Thursday, February 25, 2016

Good hardware - keeping things together for years (one hopes)

Photo from A.M.D. via Flickr
I'm a hardware fan. Hammers, chisels, screwdrivers - you name it. Good hardware will last a lifetime. And now, there's an interesting study about people hardware - in this case, stents that are devoted to stroke prevention.

Like I said, good hardware can last a long time. So this research indicates that a decade later, stents durable for stroke prevention:

Tuesday, February 23, 2016

Latest study leans toward an answer to a stroke risk factor

A still from the video of my PFO being closed
click here to view the video
We've seen a lot of information bounced back and forth about the efficacy of closing a patent foramen ovale, or a hole between the two upper heart chambers.

Now, read about a study showing that the closure may prevent further patent foramen ovale-related strokes:
"PFO-related cryptogenic strokes tend to be larger and more superficial, and PFO-unrelated cryptogenic strokes tend to be deeper and smaller, so in the medical management group we saw more larger and superficial strokes than in the device group, suggesting there were still PFO strokes in the medical management group," Thaler told MedPage Today. "So it all makes sense even though the overall trial was negative."

Thursday, February 18, 2016

Will a stroke patient need a mortgage next?

Photo from via Flickr
We've seen lots of stories lately about drug prices. And there are lots of high-price drugs that aren't in the news a lot. Just Google "Jublia price" and you'll get stories like this one.

Now, another drug is making news - and this one is close to home for past and future stroke survivors. It seems that the long-approved clot-buster is a price-buster too:
For those keeping score, here is yet another example of drug price escalation: the cost of alteplase, aka tPA, the clot-busting agent used to treat stroke, increased by 111% from 2005 to 2014 -- but Medicare payment for the drug has increased by 8% during the same period.
A standard alteplase vial contains 100 mg, and in 2014 the cost for that vial was $6,400, said Dawn Kleindorfer, MD, of the University of Cincinnati. Kleindorfer reported the results of her cost-analysis here at the International Stroke Conference. ...

Tuesday, February 16, 2016

God and time - he's got all that's needed for all of us

God has, quite literally, all the time in the world for each one of us.
-Philip Yancey
I'm a fan of time.

One of my favorite TV offerings is the program "Doctor Who" about an eccentric time traveler, with clever plots often revolving around time. And in real life, it's interesting to me how the timing of events have been so key in history and in my own life.
  • A gifted, somewhat maverick, neurosurgeon winds up in a middle-size Southern city for a short time. In that small space of time, a family with a young child suddenly needs that surgeon to save the child's life.
  • A woman facing Alzheimer's disease faces a move to be closer to one of her children. A facility just opens a new wing, offering as much independence as wanted but care if needed. As the disease progresses, the same facility builds an unparalleled skilled nursing facility next door. The woman is cared for in comfort close to a loving family in her last few months.

Tuesday, February 09, 2016

What are your blood pressure numbers? And what number seems like a good idea?

Still more about the quest for blood pressure target numbers- this time, how that the gray area for high blood pressure can make risky targets of women and minorities:
Stroke risk is lower for healthy older adults with blood pressure under 140 mm Hg than in the disputed 140 to 149 mm Hg range, particularly for minorities and women, according to a cohort study.
In the prospective population-based Northern Manhattan Study cohort of 1,750 people 60 and older, and free of stroke, diabetes, and chronic kidney disease (CKD) at baseline, the adjusted odds of incident stroke over a median 13 years of annual follow-up were a significant 70% higher with a systolic blood pressure of 140 to 149 mm Hg than with lower blood pressures.

Wednesday, February 03, 2016

Good advice - find the balance between treatment risks and benefits

Photo from U.S. Centers for Disease Control and Prevention
Now, as Paul Harvey used to say, the rest of the story.

I've posted quite a bit about high blood pressure as a stroke risk. It's the leading cause of strokes.

A wise doctor, as part of taking care of my aging mother a few years ago, described health decisions about her as a balancing act. Take this medication, and it might affect that ailment, which might affect other medication, and so on and so on. Truer words were never spoken.

Now, here's some thoughts to consider about high blood pressure, new targets and possible medication side affects, in an article stating that new blood pressure guidelines a danger to patients: