Women and minorities may be less likely to receive treatment for stroke, according to a study published in the September 14, 2016, online issue ofNeurology®, the medical journal of the American Academy of Neurology.
“Even though the clot-busting treatment for stroke called tPA improves recovery, some people who are eligible to receive the treatment are not getting it,” said study author Steven R. Messé, MD, of the University of Pennsylvania in Philadelphia and a Fellow of the American Academy of Neurology. “We wanted to find out what factors were associated with lower likelihood of treatment, which may help us find ways to improve tPA use in the future.”
For the study, the researchers looked back at more than eight years of hospital records from across the country of people with an ischemic stroke who arrived at the hospital within two hours after the start of stroke symptoms and had no documented reasons that they could not receive the treatment. The treatment, tissue plasminogen activator (tPA), can be used only for ischemic strokes, which are caused by blood clots. It cannot be used for hemorrhagic strokes, which are caused by bleeding.
Endovascular therapy for disabling strokes caused by a blockage in a more distal portion of a large vessel is effective and possibly superior to best medical management, according to a large multicenter retrospective study by The University of Texas Health Science Center at Houston (UTHealth).
The results were published today in JAMA Neurology, a journal of the American Medical Association.
Strokes that form in large vessels such as the internal carotid artery are known to be less responsive to the clot-buster tissue plasminogen activator (tPA), the only known medication to treat stroke. These large vessel occlusions are more likely to result in major disabilities and long-term care.
Researchers have identified a potential way to prevent chronic urinary tract infections (UTIs). Their research points to a key protein that bacteria use to latch onto the bladder and cause UTIs, according to scientists at Washington University School of Medicine in St. Louis. Vaccinating mice against the protein reduces the ability of bacteria to cause severe disease.
The study, published Sept. 22 in Cell Host & Microbe, suggests that targeting this protein may prevent the most serious consequences of a very common infection.
“Our findings reveal how bacteria have evolved a mechanism to colonize the bladder in order to persist and cause UTIs, and our vaccination study suggests that inhibiting this mechanism could be part of a viable approach to treating or preventing these infections,” said Scott Hultgren, PhD, the Helen L. Stoever Professor of Molecular Microbiology and one of the study’s senior authors.
The demand for family caregivers for adults who are 65 or older is increasing significantly, and family caregivers need more recognition, information, and support to fulfill their responsibilities and maintain their own health, financial security, and well-being, says a new report from the National Academies of Sciences, Engineering, and Medicine. Although caregivers’ individual circumstances vary, family caregiving can negatively affect caregivers’ mental and physical health as well cause economic harm, including loss of income and career opportunities. The report calls for health care delivery system reform that elevates family-centered care alongside person-centered care to better account for the roles of family caregivers and support their involvement in the care delivery process.
The committee that carried out the study and wrote the report found that by 2030, 72.8 million U.S. residents — more than 1 in 5 — will be 65 or older. According to the National Survey of Caregivers, in 2011, 17.7 million people — or approximately 7.7 percent of the total U.S. population aged 20 and older — were caregivers of an older adult because of health problems or functional impairments. This estimate does not include caregivers of nursing home residents. Furthermore, for most family caregivers, caregiving is not a short-term obligation. The median number of years of family care for older adults with high needs is five years. The proportion of older adults who are most likely to need intensive support from family caregivers — those in their 80s and beyond — is projected to climb from 27 percent in 2012 to 37 percent in 2050. Little action has been taken to prepare the health care and social service systems for this demographic shift, the committee said.
Relying on clinical symptoms of memory loss to diagnose Alzheimer’s disease may miss other forms of dementia caused by Alzheimer’s that don’t initially affect memory, reports a new Northwestern Medicine study.
“These individuals are often overlooked in clinical trial designs and are missing out on opportunities to participate in clinical trials to treat Alzheimer’s,” said first study author Emily Rogalski, associate professor at Northwestern’s Cognitive Neurology and Alzheimer’s Disease Center.
There is more than one kind of Alzheimer’s disease. Alzheimer’s can cause language problems, disrupt an individual’s behavior, personality and judgment or even affect someone’s concept of where objects are in space.
A breakthrough in understanding how brain damage spreads — and how it could potentially be limited — has been made through a collaboration between neuroscientists and engineers at the Universities of Dundee and Strathclyde.
They have uncovered a previously unknown mechanism in the brain that allows networks of neurons to protect against the kind of spreading secondary damage seen in cases of strokes and traumatic brain injuries.
“If this network activity could be triggered clinically as soon as possible then major brain damage could be minimised and recovery periods shortened,” said Dr Christopher Connolly, Reader in Neurobiology in the University of Dundee’s School of Medicine.
A new article suggests that an enzyme deficiency seen in the lysosomal storage disorder Krabbe’s disease may point to new mechanisms underlying certain late-onset neurodegenerative diseases such as Parkinson’s disease.
Patients with Krabbe’s disease lack galactosylceramidase, which is needed to make the protective myelin coating around nerve cells. Unfortunately, there is currently no cure, and most infants with the degenerative disorder die at a very young age.
“It’s been established that mutations to lysosomal enzymes, as present in Gaucher disease, can be a strong genetic risk factor for Parkinson’s disease. In this commentary, we highlight recent evidence that suggests pathophysiological changes due to galactosylceramidase mutations in Krabbe’s disease may also be related to the pathology of late-onset alpha-synucleinopathies,” said Dr. Michael. Marshall, co-author of the Journal of Neuroscience Research article. “While this association requires further investigation, we hope that future larger cohort studies may be able to confirm either a genetic link or common pathological mechanisms between the diseases.”
According to new research, women who are overweight or obese may have an increased risk of the most common kind of stroke, called ischemic stroke, but a decreased risk of a more often deadly stroke, called hemorrhagic stroke. The study is published in the September 7, 2016, online issue of Neurology®, the medical journal of the American Academy of Neurology.
Stroke is a leading cause of death and disability worldwide and the fifth leading cause of death in the United States.
“We found that the risk of ischemic stroke, which is associated with a blockage of blood flow to the brain and is the most common stroke subtype, is increased in overweight and obese women. By contrast, the risk of hemorrhagic stroke, which is associated with bleeding into the brain, is decreased in overweight and obese women,” said study author Gillian Reeves, PhD, with the University of Oxford, United Kingdom. “Our findings add to the growing body of evidence that different types of stroke have different risk profiles.”
During the first three months after stroke, the risk for depression was eight times higher than in a reference population of people without stroke, according to an article published online by JAMA Psychiatry.
More than 10 million people had a stroke in 2013 and more than 30 million people worldwide live with a stroke diagnosis.
Merete Osler, M.D., D.M.Sc., Ph.D., of Copenhagen University, Denmark, and coauthors used data linked from seven Danish nationwide registers to examine how risk and risk factors for depression differ between patients with stroke and a reference population without stroke, as well as how depression influences death.
A recent study from The University of Texas Medical Branch at Galveston showed that patients with strong social support from family and friends spend less time in an inpatient rehabilitation facility. This study is currently available in the Archives of Physical Medicine and Rehabilitation.
“When someone does not have the social support of family and friends, they take longer to return home to the community. We believe that support from loved ones may lead to better recovery and better quality of life,” said lead author Zakkoyya Lewis, a doctoral student in UTMB’s department of rehabilitation sciences. “Our study is one of the first to look at how level of social support impacts how long patients need to spend in a rehab facility.”