Telestroke service increases rates of 'clot-buster' treatment for stroke, reports Neurosurgery

Also new papers on gene effects on aneurysm size, outcomes after surgery for chiari malformation

2013-10-01

(Press-News.org) Philadelphia, Pa. (October 1, 2013) – A telestroke service increases the rate of effective tissue plasminogen activator (tPA) therapy for patients with acute ischemic stroke treated at community hospitals, according to a report in the October issue of Neurosurgery, official journal of the Congress of Neurological SurgeonsCongress of Neurological Surgeons. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

Other studies in the October Neurosurgery find that known gene variants don't affect the size of brain aneurysms and that surgery for a brain defect called Chiari malformation I (CMI) improves outcomes important to patients.

Remote Stroke Service Increases tPA Use at Community Hospitals Dr. Stavropoula Tjoumakaris and colleagues of Thomas Jefferson University Hospital evaluated the effects of a telestroke network including 28 community hospitals in the Philadelphia area. In the network, stroke specialists used "remote presence" technology to consult on the care of stroke patients seen at hospitals that didn't have a specialized stroke unit. The study evaluated the rate of appropriate treatment with tPA—an effective "clot-busting" drug that can be given only within the first few hours after initial stroke symptoms.

Over 18 months, the service provided nearly 1,650 remote stroke consultations; the average time from request to telemedicine response was just 12 minutes. About 14 percent of patients received tPA—including nearly all of those who could be treated in the appropriate time window. By comparison, national data suggest that only three to five percent of patients with ischemic stroke receive tPA.

About 80 percent of network hospitals increased their use of tPA for acute ischemic stroke. The percentage of patients transferred to a specialized stroke center decreased as well—possibly because patients began to improve at their original hospital. The researchers conclude, "The results support the implementation of telestroke networks for wider access to stroke expertise in underserved regions."

Gene Variants Show Little Effect on Aneurysm Size Dr. Rachel Kleinloog and colleagues of Medical Center Utrecht, The Netherlands, looked for evidence of the effects of gene variants on the size of brain aneurysms. The study included two groups totaling nearly 1,000 patients with ruptured aneurysms of blood vessels supplying the brain.

However, none of seven gene variants previously linked to aneurysms was significantly related to aneurysm size. Average aneurysm size was 7.6 millimeters for patients with a higher genetic risk score versus 7.7 millimeters for those with a lower score. The researchers note that the known variants account for no more than five percent of the genetic risk of aneurysm—other genetic factors affecting aneurysm size and rupture risk may yet be identified.

Patient-Reported Outcomes after Surgery for CMI Dr. Scott L. Parker and colleagues of Vanderbilt University Medical Center analyzed patient-reported outcomes in 50 adult patients undergoing an operation called suboccipital decompression for CMI. Chiari malformation I is a brain defect that causes part of the lower brain to be pushed down into the spinal canal. Patients with CMI often have no symptoms until adolescence or adulthood.

Three-fourths of patients had improvement in severe headaches—a major symptom of CMI. Surgery also provided good improvements in abnormal cerebrospinal fluid flow (syringes) and neurological abnormalities. Three-fourths of employed patients were able to return to work.

The study provides important information on key outcomes important to patients, with new insights into the expected benefits of surgery for CMI. "This patient-centered assessment suggests that suboccipital decompression for CMI in adults is an effective treatment strategy," The researchers conclude.

### About Neurosurgery Neurosurgery, the Official Journal of the Congress of Neurological SurgeonsCongress of Neurological Surgeons, is your most complete window to the contemporary field of neurosurgery. Members of the Congress and non-member subscribers receive 3,000 pages per year packed with the very latest science, technology, and medicine, not to mention full-text online access to the world's most complete, up-to-the-minute neurosurgery resource. For professionals aware of the rapid pace of developments in the field, Neurosurgery is nothing short of indispensable.

About Wolters Kluwer Health Wolters Kluwer Health is a leading global provider of information, business intelligence and point-of-care solutions for the healthcare industry. Serving more than 150 countries and territories worldwide, Wolters Kluwer Health's customers include professionals, institutions and students in medicine, nursing, allied health and pharmacy. Major brands include Health Language®, Lexicomp®, Lippincott Williams & Wilkins, Medicom®, Medknow, Ovid®, Pharmacy OneSource®, ProVation® Medical, and UpToDate®.

Wolters Kluwer Health is part of Wolters Kluwer, a market-leading global information services company. Wolters Kluwer had 2012 annual revenues of €3.6 billion ($4.6 billion), employs approximately 19,000 people worldwide, and maintains operations in over 40 countries across Europe, North America, Asia Pacific, and Latin America. Follow our official Twitter handle: @WKHealth.

ELSE PRESS RELEASES FROM THIS DATE:

Solving ethanol's corrosion problem may help speed the biofuel to market

2013-10-01

If we're to meet a goal set by the U.S. Environmental Protection Agency's Renewable Fuels Standard to use 36 billion gallons per year of biofuels—mostly ethanol—the nation must expand its infrastructure for transporting and storing ethanol. Currently, ethanol is transported via trucks, trains, and barges. For the large volumes required in the future, transportation by pipeline is considered to be the most efficient method to get it to customers. The integrity and safety of pipelines and storage tanks is crucial, because ethanol is both flammable and, at certain concentrations, ...

CU, MIT breakthrough in photonics could allow for faster and faster electronics

2013-10-01

A pair of breakthroughs in the field of silicon photonics by researchers at the University of Colorado Boulder, the Massachusetts Institute of Technology and Micron Technology Inc. could allow for the trajectory of exponential improvement in microprocessors that began nearly half a century ago—known as Moore's Law—to continue well into the future, allowing for increasingly faster electronics, from supercomputers to laptops to smartphones. The research team, led by CU-Boulder researcher Milos Popovic, an assistant professor of electrical, computer and energy engineering, ...

Farmers need help to plow through new food safety regulations

2013-10-01

Agricultural extension educators should take a flexible approach in teaching farmers about the changing landscape of food safety regulations, according to Penn State researchers. "We should try to focus on creating programs for growers so that they can do what they need to do economically to stay viable as they face new regulations and standards that can be complex and intimidating," said Daniel Tobin, doctoral candidate in agricultural economics, sociology and education. The researchers said that farmers who attended an extension workshop on food safety standards ...

Study: Acidity can change cell membrane properties

2013-10-01

Of all the amazing technologies humans have developed, none has matched the complexity of the fundamental building block of nature: the living cell. And none of the cell's activities would be possible without thin lipid membranes, or bilayers,that separate its parts and regulate their functions. Understanding and controlling bilayers' properties is vital for advances in biology and biotechnology. Now an interdisciplinary team of Northwestern University researchers has determined how to control bilayers' crystallization by altering the acidity of their surroundings. The ...

Protecting underground pipelines from corrosion in sub-zero environments

2013-10-01

Northern Canada's permafrost and semi-permafrost environment is a huge challenge for designing and engineering underground pipelines, and a critical aspect of protecting both the pipeline and this sensitive environment involves the design of an effective corrosion protection system. One of the most common methods to protect buried infrastructure—such as oil and gas transmission pipelines —from corrosion is the application of an external coating. "Although great advances have been made within the past 30 years in terms of coatings reliability and longevity, it's still ...

NREL releases new roadmap to reducing solar PV 'soft costs' by 2020

2013-10-01

The Energy Department's (DOE) National Renewable Energy Laboratory (NREL) recently issued a new report, "Non-Hardware ('Soft') Cost-Reduction Roadmap for Residential and Small Commercial Solar Photovoltaics, 2013,"PDF funded by DOE's SunShot Initiative and written by NREL and Rocky Mountain Institute (RMI). The report builds off NREL's ongoing soft-cost benchmarking analysis and charts a path to achieve SunShot soft-cost targets of $0.65/W for residential systems and $0.44/W for commercial systems by 2020. Non-hardware costs — also referred to as soft, balance of system, ...

Understanding soil nitrogen management using synchrotron technology

2013-10-01

As food security becomes an increasingly important global issue, scientists are looking for the best way to maintain the organic matter in soils using different methods of fertilization and crop rotation. Increasing the organic matter in soils is key to growing crops for numerous reasons, including increased water-holding capacity and improved tilth. Scientists have recently used the Canadian Light Source (CLS) to evaluate the effects of various sources of supplemental nitrogen fertilizer on the chemical composition of soil organic matter. Results of their experiments ...

Tests in mice identify compound that may keep survivors of brain aneurysms from succumbing to stroke

2013-10-01

Johns Hopkins researchers, working with mice, say they have identified a chemical compound that reduces the risk of dangerous, potentially stroke-causing blood vessel spasms that often occur after the rupture of a bulging vessel in the brain. They say their findings offer clues about the biological mechanisms that cause vasospasm, or constriction of blood vessels that reduces oxygen flow to the brain, as well as potential means of treating the serious condition in humans. When an aneurysm — essentially a blister-like bulge in the wall of a blood vessel — bursts, blood ...

Scripps Florida scientists develop new process to create artificial cell membranes

2013-10-01

JUPITER, FL – October 1, 2013 – The membranes surrounding and inside cells are involved in every aspect of biological function. They separate the cell's various metabolic functions, compartmentalize the genetic material, and drive evolution by separating a cell's biochemical activities. They are also the largest and most complex structures that cells synthesize. Understanding the myriad biochemical roles of membranes requires the ability to prepare synthetic versions of these complex multi-layered structures, which has been a long-standing challenge. In a study published ...

What makes us left or right handed? New study rules out strong genetic factors

2013-10-01

Around 10 per cent of the UK is left handed — and that percentage remains consistent in many populations around the world. But why exactly someone is left or right handed remains unclear. New research from The University of Nottingham's Professor John Armour and Dr Angus Davison, in collaboration with UCL's Professor Chris McManus, has ruled out a 'strong genetic determinant' in influencing handedness. The researchers conducted a twin study examining the whole genome — which contains hereditary information — of nearly 4,000 subjects from the London Twin Research Unit ...