THE EFFECTIVENESS AND COSTS OF INTENSIVE STROKE REHABILITATION AND IMPROVEMENTS IN PATIENT PATHWAY IN FINLAND: A RETROSPECTIVE BENCHMARKING CONTROLLED TRIAL

The only goal in stroke is 100% recovery and you tell us NOTHING ABOUT THAT!

 THE EFFECTIVENESS AND COSTS OF INTENSIVE STROKE REHABILITATION AND IMPROVEMENTS IN PATIENT PATHWAY IN FINLAND: A RETROSPECTIVE BENCHMARKING CONTROLLED TRIAL

JRM Journal of Rehabilitation JRM Journal of Rehabilitation Medicine ORIGINAL REPORT 2024 ©Author(s). Published by MJS Publishing, on behalf of the Foundation for Rehabilitation Information. This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/).1 of 10 

Objective: 

To assess the effectiveness and costs of intensive stroke rehabilitation and improvements in patient pathway in the city of Lahti and in Päijät-Häme. 

Design:  

Retrospective benchmarking controlled trial. 

Three cohorts of Finnish community-dwelling patients (94,749, n4,184, and n105,458) with ischaemic stroke between 2001 and 2019.

Methods:

This study is based on the PERFECT 2001–2019 database of ischaemic stroke patients. PERFECT indicators describe how the stroke patients recover. The difference-in-difference method was used in the main analysis.

Results:

Improved rehabilitation in Lahti increased the share of patients discharged home p= 0.005) and decreased length of first institutional episode (–4 days,p=0.006), the share of patients institutionalized(–5.1%,p=0.001), the costs first episode(€–2,085,p<0.001) compared with the rest of Finland. Discharges to home increased 6.6 percentage points p=0.021) in Lahti compared with rest of Päijät-Häme. After 2013, the costs of first institutional episode per patient in Päijät-Häme decreased significantly compared with the rest of Finland (p<0.001).

Conclusion: 

Investments in intensive stroke rehabilitation and patient pathway seem to provide both

faster and better return to home(This doesn't mean 100% recovery, does it?)for patients and

reduced costs for the healthcare system.

Dietary cholesterol or egg consumption do not increase the risk of stroke, Finnish study finds

Once again it is your doctors responsibility to determine the correct answer specifically for you. I never could figure why dietary cholesterol would translate into blood cholesterol. Don't listen to me, I'm not medically trained, is your doctor?

Are you in this group? Does your doctor know about this group?

Why Dietary Cholesterol Does Not Matter (for most people)

But this is what your doctor will point to:

Higher Egg and Cholesterol Consumption Increases Heart Disease and Death Risk  April 2019

 

The latest here:

Dietary cholesterol or egg consumption do not increase the risk of stroke, Finnish study finds

ScienceDaily | May 21, 2019

A new study from the University of Eastern Finland shows that a moderately high intake of dietary cholesterol or consumption of up to one egg per day is not associated with an elevated risk of stroke. Furthermore, no association was found in carriers of the APOE4 phenotype, which affects cholesterol metabolism and is remarkably common among the Finnish population. The findings were published in the American Journal of Clinical Nutrition.

Findings from earlier studies addressing the association of dietary cholesterol or egg intake with the risk of stroke have been contradictory. Some studies have found an association between high dietary cholesterol intake and an increased risk of stroke, while others have associated the consumption of eggs, which are high in cholesterol, with a reduced risk of stroke. For most people, dietary cholesterol plays a very small role in affecting their serum cholesterol levels. However, in carriers of the apolipoprotein E phenotype 4— which significantly impacts cholesterol metabolism—the effect of dietary cholesterol on serum cholesterol levels is greater. In Finland, the prevalence of APOE4, which is a hereditary variant, is exceptionally high, with approximately one third of the population presenting as carriers. Yet, research data on the association between a high intake of dietary cholesterol and the risk of stroke in this population group has not been available until now.
The dietary habits of 1,950 men aged between 42 and 60 years with no baseline diagnosis of a cardiovascular disease were assessed at the onset the Kuopio Ischaemic Heart Disease Risk Factor Study, KIHD, in 1984–1989 at the University of Eastern Finland. APOE phenotype data were available for 1,015 of the men participating in the study. Of those, 32% were known carriers of APOE4.

• See Also: Stressed at work and trouble sleeping? It's more serious than you think

During a follow-up of 21 years, 217 men were diagnosed with stroke. The study found that neither dietary cholesterol nor egg consumption was associated with the risk of stroke—not even in carriers of APOE4.
The findings suggest that moderate cholesterol intake or daily egg consumption are not associated with the risk of stroke, even in persons who are genetically predisposed to a greater effect of dietary cholesterol on serum cholesterol levels. In the highest control group, the study participants had an average daily dietary cholesterol intake of 520 mg and they consumed an average of one egg per day, which means that the findings cannot be generalized beyond these levels. One egg contains approximately 200 mg of cholesterol. In this study, about a fourth of the total dietary cholesterol consumed came from eggs.
Furthermore, the generalizability of this study is also weakened by the fact that the study population did not have a pre-existing cardiovascular disease at baseline and the size of the study population was relatively small. Therefore, the findings of the study should be verified in a larger cohort as well as in people with pre-existing cardiovascular disease, who are currently advised to limit their intake of cholesterol and eggs.

• See Also: Walnuts may help lower blood pressure for those at risk of heart disease

To read more, click here.

Frequent sauna bathing keeps blood pressure in check

Do you really think your hospital is ever going to put in a sauna?
This earlier report:

Frequent sauna bathing protects men against dementia  Dec. 2016 

and this:

Finns Find Steaming Hot Way to Fight Alzheimer's Disease

Frequent sauna bathing keeps blood pressure in check

29 September 2017 University of Eastern Finland

Frequent sauna bathing reduces the risk of elevated blood pressure, according to an extensive follow-up population-based study carried out at the University of Eastern Finland. The risk of developing elevated blood pressure was nearly 50% lower among men who had a sauna 4–7 times a week compared to men who had a sauna only once a week. These findings were published recently in the American Journal of Hypertension.
The same researchers have previously shown that frequent sauna bathing reduces the risk of sudden cardiac death, and cardiovascular and all-cause mortality. Elevated blood pressure is documented to be one of the most important risk factors of cardiovascular diseases. According to the research group, underlying protective mechanisms may include the beneficial effects of regular sauna bathing on blood pressure.
The Kuopio Ischaemic Heart Disease Risk Factor Study (KIHD) involved 1,621 middle-aged men living in the eastern part of Finland. Study participants without elevated blood pressure of over 140/90 mmHg or with diagnosed hypertension at the study baseline were included in this long-term follow-up study. Based on their sauna bathing habits, men were divided into three sauna frequency groups: those taking a sauna once a week, 2–3 times a week, or 4–7 times a week. During an average follow-up of 22 years, 15.5% of the men developed clinically defined hypertension. The risk of hypertension was 24% decreased among men with a sauna frequency of 2–3 times a week, and 46% lowered among men who had a sauna 4–7 times a week.
Sauna bathing may decrease systemic blood pressure through different biological mechanisms. During sauna bathing, the body temperature may rise up to 2 °C degrees, causing vessels vasodilation. Regular sauna bathing improves endothelial function, i.e. the function of the inside layer of blood vessels, which has beneficial effects on systemic blood pressure. Sweating, in turn, removes fluid from the body, which is a contributing factor to decreased blood pressure levels.  Additionally, sauna bathing may also lower systemic blood pressure due to overall relaxation of the body and mind.
A recent analysis of the same study also revealed that those taking a sauna frequently have a lower risk of pulmonary diseases.

• Full bibliographic informationZaccardi F, Laukkanen T, Willeit P, Kunutsor SK, Kauhanen J, Laukkanen JA. Sauna Bathing and Incident Hypertension: A Prospective Cohort Study. Am J Hypertens. 2017 Jun 13. doi: 10.1093/ajh/hpx102. [Epub ahead of print]
  
  Kunutsor SK, Laukkanen T, Laukkanen J. Sauna bathing reduces the risk of respiratory diseases: a long-term prospective cohort study. Letter to the Editor. Eur J Epidemiol 2017 Sep 13. doi: 10.1007/s10654-017-0311-6 [Online First]

Saunas Connected to Significant Protection Against Dementia

How fucking long is it going to take your hospital to install saunas and create stroke protocols for its use? You will need this and I bet your hospital will do nothing about preventing your likely dementia. Call the hospital president and ask when this will occur. Ask your doctor when the research on women will occur. Since this came out a year ago your hospital is incompetent if not already instituted. Why do YOU allow such incompetence in the stroke medical world?

1. A documented 33% dementia chance post-stroke from an Australian study?   May 2012.
2. Then this study came out and seems to have a range from 17-66%. December 2013.
3. A 20% chance in this research.   July 2013.

 

http://www.alzheimersweekly.com/2017/01/saunas-connected-to-significant.html 
Frequent sauna bathing can reduce the risk of dementia, according to a recent study carried out at the University of Eastern Finland. In a 20-year follow-up, men taking a sauna 4-7 times a week were 66% less likely to be diagnosed with dementia than those taking a sauna once a week. The association between sauna bathing and dementia risk has not been previously investigated.

The effects of sauna bathing on the risk of Alzheimer's disease and other forms of dementia were studied in the Kuopio Ischaemic Heart Disease Risk Factor Study (KIHD), involving more than 2,000 middle-aged men living in the eastern part of Finland. Based on their sauna-bathing habits, the study participants were divided into three groups: those taking a sauna once a week, those taking a sauna 2-3 times a week, and those taking a sauna 4-7 times a week.

The more frequently saunas were taken, the lower was the risk of dementia. Among those taking a sauna 4-7 times a week, the risk of any form of dementia was 66% lower and the risk of Alzheimer's disease 65% lower than among those taking a sauna just once a week. The findings were published recently in the Age and Ageing journal.

Previous results from the KIHD study have shown that frequent sauna bathing also significantly reduces the risk of sudden cardiac death, the risk of death due to coronary artery disease and other cardiac events, as well as overall mortality. According to Professor Jari Laukkanen, the study leader, sauna bathing may protect both the heart and memory to some extent via similar, still poorly known mechanisms. "However, it is known that cardiovascular health affects the brain as well. The sense of well-being and relaxation experienced during sauna bathing may also play a role."

SOURCE:

• Sauna bathing is inversely associated with dementia and Alzheimer's disease in middle-aged Finnish men. Tanjaniina Laukkanen, Setor Kunutsor, Jussi Kauhanen, Jari Antero Laukkanen. Age and Ageing 2016; 0: 1-5. doi: 10.1093/ageing/afw212

Finns Find Steaming Hot Way to Fight Alzheimer's Disease

How long before your hospital gets a sauna and has stroke survivors using it daily?  The women will have to take it on chance that the same effect will be found for women.
https://sputniknews.com/art_living/201612191048726312-finland-sauna-dementia/

© Photo: Pixabay

Life

10:33 19.12.2016Get short URL

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Dementia is a growing problem for Europe's ageing population, but the Finns seem to have found the most Nordic solution to counter the dreadful disease imaginable.

Men who use the sauna several times a week run a lower risk of memory-related illnesses, including dementia, a pioneering Finnish survey has found. The relationship between the sauna and dementia has not been studied before. According to the 20-year survey by the University of Eastern Finland, encompassing over 2,000 eastern Finns, regular sauna-goers are less susceptible to memory disorders and are 66 percent less likely to get diagnosed with dementia as opposed to those who only head to the sauna once a week, Finnish newspaper Hufvudstadsbladet reported.
Previously, regular sauna use was also found to significantly lower the risk of cardiac diseases.
According to Acting Professor Jari Laukkanen, who led the study, the positive effects of the sauna can potentially also apply to women, yet the matter has not yet been investigated properly. Laukkanen explained that men were chosen as "guinea pigs" because they generally run a higher risk of developing heart diseases than women.

Laukkanen ventured that the sauna can protect the heart and the mind via the same, as-of-yet poorly understood mechanism. According to the Finnish professor, there is already strong evidence to suggest that frequent sauna bathing lowers blood pressure, which in turn reduces the risk of cardiovascular diseases.

"We knew from before that cardiovascular diseases also affect the functioning of the brain. The comfortable feeling of relaxation that sauna bathing offers can also have an impact," Jari Laukkanen said.

According to the Finnish professor, the way sauna us affects various diseases should therefore be investigated further.

​Of all the Nordic nations, the Finns are the most notorious sauna-fiends: there are over three million saunas in Finland (a country of 5.4 million), yielding an average of one sauna per household. Saunas are an integral part of the Finnish way of life, as well as a popular means of relaxation. Saunas are found in public places, private apartments, corporate headquarters, and even at the House of Parliament. There is an unwritten code of conduct for the sauna and before the rise of modern public health care, most Finnish babies were born in saunas.
In 2012, Alzheimer Europe estimated the number of dementia sufferers in Finland at 92,200: 1.71 percent of the total population of 5.4 million and somewhat higher than the EU average of 1.55 percent.

...

Frequent sauna bathing protects men against dementia

You have an extremely good chance of dementia post-stroke. What the fuck is your doctor doing to prevent that? I bet your hospital will never put in a sauna.
1. A documented 33% dementia chance post-stroke from an Australian study?   May 2012.
2. Then this study came out and seems to have a range from 17-66%. December 2013.
3. A 20% chance in this research.   July 2013.
http://www.alphagalileo.org/ViewItem.aspx?ItemId=171054&CultureCode=en 
 University of Eastern Finland
Frequent sauna bathing can reduce the risk of dementia, according to a recent study carried out at the University of Eastern Finland. In a 20-year follow-up, men taking a sauna 4-7 times a week were 66% less likely to be diagnosed with dementia than those taking a sauna once a week. The association between sauna bathing and dementia risk has not been previously investigated.

The effects of sauna bathing on the risk of Alzheimer's disease and other forms of dementia were studied in the Kuopio Ischaemic Heart Disease Risk Factor Study (KIHD), involving more than 2,000 middle-aged men living in the eastern part of Finland. Based on their sauna-bathing habits, the study participants were divided into three groups: those taking a sauna once a week, those taking a sauna 2-3 times a week, and those taking a sauna 4-7 times a week.
The more frequently saunas were taken, the lower was the risk of dementia. Among those taking a sauna 4-7 times a week, the risk of any form of dementia was 66% lower and the risk of Alzheimer's disease 65% lower than among those taking a sauna just once a week. The findings were published recently in the Age and Ageing journal.
Previous results from the KIHD study have shown that frequent sauna bathing also significantly reduces the risk of sudden cardiac death, the risk of death due to coronary artery disease and other cardiac events, as well as overall mortality. According to Professor Jari Laukkanen, the study leader, sauna bathing may protect both the heart and memory to some extent via similar, still poorly known mechanisms. "However, it is known that cardiovascular health affects the brain as well. The sense of well-being and relaxation experienced during sauna bathing may also play a role."

• Full bibliographic informationSauna bathing is inversely associated with dementia and Alzheimer's disease in middle-aged Finnish men. Tanjaniina Laukkanen, Setor Kunutsor, Jussi Kauhanen, Jari Antero Laukkanen. Age and Ageing 2016; 0: 1-5. doi: 10.1093/ageing/afw212

The Kuopio Ischaemic Heart Disease Risk Factor (KIHD) Study - Finland

With any stroke leadership at all this would be repeated as a study in the US. But fuck, that will never occur. I'd be much healthier if I didn't beat my head against the same wall all the time. But then if I do get brain damage and get stupider I will no longer know or care about the fucking failures in the stroke medical world.
http://www.uef.fi/en/web/nutritionepidemiologists/study-populations

The KIHD Study is an ongoing prospective population-based cohort study designed to investigate risk factors for CVD, atherosclerosis and related outcomes in middle-aged men from eastern Finland, the population with one of the highest recorded rates of CHD.
The study population is a random sample of men living in the Kuopio city and neighbouring rural communities, stratified and balanced into four strata: 42, 48, 54, or 60 years at the baseline examination. A total of 2682 participants (82.9 % those eligible), were enrolled in the study between 1984 and 1989.
The four-year examinations for the KIHD study were carried out during 1991 to 1993 for 1038 men. Eleven-year examinations were carried out in 1998 to 1999 for men and women and 20-year examinations 2006-8. Dietary intake of nutrients was assessed quantitatively with a four day food recording at the KIHD baseline and 11-year examinations.
The explanatory data at use includes factors from genomics through bioactive molecules, pathophysiological changes (such as abnormal ECG, changes during excersise test, atherosclerosis, findings from echocardiography etc) to individual behaviors, lifestyle, personality characteristics, psychological profiles, early life histories, worktime exposures, signs of cognitive impairment at later middle-age etc. The cohort are now starting to turn geriatric, and this will bring new interesting challenges for research in coming years.
We have recently joined many notable international research consortia, where our data has been pooled or analysed together with dozens of other high-quality studies in the world.
The KIHD has yielded close to 500 international, peer-reviewed original articles and more than 20 PhD theses. The project is expected to yield interesting results well into 2020's.

Some of our KIHD Study publications:

Virtanen Jyrki K, Mursu Jaakko, Tuomainen Tomi-Pekka, Voutilainen Sari. 2014. Dietary Fatty Acids and Risk of Coronary Heart Disease in Men: The Kuopio Ischemic Heart Disease Risk Factor Study. ATVB 2014;34:2679-87.
Emerging Risk Factors Collaboration, Di Angelantonio E, Gao P, Khan H, Butterworth AS, Wormser D, Kaptoge S, Kondapally Seshasai SR, Thompson A, Sarwar N, Willeit P, Ridker PM, Barr EL, Khaw KT, Psaty BM, Brenner H, Balkau B, Dekker JM, Lawlor DA, Daimon M et. al. 2014. Glycated hemoglobin measurement and prediction of cardiovascular disease. JAMA 2014;311:1225-33.
Virtanen JK, Mursu J, Voutilainen S, Uusitupa M, Tuomainen TP. Serum Omega-3 Polyunsaturated Fatty Acids and Risk of Incident Type 2 Diabetes in Men: The Kuopio Ischaemic Heart Disease Risk Factor Study. Diabetes Care 2014;37:189-96.
Mursu J, Virtanen JK, Tuomainen T-P, Nurmi T, Voutilainen S. Intake of fruits, berries and vegetables and the risk of type 2 diabetes: the Kuopio Ischaemic Heart Disease Risk Factor Study. Am J Clin Nutr 2014;99:328-33.
Mursu J, Virtanen JK, Rissanen TH, Tuomainen T-P, Nykänen I, Laukkanen JA, Kortelainen R, Voutilainen S. Glycemic Index, Glycemic Load, and the Risk of Acute Myocardial Infarction in Middle-Aged Finnish Men: the Kuopio Ischaemic Heart Disease Risk factor Study. Nutr Metab Cardiovasc Dis 2011;21:144-9.
Tuomainen T-P, Lagundoyo A, Voutilainen S. Coffee Intake and Type 2 Diabetes Mellitus –Role for Body Iron? Archives of Internal Medicine 2010;170:1400-1.
Virtanen JK, Mursu J, Voutilainen S, Tuomainen T-P. Serum Long-Chain n-3 Fatty Acids and Risk of Atrial Fibrillation in Men: The Kuopio Ischaemic Heart Disease Risk Factor (KIHD) Study. Circulation 2009;120:2315-2321.
Mursu J, Nurmi T, Tuomainen TP, Salonen JT, Pukkala E, Voutilainen S.Intake of flavonoids and risk of cancer in Finnish men: The Kuopio Ischaemic Heart Disease Risk Factor Study. Int J Cancer 2008;123:660-3.
Sari Voutilainen, Tomi-Pekka Tuomainen, Maarit Korhonen, Jaakko Mursu, Jyrki K Virtanen, Pertti Happonen, Georg Alfthan, Iris Erlund, Kari A North, M J Mosher, Jussi Kauhanen, Jari Tiihonen, George A Kaplan, Jukka T Salonen. Interaction of serum total homocysteine and folate concentration and the catechol-o-methyltransferase (COMT) gene with risk of acute coronary events: the Kuopio Ischaemic Heart Disease Risk Factor Study. PloS ONE 2007;2:e181.
Pertti Happonen, Sari Voutilainen, Tomi-Pekka Tuomainen, Jukka T. Salonen. Catechol-O-methyltransferase gene polymorphism modifies the effect of coffee intake on incidence of acute coronary events. PloS ONE 2006;1:e117.
Virtanen JK, Voutilainen S, Rissanen TH, Mursu J, Tuomainen T-P, Korhonen MJ, Valkonen V-P, Seppänen K, Laukkanen JA, Salonen JT. Mercury Content of Hair and Risk of Acute Coronary Events and Cardiovascular and Coronary Heart Disease Mortality in Men in Eastern Finland. Arteriosclerosis, Thrombosis and Vascular Biology 2005;25:228-33.
Sari Voutilainen, Jyrki Virtanen, Tiina Rissanen, Georg Alfthan, Jari Laukkanen, Jaakko Mursu, Elina Porkkala-Sarataho, George A Kaplan, Jukka T Salonen. Serum folate, plasma homocysteine and incidence of acute coronary events: the Kuopio Ischaemic Heart Disease Risk Factor Study. American Journal of Clinical Nutrition 2004;80:317-23.
Vanharanta M, Voutilainen S, Rissanen TH, Adlercreutz H, Salonen JT. Risk of Cardiovascular and All-Cause Death According to Serum Concentrations of Enterolactone: Kuopio Ischaemic Heart Disease Risk Factor Study. Archives of Internal Medicine 2003;163:1099-1104.
Voutilainen S, Rissanen T, Virtanen J, Lakka TA, Salonen JTS. Low folate intakes are associated with an excess risk of acute coronary events: the Kuopio Ischaemic Heart Disease Risk Factor Study. Circulation 2001;103:2674-2680.
Rissanen T, Voutilainen S, Nyyssönen K, Lakka TA, Salonen JT. Fish oil derived fatty acids, docosahexaenoic acid and docosapentaenoic acid and the risk of acute coronary events: the Kuopio Ischaemic Risk Factor Study. Circulation 2000;102 2677-2679.
Vanharanta M, Voutilainen S, Lakka TA, van der Lee M, Adlercreutz H, Salonen JT. Reduced risk of acute coronary events at high levels of mammalian lignan, enterolactone: a prospective population-based cohort study. Lancet 1999;354:2112-2115.

Incidence of most fatal type of stroke decreasing rapidly – thanks to a decrease in smoking? Finland

Don't let them rest on their laurels. There are many problems in stroke to solve. And the neuronal cascade of death by these 5 causes in the first week still needs to be solved.

Incidence of most fatal type of stroke decreasing—thanks to a decrease in smoking? 

 
A recently published study indicates that Finland’s national tobacco policies seem to be radically reducing the incidence of subarachnoid haemorrhage, the most fatal form of stroke.
Previously it was thought that in Finland approximately a thousand people suffer subarachnoid haemorrhage (SAH) every year – most of them adults of working age. Up to half of those afflicted die within a year. Subarachnoid haemorrhage is typically caused by a ruptured cerebral aneurysm, which leads to a sudden increase in the intracranial pressure. Smoking is a key risk factor for SAH.
A Finnish study published in the journal Neurology looked at changes in the incidence of subarachnoid haemorrhage over a period of 15 years (1998-2012), and these were contrasted with changes in the prevalence of smoking. The results indicated that the number of people afflicted with SAH was nearly half of the previously assumed figure and that the number was in rapid decline, a trend which was particularly apparent in younger generations.
Within fifteen years, the prevalence of SAH had decreased by 45% among women, and 38% among men, under 50. During the same period, the prevalence of SAH decreased by 16% among women, and 26% among men, over 50. Smoking among Finns aged 15-64 decreased by 30% during the monitoring period.

“It is extraordinary for the incidence of any cardiovascular disease to decrease so rapidly at the population level in such a short time,” says Professor Jaakko Kaprio from the University of Helsinki, one of the primary authors of the study and director of the Institute for Molecular Medicine Finland. “Even though we cannot demonstrate a direct causation in nation-wide studies, it is highly likely that the national tobacco policies in Finland have contributed to the decline in the incidence of this type of severe brain haemorrhage.”
Cerebral aneurysms are fairly common – they are present in up to more than 10% of people over the age of 70 – but most of them never rupture. For decades, researchers have been searching for factors which could be used to identify persons at high risk of aneurysm ruptures and who should consequently be treated.
“Previous studies have indicated that smoking is one of the most important susceptibility factors for rupturing aneurysms, so in that sense the now established connection between a decrease in smoking and a decrease in SAH is not surprising,” says the other primary author of the new study, Miikka Korja, a neurosurgeon at Helsinki University Hospital.
UNRELIABLE INCIDENCE STATISTICS FOR SAH
Dr. Miikka Korja points out that in most countries the incidence of SAH is unknown, as patients who immediately die of a haemorrhage outside of hospital are often erroneously classified as having succumbed to heart failure. In Finland, autopsies are conducted in most cases where a death occurs outside of hospital, confirming the cause of death.
“According to the research, approximately one fourth of people with subarachnoid haemorrhages have died outside of hospital or in the emergency room. All Nordic countries include deaths outside of hospitals in their incidence statistics for SAH, and have reached largely similar estimates. Nevertheless, assumptions of an extraordinarily high prevalence of SAH in Finland have been repeatedly stated, even in top medical journals, leading to Finnish SAH and aneurysm studies being disregarded in general surveys and recommendations. However, research does not back this assumption,” Korja states.

Attached files

• A new study indicates that Finland’s national tobacco policies seem to be radically reducing the incidence of subarachnoid haemorrhage. (Picture: Miikka Korja)
  

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• Unruptured middle cerebral artery bifurcation aneurysm. Intracranial aneurysms locate mostly at arterial bifurcations. The same aneurysm is depicted in the video in more detail. (Picture: Miikka Korja)
  

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• Full bibliographic informationReference: Korja M, Lehto H, Juvela S, Kaprio J. Incidence of subarachnoid hemorrhage is decreasing together with decreasing smoking rates. Neurology, 2016. Published online ahead of print 12 Aug, 2016 DOI: 10.1212/WNL.0000000000003091

A novel pathway for prevention of heart attack and stroke

Get that human study going immediately. That is what a great stroke association would be doing. Ours however will just sit on their asses doing nothing with this information.
http://www.medicalnewstoday.com/releases/281372.php?tw

A recent Finnish study could pave the way for preventing brain and cardiac ischemia induced by atherosclerosis. Finnish researchers have found that the low-expression variant of fatty acid-binding protein 4 (FABP4), which is particularly common among Finns, reduces the risk of heart attack and stroke. The finding revealed a promising new way to customise a potentially preventive drug for atherosclerosis.
Finnish researchers have found that the low-expression variant of fatty acid-binding protein 4 (FABP4), which is particularly common among Finns, reduces the risk of heart attack and stroke. The finding revealed a promising new way to customise a potentially preventive drug for atherosclerosis.
Led by Professor Perttu Lindsberg, the long-term research project of the Department of Neurology at the Hospital District of Helsinki and Uusimaa (HUS) focuses on carotid atherosclerosis. It is a joint effort involving the University of Helsinki, the Helsinki University Central Hospital, the Wihuri Research Institute and the National Institute for Health and Welfare. The findings were published in the highly esteemed scientific journal Circulation: Cardiovascular Genetics.
The research indicates that people who have inherited the genetic variant reducing the expression of FABP4 from both parents have eight-fold lower odds for myocardial infarction than the rest of the population.
The researchers also found that patients with carotid stenosis who carried the protective gene variant suffered from brain ischemia three times less frequently than carotid stenosis patients without the gene variant.
"It could be that reduced cell stress in the stenosis, attenuated inflammation, as well as reduced accumulation of cholesterol and other lipids in the arteries help keep atherosclerosis asymptomatic among the gene carriers," explains Jani Saksi, a researcher in the Molecular Neurology Research Program at the University of Helsinki.
Tests on laboratory animals have previously shown that an orally ingested drug suppressing FABP4 activity effectively slows down the progression of atherosclerosis and even reduces existing stenoses. The phenomenon has not yet been studied in humans.
The Finnish study is the first to detect a link between the FABP4 variant and lower total cholesterol levels in the blood. The decrease in serum total cholesterol levels was the most pronounced in obese subjects who had inherited the gene variant from both parents. In fact, obese carriers of the gene variant show fewer clinical markers of early atherosclerosis and lower levels of stenosis than the rest of the population.
"These findings suggest that FABP4 could be a new potential target for drug development aiming to prevent lethal and disabling myocardial and cerebral infarctions induced by atherosclerosis," says Saksi. "The inhibition of FABP4 activity - especially among obese people in the risk group for atherosclerosis - may prove to be an important method for reducing these individuals' risk for cardiovascular diseases."

Adapted by MNT from original media release
The Low-Expression Variant of Fatty Acid-Binding Protein 4 Favors Reduced Manifestations of Atherosclerotic Disease and Increased Plaque Stability, Jani Saksi & al., Circulation: Cardiovascular Genetics, doi: 10.1161/​CIRCGENETICS.113.000499, published online 13 August 2014.

Long sleep and high blood copper levels go hand in hand, inflammation problems

See what your doctor has you doing to prevent inflammation. ANYTHING AT ALL? 

Long sleep and high blood copper levels go hand in hand, inflammation problems

Persons sleeping less than 6 hours or more than 10 hours suffer from low-grade inflammation more often than persons sleeping 7-8 hours per night. This was observed in a University of Eastern Finland study focusing on the health and lifestyle habits among middle-aged men.

"Earlier studies have found a relation between reduced sleep and low-grade inflammation," says Maria Luojus, MHSc, one of the study researchers.

Furthermore, low-grade inflammation occurs in overweight, depression and diabetes.

The study is the first to analyse the association between sleep duration and serum micronutrient concentrations in a large sample, and it found a link between high serum copper concentration and long sleep duration. Serum micronutrient concentrations are affected by many factors, including an individual's general health and diet.
"Based on this study, however, it is impossible to say whether sleeping long results in high serum copper concentrations or vice versa," Luojus says.

It has been suggested that high serum copper concentration associates with pro-oxidative stress.

"Pro-oxidative stress is found in many chronic diseases, such as coronary artery disease. Nevertheless, when the study participants' cardiovascular diseases were taken account for, our results remained unchanged. The association between serum copper concentration and sleep duration persisted independently of cardiovascular diseases," Luojus says.

In addition to, the study participants' age, cumulative smoking history, alcohol consumption, depressive symptoms, physical activity and metabolic syndrome were taken into account in the data analysis.

The study involved 2,682 men living in Eastern Finland, participating the Kuopio Ischemic Heart Disease Risk Factor (KIHD) study. The KIHD study has been ongoing at the University of Eastern Finland in the Institute of Public Health and Clinical Nutrition since 1984.

• Full bibliographic informationMaria K Luojus, Soili M Lehto, Tommi Tolmunen, Antti-Pekka Elomaa ja Jussi Kauhanen. Serum copper, zinc and high-sensitivity C-reactive protein in short and long sleep duration in ageing men. Journal of Trace Elements in Medicine and Biology 32:177-82. doi:10.1016/j.jtemb.2015.07.008

Day of the week and ischemic stroke: is it Monday high or Sunday low?

Well mine was on Sunday morning but my socioeconomic status was average.
http://www.ncbi.nlm.nih.gov/pubmed/15272128

Jakovljević D¹.

Author information

Abstract

BACKGROUND AND PURPOSE:

The study aim was to examine the incidence of ischemic stroke (IS) by day of the week and its relationship with age, sex, and socioeconomic status (SES).

METHODS:

A total of 12,801 IS events in men and women aged 25 to 99 years was recorded in a population-based stroke register (FINMONICA), which was functioning in Finland from 1982 to 1992. We analyzed the weekly variation in IS incidence by pooling the data and stratifying by sex and age. Taxable income and level of education were used as indicators of SES.

RESULTS:

We observed a significant weekly variation in IS occurrence, but the analysis by age group demonstrated a difference by weekday only in the age group 60 to 74, both in men and women (P<0.001 and P=0.02, respectively). The increase in the number of IS events from Sunday to Monday was pronounced in men (29.2% increase from Sunday to Monday). When stratifying by age, Monday excess in IS incidence was associated with lower SES among persons >59 years of age. No Monday excess was observed in persons with high SES.

CONCLUSIONS:

Because the incidence of IS is much higher in persons with low SES than in those with high SES, the Monday excess in persons with low SES is of substantial public health interest. This finding may suggest reasons for the higher IS incidence in persons with low socioeconomic positions and open up some possibilities for prevention.

Frequent saunas may boost survival, Finnish study suggests

How long before your hospital installs a sauna? Find out from your doctor what the frequency and heat protocol is. Do not attempt this on your own.
The readable article here:
http://news.yahoo.com/frequent-saunas-may-boost-survival-finnish-study-suggests-173148012.html
The abstract here:
http://archinte.jamanetwork.com/article.aspx?articleid=2130724

Conclusions and Relevance  Increased frequency of sauna bathing is associated with a reduced risk of SCD, CHD, CVD, and all-cause mortality. Further studies are warranted to establish the potential mechanism that links sauna bathing and cardiovascular health.

Have your doctor reconcile sauna use with this research;

Mortality rates increase due to extreme heat and cold

Up to now it has been known that high temperatures, amongst other things, can affect the blood-clotting mechanism (haemostasis) and make the blood more viscous, thereby increasing the risk of thrombosis. Furthermore, as decreasing temperatures have an impact on blood pressure, it can be assumed that there is a link between cold temperatures and the increase in cardiovascular events and stroke.

Individualised home-based rehabilitation after stroke in eastern Finland – the client's perspective

This would work so much better if our doctors would stop the neuronal cascade of death resulting in vastly less dead and dying neurons.  But alas, we are totally f*cking screwed until this happens because stroke rehabilitation only has a 10% full recovery rate.
http://onlinelibrary.wiley.com/doi/10.1111/hsc.12190/abstract;jsessionid=D5EFE6652A9DAD6BD4290E272A8CC794.f04t02?

Abstract

Reintegration into society is one of the main purposes of post-stroke rehabilitation. The experiences of clients returning home after a stroke have been studied before. There is, however, little knowledge about activities carried out during home-based rehabilitation interventions and about the involvement of clients in the process. This study focused on clients' experiences of a 3-month individualised, home-based rehabilitation programme supervised by a multidisciplinary team. The data were collected in 2009–2010, and it was based on interviews with 14 clients (48–83 years of age) conducted approximately 7 months after stroke. In the thematic analysis, five main topics describing the goals and functions of the home-based rehabilitation were identified as follows: (i) learning strategies for solving problems in daily activities at home and in the community; (ii) receiving exercise coaching; (iii) exploring community services and facilities; (iv) having a dialogue with professionals; and (v) engaging in activities aimed at returning to work. Implementing rehabilitation activities in the home environment seemed to enhance the participants' active involvement and their ability to evaluate themselves and to set goals for their recovery. Work was an important goal for clients of working age, but work-related tasks were not sufficiently integrated with home-based rehabilitation. A challenge for local communities is to provide health promotion and recreation services that are also suitable for persons with limited functioning.

Robotics offers new hope for stroke victims - Finland

I'm sure this will never get to the US because of cost.
http://yle.fi/uutiset/robotics_offers_new_hope_for_stroke_victims/7001287
This is just symptomatic of the problems in stroke research. They are looking for solutions in rehabilitation rather than the  stopping  of the neuronal cascade of death which could prevent  a lot of the disability in the first place. 

Neurosurgeons in Helsinki have teamed up with robotics experts to develop new ways of helping stroke patients. Their pioneering techniques are generating interest from doctors across the world.

Electronics professor Raimo Sepponen (centre) and Doctor Marja Hietanen demonstrate new methods of rehabilitation for stroke patients. Image: Yle

A new rehabilitation and diagnostic room at Helsinki University Hospital offers stroke patients opportunities above and beyond traditional pen and paper or onscreen tests. The floor of the SALI room has inbuilt sensors, as do the walls, and a patient's movement, response times, pathways and choices are all logged and evaluated.
"We are using different kind of stimuli, visual, auditive and movement, because this is actually what happens in everyday life situations,” says Dr Marja Hietanen from the hospital’s neuropsychology unit. “All the time we register information that comes via eyes, ears and movement."
Strokes affect some 15,000 people a year in Finland. What many don't realize is that a quarter are of working age. A fast and thorough recovery is valuable, not only for the individual, but also in terms of actively keeping people in the workforce.
Dr Hietanen teamed up with technical experts at Aalto University to develop a more hands-on approach to stroke patient care.

Rehab and entertainment

"It's very important that we think about people, how they get along in their everyday life and also if they are able to go back to work, for example, after a stroke," Hietanen says.
The collaboration was born two years ago when Professor of Electronics Raimo Sepponen and his team were developing an intelligent floor. It can tell when an elderly person or patient takes a fall, sending an alert to carers or even relatives.
For patients, it's both excellent rehab and great entertainment, and since the project is in the testing phase, the more data flowing in, the better.
"I have been contacted by people from Turkey and also from New Zealand who plan to cooperate with us and maybe build a similar system," Sepponen says.
In a world ever more brimming with stimuli, it's hoped that this patient-centred, multi-sensory approach will become the global standard.