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New study 'game-changer' for stroke treatment worldwide

Posted: Published on March 9th, 2015

A landmark study published in the New England Journal of Medicine today heralds a new era in stroke treatment across the globe A landmark study published in the New England Journal of Medicine today heralds a new era in stroke treatment across the globe. EXTEND-IA*, an Australian and New Zealand randomised clinical research study, led by The Royal Melbourne Hospital (RMH), looked at the effectiveness of a new treatment for stroke. The study involved adding a minimally invasive clot removal procedure called stent thrombectomy to standard clot-dissolving therapy, known as tissue plasminogen activator (tPA). Royal Melbourne Hospital Neurologist and co-principal investigator, Dr Bruce Campbell, said the study showed a dramatic improvement in restoring blood flow back to the brain, which is critical in the recovery of stroke. "In 89 percent of patients blood flow to the brain was restored when the clot removal therapy was used compared with 34 percent of patients who had standard clot-dissolving therapy alone," Dr Campbell said. "The addition of stent thrombectomy to standard clot-dissolving treatment led to 71 percent of patients returning to independent living, compared with 40 percent in the standard treatment group. "This is an extremely impressive outcome given these patients had the … Continue reading

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Stroke patients receiving better, more timely care

Posted: Published on March 9th, 2015

One in four acute ischemic stroke patients treated with a time-dependent clot-busting drug were quickly transferred from an emergency department or smaller community hospital to a certified stroke center, according to research presented at the American Stroke Association's International Stroke Conference 2015. This study will also publish simultaneously in the American Heart Association's journal Stroke. Intravenous (IV) tissue-plasminogen activator, or tPA, is a clot-busting drug that restores blood flow to the brain. If administered within three hours of the start of a stroke, tPA may significantly improve a patient's chances of recovery. Even though it is the only FDA-approved treatment for acute ischemic stroke, rates of its administration are low. "One in four is a very good number, and while we don't know the best target, there may be room for improvement," said Kevin N. Sheth, M.D., lead study author and Chief of Neurocritical Care and Emergency Neurology Division at Yale School of Medicine in New Haven, CT. "We have to understand geographic and community variation in usage of inter-hospital transfer of tPA patients, and why some communities may use it more than other communities. Ultimately, the goal is to have any patient that presents to their initial hospital anywhere … Continue reading

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After stroke, clot removal saves brain function, studies say

Posted: Published on March 9th, 2015

Published February 11, 2015 Grabbing and removing a clot blocking blood flow to the brain, rather than just administering clot-busting drugs, dramatically improves the likelihood that patients will recover from a stroke, according to two highly-anticipated studies released on Wednesday. The larger of the studies found that the procedure nearly halved the death rate from stroke. Because three previous studies had failed to show a benefit from procedures employing clot-removing devices, the latest research should renew interest in the devices and are likely to change stroke treatment, experts said. The two studies used devices made by Covidien, which was acquired by Medtronic PLC last month and helped pay for one of the trials. Stryker Corp and privately-held Penumbra Inc also manufacture devices approved for clot removal. The research echoes a large Dutch study published in December, called MR CLEAN, that also found a benefit from fishing a clot out of an artery. Taken together, they offer "a really persuasive signal that we're on to something," said Dr. Patrick Lyden, director of the Stroke Program at Cedars-Sinai Medical Center in Los Angeles, who was not involved in the studies. Lyden, who helped develop clot-busting drugs, said he had been skeptical of … Continue reading

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Creatine does not slow rate of Parkinson's disease progression

Posted: Published on March 9th, 2015

Treatment with creatine monohydrate for at least 5 years for patients with early and treated Parkinson disease failed to slow clinical progression of the disease, compared with placebo, according to a study in the February 10 issue of JAMA. Parkinson disease is a progressive neurodegenerative disorder that affects approximately 6 million people worldwide and more than one-half million individuals in the United States. Incidence is expected to increase over the next decade, but neither a cure nor a treatment is available that has been proven to slow progression. Evidence indicates that creatine, an amino acid, plays an important role in cellular energy production, which may be impaired in Parkinson disease. Oral creatine supplementation in mice has suggested a neuroprotective effect, according to information in the article. Karl Kieburtz, M.D., M.P.H., of the University of Rochester, Rochester, N.Y., and colleagues, randomly assigned 1,741 men and women with early (within 5 years of diagnosis) and treated (receiving dopaminergic therapy) Parkinson disease to receive placebo or creatine monohydrate (10 g/d) for a minimum of 5 years (maximum follow-up, 8 years). Participants were recruited from 45 investigative sites in the United States and Canada, enrolled from March 2007 to May 2010, and followed up … Continue reading

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Apple Announces ResearchKit, Which Uses IPhones To Gather Enormous Data Sets For Treatment And Study

Posted: Published on March 9th, 2015

At today's Apple event, Apple senior vice president of operations Jeff Williams took the stage to announce ResearchKit, a framework made specifically for medical research. Basically, it transforms the iPhone, Apple Watch, and HealthKit into an opt-in tool for research institutions. It has the potential to change the world. Apple says it worked with Mount Sinai, Stanford Medical, the University of Oxford, Penn Medicine, and other institutions to build health-monitoring applications for ResearchKit, which will be open source. For example, one of the early apps developed with the framework is called mPower. It uses tappinglike, you jab at a button on the screen multiple timesto subtly detect the presence of hand tremors, a telltale sign of Parkinson's disease. Another example: the phone can conduct gait and balance tests if you put your iPhone in your pocket before you go for a walk. Not only can it help doctors diagnose patients and track their activity, but it provides the infrastructure that allows researchers to siphon up untold amounts of health data. "Numbers are everything," Dr. Eduardo Sanchez of the American Heart Association says on Apple.com. "The more people who contribute their data, the bigger the numbers, the truer the representation of … Continue reading

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Australian researchers prove cerebral palsy can be genetic

Posted: Published on March 9th, 2015

New link found: Professor Alastair MacLennan and patient Matthew Reinertsen, who has cerebral palsy. Australian researchers have proved cerebral palsy can be genetic, a finding with significant implications for the diagnosis, management and treatment of the debilitating condition which affects movement and posture. Long thought to be caused by a lack of oxygen during pregnancy or at birth, cerebral palsy is caused by genetic mutations in at least 14 per cent of case, Adelaide University researchers have found. However head of the cerebral palsy research group at Adelaide University's Robinson Research Institute Alastair MacLennan said it could be just the start, with up to half of cases potentially caused by genetic mutations. The team, including researchers from America and the Netherlands, mapped the DNA of hundreds of Australian cerebral palsy families, looking for common genetic features. Advertisement Almost 100 gene mutations were found and some were transplanted into zebrafish, which Professor MacLennan said promptly lost control of their tail. "When we put the good gene back in, we recovered the movement of the fish," Professor MacLennan said. However he stressed that for humans, the implications of the study remained limited to cerebral palsy prevention - rather than curing the condition … Continue reading

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Head on: concussion and rugby league

Posted: Published on March 9th, 2015

Recovered: with his mother, Paula. Photo: James Brickwood Spirits were high in the NSW town of Bathurst as old foes Dubbo Senior College and Orange High rolled into town in June last year to take on the locals for the Astley Cup. Dating back to 1923, and the oldest annual tri-school sporting competition in the state, few events on the Cup's schedule had been more eagerly anticipated than Bathurst High's rugby league clash against Dubbo, and eyes were on the school's talented 16-year-old, Tyler Horton. A keen golfer, and with a fearsome reputation for smacking the seamers around the region's cricket fields, Tyler had used his speed and skill on the rugby pitch over the previous eight seasons to stake a strong claim on the five-eighth position of Bathurst's rugby league team, despite being one of the smallest players on the field. Tyler Horton playing rugby league before his injury. Photo: ZENIO LAPKA After an uneventful first half, the ball landed in Tyler's hands and he took off. As a sharp-eyed Dubbo player pounced, the left side of Tyler's head connected with his much larger rival's shoulder, whipping his neck back from the impact. Shaking off the tackle, Tyler moved … Continue reading

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Traumatic Brain Injury awareness month highlights resources

Posted: Published on March 9th, 2015

Throughout the year, we designate specific months to remind us of varying topics that are important to our well-being and/or culture. Often times we forget or overlook the significance of these awareness months due to their repetitious nature. March is intended to remind us of the serious impact of Traumatic Brain Injuries, or TBI, throughout our population. You may ask yourself, Why is this important to me? The Center for Disease Control and Prevention, also known as CDC, reports that approximately 2.5 million emergency room visits, hospitalizations, or deaths were associated with a singular TBI or a combination of a TBI and additional sources of injury. Traumatic Brain Injuries in itself are responsible for an estimated 50,000 deaths per year. The Defense and Veterans Brain Injury Center, or DVBIC, tracks the total number of Service members throughout the Department of Defense whom have been diagnosed with a TBI. Since 2000, over 313,000 Service members have been diagnosed with a TBI. These statistical numbers reflect the relevance of TBI. But why should we be concerned about a TBI? Traumatic Brain Injury-associated costs within the United States are estimated at a staggering $56 billion annually. The DoD spends an estimated $1.1 billion … Continue reading

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Nearly all Denver jail inmates in high-risk unit have brain trauma

Posted: Published on March 9th, 2015

A Denver sheriff's deputy walks through the Denver jail in 2014. (RJ Sangosti, Denver Post file) WATCH: The latest news updates on DPTV with Molly Hughes They were punched in the head in fistfights or shot, knocked around as children, beaten by spouses or struck by cars. Almost every inmate in the downtown Denver jail's high-risk unit has a traumatic brain injury, so many that what began as a one-time university service learning project has grown into a new therapy program spreading to jails along the Front Range. Neurological researchers from the University of Denver expected to find an above-average prevalence of brain trauma at the Downtown Detention Center. But the results were high enough to shock them. Nearly every inmate screened 96 percent had a traumatic brain injury. That's significantly higher than national statistics showing from 67 percent to 80 percent of inmates in jails and prisons have a traumatic brain injury, and far higher than the estimated 6 percent to 8.5 percent of the general population. The results of the Denver screenings were higher in part because researchers screened inmates kept in a high-risk unit of the jail, the unit for people who are considered a risk to … Continue reading

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Researchers propose novel new treatment of stroke and other neurological diseases

Posted: Published on March 9th, 2015

DETROIT - Medicine should reconsider how it treats stroke and other neurological disorders, focusing on the intrinsic abilities of the brain and nervous system to heal themselves rather than the "modest" benefits of clot-busting drugs and other neuroprotective treatments. Michael Chopp, Ph,D., internationally renowned stroke researcher and scientific director of the Neuroscience Institute at Henry Ford Hospital, and Zhenggang Zhang,M.D., Ph.D., senior scientist at Henry Ford's Department of Neurology, make their case for the change in treatment strategy in an editorial published online in Expert Opinion on Biological Therapy. The co-authors argue that pharmacologically enhancing the brain's own restorative abilities could benefit not only stroke patients, but those suffering other neurological damage or disease including traumatic brain injury (TBI), multiple sclerosis (MS) and peripheral neuropathy - nerve damage that afflicts the elderly, chemotherapy patients and especially diabetics. Central to their proposal is a new pharmacological agent developed by Dr. Chopp and his colleagues, a synthetic version of a peptide that occurs naturally in humans and other mammals called Thymosin beta-4. "Pioneering animal studies at Henry Ford have shown Thymosin beta-4 is highly effective for the treatment of neurological diseases in part by increasing the formation of protective myelin around nerve … Continue reading

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