Prevalence of high-risk plaques and risk of stroke in patients with asymptomatic carotid stenosis: A meta-analysis

 Tells us nothing useful. If you are asymptomatic how would you even have a clue to get tested?  I was totally asymptomatic, yet I must have had high risk plaques since I broke one loose during a whitewater canoeing trip(common for me).  

Would this work? And how many hospitals/clinics have access to these?

Lasers used to detect risk of heart attack and stroke

New developments in the detection of vulnerable plaque 2001

 

The latest here:

Prevalence of high-risk plaques and risk of stroke in patients with asymptomatic carotid stenosis: A meta-analysis

A Meta-analysis

Joseph Kamtchum-Tatuene, MD¹; Jean Jacques Noubiap, MD²; Alan H. Wilman, PhD³; et al Maher Saqqur, MD⁴; Ashfaq Shuaib, MD⁴; Glen C. Jickling, MD⁴

Author Affiliations

JAMA Neurol. Published online August 3, 2020. doi:10.1001/jamaneurol.2020.2658

Key Points

Question  Is it relevant and feasible to use multimodal neurovascular imaging to perform a risk-oriented selection for revascularization in patients with asymptomatic carotid stenosis?

Findings  In this meta-analysis of 64 studies that enrolled 20 751 participants, high-risk plaques were common in patients with asymptomatic carotid stenosis, and the associated annual incidence of ipsilateral ischemic events (4 events per 100 person-years) was higher than the currently accepted estimates.

Meaning  This study’s findings indicate that extending the assessment of asymptomatic carotid stenosis beyond the grade of stenosis is needed in routine practice to improve risk stratification and optimize therapy; clinical trials using multimodal neurovascular imaging for risk stratification before randomization are warranted to evaluate optimal strategies for stroke prevention in patients with asymptomatic carotid stenosis.

Abstract

Importance  There is an ongoing debate regarding the management of asymptomatic carotid stenosis. Previous studies have reported imaging features of high-risk plaques that could help to optimize the risk-benefit ratio of revascularization. However, such studies have not provided an accurate estimate of the prevalence of high-risk plaques and the associated annual incidence of ipsilateral ischemic cerebrovascular events to inform the design of clinical trials using a risk-oriented selection of patients before randomization.

Objective  To assess the relevance and feasibility of risk-oriented selection of patients for revascularization.

Data Sources  A systematic search of PubMed and Ovid Embase from database inception to July 31, 2019, was performed.

Study Selection  Prospective observational studies that reported prevalence of high-risk plaques and incidence of ipsilateral ischemic cerebrovascular events were included.

Data Extraction and Synthesis  Aggregated data were pooled using random-effects meta-analysis. Data were analyzed from December 16, 2019, to January 15, 2020.

Main Outcomes and Measures  Prevalence of high-risk plaques and annual incidence of ipsilateral ischemic events.

Results  Overall, 64 studies enrolling 20 751 participants aged 29 to 95 years (mean age range, 55.0-76.5 years; proportion of men, 45%-87%) were included in the meta-analysis. Among all participants, the pooled prevalence of high-risk plaques was 26.5% (95% CI, 22.9%-30.3%). The most prevalent high-risk plaque features were neovascularization (43.4%; 95% CI, 31.4%-55.8%) in 785 participants, echolucency (42.3%; 95% CI, 32.2%-52.8%) in 12 364 participants, and lipid-rich necrotic core (36.3%; 95% CI, 27.7%-45.2%) in 3728 participants. The overall incidence of ipsilateral ischemic cerebrovascular events was 3.2 events per 100 person-years (22 cohorts with 10 381 participants; mean follow-up period, 2.8 years; range, 0.7-6.5 years). The incidence of ipsilateral ischemic cerebrovascular events was higher in patients with high-risk plaques (4.3 events per 100 person-years; 95% CI, 2.5-6.5 events per 100 person-years) than in those without high-risk plaques (1.2 events per 100 person-years; 95% CI, 0.6-1.8 events per 100 person-years), with an odds ratio of 3.0 (95% CI, 2.1-4.3; I² = 48.8%). In studies focusing on severe stenosis (9 cohorts with 2128 participants; mean follow-up period, 2.8 years; range, 1.4-6.5 years), the incidence of ipsilateral ischemic cerebrovascular events was 3.7 events per 100 person-years (95% CI, 1.9-6.0 events per 100 person-years). The incidence of ipsilateral ischemic cerebrovascular events was also higher in patients with high-risk plaques (7.3 events per 100 person-years; 95% CI, 2.0-15.0 events per 100 person-years) than in those without high-risk plaques (1.7 events per 100 person-years; 95% CI, 0.6-3.3 events per 100 person-years), with an odds ratio of 3.2 (95% CI, 1.7-5.9; I² = 39.6%).

Conclusions and Relevance  High-risk plaques are common in patients with asymptomatic carotid stenosis, and the associated risk of an ipsilateral ischemic cerebrovascular event is higher than the currently accepted estimates. Extension of routine assessment of asymptomatic carotid stenosis beyond the grade of stenosis may help improve risk stratification and optimize therapy.

Lasers used to detect risk of heart attack and stroke

There was nothing in my profile or any risk calculator that even remotely suggested I was at risk for a stroke at age 50.   The only hint would have been that my Dad had 80% blockage in one of his carotid arteries.
http://www.alphagalileo.org/ViewItem.aspx?ItemId=178232&CultureCode=en

18 August 2017 Warwick, University of

Patients at risk of heart attacks and strokes may be spotted earlier thanks to a diagnosis tool that uses near-infrared light to identify high-risk arterial plaques, according to research carried out at WMG, University of Warwick, the Baker Institute and Monash University.
The scientists observed that when they increased the wavelength of the light currently used to visualise the fatty build-up found in arteries (atherosclerotic plaques) they could selectively identify the rupture-prone deposits, which commonly lead to blood clots, heart attacks and strokes.
While some fatty deposits or plaques can remain stable for years, other high-risk cases develop complications, such as bleeding into the plaque, which leads to the formation of cracks and rupture of the fatty plaque. This can result in blockages in the blood vessels causing a heart attack or stroke. Current imaging techniques are able to identify some characteristics of high-risk plaques but none are generally accepted as reliable methods for selectively detecting the dangerous plaques.
“What we have done uses innovative, materials-based techniques to assist in the development of new diagnostic tools,” explains Dr Tara Schiller, WMG, University of Warwick.
“This could help us to detect the threat of an imminent heart attack and result in a decrease of the mortality rates,” Dr Schiller continues.
Dr Tara Schiller from the International Institute for Nanocomposites Manufacturing at WMG, along with colleagues from the Baker and Monash University, have discovered that increasing the wavelength of the infra-red (IR) radiation currently used to detect fatty deposit build-up in arteries to near-infrared (NIR) wavelengths allowed them to selectively identify plaques with internal bleeding, typically associated with high-risk deposits.
The products causing this fluorescence were identified using Raman spectroscopy. They are thought to be a mixture of heme products, formed during the degradation of red blood cells. These products were only observed in the unstable plaques with internal bleeding and not observed in the more stable fatty deposits. This can improve selectivity when looking for high-risk deposits in patients and could help doctors to identify the most at-risk patients.
“Despite the millions of dollars spent each year particularly on heart imaging, there still isn't a reliable way of identifying these unstable plaques,” explains Dr Karlheinz Peter.
“We realised when we shine a light in the near-infrared wavelength range, that this light is reflected at a certain wavelength. So in a way we can use laser light to shine up the plaques that are unstable, and it's very characteristic,” Dr Peter continues.
After further investigation with clinical trials this method of imaging technique could be used to assess unstable fatty arterial plaques and could be used to monitor the effectiveness of the drugs used to prevent heart attacks or strokes.
The research ‘Near-infrared autofluorescence induced by intraplaque hemorrhage and heme degradation as marker for high-risk atherosclerotic plaques’ is published in Nature Communications.
http://www2.warwick.ac.uk/newsandevents/pressreleases/lasers_used_to/

Attached files

• Dr Tara Schiller
  

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• Full bibliographic informationTitle - Near-infrared autofluorescence induced by intraplaque hemorrhage and heme degradation as marker for high-risk atherosclerotic plaques
  Journal - Nature Communications
  Authors - Nay Min Htun, Yung Chih Chen, Bock Lim, Tara Schiller, Ghassan J. Maghzal, Alex L. Huang, Kirstin D. Elgass, Jennifer Rivera, Hans G. Schneider, Bayden R. Wood, Roland Stocker & Karlheinz Peter

The new study published in Science Translational Medicine shows that a low-power laser can trigger stem cells in your tooth to form dentin

How can this be tested for repurposing to help neuronal stem cells? That is the kind of innovative thinking our stroke associations are not doing.
Article here:

A Simple Laser Blast Could Help Grow Your Teeth Back

Research here:

Photoactivation of Endogenous Latent Transforming Growth Factor–β1 Directs Dental Stem Cell Differentiation for Regeneration

Clinical neurorestorative progress in traumatic brain injury

Which of these therapies mentioned can also be used in stroke? Does your doctor know anything about this?
http://www.dovepress.com/articles.php?article_id=20957

Authors Huang H, Chen L, Huang H
Published Date March 2015 Volume 2015:3 Pages 57—62
DOI http://dx.doi.org/10.2147/JN.S74486
Received 30 September 2014, Accepted 26 November 2014, Published 20 March 2015
Approved for publication by Prof. Dr. Hari Shanker Sharma

Huiling Huang,¹ Lin Chen,^2,3 Hongyun Huang<sup>4–6

1</sup>Tianjin Key Laboratory of Cerebral Vascular and Neurodegenerative Diseases, Tianjin Huanhu Hospital, Tianjin Neurosurgical Institute, Tianjin, People's Republic of China; ²Medical Center, Tsinghua University, Beijing, People's Republic of China; ³Tsinghua University Yuquan Hospital, Beijing, People's Republic of China; ⁴General Hospital of Chinese people's Armed Police Forces, ⁵Beijing Rehabilitation Hospital of Capital Medical University, Beijing, People's Republic of China; ⁶Beijing Hongtianji Neuroscience Academy, Beijing, People's Republic of China

Abstract: Traumatic brain injury (TBI) is a leading cause of death and disability from trauma to the central nervous system. Besides the surgical interventions and symptomatic management, the conventional therapies for TBI and its sequelae are still limited. Recently emerging evidence suggests that some neurorestorative treatments appear to have a potential therapeutic role for TBI and improving the patient's quality of life. The current clinical neurorestorative strategies available in TBI include pharmacological treatments (recombinant human interleukin-1 receptor antagonist, amantadine, lithium, and valproate), the neuromodulation treatments (repetitive transcranial magnetic stimulation, transcranial direct current stimulation, and low-level laser therapy), cell transplantation (bone marrow stromal cells and umbilical cord stromal cells), and combined neurorehabilitation. In this review, we summarize the recent clinical neurorestorative progress in the management of neurodegeneration as well as cognitive and motor deficits after TBI; indeed further clinical trials are required to provide more robust evidence.

'Brain window' implant devised

Maybe we could get laser treatments or see what optogenetics can do.
The BBC report here;

'Brain window' implant devised

the abstract and paper it is based upon here;
http://www.sciencedirect.com/science/article/pii/S1549963413003614

Or you could ask your doctor what use they will make of it to help your recovery.

The Use of Low level Laser Therapy and Injury Recall Technique in the Treatment of Closed head and Other Brain Injuries

I can't make head or tails of what the mechanism is supposed to do. Ask all the doctors you know before you attempt anything like this.
 Ok, probably quackery.
Injury recall technique is a technique to erase the neurological memory of the past. Video here: http://www.youtube.com/watch?v=fI3MaInxMlM&feature=share

http://scholar.google.com/scholar_url?hl=en&q=http://blog.drhogg.com/wp-content/uploads/LASER_IRT_BRAIN_INJURY_PAPER.doc&sa=X&scisig=AAGBfm1sG4tgbP4YlHLyeJCFIuakPbshoA&oi=scholaralrt

Introduction

Closed head injuries are a common occurrence in the United States with en estimated incidence of 200 per 100,000 people per year. (1,2) A “closed head” injury is one in which there is trauma to the brain which does not pierce the cranium. Common causes of closed head injuries include traffic accidents and falls in which the head is struck. Often the greatest injury is not from the original trauma but due to edema and intracranial bleeding putting pressure on vulnerable neural tissue in an enclosed space. Free radical damage and ischemia are likely contributor to this secondary type of brain injury. Approximately 100,000 people die as a result of closed head injuries in the United States each year(3,4). Of those who survive, another 90,000 each year suffer some level of long-standing or permanent disability (3,4). As our service men and women return, injured, from Iraq, Afganistan and elsewhere, persisting disability resulting from brain injury becomes an increasing concern.

Types of trauma in closed head injuries include “coup” injuries from direct transmission of trauma through the skull to the brain which causes injury directly beneath the point of impact. A second type of injury is the “contrecoup” in which indirect trauma to the brain occurs via rotational shear forces that cause the brain to bounce against or sweep across the interior of the cranium. In the contrecoup injury, multiple areas of brain trauma occur that are less obvious based on the point of impact. When all primary and secondary sources of brain injury in a closed head incident are considered, understanding the possible brain areas actually affected becomes complex.

Other types of brain injury considered in this paper will include additional sources of ischemic injury. Specifically I will be discussing my experience with stroke, open heart surgery and birth trauma.

Efficacy of super-pulsed 905 nm Low Level Laser Therapy (LLLT) in the management of Traumatic Brain Injury (TBI): A case study

Ask your doctor exactly how this is provided to patients and where you rent a home version.
http://scholar.google.com/scholar_url?hl=en&q=http://www.scirp.org/journal/PaperDownload.aspx%3FpaperID%3D24793&sa=X&scisig=AAGBfm3CgtJiTfyI7ht8-zY2j32CMf-mIA&oi=scholaralrt
ABSTRACT
Traumatic brain injury is a major health concern worldwide with massive financial and social impact. Conventional treatments primarily focus on the prevention of further damage to the brain parenchyma, while failing to address the already existent symptoms. Previous clinical studies have shown that Low Level Laser Therapy (LLLT) can significantly reduce pain and induce temporary vasodilation in capillaries, which the authors hypothesize can be used to improve the quality of life in TBI patients by treating their current symptoms, which are predominately migraine- like headaches. This case report illustrates the use of LLLT in the treatment of a patient with a TBI and the great clinical success achieved in the reduction of pain, as measured by VAS—achievable within five treatments of 10 minutes in duration.
1. INTRODUCTION
Traumatic brain injury (TBI) typically occurs when there is any sudden trauma to the skull that induces damage to the brain. There are many causes of TBIs, but unfortunately no documented cures. According to Faul et al., the annual incidence of TBI in the United States is approxi- mately 1.7 million incidents, which account for 30.5% of injury related deaths [1]. The direct and indirect costs of TBI totaled an estimated 76.5 billion dollars in the United States in 2000 [2]. Traumatic brain injuries play a major role in the health care of our nation, especially in our armed forces, where the men and women serving our country are at a higher risk to suffer a TBI.
Treatment is centered on preventing future insult to the brain, but very little can be done to treat the already existing symptoms. These symptoms, as described by the National Institutes of Health, range from mild to severe and include: headaches, nausea, vomiting, confusion, and blurry vision. Current theory on alleviating the symp- toms of TBIs is based on reducing inflammatory and oxi- dative stress and increasing perfusion to support meta- bolic needs [3]. A study by Naeser et al. looked at the use of Near Infra Red (NIR) light for the treatment of TBI, stroke, and neurodegenerative disease. Their results were very promising, showing that nightly treatments with NIR LED over a period of months to years improved cognitive abilities [4]. Furthermore, they showed that the use of NIR light increased ATP production, caused vaso- dilation, and improved perfusion. We believe that the superpulsed 905 nm LLLT system employed in this case study operates through similar mechanisms of action and to support our hypothesis we present a case report of a patient with a traumatic brain injury that was treated with the superpulsed 905 nm LLLT system two years after the injury occurred.

A new treatment protocol using photobiomodulation and muscle/bone/joint recovery techniques having a dramatic effect on a stroke patient's recovery: a new weapon for clinicians

You will have to have your doctor explain why this will or will not work for you. I have severe questions about the laser for our rehab.
http://casereports.bmj.com/content/2012/bcr.08.2011.4689.abstract

Summary

The subject of this case study is a 29-year-old woman who suffered a brainstem stroke. She remained severely dizzy, had a non-functional left hand secondary to weakness, severe spasticity in the right hand, a right lateral sixth nerve palsy and was unable to ambulate on presentation. The stroke occurred 2 years before presentation. The subject had been treated for 21 months at two different stroke rehabilitation centres before presentation. Our stroke protocol includes photobiomodulation administered with the XR3T-1 device and ‘muscle/bone/joint/soft tissue’ recovery techniques. The patient was seen once a week for 8 weeks and treatment sessions lasted approximately 60 min. The results were dramatic: after 8 weeks of implementation of our protocol, the patient demonstrated positive change in every area of her deficits as determined by improvements in physical examination findings. The gains achieved at 8 weeks have been maintained to this day and she continues to be treated once every 4 weeks. 

Youtube ad here:

http://www.youtube.com/watch?v=4Pfy30Pyl2g

near-infrared laser energy to treat ischemic stroke

I wonder if thick skulls would prevent the effects. What is the expected action the infrared is supposed to cause?
Whats the working hypothesis? This is it: Scientific Background of PhotoThera

Then there is this for Alzheimers:

Alzheimer's helmet stimulates growth of brain cells
http://www.photothera.com/clinical-trials
PhotoThera, Inc. is a medical device company whose platform technology seeks to employ penetrating near-infrared laser energy to treat a broad range of diseases and health conditions. The company is initially focused on the treatment of ischemic stroke and is engaged in a clinical study to investigate the effect of its Transcranial Laser Therapy (TLT) when used within 24 hours of the onset of stroke symptoms.
The link has the results for NEST-1 and NEST-2  trials
NEST-2 conclusions here:
Conclusions— TLT within 24 hours from stroke onset demonstrated safety but did not meet formal statistical significance for efficacy. However, all predefined analyses showed a favorable trend, consistent with the previous clinical trial (NEST-1). Both studies indicate that mortality and adverse event rates were not adversely affected by TLT. A definitive trial with refined baseline National Institutes of Health Stroke Scale exclusion criteria is planned. (ok, it doesn't do anything positive but it isn't bad for you.)

Clinical Application	Study	Subjects	Study Type	Status
Ischemic Stroke	NeuroThera Effectiveness and Safety Trial-1 (NEST-1)	120	Placebo-controlled, Double Blind, Randomized 2:1	Complete
Ischemic Stroke	NeuroThera Effectiveness and Safety Trial-2 (NEST-2)	660	Placebo-controlled, Double Blind, Randomized 1:1	Complete
Ischemic Stroke	NeuroThera Efficacy and Safety Trial-3 (NEST-3)	1,000	Placebo-controlled, Double Blind, Randomized 1:1	Enrolling

Laser therapy works like 'magic' for Williams Township stroke victim

I wonder what the true reason behind this is. Dual therapies of laser light and muscle recovery make it impossible to tell what really works. Magic does not exist, its just an excuse for not figuring out what is really occurring Earlier was my post of an infrared helmet.
http://oc1dean.blogspot.com/2011/04/alzheimers-helmet-stimulates-growth-of.html
The new 'magic' here;
http://www.lehighvalleylive.com/easton/index.ssf/2012/01/laser_therapy_works_like_magic.html

Dick Kaniper sat tall in his wheelchair. His white tufts of hair were combed and his beard was trimmed close, but his most noticeable feature was his smile.

The 81-year-old stroke survivor from Williams Township looked upon his wife, his certified nursing assistant and therapists with determination, optimism and compassion.

More than a year ago, this picture was different.

His stroke robbed him of mobility, speech and peace of mind. He did not have the attention span for reading, and his short-term memory was spotty. He said he would lie in the hospital bed wondering if he would ever be able to ride his tractor again.

“I have a smart mouth,” he said. “The nurse asked me if I needed anything, and I said, ‘Yes. A gun.’”

After being passed around the rehabilitation center circuit, Kaniper found the ATA Revitalization Institute in Palmer Township that employs experimental therapy with lasers and light-emitting diodes.

“I saw noticeable change in a week,” said his wife, Dawn Kaniper. “I’ve seen more progress in three months than I saw the entire year after Dick’s stroke.”

The technology has been used on surgical patients and athletes for muscle and tissue healing but has never before been used on the brain, according to Easton Hospital cardiothoracic surgeon Ab Boonswang, a co-founder of the institute.

Kaniper said the procedure is painless. The laser technology is paired with muscle/bone/joint/soft tissue therapy called muscle recovery. Muscle recovery ensures that the muscles are strong enough, realigned with nerves and they will be able to move correctly.

Kaniper received treatment three times a week for the past three months. He spends an hour at ATA during each session and also seeks additional physical therapy.

When he started physical therapy, he “hung like meat” from a harness attached to a treadmill, Dawn Kaniper said. Now he can stand on the treadmill, and last week he was able to walk for eight and a half minutes, she said.

“This is the first time I’ve seen so much progress in a stroke patient,” certified nursing assistant Naomi Monjes said. “He can get up on his own. … I don’t have to do bear hug transfers anymore.”

The droop on the left side of Kaniper’s face has disappeared and his speech has dramatically improved.

ATA employs its rehabilitation techniques on four stroke patients. All have improved, Boonswang said.

Low-level light therapy is FDA approved but not for stroke rehabilitation purposes. As a result, ATA does not accept insurance. A three-month stroke rehabilitation protocol costs about $5,800, but ATA offers a money-back guarantee.

“If we can get this going, maybe we can effect change,” Boonswang said. “We can revolutionize the way physical therapy is done. We’re looking at changing the landscape of stroke patient recovery.”

Dawn Kaniper is thrilled with her husband’s progress.

“Whatever it is, it’s magic and it works,” she said.

Photobiomodulation May Encourage Stroke Rehabilitation

I don't trust this one yet, not enough information.
http://www.rehabpub.com/news/2011-12-06_01.asp
An experimental therapy that utilizes laser and light-emitting diode (LED) light may have implications for stroke treatment. The experimental therapy was recently conducted at the ATA Revitalization Institute, based in Easton, Pa.

Ab Boonswang, MD, co-founder of ATA and cardio-thoracic surgeon at Easton Hospital, reports that he is enthusiastic about the potential for low-light therapy, also known as photobiomodulation, on stroke patients. Boonswang spotlights the therapy’s benefits based on several stroke patients of his that have undergone treatment and regained speech as well as physical function.(But was this spontaneous recovery that would have occurred anyway?)

The therapy is “virtually unknown,” according to Paul A. Lapchak, PhD, director of translational research at Cedars-Sinai Medical Center in Los Angeles, Calif. Lapchak and other researchers say that the process may involve the absorption of light into the mitochondria, stimulating cells to regenerate. The theory for stroke patients, researchers explain, is that the new cells stimulated by light can heal areas of the brain damaged by the stroke.

Margaret Naeser, PhD, VA Boston Healthcare System, Mass, reports that she has studied and used laser and LED light on acupuncture points. Naeser adds that while everyone is optimistic about the treatment, lasers are not a substitute for other forms of therapy for stroke victims.

“Patients would make more progress if they had alongside those therapies . . .acupuncture or laser therapy,” Naeser says.

Boonswang adds that although there is not yet a full understanding of how light therapy works, research and progress should not be sidelined simply because, “We don’t know everything. No physician . . .knows every minute detail of every little thing we do,” Boonswang says.

Patients at ATA currently pay out of pocket for the treatment, as it is also considered experimental by insurers. Initial visits are $160; subsequent visits can run up to $80, $90, or $110 depending upon frequency of treatment.

Canadian, Australian studies earn top honours at Stroke Congress

Good news from the stroke congress. You'll notice none is from the US. I do wish someone would put together a protocol for what normally happens in stroke recovery.

Canadian, Australian studies earn top honours at Stroke Congress

Two standout studies - one using laser beams to measure brain recovery after stroke and another proving the benefits of specially trained stroke teams in hospitals -- received top honours at the 2011 Canadian Stroke Congress.
University of British Columbia researcher Thomas Harrison, PhD, won the co-chairs' Innovation Award for research using laser light to map the brains of mice after stroke and to track recovery. Dr. Harrison and a UBC research team employed lasers to measure improvements in limb movement by focusing light pulses on the area of the brain responsible for motor control.
"One major advantage of this technique is that it is painless and can be performed repeatedly over hours, weeks and months; this has never been possible before," Dr. Harrison says. "Repeating this experiment many times before and after stroke in the same mouse allows us to monitor the process of reorganization that occurs as the brain responds to injury."
The study is still under way, but Dr. Harrison says research has already provided evidence of the brain's ability to rewire itself after stroke. "In the future, we hope to use this method to identify therapies or methods of rehabilitation that can optimize this spontaneous recovery process."
Dale Corbett, PhD, Congress Co-chair and Scientific Director of the Heart and Stroke Foundation Centre for Stroke Recovery, said the Innovation Award "highlights a study that brings a completely new approach to an important research problem with the potential for addressing questions that previously could not be investigated."
A group of researchers from Australia led by Professor Sandy Middleton, RN PhD, from Australian Catholic University and St Vincent's & Mater Health Sydney won the co-chairs' Impact Award this year for their study of team-based stroke treatment on stroke recovery.
Researchers gathered information on nearly 1,700 patients from 19 stroke units across Australia. Staff from 10 stroke units participated in team-building workshops and a staff education program to implement protocols for the management of fever, high blood sugar levels and swallowing difficulties, while staff at the other nine stroke units only received a copy of the Australian stroke care guidelines.
The study found patients treated in stroke units where staff implemented the protocols to manage fever, sugar and swallowing were healthier and 16-per-cent less likely to die or to be dependent three months after their stroke than those who weren't treated using these protocols.
"These results provide compelling evidence on how to change clinicians' behaviour and also evidence for effective team work and, in particular, good nursing care." Professor Middleton says. "This positive effect is larger than any current drug or treatment for stroke including clot busting therapy and, unlike some drugs and stroke treatments, has relevance for all people with stroke." says Professor Middleton.
Published online this week in The Lancet, the Study showed that patients who received care in stroke units using these protocols also were more likely to have fewer episodes of fever, lower mean temperatures, lower mean glucose levels and better swallowing screening practices.
The Impact Award goes to the study most likely to directly impact stroke care, says Dr. Andrew Demchuk, Congress Co-chair and Director of the Calgary Stroke Program. "More Canadians who suffer stroke need to be admitted to stroke units with comprehensive approaches to staff education, multidisciplinary teams and treatment protocols," Dr. Demchuk says. "This study proves it."
The Canadian Stroke Network's 2011 report on The Quality of Stroke Care in Canada indicates only 23 per cent of stroke patients in Canada are treated in a stroke unit, compared to 58 per cent of patients in Australia and 74 per cent in the U.K. The report calls for greater access to stroke-unit care and specially trained stroke teams.
The award-winning studies were selected from more than 200 research submissions from around the world.
Every year, there are 50,000 strokes in Canada and another 315,000 people live with the after-effects of stroke.

The Canadian Stroke Network (canadianstrokenetwork.ca) is a national research network headquartered at the University of Ottawa. It includes scientists, clinicians and health-policy experts committed to reducing the impact of stroke.

The Heart and Stroke Foundation (heartandstroke.ca), a volunteer-based health charity, leads in eliminating heart disease and stroke and reducing their impact through the advancement of research and its application, the promotion of healthy living, and advocacy.
Congress information and media registration is at www.strokecongress.ca