Jul 10, 2019
First published on ScienceDaily.com
Working long hours for 10 years or more may be associated with stroke. People under age 50 had a higher risk of stroke when working long hours for a decade or more.
People who worked long hours had a higher risk of stroke, especially if they worked those hours for 10 years or more, according to new research in the American Heart Association’s journal Stroke.
Researchers reviewed data from CONSTANCES, a French population-based study group started in 2012, for information on age (18-69), sex, smoking and work hours derived from questionnaires from 143,592 participants. Cardiovascular risk factors and previous stroke occurrences were noted from separate medical interviews.
Researchers found:
overall 1,224 of the participants, suffered strokes;
29% or 42,542, reported working long hours;
10% or 14,481, reported working long hours for 10 years or more; and
participants working long hours had a 29% greater risk of stroke, and those working long hours for 10 years or more had a 45% greater risk of stroke.
Long work hours were defined as working more than 10 hours for at least 50 days per year. Part-time workers and those who suffered strokes before working long hours were excluded from the study.
“The association between 10 years of long work hours and stroke seemed stronger for people under the age of 50,” said study author Alexis Descatha, M.D., Ph.D., a researcher at Paris Hospital, Versailles and Angers University and at the French National Institute of Health and Medical Research (Inserm). “This was unexpected. Further research is needed to explore this finding.
Read the full article here.
Jul 8, 2019
First published on ScienceDaily.com
New analysis of 16th-century drawing by Italian doctors concludes da Vinci’s right hand affected by ulnar palsy, rather than stroke
A fainting episode causing traumatic nerve damage affecting his right hand could be why Leonardo da Vinci’s painting skills were hampered in his late career. While the impairment affected his ability to hold palettes and brushes to paint with his right hand, he was able to continue teaching and drawing with his left hand. According to most authors, the origin of da Vinci’s right hand palsy was related to a stroke.
Doctors writing in the Journal of the Royal Society of Medicine reached a different conclusion after analysing a 16th-century drawing of an elderly da Vinci, together with a biography and an engraving of the Renaissance polymath artist and inventor in earlier years.
The authors, Dr Davide Lazzeri, a specialist in plastic reconstructive and aesthetic surgery at the Villa Salaria Clinic in Rome, and Dr Carlo Rossi, a specialist in neurology at the Hospital of Pontedera, focused on a portrait of da Vinci drawn with red chalk attributed to 16th-century Lombard artist Giovan Ambrogio Figino. The drawing is a rare rendering of da Vinci’s right arm in folds of clothing as if it was a bandage, with his right hand suspended in a stiff, contracted position.
Dr Lazzeri said: Rather than depicting the typical clenched hand seen in post-stroke muscular spasticity, the picture suggests an alternative diagnosis such as ulnar palsy, commonly known as claw hand.”
He suggests that a syncope, or faint, is more likely to have taken place than a stroke, during which da Vinci might have sustained acute trauma of his right upper limb, developing ulnar palsy. The ulnar nerve runs from the shoulder to little finger and manages almost all the intrinsic hand muscles that allow fine motor movements.
Please read the full article here.
Jul 5, 2019
“The life after stroke is the poorest point of the care process, especially in the chronic phase” says Esther Duarte, member of the board of Fundació Ictus, and rehabilitation doctor at IMIM Institut Hospital del Mar d’Investigacions Mèdiques in Catalonia, Spain.
SAFE: What is one issue related to the life after stroke in your country or region that you think needs special attention?
Esther Duarte
ED: In Catalonia, stroke patient associations have few members, therefore they have little power in society and official institutions, as well. In consequence, more public resources are always allocated to young patients with other illnesses, such as cancer and ischemic cardiovascular pathology. Moreover, these associations are only useful for a small percentage of patients. One of the aspects that are not taken into account is labor protection. Few patients return to work because there are no policies to facilitate it. Furthermore, other aspects with bad attention are those related to sexuality or driving, for example. On the other hand, there are few research groups focused on life after stroke and how improve patient-centered outcomes. In conclusion, access to rehabilitation services is not guaranteed in all cases and the needs of patients and caregivers are not always met.
SAFE: What would be the solution, i.e. what is your organization’s position regarding this issue?
ED: The main goal of Fundació Ictus is to improve the quality of life of stroke survivors and their caregivers. We collaborate with patient associations to meet their needs and help them in finding resources for their activities. We also help stroke survivors with specific training for caregivers and volunteers. That’s an important point, because there is not any specific course focused on stroke addressed to any professional, except the hospital nursery course that we have organized for 11 years. We also encourage patient-centered research, otherwise there is no way to advance in giving a better care to stroke survivors. Moreover, we offer advice in different dimensions: legal, labor, social, driving and sexual. Finally, we are trying to develop new platforms oriented to patients and caregivers that integrate all the information.
SAFE: Please tell us more about your organization.
ED: Fundació Ictus is an entity with a social presence with the mission of publicizing the disease, promoting research on it and supporting people who have suffered a stroke. Our main goals are popularizing the disease and spread how to prevent it, how to avoid it and how to treat it. Furthermore, we support stroke patients, offering support to people with disabilities, with alliances with other entities. In addition, we promote research on the disease in all its stages and from all perspectives.
Jul 4, 2019
This Round Table Discussion reviews NOACs in secondary stroke prevention.
Following completion of this activity, learners will be able to:
- Recall key scientific data of the NOAC trials in SPAF incl. secondary stroke prevention
- Outline key clinical questions when starting patients on NOACs, incl. potential need for reversal
- Select an appropriate NOAC for their AF patients based on these considerations
NOACs in Secondary Stroke Prevention
Faculty:
Robin Lemmens – MD, PhD, Department of Neurosciences, Experimental Neurology, Leuven Research Institute for Neuroscience and Disease, KU Leuven – University of Leuven, Leuven, Belgium
Milan Voško – MD, PhD, Department of Neurology, Kepler Universitätsklinikum, Linz, Austria
Ales Tomek – MD, PhD, FESO, Neurology Department, 2nd Medical Faculty of Charles University, Prague, Czech Republic
Jul 4, 2019
“Our system promotes health, prevents disease and provides assistance to serious patients in an exemplary manner, trains its professionals properly and generates a high added value in biomedical research, but it still has one remaining issue: to rehabilitate, take care of both the patient and the caregiver and properly reinsert citizens back into society” says Carmen Aleix, the President of the Spanish Federation of Stroke (FEI).
SAFE: What is one issue related to the life after stroke in your country that you think needs special attention?
Carmen Aleix
CA: Rehabilitation in patients with stroke occupies a very irrelevant role in most health decision-making forums throughout Spain, including Catalonia.
We know what our patients think about how the service is provided “beyond the acute phase” They notice limitations regarding care access related to age and perceive that there are no homogeneous referral criteria when accessing to certain social benefits. They also sense lack of information and greater difficulties regarding access to attention when there is cognitive damage associated with severe behavioral disorders. Patients also report important differences in the quality of the benefit depending on the center to which the patient is referred. Rehabilitation should be the main actor and not the secondary or even the absent one, as has been up to now in any plan or strategy on stroke or any other disease that produces disability. Patients demand to live with dignity.
SAFE: What would be the solution, i.e. what is your organisation’s position regarding this issue?
CA: The Spanish Stroke Federation defends the need to carry out in-depth reforms of the system to ensure its sustainability. Encourage patient self-care, health promotion, adjustment of resources to needs and continuity in care.
Our current health model needs to adapt to the new social reality marked by population aging which has become chronic, and the continuous development of technological services. For this, it considers that the person must be placed in the center of our National Health System (SNS), in order to achieve that the needs of the patient to be the ones that vertebrate all the infrastructures and sanitary and sociosanitary services, and demanding a much more active participation in the design and execution of the services that are provided, which is already happening in the most advanced countries in terms of health. Ideally, we should be able to count on a NATIONAL NETWORK OF CONTINUED CARE and to know clearly how the rehabilitation expense is managed in the Social Security and why now is there so much deficiency, so few sessions and so terrible attention in the rehabilitation of stroke patients.
SAFE: Please tell us more about your organisation.
CA: The Spanish Federation of Stroke (FEI) is a non-profit organization at the national level, independent of the administrations, of volunteering, which was founded in 2006. The lack of interest and the scarce sensitization of the health administrations towards stroke was a sufficient reason for the constitution of the federation. The mission of the FEI is to promote information and education on stroke, prevention and adequate and equitable treatment throughout the national territory. Its values are Participation, Commitment, Responsibility, Social Change.
2018 Assembly of the Federation with its associations
Commitment for 2019
1. The FEI is participating in the prevention campaign #GeneraciónInvictus.
2. It is also conducting online surveys to participate patients and caregivers.
3. We have signed a collaboration agreement with the Spanish Society of General and Family Physicians, through which an epidemiological study on the knowledge of stroke in primary care will be carried out jointly, as well as the organization of other workshops and joint activities.
A picture is worth a thousand words, to know our activities we leave our WEBs and Social Networks.
https://ictusfederacion.es/
https://www.facebook.com/ictusfederacion/
https://twitter.com/ictusfederacion
http://diamundialdelictus.org/unictusunahistoria.com/
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