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Alessandro Scaletti, Emiliana Lauro, Patrizia Belfiore, Bruno Zamparelli, Giorgio Liguori
The Stroke Units (SU) delivers high quality care and treatment in patients affected by strokes. In Italy stroke is the second leading cause of death and the first of disability in adult people. There is significant evidence in literature indicating the better quality assistance SU provide in the treatment of neurological acute disease, with significant improvements in mortality and disability, when the therapeutic intervention (thrombolysis) is carried out within 3 hours after the onset of symptoms. Two are the aims of the present study: to evaluate the economic impact of both the start-up of Stroke Units in the Campania Region and the use of thrombolytic therapy for all treatable population...
January 2014: Igiene e Sanità Pubblica
Marius Toringhibel, Tatiana Adam, Oana-Cristina Arghir, Eleonora Gima
We report the case of a 28 years old, non-smoker male with a massive pulmonary embolism and left pleural effusion associated and probably induced by olanzapine 10 mg once daily in the previous 4 months, completely recovered after 18 days of stopping the antipsychotic and trombolytic treatment. Thrombotic events have been reported with the use of antipsychotic compounds, although the incidence, predisposing factors, and biological mechanisms associated with these events in psychiatric patients are subject to debate...
April 2011: Pneumologia: Revista Societății Române de Pneumologie
M Belicová
BACKGROUND: Chronic thromboembolic pulmonary hypertension is a serious consequence of pulmonary embolism associated with considerable morbidity and mortality. It develops in about 0.1-3.8% among patients who survive pulmonary embolism despite adecvate treatment. OBJECTIVE: Retrospectively evaluate incidence, clinical picture and difficulties in diagnostics and treatment of patients, in which the diagnosis was confirmed. PATIENTS AND METHODS: In years 1996-2007 there were 33,108 patients hospitalized at 1...
February 2011: Vnitr̆ní Lékar̆ství
P Peeters, J Verbist, K Keirse, K Deloose, M Bosiers
Acute limb ischemia (ALI) refers to a rapid worsening of limb perfusion resulting in rest pain, ischemic ulcers or gangrene. With an estimated incidence of 140 million/year, ALI is serious limb-threatening and life-threatening medical emergency demanding prompt action. Three prospective, randomized clinical trials provide data on trombolytic therapy versus surgical intervention in patients with acute lower extremity ischemia. Although they did not give us the final answer, satisfactory results are reported for percutaneous thrombolysis compared with surgery...
June 2010: Journal of Cardiovascular Surgery
E Rencová
INTRODUCTION: Diabetic retinopathy is an important microvascular complication of diabetes as it threatens the vision. Diabetic maculopathy is the main cause of legal blindness in the adult population in western countries. The examination method involves digital fundus photography that enables comparison of the incidence, number as well as the size and the shape of pathological foci on the retina during patient visits. It, however, does not depict one important change--chronic retinal ischemia...
April 2010: Vnitr̆ní Lékar̆ství
E Fric, M Sín, M Rehák, O Chrapek, J Simicák, J Fehák
The authors present the possibility to influence therapeutically the submacular hemorrhage caused by age-related macular degeneration in the presence of choroidal neovascular membrane by means of recombinant plasminogen tissue activator (rt-PA) and expansive gas intravitreal injection followed by pneumatic relocation of the hemorrhage out of the foveolar region. The therapy is presented in a case report. The submacular hemorrhage without treatment causes serious decrease of visual functions. The human recombinant plasminogen tissue activator that is a glycoprotein, activating the transformation of plasminogen directly to plasmin has a trombolytic effect...
November 2008: Ceská a Slovenská Oftalmologie
I Ignjatović, M Ilić, N Marković, T Stamenić
Renal vein thrombosis (TVR) is not a common disease especially when is not associated with renal parenchymal nephropathy. TVR has no characteristic symptoms, so it is often late recognised. The main procedures for diagnosis of TVR are: echotomography, CT and phlebography. All these procedures, although very informative, have certain limits in the clinical use. Therapy of TVR trombolytic, anticoagulant or surgical: thrombectomy or nephrectomy. In cases where the underlying parenchymal disease exists, aggresive therapeutic approach is not recommended, but in acute idiopathic TVR immediate recanalisation of the renal vein is the most effective...
July 1995: Srpski Arhiv za Celokupno Lekarstvo
T Danek, R Janousek, K Havlícek
Authors present their experience with combined trombolytic-surgical treatment of acute ischaemia of low extremity based on trombosis of popliteal artery aneurysm. This treatment was performed in three patients. Authors compare results of intraarterial catheter pharmacological trombolysis of infrapopliteal arteries with indirect surgical trombolysis.
March 2006: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
Paola Bernabò, Gianfranco Mazzotta
In the text we focused our attention on beta-blocker therapy, considering the great importance of these drugs in the treatment of myocardial infarction, also in the early phase of the postinfarction clinical course. Moreover, as for other anti-ischemic therapies--i.e. nitrodrivatives and calcium-antagonists--the management of this therapy is more difficult, because it takes time to up titrate and to wash out. In our opinion, it's unadvisable to interrupt this treatment in the early phase of the postinfarction course, and it's necessary to perform predischarge exercise testing on beta-blocker therapy; and we explain all the reasons in the text...
March 2003: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
Nicola Tambasco, Francesco Corea, Roberto Luccioli, Ettore Ciorba, Lucilla Parnetti, Virgilio Gallai
There is evidence that an improvement of the diagnostic abilities could have a value for prognosis and therapy of the ischemic stroke. New neuroradiological strategies could be used with an amelioration of the evaluation and standardization of the ischemic damage. The value of early vascular sign remains controversial as a predictor of patient outcome. Early parenchymal changes are related to a poor outcome. The risk of hemorrhagic transformation increases with trombolytic therapy and especially with the onset of therapy...
October 2002: Clinical and Experimental Hypertension: CHE
Peter Sleight
I believe streptokinase is still the trombolytic of choice for the majority of patients with acute myocardial infarction for the following reasons: 1. The superiority of alteplase over streptokinase rests on insecure grounds, statistically (when net clinical benefit is computed for the SK/subcutaneous heparin arm versus the accelerated t-PA arm, the P value is only 0.04). 2. The excess of cerebral haemorrhage with t-PA is statistically highly significant and consistent over all trials. 3. Patients at greater risk of cerebral hemorrhage are those with raised systolic arterial pressure above about 130 to 140 on admission and those aged over about 55 years...
February 1995: American Journal of Therapeutics
J Rojel, A Froland, S Iversen
Treatment of acute myocardial infarction (AMI) with streptokinase in Fredericia from 1967 to 1977. During these years 184 patients with AMI were treated with trombolytic therapy. At that time such treatment was not used anywhere else in Denmark, and only in relatively few places in other countries. The patient population, the treatment, the survival rate of the patients are described, and also other measures taken to better the prognosis of patients with acute heart diseases. These measures comprised the introduction of cardiac defibrillation in 1961, the establishment of an intensive care unit in 1965, and in 1970 ambulances with equipment for ECG monitoring transmitted to the hospital (telemetry) and defibrillators to be used by paramedical personnel in the ambulances...
1999: Dansk Medicinhistorisk årbog
B Mørland, J A Aarli, E Lund, H O Myhre, B Indredavik
BACKGROUND: The Norwegian Centre for Health Technology Assessment was asked to assess the treatment of stroke by trombolytic medication. We were also asked to include an evaluation of potential consequences for the organisation of the health care system. MATERIAL AND METHODS: Relevant literature was identified on Medline, the Cochrane Library (Systematic Reviews), and INAHTA (Systematic Reviews). Of particular importance are one study from the USA and two studies originating in Europe...
March 20, 2000: Tidsskrift for Den Norske Lægeforening: Tidsskrift for Praktisk Medicin, Ny Række
R Sanjuán Máñez, M Blasco Cortés, J Muñoz Gil, C Gimeno Cardona, F Savall Calvo, J Ferreres Franco, V Bodí Peris, J Samper Codes, S Morell Cabedo, V López Merino
INTRODUCTION AND OBJECTIVES: Our purpose was to investigate the significance of inflammatory acute phase response early after myocardial infarction. We also observed how these indices were influenced by trombolytic therapy. METHOD: We examined the blood samples of 200 non consecutive patients at the first day of acute myocardial infarction (155 [77%] males; mean age 65 +/- 13 years) to characterize the proteins and proinflamatory reactants profile. Results were correlated with hospital mortality...
August 1997: Revista Española de Cardiología
E Díez-Tejedor, M Alonso de Leciñana, V C Hachinski
At the moment, the only treatment of proven efficacy in reducing mortality and improving evolution of patients with ischemic stroke is management of these patients by specialized personal, in specific units (stroke units) to provide an adequate and early program of general care, control of complications and rehabilitation. On the basis of physiopathological knowledge, other specific therapeutical agents are being investigated, following essentially two ways: 1) to provide early reperfussion of ischemic tissue by an adequate control of hemodinamics, use of antithrombotic agents and/or use of trombolytic agents, and 2) to inhibit the ischemia-reperfussion injury mediators (acidosis, cytoplasmic overload of calcium and excess of free radicals) using cytoprotectors...
January 1996: Revista de Neurologia
C Almendares, R Corbalán, P Castro, A Rodríguez, E Marchant, S Kunstmann, P Casanegra
Reperfusion therapy has contributed to decreased morbidity and mortality in patients with acute myocardial infarction (AMI). Implementation of thrombolytic therapy; primary angioplasty and emergency coronary artery by-pass surgery have proved to be effective in well designed controlled clinical trials. There is little information, however, about the impact of reperfusion therapy in the general clinical population that is usually seen in the coronary care unit. In this paper we have compared the clinical course, morbidity and mortality of patients attended for a first AMI in 2 different periods...
November 1995: Revista Médica de Chile
L M Popova, V N Pirogov
Thrombolytic agents previously employed in the treatment of ischemic stroke were associated with adverse side-effects and hemorrhagic complications. The use of streptodekase (S), a Soviet trombolytic drug, which is a long-acting immobilized ensyme proved to be highly effective. The efficacy of S in ischemic stroke was not investigated. The authors report the use of S within the first 6-8 hours after an ischemic stroke in thrombosis of the main stem of the middle meningeal artery in one case and of the vertebral and main arteries with the development of the locked-in syndrome in the other...
1986: Zhurnal Nevropatologii i Psikhiatrii Imeni S.S. Korsakova
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