Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Internet-based stroke exam speeds treatment in rural areas

14.09.2005


An Internet-based examination system enables stroke patients to be treated as rapidly in rural communities as they are in bigger hospitals with stroke teams, researchers have found.

A study of 194 stroke patients in eight rural Georgia hospitals seen via the REACH system by stroke team members at an academic medical center showed most patients got clot-dissolving tPA in less than two hours, says Dr. David Hess, chair of the Medical College of Georgia Department of Neurology and lead author on the study published in the September issue of Stroke.

The clot buster, tissue plasminogen activator, which received Food and Drug Administration approval in 1996 as the first and still the only approved stroke treatment, must be given within three hours of symptoms.



“While we have a three-hour window, the evidence suggests that if you treat patients with tPA in under two hours or, even better, under 90 minutes, you improve your outcome,” says Dr. Hess. “We actually look upon it as though we have a two-hour stroke window now.”

Sixty percent of the 30 patients treated with tPA between March 2003-February 2004 got the drug in under two hours; 23 percent were treated in 90 minutes or less. “I think it argues that the REACH system doesn’t just treat patients who never got treated before, but it treats them fast,” says Dr. Hess.

Eighty percent of the 700,000 strokes that occur annually in the United States are clot-based but only a small percentage of patients get tPA because of delays in patients seeking treatment and limited availability of stroke teams to assess and treat them when they do, Dr. Hess says.

Sam Wang, a research scientist who is now a second-year medical student at MCG, developed the REACH – Remote Evalution for Acute Ischemic Stroke – system that has a portable station at the remote site and can be accessed by a stroke specialist from any computer with Internet access. Staff at the remote hospital reach the on-call member of MCG’s stroke team by calling a 24-hour Emergency Communications Center.

A study published in the October 2003 rapid-access issue of Stroke showed essentially no difference in the results of patients seen via REACH and in person.

The newer study showed none of the treated patients had symptomatic brain hemorrhages, a potential side effect of tPA. It also indicates use of the system became more efficient over time, dropping onset to treatment time from 143 minutes in the first 10 patients to 111 minutes in the last 20.

Rural hospitals tend to have quieter emergency rooms than their big-city counterparts so patients typically are seen rapidly and have little or no wait for a confirmatory computerized tomography scan, Dr. Hess says. “There are some concerns that telemedicine would be too slow, there would be too many delays. This shows you can treat quickly. If this works in a very difficult environment with small hospitals, it’s a model of what can be done in the state of Georgia or any state,” says Dr. Hess.

In fact, state lines are the primary boundary for REACH because physicians have to be licensed to practice in the state where the patient is being seen, he says. National stroke care criteria could eliminate that problem, he adds.

MCG is working with the Southeast Affiliate of the American Heart Association to help develop a statewide stroke plan for Georgia. The national association wants every state to have such a plan, Dr. Hess says.

The Georgia Research Alliance helped MCG develop a business plan that could make REACH available to other states by detailing the installation, training and relationship building required for a successful program, he says.

Stroke care became more lucrative for hospitals recently when Medicare tripled their reimbursement for stroke care, but physicians are not paid to take call for such after-hour services, so staffing can be a problem, Dr. Hess says.

Georgia hospitals participating in the existing network include McDuffie Regional Medical Center, Thomson; Emanuel County Medical Center, Swainsboro; Washington County Regional Medical Center, Sandersville; Wills Memorial Hospital, Washington; Jenkins County Hospital, Millen; Jefferson Hospital, Louisville; Elbert County Hospital, Elberton; and Morgan County Hospital, Madison.

Toni Baker | EurekAlert!
Further information:
http://www.mcg.edu

More articles from Studies and Analyses:

nachricht Multi-year study finds 'hotspots' of ammonia over world's major agricultural areas
17.03.2017 | University of Maryland

nachricht Diabetes Drug May Improve Bone Fat-induced Defects of Fracture Healing
17.03.2017 | Deutsches Institut für Ernährungsforschung Potsdam-Rehbrücke

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Giant Magnetic Fields in the Universe

Astronomers from Bonn and Tautenburg in Thuringia (Germany) used the 100-m radio telescope at Effelsberg to observe several galaxy clusters. At the edges of these large accumulations of dark matter, stellar systems (galaxies), hot gas, and charged particles, they found magnetic fields that are exceptionally ordered over distances of many million light years. This makes them the most extended magnetic fields in the universe known so far.

The results will be published on March 22 in the journal „Astronomy & Astrophysics“.

Galaxy clusters are the largest gravitationally bound structures in the universe. With a typical extent of about 10 million light years, i.e. 100 times the...

Im Focus: Tracing down linear ubiquitination

Researchers at the Goethe University Frankfurt, together with partners from the University of Tübingen in Germany and Queen Mary University as well as Francis Crick Institute from London (UK) have developed a novel technology to decipher the secret ubiquitin code.

Ubiquitin is a small protein that can be linked to other cellular proteins, thereby controlling and modulating their functions. The attachment occurs in many...

Im Focus: Perovskite edges can be tuned for optoelectronic performance

Layered 2D material improves efficiency for solar cells and LEDs

In the eternal search for next generation high-efficiency solar cells and LEDs, scientists at Los Alamos National Laboratory and their partners are creating...

Im Focus: Polymer-coated silicon nanosheets as alternative to graphene: A perfect team for nanoelectronics

Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are less stable. Now researchers at the Technical University of Munich (TUM) have, for the first time ever, produced a composite material combining silicon nanosheets and a polymer that is both UV-resistant and easy to process. This brings the scientists a significant step closer to industrial applications like flexible displays and photosensors.

Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are...

Im Focus: Researchers Imitate Molecular Crowding in Cells

Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to simulate these confined natural conditions in artificial vesicles for the first time. As reported in the academic journal Small, the results are offering better insight into the development of nanoreactors and artificial organelles.

Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

International Land Use Symposium ILUS 2017: Call for Abstracts and Registration open

20.03.2017 | Event News

CONNECT 2017: International congress on connective tissue

14.03.2017 | Event News

ICTM Conference: Turbine Construction between Big Data and Additive Manufacturing

07.03.2017 | Event News

 
Latest News

Argon is not the 'dope' for metallic hydrogen

24.03.2017 | Materials Sciences

Astronomers find unexpected, dust-obscured star formation in distant galaxy

24.03.2017 | Physics and Astronomy

Gravitational wave kicks monster black hole out of galactic core

24.03.2017 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>