Gout – Patrick’s story – NHS video

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From NHS Choices YouTube channel: Patrick, 54, was diagnosed with gout (a form of arthritis) 22 years ago. He describes the symptoms, treatment options and how he learned to live with the condition:

Here is a list of some of the new drugs for an old disease (gout):

Febuxostat is a non-purine-analogue inhibitor of xanthine oxidase that opened a new era in the treatment of gout.

Modified uricases

The use of modified uricases to rapidly reduce serum urate concentrations in patients with otherwise untreatable gout is progressing. Pegloticase, a pegylated uricase, is in development.

JAMA update, 08/2011: New Treatment Offers Hope for Patients With Severe Gout: pegloticase (Krystexxa) costs $2,500 per dose (http://goo.gl/gz9sO).

Drugs in development

Transport of uric acid in the renal proximal tubule and the inflammatory response to monosodium urate crystals (shown above) are targets for potential new treatments.

Several pipeline drugs for gout related to the targets above include:

- selective uricosuric drug RDEA594

- various interleukin-1 inhibitors. Canakinumab (trade name Ilaris) is a human monoclonal antibody targeted at interleukin-1 beta. It was rejected by the FDA panel in June 2011.

References:

Gout therapeutics: new drugs for an old disease. The Lancet, Volume 377, Issue 9760, Pages 165 - 177, 8 January 2011.
Diuretics, beta-blockers, ACEi, non-losartan ARBs associated with increased risk of gout vs. CCB lower risk. BMJ, 2012.
With FDA Approval, a Gout Drug Now Costs $5 Instead of Pennies - WSJ, 2011.
FDA Panel Rejects Gout Drug Canakinumab on Safety Concerns http://goo.gl/lO9uy
The strange story that links gout with the birth of the cocktail drinks. Lancet, 2012.

Comments from Twitter:

francis berenbaum @Larhumato: Gout explained by a patient. Very informative for medical students.

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Plaque Build-Up in Your Brain May Be More Harmful Than Having Alzheimer's Gene

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Newswise MINNEAPOLIS A new study shows that having a high amount of beta amyloid or plaques in the brain associated with Alzheimers disease may cause steeper memory decline in mentally healthy older people than does having the APOE 4 allele, also associated with the disease. The study is published in the October 16, 2012, print issue of Neurology, the medical journal of the American Academy of Neurology.

Our results show that plaques may be a more important factor in determining which people are at greater risk for cognitive impairment or other memory diseases such as Alzheimers disease, said study author Yen Ying Lim, MPsych, with the University of Melbourne in Victoria, Australia. Unfortunately, testing for the APOE genotype is easier and much less costly than conducting amyloid imaging.

For the study, 141 people with an average age of 76 who were free of any problems in memory and thinking underwent PET brain scans and were tested for the APOE gene. Their memory and thinking was then tracked over the following year and a half, using a set of computer-based cognitive assessments that were based on playing card games and remembering word lists.

The study found that after a year and a half, people who had more brain plaques at the start of the study had up to 20 percent greater decline on the computer based assessments of memory than did those who had fewer brain plaques. The study also found that while carriers of the APOE 4 allele also showed greater decline on the memory assessments than those who did not have the allele, carrying the 4 allele did not change the decline in memory related to the plaques.

Our finding that brain plaque-related memory decline can occur while people still have normal memory and thinking shows that these plaque-related brain changes can be detected and measured while older people are still healthy. This provides an enormous opportunity for understanding the development of early Alzheimers disease and even a sound basis for the assessment of plaque-targeting therapies, said Lim.

The study was supported by the Australian Commonwealth Scientific Industrial and Research Organization, Edith Cowan University, Mental Health Research Institute, Alzheimers Australia, National Aging Research Institute, Austin Health, CogState Ltd., Hollywood Private Hospital, Sir Charles Gardner Hospital, the Australian National Health and Medical Research Council, the Dementia Collaborative Research Centers Program and the Science and Industry Endowment Fund.

To learn more about Alzheimers disease, visit http://www.aan.com/patients.

The American Academy of Neurology, an association of more than 25,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimers disease, stroke, migraine, multiple sclerosis, brain injury, Parkinsons disease and epilepsy.

For more information about the American Academy of Neurology, visit http://www.aan.com or find us on Facebook, Twitter, Google+ and YouTube.

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Antidepressants linked to increased risk of stroke, but risk is low

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Public release date: 17-Oct-2012 [ | E-mail | Share ]

Contact: Angela Babb, APR ababb@aan.com 612-928-6102 American Academy of Neurology

MINNEAPOLIS Research shows that use of popular antidepressants is linked to an increased risk of some strokes caused by bleeding in the brain, but that the risk is low, according to a multi-study analysis published in the October 17, 2012, online issue of Neurology, the medical journal of the American Academy of Neurology.

For the research, scientists analyzed all of the studies that have looked at antidepressant use and stroke, which included 16 studies with more than 500,000 total participants. They found that people taking selective serotonin reuptake inhibitors (SSRIs), which are the most commonly used antidepressants, were 50 percent more likely to have an intracranial hemorrhage than those not taking the antidepressants and about 40 percent more likely to have an intracerebral hemorrhage.

But study author Daniel G. Hackam, MD, PhD, FRCPC, of Western University in London, Ontario, said the findings should be viewed with caution. "Because these types of strokes are very rare, the actual increased risk for the average person is very low," he said.

An estimated 24.6 of these strokes occur per 100,000 people per year. According to the research, the use of SSRIs would increase the risk by one additional stroke per 10,000 people per year.

"Overall, these results should not deter anyone from taking an SSRI when it is needed," Hackam said. "In general these drugs are safe, and obviously there are risks to having depression go untreated. But doctors might consider other types of antidepressants for people who already have risk factors for these types of strokes, such as those taking blood thinners, people who have had similar strokes already or those with severe alcohol abuse."

###

To learn more about stroke, visit http://www.aan.com/patients.

The American Academy of Neurology, an association of more than 25,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as Alzheimer's disease, stroke, migraine, multiple sclerosis, brain injury, Parkinson's disease and epilepsy.

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Antidepressants linked to increased risk of stroke, but risk is low

The life of a science article: From submission to citation, see a manuscript pass through Nature’s editorial process (video)

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Source: Nature YouTube channel

Comments from Twitter:

Dean Giustini @giustini: Good one~

Link via the medical blog ScienceRoll.

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The management of ingrowing toenails – BMJ review

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Ingrowing toenails are common, cause serious disability, and affect mainly young men. Most patients with ingrowing toenails are usually male, between the ages of 15 and 40 years.

There is a spectrum to the clinical presentation with pain progressing to infection, hypergranulation, and finally chronic infection.

Ingrowing toenails can occur in normal or abnormally shaped nails.

Cases in abnormally shaped nails are more difficult to manage conservatively and usually require surgery

Historically, a recurrence rate of 13-50% has been reported after surgical treatment, although more recent papers have reported recurrence rates of less than 5%.

Symptoms are less likely to recur after partial nail avulsion and segmental phenol ablation than after simple nail avulsion or wedge excisions alone.

Podiatrist Dr. Matthew Neuhaus explains what an ingrown toenail is (video):

Ingrown toenail surgery by Dr. Leo Krawetz (video). Warning: graphic content, do not try this at home:

References:

The management of ingrowing toenails. BMJ, 2012;344:e2089.

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Academic medical centers face shrinking profits – what to do?

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Here are some suggestions from the official AMA newsletter for 5 recommendations to help academic medical centers evolve, with my comments:

1. Build a brand name by holding faculty accountable for cost and quality. Mayo Clinic has mastered that and they offer a "subscription service" allowing local hospitals to gain quick access to Mayo experts - and to advertise that in the local press.

2. Become part of a larger community network. This is part of the "spokes of a wheel" concept to generate referrals to the tertiary center from the peripheral clinics and hospitals.

3. Increase effectiveness by maximizing use of extenders such as telemedicine and simulation technology. Mayo Clinic has a TeleStroke unit. Cleveland Clinic offers an "all-electronic" second opinion for a base price of $600.

4. Become an information hub. MayoClinic.com, the online patient information portal of the Mayo organization, is a good example of that concept.

5. Align research efforts with clinical and business strategies.

Bart Demaerschalk, M.D., neurologist and medical director of Mayo Clinic Telestroke, shows us how the smartphone technology works:

References:

Academic medical centers may face shrinking profits. Amednews staff. Posted April 4, 2012.
Image source: openclipart.org, public domain.

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WSU Neurology department researches cocaine withdrawal

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Some scientists in the WSU Neurology department are addicted to drug abuse research, like researcher Bradley Winters.

In his latest science fix, Winters affirmed a cellular factor for the emotional slumps and lack of motivation experienced by cocaine addicts in withdrawal.

Winters has been researching the effects of cocaine on emotions for several years, and recently published a paper in the science journal Proceedings of the National Academy of Science.

Its a very good piece of research being published in really prestigious journals, said Steve Simasko, WSU director of neurology.

Winters research focuses on cells in a region of the brain, the nucleus accumbens, that helps translate emotional drives into motivation for action. That region is strongly affected by drug abuse and is ultimately responsible for the all-encompassing need that addicts feel to get more of the drug.

The nucleus accumbens is the input region of the brain for what is called the Basal Ganglia system, which governs action selection by filtering out unwanted options for any given action or response. In some ways, it determines what we do.

The region adds what Winters calls the emotional flavor to the nervous system.

Its how your emotions affect the way you think and what you do throughout the day, he said.

He focused on cells that produced a molecule called the Cannabanoid Receptor 1 (CB1), which is most famous for being the cell type activated by smoking marijuana, Winters said.

We knew that the cells that expressed CB1 were important because of the effects marijuana has on mood, Winters said.

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WSU Neurology department researches cocaine withdrawal

Message of President Aquino to the Child Neurology Society Philippines Inc. on the occasion of their 8th Biennial …

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Message of His Excellency Benigno S. Aquino III President of the Philippines To the Child Neurology Society Philippines Inc. On the occasion of their 8th Biennial Convention

[October 14, 2012]

My warmest greetings to the Child Neurology Society Philippines Inc., as you hold your 8th Biennial Convention.

The human mind is among the great frontiers of scientific inquiry. Your activity is part of humanitys continuing endeavor to understand the dynamics behind this amazing, complex, and efficient system that is the human body. As neurologists for children, you play an important part in nation-building, charged with the care of the minds of our youth, our leaders of tomorrow. May the ideas in this convention add to our collective medical knowledge, that we, especially our youth, may be able to live fuller, more meaningful lives.

Healthcare is an essential component in our thrust to nurture an empowered, productive citizenry. Your community is among our important allies in this endeavor, and we in government take encouragement from this convention, which demonstrates your commitment to advance your specialty. Let us hold ourselves always to the highest standards of professionalism, integrity, and excellence, as we secure our gains in our continuing journey on the straight and righteous path.

(Sgd.) BENIGNO S. AQUINO III

MANILA

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Message of President Aquino to the Child Neurology Society Philippines Inc. on the occasion of their 8th Biennial ...

New treatments for epilepsy, behavioral disorders could result from Wayne State studies

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Public release date: 11-Oct-2012 [ | E-mail | Share ]

Contact: Julie O'Connor julie.oconnor@wayne.edu 313-577-8845 Wayne State University - Office of the Vice President for Research

Three studies conducted as part of Wayne State University's Systems Biology of Epilepsy Project (SBEP) could result in new types of treatment for the disease and, as a bonus, for behavioral disorders as well.

The SBEP started out with funds from the President's Research Enhancement Fund and spanned neurology, neuroscience, genetics and computational biology. It since has been supported by multiple National Institutes of Health-funded grants aimed at identifying the underlying causes of epilepsy, and it is uniquely integrated within the Comprehensive Epilepsy Program at the Wayne State School of Medicine and the Detroit Medical Center.

Under the guidance of Jeffrey Loeb, M.D., Ph.D., associate director of the Center for Molecular Medicine and Genetics (CMMG) and professor of neurology, the project brings together researchers from different fields to create an interdisciplinary research program that targets the complex disease. The multifaceted program at Wayne State is like no other in the world, officials say, with two primary goals: improving clinical care and creating novel strategies for diagnosis and treatment of patients with epilepsy.

The three studies were published in high-impact journals and use human brain tissue research to identify new targets for drug development, generate a new animal model and identify a new class of drugs to treat the disease. In the first study, "Layer-Specific CREB Target Gene Induction in Human Neocortical Epilepsy," published recently in the Journal of Neuroscience, donated human brain samples were probed to identify 137 genes strongly associated with epileptic seizures.

Researchers then showed that the most common pathway is activated in very specific layers of the cortex, and that it's associated with increased numbers of synapses in those areas. Because epilepsy is a disease of abnormal neuronal synchrony, the finding could explain why some brain regions produce clinical seizures.

"Higher density of synapses may explain how abnormal epileptic discharges, or spikes, are formed, and in what layer," Loeb said, adding that localizing the exact layer of the brain in which that process occurs is useful both for understanding the mechanism and for developing therapeutics.

The first study, which identified a new drug target for epilepsy, precipitated a second study that has found such a drug.

In the second study, "Electrical, Molecular and Behavioral Effects of Interictal Spiking in the Rat," published recently in Neurobiology of Disease, SBEP researchers found that the same brain layers in the rat are activated as in the human tissues and searched for a drug to target those layers. In fact, the first drug they tried, a compound called SL327 that has been used in nonhuman subjects to understand how memory works, "worked like a dream," Loeb said. "SL327 prevented spiking in rat brains," he said, "which not only prevented seizures, but led to more normal behaviors as well."

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New treatments for epilepsy, behavioral disorders could result from Wayne State studies

Strokes Striking Younger People

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Diabetes, Obesity, High Blood Pressure Among Triggers, Expert Says

By Kathleen Doheny WebMD Health News

Reviewed by Louise Chang, MD

Oct. 10, 2012 -- People are having strokes at younger ages, according to new research.

"This is still a disease of the old, but a surprisingly higher proportion of younger patients are having strokes, and it's getting worse over time," says researcher Brett Kissela, MD, professor and vice chair of neurology at the University of Cincinnati.

Meanwhile, strokes are decreasing among older people, he found.

In his study, strokes among adults under age 55 grew from about 13% in 1993 to 19% in 2005.

The study, funded by the National Institutes of Health, is published in Neurology.

"Our data cannot tell us why exactly this is happening," he says. "Perhaps the largest factor has to do with the early appearance of risk factors."

He's referring to the rates of diabetes, high blood pressure, and obesity among younger people, all risk factors for strokes.

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Strokes Striking Younger People

New studies could result in better treatments for epilepsy, behavioral disorders

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ScienceDaily (Oct. 11, 2012) Three studies conducted as part of Wayne State University's Systems Biology of Epilepsy Project (SBEP) could result in new types of treatment for the disease and, as a bonus, for behavioral disorders as well.

The SBEP started out with funds from the President's Research Enhancement Fund and spanned neurology, neuroscience, genetics and computational biology. It since has been supported by multiple National Institutes of Health-funded grants aimed at identifying the underlying causes of epilepsy, and it is uniquely integrated within the Comprehensive Epilepsy Program at the Wayne State School of Medicine and the Detroit Medical Center.

Under the guidance of Jeffrey Loeb, M.D., Ph.D., associate director of the Center for Molecular Medicine and Genetics (CMMG) and professor of neurology, the project brings together researchers from different fields to create an interdisciplinary research program that targets the complex disease. The multifaceted program at Wayne State is like no other in the world, officials say, with two primary goals: improving clinical care and creating novel strategies for diagnosis and treatment of patients with epilepsy.

The three studies were published in high-impact journals and use human brain tissue research to identify new targets for drug development, generate a new animal model and identify a new class of drugs to treat the disease. In the first study, "Layer-Specific CREB Target Gene Induction in Human Neocortical Epilepsy," published recently in the Journal of Neuroscience, donated human brain samples were probed to identify 137 genes strongly associated with epileptic seizures.

Researchers then showed that the most common pathway is activated in very specific layers of the cortex, and that it's associated with increased numbers of synapses in those areas. Because epilepsy is a disease of abnormal neuronal synchrony, the finding could explain why some brain regions produce clinical seizures.

"Higher density of synapses may explain how abnormal epileptic discharges, or spikes, are formed, and in what layer," Loeb said, adding that localizing the exact layer of the brain in which that process occurs is useful both for understanding the mechanism and for developing therapeutics.

The first study, which identified a new drug target for epilepsy, precipitated a second study that has found such a drug.

In the second study, "Electrical, Molecular and Behavioral Effects of Interictal Spiking in the Rat," published recently in Neurobiology of Disease, SBEP researchers found that the same brain layers in the rat are activated as in the human tissues and searched for a drug to target those layers. In fact, the first drug they tried, a compound called SL327 that has been used in nonhuman subjects to understand how memory works, "worked like a dream," Loeb said. "SL327 prevented spiking in rat brains," he said, "which not only prevented seizures, but led to more normal behaviors as well."

That finding led to collaborations between Loeb's lab and Nash Boutros, M.D., professor of psychiatry and behavioral neurosciences, and the Belgian drug company UCB.

"Whereas animals that developed epileptic spiking became hyperactive, those treated with the drug and had less spiking in their brains were more like normal animals," Loeb said. "Now whenever we screen for drugs for epilepsy, we look at behavior as well as epileptic activity."

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More Younger Adults Having Strokes

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Featured Article Academic Journal Main Category: Stroke Also Included In: Diabetes;Neurology / Neuroscience Article Date: 10 Oct 2012 - 15:00 PDT

Current ratings for: More Younger Adults Having Strokes

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First author Brett Kissela is from the University of Cincinnati College of Medicine in Ohio and a Fellow of the American Academy of Neurology. He told the press the reason for the trend could be an increase in risk factors like diabetes, obesity and high cholesterol.

But another reason, Kissela suggests, could be improved diagnosis, such as through increased use of MRI scans.

Nevertheless, he says "the rising trend found in our study is of great concern for public health because strokes in younger people translate to greater lifetime disability."

For the study, the researchers looked at occurrences of first ever strokes in people aged from 20 to 54 in the Greater Cincinnati/Northern Kentucky region over three separate, one-year periods. One period was between July 1993 and July 1994, and the other two were during the period 1999 to 2005.

They found that the average age of a person experiencing a first ever stroke fell from 71 in the 1993-1994 period to 69 in the year 2005.

"Regression modeling showed a significant change over time (p = 0.002), characterized as a shift to younger strokes in 2005 compared with earlier study periods," write the researchers.

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Initiative on Future MS Treatment and Care Takes Significant Step Forward

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LYON, France, October 10, 2012 /PRNewswire/ --

The MS in the 21st Century initiative has taken a significant step forward with its publication in the Journal of Neurology, a leading journal in the area of neuroscience with a significant impact factor of 3.8.

The published article entitled Future MS care: a consensus statement of the MS in the 21st Century Steering Group [http://www.springerlink.com/content/l04084qgw2p647j5 ], details the work of a panel of European and Canadian neurologists and representatives from umbrella organisations, which came together to define how multiple scleroris (MS) treatment and standards of care should look in the 21st Century. The "MS in the 21st Century steering group" also aims to align the broader MS community to minimum standard of care as well as to challenge the current treatment paradigm.

Over the course of three meetings, the MS in the 21st Century steering group compiled a Consensus Statement, which it hopes will act as a call to action for healthcare providers and decision makers.

The Consensus Statement communicates the groups vision ie full access to personalised treatment, with reimbursement, to achieve freedom from disease, and outlines the seven key areas of development that it believes must be addressed to realise this vision. These are personalised care, patient engagement, commitment to research, regulatory body education and reimbursement issues, new endpoints for clinical trials, more therapy options and MS centres of excellence.

Commenting on the recent article in the Journal of Neurology, the MS in the 21st steering group chair, Professor Peter Rieckmann, said: "The publication of our approach to MS care is

a significant step forward, and will support us over the coming period when engaging with various stakeholders including regulators and patients. We recognise that a strong

collaboration across the MS community is essential to ensuring that the principles underlying the statement are accomplished."

To date endorsement for the initiative has been received from various leading experts in MS treatments and organisations including the Czech Neurological Society, MS Society, UK and MS Trust UK.

Notes to Editors

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Cannabis eases sclerosis stiffness, says study

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PARIS, Oct 10 Use of cannabis extract helps ease painful muscle stiffness among patients with multiple sclerosis (MS), according to a large trial published yesterday in the Journal of Neurology, Neurosurgery and Psychiatry.

Use of cannabis extract helps ease painful muscle stiffness among patients with multiple sclerosis (MS), according to a large new trial. AFP/Relaxnews

Over 12 weeks, 144 patients were given daily tablets of tetrahydrocannabinol, which is the active ingredient in cannabis, and 135 were given a dummy pill, also called a placebo.

Doses were gradually escalated, from 2.5 milligrams to a maximum of 25 mg for two weeks, following top-up doses for the remaining two weeks.

At the end of the study, 29.4 per cent of people in the cannabis group said they had experienced relief from muscle spasms, compared to 15.7 per cent in the placebo group, according to an 11-point rating.

They also reported improvement in sleep quality. Side effects were nervous system disorders and gut problems, but none was severe.

MS, a disease that affects the brain and spinal cord, occurs when the immune system attacks the fatty myelin sheaths that insulate nerve cells.

Painful stiffness in the muscles occurs among up to 90 per centof patients at some time, often leading to poor sleep and impaired mobility.

The trial, led by John Peter Zajicek of Britains Clinical Neurology Research Group, says standardised doses of cannabis extract can be useful in easing pain and spasms in this disease.

Previous Phase III trials on cannabis and MS have thrown up conflicting results, partly because of the scale by which users report any change in their symptoms, the MUSEC researchers said. AFP/Relaxnews

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Cannabis eases sclerosis stiffness, says study

Study: Stroke becoming more common in young people

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Public release date: 10-Oct-2012 [ | E-mail | Share ]

Contact: Rachel Seroka 612-928-6129 American Academy of Neurology

MINNEAPOLIS New research reveals that stroke may be affecting people at a younger age. The study is published in the October 10, 2012, online issue of Neurology, the medical journal of the American Academy of Neurology.

"The reasons for this trend could be a rise in risk factors such as diabetes, obesity and high cholesterol," said study author Brett Kissela, MD, MS, with the University of Cincinnati College of Medicine in Ohio and a Fellow of the American Academy of Neurology. "Other factors, such as improved diagnosis through the increased use of MRI imaging may also be contributing. Regardless, the rising trend found in our study is of great concern for public health because strokes in younger people translate to greater lifetime disability."

For the study, researchers looked at occurrences of strokes in people between the ages 20 and 54 in the Greater Cincinnati/Northern Kentucky area during three separate, one year-long periods between July of 1993 and June of 1994, and the calendar years of 1999 and 2005. Only first ever strokes were included in the analysis.

The study found that the average age of people who experienced stroke fell from 71 years in 1993 and 1994 to 69 years in 2005. In addition, the study found that strokes among people under 55 made up a greater percentage of all strokes over time, growing from about 13 percent in 1993-94 to 19 percent in 2005. The stroke rate in young people increased in both African-Americans and Caucasians, from 83 strokes per 100,000 people in 1993-94 in African-Americans to 128 per 100,000 in 2005 and in Caucasians from 26 strokes per 100,000 people in 1993-94 to 48 per 100,000 in 2005.

"The good news is that some of the possible contributing factors to these strokes can be modified with lifestyle changes, such as diet and exercise," said Kissela. "However, given the increase in stroke among those younger than 55, younger adults should see a doctor regularly to monitor their overall health and risk for stroke and heart disease."

###

The study was supported by the National Institutes of Health.

To learn more about stroke, visit http://www.aan.com/patients.

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Study: Stroke becoming more common in young people

Stroke becoming more common in young people

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ScienceDaily (Oct. 10, 2012) New research reveals that stroke may be affecting people at a younger age. The study is published in the October 10, 2012, online issue of Neurology, the medical journal of the American Academy of Neurology.

"The reasons for this trend could be a rise in risk factors such as diabetes, obesity and high cholesterol," said study author Brett Kissela, MD, MS, with the University of Cincinnati College of Medicine in Ohio and a Fellow of the American Academy of Neurology. "Other factors, such as improved diagnosis through the increased use of MRI imaging may also be contributing. Regardless, the rising trend found in our study is of great concern for public health because strokes in younger people translate to greater lifetime disability."

For the study, researchers looked at occurrences of strokes in people between the ages 20 and 54 in the Greater Cincinnati/Northern Kentucky area during three separate, one year-long periods between July of 1993 and June of 1994, and the calendar years of 1999 and 2005. Only first ever strokes were included in the analysis.

The study found that the average age of people who experienced stroke fell from 71 years in 1993 and 1994 to 69 years in 2005. In addition, the study found that strokes among people under 55 made up a greater percentage of all strokes over time, growing from about 13 percent in 1993-94 to 19 percent in 2005. The stroke rate in young people increased in both African-Americans and Caucasians, from 83 strokes per 100,000 people in 1993-94 in African-Americans to 128 per 100,000 in 2005 and in Caucasians from 26 strokes per 100,000 people in 1993-94 to 48 per 100,000 in 2005.

"The good news is that some of the possible contributing factors to these strokes can be modified with lifestyle changes, such as diet and exercise," said Kissela. "However, given the increase in stroke among those younger than 55, younger adults should see a doctor regularly to monitor their overall health and risk for stroke and heart disease."

The study was supported by the National Institutes of Health.

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The above story is reprinted from materials provided by American Academy of Neurology (AAN), via Newswise.

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Stroke becoming more common in young people

Cannabis eases sclerosis stiffness – study

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Use of cannabis extract helps ease painful muscle stiffness among patients with multiple sclerosis (MS), according to a large trial published on Tuesday in the Journal of Neurology, Neurosurgery and Psychiatry.

The "Phase III" test -- the final stage in a process to vet a new drug or medical process -- took place among 22 centres in Britain.

Over 12 weeks, 144 patients were given daily tablets of tetrahydrocannabinol, which is the active ingredient in cannabis, and 135 were given a dummy pill, also called a placebo.

Doses were gradually escalated, from 2.5 milligrams to a maximum of 25 mg for two weeks, following top-up doses for the remaining two weeks.

At the end of the study, 29.4 percent of people in the cannabis group said they had experienced relief from muscle spasms, compared to 15.7 percent in the placebo group, according to an 11-point rating.

They also reported improvement in sleep quality. Side effects were nervous system disorders and gut problems, but none was severe.

MS, a disease that affects the brain and spinal cord, occurs when the immune system attacks the fatty myelin sheaths that insulate nerve cells.

Painful stiffness in the muscles occurs among up to 90 percent of patients at some time, often leading to poor sleep and impaired mobility.

The trial, led by John Peter Zajicek of Britain's Clinical Neurology Research Group, says standardised doses of cannabis extract can be useful in easing pain and spasms in this disease.

Previous Phase III trials on cannabis and MS have thrown up conflicting results, partly because of the scale by which users report any change in their symptoms, the MUSEC researchers said.

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Cannabis eases sclerosis stiffness - study

Tomato compound tied to lower stroke risk: study

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(Reuters) - Men who love eating tomatoes may have lower odds of suffering a stroke, according to a Finnish study.

Researchers whose results appeared in the journal Neurology found that of the more than 1,000 older men they followed, those with relatively high blood levels of the antioxidant lycopene were less likely to have a stroke over a dozen years.

Lycopene is a chemical that gives a reddish hue to foods like tomatoes, red peppers, watermelon and papaya. For most people, tomatoes and tomato products are by far the biggest source of lycopene in the diet.

Lycopene is a "potent antioxidant," said lead researcher Jouni Karppi, a researcher at the University of Eastern Finland in Kuopio, which means it helps protect body cells from damage that can ultimately lead to disease.

Laboratory research also suggests that lycopene helps fight inflammation and blood clots, and may be better at it than other antioxidants.

But other researchers said the study does not prove that tomatoes alone can cut anyone's stroke risk, noting that there may be other things about men with high lycopene levels that could explain the lower chances of having a stroke.

The study looked at 1,031 men aged 46 to 55 who had their blood levels of lycopene, alpha- and beta-carotene, and vitamins E and A measured.

Over the next 12 years, there were 11 strokes among the one-quarter of men with the highest lycopene levels, compared to 25 among the one-quarter with the lowest levels.

The researchers also accounted for some major factors that affect stroke risk, like smoking, high blood pressure and diabetes - and the high-lycopene group still had a 55 percent lower risk of suffering a stroke.

"Studies like this are interesting, but they have significant limitations," said Larry Goldstein, director of the Duke Stroke Center and a professor at Duke University Medical Center in Durham, North Carolina.

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Tomato compound tied to lower stroke risk: study

New Agent May Protect Against Brain Damage After Stroke

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Editor's Choice Main Category: Neurology / Neuroscience Article Date: 08 Oct 2012 - 0:00 PDT

Current ratings for: New Agent May Protect Against Brain Damage After Stroke

At the beginning of their randomized, double-blind trial, the experts had set out to determine whether NA-1 was safe. They then focused their attention on injections of NA-1, and how these injections affected the number and volume of brain legions in stroke patients after surgery.

During the study, the researchers administered 185 patients who had just undergone surgery with either an intravenous infusion of NA-1 or a saline control - 92 of them received the NA-1 drug, while 93 participants were given the placebo. Throughout the following three days, the team performed MRIs on the patients to examine the degree of stroke legions present. To determine the results, the participants were followed-up 30 days later.

They wrote that NA-1 is effective and harmless for humans to use, in spite of two unfavorable occurrences where some of the participants were found to have transient low blood pressure caused by the new medication.

The authors also discovered that NA-1 was capable of lowering brain tissue impairment in the study participants. The patients who received the medication were found to have considerably fewer lesions than those who had been given the saline control. However, lesion volume was similar in the two groups.

Professor Michael Hill, lead author of the study, explained:

Our research, which builds on existing animal studies, suggests that intravenous infusion of NA-1 reduces tissue damage in patients who suffer a small stroke after an operation to repair a brain aneurysm, and further research is now needed to investigate the efficacy of neuroprotection in larger clinical trials."

Kaste said:

However, such drugs should first be assessed in large, well designed and well executed randomised placebo-controlled double-blind clinical trials. Only after such trials will we know whether NA-1 - or one of the other drugs which have shown comparable effects - is the long-awaited holy grail for the treatment of patients with ischaemic stroke. The door is now reopening for new neuroprotection trials in stroke."

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New Agent May Protect Against Brain Damage After Stroke

Can eating tomatoes lower the risk of stroke?

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Public release date: 8-Oct-2012 [ | E-mail | Share ]

Contact: Rachel Seroka rseroka@aan.com 612-928-6129 American Academy of Neurology

MINNEAPOLIS Eating tomatoes and tomato-based foods is associated with a lower risk of stroke, according to new research published in the October 9, 2012, print issue of Neurology, the medical journal of the American Academy of Neurology. Tomatoes are high in the antioxidant lycopene.

The study found that people with the highest amounts of lycopene in their blood were 55 percent less likely to have a stroke than people with the lowest amounts of lycopene in their blood.

The study involved 1,031 men in Finland between the ages of 46 and 65. The level of lycopene in their blood was tested at the start of the study and they were followed for an average of 12 years. During that time, 67 men had a stroke.

Among the men with the lowest levels of lycopene, 25 of 258 men had a stroke. Among those with the highest levels of lycopene, 11 of 259 men had a stroke. When researchers looked at just strokes due to blood clots, the results were even stronger. Those with the highest levels of lycopene were 59 percent less likely to have a stroke than those with the lowest levels.

"This study adds to the evidence that a diet high in fruits and vegetables is associated with a lower risk of stroke," said study author Jouni Karppi, PhD, of the University of Eastern Finland in Kuopio. "The results support the recommendation that people get more than five servings of fruits and vegetables a day, which would likely lead to a major reduction in the number of strokes worldwide, according to previous research."

The study also looked at blood levels of the antioxidants alpha-carotene, beta-carotene, alpha-tocopherol and retinol, but found no association between the blood levels and risk of stroke.

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The study was supported by Lapland Central Hospital.

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Can eating tomatoes lower the risk of stroke?