Stroke resources in Indonesia - coming to Early view

Stroke resources in Indonesia are limited; however, there has been demand to include nonbiomedical practitioners in stroke care. This paper will present a snapshot of available non-biomedical stroke ‘services’ used by stroke survivors in two subdistricts of Aceh, Indonesia. Data were collected through interviews, observations, focus groups and vignettes with stroke survivors and their carers. All practitioners discussed and demonstrated an understanding and approach to stroke treatment with multiple layers of influence, predominantly, education, religion and culture. There were a number of areas of overlap between the two categories; some of these influences were also evident in the biomedical practitioners.

Emotional stress can change brain function

The Journal of Neuroscience has recently published 'Emotional stress can change brain function' a fascinating study the researchers found that a five-minute exposure to the odor of a predator produced the insertion of receptors containing GluR2 at the connections (synapses) between nerve cells in the brain 

Early view - How to cite an Early View article.

We decided earlier this year to embark on 'Early View' as a way to expedite the publication of our ever increasing manuscript pile. We realize that authors want their manuscripts published as soon as possible; for grants and funding; to increase personal citations, and to share important information with the stroke community. Early View is now online. This means that once the reviewer and revision process is complete and your manuscript has been accepted, we'll copyedit, and make a proof. Once you approve the article will be placed online and can be cited.


Early View articles may not yet be allocated to a print edition, meaning that they do not yet have volume, issue or page numbers, therefore Early View articles cannot be cited in the traditional way. They are given a Digital Object Identifier (DOI), which allows the article to be cited and tracked before it is allocated to an issue. When you cite an article that is not yet published in print but is  published on Early View, you may do so by citing the DOI. After print publication, the DOI remains valid and can continue to be used to cite and access the article.

Sneak peek - what's coming to print in IJS this year!

“Better wear out sheets than shoes” A Survey of 202 Stroke Professionals´ Early Mobilisation Practices and Concerns

Monica Skarin1, Julie Bernhardt2, Anna Sjo¨ holm1, Michael Nilsson1, and Thomas Linden1

Background Stroke unit care improves the outcome for patients.

One component responsible for this may be that

patients are mobilised earlier and more intensively. An ongoing

randomised controlled trial is investigating the potential

benefits of early mobilisation, but currently there is

limited evidence for the practice. Therefore, current practices

may be driven by historical precedent and/or clinical opinion,

and varying approaches to mobilisation are likely. This study

aims to examine different health professionals’ concerns

regarding early mobilisation in acute stroke. In this study,

early mobilisation was defined as frequent out of bed activities

within the first 24 h after stroke onset.

Methods A nine-item anonymous questionnaire exploring

benefits and harms with early mobilisation after stroke was

used during interviews of stroke care professionals attending

the annual Australasian stroke conference in 2008.

Results The survey was completed by 202 professionals,

representing 38% of all conference attendees. 65% were

females, 50% under 40-years old, 46% worked in acute stroke

and 31% in rehabilitation. Thirty-five percent were nurses,

26% medical doctors, 19% physiotherapists and 12% occupational

therapists. Two-thirds had o10-years experience with

stroke. Sixty percent of the surveyed professionals had concerns

about early mobilisation and there were significantly

more professionals concerned about early mobilisation for

haemorrhagic (59%) than ischaemic (23%) stroke patients.

Conclusion Our study shows that most clinicians had concerns

in relation to early mobilisation of stroke patients and

more clinicians had concerns for haemorrhagic than for

ischaemic stroke. The evidence underlying these concerns is

shallow.

WSC Seoul Korea

http://www.world-stroke.org/education_webcasts.asp

The World Stroke Organization host the World Stroke Congress every two years; this year in Seoul, Korea. The meeting attendance is projected at over 3000 attendees - many of those from Korea. The program has been quite varied, as you would expect from a global conference. I understand that the WSO has a no rejection policy which is a wonderful way to be inclusive. There was some mention among some groups that this may lower the quality of the meeting, this remains to be seen but there is such a great presence and support from so many excellent strokologists at the actual meeting the quality of the meeting will be maintained and developed in others way - the ESC turned 20 this year so still early days yet!  The International Journal of Stroke held their Editorial Board meeting on Friday the 15th with excellent attendance and celebratory champagne. The outcome of the meeting was to continue to develop our successful ideas and innovations which have made us quite a hit with our readership and our publisher!

Padma Gunaratne receiving the World Stroke Day Award for Sri Lanka from Bo Norrving President of the Wold Stroke Organization.

What is a TIA?

International Journal of Stroke is at the NSRI scientific retreat in the Hunter Valley; the session is being chaired by the amazing and highly regarded clinician Marie-Germaine Bousser. So, the question posed for this discussion, headed by Simon Koblar, Helen Dewey and Dominique Cadilhac is 'What is TIA?' And the consensus is that no one can agree - how this condition is defined and how to run cohorts which supply data that is novel, relevant in Australia and of interest to public health...

Sixth International Stroke Summit

Sixth International Stroke Summit

Juehua Zhu, Gelin Xu, Xinfeng Liu

Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China

Correspondence Xinfeng Liu, Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, 305 Zhongshan East Road, Nanjing 21002, Jiangsu, China

E-Mail: xfliu2@yahoo.com.cn

To establish a platform for international communication in stroke management, Jinling hospital launched an annual conference, the International Stroke Summit in 2004. The summit has been successfully run for six times and has been endorsed by World Stroke Organization since 2007. More than 1000 doctors and researchers have participated in each meeting.

The Sixth International Stroke Summit was held on July 9-11, 2010 in Nanjing, China. The conference motif of bridging the gap between developing and developed countries in stroke management was high appropriate. Hot debate and grand attention had been focused on topics such as the development of endovascular treatment of extracranial and intracranial atherosclerotic diseases, clinical trials of stroke treatment, stroke registry and genetic factors for stroke.

On the first day of this conference, the National Neuroendovascular Association was set up. The association constitutes neurologists, vascular surgeons and intervention clinicians from major medical centers in China. The mission of such a unique association is to shed more light on the standardization of endovascular treatment in China.

Distinguished from the previous meetings, two sections specialized on endovascular therapy and an international discussion was established. In the intervention section, clinicians talked about their own experiences with cerebral angiography and stenting. In the international section, stroke specialists from America, Australia, Finland, Netherlands, Japan, India, Brazil and China shared the latest developments in stroke research.

Prof. Xinfeng Liu, the chairperson of this summit, introduced the frontier of neuroendovascular treatment. He mentioned that IV-tPA can be beneficial for acute ischemic stroke up to 4.5h from stroke onset. However, due to low recanalization rate and high re-closure rate after thrombolysis, especially in patients with severe stroke and patients with T-shaped artery occlusion, few patients who meet the criteria for IV tPA thrombolysis can benefit from it. For these patients, intra-arterial thrombolysis, mechanical thrombectomy may be the better treatment choice. Dr. Liu also introduced the recently published CREST study¹. Younger patients would benefit more from carotid stenting, older patients from endarterectomy. The CREST study proved carotid artery stenting together with endarectomy to be powerful weapons against stroke.

Dr. Yongjun Wang from Tiantan Hospital lectured on the improvement of stroke management worldwide. He introduced the GWTG-stroke program carried out in USA which raised the percentage of patients receiving standard treatment under stroke guidelines; from 41% in 2003 to 83% in 2009². This study underlined the importance of guidelines in stroke treatment. In the Canadian Stroke Strategy and British National Stroke Strategy, the importance of patient education, primary prevention, pre-hospital management, acute stroke units and subacute rehabilitation units as well as secondary prevention were highlighted. Dr. Wang said stroke management in China lagged far behind than that in these western countries. The ongoing Golden Bridge Project of Stroke Care is a first attempt in China at a national public health campaign; hopefully this project will be active throughout China in the next five years.

Dr. Yukito Shinohara, a principal investigator of the Cilostazol Stroke Prevention Study (CSPS), introduced a clinical trial for stroke prevention (CSPSII). CSPSII is a randomized, multicenter, double-blind, parallel-group study, included 2757 non-cardioembolic stroke patients from 278 centers between December 2003 and December 2008. Patients randomized to cilostazol group (1337 patients), received 100 mg twice daily and aspirin group (1335 patients), received 81 mg once daily. The duration of treatment lasted a minimum of one year and a maximum of five years. Eighty-two strokes occurred in cilostazol-treated patients, and two of these events were fatal. In the aspirin group, there were 119 strokes, including three deaths. Hemorrhagic stroke or hemorrhage requiring hospitalization occurred in 23 patients in the cilostazol group and 57 in the aspirin group. Dr. Shinohara pointed out that cilostazol would be an alternative to aspirin and clopidogrel in our arsenal against secondary stroke.

About 1200 domestic and overseas delegates participated in this meeting. Many others watched the summit via live Internet broadcast. Thirty selected abstracts submitted to the conference were published in Cerebrovascular Diseases³. The organizers announced that the next meeting, the Seventh International Stroke Summit, will be held on July, 2010 in Nanjing, China. They encouraged the clinicians and researches to join this Nanjing summer gathering and continue their contribution to boost east west academic communication. Detailed information concerning the conference is available on the website: www.stroke.net.cn

References

1. Brott TG, Hobson RW, 2nd, Howard G, Roubin GS, Clark WM, Brooks W, et al. Stenting versus endarterectomy for treatment of carotid-artery stenosis. N Engl J Med. 363(1): 11-23.

2. Fonarow GC, Reeves MJ, Zhao X, Olson DM, Smith EE, Saver JL, et al. Age-related differences in characteristics, performance measures, treatment trends, and outcomes in patients with ischemic stroke. Circulation. 121(7): 879-91.

3. Sixth International Stroke Summit. Cerebrovasc Dis. 2010; 30: 207-19.

Stroke in Nepal

Did you know there are only 10 neurologists working on stroke in Nepal? We have just received a heartfelt article on this for the journal, and it reminds you why you build international relationships where you share information resources and time; the World Stroke Organization is such a valuable resource and source of support for developing countries. Those in the west cannot imagine working in these conditions; non-existent time windows, no public campaigns or government support, no rehabilitation options, no telemedicine, very high risk of disability and death. Not to mention palliative care, family support and information etc.

Editorial Board Meeting for Korea announced!

This year in Korea the International Journal of Stroke will be celebrating our impact factor increase to 2.871, which as many of you know from our last meeting is more than we were expecting; and the appointment of our newest Associate Editor.

The details are as follows:

International Journal of Stroke Editorial Board Meeting
07:30 – 8:30, Friday, October 15, 2010
Hospitality Suite 1, which is on the third level of the COEX building.

We will of course be providing breakfast.

Looking forward to seeing many of you at the coming SSA and WSC meetings!

IJS latest impact factor

Most exciting news today - the latest IJS impact factor is 2.871 - an incredible achievement in such a short time - TSC have only been calculating our impact factor for three years.

IJS You Tube launch

IJS Geoff Donnan in conversation with Nils Wahlgren from the SITS International Trial.