promote awareness of stroke. "Awareness of stroke signs and how to react is important for all health care professionals, in any specialty," says Patrice Lindsay, director of stroke best practices and performance for the Heart and Stroke Foundation. "The reality is that people can have a stroke in hospital regardless of why they are hospitalized."
When an in-hospital stroke is identified, Dr. Saltman attributes a slower than expected response to a second factor: a lack of a standardized approach. When patients are taken to the hospital with a suspected stroke, "code stroke" protocols are in place. A team is ready to assess the patient, obtain and read images, and implement the appropriate treatment.
"When somebody has a stroke on a ward, no such standardized approach exists," says Dr. Saltman.
Lindsay says that it is mainly a systems and organizational issue, not the healthcare professionals who care for patients; it highlights an opportunity for increased awareness, standardized protocols and better coordination between internal departments throughout all acute care hospitals.
"Hospitals already have sound protocols on handling strokes coming in from the community," she says. "We need the same awareness and services within the hospital for patients who are already admitted, to ensure their rapid access to stroke care."
Hot topic in stroke: awareness of the signs Recognizing the symptoms of a stroke and acting quickly can prevent disability and save lives. A survey for the Heart and Stroke Foundation found that two-thirds of Canadians arrive at hospital too late to meet the treatment window for clot-busting drugs (or other interventions that can minimize the effects of a stroke).
Whether people have a stroke in the community or in the hospital, the clock is ticking. To respond as fast as possible, it's vital for the public and health care professionals alike to know the stroke signs and to treat them as a medical emergency:
  • Weakness: Sudden weakness, numbness or tingling in the face, arm or leg.
  • Trouble speaking: Sudden temporary loss of speech or trouble understanding speech.
  • Vision problems: Sudden loss of vision, particularly in one eye, or double vision.
  • Headache: Sudden severe and unusual headache.
  • Dizziness: Sudden loss of balance, especially with any of the above signs.
Quick action in recognizing and responding to the signs of stroke is essential, as the clot busting drug tPA can reduce the severity of a stroke and reverse some of the effects, but only if it is administered within a few crucial hours after symptoms begin for someone who has a stroke caused by a clot.
Research creates survivors
This research highlights the opportunity to create more survivors though increasing awareness and developing in-hospital protocols ─ and for more good news stories such as that of Chloé Rodier.
In 2011, the then 16-year-old, who was hospitalized for pneumothorax, woke up with a strong headache. "I asked my mom to check with the nurses if I could have some Aspirin. When I tried to try to take the pills with my left hand, I saw that it wasn't moving. I looked at my mom and told her that I couldn't feel my arm. The specialists got there quickly, and many tests had to be done to diagnose the stroke. The doctors told me that I was lucky, that things could have been worse: I could have lost my speech and memory."
 

Researchers to develop innovative hybrid technology for quicker diagnosis, treatment of strokes

Do they even know about these 17 diagnosis possibilities to find out which one is the best? Or maybe the Qualcomm Xprize for the tricorder?
http://www.news-medical.net/news/20161216/Researchers-to-develop-innovative-hybrid-technology-for-quicker-diagnosis-treatment-of-strokes.aspx
FAU has demonstrated its strength in research once again: the University is conducting a new research project together with Siemens Healthcare GmbH, Universitätsklinikum Erlangen and other European partners in which researchers will develop an innovative hybrid device that combines different medical imaging technologies and will help stroke patients in particular to receive quicker diagnosis and treatment.
The project is being funded by the European Institute of Innovation and Technology for Health (EIT Health), a publicly financed initiative that aims to ensure sustainable development of innovative health care solutions. The project 'Predictive Prevention and Personalized Interventional Stroke Therapy - P3 Stroke' is one of only two in Germany and eight in Europe to receive funding.
EIT Health connects successful regional clusters with international networks of excellent universities, institutes, university hospitals and commercial research centres through the European research and innovation framework programme Horizon 2020. Over 140 companies, research institutions and universities from across Europe collaborate on a diverse range of projects as part of EIT Health; FAU and Siemens Healthineers are among the key partners.
The initiative will receive around 80 million euros of annual funding over the next seven years. Thanks to these resources, EIT Health is able to develop innovative products, educational programmes and services that will help Europe to deal with the challenges of demographic change.
To receive sought-after funding from EIT Health, a group of partners must submit a high-quality project. Prof. Dr. Dr. Jürgen Schüttler, Dean of FAU's Faculty of Medicine, is delighted that this was achieved with the P3 Stroke project: 'The project strengthens the connection between the University, Universitätsklinikum Erlangen and partners in industry such as Siemens Healthineers, a collaboration that meets the highest standards in Europe.'
Time is brain - faster treatment for stroke patients
'With the P3 Stroke project we want to improve the diagnosis and interventional treatment of strokes on a fundamental level by combining the use of magnetic resonance imaging and angiography,' explains Dr. Heinrich Kolem, CEO of Advanced Therapies at Siemens Healthineers.
Conducting separate examinations using different devices takes time, particularly due to the need to transfer patients between locations. This is valuable time that stroke patients do not have. As an average of 2 million neurons are destroyed every minute, every minutes counts during efforts to prevent major damage after a stroke. In collaboration with Siemens Healthineers, the team of researchers led by Prof. Dr. Arnd Dörfler, head of the Department of Neuroradiology at Universitätsklinikum Erlangen, and Prof. Dr. Andreas Maier, head of the Pattern Recognition Lab at FAU, now want to combine two imaging techniques, magnetic resonance imaging and angiography. This innovative approach will be used for diagnosis and immediate treatment, reducing the time needed for patient transfers and saving valuable time when treating stroke patients.
'The pioneering system enables an exact picture of the development of the condition to be obtained without delay, allowing for effective treatment,' Professor Dörfler says. While the clinical evaluation of the new methods will be led by the Department of Neuroradiology at Universitätsklinikum Erlangen in close collaboration with the Department of Neurology, the Pattern Recognition Lab is responsible for developing the software: 'We have been conducting research in various areas of medical imaging for many years and can therefore contribute a considerable amount of expertise,' Professor Maier explains.
Although the researchers see stroke patients as the main group who will benefit from the new technology, this does not mean that it will be limited to this area. 'The system will also have applications in minimally invasive treatment for other neuro- and cardiovascular disorders and in oncology,' Professor Dörfler says optimistically.
Source:
University of Erlangen-Nuremberg

Thursday, July 21, 2016

Do You Want To Save The World? – The $5 Million IBM Watson AI XPRIZE Competition Is Waiting For You

Our fucking failures of stroke associations should be putting together a team  to solve the repeatability puzzles of neurogenesis and neuroplasticity. But they will continue to sit on their asses thinking up the next press release. Failure in action to do any action. 

Do You Want To Save The World? – The $5 Million IBM Watson AI XPRIZE Competition Is Waiting For You


 It does not matter whether you want to revolutionize healthcare or space research, or to build a smarter AI than what Siri could be or a better composer than Magenta, the floor is yours in every area. Teams have the chance to define their own goals and own challenge, and have the battle of wits for four years with annual milestone competitions in 2017, 2018 and 2019. In the final round, the top three finalists will compete for the Grand Prize at TED 2020.

Sunday, June 19, 2016

MedyMatch aims to offer second opinion in stroke diagnosis

It would be much more useful to get to an objective diagnosis of stroke, Get the damned neurologists out of the loop. This assumes that even for young patients there already is a tentative diagnosis for stroke. That is not currently  the case considering all the misdiagnosed young patients.
You fund researchers to test out these 17 possibilities to find out which one is the best. Or maybe the Qualcomm Xprize for the tricorder.
http://www.timesofisrael.com/medymatch-aims-to-offer-second-opinion-in-stroke-diagnosis/
The real life Dr. Shepherds – yes, this is a reference to the popular medical drama “Grey’s Anatomy” – who work in hospitals around the world may soon get a new assistant. No, not just another intern but an extra pair of virtual eyes to help them better diagnose stroke victims.

Tel Aviv-based MedyMatch Technology Ltd., which hopes to have its first commercially available product as soon as the first half of 2017, is developing an artificial intelligence (AI) platform for critical areas of patient care. The platform is meant to help study data more quickly and accurately than the human eye, and help physicians with their clinical decisions in a wide set of healthcare issues.
MedyMatch’s first area of focus will be for stroke patients.
“Speed is essential in treating stroke,” Gene Saragnese, MedyMatch chairman & CEO, said in an interview. “For every minute that ticks by, brain cells die.”
When dealing with stroke, the very first question doctors need to address is what kind of stroke they are seeing: is it a bleed in the brain or a blockage that prevents blood flowing to the brain? The two types of stroke are treated in a very different manner. A wrong diagnosis and treatment could mean the death of much-needed brain cells.


“Our goal is to make better decisions in that very first step in a stroke – so those patients can get moved into the appropriate treatment quickly,” Saragnese said.
The product is software that takes images from a standard CT machine and processes them in the cloud, using proprietary algorithms developed by MedyMatch. The software makes notes on the image, highlights areas for physicians so they can immediately see potential areas of bleeding – and sends the image back to the doctor’s workstation, together with the original.
The process is expected to enable doctors to get an expert opinion within three to five minutes, Saragnese said. With deep learning a series of examples are fed to the computer to set benchmarks for what is considered a baseline reading, said Saragnese, a former CEO of Philips Imaging Systems who joined MedyMatch as CEO in February. Then you upload a whole series of images to the computer – and the machine learns what a bleed looks like from those images. Basically, “you are training the computer with examples in a way that it can then start to read images by itself,” he said.
MedyMatch has secured billions of images from millions of cases via collaborations with hospitals in Israel and the US, including Hadassah Medical Center in Jerusalem and Massachusetts General Hospital in Boston. “Those places are where our experts are coming from. They help us train the software to read,” Saragnese said.
Stroke is the fourth-biggest killer in the US, and costs to treat stroke may increase from $71.6 billion in 2010 to about $183 billion by 2030, according to data published by the American Heart Association. Despite advances in medical imaging, the medical misdiagnosis error rate of around 30 percent rate has not changed for decades, said Dr. Gabriel Polliack, a director of strategy development at TEREM, a network of emergency medical centers in Israel.
“There is a need in the marketplace to provide radiologists and physicians a second set of eyes to help them overcome any limitation that is preventing them from providing a correct patient diagnosis,” said Polliack said. Polliack is a member of MedyMatch’s medical advisory board and has been actively advising the company since its founding over two years ago.
“The idea is great, and not only has significant clinical value, meaning improvement of patient outcomes, but it will have a direct impact on the cost of care,” Polliack said. “This means that MedyMatch is addressing the holy grail in the medical profession, that is, providing better patient outcomes while lowering the costs.”
MedyMatch is in the process of raising an additional $8 million in funding, after it completed an initial financing round of $2 million earlier this year, Saragnese said. Its product will need to get FDA and other approvals.
 



Thursday, June 2, 2016

Thursday, January 7, 2016

Specialized ambulances expedite stroke treatment

This is still way too slow and requires way too much specialized equipment and trained people.
No fast, easy, accurate and objective way to diagnose a stroke is the problem needing a solution, both ischemic and hemorrhagic. This is easy to solve; you fund researchers to test out these 17 possibilities to find out which one is the best. Or maybe the Qualcomm Xprize for the tricorder. No installing scanners in the ambulance, that is a waste of money. The goal should be to deliver tPA fast enough to prevent the neuronal cascade of death. But first you'll need research to determine how fast that needs to be.
 None of this lazy door-to-needle time.With no realization of the goal in minutes after stroke there can be no solution.
http://www.modernhealthcare.com/article/20160104/NEWS/160109988

Cleveland Clinic and the University of Texas Health Science Center at Houston ​have been leading​ clinical trials of mobile stroke unit vehicles, which enable hospitals to treat patients 40 minutes faster than traditional methods.  Still way too slow.

Armed with on-board imaging equipment, telemedicine equipment and lifesaving drugs, the ambulances provide faster treatment for stroke, which can cause brain damage with every passing moment. Experts say strokes often aren't treated quickly enough.

“It's about being responsible not only for the inpatient but what happens to that patient (before they arrive and) after they leave. When we thought about these topics we were thinking about that continuum,” said Diane Robertson, director of health technology assessment information services at ECRI, ECRI, a membership organization that evaluates medical technologies.

The vehicles—which were pioneered in Germany—made ECRI Institute's Top 10 Hospital C-Suite Watch list for 2016. Many of the items help providers reduce costs and curb readmissions such as warm perfusion systems for donor organs, miniature leadless pacemakers and blue-violet LED light fixtures that kill bacteria.

MSUs are modified ambulances that include a mobile blood lab, a heads-only CT scanner and telemedicine equipment that can send diagnostic images and help first responders communicate with neurologists at the hospital. UT and Cleveland Clinic each launched a single vehicle in 2014 and exclusively used them for stroke cases. Care teams are dispatched by a 911 operator when it's believed a patient is having a stroke.

Workers on the units normally include a critical-care nurse, a CT technologist, a paramedic and a driver. Normally, the crew will perform CT scans and blood testing at the scene and begin transporting the patient while a diagnosis is underway via telemedicine, said Robert Maliff, director of applied solutions at ECRI.

The MSU model allows a physician to more quickly decide whether life-saving tissue plasminogen activator therapy should be administered to break down blood clots in a patient's brain. Not all types of stroke call for t-PA therapy, but the unit can help physicians determine whether a patient should immediately receive the lifesaving drug.

Even the most sophisticated, highly efficient stroke programs have delays in getting patients to imaging equipment or receiving test results, Robertson said. MSUs start that process earlier and streamline treatment at the hospital.

“Stroke is a very common occurrence and we don't treat it very well,” Robertson said. “We don't get patients the necessary treatment they need soon enough.”  But you don't even know how quickly that even needs to be. Without that knowledge all these shots in the dark are worthless. Damn it all, rub two of your neurons together and actually think before you shoot.

With current modes of treatment, only 3% to 8% of U.S. stroke patients receive t-PA, because it must be administered within four-and-a-half hours of the onset of symptoms, according to the Cleveland Clinic. Patients often don't get treated within this timeframe because they don't immediately realize they've had a stroke, or because they've been misdiagnosed by first responders.

Preliminary data from both Cleveland Clinic and UT show patients on the units are treated within an average of 64 minutes, as compared to a 104-minute timeframe often found in the emergency room.

But the vehicles don't come cheap: ECRI estimates that the total fixed and continuing costs over five years for UT's rig will be $1.65 million. That includes a $375,000 mobile CT scanner, a $60,000 retrofit of the vehicle, $30,000 in telemedicine equipment and other ongoing expenses related to labor and telemedicine network coverage.

MSUs are among the innovations resulting from health systems' transition to value-based care and their ability to tackle care-delivery issues that have traditionally been outside of the hospital's responsibility. Stephanie Parker, a nurse and program manager of the UTHealth mobile stroke unit, said other providers won't embrace the units until ongoing studies provide enough data to show improved patient outcomes.

“You're not going to have wide adoption unless we can show that patients have better outcomes and that this is cost-effective,” Parker said. “If our study is positive, I could see it going across the country very quickly.”

UT is also examining whether it may be beneficial to include a physician on its unit, as is the norm for all ambulances in Germany. Funding is also a key hurdle to overcome in widespread implementation, she said, noting that the CMS needs to consider whether it will provide higher reimbursement for patients treated on the units, because hospitals will be much less likely to invest in the program if it's not cost-effective.

Dr. Shazam Hussain, head of Cleveland Clinic's stroke program, said the units could prove particularly useful in a rural setting where first responders must go vast distances to reach patients. He said some rural providers are considering having an MSU rendezvous with community ambulances that retrieve patients who live far from major hospitals. That saves time for the MSU.

Hussain compared the invention of MSUs to EKG machines, which first began to appear on ambulances to expedite heart attack treatment. There's often little hospital providers can do before a patient undergoes a CT scan(Bullshit, solve the objective diagnosis problem), which is what makes the pre-hospital scan so effective, he said.

“I think it's becoming clear at least from the stroke standpoint, given it is a time-sensitive treatment, that we have to be looking at ways to get to our patients faster,” Hussain said.

Thursday, December 31, 2015

Improving Human Activity Recognition and its Application in Early Stroke Diagnosis

Stroke diagnosis is pretty much a failure right now. Would anything here be better?  
Test out these 17 diagnosis possibilities to find out which one is the best?  Or maybe the Qualcomm Xprize for the tricorder? 

http://www.worldscientific.com/doi/abs/10.1142/S0129065714500361
José R. Villar
  • Corresponding author.
  • Computer Science Department, University of Oviedo, ETSIMO, Oviedo, Asturias 33005, Spain
  • Silvia González
  • Instituto Tecnológico de Castilla y León c/López Bravo 70 Burgos, Burgos 09001, Spain
  • Javier Sedano
  • Instituto Tecnológico de Castilla y León c/López Bravo 70 Burgos, Burgos 09001, Spain
  • Camelia Chira
  • Computer Science Department, Tech. University of Cluj-Napoca, 28 Gh. Baritiu Street, 400027 Cluj-Napoca, Romania
  • Jose M. Trejo-Gabriel-Galan
  • Neurology Department of the Burgos' Hospital, Burgos, Spain
  • Accepted: 4 November 2014
    Published: 16 February 2015
    The development of efficient stroke-detection methods is of significant importance in today's society due to the effects and impact of stroke on health and economy worldwide. This study focuses on Human Activity Recognition (HAR), which is a key component in developing an early stroke-diagnosis tool. An overview of the proposed global approach able to discriminate normal resting from stroke-related paralysis is detailed. The main contributions include an extension of the Genetic Fuzzy Finite State Machine (GFFSM) method and a new hybrid feature selection (FS) algorithm involving Principal Component Analysis (PCA) and a voting scheme putting the cross-validation results together. Experimental results show that the proposed approach is a well-performing HAR tool that can be successfully embedded in devices.


    Tuesday, November 24, 2015

    Effects of golden hour thrombolysis: a Prehospital Acute Neurological Treatment and Optimization of Medical Care in Stroke (PHANTOM-S) substudy

    I couldn't really tell from this if the reason better outcomes were observed was because the intervention was delivered fast enough not to trigger the neuronal cascade of death.  If we don't know what that time cutoff is then we don't know what the goal should be. And all these problems could be eliminated if we followed up on research to have a fast, easy and objective diagnosis with no neurologist involvement.
    Test out these 17 diagnosis possibilities to find out which one is the best?  Or maybe the Qualcomm Xprize for the tricorder? 

    Effects of golden hour thrombolysis: a Prehospital Acute Neurological Treatment and Optimization of Medical Care in Stroke (PHANTOM-S) substudy


    Abstract

    IMPORTANCE:

    The effectiveness of intravenous thrombolysis in acute ischemic stroke is time dependent. The effects are likely to be highest if the time from symptom onset to treatment is within 60 minutes, termed the golden hour.

    OBJECTIVE:

    To determine the achievable rate of golden hour thrombolysis in prehospital care and its effect on outcome. (Wrong objective; should be better recovery results)

    DESIGN, SETTING, AND PARTICIPANTS:

    The prospective controlled Prehospital Acute Neurological Treatment and Optimization of Medical Care in Stroke study was conducted in Berlin, Germany, within an established infrastructure for stroke care. Weeks were randomized according to the availability of a specialized ambulance (stroke emergency mobile unit (STEMO) from May 1, 2011, through January 31, 2013. We included 6182 consecutive adult patients for whom a stroke dispatch (44.1% male; mean [SD] age, 73.9 [15.0] years) or regular care (45.0% male; mean [SD] age, 74.2 [14.9] years) were included.

    INTERVENTIONS:

    The STEMO was deployed when the dispatchers suspected an acute stroke during emergency calls. If STEMO was not available (during control weeks, when the unit was already in operation, or during maintenance), patients received conventional care. The STEMO is equipped with a computed tomographic scanner plus a point-of-care laboratory and telemedicine connection. The unit is staffed with a neurologist trained in emergency medicine, a paramedic, and a technician. Thrombolysis was started in STEMO if a stroke was confirmed and no contraindication was found.

    MAIN OUTCOMES AND MEASURES:

    Rates of golden hour thrombolysis, 7- and 90-day mortality, secondary intracerebral hemorrhage, and discharge home.

    RESULTS:

    Thrombolysis rates in ischemic stroke were 200 of 614 patients (32.6%) when STEMO was deployed and 330 of 1497 patients (22.0%) when conventional care was administered (P < .001). Among all patients who received thrombolysis, the proportion of golden hour thrombolysis was 6-fold higher after STEMO deployment (62 of 200 patients [31.0%] vs 16 of 330 [4.9%]; P < .01). Compared with patients with a longer time from symptom onset to treatment, patients who received golden hour thrombolysis had no higher risks for 7- or 90-day mortality (adjusted odds ratios, 0.38 [95% CI, 0.09-1.70]; P = .21 and 0.69 [95% CI, 0.32-1.53]; P = .36) and were more likely to be discharged home (adjusted odds ratio, 1.93 [95% CI, 1.09-3.41]; P = .02).

    CONCLUSIONS AND RELEVANCE:

    The use of STEMO increases the percentage of patients receiving thrombolysis within the golden hour. Golden hour thrombolysis entails no risk to the patients' safety and is associated with better short-term outcomes. (Tell us what those better results were)

    TRIAL REGISTRATION:

    clinicaltrials.gov Identifier: NCT01382862.

    Tuesday, November 17, 2015

    Common Misdiagnoses for Stroke

    And all these problems could be eliminated if we followed up on research to have a fast, easy and objective diagnosis with no neurologist involvement.
    Test out these 17 diagnosis possibilities to find out which one is the best?  Or maybe the Qualcomm Xprize for the tricorder?  
    None of which are mentioned in this article.
    It's pretty much what I expect from StrokeSmart and the NSA. Another failure. Sure, blaming the victim for not being able to convince the doctors they are wrong and know nothing about stroke diagnosis.
    http://www.strokesmart.org/misdiagnosis-for-stroke
    Because symptoms of stroke can be mistaken for many different things, stroke patients may need to speak up and advocate for themselves to make sure they get a proper diagnosis and the care that they need as soon as possible.
    A delay in treatment can increase the severity of a stroke, so a swift and proper diagnosis is paramount.
    Here is a look at common misdiagnoses for stroke.

    Being Drunk or on Drugs

    Someone who is drunk or on drugs may act in a way or exhibit symptoms that can be confused with stroke symptoms.
    For example, they may stumble, or be unable to walk straight, and their speech may be slurred.
    So a stroke patient may need to be prepared to repeatedly answer that they are sober.
    Be clear and firm with a doctor or hospital staff that you are not under the influence of drugs or alcohol, and that your symptoms need to be addressed.

    Stroke During Pregnancy 

    Each year several thousand women in the United States have a stroke while pregnant, in delivery, or in the first few weeks following delivery.
    And warning signs of stroke, such as facial drooping and arm weakness, could be mistaken for other symptoms during pregnancy.
    For example, inflammation of the facial nerve could cause a pregnant woman’s facial muscles to droop.  And carpel tunnel syndrome, a very common symptom during pregnancy, can cause tingling and weakness in the inner portion of the arm.
    Reach out to your doctor immediately if you believe you are experiencing any warning signs of stroke before or after a pregnancy. 

    Blurred Vision

    Problems with vision including double vision, blurriness, and losing sight in one eye can all be signs of a stroke.
    Don’t dismiss these symptoms for tiredness or old age, or allow a medical professional to make the same conclusion.
    A blocked blood vessel reducing the amount of oxygen reaching an eye can cause any of these vision problems. So if you experience a sudden vision problem, don’t rule out the possibility of stroke.

    Other Misdiagnosed Signs of Stroke 

    If you are not prone to migraines, a sudden and severe headache could be a sign of stroke, as could sudden numbness or weakness in an arm.
    If you experience any of these symptoms, don’t hesitate to call 911 and reach out for help. Don’t underestimate these symptoms or allow a medical professional to do the same without checking for the possibility of a stroke.

    Thursday, September 24, 2015

    Every Patient Will be Misdiagnosed Once, Study Warns

    From a lot of the comments I see on Facebook there are lots of stroke survivors that are totally misdiagnosed. We need a fast, accurate, inexpensive and no need for a neurologist diagnosis for stroke.
    Test out these 17 diagnosis possibilities to find out which one is the best?  Or maybe the Qualcomm Xprize for the tricorder?   
     Our stroke associations should have statistics on how many patients are misdiagnosed and have a strategy to solve that problem. But shit they will be doing nothing like usual. We are totally screwed because no one is working on solving all the problems in stroke.

    http://www.wallstreethedge.com/every-patient-will-be-misdiagnosed-once-study-warns/26455/
    Most people will be misdiagnosed at least once throughout their lifetime, the Institute of Medicine (IOM) has revealed on September 22.
    According to the findings, published in the “Improving Diagnosis in Health Care” report, urgent improvements are needed in the health care system. Nowadays, everyone risks receiving a “meaningful” inaccurate or belated diagnosis, which might have disastrous consequences.
    An error of this type is defined as “failure to (a) establish an accurate and timely explanation of the patient’s health problem(s), or (b) communicate that explanation to the patient”.
    Misdiagnosis is usually caused by rush in identifying a cause for the patient’s symptoms, insufficient communication with doctors and nurses, and improper interpretation of lab tests or X-rays.
    Overall, every year around 5% of the adult patients who receive ambulatory care are misdiagnosed, and 10% of all patient deaths are linked to such errors. Inaccurate medical verdicts are the most widespread cause of malpractice lawsuits, and other claims are half as likely to have resulted in death by negligence.
    The importance of detecting with accuracy every health issue, based on its symptomatology, has been evident recently, when an Ebola patient was misdiagnosed.
    Thomas Eric Duncan ,a Liberian man who had contracted the virus, was initially told he had sinusitis and abdominal pain when he arrived at the Texas Health Presbyterian Hospital emergency room.
    He was prescribed antibiotics and was sent home, but his state worsened and eventually he was hospitalized again. In the intensive care unit, he was finally diagnosed with Ebola, but it was already too late and the patient eventually succumbed to the disease.
    Other similar cases have been reported, such as cancer patients who are diagnosed when their tumors have already metastasized, because doctors didn’t conduct enough tests to identify the illness in its early stages.
    Another patient filed a complaint at IOM claiming she was told by medical staff that she had acid reflux, when in fact she had suffered a heart attack, which resulted in serious damage.
    Back in 1999, the Institute of Medicine brought to light that between 44,000 and 98,000 deaths occur in hospitals, due to preventable medical errors. As a result of this report, emphasis has been placed on improving primary care and patient safety, but little attention was given to the importance of setting the right diagnosis.
    Nowadays, IOM is calling for health organizations to go through their records and identify such errors, so that they can be prevented in the future. Government officials are also urged to support more research in this field, especially by funding autopsy studies to identify the prevalence of misdiagnosis.
    Moreover, health practitioners should collaborate with patients, by actively involving them in the medical examination process and taking their ailments more seriously. They could also use “decision support” tools which list a variety of potential diagnoses, based on a set of symptoms.
    In addition, doctors should share their findings, upon pinpointing the correct illness or disorder, after others have failed. By turning such collaboration into a norm and increasing transparency and disclosure, health officials could learn from one another and improve their diagnosis skills.

    Sunday, August 16, 2015

    'Time is brain' in stroke assessment and treatment - Postdoctoral scholar awarded fellowship for research transforming acute stroke triage

    With the background in CT scanning there is no way he is going to solve the problem of delivering tPA in the ambulance. He defined the problem wrong from the start; The problem is how to get the fastest diagnosis to determine clot vs. bleed for tPA administration?, NOT How do I deliver a CT scan faster? This is what he should be looking at;  Test out these 17 diagnosis possibilities to find out which one is the best?  Or maybe the Qualcomm Xprize for the tricorder? 
    http://www.ucalgary.ca/utoday/issue/2015-08-14/time-brain-stroke-assessment-and-treatment
    When a patient arrives at the hospital(already you are behind the eight ball) showing signs of a stroke, every minute counts. At the Foothills Medical Centre, the internationally acclaimed stroke team immediately begins assessing the patient when they arrive so that treatment can begin as soon as possible.

    “Time is brain — you lose 2 million brain cells per minute during a stroke due to a blood clot in the brain," says Christopher d’Esterre, postdoctoral scholar and recipient of the 2015 T. Chen Fong Fellowship in Medical Imaging Science. "You need to have information quickly, and it has to be accessible and it has to be right, or else things will go wrong in a flash.”

    d’Esterre is researching computed tomography (commonly known as CT) perfusion scanning for quick assessment of acute stroke, and how it can inform treatment.

    “With CT perfusion, you inject a small amount of an inert liquid into the blood and take a picture of the brain every few seconds as it travels to the affected area. This liquid gives the image contrast so that you can see blood vessels and blood velocity,” he explains. “Using a very fast computer and a little bit of complex math, we generate blood flow images of the brain. This tells us what tissue is dead, what tissue is critical, and what tissue is not affected. We can also get a sense of whether the patient is at risk of bleeding into the brain.”

    The stroke team is also working on constructs that can tell them about the characteristics of the blood clot in the brain. According to d'Esterre, “the constructs tell us where the clot is is, how long it is, and whether it can be broken down using a clot-busting drug or whether it needs to be surgically removed. Surgical removal is more invasive but most effective, as shown in the recent ESCAPE trial."

    Improving process behind stroke treatment triage

    The primary goal of d’Esterre’s research is to improve the decision-making process for stroke treatment triage at Foothills and around the world. “We’re trying to develop easy to interpret scoring methods based on imaging that can help clinicians make a decision quickly and correctly, and have it standardized everywhere,” he says.

    “Chris d’Esterre is a bright young scientist in the early stages of his career, and is already part of team that is transforming health outcomes for all Canadians,” says Ed McCauley, vice-president (research). “He exemplifies the opportunities that exist for University of Calgary postdocs to contribute to world-changing research. We are thrilled that he has been awarded this fellowship.”

    Using an example of a stroke patient in Lethbridge, d’Esterre explains the role of CT perfusion in the critical first moments of triage. In the scenario, the patient is over an hour away, so understanding how and when brain tissue will be affected is paramount.

    “We have to decide whether we transport the patient to the Foothills hospital where we have the ability to remove the clot surgically, or if we want to keep the patient in Lethbridge. Surgical intervention isn’t currently possible in Lethbridge, but the clot-busting drug may have an equal probability of dissolving the blood clot as does surgical intervention - we need to determine this probability and act accordingly,” says d’Esterre. “Imaging is very important in making this decision as it will tell us the probability of both the drug dissolving the blood clot, and how much brain will be alive by the time the patient gets to Foothills hospital.”

    According to Dr. Bijoy Menon, d’Esterre’s supervisor and member of the Hotchkiss Brain Institute, this research has already had a positive impact on the triage process.

    “As stroke physicians, we rely heavily on imaging to make decisions, and Chris has used his skills and expertise with CT perfusion to tell us who are the right patients to have the mechanical clot-removal treatment,” he says.

    Bridging communication gap between scientists and clinicians

    When d’Esterre began his fellowship as part of the Calgary Stroke Program at the Foothills in 2013, he had his first hands-on clinical experience. “To see my basic science and physics background applied directly to stroke clinical care was the coolest aspect for me,” he says. “During my PhD training, I didn’t get to see the emergency stroke procedures in real time, and now I’m working directly with the neurologists who are making the acute treatment decisions."

    Menon credits d’Esterre’s fundamental science background with making him such an effective member of the stroke team.

    “Chris has also been able to bridge what I call the communications gap between translational scientists and clinicians,” he says. “He brings expertise where he is able to talk to us and talk to the scientists through a common language, helping us build more collaboration.”

    Learn more about advancements in acute stroke treatment at the University of Calgary.

    Wednesday, August 5, 2015

    Despite efforts to improve stroke treatment, delays in emergency transport still prevalent

    Well shit, you're thinking about this all wrong. You think the existing procedure just needs to be executed faster and more accurately. Wrong, wrong, wrong. You destroy the old procedure;
    1. NO scans - Fund researchers to test out these 17 diagnosis possibilities to find out which one is the best?  Or maybe the Qualcomm Xprize for the tricorder?  
    2.  NO neurologists - Objective tests take care of this problem.
    3. tPA delivered in the ambulance should be the goal, NOT within 60 minutes after getting to the hospital

    The stupidity in full display here:
    http://www.news-medical.net/news/20150728/Despite-efforts-to-improve-stroke-treatment-delays-in-emergency-transport-still-prevalent.aspx
    Despite efforts to close the time gap between symptom onset and stroke treatment - including improvements in public education, 911 dispatch operations, pre-hospital detection and triage, hospital stroke system development, and stroke unit management - a new study presented today at the Society of NeuroInterventional Surgery (SNIS) 12th Annual Meeting suggests that delays in emergency transport are still prevalent and that improvements are needed to ensure patients can be treated within the optimal time window.
    Perhaps more than any other condition, stroke requires timely diagnosis and treatment to yield the best possible outcomes for patients. Three recent stroke studies - MR CLEAN, ESCAPE and EXTEND IA - demonstrated that the success of endovascular therapy was due in part to reducing the time it took for patients to access treatment. Evaluation of Transfer Times for Emergent Stroke Patients from Regional Centers to a Comprehensive Stroke Center, conducted at Vanderbilt University Medical Center in Nashville, Tennessee, specifically focuses on time intervals associated with hospital-to-hospital transfer as most patients in the United States (U.S.) are transported to a regional center that is not equipped to treat all levels of stroke. Recording 70 patient transfer times within a one-year timeframe, the study found that all transfer times were significantly longer than expected driving times, with average differences per hospital ranging from 46 to 133 minutes.
    "Stroke requires a multi-disciplinary team that engages in a nuanced chain of events leading to treatment, and efficient and prompt patient transport via Emergency Medical Services (EMS) is a significant link in the process," said Dr. Michael Froehler, lead study author and neurointerventionalist at the Cerebrovascular Program at Vanderbilt University Medical Center. "Within the broader stroke community, we've definitely made progress in our systems of care that ensure an increasing number of patients receive treatment as quickly as possible. But we need to do more."
    The conversation on time to treatment is not without precedent. Within the last decade, the American Heart Association/American Stroke Association has put forth guidelines designed to advocate that stroke patients receive the highest level of care in the shortest time possible. Many state legislatures have created stroke prevention task forces and developed state-wide stroke prevention plans. Individual counties and cities have established systems to ensure that emergency medical service personnel are equipped to appropriately assess patients and immediately transfer them to the closest certified stroke center. Despite these efforts, transfer times often remain beyond the preferred treatment time window.
    "The challenge to improve upon stroke systems of care is an opportunity to transform the way we approach stroke treatment, and we're seeing the most progress in the cities, states and regions that are engaging in collective efforts to ensure that patients go to the hospital that is best equipped to treat stroke," said Dr. Donald Frei, president of SNIS. "We have a unique responsibility to continue to invest our time, resources and best thinking to better assist our patients and to continually refine systems of care that will facilitate optimal stroke treatment."
    Dr. Froehler pointed out that most changes in systems of care, while well-intentioned, are often not informed by evidence from trials. He has therefore initiated controlled study of stroke care systems at Vanderbilt University Medical Center by comparing different approaches to transporting stroke patients to the right hospital faster. "It's important that we continue to inform best practices and evolve our systems for the good of patients who depend on rapid response and timely intervention. We must rigorously apply the same evidence-based standards that we use for individual patient treatment decisions to the broader systems of care in order to achieve necessary efficiencies that can make a real difference for our patients," said Froehler.
    Stroke is the leading cause of disability and the fourth cause of death in the U.S. In 2010, stroke cost the U.S. an estimated $54 billion, including the cost of health care services, medications and missed days of work. Additionally, strokes account for $74 billion in health care expenditures annually for treatment due to disability.
    Source:
    Society of NeuroInterventional Surgery


    Wednesday, July 29, 2015

    Extremes of stroke symptoms attract misdiagnoses

    Wrong, wrong, wrong, you don't need more training of ER doctors, you need to come up with a fast, easy and objective test that doesn't need a doctor at all.
    When are we going to fund researchers to test out these 17 diagnosis possibilities to find out which one is the best?  Or maybe the Qualcomm Xprize for the tricorder?  

    http://www.news-medical.net/news/20150724/Extremes-of-stroke-symptoms-attract-misdiagnoses.aspx
    Patients with very mild or very severe stroke symptoms are at the greatest risk of being misdiagnosed in the emergency department, research suggests.
    These “stroke chameleons” were mostly missed by emergency physicians, who failed to consider a stroke diagnosis in 91.5% of the 47 patients studied. However, neurologists also did not consider stroke in 57.6% of the 33 patients about whom they were consulted.
    “Based on our data, some stroke chameleons may be preventable in part by educating physicians about unusual presentations of stroke”, say Benjamin Richoz (Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland) and co-researchers. They also suggest lowering the threshold for consulting a neurologist.
    Another problem was coexisting neurological and psychiatric conditions, which “often masked correct stroke diagnosis”, leading to misattribution of symptoms in 19.1% of patients.
    The stroke chameleon patients were identified from among 2200 acute ischaemic stroke patients admitted to a single centre over 8.25 years. Richoz et al stress that, had they been correctly diagnosed, 23.4% of the stroke chameleon patients would have been eligible for thrombolysis.
    Misdiagnosis had consequences for patient outcomes. Significantly fewer stroke chameleon patients achieved a favourable 12-month outcome, at 50.0% versus 61.6% of correctly diagnosed patients, and they were more likely to die, at 30.4% versus 19.4%, and to have a recurrence, at 13.3% versus 9.9%.
    Most independent predictors of misdiagnosis were indicative of mild stroke in younger patients with a low-risk profile. Pre-existing use of lipid-lowering drugs and the presence of eye deviation reduced the risk by 70% to 80%, and the risk of misdiagnosis also declined with older age and higher diastolic blood pressure.
    The researchers call the tendency to misdiagnose patients with a low-risk profile “understandable”, but say “it shows the importance of educating medical personnel of the possibility of stroke in young patients with acute, unexplained neurologic symptoms.”
    Cerebellar stroke was 3.78-fold more likely to be misdiagnosed than other strokes, in line with previous studies.
    Many stroke chameleon patients had low National Institutes of Health Stroke Scale scores, but a group had very high scores, of around 25 to 35, and unexplained decreased level of consciousness was a frequent misdiagnosis, given to 21.3% of patients. Eleven patients presented in a stupor or coma, mostly because of basilar artery occlusion.
    “This presentation may mislead physicians to suspect a metabolic, toxic, or anoxic encephalopathy rather than stroke”, writes the team in Neurology.
    Even brain imaging did not always prevent misdiagnosis; indeed, it contributed to the wrong diagnosis in 40.4% of the patients. In nine patients, noncontrast computed tomography (CT) findings were misinterpreted, with subtle, early ischaemic changes often overlooked, and 10 patients had no changes, leading to the exclusion of stroke as a diagnosis.
    The team therefore advises “the more systematic use” of more sensitive imagining techniques such as multimodal CT and magnetic resonance imaging.

    Tuesday, July 28, 2015

    subsets of BHAG - Big Hairy Audacious Goal

    1.  Delivery of tPA while still in the ambulance, within 15 minutes. None of this lazy-ass 60 minutes after getting to the hospital. Scanning is way too slow, expensive and requires a neurologist on duty.  Forget putting a scanner in the ambulance, that's stupid because with that money you could solve one of the 17 diagnosis possibilities.
    When are we going to fund researchers to test out these 17 diagnosis possibilities to find out which one is the best?  Or maybe the Qualcomm Xprize for the tricorder?  

    2. Solve the neuronal cascade of death. By solving this you are stopping the stroke in its tracks rather than letting it continue to kill neurons for the next week. I probably lost 5.4 billion neurons in the week following the stroke. Your doctor should be able to estimate that number pretty closely, they've had 15 million strokes a year for case studies.
    Here are the 5 possible causes;
    http://www.oc1dean.blogspot.com/2013/11/lysosomal-membrane-permeabilization-as.html

    Challenge researchers to solve them.
    3. Solve how neuroplasticity works. Saying to use neuroplasticity to recover is pretty much fucking worthless.By knowing how and why a neighboring neuron drops its extsting task and takes on a new one we will finally be able to make this automatically repeatable. This would help all the current survivors out there. Use one of these two methods to listen in on neuron communications:
    Researchers Inject Tiny, Rolled-Up Electronics into the Brain Using a Syringe
    Harvard scientists have developed a first-of-its-kind method of creating a class of nanowires
    4. Solve the neurogenesis and angiogenesis puzzles. This would allow survivors to repair/relocate functions in the dead areas in their brains.

    Wednesday, May 20, 2015

    MRI screening helps in accurate and rapid stroke treatment

    A 60 minute treatment goal is way too slow, you need to have this delivered in the ambulance. Scanning is way too slow, expensive and requires a neurologist on duty.  When are we going to fund researchers to test out these 17 possibilities to find out which one is the best?  Or maybe the Qualcomm Xprize for the tricorder?  
    http://www.news-medical.net/news/20150514/MRI-screening-helps-in-accurate-and-rapid-stroke-treatment.aspx 
    Time is critical when it comes to stroke, and early treatment is associated with better outcomes. According to the Screening with MRI for Accurate and Rapid stroke Treatment (SMART) study, small changes in quality improvement procedures enabled clinicians to use MRI scans to diagnose stroke patients before giving acute treatment, within 60 minutes of hospital arrival. MRI scans provide detailed images but take longer to complete than CT scans, which are commonly used in most centers. The findings, published in Neurology, were supported in part by the National Institutes of Health's National Institute of Neurological Disorders and Stroke (NINDS).
    "By making small changes to our processes, we were able to scan suspected stroke patients with MRI and appropriately treat patients within a goal time of 60 minutes. This is an important finding for hospitals, healthcare providers and the public," said Amie Hsia, M.D., medical director of the Comprehensive Stroke Center at MedStar Washington Hospital Center, Washington D.C., and senior author of the study. "Not only does MRI provide more precise and complete information than the traditionally used CT scan, now we've also demonstrated that it is feasible to use from a time perspective."
    National guidelines suggest that stroke patients should receive treatment within 60 minutes of arriving at the hospital. (Why so slow?)The majority of hospitals rely on rapid CT scans to determine if an individual is eligible for intravenous tPA, the only FDA-approved treatment for ischemic strokes, those caused by blood clots in the brain. If a CT scan shows the patient is having a bleeding, or hemorrhagic, type of stroke, tPA cannot be used as treatment. For many years CT scans were the only imaging tool available in most hospitals, but now MRIs are becoming more widely available.
    Clinicians at MedStar Washington Hospital Center and Suburban Hospital, Bethesda, Maryland, routinely work with physician-scientists from NIH and have access to their cutting-edge medical protocols and technologies. The two hospitals use MRI instead of CT scans to screen stroke patients. Although MRI scans can take up to 15 minutes longer than CT scans, they provide clinicians with more detailed information about what is happening in a patient's brain. Using MRI, clinicians can see early changes taking place during the stroke. In this way, they can see what tissue is at risk and identify blocked blood vessels or subtle bleeding that cannot be picked up by CT.
    To reduce the door to treatment time, multidisciplinary teams at both hospitals carefully examined the existing processes to identify time-consuming bottlenecks or duplicative methods. By using "lean process interventions," they found a number of steps that could be eliminated or changed. For example, at MedStar Washington Hospital Center, a lengthy MRI screening form was simplified to three questions; at Suburban Hospital, tPA was put into the medication cart in the MRI suite so that it could be given immediately to patients after scanning instead of returning them to the Emergency Department for treatment.
    Once the changes were implemented, Dr. Hsia's team examined whether they had an impact on treatment times for patients. The results indicated that door to treatment time was reduced from 93 to 55 minutes, a difference of 40 percent. Over a two year period, the percentage of patients treated within 60 minutes increased from 13 to 61.5 percent. Further analysis revealed that these changes were due to faster MRI start times.
    "There was no difference in the patient characteristics. It was clear the improvements were due to the changes we made in the processes at these two hospitals," said Dr. Hsia.
    "A number of the changes that Dr. Hsia's team assessed were not specific for MRI scans, but were related to general procedures of getting patients ready for imaging as quickly as possible. This suggests that these findings are relevant even in hospitals that do not have emergency access to MRI scanners," said Walter Koroshetz, M.D., acting director of NINDS. "We will persist in evaluating best practices for acute stroke care to ensure that the greatest number of patients receive treatment as early as possible following stroke."
    Dr. Hsia and her colleagues will continue to monitor the door to treatment times, to ensure they are sustainable. In addition, they plan to continue to evaluate best practices for acute stroke care and look for other improvements to further decrease door-to-treatment times for patients.
    Source:
    NIH/National Institute of Neurological Disorders and Stroke

    Novel computer-aided system developed for acute stroke detection

    This barely helps at all in reducing the time to treatment. It still requires a time consuming and expensive scan. But has this been tested for those cases where prior strokes have occurred?  When are we going to fund researchers to test out these 17 possibilities to find out which one is the best?  Or maybe the Qualcomm Xprize for the tricorder?  Does no one have a clue that we need to be following a strategy rather than this stupid scattershot approach? If our stroke associations actually wanted to be useful they would use some of the brainpower of their employees and create a strategy to solve all the problems in stroke. But no, it is more important to put out press releases.
    http://www.news-medical.net/news/20150514/Novel-computer-aided-system-developed-for-acute-stroke-detection.aspx 

    The Hong Kong Polytechnic University (PolyU) has developed a novel computer-aided detection system for acute stroke using computer intelligence technology. Reading 80-100 computer images, the system is able to detect if the patient was struck by ischemic stroke or haemorrhagic stroke. The detection accuracy is 90%, which is as high as that conducted by specialists, but at a much reduced time from 10-15 minutes to 3 minutes. The new system serves as a second opinion for frontline medical doctors, enabling timely and appropriate treatment for stroke patients.
    Providing treatment to acute stroke patients within the golden hours of stroke treatment, i.e., 3 hours of stroke onset, is vital to saving lives. However, stroke specialists do not work around the clock, increasing the risk of misdiagnosis and delayed diagnosis of acute stroke. This novel system which analyses brain scans could help save lives by assisting non-specialists in diagnosis by providing them a second opinion. Timely diagnosis and treatment within 3 hours of stroke onset also minimise damage.
    Developed by experts from the Department of Health Technology and Informatics at PolyU, the computer-aided detection for stroke (CAD stroke) technology combines sophisticated calculations, artificial intelligence and pathology to help medical professionals achieve speedy and accurate diagnosis.
    The first part of the system is an algorithm for automatic extraction of areas of suspected region of interest. A computed tomography (CT) scan uses X-rays to take pictures of the brain in slices. When blood flow to the brain is blocked, an area of the brain turns softer or decreases in density due to insufficient blood flow, pointing to an ischemic stroke.
    The second part is an artificial neural network to classify region of interest for stroke. The CAD stroke computer "learns" the defining features of stroke, and performs automated reasoning. CT scans are fed into the CAD stroke computer, which will make sophisticated calculations and comparisons to locate areas suspected of insufficient blood flow. It detects where the images look "abnormal", and will be highlighted for doctors' review. Early changes including loss of insular ribbon, loss of sulcus and dense MCA signs will appear as "abnormalities", helping doctors determine if blood clots are present. As our system is able to detect subtle change in density, our system is also able to detect haemorrhagic stroke which is presented as increase in tissue density.
    Equipped with the built-in artificial intelligence feature, the CAD stroke technology can learn by experience. With every scan passing through, along with feedback from stroke specialists, the application will improve its accuracy over time.
    The life-saving application can also detect subtle and minute changes in the brain that would escape the eye of even an experienced specialist, slashing the chances of missed diagnosis. False-positive and false-negative cases, and other less serious conditions that mimic a stroke can also be ruled out, allowing a fully-informed decision to be made.

    Thursday, April 23, 2015

    Three Keys to Blazing Fast Thrombectomy

    And you ill-informed idiots could probably cut that time in half if you embrace faster diagnosis  by maybe these methods.
    Maybe you want to look at these;
    The Qualcomm Xprize for the tricorder has selected 10 finalists?
    I've already pointed out  these 17 ways for objective diagnosis. 

    But then I'm obviously not as smart as these doctors. 
    Three Keys to Blazing Fast Thrombectomy

    Sunday, April 12, 2015

    Mobile van offers stroke care on the go - Cleveland Clinic

    Even the vaunted Cleveland Clinic can't seem to read news about stroke. This is going to be an expensive short term test.  Do they not know that the Qualcomm Xprize for the tricorder has selected 10 finalists? How long before this comes to fruition and makes the expensive and time-consuming MRI and CT scans obsolete? We also shouldn't need neurologists on call to interpret those scans.
    But do you really think your hospital will recommend this when it goes to production? It's a neurologist job killer and I doubt the stroke department head will recommend reducing head count unless you call the hospital president and make the case.
     http://www.king5.com/story/news/health/2015/04/09/stroke-tpa-mobile-unit-cleveland-cinic/25539693/

    Monday, March 30, 2015

    Daisy Hill stroke services move going ahead: Wells - UK

    If you are trying to counter the move you really need to attack their reasons for moving rather than appealing to emotion. Within 2 years the ability to objectively diagnose a stroke will probably exist and you won't need neurologists on staff or expensive scanning machines. If your medical administrators were any good at all they would know about these diagnosis possibilities already and you need to find out the real reason for the move.
    Maybe you want to look at these;
    The Qualcomm Xprize for the tricorder has selected 10 finalists?
    I've already pointed out  these 17 ways for objective diagnosis. 



    Daisy Hill stroke services move going ahead: Wells