Preclinical Stroke Research and Translational Failure: A Bird’s Eye View on Preventable Variables

2021 ◽  
Author(s):  
Devendra Singh ◽  
Himika Wasan ◽  
K. H. Reeta
Keyword(s):  
Stroke Research

An engineering contribution to stroke research

1976 ◽  
Vol 22 (11-12) ◽  
pp. 781
Author(s):  
P.A. Lynn ◽  
W.R. Parker ◽  
G.A.L. Reed
Keyword(s):  
Stroke Research

scholarly journals Impact of mobile stroke units

2021 ◽  
pp. jnnp-2020-324005
Author(s):  
Klaus Fassbender ◽  
Fatma Merzou ◽  
Martin Lesmeister ◽  
Silke Walter ◽  
Iris Quasar Grunwald ◽  
...  
Keyword(s):  
Cost Efficiency ◽  
Current Knowledge ◽  
Vascular Imaging ◽  
Vessel Occlusion ◽  
Stroke Units ◽  
Stroke Treatment ◽  
Stroke Research ◽  
Mobile Stroke Unit ◽  
Novel Strategy

Since its first introduction in clinical practice in 2008, the concept of mobile stroke unit enabling prehospital stroke treatment has rapidly expanded worldwide. This review summarises current knowledge in this young field of stroke research, discussing topics such as benefits in reduction of delay before treatment, vascular imaging-based triage of patients with large-vessel occlusion in the field, differential blood pressure management or prehospital antagonisation of anticoagulants. However, before mobile stroke units can become routine, several questions remain to be answered. Current research, therefore, focuses on safety, long-term medical benefit, best setting and cost-efficiency as crucial determinants for the sustainability of this novel strategy of acute stroke management.

scholarly journals EXPRESS: COVID-19 AND STROKE – UNDERSTANDING THE RELATIONSHIP AND ADAPTING SERVICES. A GLOBAL WORLD STROKE ORGANISATION PERSPECTIVE

2021 ◽  
pp. 174749302110064
Author(s):  
Hugh S Markus ◽  
Sheila Cristina Ouriques Martins
Keyword(s):  
Large Scale ◽  
Stroke Care ◽  
Long Term Effects ◽  
Vessel Occlusion ◽  
Stroke Incidence ◽  
Stroke Research ◽  
Incidence And Mortality ◽  
Research Initiatives ◽  
Global World

A year ago the World Stroke Organisation (WSO) highlighted the enormous global impact of the COVID-19 pandemic on stroke care. In this review we consider a year later where we are now, what the future holds, and what the long term effects of the pandemic will be on stroke. Stroke occurs in about 1.4% of patients hospitalised with COVID-19 infection, who show an excess of large vessel occlusion and increased mortality. Despite this association, stroke presentations fell dramatically during the pandemic, although emerging data suggests that total stroke mortality may have risen with increased stroke deaths at home and in care homes. Strategies and guidelines have been developed to adapt stroke services worldwide, and protect healthcare workers. Adaptations include increasing use of telemedicine for all aspects of stroke care. The pandemic is exacerbating already marked global inequalities in stroke incidence and mortality. Lastly the pandemic has had a major impact on stroke research and funding, although it has also emphasised the importnace of large scale collaborative research initiatives.

scholarly journals Disabling stroke in persons already with a disability

Neurology ◽  
2020 ◽  
Vol 94 (7) ◽  
pp. 306-310 ◽  
Author(s):  
Michael J. Young ◽  
Robert W. Regenhardt ◽  
Thabele M. Leslie-Mazwi ◽  
Michael Ashley Stein
Keyword(s):  
Clinical Practice ◽  
Health Outcomes ◽  
Acute Stroke ◽  
Care Delivery ◽  
Stroke Care ◽  
Clinical Practices ◽  
Acute Stroke Care ◽  
Persons With Disabilities ◽  
Stroke Research ◽  
Scant Attention

Stroke is the second leading cause of death worldwide and a leading cause of adult disability worldwide. More than a third of individuals presenting with strokes are estimated to have a preexisting disability. Despite unprecedented advances in stroke research and clinical practice over the past decade, approaches to acute stroke care for persons with preexisting disability have received scant attention. Current standards of research and clinical practice are influenced by an underexplored range of biases that may hinder acute stroke care for persons with disability. These trends may exacerbate unequal health outcomes by rendering novel stroke therapies inaccessible to many persons with disabilities. Here, we explore the underpinnings and implications of biases involving persons with disability in stroke research and practice. Recent insights from bioethics, disability rights, and health law are explained and critically evaluated in the context of prevailing research and clinical practices. Allowing disability to drive decisions to withhold acute stroke interventions may perpetuate disparate health outcomes and undermine ethically resilient stroke care. Advocacy for inclusion of persons with disability in future stroke trials can improve equity in stroke care delivery.

scholarly journals Roadmap for Stroke: Challenging the Role of the Neuronal Extracellular Matrix

2020 ◽  
Vol 21 (20) ◽  
pp. 7554
Author(s):  
Ciro De Luca ◽  
Assunta Virtuoso ◽  
Nicola Maggio ◽  
Sara Izzo ◽  
Michele Papa ◽  
...  
Keyword(s):  
Extracellular Matrix ◽  
Inflammatory Response ◽  
Neurovascular Unit ◽  
Neuronal Loss ◽  
Modern Medicine ◽  
Metabolic Demand ◽  
Protein Protein Interaction ◽  
Stroke Research ◽  
Accurate Design

Stroke is a major challenge in modern medicine and understanding the role of the neuronal extracellular matrix (NECM) in its pathophysiology is fundamental for promoting brain repair. Currently, stroke research is focused on the neurovascular unit (NVU). Impairment of the NVU leads to neuronal loss through post-ischemic and reperfusion injuries, as well as coagulatory and inflammatory processes. The ictal core is produced in a few minutes by the high metabolic demand of the central nervous system. Uncontrolled or prolonged inflammatory response is characterized by leukocyte infiltration of the injured site that is limited by astroglial reaction. The metabolic failure reshapes the NECM through matrix metalloproteinases (MMPs) and novel deposition of structural proteins continues within months of the acute event. These maladaptive reparative processes are responsible for the neurological clinical phenotype. In this review, we aim to provide a systems biology approach to stroke pathophysiology, relating the injury to the NVU with the pervasive metabolic failure, inflammatory response and modifications of the NECM. The available data will be used to build a protein–protein interaction (PPI) map starting with 38 proteins involved in stroke pathophysiology, taking into account the timeline of damage and the co-expression scores of their RNA patterns The application of the proposed network could lead to a more accurate design of translational experiments aiming at improving both the therapy and the rehabilitation processes.

Review and prioritization of stroke research recommendations to address the mission of the World Stroke Organization: a call to action from the WSO Research Committee

2015 ◽  
Vol 10 (SA100) ◽  
pp. 4-9 ◽  
Author(s):  
Ralph L. Sacco ◽  
Peter Sandercock ◽  
Matthias Endres ◽  
Valery Feigin ◽  
Jeyaraj Pandian ◽  
...  
Keyword(s):  
Research Committee ◽  
Call To Action ◽  
Stroke Research ◽  
The World ◽  
Research Recommendations

scholarly journals Use of Magnetic Resonance Imaging to Predict Outcome after Stroke: A Review of Experimental and Clinical Evidence

2010 ◽  
Vol 30 (4) ◽  
pp. 703-717 ◽  
Author(s):  
Tracy D Farr ◽  
Susanne Wegener
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Complete Recovery ◽  
Research Translation ◽  
Resonance Imaging ◽  
Preclinical Research ◽  
Stroke Research ◽  
Future Potential ◽  
Magnetic Resonance Imaging Mri ◽  
The Individual

Despite promising results in preclinical stroke research, translation of experimental data into clinical therapy has been difficult. One reason is the heterogeneity of the disease with outcomes ranging from complete recovery to continued decline. A successful treatment in one situation may be ineffective, or even harmful, in another. To overcome this, treatment must be tailored according to the individual based on identification of the risk of damage and estimation of potential recovery. Neuroimaging, particularly magnetic resonance imaging (MRI), could be the tool for a rapid comprehensive assessment in acute stroke with the potential to guide treatment decisions for a better clinical outcome. This review describes current MRI techniques used to characterize stroke in a preclinical research setting, as well as in the clinic. Furthermore, we will discuss current developments and the future potential of neuroimaging for stroke outcome prediction.

Opportunities for Collective Wisdom in Stroke Research

1997 ◽  
Vol 7 (6) ◽  
pp. 313-314 ◽  
Author(s):  
Michael A. Moskowitz ◽  
Turgay Dalkara
Keyword(s):  
Collective Wisdom ◽  
Stroke Research

scholarly journals Impact of Comorbidities on Acute Injury and Recovery in Preclinical Stroke Research: Focus on Hypertension and Diabetes

2016 ◽  
Vol 7 (4) ◽  
pp. 248-260 ◽  
Author(s):  
Adviye Ergul ◽  
Sherif Hafez ◽  
Abdelrahman Fouda ◽  
Susan C. Fagan
Keyword(s):  
Acute Injury ◽  
Research Focus ◽  
Stroke Research
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