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| August 10, 2006 |
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| The physicians and staff of The Neuroscience Group are providing this physician and provider communication to help you stay abreast of issues and updates in the dynamic field of neurosciences, with the goal of helping you provide better overall healthcare services to your patients. |
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Advances in Preventing and Treating Strokes
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Stroke remains the third leading cause of death, following CAD and cancer in the US. Stroke is the number one cause of long-term disabilities. Witt BJ, Brown RD et al. A Community-Based Study of Stroke Incidence after MI. Annals of Intern Med 2005; 143 studies people form Olmstead County in Minnesota between 1979 and 1998. The research demonstrated that an increase in risk of stroke in the first 30 days following MI is associated with a large increase in risk of death. These authors indicated that current post MI therapies did not confer adequate protection against subsequent stroke during the initial 30 days post. MI.
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Jennifer Less MD. PHD, researcher at the California Pacific Medical Center Research Institute reported at the international Stroke Conference that post menopausal women with osteoporosis but no history of cardiovascular disease or stroke who had high serum levels of endogenous estradiol had a 2.5 fold higher risk of stroke that those with low levels. The Multiple Outcomes of Raloxifene Evaluation (MORE) trail findings suggested that measuring endogenous estradiol to assess stroke risk in women might be advantageous. Confirmatory studies in non-osteoporotic post-menopausal women have not yet been conducted to confirm these findings. Characterized as a “noteworthy exploratory finding,” therefore, it is too early to predict if endogenous estradiol status could be used as a basis for stroke prevention.
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Another study presented at the international stroke conference reported on a study by Brazilian researchers on a small 6-person (men ages 38-58 years) sample, which used autologous bone marrow mononuclear cells for injection into an artery after acute ischemic stroke. Chief investigator, Gabriel R. de Freitas, MD, PhD reported at the conference that 3-5 days post stroke researchers aspirated cells from the posterior ileac crest, isolated BMMCs and injected these cells into the middle cerebral artery, the site of the occlusion. The patients were assessed using the NIHSS stroke scale and the Rankin scale. The proposed mechanism of action relates to the stem cell chemicals cytokines and growth factors, which had a positive effect on the infracted areas. Investigation of intracoronary injection of autologous bone marrow mononuclear cells will continue.
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| Local efforts to prevent and treat strokes received national acclaim at the recent International Stroke Conference in Orlando, Florida. Dr. Thomas Mattio, Medical Director of the Stroke Center at Theda Clark, Cathy West, ACNP and Yvonne Berzsenyi, RN, Stroke Center Coordinator, attended the meeting and was presented with the “Get with the Guidelines” initial performance award. The Stroke Center at Theda Clark was one of 31 stroke centers, out of 220 nation-wide to receive an award at the conference. Dr. Mattio, Neurologist with the Neuroscience Group of NE Wisconsin, noted, “This award recognizes the collaborative efforts of many departments and individuals who work together to provide excellent patient care. At the Stroke Center, quality indicators, such as the time it takes to get to the hospital, time to treatment and assessment of risk factors, such as smoking and lipid levels, stroke prevention education and plans for rehabilitation are measured for patients presenting for care after strokes. Published research studies have demonstrated the efficacy of stroke-center care.” |
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Here are some exercise tips for patients who are stroke survivors:
- Use a treadmill to stay fit. The repetitive walking on a treadmill, along with the opportunity to “hang on” during walking can be very beneficial.
- Swimming is an excellent form of exercise for stroke survivors-Join your local YMCA.
- Try working out with weights to improve stamina and prevent the loss of muscle and bone mass.
- Try yoga, tai chi or other non-traditional exercise classes.
- Low impact exercise machines, like the NuStep, allow for seated exercise programs and help to improve cardiovascular function.
- Mental stimulation, such as cross word puzzles, word games are great mental exercises.
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For more information, refer your patients to www.neurosciencegroup.com
and www.stroke.org.
Dr. Thomas Mattio and Cathy West, ACNP are available for provider CME sessions and community education sessions.
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