#@stroke

Hemorrhagic Stroke Recovery Flash Back - OT-Ring Toss and Peg Board. PT-...

Dr. Sarraj Amrou Sarraj, MD FAHAProfessor of Neurology, Case Western Reserve University School of MedicineGeorge M. Humphrey II Endowed Chair, University Hospitals Neurological Institute Director, Comprehensive Stroke Center and Stroke Systems, University Hospitals MedicalResearch.com: What is the background for this study? What are the main findings? Response: Endovascular thrombectomy was proven safe and effective in patients with acute ischemic, stroke, neurologist, occlusion presenting up to 24 hours from last known well in multiple clinical trials. Patients with large ischemic changes were largely excluded from those trials, and thus limited randomized evidence of thrombectomy in this patient population exists. Our study found that thrombectomy improved the odds of achieving better functional outcomes by 1.5 times in patients with large ischemic changes on non-contrast CT or perfusion imaging. Proportion of patients achieving functional independence (mRS 0-2) and Independent ambulation (mRS 0-3) were also significantly higher with thrombectomy. Symptomatic hemorrhage occurred in very few patients and was not higher with thrombectomy. Results from analyses of subgroup based on clinical and imaging characteristics were also largely similar to those of primary analysis. MedicalResearch.com: What should readers take away from your report? Response: We observed that thrombectomy improved functional outcomes overall and across different subgroups in patients from North America, Europe and Australia and New Zealand. With available results of RESCUE Japan LIMIT trial showed better rates of independent ambulation in patients with large ischemic strokes and ANGEL ASPECT trial in China, I believe we have enough evidence to support thrombectomy procedure in this patient population. MedicalResearch.com: What recommendations do you have for future research as a results of this study? Response: Endovascular thrombectomy has been proven one of the most effective treatment in the history of medicine. With the results of our trial, one more frontier has been conquered to extend the treatment to thousands of patients with larger strokes who may benefit. Optimization of health care systems and enhancing thrombectomy delivery should be a priority to offer this potent intervention to more patients. Optimization of patients' care post thrombectomy, care transition and rehabilitations delivery would be vital to improve patients' outcomes. MedicalResearch.com: Is there anything else you would like to add? Any disclosures? Response: SELECT and SELECT2 trials were investigator-initiated studies funded by research grants from Stryker Neurovascular to University Hospitals Cleveland Medical Center and UT McGovern Medical School. In addition, Dr Sarraj was an advisory board and speaker bureau member for Stryker Neurovascular and an advisory board member for AstraZeneca. Citation: Trial of Endovascular Thrombectomy for Large Ischemic Strokes A. Sarraj, A.E. Hassan, M.G. Abraham, S. Ortega‑Gutierrez, S.E. Kasner, M.S. Hussain, M. Chen, S. Blackburn, C.W. Sitton, L. Churilov, S. Sundararajan, Y.C. Hu, N.A. Herial, P. Jabbour, D. Gibson, A.N. Wallace, J.F. Arenillas, J.P. Tsai, R.F. Budzik, W.J. Hicks, O. Kozak, B. Yan, D.J. Cordato, N.W. Manning, M.W. Parsons, R.A. Hanel, A.N. Aghaebrahim, T.Y. Wu, P. Cardona‑Portela, N. Pérez de la Ossa, J.D. Schaafsma, J. Blasco, N. Sangha, S. Warach, C.D. Gandhi, T.J. Kleinig, D. Sahlein, L. Elijovich, W. Tekle, E.A. Samaniego, L. Maali, M.A. Abdulrazzak, M.N. Psychogios, A. Shuaib, D.K. Pujara, F. Shaker, H. Johns, G. Sharma, V. Yogendrakumar, F.C. Ng, M.H. Rahbar, C. Cai, P. Lavori, S. Hamilton, T. Nguyen, J.T. Fifi, S. Davis, L. Wechsler, V.M. Pereira, M.G. Lansberg, M.D. Hill, J.C. Grotta, M. Ribo, B.C. Campbell, and G.W. Albers, for the SELECT2 Investigators* This article was published on February 10, 2023, at NEJM.org. DOI: 10.1056/NEJMoa2214403 https://www.nejm.org/doi/pdf/10.1056/NEJMoa2214403 The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.     Read the full article

Dr. Donahue Katrina E. Donahue, M.D., M.P.H. Professor and Vice Chair of Research Chapel Hill Department of Family Medicine University of North Carolina Dr. Donahue joined the U.S. Preventive Services Task Force in January 2020. MedicalResearch.com: What is the background for this study? What are the main findings? Response: Heart disease and stroke are the leading causes of death in the U.S. The Task Force found that people who are 40 to 75 years old and at high risk for heart disease should take a statin to help protect their health. People in this age group who are at increased risk but not high risk should make an individual decision with their healthcare professional about whether taking a statin is right for them. There is not enough research to determine whether statins are beneficial for people 76 years and older. MedicalResearch.com: What should readers take away from your report? Response: Statins are an important tool for preventing heart attacks and strokes. Whether someone should start taking a statin to prevent a first heart attack or stroke largely depends on their age and risk for cardiovascular disease. People who are 40 to 75 years old should talk to their doctor about their risk and whether a statin can help them stay healthier for longer. MedicalResearch.com: What recommendations do you have for future research as a results of this study? Response: Despite the effectiveness of statins in lowering the risk of heart attacks and strokes, there are inequities in the rates of cardiovascular disease and access to statins among Black, Hispanic, and Asian adults. We need more information on improving the accuracy of CVD risk prediction in all racial, ethnic, and socioeconomic groups, as well as the causes of statin-use disparities among these groups and how to reduce them. It’s essential that we work to better understand and help eliminate these inequities. The Task Force is also calling for more evidence on the effectiveness, safety, and benefits of starting statins before age 40 or after age 75. MedicalResearch.com: Is there anything else you would like to add? Any disclosures? Response: Regardless of age and risk for cardiovascular disease, everyone can lower their chance of having a heart attack or stroke by quitting smoking, exercising more, and eating a healthier diet. Citation: 1) US Preventive Services Task Force. Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: US Preventive Services Task Force Recommendation Statement. JAMA. 2016;316(19):1997–2007. doi:10.1001/jama.2016.15450 2) Chou R, Dana T, Blazina I, Daeges M, Jeanne TL. Statins for Prevention of Cardiovascular Disease in Adults: Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2016;316(19):2008–2024. doi:10.1001/jama.2015.15629 The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.     Read the full article