AHA Journals, Author Interviews, Stroke / 11.09.2013

R. Gilberto González, MD, PhD Massachusetts General Hospital Department of Radiology, PO Box 9657 Boston, MAMedicalResearch.com Interview with: R. Gilberto González, MD, PhD Massachusetts General Hospital Department of Radiology, PO Box 9657 Boston, MA MedicalResearch.com: What are the main findings of the study? Dr. González: Administration of IV tPA to patients with a severe stroke syndrome caused by occlusion of the distal internal carotid artery and/or the proximal middle cerebral arteries results in good outcomes in 35% compared to 17% of similar patients who did not receive tPA.
Author Interviews, Diabetes, Kidney Disease, Stroke / 10.09.2013

MedicalResearch.com Interview with: Yongjun Wang, MD Department of Neurology, Beijing Tiantan Hospital Capital Medical University, Beijing, China MedicalResearch.com: What are the main findings of the study? Answer: Our study demonstrated that reduced eGFR was independently associated with all-cause mortality and other post-stroke outcomes in type 2 diabetic patients; stroke subtype analysis in our cohort showed that this association was only evident in ischemic stroke and TIA. We also observed a U-shaped relationship between variation of eGFR and post-stroke outcomes, that is, increased odds ratios were seen among those with low and high levels of eGFR. The cutoff points of eGFR associated with poor outcomes of stroke were eGFR<45 ml/min/1.73m2 and≥ 120 ml/min/1.73m2, respectively.
Author Interviews, Exercise - Fitness, Stroke / 26.07.2013

MedicalResearch.com Interview with: Michelle N. McDonnell, PhD Division of Health Sciences International Centre for Allied Health Evidence University of South Australia Adelaide, SA 5001 Australia.Michelle N. McDonnell, PhD Division of Health Sciences International Centre for Allied Health Evidence University of South Australia Adelaide, SA 5001 Australia. MedicalResearch.com: What are the main findings of the study? Dr. McDonnell: In this study, we asked people how many times a week they engaged in intense physical activity, enough to work up a sweat. People responded that they were physically active 0, 1-3 or 4 or more times a week. When we followed up these people for several years, those who did not do any vigorous exercise were 20% more likely to have a stroke, compared to those who exercised four or more times a week. However, when we adjusted these results for other risk factors, this attenuated the effect down to 14%  which was not statistically significant. We also noticed that people who exercised four or more times a week had less hypertension (high blood pressure), were less likely to be obese and less likely to have diabetes. Each of these things on their own reduces your risk of stroke, so when we adjust for that the association between physical activity and stroke is weaker (20% to 14%). So physical activity seems to have an effect on stroke risk by improving these other risk factors.
Author Interviews, Stroke / 22.06.2013

MedicalResearch.com Interview with: Saeid Shahidi, MD. Chief Consultant in supra-aortic surgery. Vascular Unit, Regional Hospital Slagelse, Region Zealand, Denmark. MedicalResearch.com: What is the background of your study? Answer: Our Prospective Population-based study showed, an expedited CEA can be performed in the subacute period ( >2 - <30 days) without significantly increasing the operative risk. The acute admission and urgent aggressive BMT with dual therapy in our cohort was associated with significant reduction P<0.00001 in the risk of early neurological recurrent (NR) in the CEA patient. It seems that in neurologically stable patients CEA can wait up to 30 days provided urgent BMT has been started in specialized stroke/ TIA clinics. Our study also adds to the data on the benefit of specialist TIA clinics.
Author Interviews, JAMA, Stroke / 22.05.2013

Dr. Rishi Gupta, MD Associate Professor of Neurology, Neurosurgery and Radiology Emory University School of Medicine Director, Vascular Neurology Fellowship Program Director, Multi-Hospital Acute Stroke Network Marcus Stroke and Neuroscience Center Grady Memorial Hospital MedicalResearch.com: What are the main findings of the study? Dr. Gupta: The main findings of this study are that patients with more proximal cerebral arterial occlusion involving the middle cerebral artery and internal carotid artery appear to be the targets for endovascular reperfusion therapy trials. Moreover, previous clinical trials have used a NIHSS > 8 or > 10 threshold to include patients into randomzed trials comparing endovascular therapy versus IV tPA. The threshold may need to be higher and in our analysis we found that threshold to be 14 or greater.
Author Interviews, Diabetes, Race/Ethnic Diversity, Stroke / 08.05.2013

MedicalResearch.com eInterview with Jane C Khoury, PhD

Associate Professor Division of Biostatistics and Epidemiology Cincinnati Children’s Hospital Medical Center MLC 5041, 3333 Burnet Avenue Cincinnati, Ohio 45229-3039 MedicalResearch.com: What are the main findings of the study? Dr. Khoury: Over all age groups, those with diagnosed diabetes have at least 3-fold increased risk of incident ischemic stroke compared to those without diabetes. This is even more pronounced in those less than 65 years of age, with 5-fold and 12-fold increase for those of black and white race respectively.  All rates are adjusted to the 2000 population.
Author Interviews, Emergency Care, Stroke / 03.05.2013

MedicalResearch.com eInterview with with Dr. O. James Ekundayo, MD, DrPH Assistant Professor Department of Family & Community Medicine Meharry Medical College 1005 Dr. D.B. Todd Jr. Blvd. Nashville, TN 37208 Written Interview conducted with author by Editor Marie Benz, MD MedicalResearch.com What are the main findings of the study? Answer: The key findings are: ·         One third of stroke patients did not activate Emergency Medical Services (EMS). ·         Subgroups of patients who were less likely to use EMS include younger patients, patients of minority race or ethnicity, and those living in rural communities. ·         Prior history of stroke /TIA does not confer greater likelihood of EMS activation during subsequent stroke. ·         Patients who used EMS had shorter pre-hospital and in-hospital delay. They arrived early, had prompter evaluation, and received more rapid treatment. ·         More patients, who were eligible for clot-busting drug, received them. These happened because EMS gives the receiving hospital pre-notification about the arrival of the patient and the ER staff is ready to act as soon as the patient arrives.
Author Interviews, Exercise - Fitness, JAMA, Stroke / 19.03.2013

MedicalResearch.com Interview with Carron D. Gordon, PhD Section of Physical Therapy, University of the West Indies, Mona, Box 126, Kingston 7, Jamaica, West Indies MedicalResearch.com:  What are the main findings of the study? Dr. Gordon: The walking group showed a 17.6% improvement in distance walked in six minutes (measure of endurance) compared to 4% in the control group and 16.7% improvement in SF36-Physical Component (health-related quality of life) compared to 2.6% in the control group.