Late Shift Boosts Heart, Stroke Risk

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Yoga Might Help With Stroke Rehab

HealthDay – 1 hr 11 mins ago THURSDAY, July 26 (HealthDay News) -- The ancient practice of yoga might boost stroke survivors' balance and help them become more active, a small new study suggests.

The study included 47 patients -- approximately three-quarters male -- who had suffered a stroke more than six months earlier and were assigned to one of three groups: a twice-weekly yoga group for eight weeks; a "yoga-plus" group that met twice weekly and also included a relaxation recording at least three times a week; and a usual care group.

The yoga classes were taught by a registered yoga therapist and included modified yoga postures, relaxation and meditation. The yoga classes became more challenging each week.

Compared to patients in the usual care group, those in the yoga groups showed significant improvements in their balance, were less afraid of falling and had higher scores for independence and quality of life.

The study was published July 26 in the journal Stroke.

Many stroke survivors encounter long-term balance problems, which are associated with greater disability and an increased risk of falls.

The new findings show that "something like yoga in a group environment is cost effective and appears to improve motor function and balance" for stroke survivors, lead researcher Arlene Schmid said in a journal news release.

Schmid noted that rehabilitation therapy for stroke patients typically ends after six months but brain changes and physical improvements can continue to occur after six months.

"The problem is the health care system is not necessarily willing to pay for that change," said Schmid, who is a rehabilitation research scientist at Roudebush Veterans Administration Medical Center and Indiana University in Indianapolis. "The study demonstrated that with some assistance, even chronic stroke patients with significant paralysis on one side can manage to do modified yoga poses."

Schmid is also an assistant professor of occupational therapy at Indiana University-Purdue University.

One expert who works with stroke patients believes there is a great need for effective rehabilitation strategies.

"Anything that can reduce the risk of falls -- a common sequel of stroke -- is also welcome, as is anything that improves mood and lessens symptoms of depression in the post-stroke patient," said Dr. Roger Bonomo, director of stroke care at Lenox Hill Hospital in New York City.

Yoga, however, "is not going to be available

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Stroke Patients Hospitalized on Weekends Don't Seem to Do As Well

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Anxiety, Depression May Raise Stroke Risk

HealthDay – 4 hrs ago MONDAY, June 18 (HealthDay News) --People suffering from anxiety, depression, sleeplessness or other forms of psychological distress are at greater risk of death from a stroke, according to a new study.

Researchers from University College London pointed out that psychological distress affects about 15 percent to 20 percent of the general population. Previous research has linked these common mental conditions with coronary artery disease, but an association with stroke and other cardiovascular diseases has not been established, they said.

The researchers examined information from a study of 68,652 adults who participated in the Health Survey for England. The vast majority of participants were white, 45 percent were men and the average was about 55.

Nearly 15 percent of the people questioned said they were affected by psychological distress, most of them women. Those who reported having psychological distress also tended to be younger, smokers and taking medication for high blood pressure. They also tended to have lower incomes, the researchers added.

After following the participants for an average of about eight years, the study's authors found 2,367 deaths from ischemic heart disease (blocked artery), stroke and other cardiovascular problems.

The study was published June 18 in CMAJ.

"Psychological distress was associated with death from cardiovascular disease, and the relation remained consistent for specific disease outcomes, including ischemic heart disease and cerebrovascular disease," Dr. Mark Hamer, of the college department of epidemiology and public health, and his co-authors said in a journal news release. "We saw an association between psychological distress and risk of cerebrovascular disease among our participants, all of whom had been free from cardiovascular disease at baseline. This association was similar in size to the association between psychological distress and ischemic heart disease in the same group."

The researchers concluded that questionnaires could help doctors screen their patients for common mental illnesses, which could reduce their risk of death from heart disease and stroke.

More information

The U.S. National Institutes of Health provides more information on the causes of stroke.

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Birth Control Linked to Heart Attack, Stroke

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Contraceptive pill, ring tied to higher stroke risk

Reuters – 6 hrs ago NEW YORK (Reuters Health) - The largest study to examine the risks of hormone-based birth control has concluded the contraceptives carry a small risk of stroke and heart attack, depending on the method and type of hormone used.

But the risk for individual women remains extremely low, particularly in younger women.

Danish researchers wrote in the New England Journal of Medicine that the findings suggest a higher risk of stroke in particular for women using vaginal rings, and possibly hormonal skin patches -- though the second finding was based on a smaller group of women and could have been due to chance.

Dr. James Simon, a women's health researcher at George Washington University in Washington, D.C. told Reuters Health other factors -- such as the belief that a patch or a ring might be safer for women thought to be at risk -- may explain the higher rate of stroke in that group.

Simon, who wasn't involved in the new research, said the findings probably shouldn't change how doctors prescribe birth control. The risks seen in the study, he said, pale in comparison to the risks of stroke, heart attack or death faced by women who get pregnant.

"None of the hormonal contraceptives studied

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Irregular Heartbeat Poses Greater Stroke Risk for Women Than Men

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Stopping Blood Thinners Raises Stroke Risk for Patients With Irregular Heartbeat

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Mobile Stroke Units Might Trim Time to Treatment

HealthDay – 57 mins ago WEDNESDAY, April 11 (HealthDay News) -- Clot-busting drugs can help stave off lasting disability after a stroke, but they must be given within a 4.5-hour window and many people arrive at the hospital too late to use them.

Now, German researchers report that they think they have found a solution to the problem: mobile stroke units. Equipped with what is needed to diagnose and treat a stroke, these ambulances are stocked with clot-busting tissue plasminogen activator (tPA) and the CT scanning technology needed to confirm whether an ischemic stroke has occurred, blood flow is blocked and it is safe to use tPA.

Unfortunately, while the mobile stroke units did speed the time to treatment, this did not lead to improvements in neurological outcomes or increase the number of people who received tPA. The findings are published in the April 11 online edition of The Lancet Neurology.

In the study conducted by Dr. Klaus Fassbender and his colleagues from the University of the Saarland in Homburg, 100 people with suspected stroke were either treated in the mobile stroke units or at the hospital. Use of mobile stroke units roughly halved the time from the initial emergency call to treatment decision, from 76 minutes to 35 minutes.

What's more, treatment in a mobile stroke unit also lowered the time from symptom onset to therapy decision to less than an hour for 57 percent of people. By contrast, just 4 percent who were treated in the hospital were evaluated in under an hour.

The time from calling emergency services to administering treatment was 38 minutes among people treated in the mobile unit versus 73 minutes among those who were treated at the hospital, the investigators found.

Commenting on the study, Dr. Larry Goldstein, director of the Duke Stroke Center in Durham, N.C., said that while an interesting concept, mobile stroke units may not be feasible in the United States due to cost. "There might be some circumstances where such a thing might be considered, but that would really have to be thought through very carefully."

Unless and until that occurs, the best way to make sure that people with suspected stroke get treatment promptly is to have 911 operators trained to recognize that a caller may be having a stroke and dispatch the appropriate unit to take them to the nearest stroke center where they can be evaluated and treated as quickly as possible, Goldstein said.

Dr. Robert Glatter, an emergency medicine physician at Lenox Hill Hospital in New York City, added that "the concept of a mobile stroke unit is a promising approach to more rapidly and effectively assess and treat patients with acute strokes in the field."

Some potential downsides include the cost of the set-up, Glatter pointed out. "We will need an adequately powered, larger multi-center trial to answer the question of whether largely urban-based mobile stroke units ultimately improve outcome of stroke patients in the 'time is brain' paradigm," he noted.

Glatter agreed that knowing the symptoms of a stroke is the most important way to make sure that care is delivered in timely fashion. Stroke symptoms may include facial drooping, difficulty speaking, sudden numbness, dizziness and confusion.

More information

Is it a stroke? Learn the symptoms at the National Stroke Association.

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When Paramedics Suspect Stroke, They're Usually Right

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