Immediate Statin After Acute Stroke Reduces Disability

This is extremely old news but I bet your incompetent hospital did nothing with it in the intervening 13 years. 

Statins tested in humans, March, 2011

http://www.medwirenews.com/39/91658/Stroke/Acute_statin_therapy_improves_survival_after_ischemic_stroke.html

And now lost even to the Wayback Machine

So I think this below is the actual research;

Association Between Acute Statin Therapy, Survival, and Improved Functional Outcome After Ischemic Stroke April 2011

 

Ask them why they are so fucking incompetent. I take no prisoners in assigning responsibility for the complete failure of the stroke medical world.  

Immediate Statin After Acute Stroke Reduces Disability

MUNICH — Giving intensive statin therapy to patients with acute mild ischemic stroke or with high-risk for transient ischemic attack (TIA) immediately after onset significantly reduces the risk for a poor functional outcome compared with delaying treatment, without compromising safety, results of the INSPIRES trial show.

The research, presented at the 9th European Stroke Organisation Conference (ESOC) on May 26, also showed that intensive antiplatelet therapy reduced the risk for recurrent stroke albeit at an increased in bleeding risk vs standard treatment.

The study involved more than 6000 patients with acute mild ischemic stroke or TIA and intracranial or extracranial atherosclerosis (ICAS/ECAS), who were randomly assigned in a 2 x 2 factorial design to compare intensive vs standard antiplatelet therapy and intensive statin therapy within 24 hours vs waiting up to 72 hours after onset.

Intensive antiplatelet therapy with clopidogrel plus aspirin reduced the risk for recurrent stroke within 90 days by 21% vs standard single-agent therapy, although it also doubled the risk for moderate to severe bleeding.

Starting intensive statin therapy with atorvastatin within 24 hours of onset had no impact on recurrent stroke risk but did reduce the risk for a poor functional outcome vs waiting up to 72 hours by 16%.

Moreover, it was "safe, with no increased risk of bleeding, hepatotoxicity, or muscle toxicity," said study presenter Yilong Wang, MD, Department of Neurology, Beijing Tiantan Hospital, National Clinical Research Center, Beijing, China.

There was, however, a suggestion of an interaction between intensive antiplatelet therapy and immediate intensive statin therapy, he noted, with a trend toward increased bleeding vs delaying the start of statin therapy.

Approached for comment, session co-chair Carlos Molina, MD, director of the Stroke Unit and Brain Hemodynamics in Hospital Universitari Vall d'Hebron, Barcelona. Spain, said that the study is "important because when we look at studies of minor stroke and TIA, they are just focused on long-term outcomes in terms of recurrent stroke."

Recurrence and Progression

Wang began by highlighting that acute mild stroke and high-risk TIA are common and underestimated, with a relatively high risk for recurrence and progression, often due to ICAS/ECAS.

Numerous guidelines recommend intensive antiplatelet therapy in the first 24 hours after the event, but Wang pointed out that there is little evidence to support this, and a meta-analysis suggested the window for effective treatment may be up to 72 hours.

In addition, intense statin therapy appears to be beneficial for the secondary prevention of atherosclerotic stroke in the nonacute phase, although there is no evidence for any neuroprotective effects in the acute phase nor for the optimal timing of starting the drugs.

Wang also noted that there is the potential for an interaction between intensive antiplatelet and statin therapy that could increase the risk for bleeding.

To investigate further, the researchers conducted a multicenter study involving patients aged 35-80 years with acute ischemic stroke or TIA.

The former was defined as an acute single infarction with 50% or greater stenosis of a major intracranial or extracranial artery that "probably account for the infarction and symptoms," or multiple infarctions of large artery origin, including non-stenotic vulnerable plaques.

Patients were required to have a National Institutes of Health Stroke Scale score of 4-5 24 hours or less from acute stoke onset or 0-5 between 24 and 72 hours of onset.

TIA was defined as 50% or more stenosis of major intracranial or extracranial arteries that probably account for the symptoms, and an ABCD² score for stroke risk of 4 or more within 24-72 hours of onset.

Patients were excluded if they had received dual antiplatelet therapy with aspirin and clopidogrel or high-intensity statin therapy within 14 days of random assignment or had intravenous thrombolysis or endovascular therapy after acute stroke or TIA onset.

Those included in the trial were randomly assigned in a 2 x 2 factorial design to receive:

• Intensive or dual antiplatelet therapy with clopidogrel and aspirin plus immediate high-intensity statin therapy with atorvastatin

• Intensive antiplatelet therapy plus delayed high-intensity statin therapy

• Standard antiplatelet therapy with aspirin alone plus immediate high-intensity statin therapy

• Standard antiplatelet therapy plus delayed high-intensity statin therapy

In all, 6100 patients were enrolled from 222 hospitals in 99 cities across 25 provinces in China. The mean age was 65 years, and 34.6%-37.0% were women. TIA was recorded in 12.2%-14.1% of patients; 19.5%-19.7% had a single acute infarction, and 66.4%-68.1% had acute multiple infarctions.

The time to randomization was 24 hours or less after event onset in 12.5%-13.2% of cases vs 24-48 hours in 41.2%-42.5% and 48 hours or more in 44.9%-45.7% of patients.

The primary efficacy outcome, defined as stroke at 90 days, was significantly less common with intensive vs standard antiplatelet therapy, at a cumulative probability of 9.2% vs 7.3%, or a hazard ratio of 0.79 (95% CI, 0.66-0.94; P = .007).

Clopidogrel plus aspirin was also associated with a significant reduction in a composite vascular event of stroke, myocardial infarction, or vascular death vs aspirin alone, at 7.5% vs 9.3%, or a hazard ratio of 0.80 (95% CI, 0.67-0.95, P = .01), as well as a reduction in rates of ischemic stroke (P = .002), and TIA (P = .02).

The primary safety outcome, defined as moderate to severe bleeding on the GUSTO criteria, was increased with intensive antiplatelet therapy, at 0.9% vs 0.4% for aspirin alone, with a hazard ratio of 2.08 (95% CI, 1.07-4.03; P = .02).

Turning to statin use, Wang showed that there was no significant difference in rates of stroke at 90 days between delayed and immediate intensive therapy, at a cumulative probability of 8.4% vs 8.1%, or a hazard ratio of 0.95 (P = .58).

There was also no difference in rates of moderate to severe bleeding, at 0.8% with immediate vs 0.6% for delayed intensive statin therapy, or a hazard ratio of 1.36 (95% CI, 0.73-2.54; P = .34).

Wang reported that there were no significant differences in key secondary efficacy and safety outcomes.

Analysis of the distribution of modified Rankin Scale scores at 90 days, however, indicated that there was a significant reduction in the risk for poor functional outcome, defined as a score of 2-6, with immediate vs delayed statin therapy, at an odds ratio of 0.84 (95% CI, 0.72-0.99; P = .04).

Finally, it was found that combining dual antiplatelet therapy with immediate intensive statin therapy was associated with an increase in moderate to severe bleeding vs delayed statin therapy, affecting 1.1% vs 0.7% of patients. The association nonetheless did not reach statistical significance, at a hazard ratio of 1.70 (95% CI, 0.78-3.71; P = .18).

The study was funded by the National Natural Science Foundation of China, the National Key R&D Program of China, the Beijing Outstanding Young Scientist Program, the Beijing Youth Scholar Program, and the Beijing Talent Project. The drug was provided by Sanofi and Jialin Pharmaceutical. No relevant financial relationships declared.

9th European Stroke Organisation Conference (ESOC) 2023. Presented May 26, 2023. Abstract 3116

 

 

Night Owls’ Lifespan Less Linked to Sleep Patterns, More to Lifestyle Choices

I'm definitely a night owl, may not get to bed until 2-3 in the morning, pumping out more blog posts. Don't smoke and since they didn't mention any factual basis on alcohol use, this amounts to useless information.

Night Owls’ Lifespan Less Linked to Sleep Patterns, More to Lifestyle Choices

Summary: Recent research refutes the idea that ‘night owls’ face a shorter lifespan due to their late-night tendencies, emphasizing lifestyle factors like smoking and drinking as the more significant contributors.

The study involved almost 23,000 twins from Finland, tracked over a period of 37 years. It found that while evening types have a slightly increased risk of mortality, it is more attributable to unhealthy habits than sleep patterns.

The researchers highlight the importance of considering lifestyle when examining health impacts related to chronotype – the body’s natural sleep rhythm.

Key Facts:

1. At the start of the study, participants were asked to identify themselves as ‘definitely’ or ‘to some extent’ either a morning or an evening person. This was to establish their chronotype or natural sleep pattern.
2. The study revealed that ‘definite evening types’ were less likely to report getting a full 8 hours of sleep, indicating that they had shorter average sleep durations.
3. It was found that the marginally increased mortality risk for evening types was majorly linked to lifestyle choices like smoking and alcohol consumption.

Source: Taylor and Francis Group

Staying up late at night has little impact on how long ‘night owls’ live, according to new research published in the peer-reviewed journal Chronobiology International.

Data based on nearly 23,000 twins, however shows that evening types have a slightly increased risk of dying than morning types, but this is largely linked to smoking and drinking.

The study which tracked people over the course of more than 37 years in Finland suggests that lifestyle should be considered.

This is when analyzing the impact on health of chronotype – the body’s natural inclination to sleep at a certain time. Credit: Neuroscience News

This is when analyzing the impact on health of chronotype – the body’s natural inclination to sleep at a certain time.

Managing stress and eating leafy vegetables may protect the brain

Your doctors are responsible for solving both of these post stroke. You are under massive stress because your doctor has nothing to get you 100% recovered. Has your doctor had the dietician create diet protocols for you? For all these needs?

For dementia prevention; for cognitive improvement; for cholesterol reduction; for plaque removal; for Parkinsons prevention; for inflammation reduction; etc.

I'd be willing to bet your doctor has completely failed at both these points. Why are you seeing and paying them? 

Managing stress and eating leafy vegetables may protect the brain

By Matthew Solan, Executive Editor, Harvard Men's Health Watch

• Reviewed by Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing

Scientists continue to examine what causes people's brain health to decline. While natural aging and genetics are part of the equation, lifestyle factors can play a significant role. Two recent studies further explored this connection by looking at how stress and diet might affect cognitive function and protect against Alzheimer's disease.

One study found that perceived stress — the degree of stress people feel about their life — was linked to poor cognitive health among older adults. Researchers recruited more than 24,000 people (average age 64). They measured stress and cognitive function with the Perceived Stress Scale and the Mini-Mental State Examination. The results showed that people who scored highest on the stress level scale were more likely to have low cognitive test scores. The reverse was also true — lower stress levels went hand in hand with higher test scores. The results were published online March 7, 2023, by JAMA Network Open.

In another study, published online March 8, 2023, by Neurology, researchers explored whether certain dietary habits may lower the risk of Alzheimer's. The researchers analyzed data on 581 people from the Rush Memory and Aging Project cohort, a prospective study of older adults who agreed to undergo annual evaluations and to donate their brain at death. Participants reported on their dietary habits and completed annual food questionnaires.

Protect yourself from the damage of chronic inflammation.

 

 

 

 

 

 

 

 

Science has proven that chronic, low-grade inflammation can turn into a silent killer that contributes to cardiovas­cular disease, cancer, type 2 diabetes and other conditions. Get simple tips to fight inflammation and stay healthy -- from Harvard Medical School experts.

Learn More

View Protect yourself from the damage of chronic inflammation.

The researchers found that people who regularly followed plant-based diets had lower amounts of beta-amyloid buildup in their brains, a marker for Alzheimer's. Among this group, people with the highest intake of green leafy vegetables — seven or more weekly servings — had less buildup than those who ate only one or two servings a week.

Image: © Daniel de la Hoz/Getty Images

About the Author

Matthew Solan, Executive Editor, Harvard Men's Health Watch

Matthew Solan is the executive editor of Harvard Men’s Health Watch. He previously served as executive editor for UCLA Health’s Healthy Years and as a contributor to Duke Medicine’s Health News and Weill Cornell Medical College’s … See Full Bio

Drinking alcohol weekly could be connected to 61 different diseases, study finds

What about this?

Men must drink with male friends twice a week to stay healthy, study finds

 Do not bring this to your doctor's attention, you don't want to be responsible for an exploding head.

Light Alcohol Consumption Promotes Early Neurogenesis Following Ischemic Stroke in Adult C57BL/6J Mice 

And this for the opposite of what your doctor will say:

 Increased risk for all-cause dementia in people who abstain from alcohol

There is this line in one of my research findings:

Light-to-moderate alcohol consumption is associated with a decreased risk of ischemic stroke.

Don't listen to me, I'm not medically trained, is your doctor up-to-date on all things stroke related?

The latest here:

Drinking alcohol weekly could be connected to 61 different diseases, study finds

Alcohol use flagged as important risk factor: 'The more you drink, the higher the disease risk'

By Melissa Rudy | Fox News

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Youth-aimed messaging on alcohol and marijuana is ‘destroying this generation’: Dr. Daniel Amen

Psychiatrist Dr. Daniel Amen joined ‘Fox & Friends Weekend’ to break down the impact alcohol, marijuana and vaping can have on teenagers’ mental and physical health.

Alcohol use has been linked to 61 different diseases, most of which had not been identified as having drinking-related outcomes by the World Health Organization (WHO), according to a new study. 

Beyond the more widely known conditions — such as liver cirrhosis, stroke and gastric cancers — a new study identified links to diseases including gout, cataracts, ulcers and some fractures, according to a press release announcing the findings.

Researchers from the University of Oxford in England and Peking University in Beijing analyzed self-reported data from more than 512,000 adults in China related to 207 total diseases.

DRINKING A LITTLE ALCOHOL EVERY DAY WON’T HELP YOU LIVE LONGER, SAYS NEW STUDY

Really? What about this?

Alcohol intake may lower stress-related brain activity, helping the heart

One third of the men and just 2% of the women said they drank alcohol regularly (at least once a week). 

Among the men, researchers looked at 12 years of hospital records, as well as genetic information, to determine whether alcohol consumption was linked to any of the diseases they developed.

Alcohol use has been linked to 61 different diseases, most of which had not previously been flagged by the World Health Organization, a new study has found. (iStock)

Higher amounts of consumption correlated to a higher risk of disease and hospitalization, according to the study, published in the journal Nature Medicine on June 8.

For every four drinks per day, the risk of alcohol-related diseases increased by 14%, while it rose 6% for diseases that hadn’t been previously linked to alcohol.

"Alcohol drinking adversely affects a wide range of diseases, more than what we previously knew," said lead author Dr. Pek Kei Im, an intermediate research fellow at Oxford Population Health, in a statement to Fox News Digital. 

TEENAGE BINGE-DRINKING: WHY IT’S SO DANGEROUS FOR YOUNG PEOPLE TO OVERINDULGE IN ALCOHOL

"Furthermore, the association of alcohol consumption with the overall risk of these diseases is likely to be causal in a dose-response manner (i.e., the more you drink, the higher disease risk), and our findings do not support the belief that there are health benefits of moderate drinking."

"Harmful use of alcohol is one of the most important risk factors for debilitating health."

Consumption of alcohol causes more than 140,000 deaths in the U.S., per the Centers for Disease Control and Prevention, and three million worldwide each year, according to WHO.

Alcohol use has been on the rise in China in recent decades, increasing from 59% to 85% between 1990 and 2017, the study findings stated.

"Based on this research, it’s clear that the harmful use of alcohol is one of the most important risk factors for debilitating health throughout the world," said one medical expert. "Such evidence warrants a wider scope of education, prevention and treatment." (iStock)

Dr. Chris Tuell, clinical director of addiction services at the Lindner Center of HOPE at the University of Cincinnati College of Medicine, was not involved in the new research but reviewed the results of the study and found them to be "significant." 

"With over 512,000 participants, data from such a study should be taken with notice," he told Fox News Digital. 

"Based on this research, it’s clear that the harmful use of alcohol is one of the most important risk factors for debilitating health throughout the world. Such evidence warrants a wider scope of education, prevention and treatment."

Limitations and caveats

The study did have some limitations, Im noted.

"There are some diseases [for] which we were unable to investigate their relationships with alcohol because few of them were recorded in our study context, such as dementia," she explained. 

THESE ARE THE WORST DRINKS FOR YOUR HEALTH, ACCORDING TO NUTRITIONISTS

Further investigation is also needed to confirm whether alcohol is a cause of some of the other newly identified alcohol-associated diseases, Im added. 

"Also, since our study participants predominantly consumed spirits, we could not investigate the effects of specific alcohol types, such as red wine," she said. 

"We really can’t know our true risk for any disease," said one medical expert. "That’s why we need to encourage everyone and reinforce the idea that less is healthier when it comes to our health and alcohol." (iStock)

Additionally, the study showed that genetics plays a significant role in how alcohol consumption can increase the risk for specific diseases, noted Dr. Adam D. Scioli, medical director and head of psychiatry at Caron Treatment Centers in Pennsylvania. He was not involved in the new study.

"This means we really can’t know our true risk for any disease," he told Fox News Digital. "That’s why we need to encourage everyone and reinforce the idea that less is healthier when it comes to our health and alcohol."

Puja Darbari, managing director of the International Alliance for Responsible Drinking in London, also reviewed the study findings and provided feedback to Fox News.

"For most adults, any risk posed by the moderate consumption of alcohol is low; everyone should avoid drinking to excess."

"The study has a significant limitation, as it does not differentiate between light or moderate drinking and heavy drinkers and doesn’t include a comparison with abstainers," she said.

Higher amounts of alcohol consumption correlated to a higher risk of disease and hospitalization, according to the study. (iStock)

"In further analyses, the author’s own findings support the hundreds of peer-reviewed studies since the 1970s reporting that light and moderate drinkers tend to live at least as long as non-drinkers, and generally live longer than those who drink heavily," Darbari continued.

Assessing real-world gait with digital technology? Validation, insights and recommendations from the Mobilise-D consortium

If your doctors and therapists don't objectively know what is wrong with your gait they have no idea how to correct it. So objectively how incompetent are your stroke medical 'professionals'?

Assessing real-world gait with digital technology? Validation, insights and recommendations from the Mobilise-D consortium

• M. Encarna Micó-Amigo,
• Tecla Bonci,
• Anisoara Paraschiv-Ionescu,
• Martin Ullrich,
• Cameron Kirk,
• Abolfazl Soltani,
• Arne Küderle,
• Eran Gazit,
• Francesca Salis,
• Lisa Alcock,
• Kamiar Aminian,
• Clemens Becker,
• Stefano Bertuletti,
• Philip Brown,
• Ellen Buckley,
• Alma Cantu,
• Anne-Elie Carsin,
• Marco Caruso,
• Brian Caulfield,
• Andrea Cereatti,
• Lorenzo Chiari,
• Ilaria D’Ascanio,
• Bjoern Eskofier,
• Sara Fernstad,
• for the Mobilise-D consortium

Journal of NeuroEngineering and Rehabilitation volume 20, Article number: 78 (2023) Cite this article

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Abstract

Background

Although digital mobility outcomes (DMOs) can be readily calculated from real-world data collected with wearable devices and ad-hoc algorithms, technical validation is still required. The aim of this paper is to comparatively assess and validate DMOs estimated using real-world gait data from six different cohorts, focusing on gait sequence detection, foot initial contact detection (ICD), cadence (CAD) and stride length (SL) estimates.

Methods

Twenty healthy older adults, 20 people with Parkinson’s disease, 20 with multiple sclerosis, 19 with proximal femoral fracture, 17 with chronic obstructive pulmonary disease and 12 with congestive heart failure were monitored for 2.5 h in the real-world, using a single wearable device worn on the lower back. A reference system combining inertial modules with distance sensors and pressure insoles was used for comparison of DMOs from the single wearable device. We assessed and validated three algorithms for gait sequence detection, four for ICD, three for CAD and four for SL by concurrently comparing their performances (e.g., accuracy, specificity, sensitivity, absolute and relative errors). Additionally, the effects of walking bout (WB) speed and duration on algorithm performance were investigated.

Results

We identified two cohort-specific top performing algorithms for gait sequence detection and CAD, and a single best for ICD and SL. Best gait sequence detection algorithms showed good performances (sensitivity > 0.73, positive predictive values > 0.75, specificity > 0.95, accuracy > 0.94). ICD and CAD algorithms presented excellent results, with sensitivity > 0.79, positive predictive values > 0.89 and relative errors < 11% for ICD and < 8.5% for CAD. The best identified SL algorithm showed lower performances than other DMOs (absolute error < 0.21 m). Lower performances across all DMOs were found for the cohort with most severe gait impairments (proximal femoral fracture).

Algorithms’ performances were lower for short walking bouts; slower gait speeds (< 0.5 m/s) resulted in reduced performance of the CAD and SL algorithms.

Conclusions

Overall, the identified algorithms enabled a robust estimation of key DMOs. Our findings showed that the choice of algorithm for estimation of gait sequence detection and CAD should be cohort-specific (e.g., slow walkers and with gait impairments). Short walking bout length and slow walking speed worsened algorithms’ performances.

Trial registration ISRCTN – 12246987.

Alcohol intake may lower stress-related brain activity, helping the heart

This is absolutely not possible according to this earlier research: 

Here is what your doctor will use, no thinking required:

Safest level of alcohol consumption is none, worldwide study shows

The latest here:

Alcohol intake may lower stress-related brain activity, helping the heart

Key takeaways:

• Light to moderate alcohol consumption associates with significant reductions in major adverse CV event risk, mediated by neural activity.
• The researchers said there is no safe amount of alcohol consumption.(This contradicts your title, what is the correct option?)
  

Compared with no or little alcohol intake, consuming one to 14 drinks per week is associated with lower risk for major adverse CV events, likely due to an alcohol-mediated reduction in stress-associated brain activity, researchers reported.

In an analysis of biobank and brain imaging data that included more than 50,000 participants, researchers also said there is no recommended “safe” amount of alcohol consumption and that any risks outweigh a possible heart benefit. The findings, published in the Journal of the American College of Cardiology, were first presented at the 2021 American College of Cardiology Scientific Session and reported by Healio.

Light to moderate alcohol consumption associates with significant reductions in major adverse CV event risk, mediated by neural activity.
Image: Adobe Stock

“We have known that alcohol has been associated with a reduction in CVD, at least at light to moderate consumption,” Ahmed Tawakol, MD, director of nuclear cardiology and co-director of the Cardiovascular Imaging Research Center at Massachusetts General Hospital, told Healio. “There has been a question as to the mechanism and as to whether those potential effects persist after adjustment for confounders. We also recognize that alcohol acutely reduces stress. We wanted to know: Could alcohol impact the stress systems chronically, and if so, could that be a mechanism by which it might reduce CVD risk?”

Assessing alcohol intake, brain imaging data

Ahmed Tawakol

For the analysis of the relationship between alcohol consumption and major adverse CV events, the researchers included 53,064 participants from the Mass General Brigham Biobank, established in 2010, who completed an optional health survey with information on alcohol consumption during the year before enrollment. The median age of participants was 60 years and 60% were women. Researchers classified alcohol consumption for both men and women as non/minimal, defined as less than one drink per week; light/moderate, defined as one to 14 drinks per week; and high, defined as more than 14 drinks per week.

For the analysis of the effect of stress neurobiology, the researchers included 713 participants who underwent 18F-fluorodeoxyglucose PET/CT brain imaging to assess the balance between pro-stress and regulatory signals.

Within the cohort, 23,920 were minimal drinkers; 27,053 were light/moderate drinkers and 2,091 participants were heavy drinkers. During median follow-up of 3.4 years, 1,914 participants experienced a major adverse CV event.

Compared with no or little alcohol intake (< 1 drink per week), moderate alcohol intake (1-14 drinks per week) was associated with reduced risk for major adverse CV events after adjustment for demographic factors, CVD risk factors, health behaviors, socioeconomic factors and psychological factors (OR = 0.786; 95% CI, 0.717-0.862; P < .0001).

“In this biobank cohort, we were able to adjust for many confounders, including other lifestyle approaches, socioeconomic factors and even genetic factors,” Tawakol said in an interview. “We still saw that there was this substantial relative risk reduction with light to moderate alcohol intake.”

In the imaging cohort, after adjustment for age and sex, moderate alcohol consumption was associated with less stress-associated neural activity compared with little/no or heavy alcohol consumption (standardized beta, –0.192; 95% CI, –0.338 to –0.046; P = .01).

When the researchers conducted a mediation analysis, they demonstrated that stress-associated neural activity significantly mediated the beneficial impact of alcohol on CV clinical events in the cohort.

“As an extension of this finding, we observed that alcohol associates with greater effects on CVD risk reduction among individuals with a history of anxiety in the overall study population,” the researchers wrote. “These findings yield insights into mechanisms by which alcohol may improve major adverse CV event risk and suggest that interventions targeting stress-associated neural networks may improve CVD outcomes.”

Potential adverse effects with drinking

The researchers said despite the findings that light to moderate alcohol consumption may improve CV risk, this benefit must be carefully weighed against its potential adverse impacts on other noncardiac disease processes, such as malignancy, dependence and alcohol abuse.

Compared with little or no alcohol intake, light to moderate drinking was associated with a 23% increased risk for cancer during follow-up, with an HR of 1.23 (95% CI, 1.14-1.33; P < .0001).

“At the same quantities of alcohol that was saw a relative risk reduction in CVD, we saw an increase in cancer,” Tawakol told Healio. “While we identified what might be an important mechanism by which alcohol might introduce benefits for CV health, alcohol’s overall impact on health is not positive. There is no safe quantity of alcohol. What we would like to do is further focus on this pathway of the stress neural networks and identify better approaches that more safely reduce those signals and enhance and improve CV health without the detriments of alcohol.”

Many lifestyle behaviors can have an impact on CV health that is equal to or greater than the benefit observed with light to moderate drinking, Tawakol said. These include exercise, healthy sleep and stress reduction approaches.

“Could we find other therapeutic approaches to modulate those same pathways in a way that leads to CV benefits?” Tawakol said. “More research is needed for that.”

Alcohol ‘moderation is key’

In a related editorial, Giovanni de Gaetano, MD, PhD, from the department of epidemiology and prevention at the IRCCS Istituto Neurologico Mediterraneo Neuromed in Pozzilli, Italy, and colleagues wrote that several studies have observed that moderate alcohol consumption is associated with a lower risk for cognitive decline and dementia, better cognitive function and reduced brain atrophy, suggesting that alcohol may play a protective role in brain function by promoting neural plasticity.

“Although the mechanisms underlying these neuroprotective effects are not fully understood, they may be related to the antioxidant and anti-inflammatory properties of certain compounds found in alcoholic beverages, especially in wine, such as resveratrol and flavonoids,” de Gaetano and colleagues wrote. “These compounds have been shown, in experimental systems, to protect against oxidative stress and inflammation, which can contribute to neuronal damage and cognitive decline. However, it is important to underline that excessive or irregular (binge) alcohol consumption has detrimental effects on brain health and increases the risk of cognitive impairment and dementia. As such, moderation is the key when discussing about alcohol consumption and health.”

References:

• de Gaetano G, et al. J Am Coll Cardiol. 2023;doi:10.1016/j.jacc.2023.04.018.
• Mezue K, et al. Highlighted original research: Prevention and health promotion and the year in review. Presented at: American College of Cardiology Scientific Session; May 15-17, 2021 (virtual meeting).

Measuring Arm and Hand Joint Kinematics to Estimate Impairment During a Functional Reach and Grasp Task after Stroke

This is only useful if the measurements point to EXACT PROTOCOLS THAT DELIVER RECOVERY FROM THIS!  Otherwise this is totally fucking useless! I'd fire everyone involved for incompetence.

Measuring Arm and Hand Joint Kinematics to Estimate Impairment During a Functional Reach and Grasp Task after Stroke

Preeya Khanna, PhD, Tomas Oppenheim, PhD, […], and Karunesh Ganguly, MD, PhD https://orcid.org/0000-0002-2570-9943 karunesh.ganguly@ucsf.edu+2View all authors and affiliations

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https://doi.org/10.1177/15459683231179173

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Abstract

Background

Current approaches to characterizing deficits in upper limb movements after stroke typically focus either on changes in a functional measure, for example, how well a patient can complete a task, or changes in impairment, for example, isolated measurements of joint range of motion. However, there can be notable dissociations between static measures of impairment versus those of function.

Objective

We develop a method to measure upper limb joint angles during performance of a functional task and use measurements to characterize joint impairment in the context of a functional task.

Methods

We developed a sensorized glove that can precisely measure select finger, hand, and arm joints while participants complete a functional reach-to-grasp task involving manipulation of a sensorized object.

Results

We first characterized the accuracy and precision of the glove’s joint angle measurements. We then measured joint angles in neurologically intact participants (n = 4 participants, 8 limbs) to define the expected distribution of joint angle variation during task execution. These distributions were used to normalize finger, hand, and arm joint angles in stroke participants (n = 6) as they performed the task. We present a participant-specific visualization of functional joint angle variance which illustrated that stroke participants with nearly identical clinical scores exhibited unique patterns of joint angle variation.

Conclusions

Overall, measuring individual joint angles in the context of a functional task may inform whether changes in functional scores over recovery or rehabilitation are driven by changes in impairment or the development of compensatory strategies, and provide a quantified path toward personalized rehabilitative therapy.

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Dunklau Gardens to Participate in Post-Acute Care Standards Initiative for Stroke Patients - Fremont, Nebraska

 WRONG, WRONG, WRONG! Survivors don't want 'care you blithering idiots. They want RECOVERY AND RESULTS!  GET THERE!

In my opinion this is an incompetent hospital, you shouldn't go there until they have a plan for 100% recovery.

Dunklau Gardens to Participate in Post-Acute Care Standards Initiative for Stroke Patients

June 14th, 2023 | Methodist Fremont Health

FREMONT – Dunklau Gardens will participate in the American Heart Association’s Mission: Lifeline Stroke Post-Acute Care (PAC) initiative to enhance guideline-based care for stroke patients, ultimately improving and prolonging lives.

Evidence-based rehabilitation and secondary prevention interventions improve recovery after a stroke and reduce secondary complications. However, stroke rehabilitation expertise, processes of care and educational resources vary among sites where PAC is delivered. The American Heart Association, the world’s leading nonprofit organization focused on heart and brain health for all, developed quality standards based on its 2016 Guidelines for Adult Stroke Rehabilitation and Recovery to address these gaps.

“We’re committed to improving patient care by adhering to the latest guidelines,” said Jayma Brown, BSN, RN, MHA, NE-BC, director of long-term care nursing at Dunklau Gardens. “The post-acute care standards initiative makes it easier for our teams to put proven knowledge and guidelines to work on a daily basis, which studies show can help patients recover better. The end goal is to ensure that more people in Dodge County and the surrounding areas can experience longer, healthier lives.”

Facilities participating in the PAC standards initiative receive a participation stipend and site-specific quality improvement support and process improvement ideas surrounding quality standards for stroke recovery, rehabilitation and secondary prevention. Facilities also have the opportunity to be part of a learning collaborative, working with experts in stroke rehabilitation to build tools and share and create best practices. Participation improves collaboration between PAC facilities and others involved in stroke care, including hospitals and outpatient providers.

Participation in the program benefits stroke patients and caregivers with the knowledge that the facility is committed to providing services supported by American Heart Association science. They also have the assurance that the facility is collaborating with the association on standardizing its stoke rehabilitation program in alignment with expert guidance and evidence-based research.

Stroke is the No. 5 cause of death and a leading cause of disability in the U.S. A stroke occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or bursts. When that happens, part of the brain cannot get the blood and oxygen it needs, so brain cells die. Early stroke detection and treatment are key to improving survival, minimizing disability and accelerating recovery times.

Mission: Lifeline Stroke is the American Heart Association’s community-based initiative to develop systems of care to improve outcomes for stroke patients. Made possible with a $1.5 million grant from The Leona M. and Harry B. Helmsley Charitable Trust, the PAC initiative will implement the newly developed American Heart Association Post-Acute Stroke Care Quality Standards program in rehabilitation facilities across Montana, Nebraska and North Dakota. The initiative has a goal of giving all patients the best chance at independent lives after stroke.

This work builds on the Mission: Lifeline Stroke Nebraska initiative launched in 2019. The new initiative is the first to implement the Post-Acute Stroke Care Quality Standards program developed and tested in Montana. Larger rehabilitation hospitals, skilled nursing facilities and critical access hospitals in rural and urban areas are eligible to participate.

Study reveals elevated risk of ischemic stroke in women and men with migraine headaches

Wasn't this already proven in September 2017? 

Migraine with aura – but not without – increases risk of stroke  Sept. 2017

And your doctor has you on a migraine prevention protocol? Is sex your doctor's answer?

I think by age 31 my migranes stopped  when I quit being a manager. Never did have them with aura.  If this is you you will need to demand dementia prevention protocols from your doctor. Does your doctor know about the sex link below?

From another piece of research, you might want to have sex.

34% of the patients had experience with sexual activity during an attack; out of these patients, 60% reported an improvement of their migraine attack (70% of them reported moderate to complete relief) and 33% reported worsening.

Dementia Linked to Previous Migraine History

Midlife migraine diagnosis boosted dementia rate by 50%, Danish study shows

 

Study reveals elevated risk of ischemic stroke in women and men with migraine headaches

Women and men who experience migraine headaches also carry an elevated risk of having an ischemic stroke, but women alone may carry an additional risk of heart attack and hemorrhagic stroke, according to a new study led by Cecilia Hvitfeldt Fuglsang of Aarhus University, Denmark publishing June 13^th in the open access journal PLOS Medicine.

People diagnosed with migraine are believed to have a higher risk of experiencing a heart attack or stroke before the age of 60. Previous studies have suggested that the increased risk of ischemic stroke – when a blood clot blocks a blood vessel to the brain – mostly affects young women. It was unclear whether women with migraine also carry a higher risk of heart attack and hemorrhagic stroke – when an artery in the brain bursts – compared to men, which was the aim of the new research.

Hvitfeldt Fuglsang's team conducted a nationwide study of Danish medical records collected from 1996 to 2018, from individuals aged 18 to 60. They identified men and women with migraine based on their prescription drug records and compared their risk of a heart attack and ischemic and hemorrhagic stroke before the age of 60 to the risks faced by people in the general population without migraine.

Contrary to earlier findings, the analysis showed that both men and women with migraine had a similarly increased risk of ischemic stroke. However, women with migraine may also carry a slightly higher risk of heart attack and hemorrhagic stroke, compared to men with migraine and the general population.

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Overall, the results suggest that women are more greatly impacted by migraine, especially since the condition is predominantly diagnosed in women. The researchers point out that since they used prescription drug records to identify patients with migraine, they may have missed untreated individuals, which could have resulted in an underestimation of the contribution of migraine to these health problems. Since heart attack and stroke can lead to life-long disabilities or even death, the researchers argue that it is vital to identify persons at increased risk to facilitate targeted preventative therapies.

Hvitfeldt Fuglsang adds, "Migraine was associated with a similarly increased risk of ischemic stroke among young men and women. However, migraine may be associated with an increased risk of myocardial infarction and hemorrhagic stroke only among women."

Source:

PLOS

Journal reference:

Fuglsang, C. H., et al. (2023) Migraine and risk of premature myocardial infarction and stroke among men and women: A Danish population-based cohort study. PLOS Medicine. doi.org/10.1371/journal.pmed.1004238.

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Philips' direct-to-angio stroke pathway: new analysis demonstrates substantial cost savings in addition to improved patient outcomes

Survivors really want you to measure 100% recovery, not cost. WHY THE FUCK AREN'T YOU DOING THAT? 

So no reporting or measurement of 100% recovery, obviously not important to the medical staff or researchers. But vastly important to stroke survivors. 

“What's measured, improves.” So said management legend and author Peter F. Drucker 

The latest useless stuff here:

Philips' direct-to-angio stroke pathway: new analysis demonstrates substantial cost savings in addition to improved patient outcomes

Economic analysis of cost of Vall d’Hebron University Hospital Stroke Unit shows direct-to-angio stroke pathway can save more than USD 3,000 per patient

Amsterdam, the Netherlands – Royal Philips (NYSE: PHG, AEX: PHIA), a global leader in health technology, today announced the results of a health economic analysis published in the Journal of NeuroInterventional Surgery (JNIS) that show an innovative approach to the stroke care pathway reduced costs by an average of EUR 2,848 (~USD 3,120) per patient. The retrospective analysis looked at data from the controlled single-center ANGIOCAT clinical trial conducted at the Vall d’Hebron University Hospital Stroke Unit (Barcelona, Spain) [1]. Earlier results from this study demonstrated that a ‘Direct-to-Angio Suite’ (DTAS) pathway improves clinical outcomes for patients who have suffered a stroke.

The ANGIOCAT clinical study has already shown that bringing stroke patients directly to the angio suite improves patient outcomes. The economic analysis of the data now tells us we can also significantly reduce costs.

Dr. Manuel Requena

Stroke and Interventional Neurologist, University Hospital Vall d’Hebron

“The ANGIOCAT clinical study has already shown that bringing stroke patients directly to the angio suite improves patient outcomes. The economic analysis of the data now tells us we can also significantly reduce costs,” said Dr. Manuel Requena, Stroke and Interventional Neurologist, University Hospital Vall d’Hebron. “This indicates that the initial up-front investment of a direct-to-angio suite workflow will result in a fast return on investment for healthcare providers.”

Innovating the stroke pathway

After initial triage in the emergency department, the typical treatment pathway for stroke involves sending the patient to the radiology department for a diagnostic CT or MRI brain scan. This adds time, often worsened by gaps in communication, information, and access to stroke expertise. For stroke centers, a time-saving alternative is to have a dedicated angio-suite permanently on standby, to which stroke patients can be transferred immediately after admission. Using cone-beam CT imaging, such as that built into Philips Image Guided Therapy System – Azurion, clinicians can make a diagnosis and intervene on-the-spot, saving precious time. The health economics analysis indicates that a positive return on investing in a dedicated angio suite can be achieved in only a few years.

Philips cone-beam CT

Philips’ DTAS workflow is enabled by an advanced cone-beam computed tomography (CBCT) brain scan performed directly in the angio suite to diagnose patients. CBCT utilizes a cone-shaped beam of X-rays and a flat-panel detector mounted on a C-arm gantry similar to that routinely used in an angio suite, capturing multiple images from different angles to reconstruct 3D images of the brain. Thanks to technology breakthroughs, Philips has increased the diagnostic confidence of CBCT from 32% to 93% in the space of a few years [3][4][5]. This technology can rule out intracranial hemorrhages and identify large vessel occlusions (LVOs), which account for roughly a quarter to a half of acute ischemic strokes [2]. Patients diagnosed with an LVO can then be immediately operated on using a minimally invasive image-guided procedure known as a mechanical thrombectomy to open up the blocked artery causing their stroke.

Lower cost, better patient outcomes

Multiple single-center studies have shown the positive impact of DTAS on clinical outcomes with the result that many dedicated stroke centers have already adopted it. A large multi-center randomized clinical trial called WE-TRUST (Workflow Optimization to Reduce Time to Endovascular Reperfusion for Ultra-fast Stroke Treatment) [8] is currently running to confirm the patient benefit of DTAS.

Philips’ stroke portfolio includes solutions for stroke monitoring and communication in ambulances, tele-stroke patient assessment, diagnostic imaging and analysis, image-guided therapy, neurological monitoring and assessment, and more. Its image-guided stroke therapy solutions are based on the Philips Image Guided Therapy System – Azurion.

[1] Requena M, Vanden Bavière H, Verma S, et al. Cost-utility of direct transfer to angiography suite (DTAS) bypassing conventional imaging for patients with acute ischemic stroke in Spain: results from the ANGIOCAT trial.
Journal of NeuroInterventional Surgery Published Online First: 27 April 2023. doi: 10.1136/jnis-2023-020275
[2] World Stroke Organization (WSO): Global Stroke Fact Sheet 2022 (https://www.world-stroke.org/assets/downloads/WSO_Global_Stroke_Fact_Sheet.pdf)
[3] Nicholson P, Cancelliere NM, Bracken J, et al. Novel flat-panel cone-beam CT compared to multi-detector CT for assessment of acute ischemic stroke: A prospective study. Eur J Radiol. 2021 May;138:109645. doi: 10.1016/j.ejrad.2021.109645. Epub 2021 Mar 10. PMID: 33725654.
[4] Cancelliere NM, Hummel E, van Nijnatten F, et al. The butterfly effect: improving brain cone-beam CT image artifacts for stroke assessment using a novel dual-axis trajectory. J Neurointerv Surg. 2023 Mar;15(3):283-287. doi: 10.1136/neurintsurg-2021-018553. Epub 2022 Apr 27. PMID: 35478176; PMCID: PMC9985729.
[5] Cancelliere NM, van Nijnatten F, Hummel E, et al. Motion artifact correction for cone beam CT stroke imaging: a prospective series. J Neurointerv Surg. 2022 Dec 23:neurintsurg-2021-018201. doi: 10.1136/jnis-2021-018201. Epub ahead of print. PMID: 36564201.
[6] WE-TRUST. Workflow optimization to reduce time to endovascular reperfusion for ultra-fast stroke treatment, ClinicalTrials. gov, U.S. National Library of Medicine, identifier: NCT04701684. n.d. Available: https://clinicaltrials.gov/ct2/show/ NCT04701684. The WE-TRUST study is sponsored by Philips.

NABH(National Accreditation Board for Hospitals and Healthcare Providers - India) seeks public and stakeholders suggestions on first edition draft standards for stroke centres

Get involved and ask for 100% recovery protocols. And don't acknowledge their whining when they say it can't be done. Swearing may be required.  DO NOT BACK DOWN!

NABH seeks public and stakeholders suggestions on first edition draft standards for stroke centres

Shardul Nautiyal, Mumbai Wednesday, June 14, 2023, 08:00 Hrs  [IST]

The National Accreditation Board for Hospitals and Healthcare Providers (NABH) has sought suggestions and feedback from public at large, including the stakeholders like hospitals, clinical establishments, industry and consumer groups on first edition draft standards for stroke centres. NABH standards for stroke centres have been drafted in collaboration with World Stroke Organization (WSO). “The comments may be shared on the form within 20 days of publication of this notice on the website. Last date for receiving suggestions and feedback is June 20, 2023,” according to a NABH circular. According to the draft standards for stroke centres, “The stroke centre shall define and display the services that it provides. The services provided at the stroke centre shall be defined and be in consonance with the needs of the community. Each defined service shall have diagnostic and treatment services with suitably qualified personnel who provide out-patient, in-patient and emergency cover.” The draft standards further stipulate that the stroke centre’s defined services shall be prominently displayed. The stroke centre shall have a well-defined registration and admission process. The stroke centre shall use written guidance for registering and admitting patients. A unique identification number shall be generated at the end of registration. There shall be an appropriate mechanism for transfer out or referral of patients to a higher level of care. Transfer out or referral of patients to a higher level of care shall be done appropriately. If the stroke centre does transfer patients for neurosurgical emergencies, there shall be a written guidance for urgent transfer. The stroke centre shall have a written transfer protocol, transfer agreement or a memorandum of understanding (MoU) with at least one hospital being capable of providing timely and essential stroke related services immediately. The stroke centre shall give a summary of the patient’s condition and the treatment given. Patients in the stroke centre shall be appropriately assessed and documented. Assessments shall include initial assessment and periodic re-assessment as applicable and shall be appropriate for each patient. All patients (emergency and in-patients) shall undergo an assessment based on their needs. All assessments shall be documented and signed appropriately by staff. “The doctor and nursing staff shall develop a documented care plan for the admitted stroke patient, which includes identification of individual needs for the patient, based on their condition and the family’s needs,” as per the draft standards.