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treatment
Reuters: Fewer die after treatment at stroke centers
By Genevra Pittman
NEW YORK | Tue Jan 25, 2011 5:26pm EST
NEW YORK (Reuters Health) — People treated for stroke at designated stroke centers appear to survive slightly longer than those treated at other hospitals, suggests a new study.
While the finding has important implications, it doesn’t change the most important message about stroke, which is to get help as soon as possible, said study author Dr. Ying Xian of the Duke Clinical Research Institute in Durham, North Carolina, and formerly of the University of Rochester Medical Center in New York, where he did the research.
“The most important thing for the patient is when you have a stroke attack, or you see people stroke attack, call 911 immediately,” he told Reuters Health. “Ideally, the EMS will transport people to the appropriate hospital.”
Most strokes occur when a blocked blood vessel causes some of the blood flow going to the brain to be cut off, damaging brain tissue that depends on that blood to survive.
Stroke is the third leading cause of death in the U.S., only topped by heart disease and cancer. Each year, nearly 800,000 people in the U.S. have a stroke and more than 130,000 people die as a result.
Within the last decade, both national and state programs have begun designating hospitals as official stroke centers when they demonstrate certain staff, facilities, and services believed to improve a patient’s outcome.
In addition, states such as New York require ambulances to take stroke patients straight to a designated center, as long as they can get care within two hours.
In the new study, published in the Journal of the American Medical Association, Xian and his colleagues tracked every adult admitted between 2005 and 2006 to a New York State hospital after an ischemic stroke, the most common type. About half of the nearly 31,000 patients ended up at stroke centers, while the rest were treated at hospitals without the designation.
One month after their treatment, 10.1 percent of the patients treated at stroke centers had died, compared to 12.5 percent of patients treated at other hospitals. A year later, those numbers were 22.3 percent and 26 percent, respectively.
The researchers also found that patients going to stroke centers were more likely to be treated with drugs that dissolve blood clots, but need to be given within a few hours of a stroke.
BREAKING NEWS: New Recommendations for Alzheimer’s Diagnosis
Experts Propose 3 Stages Aimed at Earlier Detection
By Kathleen Doheny
Experts from the National Institute on Aging and the Alzheimer’s Association have issued suggestions to update the criteria for the diagnosis of Alzheimer’s disease.
The new proposed criteria will be the first update in 26 years.
”The last set of criteria for Alzheimer’s disease [diagnosis] were originally developed in 1984,” says William Thies, PhD, chief medical and scientific officer at the Alzheimer’s Association. “We know a lot more now than we did before, so the new criteria are a reaction to that knowledge,” he tells WebMD.
The draft reports for the new criteria were presented Tuesday at the Alzheimer’s Association International Conference in Honolulu.
The criteria, aimed at better and earlier detection of Alzheimer’s disease, cover three stages believed to exist today: pre-clinical Alzheimer’s, mild cognitive impairment, and the last stage, Alzheimer’s dementia.
Read more here at Web MD
Also check out more news on this topic at the New York Times and Reuters.
Blogger’s note: This is a huge change in the diagnosis and care for those with Alzheimer’s disease! Stay tuned as we keep you updated on how this impacts insurance, health care and more. -SP
NEWS: Music Aids Alzheimer’s Patients in Remembering New Informations
Researchers from Boston University School of Medicine (BUSM) have shown that patients with Alzheimer’s disease (AD) are better able to remember new verbal information when it is provided in the context of music even when compared to healthy, older adults. The findings, which currently appear on-line in Neuropsychologia, offer possible applications in treating and caring for patients with AD.
Read more at ScienceDaily.com
NYT: Cycling Provides a Break for Some With Parkinson’s
By Gina Kolata at The New York Times
The man had had Parkinson’s disease for 10 years, and it had progressed until he was severely affected. Parkinson’s, a neurological disorder in which some of the brain cells that control movement die, had made him unable to walk. He trembled and could walk only a few steps before falling. He froze in place, his feet feeling as if they were bolted to the floor.
But the man told Dr. Bloem something amazing: he said he was a regular exerciser — a cyclist, in fact — something that should not be possible for patients at his stage of the disease, Dr. Bloem thought.
“He said, ‘Just yesterday I rode my bicycle for 10 kilometers’ — six miles,” Dr. Bloem said. “He said he rides his bicycle for miles and miles every day.”
“I said, ‘This cannot be,’ ” Dr. Bloem, a professor of neurology and medical director of the hospital’s Parkinson’s Center, recalled in a telephone interview. “This man has end-stage Parkinson’s disease. He is unable to walk.”
But the man was eager to demonstrate, so Dr. Bloem took him outside where a nurse’s bike was parked.
“We helped him mount the bike, gave him a little push, and he was gone,” Dr. Bloem said. He rode, even making a U-turn, and was in perfect control, all his Parkinson’s symptoms gone.
Yet the moment the man got off the bike, his symptoms returned. He froze immediately, unable to take a step.
Dr. Bloem made a video and photos of the man trying to walk and then riding his bike. The photos appear in the April 1 issue of The New England Journal of Medicine.
Read more at The New York Times
NEWS: Two-prong treatment approach holds promise
After researchers tried to reduce levels of two enzymes, beta secretase and gamma secretase, simultaneously in mice they found this combination approach worked better and prevented some of the negative side effects of treating just one of the enzymes that produces the amyloid plaque found in Alzheimer’s disease. Read More…
NEWS: Brain imaging technology may help detect early signs of Alzheimer’s disease
In examining the hippocampus, the region of the brain that controls memory, diffusion tensor imaging (DTI), an MRI technique that measures the random motion of water in tissue, better predicts verbal and spatial memory performance in healthy people than conventional MRI techniques that measure the volume of the hippocampus. Read More…
Number of Patients with Dementia on the Rise
It is that frustration that motivated Sabin to participate in University of Michigan-sponsored research designed to better diagnose and treat dementia before it escalates.
Sabin is one of millions of Americans who experience memory loss and may eventually be diagnosed with dementia. “This is an explosive disease,” says Sid Gilman, M.D., director of the Alzheimer’s Disease Research Center at University of Michigan Health System, who conducts research with Sabin and others in her community. “It’s a disease that robs people of their humanity. They forget their families and friends.”
Alzheimer’s Disease and Dementia Triple Healthcare Costs for Americans 65 and Older
In the new report, total healthcare costs are calculated as per person payments measured from all sources. Medicare payments alone are almost three times higher for people with Alzheimer’s and dementia than for others age 65 and over; Medicaid payments alone are more than nine times higher.
“With the country facing unprecedented economic challenges and a rapidly aging baby boomer population, now is the time to address the burgeoning Alzheimer crisis that triples healthcare costs for Americans age 65 and over,” said Harry Johns, Alzheimer’s Association CEO.
“It is widely understood that addressing healthcare is key to the country regaining its financial footing,” continued Johns. “And there is no way this can be done without improving Medicare and Medicaid, which Alzheimer’s directly impacts. A strategy to immediately confront Alzheimer’s has the potential to save millions of lives and billions of dollars by reducing the burden on Medicare and Medicaid.”
Read more: Right at Home
Symptoms Of Alzheimer’s May Come In Your 50s
For people with a common genetic variation, researchers have discovered signs of the possible onset of Alzheimer’s before a patient would be clinically diagnosed by a doctor.
In people with the ApoE4 gene variation, one previously implicated as affecting the likelihood of Alzheimer’s, researchers have been able to pinpoint some signs of memory loss beginning in the person’s mid- to late-50s — without the patient having full-blown Alzheimer’s disease or dementia.
“[One could argue] we really captured for the first time the onset of Alzheimer’s disease,” explained Dr. Richard Caselli, a neurologist at the Mayo Clinic in Scottsdale, Ariz.
“What’s passing as normal aging itself correlates with the most common genetic risk factor for Alzheimer’s disease,” he said, adding that the symptoms are noticeable in a clinical setting, but not in everyday life.
“It’s not the sort of thing that you can look at somebody or they can look at themselves and know.”
Researchers caution that when in interpreting the findings, one should keep in mind that people who had shown some memory loss were still functioning normally and having the gene did not impair anyone at an earlier age.
Read more here: ABC News
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