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Thrombolytic treatment

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https://www.readbyqxmd.com/read/28328661/microangiography-to-monitor-treatment-outcomes-following-severe-frostbite-injury-to-the-hands
#1
Thomas Masters, Steven Omodt, Jon Gayken, Christopher Logue, Bjorn Westgard, Stephen Hendriksen, Joseph Walter, Rachel Nygaard
Frostbite injury causes direct damage to tissues following exposure to temperatures below their freezing point causing tissue death potentially leading to serious amputations. After rewarming, a variety of treatment options have been employed to avoid amputation. This case report details the use of indocyanine green fluorescence microangiography to monitor the clinical progression of perfusion following hyperbaric oxygen therapy (HBOT) for severe frostbite injury. We present a case report of a man with deep frostbite of the bilateral hands treated with thrombolytics and HBOT...
March 15, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28318007/myocardial-infarction-in-a-neonate-lessons-for-neonatal-and-internal-medicine
#2
Werner Streif
Due to the lack of evidence-based guidelines, management strategies for neonatal MI should be individualized and administered largely at the discretion of responsible treating teams. Supportive care with a focus on preserving adequate circulation and antithrombotic therapy with a view to restoring vascular patency are the mainstays of treatment. Thrombolytic therapy of neonatal MI includes a chance to completely restore myocardial function. Understanding the resilience of the neonatal heart and mechanism of cardiac cell repair in neonates may spark novel treatment strategies for severe MI in the large number of affected individuals in an aging population...
March 20, 2017: Hämostaseologie
https://www.readbyqxmd.com/read/28306132/evaluation-of-functional-outcome-measured-by-modified-rankin-scale-in-rtpa-treated-patients-with-acute-ischemic-stroke
#3
B Georgievski-Brkic, M Savic, D Nikolic, L Nikcevic, M Vukicevic, D Kozic
Aim of our study was to assess functional outcome measured by modified Rankin scale (mRS) in patients that were treated with thrombolytic therapy-recombinant tissue plasminogen activator (rtPA) after acute ischemic stroke. The study included 100 participants that were treated after acute ischemic stroke. Analyzed parameters included: gender; age groups: age 54 and below (Groupup to-54), 55-64 (Group55-64), 65-74 (Group65-74), and 75 and above (Group75-up); cerebral blood flow (CBF) and cerebral blood volume (CBV)...
December 1, 2016: Archives Italiennes de Biologie
https://www.readbyqxmd.com/read/28296671/the-use-of-thrombolytic-therapy-in-the-treatment-of-frostbite-injury
#4
Allyson Wexler, Sarah Zavala
Frostbite can lead to severe consequences including loss of digits and limbs. One of the mechanisms of frostbite includes vascular thrombosis. The use of tissue plasminogen activator (tPA) in frostbite has been shown to be effective in case reports and small prospective studies. A retrospective chart review was performed on all patients admitted for frostbite between January 2008 and April 2015, and six patients were identified as having received treatment with intravenous tPA. Patients received an initial bolus dose followed by a 6-hour infusion of tPA...
March 3, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28294854/-registry-of-acute-coronary-syndromes-record-3-characteristics-of-patients-and-treatment-during-initial-hospitalization
#5
A D Erlikh, N A Gratsiansky On Behalf Of Record-Participants
Acute Coronary Syndrome (ACS) Registries RECORD 1-2 (2007-2001) gave valuable information on management of ACS patients in Russia. RECORD-3 was carried out in March-April, 2015. Here we present characteristics of included patients (pts) and data on their treatment during initial hospitalization. MATERIAL AND METHODS: RECORD-3 recruited pts with suspected ACS consecutively hospitalized in participating hospitals (n=47, 55% "invasive") during 1 month. RESULTS: Number of included pts was 2370 (39% women, mean age 64...
April 2016: Kardiologiia
https://www.readbyqxmd.com/read/28291676/long-term-outcome-after-thrombolysis-for-acute-lower-limb-ischaemia
#6
O Grip, A Wanhainen, S Acosta, M Björck
OBJECTIVES: The purpose was to study long-term outcome after thrombolysis for acute arterial lower limb ischaemia, and to evaluate the results depending on the underlying aetiology of arterial occlusion. METHODS: This was a retrospective study of patients entered into a prospective database. Patients were identified in prospective databases from two vascular centres, including a large number of variables. Case records were analysed retrospectively. Through cross linkage with the Population Registry 100% accurate survival data were obtained...
March 10, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28290648/deep-venous-thrombosis-and-pulmonary-embolism-current-therapy
#7
Jason Wilbur, Brian Shian
Pulmonary embolism and deep venous thrombosis are the two most important manifestations of venous thromboembolism (VTE), which is the third most common life-threatening cardiovascular disease in the United States. Anticoagulation is the mainstay of VTE treatment. Most patients with deep venous thrombosis or low-risk pulmonary embolism can be treated in the outpatient setting with low-molecular-weight heparin and a vitamin K antagonist (warfarin) or direct-acting oral anticoagulants. Inpatient treatment of VTE begins with parenteral agents, preferably low-molecular-weight heparin...
March 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28286764/phase-i-and-phase-ii-therapies-for-acute-ischemic-stroke-an-update-on-currently-studied-drugs-in-clinical-research
#8
REVIEW
Cesar Reis, Onat Akyol, Wing Mann Ho, Camila Araujo, Lei Huang, Richard Applegate Ii, John H Zhang
Acute ischemic stroke is a devastating cause of death and disability, consequences of which depend on the time from ischemia onset to treatment, the affected brain region, and its size. The main targets of ischemic stroke therapy aim to restore tissue perfusion in the ischemic penumbra in order to decrease the total infarct area by maintaining blood flow. Advances in research of pathological process and pathways during acute ischemia have resulted in improvement of new treatment strategies apart from restoring perfusion...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28284923/vascular-quadrilateral-space-syndrome-in-three-overhead-throwing-athletes-an-underdiagnosed-cause-of-digital-ischemia
#9
Johnathon Rollo, David Rigberg, Hugh Gelabert
Vascular quadrilateral space syndrome (vQSS) is an underdiagnosed cause of extremity ischemia, pain and paresthesia in overhand throwing athletes. The mechanism of vQSS is thought to result from repeated abduction and external rotation of the arm leading to a distraction injury of the posterior circumflex humoral artery (PCHA) as this courses through the quadrilateral space. This trauma may cause dissection and dissecting aneurysm formation. Thrombus from this arterial injury then embolizes down the arm resulting in the symptomatic presentation...
March 8, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28283876/purification-of-serine-protease-from-polychaeta-lumbrineris-nipponica-and-assessment-of-its-fibrinolytic-activity
#10
Seung Ju Yeon, Goo Yong Chung, Jae Sang Hong, Jin Ha Hwang, Hwa Sung Shin
Ischemic stroke and cardiovascular disease can occur from blockage of blood vessels by fibrin clots formed naturally in the body. Therapeutic drugs of anticoagulant or thrombolytic agents have been studied; however, various problems have been reported such as side effects and low efficacy. Thus, development of new candidates that are more effective and safe is necessary. The objective of this study is to evaluate fibrinolytic activity, anti-coagulation, and characterization of serine protease purified from Lumbrineris nipponica, polychaeta, for new thrombolytic agents...
March 10, 2017: In Vitro Cellular & Developmental Biology. Animal
https://www.readbyqxmd.com/read/28279987/risk-of-thrombus-fragmentation-during-endovascular-stroke-treatment
#11
J Kaesmacher, T Boeckh-Behrens, S Simon, C Maegerlein, J F Kleine, C Zimmer, L Schirmer, H Poppert, T Huber
BACKGROUND AND PURPOSE: Periprocedural thrombus fragmentation is a relevant risk in endovascular stroke treatment. Because factors influencing its occurrence are largely unknown, this study addresses a potential relationship between thrombus histology and clot stability. MATERIALS AND METHODS: Eighty-five patients with anterior circulation stroke treated with thrombectomy were included in this retrospective study. The number and location of emboli after retrieving the primary thrombus, the number of maneuvers, and TICI scores were evaluated...
March 9, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28277464/clot-imaging-in-large-vessel-occlusion-strokes
#12
Johnny H Wong, Michael P Marks
Advances in mechanical thrombectomy techniques have resulted in improved, recanalization and functional outcomes in acute stroke, as demonstrated in recent, randomized trials comparing mechanical thrombectomy with thrombolysis. In conjunction with the technological advancements in thrombectomy devices, there has been better appreciation of stricter patient selection criteria for endovascular therapy based on pre-procedural imaging, including clot location, infarct volume, and penumbral territory at risk. Pre-procedural imaging performed to assess suitability for endovascular therapy commonly provides information on clot characteristics, such as clot location, length, density, and susceptibility, which can influence and may predict the efficacy of intravenous and endovascular treatments...
March 8, 2017: Topics in Magnetic Resonance Imaging: TMRI
https://www.readbyqxmd.com/read/28277445/thrombolytic-therapy-in-wake-up-stroke-patients
#13
Gretchen M Stern, Nicholas Van Hise, Lindsay M Urben, Matthew J Korobey, Jamie M Pitlick, Andrew J Crannage
OBJECTIVE: The aim of the study is to review existing and ongoing trial data on wake-up stroke (WUS) patients for thrombolytic therapy. METHODS: A literature search was conducted in PubMed (conception-October 2016) using the terms wake-up stroke, acute ischemic stroke, wake-up thrombolysis, computed tomography imaging in wake-up stroke, and magnetic resonance imaging in wake-up stroke. Ongoing trials were found using the ClinicalTrials.gov website. RESULTS: The search yielded 61 articles in PubMed and 7 ongoing trials...
March 9, 2017: Clinical Neuropharmacology
https://www.readbyqxmd.com/read/28275084/reduction-in-time-to-treatment-in-prehospital-telemedicine-evaluation-and-thrombolysis
#14
Ather Taqui, Russell Cerejo, Ahmed Itrat, Farren B S Briggs, Andrew P Reimer, Stacey Winners, Natalie Organek, Andrew B Buletko, Lila Sheikhi, Sung-Min Cho, Maureen Buttrick, Megan M Donohue, Zeshaun Khawaja, Dolora Wisco, Jennifer A Frontera, Andrew N Russman, Fredric M Hustey, Damon M Kralovic, Peter Rasmussen, Ken Uchino, Muhammad S Hussain
OBJECTIVE: To compare the times to evaluation and thrombolytic treatment of patients treated with a telemedicine-enabled mobile stroke treatment unit (MSTU) vs those among patients brought to the emergency department (ED) via a traditional ambulance. METHODS: We implemented a MSTU with telemedicine at our institution starting July 18, 2014. A vascular neurologist evaluated each patient via telemedicine and a neuroradiologist and vascular neurologist remotely assessed images obtained by the MSTU CT...
March 8, 2017: Neurology
https://www.readbyqxmd.com/read/28268390/in-vitro-examination-of-the-pressure-effect-on-clot-dissolution-with-thrombolytic-patch
#15
Zhen Qin, Chi Hang Chon, John C K Kwok, David C C Lam
Bio-kinetic thrombus dissolution model has been developed to describe the thrombus dissolution behavior during endoluminal thrombolytic patch treatment to recanalize blocked vessel in ischemic strokes. The initial model ignored the effect of pulsatile pressure in the lumen. However, pulsatile pressure in the lumen may affect molecule diffusion and bio-chemical reaction rate and accelerate clot dissolution. The effect of pressure on the dissolution rate was examined in this study. The dissolution behaviors of 100-400 μm thick blood clot specimens subject to diastolic, systolic, and pulsatile pressure were characterized using Raman spectroscopy...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28265861/re-evaluate-the-efficacy-and-safety-of-human-urinary-kallidinogenase-resk-protocol-for-an-open-label-single-arm-multicenter-phase-iv-trial-for-the-treatment-of-acute-ischemic-stroke-in-chinese-patients
#16
Jun Ni, Jiazhi Qu, Ming Yao, Zhijun Zhang, Xihua Zhong, Liying Cui
Acute ischemic stroke (AIS) is a major medical challenge in China. Thrombolytic drugs recommended for the treatment of AIS usually have a narrow time window. Human urinary kallidinogenase (HUK) was approved by the China Food and Drug Administration (CFDA) in 2005 for the treatment of mild to moderate AIS, and it is thus widely used in China. However, large-scale clinical study data for a more complete understanding of various aspects of its safety and efficacy characteristics are still unavailable. The ongoing Reevaluate the Efficacy and Safety of Human Urinary Kallidinogenase (RESK) trial is designed to reevaluate the safety and efficacy of HUK in Chinese patients with AIS...
March 6, 2017: Translational Stroke Research
https://www.readbyqxmd.com/read/28265218/minimally-invasive-lvad-deactivation-in-a-65-year-old-man-with-recurrent-pump-thrombosis-and-left-ventricular-recovery
#17
Akshay Pendyal, Christopher V Chien, James O Mudd, Jill M Gelow
Pump thrombosis is a dire sequela after left ventricular assist device (LVAD) implantation. Treatment comprises antiplatelet agents, anticoagulants, thrombolytic agents, and pump exchange. Although pump exchange is the definitive therapy, it is also the most invasive, often exposing patients to the risks of repeat sternotomy and cardiopulmonary bypass. In some cases, patients experience left ventricular recovery after LVAD implantation. The optimal strategy surrounding the management of LVADs in patients who have experienced ventricular recovery is unknown; techniques range from total system explantation to partial pump resection...
February 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28258876/the-use-of-tissue-plasminogen-activator-in-the-treatment-of-wallenberg-syndrome-caused-by-vertebral-artery-dissection
#18
Alexis Salerno, Bradford V Cotter, Michael E Winters
BACKGROUND: Acute cerebrovascular accident (CVA) is a devastating cause of patient morbidity and mortality. Up to 10% of acute CVAs in young patients are caused by dissection of the vertebral or carotid artery. Wallenberg syndrome results from a CVA in the vertebral or posterior inferior artery of the cerebellum and manifests as various degrees of cerebellar dysfunction. The administration of a thrombolytic medication has been recommended in the treatment of patients with stroke caused by cervical artery dissection...
February 28, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28250755/computed-tomography-perfusion-and-computed-tomography-angiography-for-prediction-of-clinical-outcomes-in-ischemic-stroke-patients-after-thrombolysis
#19
Jia-Wei Pan, Xiang-Rong Yu, Shu-Yi Zhou, Jian-Hong Wang, Jun Zhang, Dao-Ying Geng, Tian-Yu Zhang, Xin Cheng, Yi-Feng Ling, Qiang Dong
Cerebral blood perfusion and cerebrovascular lesions are important factors that can affect the therapeutic efficacy of thrombolysis. At present, the majority of studies focus on assessing the accuracy of lesion location using imaging methods before treatment, with less attention to predictions of outcomes after thrombolysis. Thus, in the present study, we assessed the efficacy of combined computed tomography (CT) perfusion and CT angiography in predicting clinical outcomes after thrombolysis in ischemic stroke patients...
January 2017: Neural Regeneration Research
https://www.readbyqxmd.com/read/28248408/prognostic-importance-of-central-thrombus-in-hemodynamically-stable-patients-with-pulmonary-embolism
#20
Aysegul Senturk, Savas Ozsu, Serap Duru, Ebru Cakır, Sevinc Sarinc Ulaslı, Ezgi Demirdogen, Servet Kayhan, Aygul Guzel, Fatih Yakar, Serdar Berk
BACKGROUND: The association between mortality and localization of central thrombus in hemodynamically stable patients with pulmonary embolism (PE) is unclear. Sufficient data are not available to help clinicians to select between low molecular weight heparin (LMWH), unfractionated heparin (UFH) and thrombolytics for the management of central thrombus. The present study aims to investigate whether central thrombus in the pulmonary artery affects 30-day mortality rate, and to compare the outcomes of different treatment approaches in patients with central thrombus...
March 1, 2017: Cardiology Journal
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