New Data Presented at VAM26 Explores How Carotid Endarterectomy and Carotid Artery Stenting Compare in Real-World Patient Populations

 I can't ever see doing carotid stenting or endarterectomy with all the risks of those procedures. Your doctor NEEDS TO GUARANTEE NO PROBLEMS IF DONE OR THE MEDICAL LICENSE IS LOST! 

Possible problems:

Cognitive Dysfunction and Mortality After Carotid Endarterectomy

Carotid Interventions for Women: The Hazards and Benefits

Female Gender Increases Risk of Stroke and Readmission after CEA(Carotid endarterectomy) and CAS(carotid artery stenting)

Ticagrelor Induced Angioedema Following Carotid Artery Stenting

Cognitive Dysfunction and Mortality After Carotid Endarterectomy

Here is why your doctor needs to GUARANTEE NO complications from stenting!

• stenting (22 posts to May 2011)

• carotid stenting (21 posts to May 2016)

• carotid artery stenting (7 posts to November 2021)

 The obvious solution is check if the Circle of Willis is complete, then close up the offending artery!

My right carotid artery was at 80% blockage at time of stroke and then thankfully fully closed up 3 years later. Remained closed for 10 years and I cognitively functioned quite well with no episodes of fainting or poor executive functioning. Eventually collaterals grew around the blockage. Since my Circle of Willis is complete, I still had 3 fully functioning arteries supplying blood to the brain, obviously enough to keep me highly functioning. I'm glad that my doctors were so incompetent they never found that 80% blockage, otherwise they probably would have insisted I undergo either stenting or endarterectomy, both of which they couldn't guarantee no problems. And I didn't find out about those problems until years later researching for this blog.

The latest here:

New Data Presented at VAM26 Explores How Carotid Endarterectomy and Carotid Artery Stenting Compare in Real-World Patient Populations

Study Finds Long-Term Stroke and Death Rates Favor Carotid Endarterectomy (CEA) over Carotid Artery Stenting (CAS) in Treating Patients with Asymptomatic Carotid Artery Stenosis 

BOSTON, MA, JUNE 13, 2026 – Today, the Society for Vascular Surgery (SVS) announced the findings of a new study demonstrating the safety and efficacy of emerging treatment options for patients with asymptomatic carotid stenosis (ACS).

Carotid stenosis occurs when plaque builds up in the carotid artery, narrowing the vessel and restricting blood flow to the brain and can lead to stroke. However, ACS occurs when the artery is narrowed by at least 70-80% without a recent stroke, significantly increasing the risk of future stroke, cardiovascular events, and cognitive decline. It is estimated that two million North Americans and Europeans live with treatable asymptomatic carotid artery stenosis (NIH).

In November 2025, the New England Journal of Medicine published data from the Carotid Revascularization and Medical Management for Asymptomatic Carotid Stenosis Study (CREST-2), focused on revascularization practices to manage stroke risk in ACS patients. SVS published an opinion piece on why CREST-2 trial results should inform, not replace, clinical judgement due to how the trial reflects idealized medical therapy, not routine clinical practice. 

“Data presented at the Society for Vascular Surgery’s Vascular Annual Meeting underscores the importance of knowledge of which intervention, if any, is optimal for stroke management in patients with carotid disease,” said Keith D. Calligaro, MD, Chief, Vascular Surgery at Pennsylvania Hospital, President, Society for Vascular Surgery. “We should not disregard the findings of many past studies showing the benefit of carotid endarterectomy over carotid stenting in selected patients. The findings highlight the need for randomized clinical trials, real-world outcomes data, and the expertise of vascular surgeons, the only specialty that can perform trans-femoral carotid stenting, TCAR and CEA.”

Carotid Stenosis Patients Experience Improved Stroke and Mortality Outcomes Three Years After CEA than CAS

Using the TriNetX Collaborative US Network, a multi-institutional electronic health record platform continuously updating real-world data from healthcare organizations, researchers aim to compare perioperative and long-term outcomes of CEA and CAS in asymptomatic patients. Researchers selected adult patients with ACS who underwent CEA or CAS from the TriNetX Network. Patients were matched 1:1 using a propensity score match (PSM) to balance baseline characteristics like demographics, comorbidities, and relevant medications. The study’s primary outcomes included stroke, death, and the composite outcome of stroke or death at 30 days, one year, three years, and five years.

The study identified 101,714 patients in total, 61,124 of whom underwent CEA (60.1%) and 40,590 CAS (39.9%). Through PSM, 39,471 patients were matched to each cohort with balanced baseline characteristics. The CEA group showed consistently lower rates of stroke at 30 days (2.0% vs 2.4%, p=0.001), one year (2.9% vs 3.3%, p=0.001), three years (3.6% vs 3.9%, p=0.008), and five years (4.1% vs 4.4%, p=0.038). This group also saw significantly lower mortality rates at three years (11.8% vs 12.4%, p=0.014),though other time points reflected similar rates. At every time period stroke or death outcomes favored the CEA group, with significant differences observed at 30 days (3.9% vs 4.2%, p=0.049), one year (8.7% vs 9.4%, p=0.001), three years (14.9% vs 15.8%, p< 0.001), and five years (20.1% vs 20.8%, p=0.013).

“Our results suggest that CEA has more favorable stroke and mortality outcomes when patient demographics are equal,” said lead author Anthony H. Chau, MD, Associate Professor of Vascular and Endovascular Surgery, University of California, Irvine. “However, our findings do not conclude that every patient should undergo CEA. Instead, they remind us how paramount patient selection is when treating carotid artery stenosis, and the detail that should go into selecting the right procedure for the right patient.”

Session Details:

• “Carotid endarterectomy has improved long-term stroke and survival compared to carotid artery stenting in a real-world propensity-matched cohort analysis using the TriNetX Network”
  • Saturday, June 13th from 9:04 am – 9:11 am ET (Plenary 7)

### 

About the Society for Vascular Surgery
The Society for Vascular Surgery® (SVS) seeks to advance excellence and innovation in vascular health through education, advocacy, research, and public awareness. The organization was founded in 1946 and currently has a membership of approximately 6,500. SVS membership is recognized in the vascular community as a mark of professional achievement. For more information, visit Vascular.org.

About VAM26
The Society for Vascular Surgery’s Vascular Annual Meeting (VAM) will be held in Boston, MA, on June 10-13. Leading physicians, researchers, and health care professionals in vascular surgery gather for three full days of groundbreaking educational content showcasing the latest data, research, and innovations in vascular surgery and vascular health. For more information, visit vam.vascular.org.

Press Contact:

Bethany Grassley

bgrassley@brgcommunications.com

703-739-834

Gout and Risk of Ischemic Stroke in Patients With Atrial Fibrillation: A Nationwide Cohort Study

 

Ask your competent? doctor to compare all this research for the best course of action.

 

Your doctor has a lot of explaining to do. All this other information.

Gout may lessen Alzheimer risk March 2015

Study finds no association between gout and neurodegenerative diseases in the general population March 2023

 

Gout unveiled as surprising culprit in neurodegenerative diseases May 2023

Could Old Gout Drug Offer New CV Benefits? Nov. 2015

Gout drug could reduce stroke risk, study suggests January 2026

The latest here:

Gout and Risk of Ischemic Stroke in Patients With Atrial Fibrillation: A Nationwide Cohort Study

Antti Palomäki, MD, PhD https://orcid.org/0000-0002-8835-8116, 

Ville Langén, MD, PhD https://orcid.org/0000-0002-2382-7962, 

K.E. Juhani Airaksinen, MD, PhD https://orcid.org/0000-0002-0193-568X, 

Olli Halminen, PhD https://orcid.org/0000-0001-9266-8435,

Jari Haukka, PhD https://orcid.org/0000-0003-1450-6208, 

Jussi Jaakkola, MD, PhD https://orcid.org/0000-0002-3398-4283, 

Elis Kouki, MD https://orcid.org/0000-0002-5759-0916,

… Show All … , and Konsta Teppo, MD, PhD https://orcid.org/0000-0002-4460-0994 jkitep@utu.fiAuthor Info & Affiliations

Stroke

New online

https://doi.org/10.1161/STROKEAHA.126.055194

 

Abstract

 BACKGROUND:

Gout is an emerging cardiovascular risk factor. We aimed to assess whether gout is associated with an increased risk of stroke in patients with atrial fibrillation (AF).

METHODS:

The nationwide registry-linkage FinACAF study (Finnish Anticoagulation in Atrial Fibrillation) included all patients with AF in Finland between 2007 and 2018 from all levels of care. Based on diagnosis codes and pharmacy claims data, the association of gout and urate-lowering therapy with the incidence of ischemic stroke was assessed.

RESULTS:

We identified 229 565 patients with new-onset AF (50.0% female; mean age, 72.7 years; mean follow-up, 4.0 years), of whom 6 910 (3.0%) had a history of gout. A total of 16 296 (7.1%) patients experienced an ischemic stroke. Gout was associated with higher stroke rates in both unadjusted and adjusted analyses (incidence rate ratio, 1.35 [95% CI, 1.22–1.49] and incidence rate ratio, 1.12 [95% CI, 1.02–1.24], respectively). Analyses restricted to follow-up without anticoagulation yielded consistent results with slightly higher point estimates (incidence rate ratio, 1.88 [95% CI, 1.63–2.17] unadjusted; incidence rate ratio 1.26 [95% CI, 1.09–1.46] adjusted). In patients with gout and AF, time-dependent exposure to urate-lowering therapy was associated with a 30% lower stroke rate. Nonanticoagulated crude stroke rates were 1.5, 1.0, and 4.8 per 100 patient-years for gout patients with CHA2DS2-VA scores of 0, 1, and ≥2, respectively.

CONCLUSIONS:

Gout is an important risk factor for ischemic stroke in patients with AF, and considering gout could improve stroke risk stratification. Urate-lowering therapy was associated with reduced stroke risk, suggesting that gout is a modifiable risk factor in patients with AF.

REGISTRATION:

URL: https://www.clinicaltrials.gov; Unique identifier: NCT04645537.

Graphical Abstract

 Atrial fibrillation (AF) is the most common cardiac arrhythmia, affecting up to 5.2% of the adult population.1 It is a major cause of ischemic stroke, with the risk of stroke varying considerably among individuals based on their specific comorbidities and other characteristics.2,3 With optimal therapy, including oral anticoagulant (OAC) treatment as well as management of relevant comorbidities, the risk of stroke can be significantly reduced.4 Identifying patients who would benefit from OAC therapy and have modifiable stroke risk factors is therefore essential for improving their prognosis.

Gout is the most common form of inflammatory arthritis with increasing prevalence globally.5 It is characterized by recurrent painful flares caused by an inflammatory reaction against monosodium urate crystals deposited in joints and surrounding tissues as a result of hyperuricemia.6 Gout has been associated with the risk of cardiovascular events, including myocardial infarction, stroke, and venous thromboembolism.7–10 AF is common in patients with gout and hyperuricemia, and patients with gout often share many risk factors for AF, particularly older age, male sex, obesity, hypertension, chronic kidney disease, and alcohol use.11–14 Gout is also often undertreated, with both low rates of urate-lowering therapy initiation and poor treatment adherence.15

In patients with AF, it remains uncertain whether gout contributes to an additional and potentially modifiable risk of stroke. Moreover, while there is some evidence that long-term urate-lowering therapy may lower the risk of acute coronary syndrome and stroke in patients with gout, whether this also applies to stroke risk in patients with coexisting AF and gout is unknown.16–18 These questions are clinically important, as appropriate management of gout might offer a relatively simple and cost-effective strategy to improve outcomes in patients with AF. Therefore, we conducted a nationwide retrospective cohort study to examine the association of gout with ischemic stroke in patients with AF. Additionally, we explored whether urate-lowering therapy is associated with a reduced stroke risk in patients with gout and AF.

METHODS

Data Availability Statement

Because of the sensitive nature of the data collected for this study, requests to access the data set from qualified researchers trained in human subject confidentiality protocols may be sent to the Finnish national register holders (Social Insurance Institution of Finland, Finnish Institute for Health and Welfare, Population Register Center, and Tax Register) through Findata (https://findata.fi/en/). In the interest of research transparency and reproducibility, the analysis code used in this study has been made publicly available on GitHub and permanently archived on Zenodo under DOI 10.5281/zenodo.17228485. It can be accessed directly online at https://doi.org/10.5281/zenodo.17228485.

Study Population

The FinACAF study (Finnish Anticoagulation in Atrial Fibrillation; ENCePP Identifier: EUPAS29845) is a nationwide retrospective cohort study that includes all patients documented with AF in Finland from 2004 to 2018.19 Patients were identified using all available national health care registers, including hospitalizations and outpatient specialist visits, and primary health care. and the National Reimbursement Register maintained by the Social Insurance Institute. The cohort inclusion criterion was an International Classification of Diseases, Tenth Revision diagnosis code of I48, encompassing AF and atrial flutter, collectively referred to as AF, recorded between 2004 and 2018. Exclusion criteria encompassed permanent emigration abroad before December 31, 2018, and age below 20 years at AF diagnosis. The present substudy was conducted within a cohort of patients with incident AF from 2007 to 2018, established in previous studies of the FinACAF cohort.20–22 The patient selection process is summarized in Figure S1.

Follow-Up

The follow-up period was evaluated using 2 distinct approaches. In both strategies, the follow-up started from the first diagnosis of AF. In the main approach, follow-up continued until the occurrence of the first ischemic stroke event, death, or the end of the observation period on December 31, 2018, whichever occurred first. In this approach, the regressions were adjusted for the use of OACs in a time-dependent manner. Moreover, since it is the nonanticoagulated stroke rate that drives the clinical decision-making regarding stroke prevention with OACs, the second approach focused exclusively on the follow-up without OAC therapy.23 Thus, in the second approach, the follow-up ended on the first OAC purchase, the first stroke event, death, or the end of the observation period, whichever occurred first.

Definition of Gout

Patients were classified as having gout if they had recorded gout diagnosis codes (International Classification of Diseases, Tenth Revision: M10 or International Classification of Primary Care, Second Edition: T92) in any of the nationwide hospital or primary care registers before or at the date of the first AF diagnosis. Furthermore, to explore gout severity and gauge potential causality between gout and stroke (on the assumption that a causal risk factor should show stronger associations with greater severity), we classified patients into 2 groups: those with a hospital-recorded diagnosis of gout (a surrogate for more severe disease requiring hospital-level care) and those with gout diagnosis recorded only in primary care (a surrogate for less severe disease). Additionally, gout patients were categorized into those with a pharmacy purchase of urate-lowering therapy (allopurinol or febuxostat) within the year before their first AF diagnosis and those without urate-lowering drug purchases.

Exposure to Urate-Lowering Therapy

We considered allopurinol and febuxostat, the most commonly used urate-lowering therapies in Finland, in our analyses. First, we assessed stroke risk in patients with gout with and without these drug purchases at baseline, defined as at least 2 pharmacy purchases of allopurinol or febuxostat within the year before the first AF diagnosis (start of follow-up), including the date of diagnosis. Second, among patients with gout, we analyzed the effect of these drugs on stroke risk using a time-dependent exposure definition. In this approach, exposure to urate-lowering therapy began at the first pharmacy purchase occurring within 1 year before or any time after cohort entry and was assumed to continue until 120 days after the last recorded purchase. Follow-up with exposure to urate-lowering therapy was then compared with time without urate-lowering therapy. Purchases made >1 year before cohort entry were not considered as therapy initiation. The 120-day interval was chosen because, in Finland, medications can be reimbursed for up to 90 days at a time, with an additional 30-day grace period allowed to account for potential stockpiling and waning of the urate-lowering effect.

Definition of Ischemic Stroke

In patients without prior ischemic stroke before the first AF diagnosis, an ischemic event was considered to occur on the first date of a recorded I63 or I64 International Classification of Diseases, Tenth Revision diagnosis code in the hospital care register after the cohort entry. In patients with prior ischemic stroke, the event was considered to occur on the date of the first new hospitalization with I63 or I64 International Classification of Diseases, Tenth Revision code as the main diagnosis, with at least a 90-day gap from the prior event, which had occurred before AF diagnosis.

Study Ethics

The study protocol was approved by the Ethics Committee of the Medical Faculty of Helsinki University, Helsinki, Finland (nr. 15/2017 and 15/2024), and received research permission from the Helsinki University Hospital (HUS/46/2018 and HUS/217/2024). Respective permissions were obtained from the Finnish register holders (KELA 138/522/2018; Finnish Institute for Health and Welfare 2101/5.05.00/2018; Population Register center VRK/1291/2019-3; Statistics Finland TK-53-1713-18/ u1281; and Tax Register VH/874/07.01.03/2019). Patients’ personal identification numbers were pseudonymized, and the research group received individualized but unidentifiable data. Informed consent was waived due to the retrospective registry nature of the study. The study conforms to the Declaration of Helsinki as revised in 2024. This study is reported in accordance with the STROBE guidelines (Strengthening the Reporting of Observational Studies in Epidemiology; Supplemental Material).

Statistical Analyses

We calculated incidence rates and incidence rate ratios (IRRs) for ischemic stroke using the Poisson regression model. The model employed a Lexis-type data structure, incorporating 2 time scales: follow-up time from AF diagnosis and age.24 This statistical approach was selected to address age progression over the relatively long observation period (2007–2018). Adjusted IRRs accounted for age (categorical variable with 10-year intervals), calendar year period, sex, heart failure, diabetes, hypertension, prior ischemic stroke, vascular disease, dyslipidemia, prior bleeding, alcohol use disorder, renal failure, cancer, dementia, psychiatric disorders, and income level (divided into tertiles). The definitions of the comorbidities are presented in Table S1. In analyses that also included follow-up with anticoagulation, OAC use was treated in a time-dependent manner, with treatment initiation marked by the first OAC purchase and continuation until 120 days after the last drug purchase. Additionally, we assessed the association between urate-lowering therapy (allopurinol or febuxostat) exposure and stroke risk among patients with gout. In these analyses, urate-lowering therapy use was modeled in a time-dependent manner (as detailed above in the exposure to urate-lowering therapy paragraph), and adjusted models included the aforementioned variables, including OAC use. Sensitivity analyses were conducted among patients without baseline stroke, as first-ever strokes may be more reliably defined than recurrent events in administrative registry data. Moreover, we assessed whether the association between gout and stroke risk differed across stroke risk categories by fitting a Poisson regression model including gout, stroke risk category (3 groups: CHA2DS2-VA scores 0, 1, or ≥2), and their interaction term. Baseline variables were compared using the χ2 test, Student t test, and ANOVA. Standardized mean differences of baseline variables are also reported. All tests were 2-sided, with statistical significance assessed using a P value threshold of 0.05 or the 95% CIs. Statistical analyses were conducted using IBM SPSS Statistics software version 28.0 (SPSS Inc, Chicago, IL) and R version 4.0.5 (R Core Team, Vienna, Austria; https://www.R-project.org).

RESULTS

We identified 229 565 patients with new-onset AF (50.0% female; mean age, 72.7 years; mean follow-up time, 4.0 years). Overall, 6 910 patients (3.0%) had a history of gout, of whom 3 796 (1.7%) were diagnosed at the hospital level, and 3 114 (1.4%) had a gout diagnosis recorded only in primary care. Of the patients with gout, 2 978 (43.1%) had purchased urate-lowering therapies within a year before the first AF diagnosis. Patients with gout had a higher overall prevalence of comorbidities than patients without gout, which was also reflected in their higher stroke and bleeding risk scores (Table). Of all patients with gout, 103 (1.5%), 443 (6.4%), and 6 364 (92.1%) were classified as low (CHA2DS2-VA=0), moderate (CHA2DS2-VA=1), and high (CHA2DS2-VA≥2) stroke risk, respectively. Patients with gout diagnosed in a hospital setting had a higher prevalence of comorbidities compared with those diagnosed only in primary care. Similarly, patients with urate-lowering medication at baseline had more comorbidities than those without urate-lowering treatment (Table S2). None of the patients in the cohort used colchicine at baseline. Patients with gout were more likely to initiate OAC therapy during the follow-up period, compared with patients without gout (73.7% versus 70.4%; P<0.001). Moreover, mortality during follow-up was higher in those with gout than in those without gout (35.0% versus 33.2%; P<0.001).

These Simple Tasks Can Cut Your Risk Of Dementia, Study Finds

 Can your competent? doctor get you recovered enough to do these? Oh NO, you DON'T have a functioning stroke doctor, do you?

These Simple Tasks Can Cut Your Risk Of Dementia, Study Finds

Research is offering some actionable steps we can take to protect our minds from memory loss.

A large UK-based study published in the American Academy of Neurology’s medical journal found that physical and mental activities ― such as doing household chores, exercising or visiting loved ones may help lower the risk of dementia.

The roughly 11-year study followed 501,376 people in the UK who self-reported their physical and mental activities at the beginning of the experiment: how often they visit with friends, their education level, how often they climb stairs, how they commute to work, and more.The study found certain activities were associated with a lower risk of dementia. People who frequently exercised had a 35% lower risk, people who frequently did household chores had a 21% lower risk and people who visited daily with family and friends had a 15% lower risk.

And while dementia risk factors also include things that are out of our control ― like aging and genetics ― the research underscores that there are behaviors within your power to either reduce your risk of dementia or delay the condition, Dr. Scott Turner, director of the memory disorders program at Georgetown University Medical Center, told HuffPost.

The study does come with a few caveats: The findings are a correlation, not necessarily a direct link. Another limitation is that because people reported their own physical and mental activities, there’s always a chance that some people forgot about activities they engaged in or reported them incorrectly.

“More research is needed to confirm our findings. However, our results are encouraging that making these simple lifestyle changes may be beneficial,” study author Dr. Huan Song of Sichuan University in China, said in a statement.

Overall, the results are good news, considering more than 5 million people in the United States live with dementia — and that number is only expected to grow.

Keeping your brain stimulated is key.

Whether through physical activity, social activity or mental activity, putting your brain to work can help delay dementia onset or reduce the risk altogether.Chores double as both a physical and mental activity (and can even sometimes be considered exercise, Turner noted). Visits with loved ones are a social activity that also requires mental stimulation, and physical activity requires mental dedication, too.

Turner said that people who develop visual or hearing problems could be at a higher risk of dementia if they don’t address the problem by getting glasses or hearing aids. When you can’t hear or see, he explained, “you’re depriving your brain of sensory input, and you need to keep your brain stimulated” to help reduce your risk of dementia.

Physical activity is one way to help decrease your risk of dementia.

Popular Joint Supplement Tied to Faster AD Progression - Glucosamine

 

FYI. Ask your doctors what this means.  They have had 11 years to figure this out. How incompetent are they to have done nothing in 11 years?

• glucosamine (4 posts to March 2015)

• 
  

This research comes to a different conclusion than the latest one below so ask your doctor for EXACTNESS! Maybe age 60 is the cutoff point

The association between regular glucosamine use and risk of dementia

The latest here:

Popular Joint Supplement Tied to Faster AD Progression

Glucosamine, a popular joint-pain supplement, may worsen outcomes in people with mild cognitive impairment (MCI), and a newly identified metabolic pathway involving excessive protein glycosylation could help explain why, new research suggests.

In a large electronic health record analysis, glucosamine use was associated with a 25% higher likelihood of progression from MCI to dementia over 5 years. Experiments in human brain tissue and mouse models suggested that excessive protein glycosylation may contribute to Alzheimer’s disease (AD) progression and that glucosamine supplementation could exacerbate the process by fueling glycan production.

Although preliminary, researchers said the findings point to glycan metabolism as a possible therapeutic target and raise questions about the safety of glucosamine use among patients with established dementia.

“In the United States, there are about 7 million people living with Alzheimer’s and millions more with related dementias such as Lewy body or frontotemporal dementia. A lot of these people actively take an over-the-counter supplement that could be making their disease progression worse,” senior investigator Ramon Sun, PhD, director of the Center for Advanced Spatial Biomolecule Research and associate director for innovation at the McKnight Brain Institute at the University of Florida, Gainesville, Florida, said in a statement.

Article Key Points

Glucosamine, a common joint supplement, may accelerate Alzheimer's progression by 25% over five years, potentially due to increased protein glycosylation. This raises concerns about its safety for dementia patients, warranting further investigation.

The study was published online on June 9 in Nature Metabolism.

Impact of Intraoperative Oxygenation Practices on Patient Outcome

 It's in the stroke section of Medpage Today but nothing even remotely looks like something useful for oxygen delivery!

Maybe these, why isn't your incompetent doctor already delivering these to you?

cerebral blood flow (29 posts to July 2016)

Cerebral blood flow autoregulation (1 post to July 2021)

Cerebral Blood Flow Velocity (1 post to Febraury 2020)

cortical oxygenation (1 post to November 2020)

oxygen delivery (20 posts to January 2020)

oxygen uptake (5 posts to August 2013)

• Super Saturated Oxygen Therapy (1 post to May 2021)

Normobaric oxygen (10 posts to January 2020)

brain blood flow (3 posts to April 2019)

• Metformin (19 posts to July 2012)

Well, since this has been around for years why the hell doesn't someone actually do human testing and create protocols on stroke recovery?

Earlier research on Metformin has this line: The drug, which is cheaply available for just $0.16 a day, works by boosting the number of oxygen molecules released into a cell, which in turn seems to benefit the robustness and longevity of the body’s basic building blocks. (This would seem to be much easier and faster than HBOT. I'm requesting this at my next stroke, my doctor won't know what hit her when I tell her how to treat me.)

If your doctor doesn't know about this s/he IS COMPLETELY FUCKING INCOMPETENT? And not creating protocols is even worse, allowing millions to billions of neurons to die because of lack of oxygen during the neuronal cascade of death!

Impact of Intraoperative Oxygenation Practices on Patient Outcome

ClinicalTrials.gov IDNCT07224243

SponsorFrederic T Billings IV

Information Provided byFrederic T Billings, MD

Study Start (Actual)2025-12-01

Primary Completion (Estimated) 2028-02

Study Completion (Estimated)2028-04

Enrollment (Estimated)54000

Study TypeInterventional

Last Update Posted2026-06-10

Study Overview

Brief Summary

This multicenter, cluster-randomized, cluster-crossover clinical trial evaluates the impact of three intraoperative FiO2 (Fraction of Inspired Oxygen) oxygenation strategies-lower (FiO₂ 0.21-0.40), intermediate (FiO₂ 0.40-0.80), and higher (FiO₂ 0.80-1.00)-on postoperative organ injury and mortality in adult surgical patients. The trial aims to determine the optimal oxygenation strategy to improve perioperative outcomes.

To learn more, visitClinicalTrials.gov

Guyana to build first state-of-the-art neuro-rehabilitation facility

State of the art doesn't exist in stroke rehab! NOTHING EXISTS FOR 100% RECOVERY!

Guyana to build first state-of-the-art neuro-rehabilitation facility

—Plans include advanced stroke rehabilitation, 3D-printed prosthetics and expanded autism services as healthcare transformation continues
AS Guyana continues to strengthen its healthcare system, efforts are advancing to expand rehabilitative care through the development of a state-of-the-art neuro-rehabilitation facility, the training of specialised personnel and the introduction of advanced technologies aimed at improving patient outcomes.
Speaking recently with the Guyana Chronicle, Director of Rehabilitation and Disability Services, Dr Ariane Mangar, said the Ministry of Health is pursuing a number of initiatives designed to deliver world-class rehabilitation services in keeping with the vision outlined by President Dr Irfaan Ali.
According to Dr Mangar, rehabilitative care remains one of the major areas of focus within the health sector, with significant progress already made in expanding services and increasing the number of trained professionals.
“We have grown a lot. The services have grown, definitely. We have more professionals, more physiotherapists. We did not have speech therapists, we did not have occupational therapists,” she said.
She noted that the ministry is continuing to work through training programmes and partnerships to increase the number of speech therapists and occupational therapists available within the healthcare system.
Among the most significant projects currently in development is a dedicated neuro-rehabilitation facility, which will focus primarily on stroke patients.
“We are in the process of working with the government to have a neuro-rehab facility built,” Dr Mangar said.
“This facility will focus on stroke patients, and we are hoping that it is a state-of-the-art facility, with everything that you can think about inside, so that it is first world as the President has said,” she added.
The facility is expected to significantly enhance Guyana’s ability to provide specialised rehabilitation services by increasing capacity and accommodating advanced medical equipment.
“We want to be able to meet the needs of people and showcase what Guyana can do. We have a lot of talent, but a lot of times we do not have the machines, or we are limited in what we have because of the space we have,” Dr Mangar explained.
“Now with the bigger space we can bring in more advanced machines, so that we can improve the services we offer,” she added.
In addition to infrastructural expansion, the ministry is also investing in workforce development and emerging technologies.
Dr Mangar revealed that healthcare personnel are currently being trained as orthotic and prosthetic technicians to improve the local production of prosthetic devices.
“We are upgrading some persons as orthotic and prosthetic technicians, so we can improve the making of prostheses here. We are also having training on the making of the sockets and splints using a 3D printer,” she said.
The introduction of 3D-printing technology is expected to dramatically reduce production times for prosthetic components.
“With a 3D printer, a socket can be made in three hours rather than three days. It improves the turnaround time,” Dr Mangar noted.
The ministry is also placing increased focus on autism services and early intervention programmes.
According to Dr Mangar, upcoming training initiatives will equip therapists and medical professionals with specialised skills to better support children diagnosed with autism.
“We are going to be doing some training in autism, behavioural training for our therapists, so that they can provide a more comprehensive service to the children who would have been diagnosed with autism,” she said.
The initiative will also involve training paediatricians and other healthcare professionals to improve the identification and diagnosis of autism in children.
“We will be working with some paediatricians, some doctors, to help them to better identify autism in children. We’re going to be doing that along with Mount Sinai and personnel from the University of Indiana, and that is almost immediate,” she added.
Looking ahead, Dr Mangar said the ministry’s long-term goal is to build a comprehensive rehabilitation system supported by a full complement of specialists and modern facilities.
“Ideally, we would like to have the full staff complement, physiotherapy, speech therapy, occupational therapy, more doctors involved, more physiatrists, more audiological practitioners and specialists,” she said.
“We could serve the people better, orthotic and prosthetic specialists, so we could meet the demands of the people. Once we have the staff and we have the facility, then we can definitely provide a world-class service,” Dr Mangar added.