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New ORUEN Round Table discussion: NOACs in Secondary Stroke Prevention

New ORUEN Round Table discussion: NOACs in Secondary Stroke Prevention

This Round Table Discussion reviews NOACs in secondary stroke prevention.

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

  • Recall key scientific data of the NOAC trials in SPAF incl. secondary stroke prevention
  • Outline key clinical questions when starting patients on NOACs, incl. potential need for reversal
  • Select an appropriate NOAC for their AF patients based on these considerations

NOACs in Secondary Stroke Prevention

Faculty:

Robin Lemmens – MD, PhD, Department of Neurosciences, Experimental Neurology, Leuven Research Institute for Neuroscience and Disease, KU Leuven – University of Leuven, Leuven, Belgium

Milan Voško – MD, PhD, Department of Neurology, Kepler Universitätsklinikum, Linz, Austria

Ales Tomek – MD, PhD, FESO, Neurology Department, 2nd Medical Faculty of Charles University, Prague, Czech Republic

Should obesity be treated as any other disease?

Should obesity be treated as any other disease?

“European Obesity Day celebrated every May, brings people together to raise awareness and increase knowledge about obesity and the many other diseases on which it impacts. The aim is to get coordinated action to improve the prevention and treatment of obesity and ultimately to improve the health and quality of life of those who are living with it. The causes of obesity and overweight are known whereby there is an energy imbalance between calories consumed and calories expended. This is being fueled by an increased intake of energy-dense foods that are high in fat, sugar and salt and an increase in physical inactivity due to the increasingly sedentary nature of many forms of work, changing modes of transportation, and increasing urbanisation. Obesity is a disease often caused by factors largely beyond an individual’s control. It is a highly complex matter whereby changes in dietary and physical activity patterns are often the result of environmental and societal changes associated with development and lack of supportive policies in sectors such as health, agriculture, transport, urban planning, environment, food processing, distribution, marketing and education” said Dr Charmaine Gauci, Superintendent of Public Health, Ministry for Health, Malta.

In the meantime, SAFE is focused on what we could do as individuals to tackle this problem and reduce chances of getting a stroke. In Europe, 51.6% of adults are overweight. Being obese not only increases your risk of high blood pressure, heart disease and diabetes, but also makes you more likely to have a stroke, particularly if you are carrying extra weight around your stomach. Fortunately, this is yet another risk factor that can be potentially altered through a healthy diet, exercise and other lifestyle changes.

The relationship between abdominal obesity and stroke is long established, particularly where other conditions are also present, such as diabetes, high blood pressure and high cholesterol. But there are different opinions as to why the risk is increased in overweight people.

Some studies suggest body mass index (BMI) alone is not a good indicator for stroke risk. Instead, researchers claim excess stomach weight may be a stronger predictor. A waist measurement of over 40 inches in men and over 35 inches in women is classed as abdominal obesity.

If you wish to know more about obesity and stroke, and, more importantly, what you could do to decrease the risk of stroke, please visit our website www.strokeprevention.info for more information.

How do I cope with epilepsy after stroke?

How do I cope with epilepsy after stroke?

Written by Tom Balchin | First published on https://arni.uk.com

Stroke is one of many conditions that can lead to seizures, or epilepsy. You may think of these as ‘having fits’. In the UK this condition affects just under 1% of the population. Around 5% of people who have a stroke will have a seizure within the following few weeks. These are known as acute or onset seizures and normally happen within 24 hours of the stroke.

The good news is that your risk of having a seizure lessens with time following your stroke. But, you’ve really got to take care. I see people regularly who have fits for the first time. It’s never fun, but luckily, as someone who has had controlled epilepsy for over 20 years I know exactly how to identify these very early (it’s not that hard really). Quickly get the person to the floor, gently, into the recovery position and call for an ambulance. If you have a list of all their medications on hand to tell the paramedic, that would be ideal.

You are more likely to have had one if you have had a severe stroke, a haemorrhagic stroke or a stroke involving the part of the brain called the cerebral cortex. My own epilepsy came only after subarachnoid haemorrhage, (an uncommon, very serious and often fatal type of stroke caused by bleeding on the surface of the brain)

The causes of seizures are complex. Cells in the brain communicate with one another and with our muscles by passing electrical signals along nerve fibres. If you have epilepsy this electrical activity can become disordered and a sudden abnormal burst of electrical activity in the brain can lead to a seizure.

There are over 40 different types of seizures that can occur, but the most common ones are partial seizures or generalised seizures.

Partial or focal seizures only occurs in part of your brain. You may remain conscious and aware of your surroundings during a partial seizure (called a simple partial seizure) or you may become confused and unable to respond (a complex partial seizure). The symptoms you experience during a partial seizure will depend on which part of your brain has been affected. You may feel changes in sensation such as a tingling feeling, which spreads to other parts of your body.

Commonly people experience a rising feeling in their stomach (a bit like when you go over a humpback bridge). This is called an ‘epigastric rising sensation’. You may also experience uncontrollable stiffness, twitching or turning sensation in a part of the body such as your arm or hand, and/or disturbances in your vision, such as seeing flashing lights.

You can read the full article here.

Image credits: Pixabay.com

New report – Towards an EU Strategic Framework for the Prevention of NCDs

New report – Towards an EU Strategic Framework for the Prevention of NCDs

The European Chronic Disease Alliance (ECDA), the European Public Health Alliance (EPHA) and the NCD Alliance publish the paper “Towards an EU-Strategic Framework for the Prevention of Non-communicable Diseases” concluding that a new EU strategic framework to prevent non-communicable diseases (NCDs) is needed to address chronic diseases, the 21st century’s foremost health threat.

With 70% of respondents to a recent EU Barometer survey wanting to see more EU action on health and with epidemic levels of NCDs undermining people’s well-being, healthcare systems, and Europe’s economic and social prosperity, preventing NCDs should be a main priority for the next European Commission.

The mandate 2019-2024 is an opportunity to act upon commitments made at the UN High Level Meeting on NCDs in September 2018 and follow on the EU Reflection Process on Chronic Diseases to deliver concrete solutions to respond to the main common risk factors. While progress is made on reducing premature mortality from NCDs, longer lives do not necessarily translate into healthy lives.

With stroke being such an important topic among other non-communicable diseases, SAFE and ESO recently organised a panel discussion in the Committee of Regions in Brussels, under the Patronage of The Romanian Presidency, exploring the role of policy in tackling stroke. During the panel discussion, patient representatives and clinical experts called on the EU Institutions to recognize the burden of stroke as its own incredibly important entity, rather than diluting it in the wider classification of cardiovascular diseases. Panelists representing patients and clinicians also called for the EU to facilitate discussions between its Member States on the implementation of the Stroke Action Plan for Europe. As a next step to this meeting, SAFE and ESO begun a follow-up with speakers and participants to move forward with the identified opportunities. The immediate action that came as a result of this panel discussion was SAFE’s participation in the CHRODIS+ Conference, held in Budapest, Hungary on 15 May 2019. At this important meeting, SAFE was represented by Grethe Lunde, SAFE Board Member and a stroke survivor from Norway. SAFE actively participated in discussions on topics such as patient involvement, multi-morbidity, integrated care and employment. 

Europeans spend between a quarter and a fifth of their lives in ill-health. 700 billion EUR is spent on treating NCDs in the EU each year – although many chronic diseases are to a considerable degree preventable. The paper proposes basic principles, priorities and actions for such an EU strategic framework, setting out a roadmap to make change happen. For more information, please contact: info@alliancechronicdiseases.org or epha@epha.org.

RE-SPECT ESUS: Optimizing Prevention of Embolic Stroke of Undetermined Source

RE-SPECT ESUS: Optimizing Prevention of Embolic Stroke of Undetermined Source

We would like to recommend to your attention a Round-Table discussion that held place at last year’s WSC in Montreal, Canada.

This Round Table Discussion reviews strategies for secondary prevention strategies in ESUS and the implications of the recent RE-SPECT ESUS results for clinical practice.

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

  • Describe RE-SPECT ESUS clinical trial results
  • Outline the benefits and risks of NOACs in ESUS
  • Discuss the implications of RE-SPECT ESUS for clinical practice

RE-SPECT ESUS: Optimizing Prevention of Embolic Stroke of Undetermined Source 

Moderator:

Mike Sharma MD, MSc, Associate Professor, Division of Neurology, Department of Medicine, McMaster University, Ontario, Canada

Faculty:

Richard A. Bernstein MD, PhD, Professor of Neurology, Feinberg School of Medicine, Northwestern University, Illinois, USA

Hans-Christoph Diener MD, PhD, Professor of Neurology, University of Duisburg-Essen, Germany

Please click here to view video.

 

Long-term decline in stroke greater in older adults

Long-term decline in stroke greater in older adults

This article was first published on ScienceDaily.com

Although the occurrence of first-ever ischemic stroke (strokes due to a blood clot that blocks a blood vessel in the brain) at middle age has been decreasing over time, researchers have found that the decline is not as steep as seen in older adults.

The risk for stroke at midlife declined by approximately 39 percent, while risk of stroke at older age declined by 53 percent, when comparing a recent time period (1998-2005) to a previous time period (1962-67).

“Most strokes at midlife were due to diseases of the arteries (atherosclerosis) caused by a clot migrating from the heart. We also looked at vascular risk factors, such as hypertension and smoking, which have been declining among both age groups over time,” explained corresponding author Hugo J. Aparicio, MD, MPH, assistant professor of neurology at Boston University School of Medicine.

The researchers studied trends in the rate of ischemic stroke among two age groups in the Framingham Heart Study: middle age-35-55 years old and older age-above 55 years old. They estimated the rate of stroke occurring in four time periods, 1962-67, 1971-76, 1987-1991 and 1998-2005. They also looked at risk for stroke calculated using the Framingham Stroke Risk Profile, which gives an estimate for how likely a stroke will occur over the ensuing 10 years.

You can read the full article here.

Image source: Pixabay.com