March 23rd, 2010 by RamonaBatesMD in Better Health Network, Health Tips, News, Research
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Until recently, the therapeutic use of non-cosmetic Botox (botulinum toxin) for adult upper extremity spasticity was considered off-label use. The U.S. Food and Drug Administration (FDA) has now approved Botox to treat spasticity in the upper extremity flexor muscles in adults.
Spasticity is common after stroke, traumatic brain injury, or the progression of multiple sclerosis. Spasticity is defined as:
“a motor disorder characterized by a velocity-dependent increase in tonic stretch reflexes (muscle tone) with exaggerated tendon jerks, resulting from hyper-excitability of the stretch reflex as one component of the upper motor neuron syndrome.”
Spasticity often creates problems with mobility, self-care, and function. The spastic muscles can become stiff. Associated joints can be affected by lack decreased range-of-motion with contractures forming. Read more »
*This blog post was originally published at Suture for a Living*
March 9th, 2010 by Happy Hospitalist in Better Health Network, Opinion
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The CDC has put out an interactive map of heart disease and stroke so you can compare your state or even county with the rest of the country. It offers data on mortality, hospitalizations and even penetration of generalist and subspecialist availability.
What I found interesting was the lack of definitive association between access to generalists or subspecialists and mortality. While rural areas with a low penetration of physicians generally had a higher mortality than urban centers, many urban centers with a high penetration of generalists and subspecialist also had a high mortality as well. One could presume that rural America has many factors separate and independent of health care that affects their mortality rate. The same could be said for urban America. Read more »
*This blog post was originally published at The Happy Hospitalist*
March 1st, 2010 by JessicaBerthold in Better Health Network, Health Tips
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Some quick tips about medically managing patients with acute intracerebral hemorrhage, courtesy of a talk at Stroke 2010 by Craig Anderson, MD, George Institute for International Health in Sydney NSW, Australia:
–avoid excess elevation of variables like blood pressure, glucose levels and body temperature
–maintain hydration; many of these patients present dehydrated
–elevate the head
–abandon intensive insulin therapy
–In terms of lowering blood pressure, going from 220 mm Hg systolic to 140 mm Hg over one hour appears safe, but it’s still unknown whether more rapid lowering is better, or if it would be better to achieve a lower systolic level.
*This blog post was originally published at ACP Hospitalist*
January 20th, 2010 by JessicaBerthold in Better Health Network, News, Research
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In early 2008, researchers at the International Stroke conference unveiled two studies showing a “weekend effect” in stroke– ie, mortality from stroke was higher on the weekends (and at night) than weekdays. We explored this topic in the June 2008 ACP Hospitalist.
Now, a new Archives of Neurology study has found no difference in stroke death rates based on weekend/weekday arrival. What’s more, stroke patients admitted on weekends were more likely to get tPA. This flies in the face of one of the main theories about the weekend effect–namely, that stroke rates may be higher on weekends because there is often a shortage of staff and resources, which leads to less aggressive treatment. Read more »
*This blog post was originally published at ACP Hospitalist*
December 29th, 2009 by Medgadget in Better Health Network, News, Research
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Students at Northeastern University are developing electronic gloves to help post stroke patients recover their motor skills. The Angle Tracking and Location at Home System (ATLAS) bimanual rehabilitation glove has sensors and a feedback mechanism that interfaces with a computer to allow hand training at home. Read more »
*This blog post was originally published at Medgadget*
