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https://www.readbyqxmd.com/read/30384371/ten-year-evaluation-of-the-toyota-prehospital-stroke-scale-for-tissue-plasminogen-activator-intravenous-therapy-in-the-real-world
#1
Junichiro Suzuki, Noriyoshi Nakai, Naohide Kondo, Hirotake Tsuji, Ryosuke Inagaki, Soma Furukawa, Mai Iwata, Suguru Nishida, Yasuhiro Ito
BACKGROUND: Emergency medical services are an important part of acute stroke management. We devised a prehospital stroke scale, the TOYOTA prehospital stroke scale for tissue plasminogen activator (t-PA) intravenous therapy (TOPSPIN) for triaging patients with ischemic stroke and especial indications for intravenous t-PA therapy in December 2006; this scale comprises 5 items including consciousness, atrial fibrillation, language disorder, disturbance of the upper extremities, and disturbance of the lower extremities...
November 1, 2018: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/30364030/knowledge-and-attitudes-of-saudi-emergency-physicians-toward-t-pa-use-in-stroke
#2
Ali M Al Khathaami, Haya Aloraini, S Almudlej, Haifa Al Issa, Nourhan Elshammaa, Sami Alsolamy
Background and Objectives: Tissue plasminogen activator (t-PA) within 4.5 hours from onset improves outcome in patients with ischemic stroke and has been recommended by several international guidelines. Since its approval in 1996, the debate among emergency physicians continues particularly around the result interpretation of the first positive randomized controlled trial, the National Institute of Neurological Disorders and Stroke (NINDS) clinical trial. This lack of consensus might negatively affect the delivery of effective stroke care...
2018: Neurology Research International
https://www.readbyqxmd.com/read/30334303/favorable-renal-outcomes-after-intravenous-thrombolytic-therapy-for-acute-ischemic-stroke-clinical-implication-of-kidney-brain-axis
#3
Teng-Hsiang Chang, Ping-Fang Chiu, Chun-Chieh Tsai, Chin-Hua Chang, Chia-Lin Wu, Chew-Teng Kor, Jhao-Rong Li, Cheng-Ling Kuo, Ching-Shan Huang, Cheng-Chung Chu, Chih-Ming Lin, Chia-Chu Chang
BACKGROUND AND PURPOSE: Recombinant tissue plasminogen activator (rt-PA) administration is the most prevalent treatment for acute ischemic within golden time. However, the effects of rt-PA on the kidney function in such patients remain unknown. This study determined long-term renal outcomes in patients with acute ischemic stroke receiving systemic rt-PA. METHODS: We enrolled patients who were hospitalized for acute ischemic stroke from January 2001 to January 2017...
October 17, 2018: Nephrology
https://www.readbyqxmd.com/read/30268531/effect-of-clot-stiffness-on-recombinant-tissue-plasminogen-activator-lytic-susceptibility-in-vitro
#4
Karla P Mercado-Shekhar, Robert T Kleven, Hermes Aponte Rivera, Ryden Lewis, Kunal B Karani, Hendrik J Vos, Todd A Abruzzo, Kevin J Haworth, Christy K Holland
The lytic recombinant tissue plasminogen activator (rt-PA) is the only drug approved by the Food and Drug Administration for treating ischemic stroke. Less than 40% of patients with large vessel occlusions who are treated with rt-PA have improved blood flow. However, up to 6% of all patients receiving rt-PA develop intracerebral hemorrhage. Predicting the efficacy of rt-PA treatment a priori could help guide therapeutic decision making, such that rt-PA is administered only to those individuals who would benefit from this treatment...
December 2018: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/30119797/surgical-management-of-submacular-hemorrhage-experience-at-an-academic-canadian-centre
#5
Verena R Juncal, Mostafa Hanout, Filiberto Altomare, David R Chow, Louis R Giavedoni, Rajeev H Muni, David T Wong, Alan R Berger
OBJECTIVE: To report the anatomical and visual outcomes of patients with thick submacular hemorrhage (SMH) treated with pars plana vitrectomy (PPV), subretinal tissue plasminogen activator (t-PA), and pneumatic displacement. DESIGN: Single-centre, retrospective case series. PARTICIPANTS: A total of 99 eyes of 99 consecutive patients with thick SMH secondary to any underlying etiology treated with PPV with subretinal t-PA and pneumatic displacement by 6 vitreoretinal surgeons at St...
August 2018: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
https://www.readbyqxmd.com/read/30014239/the-intraventricular-spot-sign-prevalence-significance-and-relation-to-hematoma-expansion-and-outcomes
#6
Omar Hussein, Khalid Sawalha, Mohammad Hamed, Ahmed Abd ElAzim, Lai Wei, Michel T Torbey, Archana Hinduja
BACKGROUND: The presence of the spot sign on computed tomography angiogram (CTA) is considered a sign of active bleeding, and studies have shown it can predict hematoma expansion in intraparenchymal hemorrhage (IPH). The spot sign in intraventricular hemorrhage (IVH) has not been explored yet. The purpose of this study is to estimate the prevalence of the intraventricular-spot sign, and its prediction of hematoma expansion and clinical outcomes. METHODS: We retrieved data of hemorrhagic stroke patients seen at our medical center from January 2013 to January 2018...
October 2018: Journal of Neurology
https://www.readbyqxmd.com/read/29921716/acute-complement-inhibition-potentiates-neurorehabilitation-and-enhances-tpa-mediated-neuroprotection
#7
Ali Alawieh, Meredith Andersen, DeAnna L Adkins, Stephen Tomlinson
Because complement activation in the subacute or chronic phase after stroke was recently shown to stimulate neural plasticity, we investigated how complement activation and complement inhibition in the acute phase after murine stroke interacts with subsequent rehabilitation therapy to modulate neuroinflammation and neural remodeling. We additionally investigated how complement and complement inhibition interacts with tissue plasminogen activator (tPA), the other standard of care therapy for stroke, and a U...
July 18, 2018: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/29851904/high-dose-factor-xiii-administration-induces-effective-hemostasis-for-trauma-associated-coagulopathy-tac-both-in-vitro-and-in-rat-hemorrhagic-shock-in-vivo-models
#8
Futoshi Nagashima, Satoshi Inoue, Hiroyuki Koami, Toru Miike, Yuichiro Sakamoto, Keita Kai
BACKGROUND: Trauma-associated coagulopathy (TAC) is an early and primary complication in severe trauma patients. Factor XIII (FXIII) is reported to stabilize a clot in the late phase of the coagulation cascade. The goal of this study was to investigate whether the administration of FXIII improves the condition of TAC both in vitro and in vivo. METHODS: We evaluated the effects of different doses, including a very high dose of FXIII (3.6-32.4 IU/mL) on tissue-plasminogen activator-induced hyperfibrinolysis and the combined condition of dilutional coagulopathy and tissue-plasminogen activator-induced hyperfibrinolysis in vitro...
September 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29850586/pinocembrin-protects-blood-brain-barrier-function-and-expands-the-therapeutic-time-window-for-tissue-type-plasminogen-activator-treatment-in-a-rat-thromboembolic-stroke-model
#9
YinZhong Ma, Li Li, LingLei Kong, ZhiMei Zhu, Wen Zhang, JunKe Song, Junlei Chang, GuanHua Du
Tissue-type plasminogen activator (t-PA) remains the only approved therapy for acute ischemic stroke but has a restrictive treatment time window of 4.5 hr. Prolonged ischemia causes blood-brain barrier (BBB) damage and increases the incidence of hemorrhagic transformation (HT) secondary to reperfusion. In this study, we sought to determine the effect of pinocembrin (PCB; a pleiotropic neuroprotective agent) on t-PA administration-induced BBB damage in a novel rat thromboembolic stroke model. By assessing the leakage of Evans blue into the ischemic hemisphere, we demonstrated that PCB pretreatment 5 min before t-PA administration significantly reduced BBB damage following 2 hr, 4 hr, 6 hr, and even 8 hr ischemia...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29681849/danhong-injection-combined-with-t-pa-improves-thrombolytic-therapy-in-focal-embolic-stroke
#10
Min Li, Jing Zhou, Weifeng Jin, Xiaohong Li, Yuyan Zhang
Background: Hemorrhagic transformation, neurotoxicity, short treatment time windows, and other defects are considered as the major limitations for the thrombolytic therapy. This study is devoted to figure out whether Danhong injection (DHI) combined with tissue-plasminogen activator (t-PA) could extend the treatment time windows and ameliorate brain injury, hemorrhagic complication and BBB disruption after focal embolic stroke. Methods: In vitro , the combined concentrations of DHI and t-PA were added to wells reacted with plasminogen and D-Val-Leu-Lys-AMC...
2018: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29675813/computational-model-for-hyperfibrinolytic-onset-of-acute-traumatic-coagulopathy
#11
Tie Bo Wu, Sheng Wu, Matthew Buoni, Thomas Orfeo, Kathleen Brummel-Ziedins, Mitchell Cohen, Linda Petzold
The onset of acute traumatic coagulopathy in trauma patients exacerbates hemorrhaging and dramatically increases mortality. The disease is characterized by increased localized bleeding, and the mechanism for its onset is not yet known. We propose that the fibrinolytic response, specifically the release of tissue-plasminogen activator (t-PA), within vessels of different sizes leads to a variable susceptibility to local coagulopathy through hyperfibrinolysis which can explain many of the clinical observations in the early stages from severely injured coagulopathic patients...
August 2018: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/29503629/a-score-for-risk-of-thrombolysis-associated-hemorrhage-including-pretreatment-with-statins
#12
Hebun Erdur, Alexandros Polymeris, Ulrike Grittner, Jan F Scheitz, Serdar Tütüncü, David J Seiffge, Heinrich J Audebert, Christian H Nolte, Stefan T Engelter, Andrea Rocco
Background: Symptomatic intracranial hemorrhage (sICH) after intravenous thrombolysis with recombinant tissue-plasminogen activator (rt-PA) for acute ischemic stroke is associated with a poor functional outcome. We aimed to develop a score assessing risk of sICH including novel putative predictors-namely, pretreatment with statins and severe renal impairment. Methods: We analyzed our local cohort (Berlin) of patients receiving rt-PA for acute ischemic stroke between 2006 and 2016...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29449886/off-label-use-of-iv-t-pa-in-patients-with-intracranial-neoplasm-and-cavernoma
#13
Christopher Jan Schwarzbach, Anne Ebert, Michael G Hennerici, Eva Neumaier-Probst, Michael Platten, Marc Fatar
Background: The safety of systemic thrombolysis in patients with intracranial tumor and cavernoma are unknown. So far evidence is limited to a number of case reports and few case series or unspecified data based on population-based analysis. Our aim was to comprehend the risk of systemic thrombolysis in these patients. Methods: Patients with additional evidence of intracranial tumor or cavernoma who received IV tissue plasminogen activator (t-PA) treatment at our comprehensive stroke center over a period of 7 years were identified in our stroke database and compared to the same number of matched control subjects without any evidence of intracranial tumor and cavernoma...
2018: Therapeutic Advances in Neurological Disorders
https://www.readbyqxmd.com/read/29275501/baicalin-attenuates-blood-brain-barrier-disruption-and-hemorrhagic-transformation-and-improves-neurological-outcome-in-ischemic-stroke-rats-with-delayed-t-pa-treatment-involvement-of-onoo-mmp-9-pathway
#14
Hansen Chen, Binghe Guan, Xi Chen, Xingmiao Chen, Caiming Li, Jinhua Qiu, Dan Yang, Ke Jian Liu, Suhua Qi, Jiangang Shen
Tissue plasminogen activator (t-PA) has a restrictive therapeutic window within 4.5 h after ischemic stroke with the risk of hemorrhagic transformation (HT) and neurotoxicity when it is used beyond the time window. In the present study, we tested the hypothesis that baicalin, an active compound of medicinal plant, could attenuate HT in cerebral ischemia stroke with delayed t-PA treatment. Male Sprague-Dawley rats were subjected to middle cerebral artery occlusion (MCAO) for 4.5 h and then continuously received t-PA infusion (10 mg/kg) for 0...
October 2018: Translational Stroke Research
https://www.readbyqxmd.com/read/29107671/evaluation-of-the-effects-of-a-new-series-of-smtps-in-the-acetic-acid-induced-embolic-cerebral-infarct-mouse-model
#15
Keita Shibata, Terumasa Hashimoto, Keiji Hasumi, Kazuo Honda, Koji Nobe
We reported previously that Stachybotrys microspora triprenyl phenol-7 (SMTP-7) showed potential thrombolytic, anti-inflammatory and anti-oxidant effects that account for its excellent pharmacological activity such as having a wider therapeutic time window than tissue plasminogen activator (t-PA) and a significant protection against hemorrhage. The aim of the present study was to evaluate and compare the effect of a new series of SMTPs in the acetic acid-induced embolic cerebral infarct mouse model. Thrombotic occlusion was produced in mice by inducing the transfer of acetic acid-induced thrombi from the right common carotid artery into the brain...
January 5, 2018: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28944694/tissue-plasminogen-activator-based-nanothrombolysis-for-ischemic-stroke
#16
Shan Liu, Xiaozhou Feng, Rong Jin, Guohong Li
Thrombolysis with intravenous tissue plasminogen activator (tPA) is the only FDA approved treatment for patients with acute ischemic stroke, but its use is limited by narrow therapeutic window, selective efficacy, and hemorrhagic complication. In the past two decades, extensive efforts have been undertaken to extend its therapeutic time window and explore alternative thrombolytic agents, but both show little progress. Nanotechnology has emerged as a promising strategy to improve the efficacy and safety of tPA...
February 2018: Expert Opinion on Drug Delivery
https://www.readbyqxmd.com/read/28836238/protective-effects-of-autologous-bone-marrow-mononuclear-cells-after-administering-t-pa-in-an-embolic-stroke-model
#17
Bing Yang, Weilang Li, Nikunj Satani, Duyen M Nghiem, XiaoPei Xi, Jaroslaw Aronowski, Sean I Savitz
Tissue plasminogen activator (t-PA) is the only FDA-approved drug for acute ischemic stroke but poses risk for hemorrhagic transformation (HT). Cell therapy has been investigated as a potential therapy to improve recovery after stroke by the modulation of inflammatory responses and the improvement of blood-brain barrier (BBB) integrity, both of which are associated with HT after t-PA. In our present study, we studied the effect of autologous bone marrow mononuclear cells (MNCs) in an embolic stroke model. We administered MNCs in a rat embolic stroke 2 h after administering t-PA...
April 2018: Translational Stroke Research
https://www.readbyqxmd.com/read/28660209/intravenous-thrombolysis-in-acute-ischemic-stroke-with-active-cancer
#18
Ki-Woong Nam, Chi Kyung Kim, Tae Jung Kim, Sang Joon An, Kyungmi Oh, Sang-Bae Ko, Byung-Woo Yoon
Ischemic stroke patients with active cancer are known to have poor clinical outcomes. However, the efficacy and safety of intravenous alteplase (IV t-PA) in this group are still unclear. In this study, we aimed to evaluate whether stroke patients with cancer had poor clinical outcomes after use of IV t-PA. We reviewed ischemic stroke patients with active cancer treated with isolated IV t-PA between April 2010 and March 2015 at three national university hospitals from the registry for ischemic stroke in Korea...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28600208/purification-and-partial-characterization-of-a-low-molecular-fibrinolytic-serine-metalloprotease-c142-from-the-culture-supernatant-of-bacillus-subtilis-c142
#19
Jun-Hui Choi, Jung-Eun Kim, Seung Kim, Jaewoo Yoon, Dae-Hun Park, Hyun-Jae Shin, Hyo-Jeong Lee, Seung-Sik Cho
Novel serine metalloprotease-like enzyme, C142 was purified from the culture supernatant of Bacillus subtilis C142. The C142 was purified to homogeneity by a two-step procedure with a 20.7-fold increase in specific activity and 0.9% recovery. The molecular mass of C142 was approximately 23.5kDa based on SDS-PAGE. The N-terminal amino acid sequence of the first 21 amino acids of C142 was AQSVPYGISQIKAPALHSQGY. Its optimum pH, optimum temperature, pH stability, and thermal stability were pH 6, 40°C, pH 6-8, and 20-35°C, respectively...
November 2017: International Journal of Biological Macromolecules
https://www.readbyqxmd.com/read/28500652/freeze-dried-plasma-enhances-clot-formation-and-inhibits-fibrinolysis-in-the-presence-of-tissue-plasminogen-activator-similar-to-pooled-liquid-plasma
#20
Benjamin R Huebner, Ernest E Moore, Hunter B Moore, Angela Sauaia, Gregory Stettler, Monika Dzieciatkowska, Kirk Hansen, Anirban Banerjee, Christopher C Silliman
BACKGROUND: Systemic hyperfibrinolysis is an integral part of trauma-induced coagulopathy associated with uncontrolled bleeding. Recent data suggest that plasma-first resuscitation attenuates hyperfibrinolysis; however, the availability, transport, storage, and administration of plasma in austere environments remain challenging and have limited its use. Freeze-dried plasma (FDP) is a potential alternative due to ease of storage, longer shelf life, and efficient reconstitution. FDP potentially enhances clot formation and resists breakdown better than normal saline (NS) and albumin and similar to liquid plasma...
August 2017: Transfusion
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