Is prehospital stroke treatment associated with better outcomes?

When treating a patient with stroke, every minute counts. A specialized stroke ambulance (Stroke Emergency Mobile or STEMO) allows physicians to start specific treatment, such as thrombolysis, at scene. A recent study conducted by researchers from Charité — Universitätsmedizin Berlin investigated whether this earlier response time leads to an improved prognosis. Patients who received the appropriate treatment during transfer to the hospital were less likely to have a disability three months after their stroke than patients who received conventional treatment. Although the difference in surviving without any disability slightly failed to reach the predefined level of significance, other outcomes such as severe disability or death were also more favorable in the STEMO group. Results from this study have been published in the journal The Lancet Neurology.

Approximately 90% of strokes are ischemic strokes, i.e. they are caused by a blood clot blocking an artery in the brain. Arterial blockages of this kind can be dissolved by thrombolytic therapy. However, approximately 10% of strokes are caused by bleeding inside the brain (hemorraghic stroke). As such bleedings would be unstoppable under thrombolytic therapy, it is essential to exclude cerebral bleedings before starting treatment. Physicians achieve this by using computed tomography (CT) for brain scanning, usually in hospital.

Full story of pre-hospital stroke treatment at Science Daily

Elevating brain protein allays symptoms of Alzheimer’s, improves memory

Boosting levels of a specific protein in the brain alleviates hallmark features of Alzheimer’s disease in a mouse model of the disorder, according to new research published online August 25, 2016 in Scientific Reports.

The protein, called neuregulin-1, has many forms and functions across the brain and is already a potential target for brain disorders such as Parkinson’s disease, amyotrophic lateral sclerosis and schizophrenia.

“Neuregulin-1 has broad therapeutic potential, but mechanistically, we are still learning about how it works,” says the study’s senior investigator Kuo-Fen Lee, a professor in the Salk Institute’s Clayton Foundation Laboratories for Peptide Biology and holder of the Helen McLoraine Chair in Molecular Neurobiology. “We’ve shown that it promotes metabolism of the brain plaques that are characteristic of Alzheimer’s disease.”

Full story of elevating brain protein symptoms of Alzheimer’s at Science Daily

You want shorter ER stays? Bring in the nurses

Protocols allowing nurses to administer certain types of treatment in the emergency department can dramatically shorten length of stay for patients with fever, chest pain, hip fractures and vaginal bleeding during pregnancy, according to the results of a study published earlier this month in Annals of Emergency Medicine.

“For certain patients, nurse-driven protocols can dramatically decrease the amount of time they spend in the emergency department,” said lead study author Matthew Douma, Clinical Nurse Educator at Royal Alexandra Hospital in Edmonton, Alberta, Canada. “Emergency department crowding is a common and complicated problem, so anything we can do to get our patients treated and discharged is to the good. It helps everyone in the ER by reducing crowding.”

Full story of nurses and shorter ER stays at Science Daily

Recommended blood pressure targets for diabetes are being challenged

The Swedish National Board of Health and Welfare recently raised the recommended target blood pressure for patients with diabetes. This may lead to more patients suffering from stroke or heart attack, according to a new study from the Sahlgrenska Academy. The new study is the world’s largest on the subject and is based on data from the National Diabetes Register.

In February 2015, the Swedish National Board of Health and Welfare raised the recommended goal for systolic blood pressure (blood pressure when the heart is contracting) in their guidelines for diabetes care.

The target blood pressure was raised from the previous level of below 130 mm Hg to below 140 mm Hg. The recommended target is important for how intensive antihypertensive treatment should be in patients with diabetes.

Full story of blood pressure targets for diabetes at Science Daily

Biomarker breakthrough could improve Parkinson’s treatment

A new, non-invasive way to track the progression of Parkinson’s disease could help evaluate experimental treatments to slow or stop the disease’s progression.

University of Florida researchers used functional magnetic resonance imaging to reveal areas where Parkinson’s disease and related conditions cause progressive decline in brain activity.

The study, funded by the National Institutes of Health, was published in the journal Neurology.

While current treatments focus on controlling symptoms, biomarkers provide a quantifiable way to measure how medications address not just symptoms, but the neurological changes behind them.

Full story of biomarker breakthrough and Parkinson’s treatment at Science Daily

Vertebroplasty helps reduce acute pain among patients with spinal fractures

Vertebroplasty is a safe and effective procedure to reduce acute pain and disability in patients who have experienced spinal fractures within a 6-week period, according to a new study published this week in The Lancet. In this procedure, a special cement is injected in the fractured vertebra to stabilize the fracture and relieve patients of pressure.

The study also found patients’ hospital stays reduced by 5.5 days with vertebroplasty.

The study, coming out of Australia, “Safety and efficacy of vertebroplasty for acute painful osteoporotic fractures (VAPOUR): a multicenter, randomised, blinded, placebo-controlled trial,” considered 120 patients. Sixty-one patients were randomly assigned to vertebroplasty and 59 to a placebo procedure. Only patients with severe pain of 7 or higher on a numeric rating scale (NRS) of 10 were enrolled.

Full story of vertebroplasty to reduce pain with spinal fractures at Science Daily

Anemic adults may have a higher risk of death after stroke

Anemia, a lack of red blood cells, may be linked to a higher risk of death in older adults who have had a stroke, according to new research in Journal of the American Heart Association, the Open Access Journal of the American Heart Association/American Stroke Association.

Anemia is common in patients with acute stroke. Both anemia and low hemoglobin levels, which are proteins in red blood cells that carry oxygen throughout the body, are also common in older people, said Phyo Myint, M.D., senior study author and Professor of Medicine of Old Age at the University of Aberdeen in Scotland.

Researchers examined data from 8,013 hospital patients, average age 77, admitted with acute stroke between 2003 and 2015. Researchers assessed the impact of anemia and hemoglobin levels on death at different time points up to one year following stroke.

Full story of anemic adults and stroke risks at Science Daily

High and low levels of ‘good cholesterol’ may cause premature death

Commonly touted as “good cholesterol” for helping to reduce risk of stroke and heart attack, both high and low levels of high-density lipoprotein (HDL) cholesterol may increase a person’s risk of premature death, according to new research at Washington University School of Medicine in St. Louis and Veterans Affairs St. Louis Health Care System.

Conversely, intermediate HDL cholesterol levels may increase longevity, according to the research.

The large-scale epidemiological study is published Aug. 11 in the Clinical Journal of the American Society of Nephrology.

“The findings surprised us,” said Ziyad Al-Aly, MD, an assistant professor of medicine at Washington University and the study’s senior author. “Previously it was thought that raised levels of the good cholesterol were beneficial. The relationship between increased levels of HDL cholesterol and early death is unexpected and not fully clear yet. This will require further study.”

Full story of levels of cholesterol may cause premature deaths at Science Daily

Working, volunteering could reduce disablement in seniors, study finds

Working or volunteering can reduce the chances of chronic health conditions leading to physical disability in older Americans, according to researchers at Georgia State University and Florida State University.

The study found people ages 50 to 64 who worked full-time or part-time or volunteered up to 100 hours per year experienced a reduction in the extent to which chronic conditions were associated with subsequent functional limitations, such as the ability to walk a block or climb a flight of stairs. The findings are published in The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences.

Previous studies have not examined how working or volunteering affects functional limitations, said Ben Lennox Kail, lead author and assistant professor in the Department of Sociology at Georgia State.

Full story of working could reduce disablement in seniors at Science Daily

China facing epidemic of heart disease, stroke

A 20-year rise in cardiovascular disease (CVD) in China appears to have been spurred largely by increases in high blood pressure, according to a new study from Harvard T.H. Chan School of Public Health. Increasing body mass index (BMI), decreasing physical activity, a high prevalence of smoking, and unhealthy diet have also contributed to the growing burden of CVD — now the leading cause of death in China.

This is the first large study to analyze a wide range of dietary, lifestyle, and metabolic risk factors that may be impacting CVD burden in China. The authors suggested that major changes in Chinese society — including a dramatic shift from a traditional to a more “Western” diet and lifestyle and rapid urbanization and industrialization — may have contributed to the jump in cardiovascular diseases, such as heart attack and stroke. These changes have been accompanied by marked increases in high cholesterol, obesity, and type 2 diabetes among the Chinese population.

Full story of China facing heart disease and stroke epidemic at Science Daily