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Round Table Discussion for medical professionals: Learnings from the ESUS trials

Round Table Discussion for medical professionals: Learnings from the ESUS trials

Oruen, CNS medical publication and audio-visual platform, would like to recommend to your attention the latest round table discussion about learnings from the ESUS trials – Jesse Dawson, Martin Grond & Maurizio Paciaroni.

Faculty:

Jesse Dawson MD, Professor, Institute of Cardiovascular & Medical Sciences University of Glasgow, Scotland

Martin Grond MD, Professor, Department of Neurology Kreisklinikum Siegen, Teaching Hospital of the University of Marburg, Germany

Maurizio Paciaroni MD, Neurologist, Stroke Unit and Division of Cardiovascular Medicine, Santa Maria della Misericordia Hospital, University of Perugia, Italy

This video discusses the role of NOACs for secondary prevention of stroke in the setting of embolic stroke of unknown source

Following completion of this activity, learners will be able to:

  • Outline key features and results of the ESUS trials, with focus on NAVIGATE ESUS and RE-SPECT ESUS
  • Recognize differences in study outcomes
  • Summarise implications of ESUS as a concept for use in clinical practice

 

The Bristol-Myers Squibb-Pfizer Alliance and Fitbit Collaborate to Address Gaps in Atrial Fibrillation Detection with the Aim of Accelerating Diagnosis

The Bristol-Myers Squibb-Pfizer Alliance and Fitbit Collaborate to Address Gaps in Atrial Fibrillation Detection with the Aim of Accelerating Diagnosis

Leaders in atrial fibrillation and wearable technology to develop educational content around atrial fibrillation to help identify and support those at increased risk of stroke

Press Release | THURSDAY, OCTOBER 17, 2019
The Bristol-Myers Squibb-Pfizer Alliance and Fitbit today announced at the TIME 100 Health Summit in New York that they are working together to help drive timely diagnosis of atrial fibrillation (AFib) with the aim of improving earlier detection in individuals at increased risk of stroke. The BMS-Pfizer Alliance and Fitbit plan to collaborate on the development of educational content and guidance to support people at increased risk for AFib. Upon submission and U.S. Food and Drug Administration (FDA) clearance of the AFib detection software on Fitbit devices, the parties will aim to provide users with appropriate information to help encourage and inform discussions with their physicians.

“We’re in a new era of healthcare, where we’re not only focused on developing treatments but also looking at the potential of technology and data to help patients learn more about their health,” said Angela Hwang, Group President, Pfizer Biopharmaceuticals Group. “We are excited about wearables and how our work with BMS and Fitbit may potentially help patients and physicians detect and understand heart rhythm irregularities.”

AFib is the most common type of irregular heartbeat and is a significant risk factor for stroke.1,2 Approximately eight million people in the United States are projected to be affected by AFib in 2019.3 As the U.S. population ages, this number is expected to rise, as adults aged 65 and older are at an increased risk of developing the condition.3 Because AFib can be asymptomatic, it can often go undetected, and some studies suggest that more than 25 percent of people who have the condition find out after they have a stroke.(1,4)

“At Fitbit, we’re focused on making health more accessible and, through our efforts with the BMS-Pfizer Alliance, we have the potential to support earlier detection of atrial fibrillation, a potentially asymptomatic condition that affects millions of Americans,” said James Park, Co-founder and CEO of Fitbit. “With our continuous, 24/7 on-wrist health tracking capabilities, and our experience delivering personalized, engaging software and services, we believe we can develop content to help bridge the gaps that exist in atrial fibrillation detection, encouraging people to visit their doctor for a prompt diagnosis and potentially reduce their risk of stroke.”

Wearable technology has continued to become more integrated in the healthcare landscape(5) as people have recognized the value that 24/7 health tracking can have for people of any age or health status, including those at increased risk for specific conditions. Yet, those who use wearables to track their heart rhythm may lack the education or guidance on what to do with the data gathered from their device.6

“Too many people discover that they are suffering from atrial fibrillation only after experiencing a stroke. In fact, some studies suggest that this is true for more than 25 percent of people who have the condition,” said Joseph Eid, M.D., Head of Medical Affairs, Bristol-Myers Squibb. “These efforts with Fitbit exemplify not only our unwavering commitment to addressing the evolving needs of patients with atrial fibrillation, but also our dedication to advancing care by embracing technology as a part of routine clinical practice.”

Please continue reading here.

Image source: Fitbit.com

Breastfeeding may help protect mothers against stroke

Breastfeeding may help protect mothers against stroke

First published on SienceDaily

Breastfeeding is not only good for babies, there is growing evidence it may also reduce the risk for stroke in post-menopausal women who reported breastfeeding at least one child, according to new research in Journal of the American Heart Association, the Open Access Journal of the American Heart Association/American Stroke Association.

Stroke is the fourth leading cause of death among women aged 65 and older, and is the third leading cause of death among Hispanic and black women aged 65 and older, according to the study.

“Some studies have reported that breastfeeding may reduce the rates of breast cancer, ovarian cancer and risk of developing Type 2 diabetes in mothers. Recent findings point to the benefits of breastfeeding on heart disease and other specific cardiovascular risk factors,” said Lisette T. Jacobson, Ph.D., M.P.A., M.A., lead author of the study and assistant professor in the department of preventive medicine and public health at the University of Kansas School of Medicine-Wichita.

This is among the first studies to examine breastfeeding and a possible relationship to stroke risk for mothers, as well as how such a relationship might vary by ethnicity.

Researchers analyzed data on 80,191 participants in the Women’s Health Initiative observational study, a large ongoing national study that has tracked the medical events and health habits of postmenopausal women who were recruited between 1993 and 1998. All women in this analysis had delivered one or more children and 58 percent reported ever having breastfed. Among these women, 51 percent breastfed for one-six months, 22 percent for seven-12 months and 27 percent for 13 or more months. At the time of recruitment, the average age was 63.7 years and the follow-up period was 12.6 years.

After adjusting for non-modifiable stroke risk factors (such as age and family history), researchers found stroke risk among women who breastfed their babies was on average:

23 percent lower in all women,
48 percent lower in black women,
32 percent lower in Hispanic women,
21 percent lower in white women, and
19 percent lower in women who had breastfed for up to six months.

A longer reported length of breastfeeding was associated with a greater reduction in risk.

You can read the full article here.

How your brain remembers motor sequences

How your brain remembers motor sequences

First published on ScienceDaily.com

Ever wondered what was going on in the brain of John Coltrane when he played the famous solo on his album Giant Steps? Researchers at the National Institute of Information and Communications Technology (NICT), Japan, and Western University, Canada, have succeeded in visualizing how information is represented in a widespread area in the human cerebral cortex during a performance of skilled finger movement sequences.

Contrary to the common assumption, the researchers found that overlapping regions in the premotor and parietal cortices represent the sequences in multiple levels of motor hierarchy (e.g., chunks of a few finger movements, or chunks of a few chunks), whereas the individual finger movements (i.e., the lowest level in the hierarchy) were uniquely represented in the primary motor cortex. These results uncovered the first detailed map of cortical sequence representation in the human brain. The results may also provide some clue for locating new candidate brain areas as signal sources for motor BCI application or developing more sophisticated algorithm to reconstruct complex motor behavior.

The results were published online as Yokoi and Diedrichsen “Neural Organization of Hierarchical Motor Sequence Representations in the Human Neocortex” in Neuron on July 22, 2019.

Achievements

The best way to remember/produce long and complex motor sequences is to divide them into several smaller pieces recursively. For example, a musical piece may be remembered as a sequence of smaller chunks, with each chunk representing a group of often co-occurring notes. Such hierarchical organization has long been thought to underlie our control of motor sequences from the highly skillful actions, like playing music, to daily behavior, like making a cup of tea. Yet, very little is known about how these hierarchies are implemented in our brain.

In a new study published in a journal Neuron, Atsushi Yokoi, Center for Information and Neural Networks (CiNet), NICT, and Jörn Diedrichsen, Brain and Mind Institute, Western Univ., provide the first direct evidence of how hierarchically organized sequences are represented through the population activity across the human cerebral cortex.
You can read the full article here.

An international survey about spasticity

An international survey about spasticity

Do you or someone you know have experience with spasticity and Botulinum Toxin Type A injections?

SAFE invites you to participate in an international survey, conducted by Carenity, an online patient community, and biopharma Ipsen to help advance medical research and improve the lives of other patients.

Both patients and caregivers of patients with spasticity due to stroke (as well as traumatic brain injury or spinal cord injury) who are currently receiving Botulinum Toxin Type A injections or who have stopped receiving these injections less than a year ago can participate.

Botulinum toxin effect usually peaks around 4 to 6 weeks after injection, then it slowly decreases. This decrease is called the waning of botulinum toxin effect. The aim of this survey is to better understand patients’ experience with botulinum toxin type A injections, in particular:

– to better understand how patients experience the waning of botulinum toxin type A effects
– to identify the impact of the waning of botulinum toxin type A effects on the patient’s quality of life
– to describe patient populations profile
– to assess the reasons for stopping botulinum toxin type A injections

This survey will be the subject of communications during scientific congresses or scientific publications that will be redacted in collaboration with an international team of medical experts.

A synthesis of the results will be made available after the publications.

This international survey is conducted in Europe (France, Germany, Italy and the UK) and in the US until September 13th.

It is available in 4 languages:

English: https://member.carenity.co.uk/newSurveyBymail/0/38/0/0

French: https://membre.carenity.com/newSurveyBymail/0/107/0/0

German: https://member.carenity.de/newSurveyBymail/0/26/0/0

Italian: https://member.carenity.it/newSurveyBymail/0/25/0/0

Thank you very much for your participation!

Participation in this survey is unpaid.
To find out more about how your data will be processed and how to exercise your rights, read the survey information page, accessible when you click on the link provided above in this text.

 

 

 

 

 

 

18 Ways to Improve Cognitive Problems After Stroke

18 Ways to Improve Cognitive Problems After Stroke

First published on ARNI Institute for Stroke Rehabilitation website

A change in cognitive ability is common after a stroke. Did you know that as many as two-thirds of stroke survivors may experience cognitive impairment as a result of their stroke.? If this is you, or you know someone who seems possibly to be going through such difficulties, here’s 18 steps you can take to try and improve cognition difficulties after stroke:

First, what is cognition?

Put simply, cognition is thinking; it is the processing, organising and storing of information – an umbrella term for all of the mental processes used by your brain to carry you through the day, including perception, knowledge, problem-solving, judgement, language, and memory. The brain’s fantastic complexity means that it can collect vast amounts of information from your senses (sights, sounds, touch, etc) and combine it with stored information from your memory to create thoughts, guide physical actions, complete tasks and understand the world around you.

A stroke can affect the way your brain understands, organises and stores information. This brain injury can result in damage to the areas of the brain that are responsible for perception, memory, association, planning, concentration, etc. The severity and localisation of the stroke will effect the type and level of difficulties experienced by an individual, and will vary from person to person.

It can be difficult to plan and organise daily tasks. The brain is constantly working in the background, allowing us to complete a task based on prior knowledge, experience, and learned behaviour.

You don’t have to consciously think how to boil the kettle, change TV channels or put on your socks before your shoes: you just do it. But damage to the brain can result in problems with these planning and execution mechanisms.

You might not be able to think how to do a simple task, or you may get the sequence wrong (for example, shoes before socks). You might have trouble with orientation, which could include not knowing the date, day of the week, or even who you are with. Problem-solving too can become difficult. Making decisions, solving problems, understanding numbers and managing money can be a challenge.

Good cognitive function also relies on memory. The brain uses 2 types of memory to hold information, the long and short term memory. Short-term memory is the temporary store for small amounts of information. This information is kept readily available and can be recalled quickly. For example, a phone number can be remembered long enough for you to dial it. Long-term memory is where you keep your experiences, thoughts and feelings from the past and things stored here can be stored indefinitely. Memory problems could result in difficulty storing or recalling information. This could include problems remembering appointments, important dates or in the case of short term memory, what you were about to do, or what somebody just said to you.

Problems with concentration are common. Concentration is required for effective cognitive function, as many of your thinking process require concentration. Concentration requires our brain to filter out much of the information coming in from your conscious thinking, so you are not distracted by it.

Stroke can impact on this ability because of damage to the areas of the brain responsible for this, and also because tiredness, pain and emotional problems have an effect of the ability to stay focused and concentrate. This could result in difficulties when trying to follow a television programme, or conduct a conversation with a friend. Multi-tasking too is difficult.

18 Things to try

  1. Cognitive problems are confusing and frustrating. But, there are some things you can to do help. Most improvements occur in the first 3 months after a stroke, after which they slow down, but the brain will keep creating new neural pathways after this time.
  2. To help with memory and perception problems, try using a diary, day planner, calendar or notepad. Writing down appointments and creating to-do-lists can help you to remember them.
  3. Photos and pictures can help to ‘trigger’ your memory.
  4. Check your calendar, newspaper or diary to help you remember the day and date.
  5. Make notes of important conversations.
  6. Use notes, lists and labels around the house and help prompt you to remember. Mobile phones are a great resource. Set alarms, reminders and memos to remind you throughout the day.
  7. It is important not to overload yourself, finish one task before you start another. Plan your day and prioritise tasks.
  8. Try slowing the activity down, working through a step at a time.
  9. Keep instructions clear and short, no more than 5 or 6 words to a sentence, and only 1 or 2 instructions at a time.

Please read the full list here.