Our General Election Manifesto Make Stroke a Priority UK

With just this manifesto and NO strategy outlined on how to get to 100% recovery, this will be ignored for the useless crapola it is!

 You could vastly reduce disability and deaths by having 100% recovery protocols!  Getting people directly back to their old life. But it will require destroying the existing stroke associations since they don't know what the fuck they are doing as proven by this 'manifesto'!

Our General Election Manifesto Make Stroke a Priority UK

Stroke is the UK's fourth biggest killer and a leading cause of disability. The good news is that with the right investment, stroke is preventable, treatable, and recoverable. Ahead of the General Election, we have set out what needs to change to improve stroke care.

Read about how the next UK Government can make this happen and what you can do to help.

Read our manifesto

Stroke could cost UK £75bn by 2035, charity warns

 You could vastly reduce that by having 100% recovery protocols!  Getting people directly back to their old life. But it will require destroying the existing stroke associations since they don't know what the fuck they are doing!

Stroke could cost UK £75bn by 2035, charity warns

By PA News Agency

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Juliet Bouverie, chief executive of the Stroke Association, warned that the ‘demand for NHS services will be unsustainable by 2035’ (PA)(Well, it's simple then, create 100% recovery protocols! ARE YOU THAT BLITHERINGLY STUPID? Please answer, I'll reply with your exact excuse in my blog. Here at: oc1dean@gmail.com))

The number of people suffering a stroke for the first time is expected to rise by more than 50% by 2035, costing the UK more than £75 billion for care and lost productivity, a charity has said.

The Stroke Association urged the next government to invest more in prevention, as well as addressing issues with stroke treatment and rehabilitation services.

Failing to do so could risk demand on NHS services becoming “unsustainable” in 11 years’ time, it said.

151,000

The projected number of new stroke hospital admissions per year by 2035

The Stroke Association

A new manifesto published by the charity estimated that stroke will cost the UK about £43 billion this year, with 100,000 new stroke hospital admissions per year.

This could rise to 151,000 admissions by 2035 – the equivalent of 414 per day – with the number of stroke survivors rising from 1.3 million to 2.1 million.

Costs associated with the increase could top £75 billion, which includes projected increases in health and social care costs, as well as informal care costs.

About a quarter of strokes impact people of working age, with lost productivity currently costing an estimated £1.6 billion per year.

This too is expected to rise by 136% by 2035, according to the report.

If the next government fails to tackle prevention, treatment, and recovery at the root, then stroke will become the most avoidable burden on the NHS

Juliet Bouverie, Stroke Association

Juliet Bouverie, chief executive of the Stroke Association, warned that the “demand for NHS services will be unsustainable by 2035″.

“If the next government fails to tackle prevention, treatment, and recovery at the root, then stroke will become the most avoidable burden on the NHS,” she added.

The Stroke Association is calling on the Department of Health and Social Care (DHSC) to publish a funded stroke prevention plan to support people of all ages to reduce their risk of stroke.

This includes improving the way people detect and manage conditions that increase the risk of stroke, such as high blood pressure.

The charity also wants all patients to have 24-hour access to thrombectomies – a surgery to remove blood clots from the artery.

The procedure is usually carried out up to six hours after stroke symptoms begin.

The Stroke Association estimates that making thrombectomies universally available could save the health and care system £73 million each year and would allow 1,600 more stroke survivors to be independent.

Thanks to Life After Stroke services, I’ve slowly been rebuilding myself and I am also set to start a phased return to work later this year

Stroke survivor Marwar Uddin

It also called for the Government to address issues in access to rehabilitation and support services, such as the Life After Stroke programme.

Stroke survivor Marwar Uddin, 24, from London, spoke about the long-term impact of the condition and how support services have helped him.

He said: “I need help to go to the toilet. I can’t even dress myself. My voice is different now. I’m a different person. I cry myself to sleep most days. It’s difficult for me.

“Thanks to Life After Stroke services, I’ve slowly been rebuilding myself and I am also set to start a phased return to work later this year.

“If I didn’t have any of this support, I think I would still be in a chair in my living room watching the world go by.”

Ms Bouverie added: “Every stroke is a tragedy, but 151,000 strokes per year, and growing each year, will be a failure of leadership.

“In 2000, stroke was the second leading cause of death in the UK but by making stroke a national priority reflected in local resources, stroke mortality was halved by 2010. So, change is possible.”

Over 90% of acute stroke care providers in England are equipped with artificial intelligence, which can reduce the time it takes to access treatment such as thrombectomy by more than 60 minutes

Department of Health and Social Care

A DHSC spokesperson said: “We’re committed to improving stroke prevention, treatment, and recovery for all.

“Over 90% of acute stroke care providers in England are equipped with artificial intelligence, which can reduce the time it takes to access treatment such as thrombectomy by more than 60 minutes.

“The first ever Long Term Workforce Plan will help to shift more care into the community and invest more in prevention and early intervention, and we’re rolling out a new digital NHS Health Check which could prevent hundreds more strokes.

“We are also taking action to encourage better lifestyle choices, including creating a smoke-free generation and reducing salt intake through food to help prevent the risk of strokes.”

WSO's advocacy priorities include the need to ensure people affected by stroke have access to rehabilitation and support that is essential for health, well-being and social participation.

WHAT ABSOLUTE FUCKING BULLSHIT! 'ACCESS'  has almost nothing to do with recovery! ARE YOU THAT BLITHERINGLY STUPID?

They need to be destroyed and run by survivors!

 WSO's advocacy priorities include the need to ensure people affected by stroke have access to rehabilitation and support that is essential for health, well-being and social participation.

Our WSO President Prof Marc Fisher sets out key reasons to become a #stroke researcher at the #GSA2022

Really? ABSOLUTELY NOTHING to do with getting survivors recovered!  This is why the WSO needs to be destroyed and run by survivors.  'Improve patient care' is way too fucking wimpy to be allowed to stand.

Our WSO President Prof Marc Fisher sets out key reasons to become a #stroke researcher at the #GSA2022

Roadmap to delivering quality stroke care -WSO

 You will immediately notice how fucking useless this is: 'CARE', NOT RESULTS, NOT RECOVERY! The WSO needs to be destroyed and replaced with a survivor led one.

Roadmap to delivering quality stroke care -WSO

 

The WSO Roadmap to Delivering Quality Stroke Care is an implementation resource to accompany the WSO Global Stroke Services Guideline and Action Plan. This roadmap provides the framework for the implementation, monitoring and evaluation of stroke services globally. It provides standardization and consistency for the selection of evidence-based recommendations, approaches to implementations in clinical practice, and the calculation of performance measures to create an environment of continuous quality improvement.

The Global Stroke Guidelines and Action Plan is available for download in one pdf, alternatively, each chapter from the Global Stroke Guidelines and Action Plan can be downloaded from the links below.

The Guidelines and Action Plan is also available in 8 languages including Arabic , Chinese, Korean, Persian, Portuguese, Russian, Spanish, Turkish, Japanese and Vietnamese.

WSO Future Stroke Leaders Programme Research Project Grant Awards

 There is zero leadership here, all these are just  pretty much useless for getting survivors 100% recovered. THIS IS WHY THE WSO NEEDS TO BE DESTROYED! NO leadership, NO strategy. Nothing here is strategic. Everyone involved needs to be fired.

WSO Future Stroke Leaders Programme Research Project Grant Awards

The WSO is delighted to announce the winners of the Future Stroke Leaders Programme research project grant awards. The assessment committee considered 6 excellent project proposals which all incorporated the overall programme objective, in line with the WSO’s mission(Your mission is totally wrong, 100% recovery is the mission, you blithering idiots.), to reduce the global burden of stroke through more effective prevention, better treatment and long-term support. The duration of each grant is one year, and the maximum funding per project is USD 20,000. It was a hard choice to decide upon the final four outstanding projects that  cover a wide range of topics, from acute stroke care to rehabilitation, and aim to benefit global stroke care development.

We would like to thank all Future Stroke Leaders for their commitment to improving global stroke care and welcome the start of the implementation phase. All completed projects will be presented at the World Stroke Congress in Singapore in 2022 (WSC2022).

The titles of the 4  funded projects:

• Unveiling the cost of acute stroke care in Latin America: a comprehensive analysis
• Feasibility and challenges of acute stroke care implementation in two African countries: a pilot study
• Establishing organized stroke care in low-and-middle income countries: From training of non-specialist to implementation
• Improving life after stroke for young people: analysis of unmet needs and development of resources across countries

Congratulations! We look forward to see the interim results during the implementation year and the final outcomes at WSC2022.

 

The state of stroke services across the globe: Report of World Stroke Organization–World Health Organization surveys

THIS IS WHY THE WSO IS SO FUCKING USELESS! Measuring services rather than recovery results. They need to be destroyed and run by survivors who would never take their eyes off the only goal in stroke;100% recovery.

The state of stroke services across the globe: Report of World Stroke Organization–World Health Organization surveys

Mayowa O Owolabi1, Amanda G Thrifthttps://orcid.org/0000-0001-8533-41702, Sheila Martins3, Walter Johnson4, Jeyaraj Pandianhttps://orcid.org/0000-0003-0028-19685, Foad Abd-Allah6, Cherian Varghese7, Ajay Mahal8, Joseph Yariahttps://orcid.org/0000-0002-1899-08539, Hoang T Phan10, Gregory Roth11, Seana L Gall10, Richard Beare12, Thanh G Phanhttps://orcid.org/0000-0003-3400-632313, Robert Mikulik14, Bo Norrving15, Valery L Feiginhttps://orcid.org/0000-0002-6372-174016, The Stroke Experts Collaboration Group, S.F. Abera, A. Addissie, A. Adeleye, Y. Adilbekov, B. Adilbekova, T.A. Adoukonou, de Sousa D. Aguiar, Z. Akhmetzhanova, R.O. Akinyemi, A. Akpalu, S.F. Ameriso, S. Andonova, C. Abanto, F.E. Awoniyi, M. Bakhiet, H. Basri, P.M. Bath, D. Bereczki, S. Beretta, A.L. Berkowitz, J. Bernhardt, G. Berzina, B. Bhavsar, M.S. Bisharyan, P. Bovet, M. Brainin, H. Budincevic, N.L. Cabral, D A. Cadilhac, V. Caso, C. Chen, J.H. Chin, H Christensen, K. Chwojnicki, A.B. Conforto, V.T. Cruz, M. D'Amelio, K.E. Danielyan, S. Davis, V Demarin, R.J. Dempsey, M. Dichgans, Dokova, G. Donnan, J. Duran, M.A.B. Elizondo, M.S. Elkind, M. Endres, I. Etedal, M.E. Faris, U. Fischer, F. Gankpe, M. Gavidia, A. Gaye-Saavedra, M. Giroud, F. Gongora-Rivera, V. Hachinski, W. Hacke, R.R. Hamadeh, T.K. Hamzat, G.J. Hankey, M.R. Heldner, N.M. Ibrahim, M. Inoue, S. Jee, J. Jiann-Shing, S. Johnston, Y. Kalkonde, S. Kamenova, P. Kelly, T. Khan, S. Kiechl, A. Kondybayeva, J. Kõrv, M. Kravchenko, R. Krishnamurthi, P. Langhorne, Z.L. Kang, J. Kruja, P.M. Lavados, D. Lebedynets, T.W. Leung, D.S. Liebeskind, P. Lindsay, L. Liu, P. López-Jaramillo, P.A. Lotufo, J.M. Machline-Carrion, H.S. Markus, J.M. Marquez-Romero, M.T. Medina, S. Medukhanova, M.M. Mehndiratta, E. Mirrakhimov, S. Mohl, S. Murphy, K.I. Musa, A. Nasreldein, R. Nogueira, C.H. Nolte, B. Norrving, J.J. Noubiap, N. Novarro-Escudero, M. O'Donnell, V. Ogun, M.I. Oraby, B. Ovbiagele, D.N. Ōrken, A.O. Ōzdemir, S. Ozturk, M. Paccot, A. Peters, M. Piradov, T. Platz, T. Potpara, A. Ranta, F.A. Rathore, G. Roth, R.L. Sacco, R. Sahathevan, I.C. Santos, G. Saposnik, F.S. Sarfo, M. Sharma, K.N. Sheth, A. Shobhana, S.N. Silva, N. Suwanwela, P.N. Sylaja, K. Thakur, D. Toni, M.A. Topcuoglu, J. Torales, A. Towfighi, T. Truelsen, A. Tsiskaridze, L. Tsong-Hai, M. Tulloch-Reid, J.N. Useche, P. Vanacker, S. Vassilopoulou, N. Venketasubramanian, G. Vukorepa, V. Vuletic, K.W. Wahab, W. Wang, T. Wijeratne, C Wolfe, M.Y. Yifru, A. Yock-Corrales, N. Yonemoto, L. Yperzeele, and on behalf of the Stroke Experts Collaboration Group
Background

Improving stroke services is critical for reducing the global stroke burden. The World Stroke Organization–World Health Organization–Lancet Neurology Commission on Stroke conducted a survey of the status of stroke services in low and middle-income countries (LMICs) compared to high-income countries.
Methods

Using a validated World Stroke Organization comprehensive questionnaire, we collected and compared data on stroke services along four pillars of the stroke quadrangle (surveillance, prevention, acute stroke, and rehabilitation) in 84 countries across World Health Organization regions and economic strata. The World Health Organization also conducted a survey of non-communicable diseases in 194 countries in 2019.
Results

Fewer surveillance activities (including presence of registries, presence of recent risk factors surveys, and participation in research) were reported in low-income countries than high-income countries. The overall global score for prevention was 40.2%. Stroke units were present in 91% of high-income countries in contrast to 18% of low-income countries (p < 0.001). Acute stroke treatments were offered in ∼ 60% of high-income countries compared to 26% of low-income countries (p = 0.009). Compared to high-income countries, LMICs provided less rehabilitation services including in-patient rehabilitation, home assessment, community rehabilitation, education, early hospital discharge program, and presence of rehabilitation protocol.
Conclusions

There is an urgent need to improve access(WRONG, WRONG, WRONG, you blithering idiots. Access to stroke services that don't work is fuckingly stupid. Are you that brain dead?) to stroke units and services globally especially in LMICs. Countries with less stroke services can adapt strategies from those with better services. This could include establishment of a framework for regular monitoring of stroke burden and services, implementation of integrated prevention activities and essential acute stroke care services, and provision of interdisciplinary care for stroke rehabilitation.

 

Genentech’s Anti-Amyloid Beta Antibody Gantenerumab Granted FDA Breakthrough Therapy Designation in Alzheimer’s Disease

You'll want your doctors and stroke hospital to be closely following this so as soon as it is proven protocols are written and implemented in your hospital. If your hospital doesn't have a dedicated research analyst whose only job is to follow and implement research then you don't have a functioning stroke hospital.

Your risk of dementia, has your doctor told you of this?

1. A documented 33% dementia chance post-stroke from an Australian study?   May 2012.

2. Then this study came out and seems to have a range from 17-66%. December 2013.`    

3. A 20% chance in this research.   July 2013.

4. Dementia Risk Doubled in Patients Following Stroke September 2018 

The latest here:

 

Genentech’s Anti-Amyloid Beta Antibody Gantenerumab Granted FDA Breakthrough Therapy Designation in Alzheimer’s Disease

Gantenerumab is an investigational antibody in Phase III development for early Alzheimer's disease (AD) –

– Gantenerumab is the first and only anti-amyloid antibody being investigated for subcutaneous administration in late-stage trials for the treatment of AD –

– Ongoing Phase III GRADUATE program with gantenerumab is anticipated to deliver a comprehensive data set with expected readout in the second half of 2022 –

[Ad hoc announcement pursuant to Art. 53 LR]

October 08, 2021 04:48 PM Eastern Daylight Time

SOUTH SAN FRANCISCO, Calif.--(BUSINESS WIRE)--Genentech, a member of the Roche Group (SIX: RO, ROG; OTCQX: RHHBY), today announced that gantenerumab, an anti-amyloid beta antibody developed for subcutaneous administration, has been granted Breakthrough Therapy Designation by the U.S. Food and Drug Administration (FDA) for the treatment of people living with Alzheimer’s disease (AD). This designation is based on data showing that gantenerumab significantly reduced brain amyloid plaque, a pathological hallmark of AD, in the ongoing SCarlet RoAD and Marguerite RoAD open-label extension trials, as well as other studies. Learnings from these studies have been incorporated into the optimized design of two ongoing parallel, global, placebo-controlled and randomized Phase III trials, GRADUATE 1 and 2. The pivotal trials are evaluating gantenerumab in more than 2,000 participants for more than two years and are expected to be completed in the second half of 2022.

“For more than a decade, we’ve been committed to advancing the science of Alzheimer’s as well as our investigational medicine gantenerumab, and we look forward to delivering a comprehensive and robust data set that furthers our collective understanding of this devastating disease”

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“For more than a decade, we’ve been committed to advancing the science of Alzheimer’s as well as our investigational medicine gantenerumab, and we look forward to delivering a comprehensive and robust data set that furthers our collective understanding of this devastating disease,” said Levi Garraway, M.D., Ph.D., chief medical officer and head of Global Product Development. “This Breakthrough Therapy Designation reinforces our confidence in gantenerumab, which would be the first subcutaneous medicine for the treatment of Alzheimer’s disease with the potential for at-home administration.”

Breakthrough Therapy Designation is designed to accelerate the development and review of medicines intended to treat serious or life-threatening conditions with preliminary evidence that indicates they may demonstrate a substantial improvement over available therapies that have received full FDA approval. This designation for gantenerumab marks the 39th Breakthrough Therapy Designation for Genentech’s portfolio of medicines.

AD is a progressive, fatal disease of the brain characterized by a decline in memory, language, and other thinking skills as well as changes in mood and behavior. Biological changes in the brain are believed to start decades before clinical symptoms of AD become evident. Alzheimer's is the most common form of dementia, which currently affects more than 55 million people worldwide, and is projected to reach 78 million by 2030. An enormous and growing public health challenge, it is predicted to cost the global economy a cumulative $20 trillion over the next decade, or the U.S. $2.8 trillion per year by 2030. Approximately 10 million people are diagnosed with AD each year. Given the medical and societal complexities of AD, several tools and treatment options will likely be required to meet the multiple and diverse needs of people living with the disease.

Genentech is continuing to explore multiple approaches and molecules that may address key pathways of AD, including amyloid beta and tau, as well as innovative tools designed to more effectively diagnose AD and support clinicians in monitoring disease progression.

About gantenerumab and its clinical program

Gantenerumab is an investigational IgG1 antibody designed to bind to aggregated forms of amyloid beta and remove brain amyloid plaques, a pathological hallmark of Alzheimer’s disease (AD). Gantenerumab significantly lowered brain amyloid plaques in patients with sporadic AD in the SCarlet RoAD and Marguerite RoAD open-label extension studies (OLEs) and in patients with dominantly inherited AD in the DIAN-TU-001 study. Learnings from these studies have been incorporated into the optimized design of two ongoing parallel, global, placebo-controlled and randomized Phase III trials, GRADUATE 1 and 2.

The pivotal GRADUATE trials are investigating the effect of gantenerumab on amyloid load and downstream biomarkers of disease progression, as well as the safety and efficacy of gantenerumab in people with early (prodromal-to-mild) AD. The studies include more than 2,000 participants treated for more than two years in up to 350 study centers in more than 30 countries worldwide. It is evaluating a monthly target dose of 1,020 mg with an optimized titration, aimed at maximizing exposure and minimizing dose interruption throughout the study period for better detection of a potential clinical benefit. Data from both trials are expected in the second half of 2022.

Other studies evaluating gantenerumab in AD include:

• Open RoAD, a rollover open-label study for the former SCarlet RoAD and Marguerite RoAD OLEs to continue to evaluate the safety and tolerability of long-term administration of gantenerumab in participants with AD.
• GRADUATION, an open-label study to evaluate the pharmacodynamic (PD) effects of once weekly administration of gantenerumab in participants with early AD. The study design is similar to the GRADUATE studies and includes the option of home administration by a caregiver.
• An exploratory OLE of DIAN-TU-001, aiming to build on learnings from DIAN-TU-001 and further investigate the relationship of biomarker changes with cognitive and clinical findings in participants with autosomal dominant AD (ADAD). 

More at link.

 

World Stroke Organization Global Stroke Services Guidelines and Action Plan

Notice how fucking useless this is for survivors, no protocol database for recovery. NOTHING ON 100% RECOVERY!  They need to be destroyed and run by survivors.

 

 World Stroke Organization Global Stroke Services Guidelines and Action Plan

Patrice Lindsay1,2,*,†, Karen L. Furie3,4,†, Stephen M. Davis5,6,†, Geoffrey A. Donnan6,7,†, andBo Norrving8,†

Every two seconds, someone across the globe suffers a symptomatic stroke. ‘Silent’ cerebrovascular disease insidiously contributes to worldwide disability by causing cognitive impairment in the elderly. The risk of cerebrovascular disease is disproportionately higher in low to middle income countries where there may be barriers to stroke care. The last two decades have seen a major transformation in the stroke field with the emergence of evidence-based approaches to stroke prevention, acute stroke management, and stroke recovery.The current challenge lies in implementing these interventions, particularly in regions with high incidences of stroke and limited healthcare resources. The Global Stroke Services Action Plan was conceived as a tool to identifying key elements in stroke care(NOT RECOVERY!) across a continuum of health models.At the minimal level of resource availability, stroke care delivery is based at a local clinic staffed predominantly by non-physicians. In this environment, laboratory tests and diagnostic studies are scarce, and much of the emphasis is placed on bedside clinical skills, teaching, and prevention. The essential services level offers access to a CT scan, physicians,and the potential for acute thrombolytic therapy, however stroke expertise may still be difficult to access. At the advanced stroke services level, multidisciplinary stroke expertise, multimodal imaging, and comprehensive therapies are available. A national plan for stroke care should incorporate local and regional strengths and build upon them.This clinical practice guideline is a synopsis of the core recommendations and quality indicators adapted from ten high quality multinational stroke guidelines. It can be used to establish the current level of stroke services, target goals for expanding stroke resources, and ensuring that all stages of stroke care are being adequately addressed, even at the advanced stroke services level. This document is a start, but there is more to be done, particularly in the realm of primary prevention. Despite differences in resource availability, the message we wish to convey is that stroke awareness, education, prevention, and treatment should always be feasible. Communities and institutions should set goals to continuously expand their stroke service capabilities. This document is intended to augment stroke advocacy efforts throughout the world, providing a strategic plan for optimizing stroke outcomes.

The mission of the World Stroke Organization (WSO)

Notice how fucking useless this is for survivors, no protocol database for recovery. NOTHING ON 100% RECOVERY!  They need to be destroyed and run by survivors.

 The mission of the World Stroke Organization (WSO)

WSO aims to accomplish its mission by:

•Fostering the best standards of practice

•Increasing stroke awareness among the population and among health professionals

•Preventing subtle cerebrovascular disease leading to gait disorders,imbalance, vascular cognitive impairment, and behavioral changes

•Influencing policies for stroke prevention and improved health services

•Providing education in collaboration with public and private organizations

•Facilitating stroke research advocacy for people with stroke

•Fostering the development of systems and organizations for long-term support of stroke survivors and their families

The World Stroke Academy (WSA) is the e-learning platform for the World Stroke Organization (WSO) is calling for a social media leader

Notice very specifically, ABSOLUTELY NOTHING TO DO WITH SURVIVORS. They need to be completely destroyed and run by and for survivors.  Hell I write upwards of 50 blog posts a week, obviously that is doing no good, I have never been contacted by any stroke doctor or leader.

The World Stroke Academy (WSA) is the e-learning platform for the World Stroke Organization (WSO) is calling for a social media leader

The World Stroke Academy (WSA) is the e-learning platform for the World Stroke Organization (WSO).

WSA provides educational materials in a variety of formats to meet the needs of the WSO membership, with the support of the WSO Education Committee and the WSO Stroke Connector programme as needed.
The WSA provides an up-to-date stroke information for healthcare professionals with an aim to alleviate the global burden of stroke through the education of practitioners worldwide.
The WSA provides the technical support for, and coordination of, WSO online educational and promotional webinar and social media activity.

Responsibilities of the role as social media leader in the WSA include:
-creating and sharing social media content for health care professionals
-growing the social media reach and engaging with followers
-building the WSA brand
-promoting WSA activities

Skills we are looking for:
- Enthusiasm for social media and marketing for health care professionals
- Experience using social media professionally (especially Twitter)
- Experience creating strong, engaging social media content
- Medical background with expertise in the wide spectrum of stroke care
- Time commitment: a minimum availability of at least 3 times a week to post in social media

If you have any further questions, please get in touch with us: education@world-stroke.org

RECENT ADVANCEMENT TO IMPROVE BALANCE IN STROKE REHABILITATION.

Even professors subscribe to the tyranny of low expectations. The rot is incredibly deep in the stroke world, I think it needs to be completely destroyed.

RECENT ADVANCEMENT TO IMPROVE BALANCE IN STROKE REHABILITATION.

 2019, International Journal of Advanced Research (IJAR)
Jyoti Sharma 1 and 

Umar Abdullah 2
.
1. Assiatant Professor, Galgotias University, Greater Noida.

2. Student, Noida International University, Greater Noida
Abstract


 Manuscript History
Received: 08 January 2019 Final Accepted: 10 February 2019 Published: March 2019
Key words:-
Stroke; Rehabilitation; Balance Techniques.
After stroke, a main goal of rehabilitation is promote independent in activity of daily living.(Wrong, wrong, wrong; 100% RECOVERY IS THE GOAL.) An important determinant of activities of daily living performance is standing and balance, which is a strong predictor of functional recovery and walking capacity in post stroke rehabilitation. Purpose of this study was to investigate the effects of different balance Techniques/Approaches on post stroke rehabilitation. Furthermore, the study was aimed to identify which training regimen was most effective. Electronic databases were searched to evaluate the effects of exercise therapy on balance capacity in stroke rehabilitation. 63 articles were studied and 42 were selected after inclusion and exclusion criteria strategies. After going through all the articles, it was concluded that both the three approaches (Mental Practice/Mental Imagery MP/MI, Visual Reality VR, and Mirror Therapy MT) were effective, but MP/MI is more effective according to my studies, it was observed that mental imagery is a safe and low-cost technique that can  be performed even without supervision once the patient has completed appropriate training.
Copy Right, IJAR, 2019,. All rights reserved.

The Delta-Subunit Selective GABAA Receptor Modulator, DS2, Improves Stroke Recovery via an Anti-inflammatory Mechanism

I guess you are just going to have to wait until human followup is done. Maybe 50 years from now unless WE destroy the existing stroke associations and run them like the Michael J. Fox Foundation which is dedicated to finding a cure for Parkinson's disease. 

The Delta-Subunit Selective GABA_A Receptor Modulator, DS2, Improves Stroke Recovery via an Anti-inflammatory Mechanism

Silke Neumann^1,2†, Lily Boothman-Burrell^2†, Emma K. Gowing², Thomas A. Jacobsen³, Philip K. Ahring⁴, Sarah L. Young¹, Karin Sandager-Nielsen³ and Andrew N. Clarkson^2*

• ¹Department of Pathology, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
• ²Department of Anatomy, Brain Health Research Centre, Brain Research New Zealand, University of Otago, Dunedin, New Zealand
• ³Saniona A/S, Copenhagen, Denmark
• ⁴School of Pharmacy, University of Sydney, Sydney, NSW, Australia

Inflammatory processes are known to contribute to tissue damage in the central nervous system (CNS) across a broad range of neurological conditions, including stroke. Gamma amino butyric acid (GABA), the main inhibitory neurotransmitter in the CNS, has been implicated in modulating peripheral immune responses by acting on GABA_A receptors on antigen-presenting cells and lymphocytes. Here, we investigated the effects and mechanism of action of the delta-selective compound, DS2, to improve stroke recovery and modulate inflammation. We report a decrease in nuclear factor (NF)-κB activation in innate immune cells over a concentration range in vitro. Following a photochemically induced motor cortex stroke, treatment with DS2 at 0.1 mg/kg from 1 h post-stroke significantly decreased circulating tumor necrosis factor (TNF)-α, interleukin (IL)-17, and IL-6 levels, reduced infarct size and improved motor function in mice. Free brain concentrations of DS2 were found to be lower than needed for robust modulation of central GABA_A receptors and were not affected by the presence and absence of elacridar, an inhibitor of both P-glycoprotein and breast cancer resistance protein (BCRP). Finally, as DS2 appears to dampen peripheral immune activation and only shows limited brain exposure, we assessed the role of DS2 to promote functional recovery after stroke when administered from 3-days after the stroke. Treatment with DS2 from 3-days post-stroke improved motor function on the grid-walking, but not on the cylinder task. These data highlight the need to further develop subunit-selective compounds to better understand change in GABA receptor signaling pathways both centrally and peripherally. Importantly, we show that GABA compounds such as DS2 that only shows limited brain exposure can still afford significant protection and promote functional recovery most likely via modulation of peripheral immune cells and could be given as an adjunct treatment.

Introduction

Stroke is the leading cause of lasting disability, with patients experiencing varied levels of functional recovery, and with more than 50% of survivors being discharged into care (Dobkin, 2008; Go et al., 2014). Changes in neuronal excitability, loss of gamma amino butyric acid (GABA) inhibition, enhanced glutamatergic signaling, and changes in neuronal connections and plasticity all contribute to impairment after stroke (Wittenberg and Schaechter, 2009; Clarkson et al., 2010, 2011, 2015, 2019; Carmichael, 2012; Krakauer et al., 2012). In addition, it is well documented that the full expansion of the infarction and ongoing impairment in the weeks to months following a stroke is underpinned by inflammation and the infiltration of peripheral immune cells that cross the blood–brain-barrier (BBB) (Gelderblom et al., 2009, 2015; Doyle et al., 2015). To date, drug therapies have attempted to minimize the extent of cell death, however, all drug therapies that have been trialled have failed to translate into the clinic. Therefore, new drug therapies need to be developed in order to support the recovery of stroke patients.

Changes in inflammatory processes is a hallmark for many pathologies including obesity, diabetes and stroke. Although acute inflammation is beneficial for the repairing and healing process, chronic inflammation contributes to tissue damage. Immune cells play a critical role in contributing to brain damage initiated by ischemic stroke. As a consequence of stroke, immune cells migrate to the brain in response to danger signals (damage-associated molecular patterns, DAMPs), in an effort to repair the damage (Brait et al., 2010; Gelderblom et al., 2015). However, these cells can also promote further inflammation and damage. In addition, the injured brain has an immune-suppressive effect that promotes life-threating infections, which threaten the survival of stroke patients (Liesz et al., 2015).

Traditionally considered a disease refined to the brain, it is becoming increasingly clear that the immune system heavily impacts the pathology of stroke. Local microglia, endothelial cells, neurons, and astrocytes recognize danger signals released from dying cells, which in turn stimulate the production of pro-inflammatory cytokines that attract circulating immune cells to migrate to the central nervous system (Offner et al., 2006; Gelderblom et al., 2009). Together, local and infiltrating cells, contribute to further neural cell death by producing pro-inflammatory cytokines, reactive oxygen species and by activating matrix metalloproteinases (Amantea et al., 2015). In particular, microglia have been shown to be chronically activated even when the initial DAMPs have been cleared (Huh et al., 2003; McGeer et al., 2003). This results in prolonged neuroinflammation that is associated with delayed recovery in stroke patients (Liguz-Lecznar and Kossut, 2013), and impaired memory, sensory learning and plasticity (Greifzu et al., 2011; Doyle et al., 2015).

Gamma amino butyric acid, known for its role as inhibitory neurotransmitter in the CNS, has a similar inhibiting effect on immune cells thereby creating a link between the CNS and the peripheral inflammatory response (Reyes-Garcia et al., 2007). Both, innate and adaptive immune cells express functional GABA receptors and possess enzymes to synthesize and catabolize GABA (Wheeler et al., 2011; Fuks et al., 2012). This includes microglia, macrophages, dendritic cells and T-cells. GABA signals through GABA_A and GABA_B receptors, both of which are expressed on immune cells (Kuhn et al., 2004; Wheeler et al., 2011; Fuks et al., 2012). The composition of the five subunits that make up GABA_A receptors likely varies for the various immune cells, which in turn will account for differences in potency and efficacy of drug treatments targeting GABA receptors and GABA itself (Fuks et al., 2012). GABA is known to act on GABA_A receptors in both millimolar and nanomolar to micromolar concentrations depending on the location (synaptic versus extrasynaptic) and functional composition of the receptors (Mody, 2001; Semyanov et al., 2003; Glykys and Mody, 2007). Of importance, submicromolar GABA concentrations have not only been found around neurons in the brain, but have also been detected in blood and hormone-producing cells in the intestine (Petty et al., 1999; Braun et al., 2004; Wendt et al., 2004). In addition to being exposed to chronic low levels of GABA, these peripheral tissues and receptors are likely to also be modulated following treatment with various GABA modulators. With the development of subunit specific GABA modulators, we may be able to find and develop compounds that could selectively regulate the function of peripheral immune cells.

Extrasynaptic GABA_A receptors, which are located outside the synapse typically contain either the δ- or α5-subunit and are highly sensitive to low GABA concentrations (Mody, 2001). Recent evidence has shown that modulation of extrasynaptic GABA_A receptors plays an important role in minimizing the extent of damage when given early (within hours) to increase tonic GABA currents after a stroke. In addition, this modulation can also facilitate an improvement in motor function when treatment is initiated at a delay (days) to dampen tonic GABA currents after the initial insult (Clarkson et al., 2010, 2019). As little is known about the role of δ-containing GABA_A receptor after stroke, we were interested in testing the therapeutic effects of the δ-subunit-selective GABA_A receptor modulator DS2 (4-chloro-N-[2-(2-thienyl)imidazo[1,2-a]pyridin-3-yl]benzamide). DS2 positively modulates δ-containing GABA_A receptors (Wafford et al., 2009), however, DS2 has not been investigated in a clinical disease model. Therefore, we aimed to assess the potential of DS2 to improve stroke recovery and to modulate inflammatory responses in innate immune cells. Herein, we show that positive allosteric modulation of δ-containing GABA_A receptors with DS2 affords significant protection and improves motor function in a mouse model of stroke. Investigation into a potential mechanism of action revealed that DS2 reduces the activation of NF-κB in LPS-stimulated macrophages and reduces the expression of activation markers on bone marrow-derived dendritic cells (BMDCs). Interestingly, we show that DS2 only has limited brain exposure, indicating that DS2-mediated effects in vivo are most likely attributed to modulation of peripheral immune cells.

More at link. 

Scientists can predict risk of heart attack with 90 per cent accuracy

Our fucking failures of stroke associations should immediately sponsor research that determines whether this can also predict stroke. But they will DO NOTHING.  That is why they are fucking failures and need to be destroyed.   You could ask why they are so bad but I look at action not words.

Scientists can predict risk of heart attack with 90 per cent accuracy

Scientists have found a way to predict the risk of heart attack with 90 per cent accuracy - almost a decade in advance.
The breakthrough by Oxford University uses artificial intelligence to look “beneath the surface” of routine CT scans and spot biomarkers which can give early red flags.
Scientists said 350,000 people a year could benefit from the checks, ensuring they were given the right treatment to avert potentially deadly attacks.
And they could be rolled out across the NHS in as little as two years.
Currently, patients experiencing chest pains are sent for CT scans.
In around one quarter of cases, these show blockages which can be treated with surgery.
But most patients are sent home without treatment, despite the fact many will later go on to have heart attacks.
The new technology can detect dangerous build-up of fat and scarring around the organ.
It allows medics to predict the likelihood of a heart attack over the next nine years with up to 90 per cent accuracy.

Those deemed high risk can then be given medication and monitored more closely to prevent a deadly episode.
Professor Charalambos Antoniades, who led the study at Oxford’s Division of Cardiovascular Medicine, said until now medics could only see the “tip of the iceberg” when it came to heart risks.
The new technology allows doctors to see the full picture, he said.
Speaking at the European Society of Cardiology conference in Paris, he said: “It is massively important because it will direct treatment and it will save lives.
“A machine can read the scan and give you the accurate information. It can give you the specific risk of the patient, it can tell you that you need treatment or you don’t need treatment.
“It is up to 85-90 per cent accurate at predicting heart attack over the next nine years.”
CT scans are currently used on about 40,000 high-risk patients each year.
But Prof Antoniades said future guidelines are set to recommend using the technology to scan 350,000 people annually.
They would typically be given to people aged 40 to 70 with chest pains or who are considered at particular risk of heart attacks because of obesity, smoking or diabetes.
Every year, almost 170,000 adults die from heart attacks, strokes or other circulatory conditions.

The study, which was funded by the British Heart Foundation (BHF), was published in the European Heart Journal.

Will We Ever Cure Alzheimer’s? How about stroke?

We will never cure stroke until the existing stroke associations are destroyed and a bunch of superstar stroke researchers have funerals. 

Does Science Advance One Funeral at a Time?

 

Will We Ever Cure Alzheimer’s?

6th ESO–ESMINT–ESNR Stroke Winter School

Oh hell, what a waste, management of patients NOT interventions/protocols to get them 100% recovered. This is the exact reason everything in stroke needs to be destroyed and have survivors in charge.  They are teaching status quo, which is a complete failure.

6th ESO–ESMINT–ESNR Stroke Winter School

Report of the 6th ESO ESMINT ESNR Stroke Winter School
Urs Fischer, Pasquale Mordasini, Jan Gralla, Simon Jung

The 6th ESO ESMINT ESNR Stroke Winter School was held in Bern, Switzerland from the 29th January to 1st of February 2019. The local organizing committee were Prof. Jan Gralla, PD Dr. Pasquale Mordasini, PD Dr. Simon Jung and Prof. Urs Fischer. Joëlle Schilling, Michela Mordasini and Helena Gerber actively supported them.

We had the difficult task to select 67 participants out of 146 applicants, but eventually 37 rising stroke physicians and 30 neurointerventionalists arrived in Bern from the following 22 different countries: Albania, Austria, Belgium, Croatia, France, Germany, Greece, Israel, Italy, Latvia, Lithuania, Netherlands, Norway, Poland, Portugal, Romania, Russia, Slovakia, Sweden, Switzerland, Ukraine and United Kingdom.

The primary aim of the 6th ESO ESMINT ESNR Stroke Winter School was bringing together European stroke physicians and neurointerventionalists in order to enhance interdisciplinary management of patients with acute ischaemic stroke.
The Stroke Winter School started on the 29th of January 2019 with the welcome of the president of the European Stroke Organization (ESO) Prof. Bart Van der Worp the representative of the president of the European Society of Minimal Invasive Neurological Therapy (ESMINT) and as well of the committee of the Interventional Neuroradiology Section of the European Society of Neuroradiology (ESNR) Prof. Jan Gralla.

The 32 speakers (12 from EU, 20 from Switzerland and even one of Vietnam) including neurologists, interventional and non-interventional neuroradiologists, neurosurgeons, and neuropediatricians led challenging discussions. The teaching program included 33 lectures and 4-6 tutorials. The main focus of the lectures was interdisciplinary treatment of acute stroke. There were sessions on acute stroke imaging, acute treatment strategies including endovascular approaches, stroke treatment in difficult circumstances and needs to set up an interdisciplinary stroke center. In the afternoon tutorials were given separately for neurointerventionalists and stroke physicians. Neurointerventionalists had the opportunity for structured hands-on teaching in small groups on endovascular procedures with animal models and management of complications of endovascular treatment. Stroke physicians could learn neuroangiography on a model and they were taught interpretations of CT and MRI by neuroradiologists.

A special highlight for the interventional neurointerventionalists were the hands-on teaching sessions with the animal model. Small groups of 4-5 participants were given the opportunity to perform diagnostic angiography and endovascular treatment procedures such as thrombectomy with multiple devices.

Another highlight was the stroke simulation course: stroke physicians and neurointerventionalists took part in a real-life setting with simulated clinical stroke cases: physicians had to take care of the stroke patient and to decide on acute stroke management. Physicians were observed by colleagues and professionals and received feedback on their performance.
During the Stroke Winter School a faculty meeting was held with members of the ESO, ESMINT and ESNR in order to discuss future common strategies to enhance the quality of stroke management. Main topic was the training of future neurointerventionalists in areas with a current lack of experienced staff.

During the Stroke Winter School participants and faculty had three joint dinners to favor socialization and networking.

The following sponsors contributed to the realization of the Stroke Winter School:
Stryker, Microvention, Penumbra, Bracco, Cerenovus, Medtronic, Balt, Vascular Medical, Rapid medical, Phenox, Siemens, Boehringer Ingelheim.

The local organizing committee thanks all the invited speakers for giving time and efforts to the Stroke Winter School, for coming to Bern, and for delivering high quality lectures. Their interest and passion to teach the upcoming generation of stroke physicians and neurointerventionalists was clearly visible.

We are pleased to announce that there will be a 7th ESO ESMINT ESNR Stroke Winter School on January 28th to January 31st, 2020.

Faculty and participants of the 6th ESO ESMINT ESNR Stroke Winter School in Bern.

Getting the word out on Stroke

Apply this to stroke. What will it take to get action occurring for stroke, action meaning solving all the problems in stroke?

People already know that stroke is devastating, but they don't know that 25% of them will have a stroke. There is NO knowledge that stroke treatments are ineffective.

 tPA has been known to be a failure at complete recovery 88% of the time since approved in 1996. 

Full recovery from stroke only occurs 10% of the time. NSA statistic.

 

We have to destroy the existing stroke associations, they are making matters worse by focusing only on prevention and putting out crap like this from several years ago.  

What a bald-faced lie

Great thinking again by Seth Godin

Getting the word out on stroke

For some, this is the holy grail of marketing.
If only more people knew what you know.
If only they were aware of what you have to offer, of the work you can share.
Perhaps you can get more people to click on your video, read your tweet or see your Instagram.
Alas, awareness is not action.
Everyone reading this is aware that Peru is a country. But that doesn’t mean you’ve visited recently, or have plans to go soon.
Everyone reading this is aware that turnips are a root vegetable. But knowing they exist doesn’t mean you’re going to have them for dinner.
Awareness is important, but it is insufficient.
Action comes from tension, desire and fear. Action is the hard part.

 

What is the effect of additional physiotherapy on sitting balance following stroke compared to standard physiotherapy treatment: A systematic review

Once again laziness rules, meta-analysis rather than actually running clinical trials to solve all the problems in stroke. You can't get stroke protocols from meta-analysis.  No problem to them, they aren't the stroke survivors trying to get back to daily life.  This is why I think the complete stroke leadership(such as it is) needs to be destroyed.
http://search.naric.com/research/rehab/redesign_record.cfm?search=2&type=all&criteria=J77341&phrase=no&rec=135278&article_source=Rehab&international=0&international_language=&international_location=
Topics in Stroke Rehabilitation , Volume 23(1) , Pgs. 15-25.

NARIC Accession Number: J77341.  What's this?
ISSN: 1074-9357.
Author(s): Bank, Jessica; Charles, Katherine; Morgan, Prue.
Publication Year: 2016.
Number of Pages: 11.
Abstract: Study reviewed research that compared the effects of standard physiotherapy to standard physiotherapy plus an additional physiotherapy treatment on the outcome of sitting balance after stroke. The Cochrane Library, CINAHL, Embase, Ovid Medline, AMED, and the Physiotherapy Evidence Database (PEDro) databases were searched up to December 2014 for relevant randomized controlled trials published in English in peer-reviewed journals. The PEDro scale was used to assess study quality. Eleven studies met inclusion criteria. Nine targeted the International Classification of Function, Disability and Health (ICF) domain of Activity. The Trunk Control Test (TCT) was used as a primary outcome measure in five studies, and the Trunk Impairment Scale (TIS) was used in four. There was a significant effect (mean difference = 1.67) favoring intervention, as measured by the TIS. There was no evidence to support the effect of additional treatment on sitting balance as measured by the TCT (mean difference = −1.53). The current evidence supports strategies that target deficits at the activity level and increase total treatment time. The TIS is most responsive as a measure of treatment efficacy. Further research is required using recommended outcome measures to facilitate generation of a minimum data set and data pooling.
Descriptor Terms: EQUILIBRIUM, EXERCISE, LITERATURE REVIEWS, MOTOR SKILLS, PHYSICAL THERAPY, POSITIONING, POSTURE, REHABILITATION, STROKE.


Can this document be ordered through NARIC's document delivery service*?: Y.

Citation: Bank, Jessica, Charles, Katherine, Morgan, Prue. (2016). What is the effect of additional physiotherapy on sitting balance following stroke compared to standard physiotherapy treatment: A systematic review.  Topics in Stroke Rehabilitation , 23(1), Pgs. 15-25. Retrieved 1/11/2018, from REHABDATA database.

MedAware Systems introduces complete database of research on Alzheimer’s disease and dementia

And just when will our fucking failures of stroke associations get around to compiling a complete database of stroke research and protocols? Never? Until they are completely destroyed and run by stroke survivors? Whomever is in charge right now seems to have no intention of ever helping stroke survivors.  Dr. Watson of IBM could solve this if we would just hire her/him.
https://www.news-medical.net/news/20171222/MedAware-Systems-introduces-complete-database-of-research-on-Alzheimere28099s-disease-and-dementia.aspx

• Download PDF Copy

December 22, 2017

MedAware Systems, Inc. announced today it is launching the world’s most comprehensive database of human clinical trials data on Dementia / Alzheimer’s disease. The database currently contains over 5,000 studies on Dementia and related diseases with more than 30 million data points available for analysis. The Company continuously updates this database as new studies are published.
MedAware Systems’ patent-pending software and process converts published clinical trials into the component data which can then be analyzed using standard statistical analytic techniques.
The database, as well as analytics, are available for licensing by Industry and researchers.
“For the first time, all of the raw data from human clinical trials in the area of Dementia are available in a single database”, says Founder and Chief Science Officer, Dr. Zung Vu Tran, a leading authority on bio-statistics. He adds:

We have solved a myriad of problems in collecting, organizing, and standardizing this vast quantity of data. Companies and researchers will now have, at their fingertips, data from thousands of medical research studies on Alzheimer’s disease and other forms of dementia. This will save them years of effort in trying to collect, analyze and continuously update the available science in the field.

Source:

https://www.medawaresystems.com/wp-content/uploads/2017/12/Alz-databasePR.pdf

Top Ten Medical Research Issues and Trends to Watch in 2017

If we had a great stroke association there would be a list of: 'Top Ten Stroke Research Issues and Trends to Watch in 2017'. But we HAVE NOTHING! And there will continue to be nothing until the existing stroke world is destroyed.

Top Ten Medical Research Issues and Trends to Watch in 2017

Margaret Anderson Executive Director, FasterCures, a center of the Milken Institute

1. FDA: What is the roadmap going forward?

2. What size would you like: small, medium or big science?

3. Clinical trial innovation and reform: It’s a big job but somebody’s gotta do it.

4. Doing science in the real world.

5. Patient-centricity: What’s the ROI?

6. Move over direct-to-consumer ads - it’s time for direct-to-patient R&D.

7. Digitization of disease, and health.

8. Data sharing: Where there’s a will, there needs to be a way.

9. Evolution of value frameworks.

10. Blockchain could be good for your health.

We’ll be watching all of these issues because there are a million things we haven’t done yet to ensure that our R&D system and partners keep on innovating for patients. Just you wait!

Follow Margaret Anderson on Twitter: www.twitter.com/margaretaindc