Tag: trials

‘Lucky’ stroke survivor joins study led by the University of Edinburgh

~ Warning not to ignore subtle stroke signs just because they are uncommon ~ 

A stroke survivor is warning others to watch out for unusual symptoms after joining a study funded by the British Heart Foundation. 

Gordon Robb had a stroke involving a bleed in his brain, but his only symptom was finding that written words suddenly looked as if they were in a foreign language. 

The 63-year-old is now taking the drug clopidogrel, as part of a clinical trial run by researchers at the University of Edinburgh. This study will examine if clopidogrel or aspirin, which are ‘antiplatelet’ drugs that reduce the risk of blood clotting, can prevent future strokes, heart attacks and premature deaths in people who have had a haemorrhagic stroke – a stroke caused by a bleed in the brain. 

Gordon only discovered his stroke had happened after his cousin, whose husband had died from a stroke a few weeks earlier, insisted he go to hospital. 

Having first thought his sudden inability to read was caused by tiredness, he now describes himself as an ‘extremely lucky man’. He had none of the more commonly known symptoms of a stroke, such as problems with his face, arm, speech, eyes or balance.  

Difficulty recognising written words on its own, without any other symptoms, affects fewer than one per cent of people at the time of their stroke, say researchers. 

A few months on, Gordon’s symptoms are improving, although it now takes him half an hour to read a chapter instead of his previous 10 minutes, and more recently he has noticed he occasionally can’t find the right word during a conversation. 

Gordon said: “I am incredibly lucky, and quite honestly felt like a fraud in the stroke ward because I was no different to how I am normally, except that I suddenly could not read words. 

“A group of student doctors in neurology who were brought to see me even said they would have struggled to diagnose that I had had a stroke. 

“I knew some of the classic signs of a stroke like facial weakness, being unable to raise my arms or speech issues, but had none of these.  

“It just shows the importance of paying attention to unusual symptoms, even if they aren’t ones you have heard of before. If I hadn’t gone to the hospital, and quickly received treatment, I could have been walking around with a ticking time-bomb in my head.” 

The stroke survivor, from Bonnyrigg in Midlothian, had only been to hospital once in his life previously. A keen cyclist and runner, who had climbed to base camp at Mount Everest two years ago, he felt in perfect health. 

So when, on September 27 last year, he checked his emails and could not read them, he put it down to tiredness. 

Gordon, the former vice-president of a biotech company, said: “I was in the garden, went in to have a cup of tea, listen to some music and check my emails on my phone – and it was like they were in a foreign language. 

“I could see them clearly, and see who they were from, but the words meant nothing to me. 

“I just assumed I was tired because I had been up late the night before. When friends were then messaging me about the Ryder Cup that evening and I couldn’t see the messages, I just gave myself an early night.” 

 The following evening, when he was unable to read the instructions on a cash machine to withdraw money, he resolved to go to see his GP the next day. 

However, when he told his cousin – whose husband had died from a sudden stroke just three weeks earlier – she drove straight to his house and insisted on taking him to A&E. There, doctors told him he had had a haemorrhagic stroke. 

Approximately 15 per cent of strokes are haemorrhagic. The majority of strokes are ischaemic strokes, caused by a blocked artery. 

While in hospital, Gordon signed up to a study being led by Professor Rustam Al-Shahi Salman at the University of Edinburgh, which is called ASPIRING (Antiplatelet Secondary Prevention International Randomised study after INtracerebral haemorrhaGe).  

The international study is recruiting people who have had a stroke due to bleeding in the brain, also known as a haemorrhagic stroke. Study participants in the UK will be given  ‘antiplatelet’ medicines like clopidogrel or aspirin, which reduce the chances of a stroke or heart attack by preventing cells in the bloodstream, called platelets, from sticking together and forming a blood clot.  

Antiplatelet medicines are not routinely prescribed for people who have had a haemorrhagic stroke, because of safety concerns that they may increase the risk of bleeding. But a small study called RESTART, led by the University of Edinburgh and also funded by the British Heart Foundation, found aspirin and clopidogrel are safe after a haemorrhagic stroke.  

In this new larger study, researchers in the UK now aim to understand if clopidogrel or aspirin can reduce the likelihood of having future strokes, heart attacks and other clotting and bleeding problems in people who have survived a haemorrhagic stroke.  

Major clotting or bleeding problems occur in around one in 10 haemorrhagic stroke survivors every year.  

Professor Salman said: “It has been hard to overcome the instinctive fear that if people have had a haemorrhagic stroke, taking aspirin or a drug like it might cause more bleeding. So we were very relieved when our research showed such drugs to be safe after a haemorrhagic stroke.  

“The ASPIRING study will gather further evidence to establish if aspirin and clopidogrel can help lower the risk of future strokes and heart attacks, and potentially save the lives of people like Gordon who have had a haemorrhagic stroke.

“I believe there is a huge amount more to be done to help these people, whose lives have been turned upside down and who may be concerned about the future.” 

Gordon is one of more than 4,000 people worldwide set to join the study, which is also funded by the Dutch Heart Foundation, the Canadian Institutes of Health Research, the Research Foundation – Flanders and the Medical Research Future Fund in Australia. 

The study was endorsed by the Global Cardiovascular Research Funders Forum (GCRFF) multinational clinical trials initiative.  

Gordon said: “Being involved in this trial provides some reassurance, that this drug may reduce my risk of another stroke. 

“But it is also great to know that being involved could help improve treatment for people like me in the future, and relieve the pressure on the health system. 

“I feel extremely lucky that I did not have more long-term effects from my stroke, and that I have had the chance to try to help improve treatments.” 

Dr Sonya Babu-Narayan, the British Heart Foundation’s clinical director, said: “Facial weakness, arm or leg weakness and speech problems are well-known signs you or your loved one may be having a stroke, but there are some lesser-known symptoms like being unable to recognise the written word. 

“If you have a symptom that you feel is not right, however strange or unusual, it is really important to seek help. Every minute matters if you may be having a stroke or other medical emergency. 

“We know stroke survivors often fear having another stroke and how disabling this could be. That is why the BHF is funding clinical trials like ASPIRING, which will test whether prescribing antiplatelet drugs could protect more people.” 

The ASPIRING study is recruiting people from England, Wales and Scotland who have had a haemorrhagic stroke.

Volunteers can check their eligibility, depending on the hospital where they received treatment, and express interest by visiting www.ASPIRING.ed.ac.uk 

UK’s first AI physio clinic trialled by NHS Lothian

NHS Lothian has become one of the first health board in Scotland to trial a new physio clinic app to unlock faster, personalised treatment for patients.

The new platform – called Flok Health – provides same-day access to automated, responsive video appointments with an AI physiotherapist via a smartphone app.

Flok is the first platform of its kind to have been approved by the Care Quality Commission as a registered healthcare provider, creating a brand new treatment pathway for physiotherapy patients.

Alison MacDonald, Executive Nurse Director, NHS Lothian, said: “Technological developments such as Flok have the potential to substantially improve the care and journey for some people with back pain by complimenting the range of healthcare services available.

“We’re looking forward to continuing working with Flok to further understand and explore the potential for how we could integrate such technology with our current therapy provision.”

As part of a series of three-month pilot studies between May and December 2023, over 1000 NHS staff who were suffering from back pain self-referred to Flok’s AI physiotherapy clinic to receive treatment.

An initial video assessment was held with each of the staff members from NHS Lothian, NHS Borders, Cambridge University Hospitals, and Royal Papworth Hospital NHS Foundation Trust, and an AI physiotherapist to evaluate their symptoms and ensure Flok could safely provide the right treatment for their condition.

Once approved for treatment, patients had a weekly AI video appointment with their digital physio, which could be accessed at a time that suited them from the comfort of their own home.

During these appointments, the AI physiotherapist was able to prescribe exercises and pain management techniques, monitor each patient’s symptoms, and adjust their treatment in real-time.

The majority of patients were initially prescribed six treatment appointments with Flok’s AI physio. After these weekly appointments had been completed, patients were given unlimited access to personalised sessions for several months, during which they could focus on preventative care and reducing the risk of recurrent issues, in line with their needs.

Nearly all (97%) of the patients who self-referred to Flok within Lothian received an automated triage outcome. More than nine out of 10 (92%) were immediately approved for AI physio and given access to an appointment that same day. A handful (5%) were automatically referred to another NHS service, including NHS 111 or their GP).

The remaining three per cent of patients were given an additional assessment via telehealth appointment with a member of Flok’s clinical team. All but one of these individuals were then cleared to receive treatment with the AI physio, with the remaining patient successfully referred to an alternative service for urgent care.

In the latest service evaluation, all of the patients who took part in the survey said their experience with Flok had been at least equivalent to seeing a human physiotherapist, with nearly six in 10 (57%) of patients saying they thought the AI physio experience was better than the traditional alternative.

The digital service was also effective, with more than four in five participants (86%) reporting that their symptoms had improved during treatment with the Flok platform.

Finn Stevenson, Co-Founder and CEO at Flok Health, said: “Around 11 million people suffer from back pain in the UK and 20% of us will visit our GP with a musculoskeletal problem each year. But it’s getting harder and harder for patients to access the physiotherapy they need.

“Creating faster, more convenient access to physiotherapy services is vital to tackling this crisis. Harnessing new technologies, like AI, can help us unlock individualised treatment for thousands of patients, while reducing pressure on NHS services and freeing up capacity for treating those in need of in-person care.

“We’re proud to be leading the charge on this at Flok. It has been incredible to see the positive impact that AI physiotherapy can have throughout our initial trials with NHS Lothian, NHS Borders, Cambridge University Hospitals and Royal Papworth Hospital NHS Foundation Trust. We’re excited to be working closely with the NHS to develop this new technology and create a new care model for on-demand personalised treatment at population scale.”

For more information on FLOK check Flok Health

First trams on route to Newhaven

A little piece of local history was made on Monday night (13 March), when the first tram in over 65 years ran down Leith Walk, as the Trams to Newhaven project nears completion.

Ahead of the route opening for service in spring 2023, a period of testing and commissioning is required to ensure the newly constructed line, software and signals work effectively and safely.

On Monday, the first stage of testing began, which involves trams travelling at walking pace along small sections of the route, starting at Picardy Place. This will continue through the week, taking place during the night to minimise traffic disruption.

Once the first stage is completed, the frequency and speed of tram testing will increase, and trams will start running to a timetable. Drivers on the route have carried out significant training in the lead-up to testing, including on a state-of-the-art simulator.

People are still being encouraged to take care and be aware of the presence of trams on the route for the first time over the coming weeks.

Councillor Scott Arthur, Transport and Environment Convener, said: “This is a huge milestone for Trams to Newhaven as we see the first trams on Leith Walk in my lifetime.

“We’re fast approaching the start of passenger services this spring, and that the project is set to be delivered on time and within budget, despite the challenges of recent years, is testament to the hard work of all those involved.

“Bringing the tram to Newhaven will be transformative for the area, and the wider city. As well as boosting the economy and providing sustainable, high-capacity public transport to this densely populated part of Edinburgh, the project has significantly improved the entire route, with new cycle links, spaces to relax and spend time and newly planted trees and shrubs.

“As we enter the final phase of the project, testing and commissioning will make sure the line and infrastructure works safely and efficiently, while also confirming service capacity. Of course, this is the first time there will be trams on Leith Walk and in Leith in recent years so I would urge people to take extra care when in the area.”

Lea Harrison, Managing Director of Edinburgh Trams, said: “To see one of our trams running along Leith Walk was a proud moment for us, and this latest milestone in the project will enable us to step up our own preparations for the launch of passenger services to Newhaven.

“This includes real-world driver training on the new section of line following an intense period of familiarisation involving our state-of-the-art tram simulator.”

You could argue that this ‘historic’ event is actually running years late. The line to Newhaven and the Granton Spur were part of the original TIE network plans. The trams fiasco is the subject to a long-running inquiry led by Lord Hardie which is investigating the reasons why ‘the Edinburgh Tram project incurred delays, cost more than originally budgeted and through reductions in scope delivered significantly less than projected.’

The council maintains that the Trams to Newhaven project ‘remains on schedule for completion by spring 2023 and within the £207.3m budget, with all major construction now complete’. A specific date for when the route will be open for passengers will be announced in due course.

As part of the commissioning process every aspect of the new infrastructure will be thoroughly tested to ensure it meets the required safety standards.

There will be some bus diversions around Leith Walk in place overnight during the week commencing 13 March to allow for the testing. 

The latest information on diversions is available on the Lothian Buses website.

The council warns: ‘Due to industry wide challenges with the availability of materials and skilled labour, impacted by Brexit and the war in Ukraine along with significant demand for labour in the UK and overseas, there are small pockets of public realm works that will now be completed over the coming months.’

Full details of the programme are available on the Trams to Newhaven website.

Maria Ortega, Sacyr Farrans Neopul (SFN), project director on Trams to Newhaven, said: “As contractors on the Trams to Newhaven project, the Sacyr Farrans Neopul JV team are extremely proud to be achieving this huge milestone.  

“We have been working successfully alongside our partners, supply chain and client for over four years to deliver this significant project in Edinburgh, Scotland.

“Despite the challenges of unprecedented times experienced throughout the life cycle of the project, seeing the first tram travelling down the newly completed line as part of the testing and commissioning process will be a memorable moment.

“The testing and commissioning phase will allow the new systems and infrastructure to be integrated into the existing tram network.

“As we reach the final stages of delivering this key piece of infrastructure to the people of the city, we appreciate the public’s continued support during this final technical phase of the project.”

Steven Jackson, Director, Turner & Townsend, said: “As the City of Edinburgh Council’s delivery partner for the Trams to Newhaven project, we’re delighted to have reached this significant milestone with the commencement of the testing and commissioning period, which will see trams travelling the full route.

“Following approval of the project in March 2019, we have worked closely with all members of the project team and third parties through an early contractor involvement period, significant utility diversions, and the install of new infrastructure and systems.

“The complexity of this ambitious project has required the team to tackle and overcome many challenges along the way, but collaboration has been key.

“We look forward to successfully delivering this major transport project in line with the programme set out in the final business case; and the start of the passenger services this Spring.”

Find out more about Trams to Newhaven, including landscape plans and timelines.

Scotland men’s hockey squad faces Ireland in three-match series

The Scotland men’s squad has been announced for a three-match series against Ireland at Titwood this week.

The uncapped series began last night with an entertaining 1-1 draw and the nations will meet again over the weekend (Saturday 24 July at 4pm, and Sunday 25 July at 11:30am).

Due to Covid restrictions the maximum capacity is 50 spectators; Clydesdale Hockey Club is managing a ‘first come first served’ entry process for the matches, with doors open from one hour ahead of push back.

These matches come as the Scots build towards European competition. Scotland men are due to play at Men’s EuroHockey Championship II on 15-21 August in Gniezno, Poland, where they will face Austria, Switzerland and Ukraine in Pool B. Ireland, Italy, Croatia and Poland will also feature at the tournament.

The Blue Sticks will be battling for promotion back to the top tier of European hockey at the tournament in August. The Scots won EuroHockey Championship II back in 2017 in front of a full house in Glasgow, before goal difference saw them relegated from the EuroHockey Championships in 2019.

Match 1

Tommy Alexander (Uhlenhorst)

David Forrester (Grange)

Dan Coultas (Watsonians)

Murray Collins (Teddington)

Robbie Croll (Edinburgh University)

Gordon Amour (Cambridge City)

Duncan Riddell (Grange)

Robbie Shepherdson (Grange)

Michael Bremner (Uhlenhorst)

Rob Field (Holcombe)

Callum Mackenzie (Wimbledon)

Lee Morton (Old Georgians)

Hamish Imrie (Royal Antwerp)

Cammy Golden (Uhlenhorst)

Andrew McConnell (Western Wildcats)

Rob Harwood (Western Wildcats)

Jamie Golden (Surbiton)

Struan Walker (Club an der Alster)

Match 2

David Forrester (Grange)

Rory McCallum (Teddington)

Dan Coultas (Watsonians)

Murray Collins (Teddington)

Aidan McQuade (Qui Vive)

Gordon Amour (Cambridge City)

Robbie Croll (Edinburgh University)

Robbie Shepherdson (Grange)

Michael Bremner (Uhlenhorst)

Rob Field (Holcombe)

Hamish Galt (Western Wildcats)

Lee Morton (Old Georgians)

Gavin Byers (Grobflottbeker)

Cammy Golden (Uhlenhorst)

Andrew McConnell (Western Wildcats)

Rob Harwood (Western Wildcats)

Ed Greaves (Teddington)

Struan Walker (Club an der Alster)

Match 3

Tommy Alexander (Uhlenhorst)

Sam Lloyd (East Grinstead)

Dan Coultas (Watsonians)

Murray Collins (Teddington)

Aidan McQuade (Qui Vive)

Duncan Riddell (Grange)

Robbie Croll (Edinburgh University)

Robbie Shepherdson (Grange)

Michael Bremner (Uhlenhorst)

Rob Field (Holcombe)

Callum Mackenzie (Wimbledon)

Lee Morton (Old Georgians)

Hamish Imrie (Royal Antwerp) 

Cammy Golden (Uhlenhorst)

Andrew McConnell (Western Wildcats)

Ed Greaves (Teddington)

Jamie Golden (Surbiton)

Gavin Byers (Grobflottbeker)

Action Meso Day

Action Mesothelioma Day (Action Meso Day), an annual event to raise awareness of mesothelioma and the dangers of asbestos, will this year be a virtual event hosted by broadcaster, academic, and mesothelioma patient, Kate Williams.

The UK has the world’s highest incidence of mesothelioma, a type of cancer caused by exposure to asbestos, with more than 2,700 people diagnosed each year. Over 1600 schools in Scotland contain asbestos.

Hosted by the UK Mesothelioma Alliance (UKMA) as part of its ActionMeso campaign, the event will be held from 12.30pm to 1.30pm on Friday 2 July.

It will include panel discussions, clinical trials updates, expert insights and patient stories for anyone affected by mesothelioma. ActionMeso supporters, including support groups and charities in Scotland, will be hosting their own activities before or after the main event.

Patients, family members, friends, carers, local dignitaries, healthcare professionals, asbestos removal companies, law firms and anyone interested in mesothelioma and the dangers of asbestos are invited to join the event.

Registration is free at www.actionmeso.org/amd21 and the hashtag #ActionMeso will be used on social media platforms.

Kate Williams, broadcaster, academic, mesothelioma patient and host for the national event, said: “I was honoured to be asked to host Action Meso Day 2021. As a peritoneal mesothelioma patient myself, I am all too aware of the importance of raising awareness of the disease and the dangers of asbestos.

“This is a chance to hear from people directly affected by this cancer and along with other patients, I will be sharing my story. We’ll also be learning about the latest in treatment and care from healthcare professionals.

“Events like this and the #ActionMeso campaign are vital if we are to see companies and the government take action and prevent other families being affected by this disease.”

Phyllis Craig MBE, Director of Action on Asbestos said, “Our charity is proud to be part of an initiative that brings people together to raise awareness that mesothelioma is a preventable condition.

“Being a charity that covers the whole of Scotland we know only too well the devastation that is caused to those diagnosed with mesothelioma and their families, especially when this condition is caused through no fault of their own.

“The fact that asbestos remains in over 1600 schools in Scotland is terrifying, because this means that we may continue to see more people being diagnosed with mesothelioma in another 20 to 30 years. If we stand united, we can eradicate asbestos from all public buildings and safeguard our future – our children.”

Statistics show that 94 per cent of mesothelioma cases in the UK are caused by workplace exposures and are preventable.

ActionMeso is campaigning to promote the Mesothelioma Patient Charter to employers, healthcare providers and politicians in all the nations of the United Kingdom, which sets out the action needed to prevent this disease and ensure more families do not suffer.