Showing posts with label crock of shit. Show all posts
Showing posts with label crock of shit. Show all posts
Monday, October 2, 2017
Saturday, December 17, 2016
CDC estimates preventable deaths from 5 leading causes
What a fucking crock of bullshit. This will just allow our fucking failures of stroke associations to focus on prevention and awareness rather than tackling the difficult problems in stroke. They weren't doing one damn thing about stroke rehab before, now they will not lift a finger to fixing stroke problems. You are continually screwed until everything currently in stroke is destroyed.
CDC estimates preventable deaths from 5 leading causes
American Pharmacists Association News, 11/23/2016
New
CDC research shows that the number of potentially preventable deaths
dropped from 2010 to 2014 for three of the five top causes of death in
the United States. The five leading causes of death for people younger
than aged 80 years in 2014 were diseases of the heart, cancers, stroke,
chronic lower respiratory diseases (CLRD), and unintentional injuries,
collectively accounting for 63% of all deaths that year. CDC estimates
that 15% of these cancer deaths, 30% of these heart–disease deaths, 43%
of those unintentional–injury deaths, 36% of these CLRD deaths, and 28%
of those stroke deaths possibly could have been prevented. Compared with
4 years earlier, potentially preventable cancer deaths dropped 25%;
potentially preventable deaths from stroke declined 11%; potentially
preventable deaths from heart disease decreased 4%; potentially
preventable deaths from accidents increased 23%, in large part due to
drug poisonings and falls; and potentially preventable deaths from CLRD
rose 1%. "Fewer Americans are dying young from preventable causes of
death," said CDC Director Tom Frieden, MD MPH.
Thursday, December 1, 2016
RCP stroke guidance recommends 45 minutes of therapy daily
What a fucking piece of shit guideline. You should be doing hours upon hours of therapy daily including action observation, mirror therapy, meditation, PROM, music listening and virtual realty game playing. You will never recover much if you listen to this stupid bullshit. Until the stroke medical world starts writing protocols instead of guidelines they really are useless.
http://www.csp.org.uk/news/2016/11/30/rcp-stroke-guidance-recommends-45-minutes-therapy-daily
People with stroke should receive at least 45 minutes of each appropriate therapy a day, guidance from the Royal College of Physicians (RCP) recommends.
Rehabilitation is central to the document, which says the frequency of therapy must enable stroke patients to meet their rehabilitation goals.(That goal is 100% recovery, nothing less) And, very importantly, therapy should continue as long as patients are willing and capable of participating and showing measurable benefit from treatment.
The RCP’s Key Recommendations for Stroke 2016 offers a concise guide to better stroke care. Its 30 recommendations are based on the RCP’s detailed 151-page National Clinical Guideline for Stroke, with more than 400 recommendations covering almost every aspect of stroke management.(Pretty much useless since these are guidelines not protocols)
A stroke unit must be capable of providing rehabilitation to all its patients, it tells commissioners. In addition, it calls on them to provide a specialist early supported discharge service, so stroke patients can continue their rehabilitation at home.
Commissioners are recommended to look for specialist rehabilitation services which meet the specific health, social and vocational needs of people with stroke of all ages. And they should commission services capable of delivering specialist rehabilitation in out-patient and community settings, in liaison with inpatient services.
Daily mobilisation
Early mobilisation is key, the document says. Patients who are medically stable but have difficulty moving soon after a stroke should be offered frequent, short, daily mobilisations by appropriately trained staff. Typically this should begin between 24 and 48 hours after a stroke.
Inpatient stroke units should be staffed by a multidisciplinary team that meets at least once each week to exchange information about patients.
Nicola Hancock, lecturer in physiotherapy at the University of East Anglia, contributed to the guidance. She said physiotherapists would find the concise guidance highly accessible and hoped it would be used, along with the full guidelines, to inform, support and improve acute and rehabilitation services.
'The new National Clinical Guideline for Stroke is the most comprehensive, evidence-based tool available to guide practice all the way through the stroke pathway, from the earliest stages to long-term management of this important condition,’ she said.
‘The guidelines were developed using a highly-rigorous process of searching, appraising and compiling the evidence. The concise guide brings together a number of guidelines from the main document that are particularly relevant to physiotherapy practice.’
http://www.csp.org.uk/news/2016/11/30/rcp-stroke-guidance-recommends-45-minutes-therapy-daily
People with stroke should receive at least 45 minutes of each appropriate therapy a day, guidance from the Royal College of Physicians (RCP) recommends.
Rehabilitation is central to the document, which says the frequency of therapy must enable stroke patients to meet their rehabilitation goals.(That goal is 100% recovery, nothing less) And, very importantly, therapy should continue as long as patients are willing and capable of participating and showing measurable benefit from treatment.
The RCP’s Key Recommendations for Stroke 2016 offers a concise guide to better stroke care. Its 30 recommendations are based on the RCP’s detailed 151-page National Clinical Guideline for Stroke, with more than 400 recommendations covering almost every aspect of stroke management.(Pretty much useless since these are guidelines not protocols)
A stroke unit must be capable of providing rehabilitation to all its patients, it tells commissioners. In addition, it calls on them to provide a specialist early supported discharge service, so stroke patients can continue their rehabilitation at home.
Commissioners are recommended to look for specialist rehabilitation services which meet the specific health, social and vocational needs of people with stroke of all ages. And they should commission services capable of delivering specialist rehabilitation in out-patient and community settings, in liaison with inpatient services.
Daily mobilisation
Early mobilisation is key, the document says. Patients who are medically stable but have difficulty moving soon after a stroke should be offered frequent, short, daily mobilisations by appropriately trained staff. Typically this should begin between 24 and 48 hours after a stroke.
Inpatient stroke units should be staffed by a multidisciplinary team that meets at least once each week to exchange information about patients.
Nicola Hancock, lecturer in physiotherapy at the University of East Anglia, contributed to the guidance. She said physiotherapists would find the concise guidance highly accessible and hoped it would be used, along with the full guidelines, to inform, support and improve acute and rehabilitation services.
'The new National Clinical Guideline for Stroke is the most comprehensive, evidence-based tool available to guide practice all the way through the stroke pathway, from the earliest stages to long-term management of this important condition,’ she said.
‘The guidelines were developed using a highly-rigorous process of searching, appraising and compiling the evidence. The concise guide brings together a number of guidelines from the main document that are particularly relevant to physiotherapy practice.’
Website links
Tuesday, May 10, 2016
Major global study identifies a safer treatment of acute stroke
So 11% of patients get tPA, only 12% of those patients get back full function. This is a miniscule percentage of patients being helped. Yet all the press and F.A.S.T. make it sound like all you have to do is get to a stroke hospital fast and you'll be all better. What a lying crock of shit. Instead the press should be screaming that nothing in stroke is working and massive amounts of research are needed to solve all the problems in stroke.
http://medicalxpress.com/news/2016-05-major-global-safer-treatment-acute.html
The safety of a controversial clot-busting drug has been investigated by researchers, who have shown a modified dosage can reduce serious bleeding in the brain and improve survival rates.
It is hoped the findings from the trial of more than 3,000 patients in 100 hospitals worldwide could change the way the most common form of stroke is treated globally.
Intravenous rtPA (or alteplase) is given to people suffering acute ischaemic stroke and works by breaking up clots blocking the flow of blood to the brain.
However, it can cause serious bleeding in the brain in around five per cent of cases, with many of these proving fatal.
The study was conducted by teams at the George Institute for Global Health, and the University of Leicester's Department of Cardiovascular Sciences. The UK arm of the trial was funded by the Stroke Association.
National Coordinator of the study in the UK, Professor Tom Robinson of the University said: "This trial was a randomised controlled trial, which is the gold standard for determining whether a medicine actually has the desired effect.
"The results provide important information when discussing clot-busting treatment with patients and their families.
"Most patients who have a major stroke want to know they will survive but without being seriously dependent on their family. We have shown this to be the case with the lower dose of the drug.
"Stroke is the fourth leading cause of death in the UK and the leading cause of adult neurological disability. There are over 150,000 strokes each year in the UK, one in four of whom are in people of working age.
"Currently, approximately 11 per cent of stroke patients receive thrombolysis treatment for stroke in the UK."
Professor Craig Anderson, Lead Author of the study published in The New England Journal of Medicine, said: "At the moment you could have a stroke but end up dying from a bleed in the brain. It's largely unpredictable as to who will respond and who is at risk with rtPA.
"What we have shown is that if we reduce the dose level, we maintain most of the clot busting benefits of the higher dose but with significantly less major bleeds and improved survival rates. On a global scale, this approach could save the lives of many tens of thousands of people.
"There is a trade off with the lower dose in regards to recovery of functioning, but being alive is surely preferable to most patients than suffering an early death."
Dr Dale Webb, Director of Research and Information at the Stroke Association, said: "We've known for a while that giving stroke patients alteplase carries the risk of bleeding in the brain which can be fatal.
"However, an independent review in the UK concluded last year that the benefits outweigh the risks. This new study will be welcome news for clinicians and patients, because it suggests that we can reduce the risk of bleeding with a lower dose of alteplase, whilst retaining most of its benefit."
These differing effects meant that the trial was unable to show conclusively that the low dose was as effective as standard dose rtPA in terms of survivors being free of any disability.
rtPA is used to dissolve clots that block a blood vessel in a patient's brain within the first few hours after the onset of stroke symptoms.
Yet, because many people with stroke arrive at hospital after this crucial time window, only around five per cent of eligible people currently receive this therapy in most countries.
Concerns over the risks of bleeding on the brain associated with rtPA have prompted independent reviews of the research evidence in Australia and the UK.
Professor Tom Robinson is also from the NIHR Leicester Cardiovascular Biomedical Research Unit.
Key Findings
Explore further:
Strokes associated with surgery can be devastating
http://medicalxpress.com/news/2016-05-major-global-safer-treatment-acute.html
The safety of a controversial clot-busting drug has been investigated by researchers, who have shown a modified dosage can reduce serious bleeding in the brain and improve survival rates.
It is hoped the findings from the trial of more than 3,000 patients in 100 hospitals worldwide could change the way the most common form of stroke is treated globally.
Intravenous rtPA (or alteplase) is given to people suffering acute ischaemic stroke and works by breaking up clots blocking the flow of blood to the brain.
However, it can cause serious bleeding in the brain in around five per cent of cases, with many of these proving fatal.
The study was conducted by teams at the George Institute for Global Health, and the University of Leicester's Department of Cardiovascular Sciences. The UK arm of the trial was funded by the Stroke Association.
National Coordinator of the study in the UK, Professor Tom Robinson of the University said: "This trial was a randomised controlled trial, which is the gold standard for determining whether a medicine actually has the desired effect.
"The results provide important information when discussing clot-busting treatment with patients and their families.
"Most patients who have a major stroke want to know they will survive but without being seriously dependent on their family. We have shown this to be the case with the lower dose of the drug.
"Stroke is the fourth leading cause of death in the UK and the leading cause of adult neurological disability. There are over 150,000 strokes each year in the UK, one in four of whom are in people of working age.
"Currently, approximately 11 per cent of stroke patients receive thrombolysis treatment for stroke in the UK."
Professor Craig Anderson, Lead Author of the study published in The New England Journal of Medicine, said: "At the moment you could have a stroke but end up dying from a bleed in the brain. It's largely unpredictable as to who will respond and who is at risk with rtPA.
"What we have shown is that if we reduce the dose level, we maintain most of the clot busting benefits of the higher dose but with significantly less major bleeds and improved survival rates. On a global scale, this approach could save the lives of many tens of thousands of people.
"There is a trade off with the lower dose in regards to recovery of functioning, but being alive is surely preferable to most patients than suffering an early death."
Dr Dale Webb, Director of Research and Information at the Stroke Association, said: "We've known for a while that giving stroke patients alteplase carries the risk of bleeding in the brain which can be fatal.
"However, an independent review in the UK concluded last year that the benefits outweigh the risks. This new study will be welcome news for clinicians and patients, because it suggests that we can reduce the risk of bleeding with a lower dose of alteplase, whilst retaining most of its benefit."
These differing effects meant that the trial was unable to show conclusively that the low dose was as effective as standard dose rtPA in terms of survivors being free of any disability.
rtPA is used to dissolve clots that block a blood vessel in a patient's brain within the first few hours after the onset of stroke symptoms.
Yet, because many people with stroke arrive at hospital after this crucial time window, only around five per cent of eligible people currently receive this therapy in most countries.
Concerns over the risks of bleeding on the brain associated with rtPA have prompted independent reviews of the research evidence in Australia and the UK.
Professor Tom Robinson is also from the NIHR Leicester Cardiovascular Biomedical Research Unit.
Key Findings
- Compared to standard dose (0.9mg/kg body weight), the lower dose (0.6mg/kg) of rtPA reduced rates of serious bleeding in the brain, known as intracerebral haemorrhage (ICH), by two thirds.
- After 90 days, 8.5 per cent of patients had died after receiving low dose rtPA, compared to 10.3 per cent who received the standard dose.
- The survival benefit was offset by a slight rise in the amount of people suffering residual disability. For every 1000 patients treated, low dose rtPA, compared to the standard dose, 41 more people had physical disabilities, such as needing help dressing or walking, but 19 fewer people died.
Explore further:
Strokes associated with surgery can be devastating
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