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Mini Strokes Can Cause Brain Damage, Lead To Dementia And Cognitive Impairment: Study

Thursday, December 13, 2012

Chances are if you're a senior managing your health, you've already had a conversation with your doctor about stroke risk. While many patients know the warning signs of stroke -- slurred speech, weakness on one side of the body, coordination problems, double vision, and headaches -- health care providers often fail to educate patients about their risk for silent or mini-strokes, which can cause progressive, permanent damage and lead to dementia.

A new study published in the Journal of Neuroscience, examined the effects of these so-called mini-strokes. They frequently are not diagnosed or detected by a doctor because a patient does not immediately present with stroke signs. Mini-strokes may lead to permanent neurological damage and increase risk for full blown stroke.

Maiken Nedergaard, MD, lead author of the study and professor of neurosurgery at the University of Rochester Medical Center, says at least half of individuals over the age of 60 will experience one mini-stroke in their lifetime. She calls the prevalence of mini-strokes "an epidemic."

Read More: Mini Strokes Can Cause Brain Damage, Lead To Dementia And Cognitive Impairment: Study

Highland Appoints Adam Kelly, M.D., Chief of Neurology

Thursday, October 25, 2012

Adam Kelly, M.D., has been named Highland Hospital's Chief of Neurology. Dr. Kelly has been involved in neurological care at the hospital since April 2010, serving as the Director of Highland's Stroke Center.

Under Dr. Kelly's guidance, Highland has experienced sustained improvement in all New York state performance measures for stroke care. The hospital earned the American Heart Association's Gold-Plus Award twice in two years as well. Dr. Kelly has also led Highland's involvement in the Stroke Treatment Alliance of Rochester (STAR) collaborative to improve stroke care at hospitals throughout the community.

"Neurology is a challenging field, but I embrace that challenge, and I love patient care," Dr. Kelly said. "I look forward to building on the programs and initiatives my predecessors have put into place."

Read More: Highland Appoints Adam Kelly, M.D., Chief of Neurology

Researchers at the Doorstep of Stem Cell Therapies for MS, Other Myelin Disorders

Thursday, October 25, 2012

When the era of regenerative medicine dawned more than three decades ago, the potential to replenish populations of cells destroyed by disease was seen by many as the next medical revolution. However, what followed turned out not to be a sprint to the clinic, but rather a long tedious slog carried out in labs across the globe required to master the complexity of stem cells and then pair their capabilities and attributes with specific diseases.

In a review article appearing today in the journal Science, University of Rochester Medical Center scientists Steve Goldman, M.D., Ph.D., Maiken Nedergaard, Ph.D., and Martha Windrem, Ph.D., contend that researchers are now on the threshold of human application of stem cell therapies for a class of neurological diseases known as myelin disorders – a long list of diseases that include conditions such as multiple sclerosis, white matter stroke, cerebral palsy, certain dementias, and rare but fatal childhood disorders called pediatric leukodystrophies.

Stem cell biology has progressed in many ways over the last decade, and many potential opportunities for clinical translation have arisen, said Goldman. In particular, for diseases of the central nervous system, which have proven difficult to treat because of the brain's great cellular complexity, we postulated that the simplest cell types might provide us the best opportunities for cell therapy.

Read More: Researchers at the Doorstep of Stem Cell Therapies for MS, Other Myelin Disorders

Free Seminar for EMS Crews to Focus on Stroke Nov. 7

Monday, October 15, 2012

Highland Hospital invites local Emergency Medical Service (EMS) crews and Emergency Medical Technicians (EMTs) to its upcoming seminar, "Assessments and Acute Interventions for Stroke Patients," starting at 5:30 p.m. Wednesday, Nov. 7 in the Collins Auditorium at Highland. The event is free, but registration is required at (585) 341-6709.

Adam G. Kelly, M.D., Interim Chief of Neurology, will present on the common signs and symptoms of stroke and how Emergency Department and EMS personnel can partner to provide prompt evaluation of and treatment to stroke patients. Dr. Kelly also will discuss interventions physicians consider once the patient arrives, including the administration of IV tPA, a clot-dissolving medicine that can restore blood flow to parts of the brain affected by stroke. This can prevent parts of the brain from becoming permanently damaged.

Read More: Free Seminar for EMS Crews to Focus on Stroke Nov. 7

Two Rochester Neurologists among Those Calling for Stronger Studies

Wednesday, October 10, 2012

Two neurologists at the University of Rochester Medical Center are part of an international team of scientists who call for greater rigor in the way that early-stage biomedical research is done and reported. The group, led by scientists at the National Institute of Neurological Disorders and Stroke, part of the National Institutes of Health, makes its recommendations in a paper published in Nature.

Among the authors are Robert A. Gross, M.D., Ph.D., and Richard T. Moxley, M.D. Gross took part through his position as editor in chief of Neurology, the world's leading clinical neurology journal, while Moxley was asked to join the group because of his extensive experience working with patients and doing research on common neurological disorders.

The Nature publication is the result of a workshop organized by NINDS in June to discuss issues around preclinical research – research on which subsequent studies in people are based. Scientists, patients, and pharmaceutical companies use this early information to make crucial decisions about what compounds to pursue to try to develop better treatments for conditions like stroke, Alzheimer's, and Parkinson's disease, and which compounds or efforts to wind down because they lack promise.

Read More: Two Rochester Neurologists among Those Calling for Stronger Studies

Study Questions Validity of Quality Measure for Stroke Care

Monday, August 27, 2012

One of the key indicators of the quality of care provided by hospitals to acute stroke victims is the percentage of patients who die within a 30-day period. A new study shows that the decisions made by patients and their families to stop care may account for as many as 40 percent of these stroke-related deaths, calling into question whether it is a valid measure of a hospital’s skill in providing stroke care.

The study, which appears today in the journal Neurology, focuses on a quality measure proposed by the federal Centers for Medicaid and Medicare Services called the 30-day risk adjusted stroke mortality. While the measure is being developed as a part of federal health care reform, it is already commonly employed as an indicator of a hospital’s quality of care on websites that evaluate hospital performance.

"It is clear that a significant component of the overall mortality score as currently constructed does not tell the whole story and is predicated on the preference of patients and their families," said University of Rochester Medical Center (URMC) neurologist Adam Kelly, M.D., lead author of the study.

Read More: Study Questions Validity of Quality Measure for Stroke Care

Stroke Victims Not Receiving Timely Diagnosis, Care

Wednesday, May 2, 2012

The mantra in stroke care is “time is brain.” With each passing minute more brain cells are irretrievably lost and, because of this, timely diagnosis and treatment is essential to increase the chances for recovery. While significant strides have been made to improve the response time of caregivers, a new study shows that a critical step in the process – imaging of the brain to determine the nature of the stroke – is still occurring too slowly at too many hospitals.

A study out this month in the journal Stroke shows that only 41.7 percent of stroke patients underwent brain imaging within the recommended 25 minutes of their arrival at a hospital. It also found that certain individuals, including people with diabetes, those over 75 years of age, women, those that did not arrive by ambulance, non-whites, and those with certain cardiac conditions were less likely to receive a timely brain scan. These delays mean that treatment often comes either too late or not at all.

"We were struck by the fact that less than half of patients with acute stroke symptoms did not receive a brain scan within recommended guidelines,” said University of Rochester Medical Center neurologist Adam Kelly, M.D., lead author of the study. “This was the performance of hospitals who are actively participating in a national quality improvement program, so rates in non-participating hospitals may be even worse."

Read More: Stroke Victims Not Receiving Timely Diagnosis, Care

University Life Trustee, Neurosciences Benefactor Ernest J. Del Monte Dies

Monday, April 23, 2012

Ernest J. Del Monte, 87, real estate and hotel developer, philanthropist and University of Rochester Life Trustee, died Saturday, April 21, 2012. His generosity to the University of Rochester leaves a legacy of innovation and collaboration to help eradicate brain diseases.

Mr. Del Monte, of Pittsford, was a visionary in business and industry. With a $10 million gift to the University in 2009, he and his wife, Thelma, helped establish the E.J. Del Monte Neuromedicine Institute to expand the study and treatment of Alzheimer's disease, stroke, spinal cord and brain injuries, and brain cancers at the University of Rochester Medical Center.

The gift was the catalyst for the establishment of the Del Monte Neuromedicine Institute, which serves as an umbrella for several vibrant research centers and growing clinical care programs throughout the Medical Center and River Campus. It has also reinvigorated the scientists and physicians who treat patients with neurological conditions.

Ernie was a force of nature who touched so many of our lives at the University. I am proud to have spent time with him and his late wife, Thelma, and continue to be deeply moved by his commitment to the Del Monte Neuromedicine Institute. When I last spoke with him, he was still planning deals, always imaginative, always determined, right up to the end, said Joel Seligman, president of the University of Rochester.

Read More: University Life Trustee, Neurosciences Benefactor Ernest J. Del Monte Dies

Stop Stroke Before it Stops You - 4 Things You Should Know

Tuesday, September 27, 2011

Ask any number of men what they think their odds of having a stroke are, and you might find many of them believe stroke is frighteningly unpredictable and can attack like a bolt from the blue – without warning, trailing death and disability in its wake.

That idea is dangerously wrong. The truth is that a stroke is the bullet at the end of a very long barrel and there is a lot you can do to dodge it.

The path to stroke can be started by heart disease – especially if you have an irregular heartbeat. It also can be started by arterial disease – especially if there is a build-up of plaque in the arteries of the neck. The chain of events that begins with cardiovascular disease and ends in stroke can take years, or even decades to evolve. You probably will not know that it is happening.

Study: African Americans Have Better Stroke Survival Rates

Monday, January 31, 2011

A study published today shows that African Americans have a better survival rate compared to whites after being hospitalized for a stroke. This conclusion contradicts prevailing wisdom and is one piece in a growing body of evidence that points to the important role that patients – and the decision they and their families make in terms of treatment – may play on mortality rates.

The study found that – after adjusting data for variables such as age, socioeconomic status, and risk factors – that African Americans who were hospitalized for acute ischemic stroke had a significantly lower mortality rate than whites. The survival advantage was most pronounced early after the stroke but persisted for up to one year. The study also found that African Americans were also more likely during their hospitalization to have received more aggressive treatment measures, such as kidney dialysis, a tracheostomy, or cardiopulmonary resuscitation. They were also less likely to use hospice care. These results were published today in the Annals of Internal Medicine.

“These results fly in the face of conventional wisdom that says that black patients with strokes have worse outcomes,” said University of Rochester Medical Center neurologist Robert Holloway, M.D., M.P.H. a co-author of the study. “Even though we do not know the exact reasons for these differences, these data highlight the potential importance of treatment intensity, and the expression of patient preference for different treatments on survival and mortality. This is not such a far-fetched idea for physicians who take care of a lot of stroke patients.”

Read More: Study: African Americans Have Better Stroke Survival Rates

Study: Get Thee to a Stroke Center

Tuesday, January 25, 2011

Hospitals with designated stroke centers are associated with up to 20 percent higher survival rate for patients with ischemic stroke and significantly greater use of acute stroke therapy. That is the conclusion of a study appearing today in the Journal of the American Medical Association which compares treatment and outcomes in stroke care between hospitals in New York State.

“The basic premise of stroke centers and stroke care – that coordinated care delivered around a specific disease can likely improve outcomes – is widely accepted,” said University of Rochester Medical Center neurologist Robert Holloway, M.D., M.P.H., a co-author of the study. However, there has been limited empirical evidence demonstrating that admission to a stroke center is associated with lower mortality. This study shows that designated stroke centers not only have a greater adherence to evidence based practices but they also save lives.

Read More: Study: Get Thee to a Stroke Center

Neuroscientist to Discuss Action Video Games as Learning Tool

Monday, January 10, 2011

Cognitive scientist Daphne Bavelier, Ph.D., will discuss her work using video games to explore the remarkable capacity of the brain to adapt as part of a lecture series highlighting biological and biomedical research at the University of Rochester.

Bavelier will discuss her research this Friday, Jan. 14, in the Class of '62 Auditorium (Room G-9425) at the Medical Center. The talk, part of the “Second Friday Science Social” lecture series, is geared mainly to faculty, staff and students at the University, though the general public is welcome as well.

Bavelier, professor of Brain and Cognitive Sciences, is an expert on the brain's ability to learn and adapt to an ever-changing environment. For the past decade, she has employed video games as a way to explore the brain's ability to adapt – a capability crucial for people trying to recover from a stroke or a traumatic brain injury or for people seeking to keep their mind as sharp as possible as they age.

Read More: Neuroscientist to Discuss Action Video Games as Learning Tool