ESO: Stroke Care During COVID-19 Pandemic

ESO: Stroke Care During COVID-19 Pandemic

In the midst of the COVID-19 Pandemic, several European physicians have reported a reallocation of stroke resources and reduction of hospital staff due to quarantine or infection. Francesco Corea, FESO, Chair of the ESO Social Media Committee and Marialuisa Zedde, Chair of the ESO PR Committee, each took some time to record their experiences and observations in Italy, one of the first and hardest hit European countries thus far.

“While the price in terms of victims for COVID19 increases there can be further dramatic repercussions for many other diseases and clinical fields. The toll could be very high. My personal point of view, the Italian health care system suffers the shock of corona virus pandemic. From the news that I have available, several stroke units of large hospitals have been reorganized, moved or even closed to meet the need to assist hundreds of patients with serious infectious and respiratory problems” says Francesco Corea, Ospedale San Giovanni Battista Foligno, Italy. Read the full text here.

“Some practical considerations on how the organization of our daily work has already changed and is still changing in taking care of patients with acute stroke. My point of observation comes from a hospital earlier and more directly involved in the ongoing emergency, being close to Lombardy region. Anyway, it is only a personal view but I hope these experiences and reflections may be useful for other colleagues in different countries” said Marialuisa Zedde, Reggio Emilia Hospital, Italy. You can read her full text here

We recommend you keep an eye on ESO blog about the Covid19 crisis to stay up to date with the latest developments.

Featured image by Gerd Altmann from Pixabay

The ESO-WSO Conference is Postponed to 6-9 November 2020

The ESO-WSO Conference is Postponed to 6-9 November 2020

by ESO | 12.3.2020 | ESO |

Due to the latest developments regarding the COVID-19 outbreak, and in an effort to prevent spreading the virus and for the sake of event participants, the European Stroke Organisation together with the World Stroke Organization, have decided to postpone the ESO-WSO 2020 Conference, scheduled to take place in Vienna from 12-15 May 2020.

The new dates for ESO-WSO 2020 are 6-9 November. Answers to FAQ related to this postponement can be found on the conference website.

The conference will take place at the same venue, Austria Center Vienna and current registrations will be transferred to the new Conference dates.
In the coming weeks we will be updating the website with new registration deadlines, new programme scheduling and additional information.

Image by ESO.

Can brain stimulation help your arm after stroke?

Can brain stimulation help your arm after stroke?

First published on ARNI Institute for Stroke Rehabilitation website | March 9, 2020

Neuromodulatory non-invasive brain stimulation (NIBS) techniques are experimental therapies for improving motor function after stroke. The aim of neuromodulation is to enhance adaptive or suppress maladaptive processes of post-stroke reorganisation. However, results on the effectiveness of these methods, which include transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) are mixed. It’s posited that recent developments in NIBS technology will likely contribute to individualised therapy. Moving beyond single-area stimulation, targeting specific muscle groups that play different roles in post-stroke motor recovery (for example, finger flexors vs. extensors) may well be possible using multi-locus TMS. NIBS in stroke faces a challenge reminiscent of the development of other stroke therapies, such as thrombolysis and mechanical thrombectomy, where early studies were largely mixed before patient selection and individualising protocols were refined to determine its therapeutic potential.

So, researchers at UCL want to find out:

  • How brain activity changes after someone has a stroke.
  • If weak, non-invasive brain stimulation could encourage the brain into a pattern of brain activity which is useful for upper limb rehabilitation.

Please follow this link to red the full article.

Image by Gerd Altmann from Pixabay

Pregnancy and Stroke – and the other way around

Pregnancy and Stroke – and the other way around

First published by ESO | 6.3.2020

Author: Dr Nicolas Martinez-Majander, Department of Neurology, Helsinki University Hospital, Finland

Incidence of young-onset ischemic stroke is currently about 13/100 000 per year in high-income countries and has been increasing since 1980s. In young patients, stroke affects social life, family, and working ability for years after the event. In addition to well-known risk factors, such as diabetes mellitus, hypertension, and hypercholesterolemia, young patients also have unconventional, age-specific risk factors such as pregnancy and puerperium. However, there are still many unanswered questions in terms of risk factors for stroke in the young, and so far study results have been inconsistent.

Ischemic stroke during and after pregnancy

Both pregnancy and puerperium are associated with an increased risk of all stroke subtypes. In a single-center Canadian study, most ischemic strokes occurred during the third trimester, around delivery, or during postnatal period with an incidence of 18 strokes per 100.000 deliveries.(1) Furthermore, of all thromboembolisms during pregnancy, stroke contributed to 12% of them.(2) Up to 25% of ischemic strokes during pregnancy can be associated with eclampsia.(3)Other risk factors for ischemic stroke during pregnancy include e.g. hypertension, diabetes, age over 35 years, black ethnicity, migraine headaches, thrombophilia, smoking, alcohol, and other substance abuse.(4) Kittner et al. also showed that the relative risk of ischemic stroke was up to 8.7 (95% CI, 4.6-16.7) during puerperium.3

The choice of secondary prevention depends mostly on the stroke etiology and gestational age. Aspirin in low daily doses is usually the drug of choice especially during the second and third trimester, but there are inconsistent results regarding its teratogenic effects during the first trimester.5 If anticoagulation is indicated, e.g. in high-risk source of cardioembolism, then low-molecular-weight heparin would be recommended instead of novel anticoagulants or warfarin which crosses placenta and is found to be potentially teratogenic. A few case reports and retrospective studies have shown that in acute treatment, intravenous thrombolysis (rtPA) might be safe during pregnancy, but since these women were excluded from all the randomized clinical trials, pregnancy is still a formal contraindication of rtPA. The same applies to mechanical thrombectomy and treatment decisions should be made on an individual basis for each patient.

You can read the full article and references here.

Illustration: Image by ekseaborn0 from Pixabay

PRECIOUS trial: Looking for ways to improve the recovery of stroke patients aged 66 years or older

PRECIOUS trial: Looking for ways to improve the recovery of stroke patients aged 66 years or older

Every year, around 1.3 million Europeans have a stroke. Twenty to 35% of the patients die in the first month after stroke, and around one third remain dependent on the help of others. The annual costs for stroke care in Europe are estimated at € 64.1 billion. Mainly in the first days after stroke onset, patients are at risk of complications, such as infections and fever. These complications are strongly and independently associated with a higher risk of death or dependency. This week, we bring you an interview with  Jeroen de Jonge, Neurology Resident, UMC Utrecht, a trial manager of PRECIOUS, a trial that is looking for ways to improve the recovery of stroke patients aged 66 years or older.

SAFE: If you were to explain the project’s aim to a person without any medical background, what would you say?

The PRECIOUS trial stands for ‘PREvention of Complications to Improve OUtcome in elderly patients with acute Stroke’. This medical trial is an EU-funded Horizon 2020 collaborative research project dedicated to look for ways to improve the recovery of stroke patients aged 66 years or older. After a stroke, patients can have complications, such as fever or a pneumonia. Patients who have a complication after stroke, usually recovery worse than patients without a complication. Normally, the complications are treated when symptoms become obvious. Fever is treated with paracetamol, nausea and vomiting with metoclopramide, and infections are treated with antibiotics. In this trial, we give the treatments before symptoms occur, to test if we can prevent the complications and thereby improve recovery.

SAFE: What types of partner do you need to carry out a project like this?

The setting-up, conduct and management of a trial like PRECIOUS involves many different partners and organizations. PRECIOUS is carried out in about 80 hospitals in 9 European countries. Before starting medical research with patients, it has to be approved by regulatory authorities, which assess if your trial is useful, safe, ethical and feasible. In every participating hospital, there is a dedicated doctor who helps with setting-up the trial. However, sometimes the rules and regulations are so complex, that a specialized research organization is involved to help this process.

During the course of the trial, several partners are involved, each with a specific task. For example, there is a safety team that collects information about potential side effects of the drugs, to keep an eye on the safety of the treatments. A different team designs an electronic data system, which is a safe online platform where local investigators can fill in patient data. Also, there is a team that visits the hospitals periodically, to monitor if the trial is being performed according to the rules. Also, at the end of the trial, a lot of information is gathered, and we need a statistical team to process all the information to determine if the treatments are effective. However, these are just a few examples, and you need a lot of partners to carry out such as project.

SAFE: Can you briefly describe your role in the project?

My role as a trial manager is to oversee all processes related to PRECIOUS on a day-to-day basis. The work is very broad and consists, for example, the general management of the trial, support with obtaining regulatory approvals, setting-up participating hospitals, including patients into the trial, and answering questions of local investigators about patient recruitment, data collection or follow-up of patients.

SAFE: What (if any) are the difficulties with carrying out the work?

Obtaining regulatory approvals in different countries and hospitals requires a lot of paperwork and bureaucratic tasks. This process takes a lot of time. Off course, it is very important that research is assessed very carefully before it can start, but sometimes specific aspects of the research are being assessed multiple times. It takes a lot of time before the research can actually start, and that is sometimes challenging.

SAFE: What personally attracted you to be in this project?

Stroke is the world’s second largest cause of death and the third cause of long-term disability.

Many patients suffer from a stroke on a daily basis. However, there are still limited treatment options available. Because of medical research, there has been considerable progress in the treatment of stroke and new effective treatment options have become available in the past decade. The possibility support research that looks for new ways to treat stroke is what personally attracts me in this project.

SAFE: When this project ends, what do you expect to change, i.e. how it will reflect on stroke treatment?

We hope to find a simple, safe and effective treatment strategy for patients who have had a stroke, which can prevent the development of complications and improve recovery after stroke.

PRECIOUS has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 634809.

Save the date!     World’s largest stroke congress in Vienna from May 12 to 15

Save the date!   World’s largest stroke congress in Vienna from May 12 to 15

European Stroke Organisation and World Stroke Organization Conference ESO-WSO 2020

May 12-15, 2020

Austria Center Vienna

Bruno-Kreisky-Platz 1

1220 Vienna, Austria
www.eso-wso-conference.org

The world’s largest and most important congress on the subject of stroke will take place in Austria’s capital from May 12 to 15. For the first time, the European Stroke Organisation (ESO) and the World Stroke Organization (WSO) are jointly organizing this expert conference. Around 6,500 participants are expected, including leading stroke specialists from all over the world. More than 3,000 abstracts have been submitted.

In addition to the initial presentation of large clinical studies, important current topics such as the increasing significance of thrombectomy will be discussed. Another major focus is stroke prevention, which is a global challenge.

For further details on the ESO-WSO 2020, please visit https://eso-wso-conference.org

If you have not yet put a placeholder in your diary for this important event, we encourage you to do so.

Media registration is open – please send an e-mail to reg_esowso20@kenes.com

Press contact
Urban & Schenk medical media consulting
Barbara Urban: +43 664/41 69 4 59, barbara.urban@medical-media-consulting.at
Harald Schenk: +43 664/160 75 99, harald.schenk@medical-media-consulting.at

Yours sincerely,

Prof. Jesse Dawson (ESO)                                    Prof. Michael Brainin (WSO)
Co-Chair of the Conference Planning Group       Co-Chair of the Conference Planning Group

Dr. Mira Katan, Prof. Patrik Michel, Prof. Stefan Kiechl, Dr. Vasantha Padma,
Dr. Diana Aquiar de Sousa, Dr. Yvonne Chun (PR Committee / Press Liaison)

Barbara Urban, Harald Schenk (PR Liaison)

President of Slovakian Stroke Support Organisation nominated for Slovak Woman of the Year

President of Slovakian Stroke Support Organisation nominated for Slovak Woman of the Year

Slovak weekly magazine in cooperation with RTVS -Slovak national TV and Radio and with the Slovak National Theater presented the nominees of the twelfth year of the SLOVENKA OF THE YEAR.

JUDr. Alžbeta Husarovič, MHA, MPH is one of this year’s laureates for the Slovakian Women of the Year. She is the President of the civic association Porážka.sk, which is dedicated to raising stroke awareness and helping patients and their families with information about physiotherapy, speech therapy, psychology, social assistance. The aim of this organisation is to improve patients’ quality of life and lead them to self-sufficiency.

“I was very pleased and amazed when I became the Nominee for the Slovak Woman of the year 2020. I didn’t think that somebody is even noticing me for what I am doing. And I am doing this activity with love” said Alžbeta, adding: “This event Slovak Woman is a competition but I don’t consider it so. For me, it is a opportunity for woman to show others what the can do!”

The Official Press Release “Slovakia 2020”

We have no idea yet of which successful Slovak woman will be awarded in the following categories: Business and Management, Arts and Culture, Media and Communication, Science and Research, Education, Support for Young Talents, Healthcare, Sport and Charity, since all laureates are inspirational ladies, who will be introduced to you over the next few weeks.

In addition, this year the nomination committee will award the title of Absolute Slovak Woman of the Year and the Special Lifetime Achievement Award for Slovakia. We will come to learn the winning names during the gala evening in the historical building of the Slovak National Theater and live broadcast of RTVS – Slovak National TV and Radio on May 31, 2020.

Throwback

Historically, the first Slovak Woman of the year in 2009 became the head physician of the 2nd Pediatric Clinic of the Faculty of Medicine and the Pediatric University Hospital with the Policlinic in Bratislava MUDr. Anna Hlavatá, and so far the last – Slovak of the year 2019 – is Andrea Gontkovičová.

Voting from today at www.slovenkaroka.sk

Starting today, it is possible to vote for individual nominees at www.slovenkaroka.sk and from next week also in the weekly Magazine Slovenka. Vote for your favorite and win an exclusive 8-day vacation stay for 2 people at Labranda Coral Beach 4 * with all inclusive in attractive Gambia from CK Hydrotour.

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Image credits: Porazka.sk

PRESTIGE-AF: Should patients with a brain bleed be given anticoagulant medication?

PRESTIGE-AF: Should patients with a brain bleed be given anticoagulant medication?

Stroke is one of the largest public health challenges around the world, and occur when the blood supply to the brain is interrupted, such as through a clot or a brain bleed. It is the most common cause of adult-acquired disability, the second leading cause of death globally and the second most frequent cause of dementia. In addition, its impact is expected to further increase in the coming decades due to the ageing population.

PRESTIGE AF

Dr Eleni Korompoki, MD, PhD, FESO, PRESTIGE AF researcher

We spoke with Dr Eleni Korompoki, MD, PhD, FESO, about a €6.9m worth EU funded research project, aimed at patients with atrial fibrillation (AF), a common heart condition which causes irregular and abnormally fast heartbeat, who have previously had a stroke caused by bleeding in the brain (termed intracerebral hemorrhage or ICH). The Prevention of Stroke in intracerebral hemorrhage survivor with Atrial Fibrillation (PRESTIGE-AF) brings together scientists and clinicians across Europe with the goal of reducing the risk of further stroke in this group of patients. Dr Korompoki is a Clinical Research Fellow in Stroke Medicine at Division of Brain Sciences, Imperial College London.

SAFE: If you were to explain the project’s aim to a person without any medical background, what would you say?
EK: We are conducting a research study to show whether or not patients who have had a brain hemorrhage should be given anticoagulant medication to prevent blood clots that can be caused by a heart arrhythmia called atrial fibrillation. Currently we do not know the best way to prevent strokes in these patients.

SAFE: What types of partner do you need to carry out a project like this?
EK: This project is covering many specialties, so we need to have partners with experts in stroke, cardiology, genetics, biomarkers, neuroimaging and predictive modelling to name just a few!

SAFE: Can you briefly describe your role in the project?
EK: I am part of the central clinical trial team who assist all of the (70!) hospitals who recruit to our clinical trial. I am available to provide medical support, answer questions about patient eligibility and review the safety reports (called adverse events) as we closely monitor all health complaints that patients have whilst they are in the study. Towards the end of the project I will be involved with data analysis and writing up the results of the trial.

SAFE: What (if any) are the difficulties with carrying out the work?
EK: Stroke is the leading cause of disability in Europe and strokes caused by bleeding tend to be more disabling. Therefore it can be a challenge to identify patients who are willing and able to take part in a study like this.

SAFE: What personally attracted you to be in this project?
EK: I have been involved in stroke research for more than 10 years, focusing on stroke prevention and heart-brain connection. As a physician and researcher, I strongly believe that prevention is the key element for well- being. PRESTIGE-AF is a prevention trial targeting an individualised approach and better quality of life after stroke. The trial will also address important aspects such as gender differences, and patients’ attitudes and preferences.

As part of PRESTIGE-AF consortium I have plenty opportunity to interact with internationally recognised experts of ten leading European academic institutions, to work together with a multidisciplinary team from different European countries gaining a lot of experience and improving my scientific skills.

SAFE: When this project ends, what do you expect to change, i.e. how it will reflect on stroke treatment?
EK: We expect to be able to provide evidence based treatment to patients who have had a brain hemorrhage and have atrial fibrillation, the most common cardiac arrhythmia. In addition we hope that we will be able to start using a more person centered approach with these patients using information learnt from looking at brain scans, blood tests, gender differences and psychological aspects.

PRESTIGE-AF has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No. 754517.

 

SAVE THE DATE – European Life After Stroke Forum, 19 November 2020, Barcelona, Spain

SAVE THE DATE – European Life After Stroke Forum, 19 November 2020, Barcelona, Spain

Life after stroke is a key priority within SAFE’s strategy. It is our pleasure to share with you the date of the first European Life After Stroke Forum – the 19 November 2020 in Barcelona, Spain.

This first European Life After Stroke Forum is driven by the need to implement the Stroke Action Plan for Europe and to create a network of stakeholders involved in professionally researching, advocating and providing evidence for improved life after stroke care.

SAVE THE DATE – EUROPEAN LIFE AFTER STROKE FORUM, 19 NOVEMBER 2020, BARCELONA, SPAIN

We hope we could get you to support the European Life After Stroke Forum by sharing this information with people you know.

When? 19 November 2020

Where? Hotel Catalonia Barcelona Plaza, Barcelona, Spain

Who can attend?  Organisations and individuals who operate in the life after stroke area and are research, policy, advocacy or support oriented.

How to register? The registration link will be available soon. Stay tuned!

Please put this date in your calendar and stay tuned for more information that will follow.

We hope to welcome you to Barcelona,

SAFE team

Turning the Tide: Stroke Ready Hospitals

Turning the Tide: Stroke Ready Hospitals

Turning the Tide is a series of 26 mini-films from 24 countries, presenting the bold actions being carried out by communities and organisations to take on the world’s biggest killers – non-communicable diseases, like cancer, diabetes and lung disease – and bring better health for all.

Time is everything when dealing with stroke patients, but many hospitals are not “stroke ready”. Every 30 minutes a stroke patient who could have been saved, dies or is permanently disabled, because they were treated in the wrong hospital.

The Angels Initiative is building a global community of stroke centres and stroke-ready hospitals, working every day to improve the quality of treatment for every stroke patient. The story in this video would have been very different if it wasn’t for a joint effort of the Angels Community.

The man who can be seen in the video is one of the lucky ones. Both he and his wife are medics, so, when he collapsed from a stroke in his home in Sofia, Bulgaria, his wife instantly recognised what happened and knew that she had to act quickly. He was swiftly taken to the nearest stroke-ready hospital and was treated immediately by the responding doctors. Thanks to a swift reaction from their colleagues, medics who work in the stroke-ready hospital and to the timely received treatment, the man was able to recover. “I started to go shopping. I started driving. I started to feel like a normal human being again. These days I realise how blessed I was to have fully recovered to be with my family, my children and my grandchildren” he said.

Please watch the video and see how having stroke-ready hospitals helps #TurningTheTide.

The video was produced by the NCD Alliance and BBC StoryWorks

The Angels Initiative, launched by Boehringer Ingelheim in partnership with the European Stroke Organisation (ESO), and the World Stroke Organisation (WSO), the Stroke Alliance for Europe (SAFE) and others is set to improve acute stroke care, by increasing the number of patients treated in stroke ready hospitals and optimising the quality of treatment in all existing stroke centres. For more information about Angels Initiative, please visit www.angels-initiative.com

Image source: The video print screen