Hospital bosses support changes to stroke services 'in principle' - Coventry and Warwickshire

What a fucking waste. Talking about 'care' not results. No wonder stroke survivors  never get  better stroke protocols. No one  is working to better stroke rehabilitation. 
https://stratfordobserver.co.uk/news/hospital-bosses-support-changes-to-stroke-services-in-principle/

HOSPITAL bosses have spoken out in support of stroke services which will see all specialist beds removed from Warwick Hospital.
The first stage of the Coventry and Warwickshire Sustainability and Transformation Plan (STP) – which covers NHS spending over the next five years in a bid to save £267million – has seen proposals to cut all 12 specialist stroke beds at the Lakin Road hospital, and remove treatment facilities for those at risk of mini-strokes.
George Eliot Hospital in Nuneaton would have some beds turned into rehab beds but lose acute beds, as would Rugby St Cross.
All patients from across Warwickshire will instead be taken to University Hospital Coventry (UHCW), where an extra six ‘hyper-acute’ care beds are being made available for those who have just suffered a stroke – taking the total beds up to 12.
Glen Burley, the chief executive of South Warwickshire Foundation Trust – which runs Warwick Hospital – says the trust ‘supports the plans in principle’ as they were devised before the STP and follow national guidelines.
He also believes it will improve care at home which is being focused on in the STP plans.
Mr Burley said: “This is not a savings initiative. While the costing of the model is still being worked on, the expectation is that the model is likely to be more expensive overall, at least initially.
“Historically home rehabilitation capacity has been poor locally and we have been keen for some time to address this. The model will see an investment in an ‘early supported discharge’ service. As a result of the current imbalance, patients spend longer than they should in hospital and consequently have worse outcomes.
“The most positive thing for Warwickshire is the investment in community rehabilitation and the recognition in South Warwickshire that Leamington Hospital should be maintained and strengthened as the inpatient rehabilitation facility for South Warwickshire, Coventry and Rugby.”
Rehabilitation beds will be provided at Leamington Hospital, which will lose one bed taking its total to 19, and George Eliot Hospital will also have 20 beds. These would both cater for patients from across Warwickshire.
The result of the STP would see most care delivered in the community and bosses plan to focus more on stroke prevention for those at risk.

Inhibition of prolyl hydroxylases by dimethyloxaloylglycine after stroke reduces ischemic brain injury and requires hypoxia inducible factor-1α

Only 5.5 years old and I bet not one thing has been done to get this into a stroke protocol. No one cares about helping stroke survivors, certainly not the ASA, NSA or the WSO. You are completely on your own, start saving your money to hire your own researchers. Your children and grandchildren will need it.
http://www.sciencedirect.com/science/article/pii/S0969996111003524

Department of Anesthesiology, Emory University, Atlanta, GA 30322, USA

https://doi.org/10.1016/j.nbd.2011.10.020Get rights and content

Abstract

Pathological oxygen deprivation inhibits prolyl hydroxylase (PHD) activity and stimulates a protective cellular oxygen-sensing response in part through the stabilization and activation of the Hypoxia Inducible Factor (HIF) 1α transcription factor. The present investigation tested the therapeutic potential of enhanced activation of oxygen-sensing pathways by competitive pharmacologic PHD inhibition after stroke, hypothesizing that post-ischemic PHD inhibition would reduce neuronal cell death and require the activation of HIF-1α. The PHD inhibitor dimethyloxaloylglycine (DMOG, 100 μM) reduced cell death by oxygen glucose deprivation (OGD), an in vitro model of ischemia, and the protection required HIF-1α. In vivo, DMOG (50 mg/kg, i.p.) administered 30 or 60 min after distal occlusion of the middle cerebral artery (MCA) in mice enhanced the activation of HIF-1α protein, enhanced transcription of the HIF-regulated genes vascular endothelial growth factor, erythropoietin, endothelial nitric oxide synthase, and pyruvate dehydrogenase kinase-1, reduced ischemic infarct volume and activation of the pro-apoptotic caspase-3 protein, reduced behavioral deficits after stroke, and reduced the loss of local blood flow in the MCA territory after stroke. Inhibition of HIF-1α in vivo by Digoxin or Acriflavine abrogated the infarct sparing properties of DMOG. These data suggest that supplemental activation of oxygen-sensing pathways after stroke may provide a clinically applicable intervention for the promotion of neurovascular cell survival after ischemia.

Highlights

► PHD inhibition by DMOG after stroke reduces ischemic damage. ► Post-ischemic DMOG enhances peri-infarct HIF-1α expression. ► Neuroprotection by DMOG in vivo requires HIF-1α activity.

Keywords

Focal cerebral ischemia

Hypoxia inducible factor

Prolyl hydroxylase

preconditioning

Postconditioning

Dimethyloxaloylglycine

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Copyright © 2011 Elsevier Inc. All rights reserved.