Deans' stroke musings

Changing stroke rehab and research worldwide now.Time is Brain!Just think of all the trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 493 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It's quite disgusting that this information is not available from every stroke association and doctors group.
My back ground story is here:http://oc1dean.blogspot.com/2010/11/my-background-story_8.html

Saturday, May 27, 2017

End-of-Life Care After Stroke Varies Widely

Likely because they have not done any objective 3d scans of the dead and dying areas to know how bad the stroke was. 
https://www.medpagetoday.com/Neurology/Strokes/65606?xid=nl_mpt_DHE_2017-05-27&eun=g424561d0r&pos=1

Transition to palliative care varies by patient and hospital factors

  • by
    Contributing Writer, MedPage Today

Action Points

  • Note that this observational study found that the use of "comfort measures only" for stroke patients varies significantly from hospital to hospital.
  • This variation is not solely due to hospital acuity levels, suggesting that approach to these patients might benefit from more standardization.
Early use of comfort measures only following admission for acute stroke varies widely between hospitals, as influenced by hospital and patient characteristics, researchers reported.
Overall, about one in 20 people (5.6%) were transitioned from traditional or aggressive acute treatment to comfort measures only (CMO) within 48 hours of admission for acute hemorrhagic or ischemic stroke, Shyam Prabhakaran, MD, of Northwestern University in Chicago, and colleagues reported online in Neurology: Clinical Practice.
However, early use of a palliative approach by individual hospitals ranged widely, from less than 1% of people with stroke to 38%, and rates among those with intracerebral hemorrhage reached 76% at some hospitals.
Early palliative care was more likely to be initiated in rural than in urban hospitals, in hospitals in the Midwest, South, and West regions versus those in the Northeast, and in smaller hospitals.
Palliative care was more commonly ordered early for those with an intracerebral hemorrhage (19.4%) or subarachnoid hemorrhage (13.1%) – which are associated with higher mortality – and less likely for those with ischemic stroke (3.0%).
Overall, use of comfort-only measures declined during the study period from 6.1% in 2009 to 5.4% in 2013 (P<0.001) in the analysis of 4 years of data from 963,525 patients attending 1,675 hospitals included in the Get With The Guidelines–Stroke registry.
"End-of-life and palliative care plays an important role with stroke, since the death rate is high yet there has been limited data on the transition from treatment to comfort care," Prabhakaran said in a statement.
Approximately 10% of ischemic stroke patients and up to 30% of hemorrhagic stroke patients die within 30 days following stroke, a reality reflected in the American Heart Association/American Stroke Association's 2014 scientific statement concerning core concepts, skills, and expectations surrounding end-of-life care services for stroke patients, the researchers noted.
(this could be reduced substantially if the neuronal cascade of death was stopped)
Prabhakaran's group distinguished between comfort-only measures and do-not-resuscitate orders, which do not limit intensive acute stroke treatments, noting that use of CMO before a clear prognosis has been made may be detrimental.
The correlation between hospital-level risk-adjusted mortality and the use of early comfort measures only was stronger for subarachnoid hemorrhage (r=0.52) and intracerebral hemorrhage (r=0.50) than for acute ischemic stroke (r=0.15) patients.
Multivariable analysis for all strokes found the following factors significantly and independently associated with early versus no comfort-only measures:
  • Intracerebral or subarachnoid hemorrhage (OR 6.79 and 6.94, respectively)
  • Older age (OR 1.85 per 10 years beyond age 65)
  • Female sex (OR 1.26)
  • White race (OR 0.64 for non-Hispanic black and 0.78 for Hispanic)
  • Medicaid and self-pay/no insurance (OR 1.08 and 1.21, respectively)
  • Arrival by ambulance or off-hours (OR 3.96 and 1.10, respectively)
  • Non-ambulatory status pre-stroke (OR 2.36)
Among medical risk factors, atrial fibrillation and coronary artery disease were associated with increased odds of early CMO use, while hypertension, diabetes, dyslipidemia, prior stroke or transient ischemic attack, carotid stenosis, and smoking history were associated with lower odds of early CMO use.
"Severe stroke is a common event often close to one's death that unleashes a series of intense conversations among doctors, patients and families about what health states are acceptable or unacceptable and what makes life worth living," Robert Holloway, MD, MPH, of New York's University of Rochester Medical Center, and James L. Bernat, MD, of Dartmouth in Hanover, N.H., wrote in an accompanying editorial.
Given that discussions about preferences for life-limiting therapies were documented in fewer than 40% of dying stroke patients (based on a study of 2006-2007 data), considerable quality improvement opportunities remain, Holloway noted. "This study gives us insights into how these transitions are happening and will stimulate discussion about how we can improve this process to help ensure that care is high quality and consistent with the patient's goals."
Limitations noted by researchers include the lack of evaluation of specific clinical and radiographic factors (including level of consciousness and brainstem function) that affect prognosis after stroke, the absence of do-no-resuscitate order data in the GWTG-Stroke registry, and the inclusion of early but not late CMO data that likely resulted in underestimation of the effect of comfort measures only on in-hospital mortality at the hospital level.
No targeted study funding was reported.
Prabhakaran served as a section editor for Current Atherosclerosis Reports, receives publishing royalties from UpToDate, and receives research support from NIH/National Institute of Neurological Disorders and Stroke and PCORI.
The editorialists disclosed no relevant relationships with industry.
  • Reviewed by F. Perry Wilson, MD, MSCE Assistant Professor, Section of Nephrology, Yale School of Medicine and Dorothy Caputo, MA, BSN, RN, Nurse Planner

Better prescribing might prevent thousands of strokes in the UK

This blaming the victim means the stroke medical world doesn't have to solve any of the problems in stroke. The can continue to be lazy bums sitting on their asses doing nothing to help stroke survivors get to 100% recovery.
https://discover.dc.nihr.ac.uk/portal/article/4000648/better-prescribing-might-prevent-thousands-of-strokes-in-the-uk#.WSmJ85YcQaQ.google_plusone_share
One third of people who had a first stroke in the UK between 2009 and 2013 had known risk factors and were not taking the drugs that might have prevented their stroke.
Electronic general practice records from almost 30,000 people who had a stroke showed that about 60% had risk factors that meant they might have been eligible to take cholesterol-lowering, anti-clotting or blood pressure medication. But 54% of these people had no recent prescription for the appropriate drug(s).
The researchers estimate that almost 12,000 strokes a year in the UK could be prevented if everyone eligible for preventive drugs took them.
We don’t know the reasons why people weren’t prescribed these drugs. They might have had valid medical reasons for not taking them or have chosen not to take them against medical advice. The large scale of under-prescribing revealed in this study suggests a possible need for more systematic processes around identification and management of people with cardiovascular risk factors.

Burke Announces Honorees For Annual Awards Dinner - stroke survivor Barbara Rubin Kessler

Awards for stroke survivors should never need to occur. They shouldn't have to struggle and be brave in the face of impossible odds of getting fully recovered.  This need for an award shows that the Burke Rehabilitation Hospital is a complete failure at stoke rehab and recovery.
 We'll see if they post my reply;
"The need for this award shows the Burke Rehabilitation Hospital is failing at getting stroke survivors to 100% recovery."
We need to be commenting on all stroke stories pointing out the failures of our stroke medical professionals and keep doing that until they take responsibility for those failures. 
http://harrison.dailyvoice.com/events/burke-announces-honorees-for-annual-awards-dinner/711934/

WHITE PLAINS, N.Y. -- Burke Rehabilitation Hospital is honoring those who make a difference at its annual Burke Award Dinner.
The dinner will be held June 8 at 6 p.m. at Brae Burn Country Club at 39 Brae Burn Drive, Purchase, NY.
Burke is honoring Barbara Rubin Kessler and Steven Kessler, Scarsdale residents. Barbara experienced a severe ischemic stroke that left her unable to walk or talk and paralyzed on her right side.
After rehabilitation at Burke, Barbara was able to regain function but was diagnosed with aphasia, a communication disorder that results from damage to the parts of the brain that contain language. Today, she is active as a national advocate for brain trauma and stroke patients with aphasia and other challenges and is on the board of the National Aphasia Association.
Her husband, Steven is Barbara's caregiver. He works with her on advocacy for brain trauma, stroke and aphasia patients, and their families. He is also committed to improving medical care for returning U.S. war veterans.
Dr. Michael James Reding, a Yorktown Heights resident, is the former director of the Stroke Rehabilitation Program at Burke and current volunteer clinical researcher at Burke and the Burke Medical Research Institute is also being honored.
Reding was the medical director of the Stroke Rehabilitation Program at Burke from 1980 until 2013 when he assumed emeritus status. He was also one of the founders of Burke’s Neurorehabilitation Fellowship Program. He is currently a full-time volunteer clinical researcher at Burke and the Burke Medical Research Institute.
John Berman, co-anchor of “CNN Newsroom,” is serving as MC for the evening.
“It is a privilege to honor these inspiring individuals, who exemplify the Burke mission and our unparalleled commitment to helping patients recover from life-changing illness, injury, or surgery,” said Jeffrey Menkes, president, and CEO of Burke Rehabilitation Hospital. “Each of these honorees has demonstrated great compassion and dedication to advancing the field of rehabilitation and enabling people to reclaim their lives.”

Empathic Avatars in Stroke Rehabilitation: A Co-designed mHealth Artifact for Stroke Survivors

Rather than actually SOLVING all the problems in stroke, this goes down the route of making you feel better about your engagement with your disability therapies.  And making sure you attend to your therapies that might get you to your 10% chance of  100% full recovery. Solve the fucking problems you lazy blithering idiots.  This just kicks the full responsibility for recovery on patients, the doctors and therapists have to do nothing.
https://link.springer.com/chapter/10.1007/978-3-319-59144-5_5
  • Hussain M. Aljaroodi
  • Marc T. P. Adam
  • Raymond Chiong
  • David J. Cornforth
  • Mario Minichiello
  • Hussain M. Aljaroodi
    • 1
  • Marc T. P. Adam
    • 1
  • Raymond Chiong
    • 1
  • David J. Cornforth
    • 1
  • Mario Minichiello
    • 1
  1. 1.The University of NewcastleCallaghanAustralia
Conference paper
DOI: 10.1007/978-3-319-59144-5_5
Part of the Lecture Notes in Computer Science book series (LNCS, volume 10243)
Cite this paper as:
Aljaroodi H.M., Adam M.T.P., Chiong R., Cornforth D.J., Minichiello M. (2017) Empathic Avatars in Stroke Rehabilitation: A Co-designed mHealth Artifact for Stroke Survivors. In: Maedche A., vom Brocke J., Hevner A. (eds) Designing the Digital Transformation. DESRIST 2017. Lecture Notes in Computer Science, vol 10243. Springer, Cham

Abstract

Stroke is the second highest cause of death and disability worldwide. While rehabilitation programs are intended to support stroke survivors, and promote recovery after they leave the hospital, current rehabilitation programs typically provide only static written instructions and lack the ability to keep them engaged with the program. In this design science research paper, we present an mHealth artifact that builds on behavior change theory to increase stroke survivors’ engagement in rehabilitation programs. We employed a co-design methodology to identify design requirements for the stroke rehabilitation mHealth artifact, addressing stroke survivors’ needs and incorporating expertise of healthcare providers. Guided by these requirements, we developed design principles for the artifact pertaining to visual assets that are essential in immersing users in the design. We carried out a two-stage development process by having workshops and interviews with experts. Following this, a prototype was developed and evaluated in a series of workshops with multiple stakeholders.

Statins associated with improved heart structure and function

You'll have to ask your doctor  how bad the atherosclerosis is in your brain compared to your heart. Because your doctor will just look at your cholesterol levels which tell you almost nothing about your CVD risk.
http://www.alphagalileo.org/ViewItem.aspx?ItemId=175721&CultureCode=en
Benefits occurred above and beyond the cholesterol lowering effect of statins
Statins are associated with improved heart structure and function, according to research presented today at EuroCMR 2017.1 The benefits were above and beyond the cholesterol lowering effect of statins.
“Statins are primarily used to lower cholesterol,” said lead author Dr Nay Aung, a cardiologist and Wellcome Trust research fellow, William Harvey Research Institute, Queen Mary University of London, UK. “They are highly effective in preventing cardiovascular events in patients who have had a heart attack or are at risk of heart disease.”
He continued: “Statins have other beneficial, non-cholesterol lowering, effects. They can improve the function of the blood vessels, reduce inflammation, and stabilise fatty plaques in the blood vessels. Studies in mice and small studies in humans have shown that statins also reduce the thickness of heart muscle but this needed to be confirmed in a larger study.”
This study investigated the association between statins and heart structure and function. The study included 4,622 people without cardiovascular disease from the UK Biobank, a large community-based cohort study. Cardiac magnetic resonance imaging was used to measure left and right ventricular volumes and left ventricular mass. Information on statin use was obtained from medical records and a self-reporting questionnaire.
The relationship between statin use and heart structure and function was assessed using a statistical technique called multiple regression which adjusts for potential confounders that can have an effect on the heart such as ethnicity, gender, age, and body mass index (BMI).
Nearly 17% of participants were taking statins. Those taking statins were older, had higher BMI and blood pressure, and were more likely to have diabetes and hypertension. “This was not surprising because we prescribe statins to patients at high risk of heart disease and these are all known risk factors,” said Dr Aung.
Patients taking statins had a 2.4% lower left ventricular mass and lower left and right ventricular volumes. Dr Aung said: “People using statins were less likely to have a thickened heart muscle (left ventricular hypertrophy) and less likely to have a large heart chamber. Having a thick, large heart is a strong predictor of future heart attack, heart failure or stroke and taking statins appears to reverse the negative changes in the heart which, in turn, could lower the risk of adverse outcomes.”
“It is important to note that in our study, the people taking statins were at higher risk of having heart problems than those not using statins yet they still had positive heart remodelling compared to the healthier control group,” added Dr Aung.
In terms of how statins might reduce the thickness and volume of the heart, Dr Aung said several studies have demonstrated that statins reduce oxidative stress and dampen the production of growth factors which stimulate cell growth. Statins also increase the production of nitric oxide by the cells lining the blood vessels, leading to vasodilatation, improved blood flow, lower blood pressure, and lower stress on the heart, which is less likely to become hypertrophied.
The findings raise the issue of extending statin prescriptions to anyone above the age of 40, but Dr Aung said that was probably not the way to go.
“There are clear guidelines on who should receive statins,” he said. “There is debate about whether we should lower the bar and the question is when do you stop. What we found is that for patients already taking statins, there are beneficial effects beyond cholesterol lowering and that’s a good thing. But instead of a blanket prescription we need to identify people most likely to benefit – i.e. personalised medicine.”
Dr Aung said: “A dual approach should be considered to identify people who will benefit most from statins. That means looking at not only clinical risk factors such as smoking and high blood pressure, but also genetic (hereditary) factors which can predict individuals’ response to statins. This is an area of growing interest and one that we are also investigating in our lab with our collaborators.”
https://www.escardio.org/The-ESC/Press-Office/Press-releases/Statins-associated-with-improved-heart-structure-and-function?hit=wireag

Friday, May 26, 2017

This Subtle Dementia Symptom Sends Early Warning

Your doctor should be using this to baseline your cognition since you are likely to get dementia. If s/he doesn't baseline you at all, my opinion would be incompetency on their part.
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.

This Subtle Dementia Symptom Sends Early Warning

Dementia breaks down the brain’s ability to perform complex tasks, like this one.
Being unable to understand sarcasm is an early warning sign of dementia, research finds.
Deterioration in key parts of the brain in neuro-degenerative diseases causes people to have problems spotting insincere communication.
Detecting lies and sarcasm is a relatively complex cognitive task.
It requires being able to simulate the other person’s mind and inferring what they must mean.
Those with dementia also find it hard to spot lies.
Dr Katherine Rankin, who led the study, said:
“These patients cannot detect lies.
This fact can help them be diagnosed earlier.”
Scientists are always looking for ways of spotting dementia earlier, as this is the key to better treatment.
The study involved 175 people, some of whom had neurodegenerative diseases.
They were shown videos of people talking, who were sometimes sarcastic or told lies.
People with frontotemporal dementia found it particularly difficult to spot the lies and sarcasm.
This could provide a useful early warning sign.
Dr Rankin said:
“If somebody has strange behavior and they stop understanding things like sarcasm and lies, they should see a specialist who can make sure this is not the start of one of these diseases.”
Other early warning symptoms of dementia include a change in sense of humour:
“Changes in sense of humour could be an early sign of dementia, a new study finds.
A shift to preferring slapstick humour — like Mr Bean — over satirical or absurdist comedy, such as Monty Python, could be an early sign of Alzheimer’s.
Friends and relatives of those with dementia reported seeing changes around nine years before the more typical memory problems.”
Another even more surprising sign of dementia is being unable to smell peanut butter.
The study was published in the journal Cortex (Shany-Ur et al., 2012).

6 Ways You Can Reduce Your Risk of Suffering a Stroke - National Stroke Association

Another lazy fucking press release from the NSA. They obviously care not one whit about stroke survivors. I don't see them doing one damn thing to solve all the problems in stroke. They must not even have two functioning neurons to rub together. Why is Stroke in their name anyway? False advertising.
http://www.cheatsheet.com/health-fitness/reduce-risk-suffering-stroke.html/?ref=YF&yptr=yahoo




We all know our brain is one of the most important organs in our body (it does control bodily functions and memory, after all), yet we rarely ever talk about how serious strokes can be. Maybe it’s because most of us don’t truly understand what these events actually are. Time for a primer.
According to the National Stroke Association, a stroke occurs when blood flow to one area of the brain gets cut off. This stops the flow of oxygen, leading to cell death. Depending on what part of the brain is affected, a person may lose control of certain muscles and may have difficulty remembering things. Because it’s the fifth leading cause of death in the U.S., you should do everything you can to reduce your risk. Make sure to follow these tips to lower your chances of having a stroke.

1. Increase your fruit and vegetable intake

bucket of vegetables
A diet rich in produce is good for just about everything, including minimizing your stroke risk. | iStock.com
According to an analysis, eating more fruits and vegetables has been linked to reducing the risk of stroke. The analysis included 20 different studies, which compiled data from over 700,000 people and close to 17,000 strokes. The article mentions that for every 200 grams of fruit eaten a day, the risk of stroke decreased by 32%. For every 200 grams of vegetables, it decreased by 11%. Findings were consistent for both men and women of various ages. In other words, eat up.

2. Avoid high-cholesterol foods

Raw steak high in saturated fat
Consider cutting back on red meat. | iStock.com
The National Stroke Association mentions having high cholesterol may contribute to stroke. When there’s a lot of fatty substances in the blood, it can lead to plaque buildup in the arteries. We often associate this with heart attack, but it may also lead to a stroke. To lower harmful fat substances in the blood, the American Heart Association says to avoid foods like full-fat dairy products, red meats, and foods high in saturated fat, which contribute to high cholesterol levels in the body. Genetics also play a large role, so be sure to discuss family history of high cholesterol with your doctor.

3. Get moving

woman doing jumping jack exercises
Even jumping jacks ill do the trick. | iStock.com/Nektarstock
Most of us think about working out as a way to keep our weight in check, but that’s just one part of the picture. Mayo Clinic says regularly working up a sweat can provide health benefits by making the heart stronger. And it may take up to three months for exercise to be effective, so it’s important to make it a regular habit. Aim for 150 minutes of moderate-intensity aerobic activity per week, plus some strength training.
Where should you start? It really depends on your preferences. If you despise running, for example, don’t try to train for a marathon. Instead, focus on something you actually enjoy. Maybe it’s tennis or maybe it’s hitting the pool. Choosing something that you actually like to do means you’re a lot more likely to make it a habit.

4. Lower your blood pressure

elements of blood pressure
Make sure you’re keeping track of your numbers. | iStock.com
By lowering high blood pressure, you can reduce risk of stroke and other life-threatening issues like kidney failure and heart attack. According to the National Stroke Association, high blood pressure causes your heart to work harder to pump blood throughout your body. When this happens, major organs like the brain become damaged because of weakened blood vessels. If high blood pressure is not regulated, risk of stroke may increase by four to six times. A few ways to lower blood pressure include following a diet low in fat and sodium and limiting alcohol intake.
You should always start with diet and exercise, which we’ve covered, but it may not be enough for some people. If efforts to eat right and regularly work up a sweat aren’t helping your numbers enough, it’s time to talk about other options with your physician. He or she may prescribe medication to help. For a bit of background on what your discussion might entail, check out the different classes of options and some examples of each over at Healthline.

5. Say no to cigarettes

wood deck with an ashtray filled with cigarette butts
Still smoke? It’s time to quit. | iStock.com
The National Institute of Neurological Disorders and Stroke says smoking can double chances of ischemic stroke and increase the risk of hemorrhagic stroke by up to four times. This may be because smoking causes plaque buildup in the artery that delivers blood from the heart to the brain. If that flow gets cut off, you’re in major trouble. Even if you only occasionally smoke, it’s best to give up the habit entirely. And bonus, you’ll save some money.


Thursday, May 25, 2017

Stroke survivors come back strong - National Stroke Association event

WOW, just FUCKING WOW! Aims to inspire hope in stroke survivors. If the NSA would get off their fucking asses and solve the problems in stroke survivors wouldn't have to hope. They would be able to use proven therapies and interventions that get you to 100% recovery. But that won't occur until the NSA is destroyed and recreated as a great stroke association.
http://littletonindependent.net/stories/stroke-survivors-come-back-strong,249045

Kyle Harding
Posted
Stroke survivors and their supporters celebrated their recovery and raised money on May 22 at the Comeback Trail 5K at Hudson Gardens & Event Center in Littleton.
The run is hosted by the National Stroke Association and is part of its Come Back Strong campaign, which aims to inspire hope in stroke survivors.
Hudson Gardens was the site of the first Comeback Trail 5K last year, and now eight are held around the country.

Gut Microbiota Potential for a Unifying Hypothesis for Prevention and Treatment of Hypertension

This would be cool because of the side effects of hypertension medications.
http://circres.ahajournals.org/content/120/11/1724?etoc=
YanFei Qi, Seungbum Kim, Elaine M. Richards, Mohan K. Raizada, Carl J. Pepine
Despite major advances in pharmacological and device-based therapies, systemic hypertension (HTN) continues to be the major, modifiable risk factor for most cardiovascular disease and a leading cause of morbidity and mortality. Treatment resistant HTN (RH) is present in ≈15% to 20% of hypertensive patients, with few treatment options. These facts provide an opportunity to develop novel hypotheses to advance this field.
Over 60 years ago, Irvine Page1 proposed a mosaic theory where interplay of multiple factors integrate to increase blood pressure (BP). This fostered establishment of cellular, molecular, and physiological mechanisms altered in HTN. However, how these diverse factors integrate to impair BP control remains a challenge. Furthermore, why some factors are prohypertensive in one individual and not in another, and where prohypertensive signals originate, remains an enigma.
In this Viewpoint, we propose that the gut and gut microbiota could be one missing link and provide a potential unifying concept. We summarize most recent evidence for involvement of gut microbiota in BP control and HTN. We present our thoughts on the current state and relevant knowledge gaps to be addressed to determine whether targeting gut microbiota and related pathology would be a next frontier in HTN therapeutics.

Are HTN or RH Associated With a Unique Gut Microbial Signature?

Gut dysbiosis and microbial functions contribute to pathological effects beyond the gastrointestinal system. Gut microbiota play a role in BP regulation, and gut dysbiosis has been observed in multiple animal models of HTN.25 Our group was among the first to document HTN-associated gut dysbiosis and an increased Firmicutes/Bacteroidetes ratio.2,3 This was associated with a decrease in acetate- and butyrate-producing bacteria and an increase in the lactate-producing bacteria. High-fiber diet and acetate supplementation correct gut dysbiosis, increase the abundance of acetate-producing bacteria, and are associated with lower BP in DOCA-salt mice.5 Stroke-prone spontaneously hypertensive rats exhibit gut dysbiosis, and fecal microbiota transplant (FMT) from stroke-prone spontaneous hypertensive rats to Wistar–Kyoto normotensive rats increases BP.4 Furthermore, we noted that HTN is associated with profound pathological changes in the gut and increases brain–gut transmission in animal models of HTN.6
Microbial dysbiosis has also been observed in patients with high BP.2,3 Interestingly, subjects with HTN or pre-HTN demonstrate similar characteristic changes in gut microbiota composition.7 In a RH patient, antibiotic treatment resulted in BP under control with only an angiotensin-converting enzyme inhibitor, suggesting possible involvement of gut microbiota in the pathogenesis of RH as antibiotics alter gut microbiota.8 Future work will be needed to determine whether a unique microbial signature in the gut, gut pathology, and increased brain–gut–bone marrow connection are present in patients with RH.

Oral Abstracts from 3rd European Stroke Organisation Conference (ESOC 2017)

Useless, I don't see anything that addresses the neuronal cascade of death or any useful rehab strategies. Proves once again there is no strategy to get all stroke survivors 100% recovered.
http://journals.sagepub.com/doi/full/10.1177/2396987317705236

THE NORWEGIAN TENECTEPLASE STROKE TRIAL (NOR-TEST): RANDOMISED CONTROLLED TRIAL OF TENECTEPLASE VS. ALTEPLASE IN ACUTE ISCHAEMIC STROKE

 

EFFICACY OF EARLY COGNITIVE-LINGUISTIC TREATMENT FOR APHASIA DUE TO STROKE; A RANDOMISED CONTROLLED TRIAL (RATS-3)

 

CLOSURE OF PATENT FORAMEN OVALE, ORAL ANTICOAGULANTS OR ANTIPLATELET THERAPY TO PREVENT STROKE RECURRENCE (CLOSE): A RANDOMIZED CLINICAL TRIAL

 

PROBUCOL FOR PREVENTION OF CARDIOVASCULAR EVENTS IN ISCHEMIC STROKE PATIENTS WITH HIGH RISK OF CEREBRAL HEMORRHAGE (PICASSO) STUDY: A MULTICENTER, RANDOMIZED CONTROLLED TRIAL

 

PROGNOSTIC AND TREATMENT IMPACT OF PENUMBRAL IMAGING IN POOLED ANALYSIS OF RANDOMIZED TRIALS OF ENDOVASCULAR STENT THROMBECTOMY

 

TESPI(THROMBOLYSIS IN ELDERLY STROKE PATIENTS IN ITALY): RANDOMIZED CONTROLLED TRIAL OF ALTEPLASE VERSUS STANDARD TREATMENT IN PATIENTS AGED >80 YEARS WITHIN 3HRS AFTER STROKE ONSET

 

OFF LABEL USE OF ALTEPLASE FOR ACUTE ISCHEMIC STROKE (AIS) IN PATIENTS OVER 80 YEARS OF AGE: INDIVIDUAL-PATIENT-DATA META-ANALYSIS OF EIGHT TRIALS

 

LOW-DOSE VERSUS STANDARD-DOSE ALTEPLASE BY AGE, ETHNICITY, AND SEVERITY OF ACUTE ISCHAEMIC STROKE: THE ENCHANTED TRIAL

 

THROMBOLYSIS IMPLEMENTATION IN STROKE (TIPS) TRIAL: A CLUSTER RANDOMISED CONTROL TRIAL OF IMPLEMENTATION STRATEGIES FOR INTRAVENOUS THROMBOLYSIS

 

CHARACTERISTICS, MANAGEMENT AND RESPONSE TO TREATMENT IN CHINESE VS. NON-CHINESE PARTICIPANTS IN THE ENCHANTED TRIAL

 

THE NORWEGIAN SONOTHROMBOLYSIS IN ACUTE STROKE STUDY (NOR-SASS). A RANDOMIZED CONTROLLED STUDY OF CONTRAST-ENHANCED SONOTHROMBOLYSIS

 

INTRAVENOUS THROMBOLYSIS IN PATIENTS WITH STROKE UNDER RIVAROXABAN USING DRUG SPECIFIC PLASMA LEVELS – EXPERIENCE WITH A STANDARD OPERATION PROCEDURE IN CLINICAL PRACTICE

 

PROFESSIONAL GUIDELINE VERSUS PRODUCT LICENCE SELECTION FOR TREATMENT WITH IV THROMBOLYSIS: COMPLIANCE WITH PRODUCT LICENCES IS HIGHEST IN LOWER EFFICIENCY SITES AND RESTRICTS THROMBOLYSIS USAGE

 

OUTCOME AFTER ISCHEMIC STROKE IN PATIENTS OVER 80 YEARS TREATED WITH IV THROMBOLYSIS IN THE 3–4.5H COMPARED TO 3H TIME WINDOW: RESULTS FROM SITS-ISTR

 

NON-VITAMIN-K-ANTAGONIST ORAL ANTICOAGULANTS VERSUS WARFARIN IN PATIENTS WITH ATRIAL FIBRILLATION AND PREVIOUS STROKE OR TIA: AN UPDATED SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS

 

EFFECTIVENESS OF DIRECT ORAL ANTICOAGULANTS IN A POPULATION STUDY OF INCIDENT ATRIAL FIBRILLATION

 

PREDICTING RISK OF MAJOR BLEEDING IN PATIENTS WITH ATRIAL FIBRILLATION TREATED WITH ORAL ANTICOAGULATION AFTER TIA OR STROKE: EXTERNAL VALIDATION OF RISK SCORES

 

EARLY RECURRENCE AND MAJOR BLEEDING IN PATIENTS WITH ACUTE ISCHAEMIC STROKE AND ATRIAL FIBRILLATION TREATED WITH DIRECT ORAL ANTICOAGULANTS. THE RAF-DOAC STUDY

 

EVALUATING THE EFFECTIVENESS AND SAFETY OF NOVEL ORAL ANTICOAGULANTS COMPARED WITH VITAMIN-K ANTAGONISTS

 

POPULATION-BASED STUDY OF PROGNOSIS OF BRIEF EPISODES OF ATRIAL FIBRILLATION ON 5-DAY HOME CARDAIC RHYTHM MONITORING AFTER TIA AND ISCHAEMIC STROKE

 

PILOT STUDY OF CARDIAC MAGNETIC RESONANCE IMAGING IN EMBOLIC STROKE OF UNDETERMINED SOURCE (MR-ESUS)

 

COMPARATIVE EFFECTIVENESS OF NON-VITAMIN K ANTAGONIST ORAL ANTICOAGULANTS AND WARFARIN IN THE SCOTTISH ATRIAL FIBRILLATION POPULATION: THE VALUE OF REAL WORLD EVIDENCE

 

PREDICTIVE FACTORS OF STROKE RECURRENCE IN PATIENTS WITH ISCHEMIC STROKE DUE TO ATRIAL FIBRILLATION

 

OPTIMAL TIMING TO START RIVAROXABAN ADMINISTRATION TO PREVENT RECURRENT EMBOLISM IN ACUTE STROKE PATIENTS WITH NONVALVULAR ATRIAL FIBRILLATION (NVAF): THE RELAXED STUDY

 

NURSE-LED, TELEPHONE-BASED, SECONDARY PREVENTIVE FOLLOW-UP AFTER STROKE OR TIA IMPROVES BLOOD PRESSURE AND LDL CHOLESTEROL: THREE-YEAR RESULTS FROM THE RANDOMIZED CONTROLLED NAILED STROKE TRIAL

 

TICAGRELOR VERSUS ASPIRIN IN ACUTE EMBOLIC STROKE OF UNDETERMINED SOURCE (ESUS)

 

PRIMARY RESULTS OF EBBINGHAUS, A COGNITIVE STUDY OF PATIENTS ENROLLED IN THE FOURIER TRIAL

 

A CULTURALLY-TAILORED, SKILLS-BASED INTERVENTION TO REDUCE BLOOD PRESSURE IN A MULTI-ETHNIC GROUP OF MILD/MODERATE STROKE SURVIVORS WITH HYPERTENSION: RESULTS FROM THE DESERVE TRIAL

 

SECULAR TRENDS IN PROCEDURAL STROKE OR DEATH RISKS OF STENTING VERSUS ENDARTERECTOMY FOR SYMPTOMATIC CAROTID STENOSIS – A POOLED ANALYSIS OF RANDOMISED TRIALS

 

RESTENOSIS AFTER STENTING VERSUS ENDARTERECTOMY FOR SYMPTOMATIC CAROTID STENOSIS AND ITS RELATIONSHIP WITH RECURRENT STROKE IN THE RANDOMISED INTERNATIONAL CAROTID STENTING STUDY (ICSS)

 

ENDOVASCULAR TREATMENT VERSUS ENDARTERECTOMY FOR CAROTID ARTERY STENOSIS: RESULTS FROM THE UPDATED SYSTEMATIC COCHRANE REVIEW

 

THE EVOLUTION OF CAROTID INTERVENTION: SECULAR TRENDS IN STENT TYPE, CEREBRAL PROTECTION DEVICES AND MEDICATION IN ACST-2, A LARGE INTERNATIONAL RCT COMPARING SURGERY WITH STENTING