Tuesday, September 27, 2011

Neurology Apples, Pears Linked to Reduced Stroke Risk

September 15, 2011 — A new study shows an association between a high intake of fruits and vegetables with white flesh, in this research mainly apples and pears, and a reduced risk for stroke on the order of 50%.
In this large, population-based study, each 25 g/day increase in consumption of white fruits and vegetables was associated with a 9% decrease in stroke risk.
However, lead author Linda M. Oude Griep, MSc, from the Division of Human Nutrition at Wageningen University, the Netherlands, cautioned that as this is the first such study to look at color groups of fruits and vegetables in relation to stroke, no definite conclusions can be made.
Linda M. Oude Griep
"There are more studies needed to confirm these findings," Ms. Oude Griep told Medscape Medical News. "It's also the case that maybe other color groups of fruits and vegetables may protect against other chronic diseases, so it remains of importance that patients eat a variety of fruits and vegetables."
Their findings are published online September 15 and will appear in the November issue of Stroke.
Color Mirrors Content.................
In this study, the researchers investigated whether fruits and vegetables grouped into different colors were associated with incident stroke. Although studies have consistently shown that a high consumption of fruit and vegetables overall is associated with a lower stroke risk, the researchers note, few studies have examined the association between stroke risk and groups of fruit and vegetables grouped according to the color.
The color of the primary edible portion of fruits and vegetables reflects the presence or absence of particular pigmented bioactive compounds, such as carotenoids, anthocyanidins, and flavonoids, the authors write. Which fruits and vegetables in particular contribute most the reduction in stroke risk from overall high consumption is not known, and that was the primary aim of this study.
The researchers used data from the Monitoring Project on Risk Factors and Chronic Diseases in the Netherlands Study, a population-based cohort study including 20,069 men and women aged 20 to 65 years and free of cardiovascular disease at baseline.
Information on fruit and vegetable intake was taken from a validated, 178-item food frequency questionnaire that included juices and sauces.
Fruits and vegetables were classified into 4 color groups according to the edible portion: green included such items as broccoli, brussels sprouts, and kiwi fruit; orange/yellow included citrus fruits, carrots, and cantaloupe; red/purple encompassed things like cherries, grapes, red cabbage, and tomatoes; and white included the allium family of garlic and onion, hard fruits such as apples and pears, and bananas, cauliflower, or cucumber.
Potatoes and legumes were not included as vegetables, "because their nutritional value differs significantly from that of true vegetables," the researchers note.
The median consumption of white fruits and vegetables was highest in this population, and apples and pears were the most commonly consumed of these, making up 55% of intake.
Median Consumption of Fruits and Vegetables by Color Group
Color Group G/Day
Green 62
Orange/Yellow 87
Red/Purple 57
White 118
During 10 years of follow-up, 233 incident cases of stroke were documented. Hazard ratios were calculated for incident stroke, adjusting for age, sex, lifestyle, and dietary factors.
The authors report that although no such relationship was seen with green, orange/yellow, or red/purple groups, there was a significant reduction of 52% in 10-year stroke incidence for those participants in the highest quartile for white fruit and vegetable consumption vs those in the lowest quartile.
Stroke Risk for Highest vs Lowest Intake of White Fruits and Vegetables
Comparison Hazard Ratio 95% Confidence Interval
Quartile 4 vs quartile 1 (>171 g/day ≤78 g/day) 0.48 0.29 - 0.77
Each 25 g/day increase in white fruit and vegetable consumption was associated with a 9% lower risk for stroke (hazard ratio, 0.91; 95% confidence interval, 0.85 - 0.97).
Previous studies have suggested that apples and pears are inversely related to incident stroke, although the findings were not statistically significant in those studied, the researchers note. Apples are a rich source of dietary fiber and the flavonol quercetin, the authors note.
Another important contributor to white fruit consumption was bananas, they add. "To our knowledge, no previous prospective cohort studies have investigated the association between bananas and incident stroke."
"Apple a Day" Clinical Trial?
In an editorial accompanying the publication, Heike Wersching, MD, from the University of Muenster Institute of Epidemiology and Social Medicine, Germany, points out that this study focuses on the beneficial effects of food groups, allowing for the synergistic effects of different nutrients in whole fruits and vegetables to be evaluated.
"This approach is of particular importance in the active prevention of cerebrovascular disease, as it directly translates into healthy food choices," Dr. Wersching writes.
The adjustment in this large trial, however, still may not completely rule out the effects of a generally healthy lifestyle, she notes. "Thus, specific reduction in stroke risk for single subgroups of plant foods still needs to be interpreted with caution."
Nevertheless, "The work by Griep et al proposed an interesting and practical concept that calls for replication studies, ideally supported by analysis of corresponding biomarker profiles," she concludes. "If replication is successful in independent studies and countries, the time for an 'apple a day' clinical trial has come."
The Monitoring Project on Risk Factors and Chronic Diseases in the Netherlands Study was supported by the Ministry of Health, Welfare, and Sport of the Netherlands; the National Institute of Public Health and the Environment, Bilthoven, the Netherlands; and the Europe Against Cancer Program of the European Union. An unrestricted grant was obtained by one of the article coauthors from the Product Board for HorticuIture, Zoetermeer, the Netherlands, to cover the costs of data analysis for the present study. The other authors and the editorialist have disclosed no relevant financial relationships.
Stroke. Published online September 15, 2011.

Stroke Patients Get Robot Legs

Stroke Patients Get Robot Legs

Robot_leg What's the Latest Development?
A powerful exoskeleton is helping stroke patients and victims of spinal cord injuries to walk again. "The prototype device is called the Lower-extremity Powered ExoSkeleton, or LOPES, and works by training the body and mind of a patient to recover a more natural step." Developed over the last several years at the University of Twente in Enschede in the Netherlands, the device "can do all the walking for the patient, or it can offer targeted support in either one leg or with one element of the walking process."
What's the Big Idea?
Commercial versions of the product could be developed as early as next year. Beyond victims of medical injuries, the lower-extremity exoskeleton is being designed with military function in mind. A California company is developing an exoskeleton that "enables infantry soldiers to lift and carry weights of up to 90kg in the field, and consists of a hydraulic-powered frame which straps around the soldier's body." In the future, exoskeleton devices may be used by aging individuals to keep pace with younger ones when families are out and about. .......  

Can eating fish save you from getting a stroke?

Vitamin D, selenium and certain types of proteins in fish may also have stroke-related benefits, Mozaffarian added.
NEW YORK: People who eat fish a few times each week are slightly less likely to suffer a stroke than those who only eat a little or none at all.
That’s the conclusion of an analysis of 15 studies, each of which asked people how frequently they ate fish, then followed them for between four and 30 years to see who suffered a stroke.
“I think overall, fish does provide a beneficial package of nutrients, in particular the omega-3s, that could explain this lower risk,” said Dr. Dariush Mozaffarian, a Harvard School of Public Health epidemiologist whose research was included in the analysis.
“A lot of the evidence comes together suggesting that about two to three servings per week is enough to get the benefit.”......

Study reveals natural protection mechanism during stroke

Last updated 17 August 2011
Scientists have discovered how some nerve cells in the brain are resistant to damage during a stroke - a finding that could one day pave the way for new therapies to protect other types of nerve cells.

A research team at the University of Bristol examined two types of nerve cell in the hippocampus - part of the brain that is involved in memory and navigation.

One of the cell types, the CA1 cell, is highly susceptible to stroke-related damage, while the other type, the CA3 cell, is much more resistant.

The researchers found that CA1 cells' susceptibility appears to be linked to the absence of adenosine A3 receptors, which are normally activated by high levels of adenosine during stroke conditions.

Dr Jake Mellor, senior lecturer in the university's School of Physiology and Pharmacology, said: 'We hope that if we can understand why some nerve cells are resistant to stroke damage we may be able to develop strategies to protect those cells that are sensitive.'

The scientist, whose findings are published in the Journal of Neuroscience, noted that stroke's unpredictability and the need to administer drugs within minutes of onset have historically made it difficult to treat.

'These problems will not be overcome by our research but our findings do reveal a natural protection mechanism in some nerve cells, which may be useful in developing treatments to protect other nerve cell types,' he added.

Around 150,000 people in the UK are affected by stroke each year, according to the Stroke Association.ADNFCR-554-ID-800702374-ADNFCR....... http://bit.ly/qIIqXI

Monday, September 26, 2011

Life After Stroke Audiobook

In this unique and gentle approach to Stroke, learn
everything there is to know about stroke whether a
survivor, friend, family member or caregiver.

This important guide contains information that will:

Educate you about the immediate aftereffects of stroke,
so you know what to expect and how to overcome setbacks
in the early weeks following a stroke.

Teach you how to set goals following a stroke that will
speed the progression of your healing.

Help you understand what rehabilitation is all about,
including what forms of rehabilitation are available
and how they can improve your quality of life and
standard of living,..... http://bit.ly/qsRgOm

Sunday, September 18, 2011

Speaking and Listening Share Large Part of Brain Infrastructure

ScienceDaily (Aug. 16, 2011) — What areas of the brain are involved in the linguistic processes underlying speech and listening and are there large differences between these? Neuroscientists from the Donders Institute for Brain, Cognition and Behaviour at Radboud University Nijmegen are the first to have successfully investigated this question using functional magnetic resonance imaging (fMRI). In what may come as a surprise to many scientists, the researchers have established that there is a large degree of overlap between the areas involved.
The results are published in the journal Psychological Science.
Within the scientific community there is a lot of discussion about whether the brain functions involved in speech production are also involved in the comprehension of speech. In the area of mirror neuron research in particular (a hot topic for the past 15 years), research has viewed the overlap between the areas of the brain involved in speech and listening as reaction and observed action, says neuroscientist Laura Menenti, who is currently working at the University of Glasgow. However, speaking and listening are more than just action and observation. They also involve linguistic processing. Menenti and her colleagues mainly focused on this last aspect:..... http://bit.ly/nXC6tn

Sunday, September 11, 2011

FDA panel votes 9-2 in favor of new blood thinner drug

By Dr Ananya Mandal, MD
A new stroke preventer from Bayer and Johnson & Johnson – Xarelto moved one step closer to U.S. approval, but questions remained about restrictions on labeling and the need for more studies.
An Food and Drug Administration (FDA) panel advisory looked at the effectiveness and safety of blood thinner Xarelto compared to standard warfarin in the ROCKET-AF trial. They voted 9-2 on Thursday to recommend approval of the once-a-day anti-clotting pill, called Xarelto. They asked for further studies on how to transition off of Xarelto. FDA decision on the drug is expected by Nov. 4
Xarelto is one of several promising entrants angling to replace warfarin for people with dangerously irregular heart rhythms, called atrial fibrillation (AF). Warfarin is a problematic decades-old clot preventer originally developed as rat poison. AF patients' irregular heartbeats can cause blood to pool, increasing their risk of blood clots and strokes. But many are unwilling to take warfarin, which requires regular blood tests, or are unable to tolerate it.
The study involved 14,264 patients across 1,178 sites in 45 countries. Patients were diagnosed with persistent or paroxysmal AF with additional risk factors for stroke, and were randomly assigned to warfarin (Coumadin, Bristol-Meyers Squibb) or rivaroxaban (Xarelto, Johnson & Johnson). Patients who were assigned to rivaroxaban received a 20mg dose once daily, and warfarin was titrated to a target range of two to three.
Overall, a decreased rate of stroke and non-CNS embolism events were associated with rivaroxaban during treatments vs. warfarin (P=.015). In the intention-to-treat analysis, rivaroxaban was non-inferior to warfarin (P=.117). The rate of bleeding and adverse events was similar between the rivaroxaban and warfarin arms, but rivaroxaban was associated with less intercranial hemorrhage and fatal bleeding.
“I've seen the problems many patients face with warfarin,” said Dr. Philip Sager, a panel member and executive committee member of the Cardiac Safety Research Consortium in San Francisco. “I think there's a tremendous unmet medical need for new therapies.”
Panelists were divided on whether Xarelto, with the clinical name rivaroxaban, was as effective as warfarin. In clinical trials that compared Xarelto to warfarin, panelists and the FDA said the older drug was not always given in the proper dosing, making it more difficult to determine if Xarelto was just as good.
“I've heard nothing that convinces me that rivaroxaban should be first-line treatment for many patients,” said Allan Coukell, the patient representative on the panel and director for medical safety at Pew Health Group, adding that Xarelto's label should reflect that......