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https://www.readbyqxmd.com/read/29774194/improper-use-of-thrombolytic-agents-in-acute-hemiparesis-following-misdiagnosis-of-acute-ischemic-stroke
#1
Min Chan Kim, Seok Won Kim
Objective: Acute hemiparesis is often an early presentation of acute ischemic stroke, though it can occur in various disorders. This study aimed to investigate the improper use of thrombolytic agents for patients with acute hemiparesis, following the misdiagnosis of acute ischemic stroke. Methods: We analyzed the clinical and radiological data of nine patients initially misdiagnosed with cerebral stroke in the emergency room from May 2013 to January 2017. All the patients were treated with tissue plasminogen activator (TPA) owing to the presence of acute hemiparesis...
April 2018: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/29773569/mobile-stroke-unit-reduces-time-to-image-acquisition-and-reporting
#2
E M Nyberg, J R Cox, R G Kowalski, D V Duarte, B Schimpf, W J Jones
Timely administration of thrombolytic therapy is critical to maximizing the likelihood of favorable outcomes in patients with acute ischemic stroke. Although emergency medical service activation overall improves the timeliness of acute stroke treatment, the time from emergency medical service dispatch to hospital arrival unavoidably decreases the timeliness of thrombolytic administration. Our mobile stroke unit, a new-generation ambulance with on-board CT scanning capability, reduces key imaging time metrics and facilitates in-the-field delivery of IV thrombolytic therapy...
May 17, 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29768935/catheter-directed-thrombolysis-with-a-continuous-infusion-of-low-dose-alteplase-for-subacute-proximal-venous-thrombosis-efficacy-and-safety-compared-to-urokinase
#3
Maofeng Gong, Xu He, Jinhua Song, Boxiang Zhao, Wanyin Shi, Guoping Chen, Jianping Gu
The purpose of this study was to compare the efficacy and safety associated with catheter-directed thrombolysis (CDT) using either recombinant tissue plasminogen activator (rt-PA) or urokinase (UK) for subacute deep venous thrombosis (DVT). From January 2014 to December 2016, we conducted a retrospective analysis on a total of 49 patients who underwent consistent CDT with either rt-PA (rt-PA-CDT group) or UK (UK-CDT group) treatment. The thrombolytic rate of the rt-PA-CDT group was significantly higher than that of the UK-CDT group (87...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29763939/erratum-intra-arterial-thrombolytic-therapy-is-not-a-therapeutic-option-for-filler-related-central-retinal-artery-occlusion
#4
Yi-Chun Chen, Hsiu-Mei Wu, Shih-Jen Chen, Han-Jui Lee, Jiing-Feng Lirng, Chung-Jung Lin, Feng-Chi Chang, Chao-Bao Luo, Wan-Yuo Guo
No abstract text is available yet for this article.
May 15, 2018: Facial Plastic Surgery: FPS
https://www.readbyqxmd.com/read/29755795/double-bolus-alteplase-therapy-during-cardiopulmonary-resuscitation-for-cardiac-arrest-due-to-massive-pulmonary-embolism-guided-by-focused-bedside-echocardiography
#5
Hafiz B Mahboob, Bruce W Denney
Massive pulmonary embolism (PE) frequently leads to cardiac arrest (CA) which carries an extremely high mortality rate. Although available, randomized trials have not shown survival benefits from thrombolytic use. Thrombolytics however have been used successfully during resuscitation in clinical practice in multiple case reports and in retrospective studies. Recent resuscitation guidelines recommend using alteplase for PE related CA; however they do not offer a standardized treatment regimen. The most consistently applied approach is an intravenous bolus of 50 mg tissue plasminogen activator (t-PA) early during cardiopulmonary resuscitation (CPR)...
2018: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29752695/sodium-tanshinone-ii-a-sulfonate-for-coronary-heart-disease-a-systematic-review-of-randomized-controlled-trials
#6
Mei-Li Yu, Si-Ming Li, Xiang Gao, Jin-Gen Li, Hao Xu, Ke-Ji Chen
OBJECTIVE: To assess whether an adjunctive therapy of Sodium Tanshinone II A Sulfonate Injection (STS) is effective and safe in improving clinical outcomes in patients with coronary heart disease (CHD). METHODS: literature search was conducted through PubMed, the Cochrane Library, Knowledge Infrastructure Databases (CNKI), Chinese Biomedical Literature Database (SinoMed), Chinese Science and Technology Periodical Database (VIP) and Wanfang Database up to August 2017...
May 11, 2018: Chinese Journal of Integrative Medicine
https://www.readbyqxmd.com/read/29750227/facilitators-context-of-and-barriers-to-acute-coronary-syndrome-care-at-kenyatta-national-hospital-nairobi-kenya-a-qualitative-analysis
#7
Ehete Bahiru, Tecla Temu, Julia Mwanga, Kevin Ndede, Sophie Vusha, Bernard Gitura, Carey Farquhar, Frederick Bukachi, Mark D Huffman
BACKGROUND: The prevalence of ischaemic heart disease and its acute manifestation, acute coronary syndrome (ACS), is growing throughout sub-Saharan Africa, including Kenya. To address this increasing problem, we sought to understand the facilitators, context of and barriers to ACS care at Kenyatta National Hospital, with the aim of improving the quality of care of ACS. METHODS: We conducted in-depth interviews with healthcare providers involved in the management of ACS patients from January to February 2017 at Kenyatta National Hospital in Nairobi, Kenya...
April 20, 2018: Cardiovascular Journal of Africa
https://www.readbyqxmd.com/read/29749281/is-the-removal-of-a-central-venous-catheter-always-necessary-in-the-context-of-catheter-related-right-atrial-thrombosis
#8
Luigi Rossi, Pasquale Libutti, Francesco Casucci, Piero Lisi, Annalisa Teutonico, Carlo Basile, Carlo Lomonte
Catheter-related right atrial thrombosis is a severe and life-threatening complication of central venous catheters in both adult and young patients. Catheter-related right atrial thrombosis can occur with any type of central venous catheters, utilized either for hemodialysis or infusion. Up to 30% of patients with central venous catheter are estimated to be affected by catheter-related right atrial thrombosis; however, neither precise epidemiological data nor guidelines regarding medical or surgical treatment are available...
May 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29742224/massive-hemoptysis-successfully-treated-with-extracorporeal-membrane-oxygenation-and-endobronchial-thrombolysis
#9
Antônio Aurélio de Paiva Fagundes Júnior, Renato Bueno Chaves, Amanda Robassini Dos Santos, Humberto Alves de Oliveira, Marcello Henrique Paschoal
Extracorporeal membrane oxygenation has been used to treat refractory hypoxemia in numerous clinical scenarios. The fundamental principles for the management of massive hemoptysis patients include protecting the airway and healthy lung, locating the source of bleeding and controlling the hemorrhage. We report the case of a patient with acute respiratory failure associated with massive hemoptysis secondary to lung laceration during cardiac surgery. The use of extracorporeal membrane oxygenation allowed patient survival...
March 2018: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29726798/computational-simulations-assessment-of-mutations-impact-on-streptokinase-sk-from-a-group-g-streptococci-with-enhanced-activity-insights-into-the-functional-roles-of-structural-dynamics-flexibility-of-sk-and-stabilization-of-sk-%C3%AE-plasmin-catalytic-complex
#10
Faegheh Kazemi, Seyed Shahriar Arab, Nasir Mohajel, Malihe Keramati, Niloofar Niknam, Mohammad Mehdi Aslani, Farzin Roohvand
Streptokinase (SK), a plasminogen activator (PA) that converts inactive plasminogen (Pg) to plasmin (Pm), is a protein secreted by groups A, C and G streptococci (GAS, GCS and GGS, respectively), with high sequence divergence and functional heterogeneity. While roles of some residual changes in altered SK functionality are shown, the underlying structural mechanisms are less known. Herein, using computational approaches, we analyzed the conformational basis for the increased activity of SK from a GGS (SKG132) isolate with four natural residual substitutions (Ile33Phe, Arg45Gln, Asn228Lys, Phe287Ile) compared to the standard GCS (SKC)...
May 4, 2018: Journal of Biomolecular Structure & Dynamics
https://www.readbyqxmd.com/read/29724918/management-appropriateness-and-outcomes-of-patients-with-acute-pulmonary-embolism
#11
David Jimenez, Behnood Bikdeli, Deisy Barrios, Raquel Morillo, Rosa Nieto, Ina Guerassimova, Alfonso Muriel, Luis Jara-Palomares, Lisa Moores, Victor Tapson, Roger D Yusen, Manuel Monreal
Background: Studies have not well defined the impact of adherence to published guidelines on the outcomes of patients with acute pulmonary embolism ( PE ). Methods: In this prospective cohort study of patients admitted to a respiratory department (N=2096), we evaluated whether patients with PE had better outcomes if they were acutely managed according to international guidelines. Outcomes consisted of all-cause mortality, PE-related mortality, recurrent venous thromboembolism ( VTE ), and major bleeding events during the first month of follow-up after diagnosis...
May 3, 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29724190/association-between-different-acute-stroke-therapies-and-development-of-post-stroke-seizures
#12
Jillian Naylor, Arthur Thevathasan, Leonid Churilov, Ruibing Guo, Yunyun Xiong, Miriam Koome, Ziyi Chen, Ziyuan Chen, Xinfeng Liu, Patrick Kwan, Bruce C V Campbell
BACKGROUND: Epilepsy is a major complication of stroke. We aimed to establish whether there is an association between intravenous thrombolysis, intra-arterial thrombolysis and post stroke seizure (PSS) development. Improved understanding of the relationship between reperfusion therapies and seizure development may improve post-stroke monitoring and follow-up. METHODS: This was a retrospective, multicentre cohort study conducted at the Royal Melbourne Hospital and Jingling Hospital Nanjing...
May 3, 2018: BMC Neurology
https://www.readbyqxmd.com/read/29719556/association-of-blood-glucose-and-clinical-outcome-after-mechanical-thrombectomy-for-acute-ischemic-stroke
#13
Weston R Gordon, Russell M Salamo, Anit Behera, John Chibnall, Amer Alshekhlee, Richard C Callison, Randall C Edgell
Background: Elevated blood glucose levels following acute ischemic stroke have been associated with adverse clinical outcomes in thrombolytic and nonthrombolytic treated patients. The current study examined multiple blood glucose parameters and their association with modified Rankin Scale (mRS) score at 3 months following mechanical thrombectomy and hospital discharge. Methods: Acute ischemic stroke patients undergoing mechanical thrombectomy with a retrievable stent at two stroke centers were studied...
April 2018: Interventional Neurology
https://www.readbyqxmd.com/read/29718846/high-risk-pulmonary-embolism-assessed-by-transthoracic-echocardiography-a-case-report
#14
Jiahong Wu, Jing Zhang, Fangfang Yang, Chuanbao Li, Mei Ni
RATIONALE: Acute pulmonary embolism (APE) as a life-threatening illness may present with a wide range of manifestations. APE was diagnosed using computed tomographic pulmonary angiography (CTPA); however, transthoracic echocardiography (TTE) can reveal hemodynamic status. Early thrombolysis is the most effective therapy for the treatment of massive pulmonary embolism. PATIENTS CONCERNS: Herein, we report a case of high-risk APE with a wide range of manifestations, including chest pain, dyspnea, low-blood pressure, and syncope...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29717825/treatment-of-nonarteritic-acute-central-retinal-artery-occlusion
#15
Rahul A Sharma, Michael Dattilo, Nancy J Newman, Valerie Biousse
Central retinal artery occlusion (CRAO) is an event most often caused by an embolus originating in the ipsilateral carotid artery, aortic arch, or heart. CRAO may result from partial or complete occlusion of the central retinal artery (CRA), which acts as the primary blood supply to the inner neurosensory retina, and typically results in profound vision loss and permanent visual disability. No consensus has emerged regarding the optimal treatment of CRAO. All proposed treatments are of questionable efficacy and many have uncertain risk profiles...
May 2, 2018: Asia-Pacific Journal of Ophthalmology
https://www.readbyqxmd.com/read/29715283/leukoaraiosis-and-risk-of-intracranial-hemorrhage-and-outcome-after-stroke-thrombolysis
#16
Chun-Ming Yang, Chien-Ling Hung, Hui-Chen Su, Huey-Juan Lin, Chih-Hung Chen, Chou-Ching Lin, Han-Hwa Hu, Sheng-Hsiang Lin, Pi-Shan Sung
BACKGROUND: The impact of leukoaraiosis on the risk of symptomatic intracerebral hemorrhage (SICH) after stroke thrombolysis is conflicting, and the data on Asian populations are lacking. Therefore, in this study, we assessed the association between leukoaraiosis and SICH, and the association between leukoaraiosis and the 90-day functional outcome in the Asian population. METHODS: Data were collected from a two-center prospective registry of acute ischemic stroke patients given intravenous tissue plasminogen activator between 2006 and 2014...
2018: PloS One
https://www.readbyqxmd.com/read/29713600/spectrophotometric-analysis-of-thrombolytic-activity-sata-assay
#17
Masumeh Zamanlu, Morteza Eskandani, Reza Mohammadian, Nazila Entekhabi, Mohammad Rafi, Mehdi Farhoudi
Introduction: Measurement of thrombolytic activity is crucial for research and development of novel thrombolytics. It is a key factor in the assessment of the effectiveness of conventionally used thrombolytic therapies in the clinic. Previous methods used for the assessment of thrombolytic activity are often associated with some drawbacks such as being costly, time-consuming, complex with low accuracy. Here, we introduce a simple, economic, relatively accurate and fast method of spectrophotometric analysis of thrombolytic activity (SATA) assay, standardized by tissue plasminogen activator (tPA), which can quantitatively measure in vitro thrombolytic activity...
2018: BioImpacts: BI
https://www.readbyqxmd.com/read/29712879/low-levels-of-caveolin-1-predict-symptomatic-bleeding-after-thrombolytic-therapy-in-patients-with-acute-ischemic-stroke
#18
Mar Castellanos, Cecile van Eendenburg, Carme Gubern, Elisabet Kádár, Gemma Huguet, Josep Puig, Tomás Sobrino, Gerard Blasco, Joaquín Serena, Juan Manuel Sánchez
BACKGROUND AND PURPOSE: Experimental models of cerebral ischemia demonstrate that the decrease in the caveolin-1 membrane protein results in an increase in endothelial permeability. Because this phenomenon is responsible for hemorrhagic transformation (HT) after cerebral ischemia, we aimed to determine whether caveolin-1 levels may predict bleeding after recombinant tissue-type plasminogen activator (r-tPA) administration in patients with acute stroke. METHODS: We studied 133 patients with a first hemispheric stroke treated with r-tPA within 4...
April 30, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29710463/a-comprehensive-review-on-regulatory-effects-of-crocin-on-ischemia-reperfusion-injury-in-multiple-organs
#19
REVIEW
Ghaidafeh Akbari, Seyyed Ali Mard, Ali Veisi
Ischemia-reperfusion (I/R) injury affects o2 -dependent organs including liver, kidneys, heart, brain, and intestine. I/R injury is described as the cellular injury in an organ caused by ischemia and then further aggravated during the reperfusion due to intracellular alterations. It is a process that happens in clinical settings such as organ transplantation, reperfusion after thrombolytic therapy, and coronary angioplasty. Crocus sativus L. known as saffron used in folk medicine for its beneficial effects...
March 2018: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/29708218/stroke-code-simulation-benefits-advanced-practice-providers-similar-to-neurology-residents
#20
Muhib Khan, Grayson L Baird, Theresa Price, Tricia Tubergen, Omran Kaskar, Michelle De Jesus, Joseph Zachariah, Adam Oostema, Raymond Scurek, Robert R Coleman, Wendy Sherman, Cynthia Hingtgen, Tamer Abdelhak, Brien Smith, Brian Silver
Background: Advanced practice providers (APPs) are important members of stroke teams. Stroke code simulations offer valuable experience in the evaluation and treatment of stroke patients without compromising patient care. We hypothesized that simulation training would increase APP confidence, comfort level, and preparedness in leading a stroke code similar to neurology residents. Methods: This is a prospective quasi-experimental, pretest/posttest study. Nine APPs and 9 neurology residents participated in 3 standardized simulated cases to determine need for IV thrombolysis, thrombectomy, and blood pressure management for intracerebral hemorrhage...
April 2018: Neurology. Clinical Practice
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