Long-term Predictors of Stroke in Healthy Middle-aged Men - Erik Prestgaard

August 18, 2017

As you can imagine a longitudinal study of 2014 Norwegian men who were recruited from 1972-1975, and then followed up until 1997, is an amazing source of data. Researchers from the Institute of Clinical Medicine, and the Department of Informatics at the University of Oslo, and from the Department of Cardiology, Oslo University Hospital, Ullevål, Norway investigated the long term predictive impact on stroke risk of baseline variables including haemodynamic variables measured at rest and during exercise in these same middle-aged, healthy men. 

Carmen Lahiff-Jenkins, Managing Editor of the International Journal of Stroke and I spoke to Dr Erik Prestgaard, lead author of the paper‘Long-term Predictors of Stroke in Healthy Middle-aged Men, recently published in the International Journal of Stroke.

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Where to now? AVERT answered an important question, but raised many more

August 14, 2017

The AVERT trial was a Phase 3 randomised trial with over 2100 subjects designed to end the controversy about the early mobilisation of stroke patients. It sounds intuitive doesn’t it, if a patient has a stroke get them up and moving as soon as possible get the blood flowing and consequently the patient healing faster.

But this wasn’t the case, and the stroke community, especially the rehab and recovery arm were collectively shocked by the results which indicated that early mobilization may actually cause harm.  

Undoubtedly this ultimately successful trial answered an important clinical question, opening the door for more large scale rehab and recovery trials.

Now the priority questions are: (1) What is the optimal dose in minutes of VEM in duration and frequency? (2) How intense should the exertion be? (3) How should we design trials that compare different specified doses for different subgroups? 

I’m Carmen Lahiff-Jenkins Managing Editor of the International Journal of Stroke and I spoke to Mark Bayley author of Where to now? AVERT answered an important question, but raised many more recently published in the International Journal of Stroke.

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Stroke while driving: frequency and association with automobile accidents

August 6, 2017

Driving while having a stroke is potentially life threatening, imagine driving down a dark road at night, or a busy peak hour city street and suffering a stroke? A group of researchers in Japan, have looked at stroke while driving and they may be on the way to pinpointing the risk factors, that may potentially be modified to make driving safer to those at risk of stroke. 

Carmen Lahiff-Jenkins, Managing Editor of the International Journal of Stroke spoke to Dr Joji Inamasu from Saiseikai Utsunomiya Byoin, Department of Neurosurgery in Tochigi, Japan. This article is published online, via the International Journal of Stroke. Please follow this link to read this article

In this study a majority of patients with stroke while driving were women, with a medium age of 63, age however, did not differ from gender, and the most common co-morbidity was hypertension across both stroke types.

The international Journal of Stroke is the flagship publication of the World Stroke Organisation, please consider becoming a member. Click here to open our webpage

 

The music used in this podcast ‘Kool Kats’ composed by Kevin MacLeod is licence free. 

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Stroke Recovery and Rehabilitation Roundtable - development, monitoring and reporting - Marion Walker

July 20, 2017

Improving the development, monitoring and reporting of stroke rehabilitation research: consensus-based core recommendations from the Stroke Recovery and Rehabilitation Roundtable (SRRR) 

An international partnership of stroke rehabilitation experts committed to developing consensus-based core recommendations with a remit of addressing the issues identified as limiting stroke rehabilitation research in the areas of developing, monitoring and reporting stroke rehabilitation interventions. Work exploring each of the three areas took place via multiple teleconferences and a two-day meeting in Philadelphia in May 2016 15    recommendations were made under the auspice of the Stroke Recovery and Rehabilitation Roundtable taskforce! 

Recent reviews demonstrate that the quality of stroke rehabilitation research has continued to improve over the last four decades, however, despite this progress there are still so many barriers to moving the field forward. Rigorous development, monitoring and complete reporting of interventions in stroke trials are essential in providing rehabilitation evidence that is robust, meaningful and implementable. 

To validate the need for the 15 recommendations the #SRRR group reviewed all stroke rehabilitation trials published in 2015 (n=182 papers) and found that highlighted was that the majority of publications didn’t clearly describe how interventions were developed or monitored during the trial. In particular, under-reporting of the theoretical rationale for the intervention and the components of the intervention calls into question many interventions that have been evaluated for efficacy. 

More trials were found to have addressed the reporting of interventions recommendations than those related to development or monitoring. Nonetheless the majority of reporting recommendations were still not adequately described. 

To progress the field of stroke rehabilitation research and to ensure stroke patients receive optimal evidence based clinical care we urge the research community to endorse and adopt our recommendations. 

I’m Carmen Lahiff-Jenkins and I spoke to Professor Marion Walker who took me through the recommendations and the thinking behind their development.  

Please clink this link to go to the landing page for the series

 

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Stroke Recovery and Rehabilitation Roundtable - definitions - Karen Borschmann and Kate Hayward

July 19, 2017

Agreed definitions and a shared vision for new standards in stroke recovery research: The Stroke Recovery and Rehabilitation Roundtable taskforce. 

Common language and definitions were required to develop an agreed framework spanning the four working groups for the The Stroke Recovery and Rehabilitation Roundtable taskforce: translation of basic science, biomarkers of stroke recovery, measurement in clinical trials and intervention development and reporting. 

The Stroke Recovery and Rehabilitation Roundtable (SRRR) was convened with the aim to move rehabilitation research forward. Working collectively across four initial priority areas the #SRRR team reviewed, discussed, and attempted to achieve consensus on key recommendations in each of the areas of translation of basic science, biomarkers of stroke recovery, measurement in clinical trials and intervention development and reporting. 

I’m Carmen Lahiff-Jenkins, Managing Editor of the International journal of Stroke and I spoke to Karen Borschmann and Kate Hayward researchers involved in the SRRR project. 

Click or tap here to go straight into the series free online

The music for this podcast was 'Kool Kats' by Kevin MacLeod 

 

 

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Stroke Recovery and Rehabilitation Roundtable - Translational/Preclinical with Dr Dale Corbett

July 6, 2017

Stroke recovery research involves distinct biological and clinical targets compared to the study of acute stroke. We know that moving preclinical treatments into the clinical realm has been fraught with notorious difficulties, one very well known area has been, of course the incredible disappointments with neuroprotection. In comparison stroke recovery involves distinct biological principles and a very different time window, it is in fact unlike acute stroke at all!

 

We spoke to Dr Dale Corbett Proferssor in Cellular and mollecular medicine in the faculty of Medicine at the Univeristy of Ottawa, who was the lead author on the Stroke Rrecovery and Rehabilitation Roundtable paper on Enhancing the alignment of the preclinical and clinical stroke recovery research pipeline.

 

The music used in this podcast is 'Kool Kats' by Kevin MacLeod

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Stroke Recovery and Rehabilitation Roundtable - Biomarkers with Dr Lara Boyd

July 5, 2017

A biological marker or biomarker is a naturally occurring molecule, gene, or characteristic that is objectively measured and evaluated as an indicator of normal biological processes, pathogenic processes, or pharmacologic responses to a therapeutic intervention

Dr Lara Boyd, Physical therapist from the University of British Columbia, Canada. 

@laboyd47; @UBC_BrainLab

The music for this podcast was 'Kool Kats' by Kevin MacLeod 

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Long-term cost-effectiveness of thrombectomy for acute ischaemic stroke in real life: An analysis based on data from the Swedish Stroke Register (Riksstroke)

April 9, 2017

Thrombectomy has a small effect on hospital costs except for the direct intervention cost. However, thrombectomy is highly likely to lead to substantial cost savings in the social service sector.

My name is Carmen Lahiff-Jenkins and I’m the Managing Editor of the International Journal of Stroke and I spoke to Katarina Steen Carlsson, PhD in Economics, from the Department of Clinical Sciences, Malmö, Health Economics, Lund University, Sweden who with a team of researchers from Lund investigated the long-term cost-effectiveness of thrombectomy after thrombolysis versus thrombolysis alone using real-world outcome data on need for health care, home help and nursing home care.

This research has been published online in the International Journal of Stroke in the article Long-term cost-effectiveness of thrombectomy for acute ischaemic stroke in real life: An analysis based on data from the Swedish Stroke Register (Riksstroke)

The international Journal of Stroke is the flagship publication of the World Stroke Organisation, please consider becoming a member.

Download article from here

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Thrombectomy accessibility after transfer from a primary stroke center: analysis of a 3-year prospective registry

April 9, 2017

No comprehensive study exists on Mechanical Thrombectomy accessibility for patients admitted to a primary stroke center without on-site interventional neuroradiology services.

My name is Carmen Lahiff-Jenkins and I’m the Managing Editor of the International Journal of Stroke and I spoke to Dr Denis Sablot from the Centre Hospitalier de Perpignan, Neurologie, France and submitting author of Thrombectomy accessibility after transfer from a primary stroke center: analysis of a 3-year prospective registry, this article is available online at the International Journal of Stroke website, hosted by SAGE.  

This podcast recordng was developed and produced by the World Stroke Organization.

Download article here. 

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Apixaban for treatment of embolic stroke of undetermined source (ATTICUS randomized trial) - Rationale and study design Tobias Geisler

February 12, 2017

 

 Article link here

Optimal secondary prevention of embolic stroke of undetermined source (ESUS) is not established. The current standard in these patients is acetylsalicylic acid (ASA), despite high prevalence of yet undetected paroxysmal atrial fibrillation (AF).

ESUS is caused by embolic disease and associated with a high risk of recurrent ischemic strokes and clinically silent cerebral ischemic lesions. The ATTICUS randomized trial will investigate the impact of AF detected by ICM and the effects of early anticoagulation with apixaban compared to antiplatelet therapy with ASA on the incidence of NIL after ESUS.

I’m Carmen Lahiff-Jenkins Managing Editor of the International Journal of Stroke and I spoke to Tobias Geisler, lead author for the Apixaban for treatment of embolic stroke of undetermined source (ATTICUS randomized trial) - Rationale and study design published in the International Journal of Stroke. 

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