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https://www.readbyqxmd.com/read/29040276/the-impact-of-acute-kidney-injury-on-in-hospital-mortality-in-acute-ischemic-stroke-patients-undergoing-intravenous-thrombolysis
#1
Florica Gadalean, Mihaela Simu, Florina Parv, Ruxandra Vorovenci, Raluca Tudor, Adalbert Schiller, Romulus Timar, Ligia Petrica, Silvia Velciov, Cristina Gluhovschi, Flaviu Bob, Adelina Mihaescu, Bogdan Timar, Goce Spasovski, Viviana Ivan
INTRODUCTION: Acute kidney injury (AKI) increases the risk of death in acute ischemic stroke (AIS) patients. Intravenous thrombolytic therapy (iv. rt-PA) seems to be the most effective treatment for AIS patients. The effects of AKI on iv. rt-PA treated AIS cases is less studied. Our paper addresses this issue. METHODS: 45 consecutive stroke patients treated with iv. rt-PA (median age = 64 years; 29 male) and 59 age and sex matched controls not eligible for iv. rt-PA have been enrolled in our study...
2017: PloS One
https://www.readbyqxmd.com/read/29037011/visibility-of-ct-early-ischemic-change-is-significantly-associated-with-time-from-stroke-onset-to-baseline-scan-beyond-the-first-3-hours-of-stroke-onset
#2
Jian Gao, Mark W Parsons, Hiroyuki Kawano, Christopher R Levi, Tiffany-Jane Evans, Longting Lin, Andrew Bivard
BACKGROUND AND PURPOSE: Non-contrast brain computed tomography (NCCT) remains the most common imaging modality employed to select patients for thrombolytic therapy in acute ischemic stroke. The current study used the Alberta Stroke Program Early CT Score (ASPECTS) to identify early ischemic changes on brain NCCT imaging with the aim to investigate whether a relationship exists between time from symptoms onset to NCCT with the presence of early ischaemic change quantified by ASPECTS. METHODS: We studied 1,329 ischemic stroke patients who had NCCT within 8 hours of stroke onset...
September 2017: Journal of Stroke
https://www.readbyqxmd.com/read/29034073/unmet-goals-in-the-treatment-of-acute-myocardial-infarction-review
#3
REVIEW
Alejandro Farah, Alejandro Barbagelata
Reperfusion therapy decreases myocardium damage during an acute coronary event and consequently mortality. However, there are unmet needs in the treatment of acute myocardial infarction, consequently mortality and heart failure continue to occur in about 10% and 20% of cases, respectively. Different strategies could improve reperfusion. These strategies, like generation of warning sign recognition and being initially assisted and transferred by an emergency service, could reduce the time to reperfusion. If the first electrocardiogram is performed en route, it can be transmitted and interpreted in a timely manner by a specialist at the receiving center, bypassing community hospitals without percutaneous coronary intervention capabilities...
2017: F1000Research
https://www.readbyqxmd.com/read/29034035/surgical-embolectomy-for-acute-pulmonary-thromboembolism
#4
REVIEW
Ikuo Fukuda, Kazuyuki Daitoku
Acute pulmonary thromboembolism is a catastrophic event, especially for hospitalized patients. The prognosis of pulmonary thromboembolism depends on the degree of pulmonary arterial occlusion. The mortality of massive pulmonary embolism is reportedly as high as 25% without cardiopulmonary arrest and 65% with cardiopulmonary arrest. In patients with unstable hemodynamics due to pulmonary thromboembolism, surgical pulmonary embolectomy is indicated for patients with a contraindication to thrombolysis, failed catheter therapy, or failed thrombolysis...
June 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29032034/therapeutic-investigations-of-novel-indoxyl-based-indolines-a-drug-target-validation-and-structure-activity-relationship-of-angiotensin-converting-enzyme-inhibitors-with-cardiovascular-regulation-and-thrombolytic-potential
#5
A Manikandan, Pearl Moharil, M Sathishkumar, C Muñoz-Garay, A Sivakumar
A family of 12 members of Naphthalene-2-ol-indolin-2-one-thiocarbamides (5a-l) with pharmacological potentials of cardiovascular modulator were efficiently synthesized and evaluated. These compounds show inhibitory activity on angiotensin-converting enzyme (ACE), which is a principal constituent of the renin-angiotensin system and causative source for hypertension (HTN) (elevated blood pressure) and congestive heart failure (CHF), a parameter that was tested in this report. Prior to this, to get more insight into the binding mode and inhibition of human ACE C-domain (PDB ID: 2XY9) and N-domain (PDB ID: 3NXQ) compounds 5a-l was docked into the active site of them...
October 5, 2017: European Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/29029714/catheter-directed-therapy-for-acute-submassive-pulmonary-embolism-summary-of-current-evidence-and-protocols
#6
Andrew Kesselman, William T Kuo
Treatment of acute submassive pulmonary embolism (PE) with thrombolytic therapy remains an area of controversy. For patients who fail or who have contraindications to systemic thrombolysis, catheter-directed therapy (CDT) may be offered depending on the patient's condition and the available institutional resources to perform CDT. Although various CDT techniques and protocols exist, the most studied method is low-dose catheter-directed thrombolytic infusion without mechanical thrombectomy. This article reviews current protocols and data on the use of CDT for acute submassive pulmonary embolism...
September 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29029712/advanced-cardiopulmonary-support-for-pulmonary-embolism
#7
Oren Friedman, James M Horowitz, Danny Ramzy
Management of high-risk pulmonary embolism (PE) requires an understanding of the pathophysiology of PE, options for rapid clot reduction, critical care interventions, and advanced cardiopulmonary support. PE can lead to rapid respiratory and hemodynamic collapse via a complex sequence of events leading to acute right ventricular failure. Importantly, reduction in pulmonary vascular resistance must be accomplished either by systemic thrombolytics, catheter directed thrombolytics, endovascular clot extraction, or surgical embolectomy...
September 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29029710/systemic-thrombolysis-for-pulmonary-embolism-who-and-how
#8
Victor F Tapson, Oren Friedman
Anticoagulation has been shown to improve mortality in acute pulmonary embolism (PE). Initiation of anticoagulation should be considered when PE is strongly suspected and the bleeding risk is perceived to be low, even if acute PE has not yet been proven. Low-risk patients with acute PE are simply continued on anticoagulation. Severely ill patients with high-risk (massive) PE require aggressive therapy, and if the bleeding risk is acceptable, systemic thrombolysis should be considered. However, despite clear evidence that parenteral thrombolytic therapy leads to more rapid clot resolution than anticoagulation alone, the risk of major bleeding including intracranial bleeding is significantly higher when systemic thrombolytic therapy is administered...
September 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29029706/pulmonary-embolism-in-2017-how-we-got-here-and-where-are-we-going
#9
Geno J Merli
In the 1970s, both the Urokinase Pulmonary Embolism and Urokinase-Streptokinase Pulmonary Embolism trials began the quest to develop thrombolytic therapy for the treatment of acute massive and submassive pulmonary embolism (PE). The goals of these studies were the immediate reduction in clot burden, restoration of hemodynamic stability, and improved survival. Major bleeding became the major barrier for clinicians to employ these therapies. From 1980s to the present time, a number of studies using recombinant tissue-type plasminogen activator for achieving these same above outcomes were completed but major bleeding continued to remain an adoption barrier...
September 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29019875/anterograde-injection-of-low-dose-urokinase-salvages-free-anterolateral-thigh-flap-a-case-report-of-safe-and-effective-treatment
#10
Shao-Yun Hsu, Hsu-Tang Cheng, Oscar Manrique, Yung-Chang Hsu
RATIONALE: A 54-year-old Taiwanese male came to our hospital presented with right retromolar mucoepidermoid carcinoma. Composite resection and right modified radical neck dissection were performed. We then use free anteral lateral thigh flap to reconstruct the defect. However, venous congestion was found 32 h after the surgery. PATIENT CONCERNS: The main concerns of the patient is complete salvage of the free flap, and avoiding the secondary free flap harvesting and reconstruction surgeries...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28992998/predictive-value-of-depression-and-anxiety-for-long-term-mortality-differences-in-outcome-between-acute-coronary-syndrome-and-stable-angina-pectoris
#11
Tom A J de Jager, Karolijn Dulfer, Sumant Radhoe, Michael J Bergmann, Joost Daemen, Ron T van Domburg, Mattie J Lenzen, Elisabeth M W J Utens
BACKGROUND: Since the early 2000s the treatment of choice for an acute myocardial infarction has moved from thrombolytic therapy to primary PCI (pPCI). As a result, the majority of patients undergoing PCI shifted from stable angina pectoris (SA) to acute coronary syndrome (ACS). Additionally the previously observed association between depression and anxiety and long-term outcome in patients who underwent a PCI may have been changed. The main objective of this study was to investigate the predictive value of depression and anxiety for 10-year mortality, in a cohort with post-PCI patients treated for SA versus patients treated for ACS...
October 6, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28987516/cannabis-can-augment-thrombolytic-properties-of-rtpa-case-report-of-an-intracranial-hemorrhage-in-a-heavy-cannabis-user
#12
Amar Shere, Hemant Goyal
Cannabis is one of the most commonly used illicit drugs in the United States and is considered to have several adverse health effects. There is evidence suggesting that its recreational use is associated with both increased cardio- and cerebrovascular events. Recently, multiple cases of ischemic and hemorrhagic strokes associated with cannabis use were reported in the literature (Goyal et al., 2017). It has been suggested that cannabis can affect cerebral auto-regulation and vascular tone leading to vasoconstriction and acute ischemic stroke...
September 28, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28985990/the-importance-of-atrial-fibrillation-and-selected-echocardiographic-parameters-for-the-effectiveness-and-safety-of-thrombolytic-therapy-in-patients-with-stroke
#13
Lasek-Bal Anetta, Kowalewska-Twardela Teresa, Warsz-Wianecka Aldona, Puz Przemysław, Krzan Aleksandra, Cieślik Aleksandra
BACKGROUND: The efficacy and safety of thrombolytic therapy in stroke depend on multiple factors. The aim of this study was to evaluate the significance of atrial fibrillation the prognosis in terms of the functional status in patients with stroke treated with intravenous thrombolysis. An additional aim was also to assess the potential significance of reduced ejection fraction (EF) and enlarged left atrium (LA) of the heart for the prognosis in patients with stroke who underwent thrombolytic therapy...
September 19, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28985592/pharmacological-thrombolysis-for-acute-ischemic-stroke-treatment-gender-differences-in-clinical-risk-factors
#14
Michael J Colello, Lauren E Ivey, Jordan Gainey, Rakiya V Faulkner, Ashleigh Johnson, Leanne Brechtel, Lee Madeline, Thomas I Nathaniel
BACKGROUND: In a stroke population, women have a worse outcome than men when untreated. In contrast, there is no significant difference in treated patients. In this study, we determined whether clinical variables represent a promising approach to assist in the evaluation of gender differences in a stroke population. METHODS: We analyzed data from ischemic stroke patients' ≥18 years-old from the stroke registry on rtPA administration and identified gender differences in clinical factors within inclusion and exclusion criteria in a stroke population that received rtPA...
October 3, 2017: Advances in Medical Sciences
https://www.readbyqxmd.com/read/28982494/techniques-for-endovascular-treatment-of-acute-ischemic-stroke
#15
REVIEW
L Pierot, M Gawlitza, S Soize
Early recanalization of occluded vessels in patients with acute ischemic stroke (AIS) by either intravenous thrombolysis (IVT) or endovascular revascularization has been shown to be associated with improved clinical outcomes and reduced mortality. Since the initial report regarding endovascular treatment (EVT) of AIS in 1983, endovascular techniques have been tremendously improved, advancing from intra-arterial administration of thrombolytic drugs to stent retrievers. IVT has been evaluated in several large randomized trials and has been shown to improve clinical outcomes at 90 days if treatment was initiated within 3h of stroke onset, while its benefit at 3-4...
October 2, 2017: Revue Neurologique
https://www.readbyqxmd.com/read/28982227/blood-pressure-and-in-hospital-outcomes-in-patients-presenting-with-ischaemic-stroke
#16
Sripal Bangalore, Lee Schwamm, Eric E Smith, Anne S Hellkamp, Robert E Suter, Ying Xian, Phillip J Schulte, Gregg C Fonarow, Deepak L Bhatt
Aims: Post-stroke hypertension is associated with poor short-term outcome, although the results have been conflicting. Our objective was to evaluate the association of blood pressure (BP) and in-hospital outcomes in patients with acute ischaemic stroke. Methods and results: Patients in the Get With The Guidelines-Stroke registry with acute ischaemic stroke were included. Admission systolic and diastolic BP was used to compute mean arterial pressure (MAP) and pulse pressure (PP)...
October 1, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28981441/assessment-of-the-antioxidant-thrombolytic-analgesic-anti-inflammatory-antidepressant-and-anxiolytic-activities-of-leaf-extracts-and-fractions-of-tetracera-sarmentosa-l-vahl
#17
Mir Muhammad Nasir Uddin, Mohammad Shah Hafez Kabir, Mahmud Hasan, Zobaer Al Mahmud, N M Mahmudul Alam Bhuiya, Farhan Ahmed, Md Rakibul Hasan, Mohammad Tanvir Hosen, Mohammad Shahin Alam
BACKGROUND: The plant under investigation (Tetracera sarmentosa) is a dicotyledonous flowering plant and belongs to the family Dilleniaceae. The goal of our investigation was to determine whether the leaf extracts of this plant held any significant medicinal properties. METHODS: Leaves of T. sarmentosa were extracted with pure ethanol (EETS) and methanol (METS), and then methanol extract fractioned with n-hexane (NHFMETS) and chloroform (CHFMETS). The extracts and fractions were tested for antioxidant activity, which was measured by using qualitative and quantitative procedures...
October 5, 2017: Journal of Basic and Clinical Physiology and Pharmacology
https://www.readbyqxmd.com/read/28980181/outcome-of-intra-arterial-thrombolysis-in-patients-with-diabetes-and-acute-lower-limb-ischemia-a-propensity-score-adjusted-analysis
#18
Talha Butt, Anders Gottsäter, Jan Apelqvist, Gunnar Engström, Stefan Acosta
The presence of diabetes mellitus is rarely addressed in acute lower limb ischaemia (ALLI). The aim of this study was to evaluate the outcome of local intra-arterial thrombolysis for ALLI in patients with diabetes mellitus (DM). Outcome of all thrombolytic events performed in an endovascular first-strategy centre during a 13-year period between 2001 and 2013 in patients with ALLI were followed to January 2017. A propensity score adjusted analysis was performed to evaluate results in patients with (n = 83) versus without (n = 316) DM...
October 4, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28976630/comparison-of-the-ecarin-chromogenic-assay-and-diluted-thrombin-time-for-quantification-of-dabigatran-concentrations
#19
Iqbal H Jaffer, Noel Chan, Robin Roberts, James C Fredenburgh, John W Eikelboom, Jeffrey I Weitz
BACKGROUND: Although routine coagulation monitoring is unnecessary, measuring plasma dabigatran concentrations can be useful for detecting drug accumulation in renal failure or overdose, assessing the contribution of dabigatran to serious bleeding, planning the timing of urgent surgery or intervention; or determining the suitability for thrombolytic therapy for acute ischemic stroke. Dabigatran concentrations can be quantified using chromogenic or clot-based tests, such as the ecarin chromogenic assay (ECA) and the diluted thrombin time (dTT), respectively...
October 4, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28976409/subdural-instillation-of-a-thrombolytic-agent-for-treatment-of-recurrent-subdural-hematoma
#20
Mark B Frenkel, Aarti Sarwal, Mary Petrulis Wren, Christopher R Newey, Daniel E Couture
OBJECTIVE: This study aims to report the case of a patient with recurrent subdural hemorrhage (SDH) who was administered tissue plasminogen activator through a subdural drain to enhance drainage and prevent recurrence. METHODS: An 85-year-old man was treated for subacute over chronic SDH that kept on reaccumulating despite serial twist drill drainage, burr hole drainage, and craniotomy. No coagulopathy was identified with adequate blood pressure control. RESULTS: Treatment with tissue plasminogen activator resulted in successful drainage of the SDH, and the patient had no further recurrence at 9-month follow-up...
October 2, 2017: Clinical Neuropharmacology
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