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Thrombolytics

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https://www.readbyqxmd.com/read/29349406/thrombolytic-therapy-for-critical-limb-ischemia-in-a-jehovah-s-witness-with-severe-anemia
#1
Jeremy D Kauffman, T Joseph Watson, Joseph J Campbell
A patient's refusal to receive blood products can pose both clinical and ethical challenges to the surgeon. In this report, we review the case of a Jehovah's Witness presenting with critical lower limb ischemia and severe anemia for whom the decision of whether to perform thrombolytic therapy was complicated by his refusal to accept blood products. The case demonstrates that thrombolytic therapy can produce favorable results in severely anemic patients even when transfusion is not an option. We conclude that offering thrombolytic therapy in this context is a reasonable therapeutic option from both a clinical and ethical perspective...
September 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29345016/evaluation-of-the-implementation-of-a-24-hour-stroke-thrombolysis-emergency-treatment-for-patients-with-acute-ischemic-stroke
#2
Jun Zhao, Xingqiang Li, Yingchun Liang, Liang Zhao, Xinping Zhang, Yunlin Liu
AIMS AND OBJECTIVES: To assess the trends of intravenous (IV) thrombolysis with recombinant tissue plasminogen activator (rt-PA) among patients with acute ischemic stroke (AIS) admitted to our hospital between 2012 and 2014 and investigate the effects of a 24-hours (h) stroke thrombolysis emergency treatment on the intra-hospital clinical data and outcomes of these patients treated with IV rt-PA thrombolysis. BACKGROUND: Although pre-notification of stroke by emergency medical services have been endorsed by the national recommendations and implemented in some developed countries, the development in China is limited...
January 18, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29338750/reperfusion-therapy-in-acute-ischemic-stroke-dawn-of-a-new-era
#3
REVIEW
Sonu Bhaskar, Peter Stanwell, Dennis Cordato, John Attia, Christopher Levi
Following the success of recent endovascular trials, endovascular therapy has emerged as an exciting addition to the arsenal of clinical management of patients with acute ischemic stroke (AIS). In this paper, we present an extensive overview of intravenous and endovascular reperfusion strategies, recent advances in AIS neurointervention, limitations of various treatment paradigms, and provide insights on imaging-guided reperfusion therapies. A roadmap for imaging guided reperfusion treatment workflow in AIS is also proposed...
January 16, 2018: BMC Neurology
https://www.readbyqxmd.com/read/29332028/possible-erythrocyte-contributions-to-and-exacerbation-of-the-post-thrombolytic-no-reflow-phenomenon
#4
Shang-Jen Yu, James P Buerck, Edgar A O'Rear, Thomas L Whitsett
BACKGROUND: Reperfusion injury often occurs with therapeutic intervention addressing the arterial occlusions causing acute myocardial infarction and stroke. The no-reflow phenomenon has been ascribed to leukocyte plugging and blood vessel constriction in the microcirculation. OBJECTIVE: To assess possible red cell contributions to post thrombolytic no-reflow phenomenon. METHODS: Blood clots were formed by recalcifying 1 ml of citrated fresh human venous blood and then lysed by adding 1,000 units of streptokinase (SK) at several intervals within 1 hour...
January 11, 2018: Biorheology
https://www.readbyqxmd.com/read/29327535/catheter-assisted-management-of-massive-pulmonary-embolism
#5
Amey Beedkar, Rohan Parikh, Bhavesh Patel, Mahendra Mhaske, Sunil Washimkar, Pradeep Deshmukh, Mukund Deshpande
Pulmonary thromboembolism is common and missed by clinicians. We report a case of massive pulmonary embolism which was life threatening treated by the catheter assisted technique. Anticoagulation is the mainstay of therapy for most patients, with thrombolytic therapy reserved for some patients.1 Recent studies have suggested a role for systemic or catheter-directed thrombolytic therapy in selected patients.2 We present a case of a patient who presented with an PE, was successfully treated with catheter-directed thrombolysis...
December 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29326820/a-case-of-intra-arterial-thrombolysis-with-alteplase-in-a-patient-with-hypothenar-hammer-syndrome-but-without-underlying-aneurysm
#6
Harshal Shukla, Vicken Yaghdjian, Issam Koleilat
Hypothenar hammer syndrome is a cause of symptomatic ischemia of the hand secondary to the formation of aneurysm or thrombosis of the ulnar artery in the setting of a complete or incomplete palmar arch. Acute occlusive thrombus or embolus of the hand represents a complex problem that often may require immediate surgical intervention. We report a case of acute unilateral arterial hand ischemia requiring catheter-directed thrombolysis with Alteplase therapy in a patient with acute occlusive arterial thrombosis of the left ulnar artery...
2018: SAGE Open Medical Case Reports
https://www.readbyqxmd.com/read/29322705/a-comparative-study-of-in-hospital-outcome-of-patients-with-st-segment-elevation-myocardial-infarction-with-and-without-diabetes-mellitus-after-thrombolytic-therapy-in-government-hospital-of-rajkot-gujarat-india
#7
Varshit Hathi, Meghal Anadkat
Background: Diabetes mellitus is considered as a major health problem and an epidemic throughout the world. The mortality of patients with diabetes is almost twice that of non-diabetic. The outcome of in-hospital patients with myocardial infarction with and without diabetes after thrombolytic therapy is presented here. Aim: To compare the outcome of patients with myocardial infarction after thrombolysis in diabetics and non-diabetics in government hospital of Rajkot, India...
November 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29322232/mechanical-thrombectomy-using-the-new-solitaire%C3%A2-platinum-stent-retriever-reperfusion-results-complication-rates-and-early-neurological-outcome
#8
Johannes Pfaff, Stefan Rohde, Tobias Engelhorn, Arnd Doerfler, Martin Bendszus, Markus Alfred Möhlenbruch
BACKGROUND AND PURPOSE: The application of radiopaque markers to the Solitaire™ stent-retriever for better visibility during mechanical thrombectomy (MT) has the potential to alter the well-known characteristics of the device; however, it is uncertain whether this adjustment influences efficacy or safety of the enhanced stent-retriever. METHODS: Retrospective analysis of stroke databases of three comprehensive stroke centers. Our investigation was focused on technical and angiographic parameters, including procedure times, reperfusion results (thrombolysis in cerebral infarction, TICI), periprocedural complications and favorable early neurological recovery at discharge (modified Rankin scale ≤2 or National Institutes of Health Stroke Scale, NIHSS = 0 or ∆NIHSS ≥ 10), from consecutive patients with acute anterior circulation ischemic stroke treated with a Solitaire™ Platinum stent-retriever between October 2016 and March 2017...
January 10, 2018: Clinical Neuroradiology
https://www.readbyqxmd.com/read/29321997/ascertainment-of-pharmacological-activities-of-allamanda-neriifolia-hook-and-aegialitis-rotundifolia-roxb-used-in-bangladesh-an-in%C3%A2-vitro-study
#9
Imam Hasan, Md Saddam Hussain, Md Shalahuddin Millat, Niloy Sen, Md Abdur Rahman, Md Atikur Rahman, Safiqul Islam, Md Mizanur Rahman Moghal
The present study was cherished to investigate in vitro thrombolytic, membrane stabilizing and antibacterial activities of Allamanda neriifolia and Aegialitis rotundifolia. Different types methanolic extracts of these two medicinal plants were tested for determining membrane stabilizing activity at a hypotonic solution and heat induce condition by comparing with reference standard acetyl salicylic acid (0.10 mg/mL), where thrombolytic activity assessment was done by employing Streptokinase as standard drug...
January 2018: Journal of Traditional and Complementary Medicine
https://www.readbyqxmd.com/read/29317059/pathophysiological-significance-of-protein-hydrophobic-interactions-an-emerging-hypothesis
#10
Marek Kieliszek, Boguslaw Lipinski
Fibrinogen is a unique protein that is converted into an insoluble fibrin in a single enzymatic event, which is a characteristic feature of fibrinogen due to its susceptibility to fibrinolytic degradation and dissolution. Although thrombosis is a result of activated blood coagulation, no explanation is being offered for the persistent presence of fibrin deposits in the affected organs. A classic example is stroke, in which the thrombolytic therapy is effective only during the first 3-4 h after the onset of thrombosis...
January 2018: Medical Hypotheses
https://www.readbyqxmd.com/read/29309907/a-targeted-ferritin-microplasmin-based-thrombolytic-nanocage-selectively-dissolves-blood-clots
#11
Junyoung Seo, Taslim A Al-Hilal, Jun-Goo Jee, Yong-Lim Kim, Ha-Jeong Kim, Byung-Heon Lee, Soyoun Kim, In-San Kim
The use of thrombolytic therapies is limited by an increased risk of systemic hemorrhage due to lysis of hemostatic clots. We sought to develop a plasmin-based thrombolytic nanocage that efficiently dissolves the clot without causing systemic fibrinolysis or disrupting hemostatic clots. Here, we generated a double chambered short-length ferritin (sFt) construct that has an N-terminal region fused to multivalent clot targeting peptides (CLT: CNAGESSKNC) and a C-terminal end fused to a microplasmin (μPn); CLT recognizes fibrin-fibronectin complexes in clots, μPn efficiently dissolves clots, and the assembly of double chambered sFt (CLT-sFt-μPn) into nanocage structure protects the activated-μPn from its circulating inhibitors...
January 5, 2018: Nanomedicine: Nanotechnology, Biology, and Medicine
https://www.readbyqxmd.com/read/29304529/passivating-injured-endothelium-with-kinexins-in-thrombolytic-therapy
#12
Yunn-Hwa Ma, Chao-Wei Huang, Chih-Jen Wen, Yi-Ching Lu, Shiaw-Pyng Wey, Tze-Chein Wun
Without conjunctive administration of an anticoagulant, endothelial injury-induced thrombosis is resistant to thrombolysis and prone to re-thrombosis. We hypothesized that co-delivery of recombinant tissue plasminogen activator (rtPA) with annexin V-containing anticoagulants that specifically target the injured endothelium may passivate the thrombogenic elements of the vascular injury site and enhance rtPA-induced thrombolysis. In this study, the effects of conjunctive administration of Kinexins (Kunitz inhibitor-annexin V fusion proteins) with rtPA on thrombolysis were determined in vitro and in vivo...
January 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29303776/evaluation-of-morning-glory-jacquemontia-tamnifolia-l-griseb-leaves-for-antioxidant-antinociceptive-anticoagulant-and-cytotoxic-activities
#13
Mohammad Shahadat Hossain, A S M Ali Reza, Md Masudur Rahaman, Mst Samima Nasrin, Mohammed Rasib Uddin Rahat, Md Rabiul Islam, Md Josim Uddin, Md Atiar Rahman
BACKGROUND: The present study was planned to investigate the phytochemical, antioxidant, antinociceptive, anticoagulant and cytotoxic activities of the Jacquemontia tamnifolia (L.) Griseb leaf methanol extract (MExJT) in the laboratory using both in vitro and in vivo methods. METHODS: Phytochemical values, namely, total phenolic and flavonoid contents, 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical scavenging effect and FeCl3 reducing power effects, were studied by established methods...
January 5, 2018: Journal of Basic and Clinical Physiology and Pharmacology
https://www.readbyqxmd.com/read/29303110/-role-of-thrombectomy-in-acute-ischemic-stroke
#14
Albert Pall Sigurdsson
This article discusses endovascular thrombectomy in acute ischemic stroke. This treatment is vascular medicine's most significant leap in years. This treatment is complicated, and various technical aspects are discussed. Close cooperation is required between different specialties since patient selection for treatment is complex. Interventionists need close collaboration with stroke neurologists. Government needs to be involved as this treatment mandates structural changes which will incur more manpower and financial resources...
January 2018: Læknablađiđ
https://www.readbyqxmd.com/read/29302580/protective-effect-of-allium-tuberosum-extract-on-vascular-inflammation-in-tumor-necrosis-factor-%C3%AE-induced-human-vascular-endothelial-cells
#15
Haeng Jeon Hur, Ae Sin Lee
Background: Endothelial adhesion molecule expression induced by pro-inflammatory cytokine plays an important role in vascular endothelial cell injury, leading to vascular disease. Allium tuberosum (AT), which is used as a functional food, has a thrombolytic effect. It contains vitamin A, vitamin C, carbohydrate, calcium, iron, and phosphorus. There are many carotenes that turn into vitamin A in the body. Also, it helps blood circulation and stimulates metabolism. The purpose of the this study was to estimate the anti-inflammatory effects of the AT extract...
December 2017: Journal of Cancer Prevention
https://www.readbyqxmd.com/read/29301447/defibrotide-sodium-for-the-treatment-of-hepatic-veno-occlusive-disease-sinusoidal-obstruction-syndrome
#16
Paul G Richardson, Brandon M Triplett, Vincent T Ho, Nelson Chao, Fiona L Dignan, Michelle Maglio, Mohamad Mohty
Hepatic veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS) is an unpredictable condition associated with endothelial-cell damage due to conditioning for hematopoietic stem-cell transplantation (HSCT) or chemotherapy without HSCT. Mortality in patients with VOD/SOS and multi-organ dysfunction (MOD) may be >80%. Areas covered: Defibrotide is the only approved drug for the treatment of severe hepatic VOD/SOS after HSCT in the European Union and hepatic VOD/SOS with renal or pulmonary dysfunction in the United States...
January 5, 2018: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/29301024/thrombolytic-therapy-to-the-patients-with-de-winter-electrocardiographic-pattern-is-it-right
#17
M Y Rao, Y L Wang, G R Zhang, Y Zhang, T Liu, A J Guo, L Li, K Zhou, M Wang
No abstract text is available yet for this article.
December 29, 2017: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/29298088/echocardiogram-in-the-evaluation-of-hemodynamically-stable-acute-pulmonary-embolism-national-practices-and-clinical-outcomes
#18
David M Cohen, Michael Winter, Peter K Lindenauer, Allan J Walkey
RATIONALE: Societal guideline recommendations vary with regard to the role of routine trans-thoracic echocardiography (TTE) to screen for right ventricular strain in patients with hemodynamically-stable, acute pulmonary embolism (PE). OBJECTIVE: To characterize national patterns in use of early TTE for the evaluation of patients with hemodynamically-stable, acute PE, and determine associations between TTE use and patient outcomes. METHODS: Retrospective cohort study using Premier, Inc...
January 3, 2018: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29288062/the-degree-of-leukoaraiosis-predicts-clinical-outcomes-and-prognosis-in-patients-with-middle-cerebral-artery-occlusion-after-intravenous-thrombolysis
#19
Yanyan Liu, Min Zhang, Yuan Chen, Ping Gao, Wenwei Yun, Xianju Zhou
Leukoaraiosis (LA) is common in elderly patients with ischemic stroke on magnetic resonance imaging. In this study, we investigate whether the degree of LA is associated with clinical outcomes and prognosis of patients with middle cerebral artery occlusion following intravenous thrombolytic. Ninety-seven patients were recruited and divided into three groups based on the degree of LA (no, mild and moderate to severe LA) by the Fazekas scale. Clinical outcomes, recurrent stroke, Fugl-Meyer rating scale (FMS) and complications of intravenous thrombolysis were assessed...
December 26, 2017: Brain Research
https://www.readbyqxmd.com/read/29283052/thrombolytic-therapy-in-the-current-era-myocardial-infarction-and-beyond
#20
Patrick Proctor, Massoud A Leesar, Arka Chatterjee
Thrombolytic therapy kick-started the era of modern cardiology but in the last few decades it has been largely supplanted by primary percutaneous coronary intervention (PCI) as the go-to treatment for acute myocardial infarction. However, these agents remain important for vast populations without access to primary PCI and acute ischemic stroke. More innovative uses have recently come up for the treatment of a variety of conditions. This article summarizes the history, evidence base and current use of thrombolytics in cardiovascular disease...
December 27, 2017: Current Pharmaceutical Design
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