Podcasts about ischaemic

When someone has an acute ischemic stroke, urgent, effective, simple and reliable treatments will reduce their risks of disability or dying from their brain tissue damage. The treatments used vary around the world, and a drug called cerebrolysin and its analogues are widely used in post-Soviet countries, Eastern Europe, and Central and Southeast Asia. In October 2023, the latest update of the Cochrane review was published by researchers from Cochrane Russia based at the Russian Medical Academy of Continuing Professional Education and two of the authors, Dilyara Nurkhametova and Liliya Eugenevna Ziganshina, discuss it for this podcast.

When someone has an acute ischemic stroke, urgent, effective, simple and reliable treatments will reduce their risks of disability or dying from their brain tissue damage. The treatments used vary around the world, and a drug called cerebrolysin and its analogues are widely used in post-Soviet countries, Eastern Europe, and Central and Southeast Asia. In October 2023, the latest update of the Cochrane review was published by researchers from Cochrane Russia based at the Russian Medical Academy of Continuing Professional Education and two of the authors, Dilyara Nurkhametova and Liliya Eugenevna Ziganshina, discuss it for this podcast.

In this episode, we discuss recently published landmark RCT which compared the timing for initiation of oral anticoagulation in patients who presented with ischaemic stroke with rapid AF. 

Welcome to our new CotECast series: "Ask the Expert". This series we will be delving deeper into some of the hot topics in geriatrics and we are going to be starting with a stroke mini-series! This is the thrid episode in this mini-series and Dr Chris Taylor is back to discuss acute treatment of ischaemic strokes.  

What's the episode about? Dr Xavier Aldana Reyes on horror studies, the Gothic, graveyards and death, body horror, horror and trauma, film, TV and English Literature and experiencing a transient ischaemic attack, plus highlights from the Death Online Research Symposium (DORS) conference 2023! Who is Xavier?  Dr Xavier Aldana Reyes is Reader in English Literature and Film at Manchester Metropolitan University, co-director of the Manchester Centre for Gothic Studies and, since 2022, co-president of the International Gothic Association. His books include Gothic Cinema (Routledge, 2020), Twenty-First-Century Gothic: An Edinburgh Companion (Edinburgh University Press, co-edited with Maisha Wester, 2019), Horror Film and Affect (Routledge, 2016), Horror: A Literary History (British Library Publishing, 2016) and Body Gothic (University of Wales Press, 2014). Xavier is chief editor of the international academic book series ‘Horror Studies' and a founding member of the Horror Studies special interest group of the British Association of Film, Television and Screen Studies. He is currently working on the forthcoming edited collection Graveyard Gothic (Manchester University Press) and on a new monograph entitled Contemporary Body Horror on Page and Screen (Cambridge University Press). Although by no means a thanatologist, Xavier has strong interests in adjacent areas. How do I cite the episode in my research and reading lists? To cite this episode, you can use the following citation: Aldana Reyes, X. (2023) Interview on The Death Studies Podcast hosted by Michael-Fox, B. and Visser, R. Published 2 August 2023. Available at: www.thedeathstudiespodcast.com, DOI: 10.6084/m9.figshare.23823135 What next? Check out more episodes or find out more about the hosts! Got a question? Get in touch. --- Send in a voice message: https://podcasters.spotify.com/pod/show/thedeathstudiespodcast/message

After his second covid 19 vaccination Sherif Aboutouk experienced an Ischaemic Stroke that amongst other things has caused vision problems. The post Ischaemic Stroke Recovery – Sherif Aboutouk appeared first on Recovery After Stroke.

In this episode of the Heart podcast, Digital Media Editor, Professor James Rudd, is joined by Dr Helen Routledge from Worcester Royal Hospital, UK. They discuss all aspects of intervention for ischaemic stroke, including the workforce challenges in delivering this lifesaving therapy. If you enjoy the show, please leave us a podcast review at https://itunes.apple.com/gb/podcast/heart-podcast/id445358212?mt=2 Link to published paper: https://heart.bmj.com/content/109/10/794

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2023.04.03.535309v1?rss=1 Authors: Peh, A., Dinakis, E., Nakai, M., Muralitharan, R. R., Rupasinghe, S., Wilson, J. L., Wong, C. H. Y., Jama, H., Barker, C. M. O., Modarresi, M., Kemp-Harper, B. K., Zheng, T., Marques, F. Z., Broughton, B. R. S. Abstract: We provide evidence that stroke-induced gut breakdown results in bacteria translocation to the ischaemic mouse brain. Inhibition of sympathetic tone reduced bacterial load in the post-stroke brain and reduced functional deficits without altering cerebral apoptosis, neuroinflammation or infarct volume. These findings indicate that the activation of the sympathetic nervous system after stroke promotes gut-derived bacteria to enter to the brain, and this process worsens motor function in mice. Copy rights belong to original authors. Visit the link for more info Podcast created by Paper Player, LLC

Ischaemic heart disease is the amongst the leading causes of death in the United Kingdom in men and women.What exactly is a heart attack?The progression of heart disease is determined by the progression of atherosclerosis (or to put it plainly, how much plaque is built up in your blood vessels). Heart attacks result from the formation of atherosclerosis, and of sclerotic plaques which are liable to block the passage of blood in the blood vessels to the heart. Try picturing a pipe that's clogged up with muck: whilst there's just a little, water can flow through but the flow of water will get weaker and weaker as the muck gets clogged and eventually, unless we clean the pipe, no water will be flowing through. If you need a visual, watch this short video by the British Heart Foundation.When this happens, without the supply of oxygen from the blood, the heart tissue will die. This is a heart attack.To read more, please visit https://www.mayanaturopathy.co.uk/naturopathy/heart-attacks-reduce-risk/ 

With Alessia Gimelli, Fondazione Toscana Gabriele Monasterio, Pisa - Italy & Riccardo Liga, University of Pisa, Pisa - Italy Link to paper Link to editorial

References Dr. Guerra's: membrane lectures J Clin Med. 2021 Sep; 10(17): 3795 J Neuroinflammation. 2016; 13: 264. --- Send in a voice message: https://anchor.fm/dr-daniel-j-guerra/message

In this episode we are joined by Dr Regan Cooley to discuss his approach to a young patient presenting with ischaemic stroke.

The most common type of stroke is one in which a large artery in the brain gets blocked by a blood clot and there are dozens of Cochrane reviews of various treatments for these ischaemic strokes. One of these reviews, looking at the effects of endovascular thrombectomy and intra-arterial interventions, was updated in June 2021 and lead author, Melinda Roaldsen from the Arctic University of Norway in Tromsø, briefly describes the new findings in this  podcast.

The most common type of stroke is one in which a large artery in the brain gets blocked by a blood clot and there are dozens of Cochrane reviews of various treatments for these ischaemic strokes. One of these reviews, looking at the effects of endovascular thrombectomy and intra-arterial interventions, was updated in June 2021 and lead author, Melinda Roaldsen from the Arctic University of Norway in Tromsø, briefly describes the new findings in this  podcast.

Ischaemic stroke is a leading cause of morbidity and mortality. The World Health Organization defines stroke as “a clinical syndrome consisting of rapidly developing clinical signs of focal (or global) disturbance of cerebral function, lasting more than 24 hours or leading to death, with no apparent cause other than that of vascular origin”. David Wang, Professor of Neurology, Barrow Neurological Institute, Phoenix, Arizona, gives us a clinical overview of the condition. For more on ischaemic stroke, visit BMJ Best Practice: bestpractice.bmj.com/topics/en-gb/3000114 - The purpose of this podcast is to educate and to inform. The content of this podcast does not constitute medical advice and it is not intended to function as a substitute for a healthcare practitioner's judgement, patient care or treatment. The views expressed by contributors are those of the speakers. BMJ does not endorse any views or recommendations discussed or expressed on this podcast. Listeners should also be aware that professionals in the field may have different opinions. By listening to this podcast, listeners agree not to use its content as the basis for their own medical treatment or for the medical treatment of others.

Assessing the continuing ability to treat COVID-19 with antibody infusions. | A 'temporary stroke' means people get the signs of a stroke but the symptoms go away it's a called a Transient Ischaemic Attack - but that could be a misnomer. | If you have high blood pressure and lifestyle controls are not helping - by how much should pressure be reduced? | Primary aldosteronism (PA) is a hormonal cause of high blood pressure; it's treatable and there's a simple test.

A 'temporary stroke' means people get the warning signs of a stroke but the symptoms go away without treatment. The medical name for this has been a Transient Ischaemic Attack - or a TIA. 

Ischaemic v Non-ischamic Cardiac MRI and various Cardiomyopathies

Journal of Neurochemistry, Volume: 146, Issue: 4, Pages: 416-428, First published: 20 May 2018, DOI: (10.1111/jnc.14464 --- Send in a voice message: https://anchor.fm/dr-daniel-j-guerra/message Support this podcast: https://anchor.fm/dr-daniel-j-guerra/support

This episode Sam was joined by Acute Medical SpR with a specialist interest in Stroke Medicine, Dr Jen Collinson where they discussed typical elements of a history, a focussed examination as well as the investigations and management of these patients!    Twitter: @prepacespodcast - follow our tweetorials!  Email: prepacespodcast@gmail.com https://www.buymeacoffee.com/prepacespodcast

This episode covers everything COLITIS!- infectious colitis - including a quick touch on common infectious causes and how to treat them- pseudomembranous colitis and clostridium difficile infection- diverticulitis in all it's glory - be prepared for some pathophysiology, classification systems (Hinchey I'm looking at you), and discussion about treatment- and to round them off we take a look at ischaemic colitis!If you want to learn more about ischaemic colitis - feel free to read this awesome review article (by yours truly): Ischaemic colitis: uncertainty in diagnosis, pathophysiology and management. https://onlinelibrary.wiley.com/doi/abs/10.1111/ans.14237 DisclaimerThe information in this podcast is intended as a revision aid for the purposes of the General Surgery Fellowship Exam.This information is not to be considered to include any recommendations or medical advice by the author or publisher or any other person. The listener should conduct and rely upon their own independent analysis of the information in this document.The author provides no guarantees or assurances in relation to any connection between the content of this podcast and the general surgical fellowship exam.  No responsibility or liability is accepted by the author in relation to the performance of any person in the exam.  This podcast is not a substitute for candidates undertaking their own preparations for the exam.To the maximum extent permitted by law, no responsibility or liability is accepted by the author or publisher or any other person as to the adequacy, accuracy, correctness, completeness or reasonableness of this information, including any statements or information provided by third parties and reproduced or referred to in this document. To the maximum extent permitted by law, no responsibility for any errors in or omissions from this document, whether arising out of negligence or otherwise, is accepted.The information contained in this podcast has not been independently verified.© Amanda Nikolic 2021

The Oxford Astra Zeneca vaccine has been associated with a rare complication of cerebral venous sinus thrombosis. Dr Colin Mahoney, JNNP Podcast Editor, interviews Prof David Werring, Professor of Clinical Neurology, UCL Queen Square Institute of Neurology, UK, about the new evidence which supports an association between vaccination and more common large vessel arterial stroke. They also discuss several cases, including treatment, and emerging biological evidence relating to causation. Read the paper "Ischaemic stroke as a presenting feature of ChAdOx1 nCoV-19 vaccine-induced immune thrombotic thrombocytopaenia", on the JNNP website: https://jnnp.bmj.com/content/early/2021/05/20/jnnp-2021-326984. Related editorial paper: https://jnnp.bmj.com/content/early/2021/05/20/jnnp-2021-327057

The Oxford Astra Zeneca vaccine has been associated with a rare complication of cerebral venous sinus thrombosis. Dr Colin Mahoney, JNNP Podcast Editor, interviews Prof David Werring, Professor of Clinical Neurology, UCL Queen Square Institute of Neurology, UK, about the new evidence which supports an association between vaccination and more common large vessel arterial stroke. They also discuss several cases, including treatment, and emerging biological evidence relating to causation. Read the paper "Ischaemic stroke as a presenting feature of ChAdOx1 nCoV-19 vaccine-induced immune thrombotic thrombocytopaenia", on the JNNP website: https://jnnp.bmj.com/content/early/2021/05/20/jnnp-2021-326984. Related editorial paper: https://jnnp.bmj.com/content/early/2021/05/20/jnnp-2021-327057

This week Dr Celyn Kenny (Dragon Bytes host) and Dr Elisa Smit (Consultant Neonatologist, University Hospital of Wales) continue their discussion about hypoxic-ischaemic encephalopathy. Part 2 of 2.

This week Dr Celyn Kenny (Dragon Bytes host) is joined by Dr Elisa Smit (Consultant Neonatologist, University Hospital of Wales) to discuss hypoxic-ischaemic encephalopathy. Part 1 of 2.

In this episode, Sophia Khattak discusses key points from a recent case report published in EHJ – Case Reports.

In this episode of the Heart podcast, Digital Media Editor, Dr James Rudd, is joined by Dr Matthew Ryan from King's College, London. They discuss whether and how we should revascularise patients with ischemic cardiomyopathy, plus also mention the REVIVED study which reports in 2022. If you enjoy the show, please subscribe to the podcast to get episodes automatically downloaded to your phone and computer. Also, please consider leaving us a review at https://itunes.apple.com/gb/podcast/heart-podcast/id445358212?mt=2 Link to published paper: https://heart.bmj.com/content/early/2021/01/12/heartjnl-2020-316856

In this episode we are joined by Professor Bruce Campbell to discuss CT perfusion scanning and it's role in the diagnosis and management of acute ischaemic stroke. Visit www.neuropodcases.co.uk to access the radiology images discussed in the episode. All clinical cases in these podcast episodes have been created based on past interactions with real patients but are not intended to represent any specific person. No specific individual patient information will ever be provided in the podcast. Music: Good Starts - Jingle Punks https://youtu.be/NstTz8iyl-c

In this episode we are joined by Professor Bernard Yan to discuss the past, present and future of mechanical thrombectomy as a treatment for patients presenting with acute ischaemic stroke. Music: Good Starts - Jingle Punks https://youtu.be/NstTz8iyl-c

This episode covers hypoxic-ischaemic encephalopathy.Written notes can be found at https://zerotofinals.com/paediatrics/neonatology/hie/ or in the neonatology section in the Zero to Finals paediatrics book.The audio in the episode was expertly edited by Harry Watchman.

EJVES Editor's Choice

With Danilo Neglia & Riccardo Liga, University of Pisa - Italy. Link to paper Link to editorial

Please visit our website medicolifestyle.com

S 4 Ep 4 – Sleep and Circadian Rhythm Dysfunction in Human Ischaemic Stroke with Elie Gottlieb In this episode of S4P Radio, we welcome Elie Gottlieb. Elie is a final-year neuroscience PhD candidate at the University of Melbourne and Florey Institute of Neuroscience & Mental Health with a passion for clinical sleep and circadian rhythm research. Elie’s PhD examines the pathogenesis of post-stroke sleep architectural and circadian rhythm dysfunction using MRI, polysomnography, and melatonin assay. Additionally, Elie was a recipient of the Melbourne Research Scholarship working within Professor Amy Brodtmann’s clinical cognitive neuroscience and vascular neurodegeneration laboratory. You can get in touch with Elie via twitter @ElieGottlieb Or via his email elie.gottlieb@florey.edu.au     Contact me at iandunican@sleep4performance.com.au or our editor/producer at ricky.krstic@meliusconsulting.com.au www.sleep4performance.com.au Twitter @sleep4perform You can also listen to S4P Radio on YouTube and Spotify    

In 2017, for the first time, stroke, became the second most common cause of both death and disability in the world.  In New Zealand (NZ) the situation is even more dire as was previously shown through a series of population-based Auckland Regional Community Stroke Studies (ARCOS) population-based studies. The number of stroke survivors have tripled over the last three decades, and there are also significant ethnic disparities in stroke, with the risk of stroke in Māori and Pacific people two to three times greater than in NZ Europeans. In 2011-2012, the age-adjusted incidence of stroke in NZ was the fourth highest in high-income countries.  Carmen Lahiff-Jenkins Managing Editor of the International journal of Stroke spoke to Professor Valery Feigin from the National Institute for Stroke and Applied Neurosciences, Auckland University of Technology, Auckland, New Zealand he is also the submitting author for the article Measuring stroke and transient ischaemic attack burden in New Zealand: protocol for the fifth Auckland Regional Community Stroke Study (ARCOS V) now online in the International Journal of Stroke.    To become a member please click here   Music is Kool Kats by Kevin McCloud 

Andrew Dixon from Radiopaedia covers the common pathology seen on CT scans in critical care. He covers basic anatomy and important areas not to miss, strokes, trauma, herniation syndromes, hypoxic brain injury and diffuse axonal injury

This lecture presents evidence-based information about the diagnosis, reperfusion treatment, and prevention of acute ischaemic stroke.  The discussion will centre on nursing clinical localization diagnostic skills, the availability and utility of computed tomographic (CT) technology, and nursing’s role in the development of systems of care that support stroke management. Specific topics will include intravenous alteplase and thrombectomy treatments, rapid emergency department management paradigms, the evolution of prehospital treatment on mobile stroke units, and the importance of primary and secondary stroke prevention.

When someone has an acute ischemic stroke, urgent effective, simple and reliable treatments will reduce their risks of disability or dying from their brain tissue damage. The treatments used vary around the world, and a drug called cerebrolysin is widely used in post-Soviet countries, Eastern Europe, Central and Southeast Asia. In April 2017, the latest update of this review was published by researchers from Kazan Federal University in Russia and Chinara Razzakova, a PhD student from the university interviewed one of the authors, Liliya Eugenevna, for this podcast.

When someone has an acute ischemic stroke, urgent effective, simple and reliable treatments will reduce their risks of disability or dying from their brain tissue damage. The treatments used vary around the world, and a drug called cerebrolysin is widely used in post-Soviet countries, Eastern Europe, Central and Southeast Asia. In April 2017, the latest update of this review was published by researchers from Kazan Federal University in Russia and Chinara Razzakova, a PhD student from the university interviewed one of the authors, Liliya Eugenevna, for this podcast.

When someone has an acute ischemic stroke, urgent effective, simple and reliable treatments will reduce their risks of disability or dying from their brain tissue damage. The treatments used vary around the world, and a drug called cerebrolysin is widely used in post-Soviet countries, Eastern Europe, Central and Southeast Asia. In April 2017, the latest update of this review was published by researchers from Kazan Federal University in Russia and Chinara Razzakova, a PhD student from the university interviewed one of the authors, Liliya Eugenevna, for this podcast.

Bruce Campbell joins The Lancet Neurology to discuss his systematic review of the HERMES collaboration.

In this episode, Dr Thomas Craven discusses key points from a recent case report published in EHJ – Case Reports. For the paper discussed in this episode, please visit https://doi.org/10.1093/ehjcr/yty077.

Commentary by Dr. Valentin Fuster

We kick off a series of episodes on ischaemic heart disease with stable angina. Hope you enjoy it!

Stroke thrombolysis - why are we still arguing? Summary by Lachlan Donaldson The debate regarding the efficacy of thrombolysis grumbles on… How is it that two different groups (i.e. mostly ED doctors and neurologists) can look at the same set of trials and come to fundamentally different conclusions? To examine this, these authors have attempted to perform an unbiased meta-analysis and systematic appraisal of the evidence supporting the use of thrombolysis in ischaemic stroke (paper available here). Consistent with other meta-analyses, the authors found a moderately increased probability of good functional outcome (OR 1.14) alongside a markedly increased risk of ICH (OR 4.28). However, as discussed, this debate is likely to be driven by the quality of the trials that populate this meta-analysis. For instance, of the 16 studies that nominated a specific primary outcome, only 2 studies reported a significant treatment effect in favour of thrombolysis as their primary outcome- the NINDS trial and ECASS III. Both of these studies have reported concerns baseline imbalance. Buried in the Supplementary Appendix is also the 'influence analysis' which shows the significant influence of the NINDS and IST-3 trial, both of which have significant methodological limitations.  Transparently analysing this controversial data was not without challenge – most trialists and drug companies were reluctant to share trial data without contracts and editorial influence (notwithstanding stated commitments to data-sharing). Once completed, most journals with broad readership rejected the paper on the basis that there was no ongoing debate; their view was that that the evidence was sound and that replication studies were not warranted.   9vhphp4z

2016 is the 30th anniversary of ischaemic preconditioning. Remote ischaemic preconditioning is the magical offspring of ischaemic preconditioning and refers to the phenomenon whereby brief periods of ischaemia in one organ can protect other organs from subsequent prolonged ischaemic insults. In theory, remote ischaemic preconditioning can be induced by temporarily interrupting the blood supply to an extremity using a blood pressure cuff. In experimental models this technique is effective in reducing ischaemia / reperfusion injury when applied after ischaemia but before reperfusion. As a result the technique has a wide range of potential clinical implications including: 1. Heart surgery with cardiopulmonary bypass 2. Planned percutaneous coronary interventions 3. Acute myocardial infarction 4. CBA being treated with lysis or clot retrieval 5. Carotid endarterectomy surgery 6. Hypoxic ischaemic encephalopathy 7. Organ transplantation 8. abdominal aortic aneurysm surgery While this technique is not yet ready for clinical application, it remains an exciting potential therapeutic modality for the future.

The World Health Organization lists COPD (chronic obstructive pulmonary disease) as the #3 killer worldwide,lower respiratory infections at #4, and cancer of trachea, bronchus, lung collectively at #5 cause of deaths worldwide. That is, the #3, #4, and #5 causes of human death around the planet all have to do with the respiratory tract. (Ischaemic heart disease and stroke are #1 and #2) If you put these three sets of symptoms together - that is, COPD, lower respiratory infections, and cancer of the trachea, bronchus and lung - and then you add in the several more respiratory symptoms that aren't listed in these three categories ...well, respiratory illness is clearly the number one killer on the planet. What's not clear is why the particular symptoms form, why respiratory illness affects different people differently in different parts of the world ...or what to do about respiratory illness. What most health practitioners don’t know (because it's a very new discovery), is that health symptoms that affect the respiratory system follow the laws of nature. Strictly. This realization opens up a whole new strategy for healing and then maintaining healthy breathing for the rest of your life. If you happen to know how and why nature creates these symptoms …a whole new strategy for healing and for maintaining healthy breathing throughout your life will open up for you. In Episode 6 of the Mind Over Symptom Podcast, "Mind Over Respiratory Illness," you get a framework for understanding the predictable, structured, and logical process that underlies every symptom from a tickle in your throat all the way to lung cancer. World Health Organization global statistics: http://www.who.int/mediacentre/factsheets/fs310/en/   Web MD on “Lung Diseases" http://www.webmd.com/lung/lung-diseases-overview   Mind Over Symptom Episode 3 - Anatomy Made Simple: the Mind-Body Code Revealed http://mindoversymptom.libsyn.com/3-anatomy-made-simple-the-mind-body-code-revealed   Get your (free) Mind Over Symptom Training or book a session to uncover the source of your symptom: http://mindtreehealth.net/services/   Rate/Review this podcast in iTunes: https://itunes.apple.com/ca/podcast/mind-over-symptom/id1135291574?mt=2

The second in out series of strokes is the effects of ischaemia. Hope you enjoy it!

Finally, learning all that cerebrovascular anatomy is going to come to use as we discuss the effects of ischaemic and haemorrhage strokes in our series starting with transient ischaemic attacks.

Jonathan Davis interviews Alistair Gunn and Jeff Kaiser about their March 2016 FNN Editor's Choice article 'Hypoglycaemia and hyperglycaemia are associated with unfavourable outcome in infants with hypoxic ischaemic encephalopathy: a post hoc analysis of the CoolCap Study' Read the free article here: http://fn.bmj.com/content/101/2/F149.full

Dr Divaka Perera from King's College, London and Guy's and St Thomas' Hopsital joins Dr James Rudd, associate editor at Heart, to discuss his recent Education in Heart paper titled: "Ischaemic cardiomyopathy: pathophysiology, assessment and the role of revascularisation" They cover the aetiology of ischaemic cardiomyopathy, the definitions of stunning, hibernation and viability and what the trials and guidelines can tell us. Optimal imaging strategies are debated. There is also mention of the REVIVED BCIS-2 study, of which Dr Perera is PI.

In this episode of the Heart Podcast, Heart Digital Media Editor Dr James Rudd is in conversation with Dr Chris Fordyce from the Duke Clinical Research Institute. His team has just published an Education in Heart paper on "Optimal non-invasive imaging test selection for the diagnosis of ischemic heart disease." In this podcast, they discuss the similarities and differences between the international guidelines on the investigation of chest pain. They also highlight the results of the landmark PROMISE and SCOT-HEART studies and discuss how the results of these trials might influence future guidelines. The paper contains many high-resolution multimedia elements, along with MCQs to test your knowledge in this area.

Is Suspended Animation only in the realms of science fiction, or is this a realsitic treatment option? Mervyn Singer questions if we can prevent secondary reperfusion injury following cerbral ischaemia.

In the US the licence, or marketing authorisation, for alteplase is limited to 0-3 hours after onset of stroke, but some other countries - including the UK and Australia - have extended the licence to 4.5 hours. In an analysis article on thebmj.com Brian Alper, vice president of evidence based medicine research and development at Dynamed, and colleagues, interpret the evidence to suggest increased mortality with uncertain benefit for its use beyond three hours. Read their full analysis: http://www.bmj.com/content/350/bmj.h1075

This week: Economic Incentives for Voluntary Medical Male Circumcision, and Lifestyle Counselling for Ischaemic Heart Disease Reena and Amol want you to: 1. Understand that medical male circumcision is effective in reducing transmission of HIV and other sexually-transmitted infections. 2. Recognize that an economic incentive designed to compensate people for ancillary costs and lost wages is modestly ... The post A Tale of Two Studies: Medical Male Circumcision, Ischaemic Heart Disease appeared first on Healthy Debate.

Background: Acute non-traumatic focal subarachnoid haemorrhage (fSAH) is a rare transient ischaemic attack (TIA)-mimic. MRI is considered to be indispensable by some authors in order to avoid misdiagnosis, and subsequent improper therapy. We therefore evaluated the role of CT and MRI in the diagnosis of fSAH patients by comparing our cases to those from the literature. Methods: From 01/2010 to 12/2012 we retrospectively identified seven patients with transient neurological episodes due to fSAH, who had received unenhanced thin-sliced multiplanar CT and subsequent MRI within 3 days on a 1.5 T scanner. MRI protocol included at least fast-field-echo (FFE), diffusion-weighted imaging (DWI), T2-weighted fluid-attenuated inversion recovery (FLAIR) and time-of-flight (TOF) MRA sequences. By using MRI as gold-standard, we re-evaluated images and data from recent publications regarding the sensitivity to detect fSAH in unenhanced CT. Results: fSAH was detected by CT and by FFE and FLAIR on MRI in all of our own cases. However, DWI and T2w-spinecho sequences revealed fSAH in 3 of 7 and 4 of 6 cases respectively. Vascular imaging was negative in all cases. FFE-MRI revealed additional multiple microbleeds and superficial siderosis in 4 of 7 patients and 5 of 7 patients respectively. Including data from recently published literature CT scans delivered positive results for fSAH in 95 of 100 cases (95%), whereas MRI was positive for fSAH in 69 of 69 cases (100%). Conclusions: Thin-sliced unenhanced CT is a valuable emergency diagnostic tool to rule out intracranial haemorrhage including fSAH in patients with acute transient neurological episodes if immediate MRI is not available. However, MRI work-up is crucial and mandatorily has to be completed within the next 24-72 hours.

This month, whole brain radiation vs radiosurgery for cerebral metastases. Does the former cause significantly more cognitive defects, and are any blanket, mopping up effects worth it? Clark Chen, vice chairman of neurosurgery, University of California San Diego, talks us through his review.And a clinical guide to the genetics of ischaemic stroke, from Pankaj Sharma, Imperial College Cerebrovascular Research Unit.Read the full papers:Review: Genetics of ischaemic stroke bit.ly/1aptzNlNeurocognitive assessment following whole brain radiation therapy and radiosurgery for patients with cerebral metastases http://bit.ly/1aptIjQ

A video podcast of the pathology of ischaemic heart disease. Including gross and microscopic images.

In this special edition of the podcast, JNNP associate editor Nick Ward looks into some of the latest research into stroke.Tracking cognitive function in those recovering from stroke in routine. Owen White, associate professor, Department of Neurology, Royal Melbourne Hospital, describes how assessing ocular motor deficits is a sensitive way of doing this. Furthermore, he describes the computerised programme he’s come up with to treat these, and why he believes doing so will lead to improvement in both sensory and motor areas.Tatu Kauranen has also been looking into assessing cognitive function, and discusses the value of this in predicting return to work after stroke.And Peter Rothwell explains why it’s safe and effective to treat those who’ve had an acute minor stroke as outpatients.See also:Stroke: mechanisms, stratification and implementation http://bit.ly/16o2YmFIschaemic stroke: the ocular motor system as a sensitive marker for motor and cognitive recovery http://bit.ly/ZmHFdTCould saccadic function be a useful marker of stroke recovery? http://bit.ly/10VojTzThe severity of cognitive deficits predicts return to work after a first-ever ischaemic stroke http://bit.ly/ZVjeJgReturn to work after stroke: the role of cognitive deficits http://bit.ly/10VorCvFeasibility, safety and cost of outpatient management of acute minor ischaemic stroke: a population-based study http://bit.ly/11VFocMIs the outpatient management of acute minor stroke feasible and safe? http://bit.ly/11VFocMThe JNNP stroke special edition jnnp.bmj.com/content/84/3Follow Nick Ward’s lab at UCL on Twitter http://bit.ly/18cNstj

Dr Peter Baxter, Editor in Chief of Developmental Medicine and Child Neurology, introduces a podcast based on an article in the November issue ‘Epilepsy in hemiplegic cerebral palsy due to perinatal arterial ischaemic stroke' by J. Wanigansinghe et al. This paper is a retrospective study of children with cerebral palsy, particularly on those with hemiplegic cerebral palsy and is discussed in this podcast by Dr Simon Harvey (Director, Epileptic programme, Royal Children's Hospital, Melbourne, Australia) and Professor Brian Neville (Professor,Childhood Epilepsy, Institute of Child Health, London, UK). Related Articles: Epilepsy in hemiplegic cerebral palsy due to perinatal arterial ischaemic stroke, BRIAN NEVILLE http://onlinelibrary.wiley.com/doi/10.1111/j.1469-8749.2010.03720.x/abstract Epilepsy in hemiplegic cerebral palsy due to perinatal arterial ischaemic stroke JITHANGI WANIGASINGHE, SUSAN M REID, MARK T MACKAY, DINAH S REDDIHOUGH, A SIMON HARVEY, JEREMY L FREEMAN http://onlinelibrary.wiley.com/doi/10.1111/j.1469-8749.2010.03699.x/abstract

A video podcast of the pathology of ischaemic heart disease. Including gross and microscopic images.

Ischaemic preconditioning for patients with acute myocardial infarction.

Professor Derek Yellon discusses a proof of concept study in this week's issue. This highlights the potential of remote ischaemic preconditioning in the upper arm to reduce myocardial injury among patients about to have coronary artery bypass surgery.

1. The mechanism of post-ischaemic ectopic impulse generation in nerve is not known, and previous measurements of excitability changes in human motor axons have appeared to conflict. We have used automatic threshold tracking and different stimulus-response combinations to follow the effects on excitability of brief (5-10 min) periods of ischaemia, too short to induce motor fasciculations. Excitability changes have been compared at different sites in axons innervating hand, arm and foot muscles. 2. Threshold was determined as the percutaneous stimulus current required to excite a single motor unit, or to evoke a constant multiunit response, after rectifying and integrating the electromyogram (EMG). Three different waveforms of stimulus current were compared: short (less than or equal to 2 ms) pulses, long (100-200 ms) pulses to measure rheobase, and 100 ms current ramps. We also measured accommodation by recording the effects of subthreshold depolarizing currents on excitability. 3. Ischaemic and post-ischaemic excitability changes were greatest in the proximal parts of the longest motor axons, and greater if the sphygmomanometer cuff was inflated over, rather than proximal to, the stimulating site. 4. Using integrated EMG responses from abductor digiti minimi, the ulnar nerve stimulated above the elbow became rapidly much less excitable after ischaemia when tested with short pulses, but more excitable when tested with current ramps. The rheobase rose briefly, but then fell, often below resting level, always staying below the pulse and ramp thresholds. 5. The latency of the response to a rheobasic stimulus altered in parallel with the threshold to short current pulses, and increased dramatically after ischaemia. This latency increase was associated with a prolonged phase of 'negative accommodation', i.e. the continued increase in excitability to a maintained subthreshold depolarizing current. 6. Changes in excitability and accommodation similar to those occurring after ischaemia were recorded following high frequency trains of stimuli. They were attributed primarily to hyperpolarization by the electrogenic sodium pump, since comparable changes could be induced by passing a steady hyperpolarizing current through the stimulating electrode. 7. Threshold and latency recordings from single motor units during and after ischaemia resembled in most respects the multiunit responses, but single unit rheobase did not show a post-ischaemic fall below the resting level. Repetitive firing contributed to the low multiunit thresholds recorded with long current pulses during the post-ischaemic period. 8. We conclude that human motor nerves become simultaneously both more and less excitable than normal after 10 min of ischaemia, depending on the choice of stimulus and response.