Specific inhibition on PAI-1 reduces the dose of Alteplase for ischemic stroke treatment
Int J Biol Macromol. 2023 Dec 7:128618. doi: 10.1016/j.ijbiomac.2023.128618. Online ahead of print.ABSTRACTAdministration of recombinant tPA (rtPA, or a trade name Alteplase®) is an FDA-approved therapy for acute ischemic stroke (AIS), but often poses the risk of hemorrhagic complications. Recombinant tPA can be rapidly inactivated by the endogenous inhibitor, plasminogen activator inhibitor 1 (PAI-1). In this work, we study a novel treatment approach that combines a PAI-1 inhibitor, PAItrap4, with a reduced dose of rtPA to address the hemorrhagic concern of rtPA. PAItrap4 is a highly specific and very potent protein-base...
Source: International Journal of Biological Macromolecules - December 9, 2023 Category: Biochemistry Authors: Yanyan Xu Yinping Hu Guangqian Wu Lili Niu Chao Fang Yongkun Li Longguang Jiang Cai Yuan Mingdong Huang Source Type: research
Implementation of Tenecteplase for Acute Ischemic Stroke Treatment
Acute ischemic stroke is a neurologic emergency, requiring rapid recognition and treatment with intravenous thrombolysis. Since the publication of the 2019 American Heart Association/American Stroke Association Guidelines that recommend tenecteplase as an alternative agent, several centers across the United States are transitioning from alteplase to tenecteplase as the agent of choice for thrombolysis in acute ischemic stroke. (Source: Journal of Emergency Nursing: JEN)
Source: Journal of Emergency Nursing: JEN - December 7, 2023 Category: Nursing Authors: Caitlin S. Brown, Francis C. Manuel, Alicia E. Mattson, Cassandra J. Schmitt, Jodi D. Hellickson, Sarah L. Clark, Erin D. Wieruszewski Tags: Clinical Source Type: research
External quality monitoring facilitates improvement in already well-performing stroke units: insights from RES-Q Poland
CONCLUSIONS: Quality-oriented projects facilitate the improvement of stroke care, even in centres demonstrating good baseline performance. Polish stroke units that consistently reported cases to the RES-Q demonstrated improvement in terms of door-to- -needle time and dysphagia screening. However, there is still a need to shorten the time to dysphagia screening, and carefully monitor stroke unit mortality following the COVID-19 pandemic.PMID:38037889 | DOI:10.5603/pjnns.96442 (Source: Neurologia i Neurochirurgia Polska)
Source: Neurologia i Neurochirurgia Polska - December 1, 2023 Category: Neurology Authors: Micha ł Karliński Adam Kobayashi Maciej Niewada Waldemar Fryze Agata Tomczak Waldemar Brola Konrad Rejdak Piotr Luchowski Bo żena Adamkiewicz Ma łgorzata Wiszniewska Urszula W łodarczyk Rados ław Kaźmierski Pawel Kram Halina Bartosik-Psujek Rafa ł Source Type: research
External quality monitoring facilitates improvement in already well-performing stroke units: insights from RES-Q Poland
CONCLUSIONS: Quality-oriented projects facilitate the improvement of stroke care, even in centres demonstrating good baseline performance. Polish stroke units that consistently reported cases to the RES-Q demonstrated improvement in terms of door-to- -needle time and dysphagia screening. However, there is still a need to shorten the time to dysphagia screening, and carefully monitor stroke unit mortality following the COVID-19 pandemic.PMID:38037889 | DOI:10.5603/pjnns.96442 (Source: Neurologia i Neurochirurgia Polska)
Source: Neurologia i Neurochirurgia Polska - December 1, 2023 Category: Neurology Authors: Micha ł Karliński Adam Kobayashi Maciej Niewada Waldemar Fryze Agata Tomczak Waldemar Brola Konrad Rejdak Piotr Luchowski Bo żena Adamkiewicz Ma łgorzata Wiszniewska Urszula W łodarczyk Rados ław Kaźmierski Pawel Kram Halina Bartosik-Psujek Rafa ł Source Type: research
External quality monitoring facilitates improvement in already well-performing stroke units: insights from RES-Q Poland
CONCLUSIONS: Quality-oriented projects facilitate the improvement of stroke care, even in centres demonstrating good baseline performance. Polish stroke units that consistently reported cases to the RES-Q demonstrated improvement in terms of door-to- -needle time and dysphagia screening. However, there is still a need to shorten the time to dysphagia screening, and carefully monitor stroke unit mortality following the COVID-19 pandemic.PMID:38037889 | DOI:10.5603/pjnns.96442 (Source: Neurologia i Neurochirurgia Polska)
Source: Neurologia i Neurochirurgia Polska - December 1, 2023 Category: Neurology Authors: Micha ł Karliński Adam Kobayashi Maciej Niewada Waldemar Fryze Agata Tomczak Waldemar Brola Konrad Rejdak Piotr Luchowski Bo żena Adamkiewicz Ma łgorzata Wiszniewska Urszula W łodarczyk Rados ław Kaźmierski Pawel Kram Halina Bartosik-Psujek Rafa ł Source Type: research
External quality monitoring facilitates improvement in already well-performing stroke units: insights from RES-Q Poland
CONCLUSIONS: Quality-oriented projects facilitate the improvement of stroke care, even in centres demonstrating good baseline performance. Polish stroke units that consistently reported cases to the RES-Q demonstrated improvement in terms of door-to- -needle time and dysphagia screening. However, there is still a need to shorten the time to dysphagia screening, and carefully monitor stroke unit mortality following the COVID-19 pandemic.PMID:38037889 | DOI:10.5603/pjnns.96442 (Source: Neurologia i Neurochirurgia Polska)
Source: Neurologia i Neurochirurgia Polska - December 1, 2023 Category: Neurology Authors: Micha ł Karliński Adam Kobayashi Maciej Niewada Waldemar Fryze Agata Tomczak Waldemar Brola Konrad Rejdak Piotr Luchowski Bo żena Adamkiewicz Ma łgorzata Wiszniewska Urszula W łodarczyk Rados ław Kaźmierski Pawel Kram Halina Bartosik-Psujek Rafa ł Source Type: research
EE619 A Cost-Utility Analysis of Low-Dose vs Standard-Dose Intravenous Alteplase in the Management of Acute Non-Lacunar Ischaemic Strokes: A Perspective From the NHS
Studies exploring the efficacy and safety of low-dose (0.6 mg/kg) vs standard-dose (0.9mg/kg) intravenous alteplase in treating acute non-lacunar ischaemic strokes (aNLIS) have shown no significant difference in treatment effects, however, the risk of symptomatic intracerebral haemorrhage (ICH) is reduced with low dose alteplase. The aim of this study was to perform a cost-utility analysis (CUA) of low-dose and standard-dose intravenous alteplase in treating aNLIS. (Source: Value in Health)
Source: Value in Health - December 1, 2023 Category: International Medicine & Public Health Authors: H. Okechukwu, Y. Fazaldin, D. Kanapathipillai, V. Shankar, Z. Sohrabi, A. Braniste, Z. Mohammed Source Type: research
Comparative safety of tenecteplase vs alteplase for acute ischemic stroke
Tenecteplase has been compared to alteplase in acute stroke randomized trials, with similar outcomes and safety measures, but higher doses of tenecteplase have been associated with higher hemorrhage rates in some studies. Limited data are available on the safety of tenecteplase outside of clinical trials. (Source: Journal of Stroke and Cerebrovascular Diseases)
Source: Journal of Stroke and Cerebrovascular Diseases - November 30, 2023 Category: Neurology Authors: Alexander C Flint, Abigail Eaton, Ronald B Melles, Jonathan Hartman, Sean P Cullen, Sheila L Chan, Vivek A Rao, Mai N Nguyen-Huynh, Brij Kapadia, Nihar U Patel, Jeffrey G Klingman Source Type: research
Thrombolysis with Recombinant Human Prourokinase 4.5 –6 h After Acute Ischemic Stroke: A Phase IIa, Randomized, and Open-Label Multicenter Clinical Trial
ConclusionIn the 4.5 –6 h time window, more than 60% of patients at either dose of rhPro-UK (50 mg or 35 mg) achieved functional independence at 90 days without increased mortality and sICH risk. Thus, intravenous rhPro-UK was effective and safe for patients with AIS within 4.5–6 h after stroke onset. While no signi ficant differences were identified between different dosages of rhPro-UK regarding clinical outcomes, it is a logical step to further test the safety and efficacy of the low dose of rhPro-UK in a well-powered phase III study.Trial Registrationhttp://www.chictr.org.cn. Identifier: ChiCTR1800016519. Date of r...
Source: CNS Drugs - November 29, 2023 Category: Neurology Source Type: research
Risk of Bleeding Following NOAC Use in Patients With Acute Ischemic Stroke Treated With Alteplase
This Taiwanese cohort study evaluates the risk of bleeding and mortality after alteplase treatment for patients with acute ischemic stroke treated with non –vitamin K antagonist oral anticoagulants (NOACs) vs not treated with NOACs. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - November 20, 2023 Category: Internal Medicine Source Type: research
A case series analysis of bicarbonate-based purge solution administration via Impella ventricular assist device
CONCLUSION: This case series adds to the literature describing clinical outcomes for patients on Impella support with BBPS. While BBPS offers a viable option for the management of patients on Impella devices who are unable to tolerate heparin-based purge solutions, further data is needed to determine the longevity of the Impella device with BBPS to minimize risk of Impella complications.PMID:37952169 | DOI:10.1093/ajhp/zxad278 (Source: American Journal of Health-System Pharmacy : AJHP)
Source: American Journal of Health-System Pharmacy : AJHP - November 12, 2023 Category: Drugs & Pharmacology Authors: Mariah I Sigala Jesse E Harris Celia Morton Kevin R Donahue Ju H Kim Source Type: research
A case series analysis of bicarbonate-based purge solution administration via Impella ventricular assist device
CONCLUSION: This case series adds to the literature describing clinical outcomes for patients on Impella support with BBPS. While BBPS offers a viable option for the management of patients on Impella devices who are unable to tolerate heparin-based purge solutions, further data is needed to determine the longevity of the Impella device with BBPS to minimize risk of Impella complications.PMID:37952169 | DOI:10.1093/ajhp/zxad278 (Source: American Journal of Health-System Pharmacy : AJHP)
Source: American Journal of Health-System Pharmacy : AJHP - November 12, 2023 Category: Drugs & Pharmacology Authors: Mariah I Sigala Jesse E Harris Celia Morton Kevin R Donahue Ju H Kim Source Type: research
A case series analysis of bicarbonate-based purge solution administration via Impella ventricular assist device
CONCLUSION: This case series adds to the literature describing clinical outcomes for patients on Impella support with BBPS. While BBPS offers a viable option for the management of patients on Impella devices who are unable to tolerate heparin-based purge solutions, further data is needed to determine the longevity of the Impella device with BBPS to minimize risk of Impella complications.PMID:37952169 | DOI:10.1093/ajhp/zxad278 (Source: American Journal of Health-System Pharmacy : AJHP)
Source: American Journal of Health-System Pharmacy : AJHP - November 12, 2023 Category: Drugs & Pharmacology Authors: Mariah I Sigala Jesse E Harris Celia Morton Kevin R Donahue Ju H Kim Source Type: research
