Every 15-minute delay in delivering a clot-busting drug after stroke robs survivors of about a month of disability-free life, according to a new study.
On the other hand, speeding treatment by just one minute means another 1.8 days of healthy life, researchers said.
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In the first study of its kind, a consortium led by UCLA physicians found that giving stroke patients intravenous magnesium within an hour of the onset of symptoms does not improve stroke outcomes.

However, the 8-year trial did find that with the help of paramedics in the field, intravenous medications can frequently be administered to stroke victims within that so-called ‘golden hour,’ during which they have the best chance to survive and avoid debilitating, long-term neurological damage.
The latter finding is a ‘game-changer,’ said Dr. Jeffrey Saver, director of the UCLA Stroke Center and a professor of neurology at the David Geffen School of Medicine at UCLA. Saver served as co-principal investigator on the research.
‘Stroke is a true emergency condition. For every minute that goes by without restoration of blood flow, 2 million nerve cells are lost,’ Saver said. ‘Since time lost is brain lost, we wanted to develop a method that let us get potentially brain-saving drugs to the patient in the earliest moments of onset of the stroke. If these patients don’t get protective drugs until two, three or four hours later, irreversible brain damage has already occurred.’
While the Phase 3 clinical trial found that magnesium does not improve stroke-related disability, the search is now on for new drugs and treatments that can be administered in the field to improve long-term outcomes. The infrastructure to treat patients quickly was created by this study is in place, and that is a major accomplishment, Saver said.
The trial, called Field Administration of Stroke Therapy

In just four months, Singapore will once again play host to MEDICAL FAIR ASIA, as it makes a much anticipated return on 9 to 11 September 2014 at Suntec Singapore. The 10th edition of the international exhibition on Hospital, Diagnostic, Pharmaceutical, Medical & Rehabilitation Equipment & Supplies continues its tradition of show-on-show growth, with an expected 25% increase in exhibitors from its 2012 edition.
Extremely positive exhibitor response has resulted in a marked increase in space bookings received, which sees the show expand across two exhibition levels to meet the growing demand for floor space. Further driving this growth is the strong support received in the international arena, with new and returning nations Italy, Spain, Hungary, Turkey and The Netherlands showing keen interest in joining a broad line-up of country pavilions which already include Germany, Austria, France, UK, USA, China, Taiwan, Singapore, Korea, Japan and Malaysia.
Organized by Messe Dusseldorf Asia, Medical Fair Asia brings
together all facets of the medical and healthcare industry for networking, sharing of best industry practices, as well as product, service and solutions development. Part of MEDICA

Experts from the Too Fit to Fracture Initiative presented the results of an international consensus process to establish exercise recommendations for people with osteoporosis, with or without spine fractures. The results were presented at the World Congress on Osteoporosis, Osteoarthritis and Musculoskeletal Diseases in Seville, Spain.

Using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) method, the international multidisciplinary panel examined literature on exercise effects on: 1) falls, fractures, BMD, and adverse events for individuals with osteoporosis or spine fractures; and 2) pain, quality of life, and physical function after spine fracture. Evidence was rated as high, moderate, low, or very low.

In addition, a consensus process was used to established recommendations on assessment, exercise, and physical activity in the context of three cases with varying risk – one having osteoporosis based on bone density; one having osteoporosis and 1 spine fracture; and one having osteoporosis and multiple spine fractures, hyperkyphosis and pain.

The panel recommends that all individuals with osteoporosis should engage in a multicomponent exercise programme that includes resistance and balance training; they should not engage in aerobic training to the exclusion of resistance or balance training.

Other key points included:
current national physical activity guidelines are appropriate for individuals with osteoporosis in the absence of spine fracture, but not for those with spine fracture;
after spine fracture, aerobic activity of moderate intensity is preferred to vigorous; physical therapy consultation is recommended;
daily balance training and endurance training for spinal extensor muscles are recommended for all individuals with osteoporosis;
restrictions are a disincentive to activity participation, and for people with osteoporosis but no history of spine fracture, desired activities should be encouraged if they can be performed safely or modified;
health care providers should provide guidance on safe movement, rather than providing generic restrictions (e.g., lifting);
physical or occupational therapist consult is recommended for advice on exercise and physical activity among those with a history of spine fracture, particularly in the presence of balance or posture impairments, pain, comorbid conditions or that increase the risk of adverse events with exercise or activity, or unsafe movement patterns.

Lead author Dr Lora Giangregorio, University of Waterloo, Waterloo, Canada, stated, ‘People with osteoporosis and spinal fractures should be encouraged to participate in resistance training and balance training, as the strongest evidence we have supports multimodal exercise programs. We have developed evidence-based recommendations, as well as a report that addresses the ‘frequently asked questions’ of patients and health care providers around physical activity. We hope that the recommendations are helpful to health professionals worldwide as they guide their osteoporosis patients in safe, effective – and enjoyable – exercise regimens.’ International Osteoporosis Foundation

At least 30 percent of patients in intensive care units (ICUs) suffer some form of mental dysfunction as reflected in anxiety, depression, and especially delirium. In mechanically-ventilated ICU patients, the incidence of delirium is particularly high, about 80 percent, and may be due in part to damage in the hippocampus, though how ventilation is increasing the risk of damage and mental impairment has remained elusive.  A new study found a molecular mechanism that may explain the connection between mechanical ventilation and hippocampal damage in ICU patients.  
The investigators, including Adrian Gonz