Intravenous tPA for Stroke: Putting the Controversy to Rest Intravenous tPA for Stroke: Putting the Controversy to Rest
Dr Mark Alberts addresses recent controversial statements by some cardiology colleagues and other medical specialists regarding the safety and efficacy of IV tPA in treating acute ischemic stroke.Medscape Neurology
In this study, the protective effect of GSTTF on ischemic stroke in a middle cerebral artery occlusion (MCAO) rat model was investigated by the GC-MS-based metabolomics approach. 2,3,5-triphenyltetrazolium chloride (TTC) staining of brain tissues showed that GSTTF significantly reduced the infarct area after MCAO surgery. Metabolomic profiling showed a series of metabolic perturbation occurs in ischemic stroke compared with sham group. GSTTF can reverse the MCAO-induced serum metabolic deviations by regulating multiple metabolic pathways including fatty acids metabolism, amino acids metabolism, and carbohydrates metabolism...
Lu Yu, Yuhui Chen, Min Chen, Xiaojie Luo, Shanshan Jiang, Yi Zhang, Haibo Chen, Tao Gong, Jinyuan Zhou, Chunmei Li
Publication date: Available online 20 February 2019Source: American Heart JournalAuthor(s): Eric D. Peterson, Veronica Ashton, Yen-Wen Chen, Bingcao Wu, Alex C. SpyropoulosBackgroundThere are limited data regarding clinical outcomes and healthcare resource utilization of direct oral anticoagulants (DOACs) in patients with atrial fibrillation (AF) who are morbidly obese (body mass index>40 kg/m2 or body weight> 120 kg).MethodsUsing data from 2 US healthcare claims databases, we identified patients initiating rivaroxaban or warfarin who had ≥1 medical claim with an AF diagnosis, a diagnostic code for ...
With 827 consecutive post-carotid endarterectomy completion arteriograms, Dr Wieker and colleagues detected 57 (6.9%) defects requiring immediate surgical revision. One in 14 of their cases required reopening of the artery! Despite their significant incidence of defects requiring immediate revision, the authors' overall results are superb (0.2%, 0.5%, and 0.6% 30-day mortality, stroke, and transient ischemic attack rates, respectively), and immediate revision was not associated with worse outcomes.
Jeffrey R. Vitt, Michael Trillanes, J. Claude Hemphill
This study aims to investigate the effect of Netrin-1 on autophagy of ischemic brain tissues and hypoxic neurons. Methods: We constructed rat persistent middle cerebral artery occlusion model in vivo and constructed the Oxygen Glucose-Deprivation model in vitro.
Acute ischemic strokes account for 85% of all strokes and are the fifth leading cause of mortality in the United States. About one in five of all ischemic strokes occur during sleep and are not noticed until the patient wakes up with neurological deficits. There is growing evidence to support that a significantly higher number of stroke patients could benefit from more aggressive care, especially those patients who wake up with strokes. There is increasing research to support a physiologically-based approach based on advanced imaging rather than simply a time-based determination of whether or not a patient would benefit from reperfusion.
Conclusion: Incorrect computerized interpretation of atrial fibrillation, combined with the failure of the ordering physician to correct the erroneous interpretation, can result in the initiation of unnecessary, potentially harmful medical treatment as well as inappropriate use of medical resources. Greater efforts should be directed toward educating physicians about the electrocardiographic appearance of atrial dysrhythmias and in the recognition of confounding artifacts.