Use the labels in the right column to find what you want. Or you can go thru them one by one, there are only 29,164 posts. Searching is done in the search box in upper left corner. I blog on anything to do with stroke. DO NOT DO ANYTHING SUGGESTED HERE AS I AM NOT MEDICALLY TRAINED, YOUR DOCTOR IS, LISTEN TO THEM. BUT I BET THEY DON'T KNOW HOW TO GET YOU 100% RECOVERED. I DON'T EITHER BUT HAVE PLENTY OF QUESTIONS FOR YOUR DOCTOR TO ANSWER.
Changing stroke rehab and research worldwide now.Time is Brain!trillions and trillions of neuronsthatDIEeach day because there areNOeffective 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.
At 1 year after index hospitalization, women vs men with
stroke were more likely to have nonadherence to statins,
antihypertensives, and a combination of the 2 medications.
Guideline-directed medical therapy (GDMT) is less likely after
hospitalization for an ischemic stroke in women vs men. Moreover, women
are more likely to not adhere to these medications. These are the
findings of a study published in the journal Stroke.
Although previous studies have shown sex-specific differences in
medication adherence among patients with chronic diseases, limited data
are available on GDMT adherence in men vs women after a stroke.
Therefore, researchers of a retrospective cohort analysis compared
prescription patterns for GDMT after hospitalization and medication
adherence to GDMT 1 year after a stroke, and identified predictors of
medication nonadherence to GDMT.
The researchers identified adult participants, with hospitalization
after an acute ischemic stroke or transient ischemic attack (TIA), from a
claims database between 2016 and 2020. In addition, only participants
who were “new users” of GDMT medications were included in the study.
The unique barriers facing women with regard to receiving evidence-based, guideline-recommended care should be characterized.
Treatment initiation of GDMT was considered as the index date.
Primary study outcome was sex differences in GDMT initiation, defined
as filling of a new prescription for statins, antihypertensives, and
oral anticoagulants, within 30 days of discharge from hospital.
Secondary outcome was sex differences in GDMT adherence, defined by
proportion of days covered (PDC).
A total of 15,919 patients (women, 48.3%) with hospitalization of
ischemic stroke/TIA who were initiated on GDMT were included in the
analysis. The most common comorbidities were hypertension (48.7%),
hyperlipidemia (30.1%), and diabetes (14.6%).
Compared with men, women were younger (56.3 vs 55.2 years) and had a
lower prevalence of comorbidities, including hypertension (61.5% vs
50.9%) and diabetes (20.1% vs 14.9%, respectively).
Of the total cohort, 10,302 (64.7%) were initiated on statins and
5501 (34.6%) on antihypertensives, as well as oral anticoagulants for
patients with atrial fibrillation, within 30 days of discharge. Overall,
women vs men were less likely to receive statins (58.0% vs 71.8%),
high-potency statins (39.7% vs 53.6%), oral anticoagulants (41.2% vs
45.0%), and antihypertensives (27.7% vs 41.8%, respectively). Results
were consistent within 60 days of discharge, as well.
At 1 year after index hospitalization, women vs men were more likely
to have nonadherence (PDC <0.80) to statins (47.3% vs 41.6%; P <.0001), antihypertensives (33.3% vs 32.2%; P =.01), and a combination of the 2 medications (49.6% vs 45.0%; P =.006, respectively).
In a multivariable analysis, the researchers found that women vs men
had a higher likelihood of nonadherence to statins and antihypertensives
at 1 year (odds ratio [OR], 1.23; 95% CI, 1.08-1.41). Of note, older
age predicted increased risk for nonadherence (OR, 0.98; 95% CI,
0.97-0.99).
Limitations of the analysis included the retrospective design; lack
of complete information on demographic characteristics, such as race;
and diagnoses of acute ischemic stroke based on the International Classification of Diseases (ICD) codes, which may have led to misclassification.
“The unique barriers facing women
with regard to receiving evidence-based, guideline-recommended care
should be characterized. Such information is critically important for
the development of novel interventions designed to address and minimize
these disparities,” the researchers concluded.
Multiple study authors declared affiliations with biotech,
pharmaceutical, and/or device companies. Please see the original
reference for a full list of the authors’ disclosures.
My definition of a competent doctor would have already created a protocol on this and installed it in their hospital. September 22, 2024 publication. Do you have a functioning stroke doctor, or not? Have you fired the incompetent ones yet?
Long-term treatment with scrambler vs sham therapy resulted
in improvements in patient-reported pain in 80% vs 40% of participants,
respectively.
Scrambler therapy — a noninvasive electroanalgesia device —
effectively reduces poststroke pain and may be beneficial in the
long-term treatment of pain in peripheral neuropathy, according to the
findings of a small study published in Annals of Clinical and Translational Neurology.
Scrambler therapy has been approved by the US Food and Drug
Administration (FDA) for the treatment of acute, chronic, and
postoperative pain. However, there is limited information on the
effectiveness of scrambler therapy for central nervous system
(CNS)-related pain.
Researchers of a randomized, single-blind, sham-controlled trial
assessed the efficacy of scrambler therapy vs sham in reducing
poststroke pain.
Eligible participants were aged at least 18 years, had a prior
ischemic or hemorrhagic stroke, and had pain at the area affected by the
stroke.
The ability of ST to reduce pain to a
greater extent than previously studied medication regimens, without
significant toxicity or side effects, could improve care by reducing
burden of disease and enhancing quality of life for stroke survivors.
The researchers collected pain scores from all participants, using
the Numerical Rating Scale, before neurostimulation. Electrodes were
placed on the area of pain.
Participants were randomly assigned to receive scrambler therapy or
sham placebo. Those in the treatment group received 40 minutes of
treatment during each session at a consistent current intensity, and
those in the sham group had an initial increase in channel intensity,
but the channels were turned off during the session. All participants
received a total of 5 daily treatments or until pain levels of 0 were
reached at 2 consecutive assessments.
Of the 20 participants in the study, 10 (mean age, 60 years; women,
30%) received scrambler therapy and the remaining 10 (mean age, 56.9
years; women, 70%) received sham therapy. Mean time from stroke was 35
and 29.5 months, respectively.
Mean pain scores were lower in those who received scrambler vs sham
therapy (5.73 vs 6.68), with scores improving over time in the scrambler
therapy group and remaining constant in the sham group.
At the completion of the sessions, mean change in pain scores in the
scrambler vs sham therapy group was -3.73 vs -0.94 (56% vs 16% reduction
in pain), respectively. A large percentage of participants (90%) who
received scrambler therapy observed improvements in pain scores during
the treatment period, while these improvements were observed in 70% who
received sham therapy (P =.264). In addition, 70% vs 10% of the participants in the groups, respectively, reported a decrease in more than 50% of pain (P =.006). Results of the paired t-test
were also consistent with these findings, with patients who received
scrambler vs sham therapy having significant changes in pain scores from
baseline (P =.003 and P =.057, respectively).
At the 4-week follow-up, participants in the scrambler vs sham
therapy group continued to have pain relief, reporting mean changes in
pain scores of -2.57 and -0.25, a 38% and 4% reduction in pain,
respectively. Paired t-test showed significant changes in pain scores for the scrambler therapy group (P =.004).
Long-term treatment with scrambler vs sham therapy resulted in improvements in patient-reported pain (P
=.068) in 80% vs 40% of participants, respectively, with more than a
50% reduction in pain in 30% vs 10% of the groups, respectively (P =.264).
Study limitations included the small sample size and that the study
was conducted at a single center. The long-term benefits of scrambler
therapy also warrant further investigation.
“Overall, results suggest that [scrambler therapy] may be an
effective acute and potentially longer-term treatment of poststroke pain
and may be a suitable alternative to pharmacologic treatment,” the
researchers noted.
They added, “The ability of [scrambler therapy] to reduce pain to a
greater extent than previously studied medication regimens, without
significant toxicity or side effects, could improve care by reducing
burden of disease and enhancing quality of life for stroke survivors.”
Does your competent? doctor and hospital have enough functioning brain cells to see the word neuroprotection and realize this needs to be followed up to save brain cells immediately post stroke? NO? So, you DON'T have a functioning stroke doctor or hospital? RUN AWAY!
If your doctor has nothing on these maybe you want to ask when they will become competent in stroke rehab.
Summary: Researchers identified specific plant
compounds that provide antioxidant and neuroprotective effects,
contributing to brain health beyond basic nutrition. By analyzing
plant-based foods like lemon balm, sage, and elderberry, scientists
linked compounds such as phenolics and terpenes to benefits like
reducing oxidative stress and scavenging harmful reactive species.
Quercetin-rich
foods, such as Queen Garnet plum and clove, showed strong potential to
prevent neuron-like cell damage. This study sheds light on how
plant-based diets and supplements could support brain health and manage
neuroinflammation-related conditions.
Key Facts:
Phenolics and terpenes in plants show neuroprotective and antioxidant effects.
Lemon balm, sage, and elderberry support brain health via distinct compound profiles.
Source: University of Wollongong
A
new study by the University of Wollongong (UOW) has revealed why some
plant-based foods have benefits beyond their nutritional value.
Led
by Naomi May, a PhD candidate in the School of Medical, Indigenous and
Health Sciences, the research found that different species of plant
compounds were associated with various antioxidant effects, such as the
ability to prevent oxidative stress-induced cell death in neuron-like
cells, scavenge reactive oxygen and nitrogen species, and chelate metal
ions. These contribute to neuronal damage and the progression of brain
illnesses.
The
research focused on six specific plant-based foods – Queen Garnet plum,
black pepper, clove, elderberry, sage and lemon balm – and found they
have antioxidant and protective effects on the brain. Credit:
Neuroscience News
While the benefits of plant-based diets are well known, the study, published in Food & Function, sought to uncover which compounds were responsible for the positive effects on the brain.
The
paper was co-authored by Dr Jiahua Shi, Helen Clunas, Dr Julianna Lys
de Sousa Alves Neri, Dr Celine Kelso, Dr Jody Morgan, Dr Yinghua
Yu, Professor Karen Charlton, and Associate Professor Katrina
Weston-Green from UOW.
The researchers were interested in the
health benefits of various classes of plant compounds: phenolics, which
can contribute to the plants colour, and terpenes, which are responsible
for the flavour and fragrance of plants.
Naomi used mass
spectrometry to measure the individual species of the plant compounds in
order to determine which species are associated with various
antioxidant and neuroprotective effects.
“Many
plant-based foods have been shown to benefit our brain and overall
health,” Naomi said. But until now, we haven’t known which complex mix
of compounds packs the most punch.
“Why is lemon balm calming? How can sage help the body? Why are
elderberries so beneficial to our immune system? We finally have data to
begin to answer these questions.”
The research focused on six
specific plant-based foods – Queen Garnet plum, black pepper, clove,
elderberry, sage and lemon balm – and found they have antioxidant and
protective effects on the brain. It also looked at over-the-counter
complementary food supplements derived from these plants, including two
blends rich in astralagus and lemon balm.
The astralagus
supplement had the highest rates of phenolics, followed by the Queen
Garnet plum, elderberry, and clove. In particular, these plant products
were high in derivates of compound called quercetin, which was
associated with an ability to prevent oxidative stress-induced cell
death and chelate copper ions.
Black pepper had the strongest
terpene concentration, followed by clove and sage, which was associated
with an ability to reduce reactive oxygen species.
“This
is the first research that has looked at the relationship between these
species of compounds and different antioxidant abilities in these
plants.
“We found significant positive relationships between the
concentration of individual compounds measured and certain antioxidant
abilities. This is important for understanding how these plant foods can
be used to protect our brains and bodies from damage,” Naomi said.
“Understanding the phytochemical profile of plant foods is vital to understanding how they benefit and boost our brain health.
“There
is a lot of potential to use plant-based foods as part of a toolkit to
manage conditions caused by neuroinflammation and oxidative stress, such
as neurodegenerative disease. They are also just great for our general
health.”
About this diet and neuroscience research news
Author: India Glyde Source: University of Wollongong Contact: India Glyde – University of Wollongong Image: The image is credited to Neuroscience News
Where is the protocol for this located so stroke survivors can inform their stroke medcal 'professionals' about using this? Oh, you didn't create one, did you? YOU'RE FIRED!
You'll have to ask your competent? doctor why the hell edaravone is approved in Japan since 2001 but not the US.
Has your stroke hospital done anything with edaravone in the last decade?
RESEARCH ARTICLE Synergistic effects of neuroprotective drugs with intravenous recombinant tissue plasminogen activator in acute ischemic stroke: A Bayesian network meta-analysis Chun DangID1, Qinxuan Wang2, Yijia Zhuang2, Qian Li3, Yaoheng LuID4☯*, Ying XiongID1☯*, Li Feng5☯* 1Department of Periodical Press/Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China,2West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China,3Department of Neurology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China,4Department of General Surgery, Chengdu Integrated Traditional Chinese Medicine and Western Medicine Hospital, Chengdu, China,5Department of General Surgery and Regenerative Medicine Research Center, West China Hospital, Sichuan University, Chengdu, China ☯These authors contributed equally to this work. *fengli@scu.edu.cn (LF); 61711445@qq.com (YX); lyh93@cdutcm.edu.cn (YL)
Abstract
Neuroprotective drugs as adjunctive therapy for adults with acute ischemic stroke (AIS) remains contentious. This study summarizes the latest evidence regarding the benefits of neuroprotective agents combined with intravenous recombinant tissue plasminogen activa- tor (rt-PA) intravenous thrombolysis. This study conducted a structured search of PubMed, the Cochrane Library, EMBASE, Wanfang Data, and CNKI databases from their inception to March 2024. Grey literature was also searched. The outcomes included efficacy (National Institutes of Health Stroke Scale (NIHSS) score and Barthel Index (BI) score) and safety (rate of adverse reactions). A total of 70 randomized controlled trials were selected for this network meta-analysis (NMA), encompassing 4,140 patients with AIS treated using different neuroprotective agents plus RT-PA, while 4,012 patients with AIS were in control groups. The top three treatments for NIHSS scores at the 2-week follow-up were Edaravone Dex- borneo with 0.9 mg/kg rt-PA, Edaravone with 0.9 mg/kg rt-PA, and HUK with 0.9 mg/kg rt- PA. HUK with 0.9 mg/kg rt-PA, Dl-3n-butylphthalide with 0.9 mg/kg rt-PA, and Edaravone Dexborneo with 0.9 mg/kg rt-PA were ranked the top three for BI scores at the 2-week fol- low-up. The top three treatments with the lowest adverse effect rates were 0.6 mg/kg rt-PA, HUK with 0.9 mg/kg rt-PA, and Edaravone Dexborneo with 0.9 mg/kg rt-PA due to their excellent safety profiles. Compared to rt-PA alone, the combination treatments of Edara- vone+rt-PA, Edaravone Dexborneol+rt-PA, HUK+rt-PA, Dl-3n-butylphthalide+rt-PA, and Ganglioside GM1+rt-PA have shown superior efficacy. This NMA suggest that combination therapies of neuroprotective agents and rt-PA can offer better outcomes for patients with AIS. The results support the potential integration of these combination therapies into stan- dard AIS treatment, aiming for improved patient outcomes and personalized therapeutic approaches.
I can easily walk 160 minutes a day but since my STROKE MEDICAL 'PROFESSIONALS' COMPLETELY FAILED AT GETTING ME RECOVERED I can't get to 3mph due to my unresolved spasticity!
Walking a certain amount of time each day could extend your life, new research finds.
Scientists
found that if all people boosted their activity to 160 minutes daily,
they could increase their life expectancy over five years.
Experts explain how walking can benefit your health.
The benefits of walking
abound: improving heart health, sleep quality, and mood are just a few
of the many pros of going for a stroll. Now, new research has found that
walking could add over 10 years to your life—specifically, walking 160
minutes a day at 3 miles per hour.
A study published in the British Journal of Sports Medicine
analyzed data from the National Health and Nutritional Examination
Survey (NHANES), looking at U.S. adults 40 and older. Participants wore
activity monitors for at least four days. Researchers then created a
mathematical model to predict how different levels of physical activity
could influence how long they lived.
By
comparing the most active participants to the least, researchers found
that the more physically active participants tended to have the highest
life expectancy. More specifically, they found that 25 percent of the
most active people in the study walked 160 minutes daily at 3 mph. Based
on this, researchers estimated that if all people boosted their
activity to this level, they could increase their life expectancy from
78.6 to 84 years—an increase of over five years.
However,
being in the lowest 25 percent of activity was associated with a
decrease in life expectancy of around six years. Still, if these
less-active individuals logged an additional 111 minutes of walking each
day, they could conceivably experience even greater benefits, living
nearly 11 years longer.
This
study reinforces what we’ve known for a while: Staying active, even
with something as simple as walking, may significantly increase life
expectancy, says Adedapo Iluyomade, M.D.,
preventative cardiologist with Baptist Health Miami Cardiac &
Vascular Institute. “For those who are currently least active, adding
just one hour of walking a day can result in measurable gains in
longevity—potentially adding hours [of life] for every hour walked.”
Walking
is one of the most accessible forms of physical activity with
far-reaching benefits, Dr. Ilyuomade continues. “It improves
cardiovascular health, lowers blood pressure, and helps maintain a
healthy weight. It also supports mental well-being, reducing stress
and boosting mood.” Regular walking even reduces the risk of chronic
diseases like type 2 diabetes, heart disease, and some cancers, he adds.
This
study promotes the importance of an active lifestyle over a sedentary
one, says Alisha Goodrum, M.D., an internal medicine physician with PlushCare.
“Although socioeconomic conditions and baseline health conditions
impact activity levels, walking is a no-cost physical activity that
benefits everyone.”
The bottom line
The
key takeaway from this new research is that even small, consistent
increases in physical activity—like walking—can have a profound impact
on health and longevity, says Dr. Iluyomade. “These findings highlight
how accessible and impactful walking can be, especially for those who
feel daunted by the idea of intense exercise.” It’s a powerful reminder
that investing time in movement today can add meaningful time to our
lives tomorrow, he notes.
You
can add more walking into your day by making little changes, says Dr.
Goodrum. “This can include parking your car further away from the
entrance of a store or using the stairs instead of the elevator. You can
also take multiple shorter walks in the day instead of making time for a
longer exercise.” Walking is a great activity to do with others, grab a
family member or neighbor, and spend time catching up instead of a
sedentary activity, she suggests.
Walking
is for everyone, regardless of fitness level or age, says Dr.
Iluyomade. “Start where you are—whether that’s a five-minute stroll or a
longer hike. Over time, you’ll not only see physical benefits but also
notice how walking enhances your mental clarity and energy.” The key is
consistency: Every step counts toward a healthier, longer life, he
explains.
Microplastics
have been found in the lungs, liver, blood, and heart. Now, researchers
report they have found the first evidence of the substances in human
brains.
In a recent case series study
that examined olfactory bulb tissue from deceased individuals, 8 of the
15 decedent brains showed the presence of microplastics, most commonly
polypropylene, a plastic typically used in food packaging and water
bottles.
Measuring less than 5 mm in size, microplastics are
formed over time as plastic materials break down but don’t biodegrade.
Exposure to these substances can come through food, air, and skin
absorption.
While
scientists are learning more about how these substances are absorbed by
the body, questions remain about how much exposure is safe, what effect
— if any — microplastics could have on brain function, and what
clinicians should tell their patients.
What Are the Major Health Concerns?
The
Plastic Health Council estimates that more than 500 million metric tons
of plastic are produced worldwide each year. In addition, it reports
that plastic products can contain more than 16,000 chemicals, about a
quarter of which have been found to be hazardous to human health and the
environment. Microplastics and nanoplastics can enter the body through
the air, in food, or absorption through the skin.
As previously reported by Medscape Medical News,
a study published in March showed that patients with carotid plaques
and the presence of microplastics and nanoplastics were at an increased
risk for death or major cardiovascular events.
Other studies
have shown a link between these substances and placental inflammation
and preterm births, reduced male fertility, and endocrine disruption —
as well as accelerated spread of cancer cells in the gut.
There is also evidence suggesting that microplastics may facilitate the development of antibiotic resistance in bacteria and could contribute to the rise in food allergies.
And now, Thais Mauad, MD, PhD, and colleagues have found the substances in the brain.
How Is the Brain Affected?
The
investigators examined olfactory bulb tissues from 15 deceased Sao
Paulo, Brazil, residents ranging in age from 33 to 100 years who
underwent routine coroner autopsies. All but three of the participants
were men.
Exclusion criteria included having undergone previous
neurosurgical interventions. The tissues were analyzed using
micro–Fourier transform infrared spectroscopy (µFTIR).
In
addition, the researchers practiced a “plastic-free approach” in their
analysis, which included using filters and covering glassware and
samples with aluminum foil.
Study findings showed microplastics in
8 of the 15 participants — including in the centenarian. In total,
there were 16 synthetic polymer particles and fibers detected, with up
to four microplastics detected per olfactory bulb. Polypropylene was the
most common polymer found (44%), followed by polyamide, nylon, and
polyethylene vinyl acetate. These substances are commonly used in a wide
range of products, including food packaging, textiles, kitchen
utensils, medical devices, and adhesives.
The microplastic
particles ranged in length from 5.5 to 26 microns (one millionth of a
meter), with a width that ranged from 3 to 25 microns. The mean fiber
length and width was 21 and 4 microns, respectively. For comparison, the
diameter of one human hair averages about 70 microns, according to the US Food and Drug Administration (FDA).
“To
our knowledge, this is the first study in which the presence of
microplastics in the human brain was identified and characterized using
µFTIR,” the researchers wrote.
How Do Microplastics Reach the Brain?
Although
the possibility of microplastics crossing the blood-brain barrier has
been questioned, senior investigator Mauad, associate professor in the
Department of Pathology, the University of Sao Paulo, Sao Paulo, Brazil,
noted that the olfactory pathway could offer an entry route through
inhalation of the particles.
This means that “breathing within
indoor environments could be a major source of plastic pollution in the
brain,” she said in a press release.
“With much smaller
nanoplastics entering the body with greater ease, the total level of
plastic particles may be much higher. What is worrying is the capacity
of such particles to be internalized by cells and alter how our bodies
function,” she added.
Thais Mauad, MD, PhD
Mauad told Medscape Medical News
that although questions remain regarding the health implications of
their findings, some animal studies have shown that the presence of
microplastics in the brain is linked to neurotoxic effects, including
oxidative stress.
In
addition, exposure to particulate matter has been linked previously to
such neurologic conditions as dementia and neurodegenerative conditions
such as Parkinson’s disease “seem to have a connection with nasal
abnormalities as initial symptoms,” the investigators noted.
While
the olfactory pathway appears to be a likely route of exposure the
researchers noted that other potential entry routes, including through
blood circulation, may also be involved.
The research suggests
that inhaling microplastics while indoors may be unavoidable, Mauad
said, making it unlikely individuals can eliminate exposure to these
substances.
“Everything that surrounds us is plastic. So we can’t really get rid of it,” she said.
Are Microplastics Regulated?
The most effective solution would be stricter regulations, Mauad said.
“The
industry has chosen to sell many things in plastic, and I think this
has to change. We need more policies to decrease plastic production —
especially single-use plastic,” she said.
Federal,
state, and local regulations for microplastics are “virtually
nonexistent,” reported the Interstate Technology and Regulatory Council
(ITRC), a state-led coalition that produces documents and trainings
related to regulatory issues.
In 2021, the ITRC sent a survey to
all US states asking about microplastics regulations. Of the 26 states
that responded, only four said they had conducted sampling for
microplastics. None of the responders indicated they had established any
criteria or standards for microplastics, although eight states
indicated they had plans to pursue them in the future.
Although
federal regulations include the Microbead-Free Waters Act of 2015 and
the Save Our Seas Act 2.0, the rules don’t directly pertain to
microplastics.
There are also no regulations currently in place regarding microplastics or nanoplastics in food. A report
issued in July by the FDA claimed that “the overall scientific evidence
does not demonstrate that levels of microplastics or nanoplastics found
in foods pose a risk to human health.”
International efforts to regulate microplastics are much further along. First created in 2022, the treaty would forge an international, legally binding agreement.
While
it is a step in the right direction, the Plastic Health Council has
cautioned about “the omission of measures in draft provisions that fully
address the impact of plastic pollution on human health.” The treaty
should reduce plastic production, eliminate single-use plastic items,
and call for testing of all chemicals in plastics, the council argues.
The final round of negotiations for the UN Global Plastic Treaty is set for completion before the end of the year.
What Should Clinicians Know?
Much
remains unknown about the potential health effects of microplastic
exposure. So how can clinicians respond to questions from concerned
patients?
Phoebe Stapleton, PhD
“We
don’t yet have enough evidence about the plastic particle itself, like
those highlighted in the current study — and even more so when it comes
to nanoplastics, which are a thousand times smaller,” Phoebe Stapleton,
PhD, associated professor in the Department of Pharmacology and
Toxicology at the Ernest Mario School of Pharmacy at Rutgers University,
Piscataway, New Jersey, told Medscape Medical News.
“But
we do have a lot of evidence about the chemicals that are used to make
plastics, and we’ve already seen regulation there from the EPA. That’s
one conversation that clinicians could have with patients: about those
chemicals,” she added.
Stapleton
recommended clinicians stay current on the latest research and be ready
to respond should a patient raise the issue. She also noted the
importance of exercising caution when interpreting these new findings.
While
the study is important — especially because it highlights inhalation as
a viable route of entry — exposure through the olfactory area is still
just a theory and hasn’t yet been fully proven.
In addition,
Stapleton wonders whether there are tissues where these substances are
not found. A discovery like that “would be really exciting because that
means that that tissue has mechanisms protecting it, and maybe, we could
learn more about how to keep microplastics out,” she said.
She would also like to see more studies on specific adverse health effects from microplastics in the body.
Mauad agreed.
“That’s
the next set of questions: What are the toxicities or lack thereof in
those tissues? That will give us more information as it pertains to
human health. It doesn’t feel good to know they’re in our tissues, but
we still don’t have a real understanding of what they’re doing when
they’re there,” she said.
The
current study was funded by the Alexander von Humboldt Foundation and
by grants from the Brazilian Research Council and the Soa State Research
Agency. It was also funded by the Plastic Soup Foundation — which,
together with A Plastic Planet, forms the Plastic Health Council. The
investigators and Stapleton reported no relevant financial
relationships.
Mangaluru, Dec 2:
First Neuro, Brain & Spine Super Speciality Hospital, Mangaluru is
proud to announce that it is the only hospital in the region which has
been honoured with the prestigious award for Best Stroke Ready Hospital
of the Year Award by VOH (Voice of Healthcare) in association with ISA
(Indian Stroke Association).This recognition comes in light of the
hospital's unwavering commitment to excellence in stroke care and its
continuous efforts to enhance patient outcomes.
First Neuro, Brain & Spine Super
Speciality Hospital for its outstanding contributions to stroke care,
particularly in the areas of rapid response, advanced treatments and
patient-focused care and presented the Best Stroke Ready Hospital of the
Year award. This acknowledgement reaffirms the hospital's dedication to
providing high-quality stroke care services to the community. Prathyush
Shetty, head-business development, received the award at the event,
which took place on November 30, 2024, at the Hyatt Regency in New
Delhi.
"We are deeply honoured to receive the
Best Stroke Ready Hospital of the Year award," said Dr Rajesh Shetty,
managing director at First Neuro Brain & Spine Super Speciality
Hospital. "This prestigious recognition showcases the hard work and
dedication of our entire team who strive relentlessly to deliver
exceptional care to our stroke patients. We remain committed to
advancing our stroke care services and ensuring that our patients
receive most effective and efficient support and treatment with best
possible outcomes."
Stroke is a leading cause of disability
and death worldwide. First Neuro Brain & Spine Super Speciality
Hospital is committed to raising awareness about stroke prevention,
symptoms, and treatments. The hospital's multidisciplinary team of
experts, employ the latest technologies and evidence-based practices to
provide comprehensive stroke care to patients, including emergency
interventions, rehabilitation, and ongoing support for stroke survivors
and their families.
First Neuro Brain and Spine
Super-Specialty Hospital in Mangaluru is indeed a significant
development in the healthcare sector for the coastal city. Neurological
issues related to the brain and spine are complex and often require
specialized expertise and state-of-the-art facilities for diagnosis and
treatment.
Here are some potential benefits and highlights of having such a dedicated neuro hospital in the region:
Specialized Care: With a
team of highly professional and specialized doctors and healthcare
staff, the hospital can provide focused care for patients dealing with
neurological disorders. This includes conditions such as brain tumours,
spinal injuries, epilepsy, stroke, and more. Advanced Technology:
Specialized neuro hospitals typically invest in advanced medical
equipment and technology to ensure accurate diagnosis and treatment.
This ensures that patients have access to cutting-edge medical care. Comprehensive Services:
Neuro hospitals often offer a wide range of services, including
neurosurgery, neurology, neurorehabilitation, and pain management. This
comprehensive approach to neurological healthcare can greatly benefit
patients in need. Improving Healthcare Standards:
The presence of a specialized neuro hospital can also lead to an overall
improvement in healthcare standards in the region. It may encourage
other medical facilities to enhance their services and competencies. Patient Convenience:
Having a dedicated neuro hospital means that patients can access
specialized care in a single location, which can make the healthcare
journey more convenient and less stressful.
In summary, the introduction of First
Neuro Brain and Spine Super-Specialty Hospital in Mangaluru is a
significant development that can enhance the region's healthcare
services, particularly in the field of neurosciences. It is the only in
the region which has advanced stroke centre accreditation by QAI
(Quality and Accreditation Institues).It represents a commitment to
improving patient care, advancing medical knowledge, and offering
specialized treatments for neurological conditions, ultimately
benefiting the local community.
For more information about First Neuro Brain & Spine Super Speciality Hospital and its stroke care services, please visit www.firstneuro.in
Summary: Ketone bodies, known for their role in
energy metabolism during fasting, have been shown to directly interact
with damaged proteins in the brain, aiding their clearance through
autophagy. Researchers discovered that the ketone body β-hydroxybutyrate
alters the solubility of misfolded proteins, facilitating their removal
and reducing pathological aggregation.
Tests in mouse models of
Alzheimer’s and aging confirmed these effects, with treated animals
showing improvements in protein quality control and brain health. This
breakthrough provides a new metabolic link to aging and
neurodegeneration, offering a potential pathway for therapeutic
applications.
Key Facts
Ketone bodies directly bind to misfolded proteins, enhancing their clearance via autophagy.
Mice treated with ketone esters displayed reduced aggregation of insoluble brain proteins.
Similar metabolites tested showed effects equal to or better than β-hydroxybutyrate.
Source: Buck Institute
Ketone
bodies, produced by the body to provide fuel during fasting, have roles
in regulating cellular processes and aging mechanisms beyond energy
production.
Research at the Buck Institute shows that
ketone bodies can best be understood as powerful signaling metabolites
affecting brain function in aging and Alzheimer’s disease.
A new
study demonstrates that ketone bodies and similar metabolites have
profound effects on the proteome and protein quality control in the
brain.
While
acknowledging that other mechanisms like energy supply are also
important to brain health, Newman calls the discovery new biology.
Credit: Neuroscience News
Publishing in Cell Chemical Biology, Buck Institute scientists, working in mouse models of Alzheimer’s disease and aging, and in the nematode C. elegans, reveal
the ketone body β-hydroxybutyrate interacts directly with misfolded
proteins, altering their solubility and structure so they can be cleared
from the brain through the process of autophagy.
Previous studies
have shown that boosting ketone bodies through diet, exercise and
supplementation can be good for brain health and cognition, both in
rodents and humans.
Senior author John Newman, MD, PhD, an
assistant professor at the Buck, says many theorized that the ketone
body-based improvements were caused by increased energy to the brain or a
reduction in brain inflammation, with reported improvements in amyloid
plaques in mouse models being an indirect by-product.
“Now we
know that’s not the whole story,” he said. “Ketone bodies interact with
damaged and misfolded proteins directly, making them insoluble so they
can be pulled from the cell and recycled.”
While acknowledging
that other mechanisms like energy supply are also important to brain
health, Newman calls the discovery new biology.
“It’s a new link between metabolism in general, ketone bodies and aging,” he said.
“Directly linking changes in a cell’s metabolic state to changes in the proteome is really exciting.”
Noting
that ketone bodies are easy to manipulate experimentally and
therapeutically, Newman adds, “This might be a powerful avenue to assist
with global clearing of damaged proteins.
“We’re just scratching the surface as to how this might be applied to brain aging and neurodegenerative disease.”
In
addition to testing the changing solubility and structure of proteins
in test tubes, the project also involved feeding a ketone ester to mice
to confirm that the test tube results were reproduced in the brain. In
mice, the ketone ester treatment resulted in clearance rather than
pathological aggregation of insoluble proteins.
The work also highlights the power of the Buck’s collaborative environment.
The Schilling lab generated detailed proteome-wide solubility maps from both the test tube and mouse experiments.
To
test if the solubility changes caused by ketone bodies helped improve
models of pathological aggregation, the Lithgow lab fed ketone bodies
to tiny nematode worms that were genetically modified to express the
human equivalent of amyloid beta, which causes amyloid plaques.
“The amyloid beta affects muscles and paralyzes the worms,” says
Sidharth Madhavan, a PhD candidate and lead author on the study.
“Once
they were treated with ketone bodies the animals recovered their
ability to swim. It was really exciting to see such a dramatic impact in
a whole animal.”
Madhavan is now pursuing whether ketone bodies
and related metabolites have similar effects outside the brain, such as
in the gut. A key next step will be to test this new protein quality
control mechanism in people to help guide how best to apply it in
therapies, he adds.
Newman says the study highlights a new form of metabolic regulation of protein quality control.
“This is not just about ketone bodies,” he said.
“We
tested similar metabolites in test tubes and a bunch of them had
similar effects. In some cases, they performed better than
β-hydroxybutyrate. It’s beautiful to imagine that changing metabolism
results in this symphony of molecules cooperating together to improve
brain function.”
Funding: This work was supported
by the National Institutes of Health (NIH R01AG067333, NIA T32AG052374,
NIA T32 AG000266, NIH R01AG067333-02S1), a sponsored research agreement
from BHB Therapeutics, University of Southern California Provost
Fellowship Funding, the Larry L. Hillblom Foundation, and Buck Institute
institutional funding.
About this neuroscience research news
Author: Kris Rebillot Source:Buck Institute Contact: Kris Rebillot – Buck Institute Image: The image is credited to Neuroscience News
Abu Dhabi, UAE — In the latest multicenter randomized trial testing a combination of edaravone and dexborneol for the treatment of acute stroke, the proportion of patients with complete or near complete function at 90 days was improved significantly relative to placebo.
The
third in a series, this trial, like the previous two, showed that
participants who received the experimental treatment “were more likely
to achieve functional independence at 90 days without increased safety
concerns,” said study investigator Chun-Juan Wang, MD, PhD, Department
of Neurology, Beijing Tiantan Hospital, Capital Medical University,
Beijing, China.
For
the study, 1362 patients were randomly assigned to receive edaravone
dexborneol or placebo within 24 hours of an acute stroke at 106
participating centers. The primary outcome assessed at 90 days was
functional independence as defined by a modified Rankin Scale (mRS) score of 0 to 2.
Unlike
in the previous two trials, all patients underwent endovascular
thrombectomy (EVT). All three multicenter studies were conducted in
China.
The
primary endpoint was reached by 55.0% of participants in active
treatment arm vs 49.6% of those in the placebo group, producing a 24%
improvement in the odds ratio (OR) of achieving a functional recovery
(OR, 1.24; P < .047).
Edaravone, which is an antioxidant but might have other neuroprotective activity, is currently approved for the treatment of amyotrophic lateral sclerosis.
Borneol, the active ingredient of dexborneol, has been shown to
downregulate anti-inflammatory factors in the experimental setting and
might also have other neuroprotective properties.
The combination of these active drugs in a single infusion was first evaluated in the TASTE-1 trial, which was published in 2021.
In that phase 3 double-blind study, 1165 acute stroke patients were
randomly assigned to receive edaravone dexborneol or edaravone alone
within 48 hours of an acute stroke. The primary endpoint of mRS score ≤ 1
was achieved by 67.18% of those in the combination therapy arm vs 58.9%
of those receiving dexborneol alone (OR, 1.42; P < .001).
A second large randomized trial, called TASTE-SL, was published in JAMA Neurologyearlier this year.
In this multicenter study, 914 acute stroke patients were assigned in a
1:1 fashion to sublingual edaravone dexborneol or matching placebo
within 48 hours of symptom onset. The primary endpoint of mRS score ≤ 1
was achieved by 64.4% of those assigned to receive the combination
therapy vs 54.7% of those receiving placebo (OR, 1.50; P = .003).
TASTE-1
enrolled acute stroke patients with a median baseline National
Institutes of Health Stroke Scale (NIHSS) score of 6. They did not
receive reperfusion therapy. TASTE-SL enrolled patients with a median
NIHSS score of 7 who did not undergo EVT. In TASTE-2, the median NIHSS
score was 15, and EVT was an inclusion criterion.
When patients
were stratified by specific functional mRS scores, there was a
numerically higher proportion of patients achieving mRS score of 0
(22.1% vs 20.9%) and 1 (18.1% vs 17.4%) but the greatest between-group
difference was seen for an mRS score of 2 (14.8% vs 11.3%).
The
advantage of edaravone dexborneol moved in the same direction across
almost all subgroups evaluated. There were trends for greater benefit
among those treated within 6 hours relative to later and in those who
had hypertension, coronary artery disease, or a high NIHSS score (≥ 15) relative to those who did not.
The
proportion of patients with adverse events (33.0% vs 32.3%) or serious
adverse events (27.2% vs 25.7%) was slightly higher in the active
treatment arm, but none of these adverse events were considered to be
treatment related.
The proportion of patients with intracranial hemorrhage
within 36 hours was numerically lower in the active treatment arm (5.3%
vs 6.5%). The all-cause mortality at 90 days was the same in both
groups (16.5%).
The effect size of edaravone dexborneol was
smaller than that anticipated in the design of the trial, but Chun-Juan
Wang, who presented these data along with the senior investigator,
Yongjun Wang, MD, chief physician at her institution, said that the
positive results from three randomized trials are mutually reinforcing.
Conducted in a population with a higher NIHSS score, TASTE-2 supports
broader application.
On the basis of these data, “edaravone
dexborneol may serve as a concomitant agent with EVT or with intravenous
thrombolysis,” Chun-Juan Wang said.
Additional Therapeutic Evidence
By
itself, edaravone has demonstrated a therapeutic effect in acute stroke
in numerous trials, according to Mariana Fidalgo, MD, Centro Hospitalar
de Vila Nova de Gaia/Espinho, Vila Nova De Gaia, Portugal. In a
systemic review and meta-analysis that she published 2 years ago, based
on 19 randomized controlled trials, the likelihood of a good (OR, 1.31;
95% CI, 1.06-1.67) or excellent (OR, 1.26, 95% CI, 1.04-1.54) outcome at
90 days was increased significantly.
“Edaravone
was also associated with a lower risk of death compared to placebo or
no therapy,” Fidalgo said, noting that these studies, like the TASTE
trials, did not associate edaravone with an increased risk for
intracranial hemorrhage or other serious adverse events.
Despite
these data, edaravone with or without dexborneol has not received
regulatory approval for the treatment of acute stroke, but Fidalgo, who
was not involved in the TASTE trials, called an edaravone-based therapy
given shortly after the onset of stroke “promising” for increasing the
odds of functional recovery.
Marc Fisher, MD, professor of
neurology at Beth Israel Deaconess Medical Center, Harvard Medical
School, Boston, noted that edaravone dexborneol has now demonstrated a
statistically significant benefit for acute stroke in three large
blinded multicenter trials.
Fisher, who was the senior author on a review article published 2 years ago
that suggested cytoprotective therapies are showing promise as adjuncts
to acute stroke reperfusion therapies, acknowledged that the relative
benefit of edaravone dexborneol has been modest across the three trials
in which it was studied, but these data are “clinically meaningful for a
drug that is safe.”
The study received funding from Simcere
Pharmaceutical Group Limited. Chun-Juan Wang, Yongjun Wang, and Fidalgo
report no relevant financial relationships. Fisher reports that he has
been a consultant for Simcere.
At 1 year after index hospitalization, women vs men with
stroke were more likely to have nonadherence to statins,
antihypertensives, and a combination of the 2 medications.
