Stroke
Bret Michaels’ speech slurred after brain hemorrhage
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Rock singer and TV reality star Bret Michaels remained in critical condition, but was conscious and talking with slurred speech after suffering a brain hemorrhage, his publicist said on Sunday.
The front man of glam rock band Poison was rushed to an undisclosed hospital on Friday with a severe headache. Doctors diagnosed a massive subarachnoid hemorrhage, or bleeding at the base of his brain stem.
A statement issued on Sunday by publicists for the 47-year-old singer said he was still under 24-hour supervision and in critical condition and that doctors were trying to locate the source of the bleeding.
Useful stroke trials left unpublished
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An investigation into unpublished stroke research data has revealed that 19.6% of completed clinical trials, which could potentially influence patient care, are not published in full. Researchers writing in BioMed Central’s open access journal Trials describe how these unpublished studies included more than 16,000 participants and tested 89 different interventions.
Peter Sandercock and his colleague Lorna Gibson worked with a team of researchers from the University of Edinburgh, UK, to search the Cochrane Stroke Group’s Specialised Register of Trials for completed trials of pharmacological interventions for acute ischemic stroke, and to determine how many of these were ultimately published. He said, “Failure to publish trial data is to be deprecated as it sets aside the altruism of participants’ consent to be exposed to the risks of experimental interventions, potentially biases the assessment of the effects of therapies, and may lead to premature discontinuation of research into promising treatments”.
The researchers identified 940 trials, of which 125 were not published in full. The largest trial included 856 patients, while two unpublished trials included fewer than 10 patients each. According to Sandercock, “Several of the trials we identified may have been large enough to influence clinical practice and the findings of systematic reviews and meta-analyses”.
Novel stroke treatment passes safety stage of UCI-led clinical trial
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A clinical research trial of a new treatment to restore brain cells damaged by stroke has passed an important safety stage, according to the UC Irvine neurologist who led the effort.
Dr. Steven C. Cramer said patients showed no ill effects after the sequential administration of growth factors encouraging the creation of neurons in stroke-damaged areas of the brain. All new drug treatments must pass this safety stage before doctors can study their effectiveness in subsequent studies.
Results of the phase IIa trial appear on the Web site of Stroke, a journal of the American Heart Association.
Different strokes help tissue heal
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Using simple handheld tools, physical therapist Laurie Eickhoff carefully rubs patient Lisa Maharry’s leg to treat her Achilles injury with a new therapy intended to stimulate the body’s normal healing process.
Maharry has received augmented soft tissue manipulation, or ASTYM, at Ingersoll Physical Therapy since January. The clinic, affiliated with Accelerated Rehabilitation Centers, is one of a few providers in the metro area and about 30 in Iowa that offer the treatment.
Eickhoff has used the technique on a dozen patients since November. Some were referred by physicians, while others were existing patients she transitioned into the therapy after trying other measures.
Taiwan’s hospital payment cuts tied to stroke deaths
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Cuts in reimbursement to hospitals made by Taiwan’s universal healthcare system in recent years may have slowed a decade-long decline in stroke deaths, hints a new study.
What the findings could mean for the U.S. and other countries wrestling with the question of how to control healthcare costs is unclear. But Taiwan’s experience might offer some wider lessons, the researchers say.
The study, published in the journal Stroke, found that from 1998 to 2007, the 30-day death rate among Taiwanese patients hospitalized for a stroke gradually declined—from 5.8 percent in 1998 to 3.7 percent by 2007.
Degree of obesity raises risk of stroke, regardless of gender, race
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The higher a person’s degree of obesity, the higher their risk of stroke — regardless of race, gender and how obesity is measured, according to a new study published in Stroke: Journal of the American Heart Association.
“It has not been clear whether overweight and obesity are risk factors for stroke, especially among blacks,” said Hiroshi Yatsuya, M.D., Ph.D., study lead author and visiting associate professor at the University of Minnesota in Minneapolis. “There are also questions about which measure of excess weight (body mass index [BMI], waist circumference or waist-to-hip ratio) is most closely associated with disease risk.”
Analyzing the ARIC Study database in which subjects’ BMI, waist circumference and waist-to-hip ratio were measured at the study’s start, Yatsuya and colleagues followed 13,549 middle-aged black and white men and women in four U.S. communities from 1987 through 2005. Participants started the study free of cancer and cardiovascular disease.
Higher stroke, heart disease risks for A-bomb survivors
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A study of atomic bomb survivors in Japan conducted over 53 years has found that they appear to suffer a far higher risk of heart disease and stroke because of their exposure to radiation.
The study, published in the British Medical Journal, involved 86,611 survivors from the bombings of Hiroshima and Nagasaki in 1945, which forced Japan into surrendering to the Allied Powers and officially ending World War II.
Each person was exposed to an absorbed radiation dose of between 0 and 4 Gy (Gray) at the time of the bombings.
Obesity adds to risk of death after stroke
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Obesity increases the risk of death after stroke in younger stroke patients, according to a new study.
Dr. Amytis Towfighi, of the University of Southern California, Los Angeles, and Dr. Bruce Ovbiagele of the University of California, Los Angeles used data from the National Health and Nutrition Examination Surveys (NHANES) on 20,050 adults.
Of those adults, 547 had a stroke through 2000 and had weight records available. Of these, 211 were classified as overweight, and 127 were obese.
Hopelessness raises stroke risks for women: study
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For women, feelings of hopelessness are not just unfortunate, they are a stroke risk, U.S. researchers said on Thursday.
They said otherwise healthy women who are chronically hopeless are more likely to have a buildup of plaque in their neck arteries that can trigger a stroke.
“These findings suggest that women who experience feelings of hopelessness may have greater risk for future heart disease and stroke,” said Susan Everson-Rose of the University of Minnesota Medical School, whose study appears in the journal Stroke.
Surprising rate of recurring heart attacks, strokes globally
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Despite many medicines and other treatments for patients with vascular disease, a large international study shows these patients have a surprisingly high rate of recurring events such as strokes, heart attacks and hospitalizations as well as mortality.
Also unexpected: patients in North America (including the U.S.) experienced an above-average rate of these events. Patients in Eastern Europe had the highest rate, and those in Australia and Japan had the lowest.
The results from the international REACH (Reduction of Atherothrombosis for Continued Health) Registry, presented by a researcher from Northwestern University Feinberg School of Medicine, examined data for 32,247 patients one and three years after they enrolled in the registry. Patients who had symptomatic vascular disease had a 14.4 percent rate at one year and 28.4 percent rate at three years of having a heart attack, stroke, rehospitalization for another type of vascular event or vascular death. Patients with vascular disease in more than one location of the body had the highest event rate at 40.5 percent at three years.
Minorities have poorer results, higher rates of inappropriate carotid-artery surgery to prevent stro
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Minorities have poorer results, higher rates of inappropriate carotid-artery surgery to prevent stroke
Minorities have poorer results and higher rates of unnecessary surgery from a common procedure used to remove plaque from inside the carotid artery, according to a UT Southwestern Medical Center doctor who is lead author of the study in the journal Stroke.
The multicenter study, available online and appearing in the July issue of the journal, found that higher rates of poor surgical outcomes for carotid endartectomy (CEA) — a procedure performed to prevent stroke — appeared to be due not only to elevated patient clinical risk in African-American and Hispanics, but also to the individual skill and experience of the doctor performing the operation.
“Identifying how various patient, physician and hospital-level factors may contribute to disparities has important implications for the design of clinical and health policy strategies for reducing them,” said Dr. Ethan Halm, chief of the William T. and Gay F. Solomon Division of General Internal Medicine at UT Southwestern.
Biomarker of breathing control abnormality associated with hypertension and stroke
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A study in the July 1 issue of the journal SLEEP identified a distinct ECG-derived spectrographic phenotype, designated as narrow-band elevated low frequency coupling (e-LFCNB), that is associated with prevalent hypertension, stroke, greater severity of sleep disordered breathing and sleep fragmentation in patients suffering from obstructive sleep apnea (OSA).
Results indicate that the odds ratio for prevalent stroke was 1.65 [CI: 1.19ԃ.29] in those with versus without the presence of e-LFCNB. The biomarker was detected in 1,233 participants (23.5 percent), with statistically significant differences between those with and without it. Patients with the biomarker tended to be older (average 64.7 years versus 61.4 years), male (63.3 percent versus 45.1 percent), slightly heavier (average body mass index 29.3 versus 28.6) and sleepier (according to the Epworth Sleepiness Score test results). Sleep apnea severity and use of diuretics, calcium blockers, and B-blockers were associated with increased e-LFCNB. After adjustment for age, sex, body mass index, hypertension, and diabetes, only prevalent stroke remained associated with both categorical and continuous measures of e-LFCNB, while treated and total hypertension were associated only with the ECG biomarker as continuous measure.
According to lead author Robert J. Thomas, MD, assistant professor of medicine at the Beth Israel Deaconess Medical Center & Harvard Medical School in Boston, Mass., the electrocardiogram (ECG)-based technique allows the tracking of interactions (“coupling”) of breathing amplitude and heart-beat rate changes, which are both influenced by sleep, thus providing a ‘map’ of sleep behaviors. Use of this technique allows physicians to assign patients with sleep apnea into groups who have or do not have breathing control abnormalities.
New tool finds best heart disease and stroke treatments for patients with diabetes
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Researchers from North Carolina State University and Mayo Clinic have developed a computer model that medical doctors can use to determine the best time to begin using statin therapy in diabetes patients to help prevent heart disease and stroke.
“The research is significant because patients with diabetes are at high risk for cardiovascular disease and statins are the single most commonly used treatment for patients at risk of heart disease and/or stroke,” says Dr. Brian Denton, “and this model can help determine the best course of action for individual patients based on their risk of developing cardiovascular disease.” Denton is an assistant professor in NC State’s Edward P. Fitts Department of Industrial & Systems Engineering and lead author of the study.
Statins are a key component of current cardiovascular medical treatment guidelines, Denton says. They lower cholesterol levels and may significantly reduce the risk of heart attack and stroke, particularly in patients that are considered to be at high risk.
Researchers Draft 3-D Protein Map to Aid Stroke, Cancer Research
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A new three-dimensional computer protein map is helping researchers at the University of Alabama at Birmingham (UAB) unravel the biological pathways that control brain-cell death after a stroke.
The new map will help identify new drug targets and test compounds to slow brain-cell death, halt brain cancer and improve pain control, the study authors said. The findings are published online in the Journal of Biological Chemistry.
Starting with known cell coordinates, biological structures and other data, UAB researchers focused on a protein called acid-sensing ion channel-1, or ASIC-1. This protein acts as a gateway on the surface of brain cells called neurons. The researchers generated a 3-D computer map of ASIC-1, which greatly simplifies the testing of any drug or compound designed to protect neurons, regulate their molecular interactions or isolate brain tumors.
Had a stroke? The elderly may not know, or remember
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Older adults often do not realize or may even forget they have had a stroke and may not be a reliable source of medical information, U.S. researchers said on Monday.
Brain scans showed that while just 12 percent of seniors asked about strokes remembered having had one, nearly a third had brain damage showing they had.
The stroke itself could damage memory, and many people may also have so-called silent strokes that are never diagnosed at the time, Dr. Christiane Reitz of Columbia University Medical Center in New York and colleagues wrote in the Archives of Neurology.
