Tuesday, September 16, 2014

Listen and learn, young people ...

A cautionary tale ... .

Young people - that is, people under 45 - can have strokes, too. In fact, it happens too often. Mine happened at age 39.

Ran across a recent story quoting an expert saying that patients under 45 years of age often miss stroke symptoms:
Neil Schwartz, M.D., Ph.D., says strokes are not uncommon in younger patients.
"We do see 10 or more percent of strokes occurring in younger patients under the age of 45," says Schwartz.
In fact, a new nationwide study found that while the incidences of stroke has dropped by nearly half over the last two decades, most of that improvement was in patients over 65 years old. Researchers believe some younger patients may not have seen the improvement because of an increase in risk factors like obesity and diabetes.
So even if you're young and active, know the stroke signs and don't be afraid to act!

Thursday, September 11, 2014

Potassium linked to reduced stroke risk

Like the old song says, "I Like Bananas Because They Have No Bones."

Now, another reason. Recent research shows that potassium is tied to lower stroke risk:
An analysis of data from the Women's Health Initiative (WHI) found an inverse relationship between self-reported dietary potassium intake and stroke in postmenopausal women.
Women (mean age 63.6) who consumed the most potassium each day ... had a 12% lower overall risk of all stroke ... and a 16% lower risk of ischemic stroke ... when compared with women consuming very little potassium ..., reported Sylvia Wassertheil-Smoller, PhD, of Albert Einstein College of Medicine in New York City, and colleagues.
In addition, among women without hypertension, those in the highest quartile of reported potassium consumption had a 27% lower risk of ischemic stroke than those in the lowest quartile, they wrote in the journal Stroke.
All kidding aside, there are other potassium sources other than bananas. So enjoy your favorite!

Tuesday, September 09, 2014

They know what they want to say ...

My words: towrith, rithe, rice.

And I was trying to say "Jonesboro."

That's what happened as a result of my stroke in 1998. My wife had asked me to say the word Jonesboro, a northeast Arkansas city I'd recently visited, and that's how it came out: towrith, rithe, rice. I knew what I wanted to say, but just couldn't say it. Intelligent wasn't affected - just the connection between thought and actual speech.

Thus began my education about aphasia and stroke results. And many, many stroke patients have language difficulties.

So, I watch out for news about aphasia and ran across a recent article about recovering language after a stroke:
“People refer to it as kind of being in a prison because they have the words. They retain their knowledge and intellect,” says Ellayne Ganzfried, executive director of the National Aphasia Association in New York. “They know what it is they want to say, but they can’t access it the way they used to.”
Ganzfried estimates that between 25 and 40 percent of stroke victims suffer from aphasia, a condition that can also result from brain tumors or other neurological disorders. With stroke victims, various levels of communication can be affected, depending on what part of the brain was most damaged and how significant the stroke was, adds Michelle Troche, director of clinical science research at the University of Florida Health Upper Airway Dysfunction Lab.
“Aphasia is when someone has trouble coming up with words, grammar, comprehension … There can also be the speech problem,” Ganzfried adds. “It’s not as crisp because of weakness in the muscles.”
A good article that might help others understand the problem - when the thought process is still intact but the speech process is interrupted.

Thursday, September 04, 2014

Fascinating research about learning brains

We know so little about the human brain. And for a lot of reasons - including improving stroke recovery results - this knowledge is so important.

Interesting item about research - admittedly, just monkeys - in which scientists are plugging into a learning brain:
“We looked into the brain and may have seen why it’s so hard to think outside the box,” said Aaron Batista, Ph.D., an assistant professor at the University of Pittsburgh and a senior author of the study published in Nature, with Byron Yu, Ph.D., assistant professor at Carnegie Mellon University, Pittsburgh.
The human brain contains nearly 86 billion neurons, which communicate through intricate networks of connections. Understanding how they work together during learning can be challenging. Dr. Batista and his colleagues combined two innovative technologies, brain-computer interfaces and machine learning, to study patterns of activity among neurons in monkey brains as the animals learned to use their thoughts to move a computer cursor.
“This is a fundamental advance in understanding the neurobiological patterns that underlie the learning process,” said Theresa Cruz, Ph.D., a program official at the National Center for Medical Rehabilitations Research at NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). “The findings may eventually lead to new treatments for stroke as well as other neurological disorders.”
As we all know, monkeys aren't people. However, this kind of research might well lead to advances. Worthy of watching.

Tuesday, September 02, 2014

It's global: Telemedicine can make a difference

Telemedicine is important in rural America. I've been through lots of small towns with few or no specialists who can make the difference between proper treatment and permanent disability or death.

Now, a study in Germany shows the impact telemedicine in that country:
During the same interval, the proportion of patients receiving thrombolytic therapy rose from 2.6% to 15.5%.
"The main findings of 10-year experience of TEMPiS showed that this type of telemedical stroke unit network is sustaining, offers state-of-the-art acute stroke care by increasing access to stroke units and improving thrombolysis service, and is associated with long-term improvement in terms of quality indicators of acute hospital care," Muller-Barna and colleagues wrote.
Telemedicine -- the use of modern teleconferencing technology to evaluate patients remotely and to recommend treatment strategies -- has increasingly been adopted in developed countries as a way to bring specialist care to rural areas where it is otherwise scarce or unavailable.
In the stroke setting, it involves putting stroke neurologists located mainly in urban tertiary care centers on call to evaluate patients brought into community hospitals in distant towns.
Time, as mentioned in this blog before, is key in stroke response. Using the combination of technology and medicine can decrease that time and improve outcomes.

Thursday, August 28, 2014

Less education and smoking: Deadly combination?

There's  been lots of studies and stories about disparities among more vulnerable populations. People with less education are no exception, especially those who smoke. One recent study found that less educated smokers are at greatest risk for stroke:
"The combined effect of low educational level and smoking on the risk of stroke is the most surprising finding of our paper," said study author Helene Nordahl, an epidemiologist in the department of public health at the University of Copenhagen.
She added that reducing smoking among those with the least education could potentially reduce strokes more than targeting smoking in those with the most schooling.
Although the study included Danish participants, Nordahl believes her findings are applicable to other countries.
"Since the most disadvantaged groups are often exposed to a wide number of stroke risk factors, it seems plausible that these people are at increased risk of stroke, not only in Denmark but also in the U.S.," Nordahl said.
The second paragraph of this excerpt hits home - for public health education, it's important connect with the right people to reduce stroke risk.

And EVERYONE is important...

Tuesday, August 26, 2014

Time for younger set to start taking care

Once again, we're seeing more concerns about young people and stroke risk. for older people, the rate of stroke is declining. For people younger, there seems to be trouble. Read this article how stroke incidence is down and survival up -- for some:
These stroke incidence data appear to reflect both positive and negative trends in stroke prevention and treatment over the last few decades, Koton said.
Photo from U.S. Centers for
Disease Control and Prevention
On the plus side, increased use of statins and hypertension medications and a dramatic decline in smoking may largely explain the lower stroke rate among people over the age of 65, while the rise in obesity and diabetes in younger adults could explain the lack of progress in reducing stroke incidence in younger adults, Koton told MedPage Today.
"More younger adults are obese, and when obesity increases so does hypertension and diabetes," she said. "Hypertension is the main risk factor for stroke. I think this is a warning sign for us to take these risk factors as seriously in younger people as we do in older people."
Yes - time for ALL ages to take stroke risk factors SERIOUSLY.