Stroke

Test Your Knowledge: Ten Questions about Stroke
This quiz is related to the Learning Forum article in the April issue of PLoS Medicine (DOI: 10.1371/journal.pmed.0020079).

A 75-Year-Old Woman with a Hemispheric Stroke
A 75-year-old right-handed woman presented with a two-day history of symptoms suggestive of a right hemispheric stroke (slurred speech and left facial and left arm weakness).

Relationship between oxygen supply and cerebral blood flow assessed by transcranial Doppler and near – infrared spectroscopy in healthy subjects during breath – holding
Unlike the other organs, human brain needs a constant oxygen supply in order to maintain its functional and structural integrity.

ReoPro and Retavase to Treat Acute Stroke

• Clot lysis in a primate model of peripheral arterial occlusive disease with use of systemic or intraarterial reteplase: addition of abciximab results in improved vessel reperfusion
• Reperfusion therapy for acute myocardial infarction with fibrinolytic therapy or combination reduced fibrinolytic therapy and platelet glycoprotein IIb/IIIa inhibition: the GUSTO V randomised trial
• Reteplase monotherapy and reteplase/abciximab combination therapy in peripheral arterial occlusive disease: results from the RELAX trial
• Mortality at 1 year with combination platelet glycoprotein IIb/IIIa inhibition and reduced-dose fibrinolytic therapy vs conventional fibrinolytic therapy for acute myocardial infarction: GUSTO V randomized trial
• Combination reperfusion therapy with abciximab and reduced dose reteplase: results from TIMI 14. The Thrombolysis in Myocardial Infarction

Safety Study of Interferon Beta 1a to for Acute Stroke

This study will examine the safety of the drug interferon beta 1a in patients with acute ischemic stroke to determine the highest dose patients can tolerate without serious side effects and to determine the best way to give the medication. Ischemic stroke is caused by a blood clot blocking the flow of blood to brain tissue, causing loss or impairment of bodily functions governed by the affected part of the brain. Interferon beta 1a is approved for use in patients with multiple sclerosis to prevent further brain injury caused by inflammation; the drug may also help prevent further brain injury in patients with acute stroke.

• Trial design and reporting standards for intra-arterial cerebral thrombolysis for acute ischemic stroke
• Potential Role of Neuroprotective Agents in the Treatment of Patients with Acute Ischemic Stroke
• Potential Role of Neuroprotective Agents in the Treatment of Patients with Acute Ischemic Stroke
• The need for new therapies for acute ischaemic stroke
• Neuroprotection in cerebral ischaemia: facts and fancies--the need for new approaches

Telerehabilitation for the Hand and Arm After Stroke and Traumatic Brain Injury

The goal of this project is to develop a low-cost, user-friendly, portable telerehabilitation system for physical therapy of the upper limb after stroke or traumatic brain injury. The system is based on the use of a commercially available force feedback joystick and will work with an ordinary home PC and a standard high-speed internet connection. Using the joystick, the patient will perform exercises designed to aid in recovering motor function of the hand and arm. The joystick will be programmed to either assist or resist the patient's movements.

The system will include sophisticated analysis of patient status and progress to provide the therapist and physician with detailed information. In the first phase of the study, we will develop the system in cooperation with the physical therapy staff and other rehabilitation specialists. We will examine the useability, comfort, safety and therapeutic benefit of the system. In the second phase of the study, we will employ the system in patients' homes, using the internet to connect to rehabilitation specialists in the clinic. The study hypothesis is that it is possible to adapt commercially available, low cost gaming equipment such as force feedback joysticks to provide therapy for patients in their own homes, and that patients will be able to work with this system and will find it enjoyable and helpful for recovering motor function.

• PC-based telerehabilitation system with force feedback
• A virtual-reality-based telerehabilitation system with force feedback
• Shared virtual environments for telerehabilitation
• Seven years experience with a computerized diabetes clinic database
• Telematic system for monitoring of asthma severity in patients' homes

• Statins, fenofibrate, and quinapril increase clot permeability and enhance fibrinolysis in patients with coronary artery disease
• Blood coagulation at the site of microvascular injury: effects of low-dose aspirin
• The effect of angiotensin converting enzyme inhibition on myocardial function and blood pressure after coronary artery bypass surgery--a randomised study
• Atorvastatin reduces thrombin generation after percutaneous coronary intervention independent of soluble tissue factor
• Simvastatin depresses blood clotting by inhibiting activation of prothrombin, factor V, and factor XIII and by enhancing factor Va inactivation