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Condition: Disability
Therapy: Thrombolytic Therapy
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Total 183 results found since Jan 2013.
Stroke Care: A Balanced Approach to the tPA Debate
In conclusion, alteplase is the only treatment available for acute ischemic stroke that is effective in some patients. In order to improve tPA effectiveness and minimize risks, patients with symptoms suggestive of an AIS should get rapid assessment and treatment with tPA after careful review of the contraindications. Given that smaller strokes can still be associated with considerable long term neurological morbidity, treatment should still be considered in those patients after weighing the risks and benefits and in consultation with the patient and family. Advanced age should also not be a limiting factor. Although the NI...
Source: EPMonthly.com - December 31, 2016 Category: Emergency Medicine Authors: Logan Plaster Tags: Uncategorized Source Type: news
The role of stem cell factor and granulocyte-colony stimulating factor in treatment of stroke.
This article summarizes the discovery of new routes of treatment for acute and chronic stroke using two hematopoietic growth factors, stem cell factor (SCF) and granulocyte-colony stimulating factor (G-CSF). In a study of acute stroke, SCF and G-CSF alone or in combination displays neuroprotective effects in an animal model of stroke. SCF appears to be the optimal treatment for acute stroke as the functional outcome is superior to G-CSF alone or in combination (SCF+G-CSF); however, SCF+G-CSF does show better functional recovery than G-CSF. In a chronic stroke study, the therapeutic effects of SCF and G-CSF alone or in comb...
Source: Recent Patents on CNS Drug Discovery - November 20, 2014 Category: Drugs & Pharmacology Tags: Recent Pat CNS Drug Discov Source Type: research
China stroke surveillance report 2021
AbstractSince 2015, stroke has become the leading cause of death and disability in China, posing a significant threat to the health of its citizens as a major chronic non-communicable disease. According to the China Stroke High-risk Population Screening and Intervention Program, an estimated 17.8 million [95% confidence interval (CI) 17.6 –18.0 million] adults in China had experienced a stroke in 2020, with 3.4 million (95% CI 3.3–3.5 million) experiencing their first-ever stroke and another 2.3 million (95% CI 2.2–2.4 million) dying as a result. Additionally, approximately 12.5% (95% CI 12.4–12.5%) of stroke survi...
Source: Military Medical Research - July 19, 2023 Category: International Medicine & Public Health Source Type: research
Neurophysiology tools to lower the stroke onset to treatment time during the golden hour: microwaves, bioelectrical impedance and near infrared spectroscopy
Ann Med. 2022 Dec;54(1):2658-2671. doi: 10.1080/07853890.2022.2124448.ABSTRACTReperfusion therapy administration timing in acute ischaemic stroke is the main determinant of patients' mortality and long-term disability. Indeed, the first hour from the stroke onset is defined the "golden hour", in which the treatment has the highest efficacy and lowest side effects. Delayed ambulance transport, inappropriate triage and difficulty in accessing CT scans lead to delayed onset to treatment time (OTT) in clinical practice. To date brain CT scan is needed to rule out intracranial haemorrhage, which is a major contraindication to t...
Source: Annals of Medicine - September 26, 2022 Category: Internal Medicine Authors: Lazzaro di Biase Adriano Bonura Maria Letizia Caminiti Pasquale Maria Pecoraro Vincenzo Di Lazzaro Source Type: research
Management of Acute Ischemic Stroke-Specific Focus on Anesthetic Management for Mechanical Thrombectomy.
Abstract
Acute ischemic stroke is a neurological emergency with a high likelihood of morbidity, mortality, and long-term disability. Modern stroke care involves multidisciplinary management by neurologists, radiologists, neurosurgeons, and anesthesiologists. Current American Heart Association/American Stroke Association (AHA/ASA) guidelines recommend thrombolytic therapy with intravenous (IV) alteplase within the first 3-4.5 hours of initial stroke symptoms and endovascular mechanical thrombectomy within the first 16-24 hours depending on specific inclusion criteria. The anesthesia and critical care provider may b...
Source: Anesthesia and Analgesia - July 6, 2020 Category: Anesthesiology Authors: Businger J, Fort AC, Vlisides PE, Cobas M, Akca O Tags: Anesth Analg Source Type: research
Prediction-Driven Decision Support for Patients With Mild Stroke: A Model Based on Machine Learning Algorithms
Conclusions: DAMS and R-DAMS, as prediction-driven decision support tools, were designed to aid clinical decision-making for mild stroke patients in emergency contexts. In addition, even within a narrow range of baseline scores, NIHSS on admission is the strongest feature that contributed to the prediction.
Source: Frontiers in Neurology - December 23, 2021 Category: Neurology Source Type: research
Perspectives in neonatal and childhood arterial ischemic stroke.
Authors: Fluss J, Dinomais M, Kossotoroff M, Vuillerot C, Darteyre S, Chabrier S
Abstract
INTRODUCTION: Over the last decade considerable advances have been made in the identification, understanding and management of pediatric arterial ischemic stroke. Such increasing knowledge has also brought new perspectives and interrogations in the current acute and rehabilitative care of these patients.
AREAS COVERED: In developed countries, focal cerebral arteriopathy is one of the most common causes of arterial ischemic stroke in childhood and imaging features are well characterized. However, there are ongoing debates regar...
Source: Expert Review of Neurotherapeutics - October 1, 2016 Category: Neurology Tags: Expert Rev Neurother Source Type: research
Fibrinolysis: Strategies to enhance the treatment of acute ischemic stroke.
This article is protected by copyright. All rights reserved.
PMID: 29953716 [PubMed - as supplied by publisher]
Source: Thrombosis and Haemostasis - June 28, 2018 Category: Hematology Authors: Henderson SJ, Weitz JI, Kim PY Tags: J Thromb Haemost Source Type: research
Measuring Quality Improvement in Acute Ischemic Stroke Care: Interrupted Time Series Analysis of Door-to-Needle Time
Background: In patients with acute ischemic stroke, early treatment with recombinant tissue plasminogen activator (rtPA) improves functional outcome by effectively reducing disability and dependency. Timely thrombolysis, within 1 h, is a vital aspect of acute stroke treatment, and is reflected in the widely used performance indicator ‘door-to-needle time' (DNT). DNT measures the time from the moment the patient enters the emergency department until he/she receives intravenous rtPA. The purpose of the study was to measure quality improvement from the first implementation of thrombolysis in stroke patients in a university ...
Source: Cerebrovascular Diseases Extra - November 7, 2014 Category: Neurology Source Type: research
Understanding delays in acute stroke care: a systematic review of reviews
ConclusionThis review provides a wide overview of factors influencing acute stroke pathway. Since it was observed that the identified factors were interrelated, they needed to be analyzed in a systematic way. We hence created a synthetic framework that combines several categories of factors while assuming that factor weight varies from a study context to another. Better knowledge on underlying mechanisms between factors would provide crucial improvement of the interventions aiming at reducing delays in both pre-hospital and inhospital stages. For future research, we recommend adopting a systemic perspective on factors infl...
Source: The European Journal of Public Health - April 20, 2018 Category: General Medicine Source Type: research
The PLAN score predicted death and severe disability in patients with acute ischemic stroke.
CONCLUSION The 9-item PLAN score based on data collected at hospital admission predicted death and severe disability in patients with acute ischemic stroke.PLAN score for predicting death and severe disability in patients hospitalized with acute ischemic stroke*PLAN score rangeNumber of patientsOutcomes (range)30-d mortality1-y mortalityDeath or severe disability at discharge†< 1048440.7% to 4.4%2.1% to 13%0.9% to 4.3%10 to 1224454.4% to 11%16% to 26%6.0% to 15%13 to 15126715% to 29%32% to 46%20% to 36%> 15129135% to 66%58% to 84%44% to 78%*PLAN = Preadmission comorbid conditions, Level of consciousness, ...
Source: Annals of Internal Medicine - February 19, 2013 Category: Internal Medicine Authors: Rowland K Tags: Ann Intern Med Source Type: research
Treatment with TPA in the "Golden Hour" and the Shape of the 4.5 Hour Time-Benefit Curve in the National US Get With The Guidelines-Stroke Population.
CONCLUSIONS: -Thrombolysis started within the first 60 minutes after onset is associated with best outcomes for patients with acute ischemic stroke, and benefit declined more rapidly early after onset for ability to be discharged home. These findings support intensive efforts to organize stroke systems of care to improve the timeliness of thrombolytic therapy in acute ischemic stroke.
PMID: 27815374 [PubMed - as supplied by publisher]
Source: Circulation - November 3, 2016 Category: Cardiology Authors: Kim JT, Fonarow GC, Smith EE, Reeves MJ, Navalkele DD, Grotta JC, Grau-Sepulveda MV, Hernandez AF, Peterson ED, Schwamm LH, Saver JL Tags: Circulation Source Type: research
Diverse roles of mitochondria in ischemic stroke
Publication date: June 2018 Source:Redox Biology, Volume 16 Author(s): Jenq-Lin Yang, Sujira Mukda, Shang-Der Chen Stroke is the leading cause of adult disability and mortality in most developing and developed countries. The current best practices for patients with acute ischemic stroke include intravenous tissue plasminogen activator and endovascular thrombectomy for large-vessel occlusion to improve clinical outcomes. However, only a limited portion of patients receive thrombolytic therapy or endovascular treatment because the therapeutic time window after ischemic stroke is narrow. To address the current shortage of st...
Source: Redox Biology - March 15, 2018 Category: Biology Source Type: research
Mean Platelet Volume, C-Reactive Protein, and Prognosis in Patients with Acute Ischemic Stroke Following Intravenous Thrombolytic Treatment.
CONCLUSIONS MPV and CRP values were significantly associated with improvement in the NIH Stroke Scale and MRS scores in AIS when patients were treated with IV thrombolytic therapy within 4.5 hours of the onset of symptoms.
PMID: 29869620 [PubMed - in process]
Source: Medical Science Monitor - June 7, 2018 Category: Research Tags: Med Sci Monit Source Type: research
